Ali Haider Naqvi, Jawaid Sami, Akhtar Ali Baloch, Munir Ahmed Shaikh.
Variants of Tuberculosis in Diabetic Populations in Karachi.
Pak J Chest Med Jan ;25(2):55-8.

Background: Tuberculosis is one of the commonest infective disease associated with Diabetes Mellitus (DM) as due to DM immune system become weak. Objective: The purpose of the present study was to calculate the different variants of active Tuberculosis in the diabetic population. Methodology: This was a cross-sectional/observational and qualitative study. The diabetics with at least 7 years were interviewed in three outpatients departments (OPD) of Medical, National Institute of Diabetes and Endocrinology, and Ojaha Chest clinic (DUHS) and selected as per inclusion criteria viz. cough with and without expectoration, hemoptysis, prolonged fever and unexplained weight loss. Short duration of diabetes, age less than 12 and more than 80 years and all cases of immuno comprisation and secondary diabetes were excluded. After taking consent, detail history, clinical examination and investigations were analyzed for possible tuberculosis. All the data were entered in the SPSS version 19 for data entry and then analysis from the registered data. Results: Out of 1100 patients interviewed, 301 cases were selected for possible tuberculosis. Only 39 patients (12.95%) were diagnosed to have active tuberculosis. Mean age was 54.4 +- 11.1, male to female ratio was 1.9:1.5, and mean duration of diabetes found was 11.5 years. All were type 2 diabetics except one which turned out to be type 1. Pulmonary Tuberculosis were found to be 53.88% and extra pulmonary was 46.12%. In the case of pulmonary, the primary was 10.25%, post primary was 17.94% and milliary was 5.12%. MDRTB was found in 20.15% of the cases which is almost double in comparison with non diabetics, and the smear positive were found to be among 56.54%. Conclusion: Tuberculosis frequency is more common in diabetics than in general population. The frequency of extra pulmonary TB is also higher comparing non-diabetics. The diagnosis of the disease should be more prompt in diabetics otherwise MDR-TB can become a serious public health problem among diabetics and non diabetics of this poor country.

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