Correlation of Radiological Changes, BMI and Weight Variation With Anti-Tubercular Treatment in Pulmonary Tuberculosis Patients

Abstract

Introduction:Despite of a relatively low transmission rate in TB as compared with other contagious diseases and the existence of effective chemotherapy for the past five decades, still tuberculosis remains a major global public health problem. Approximately one-third of the world’s population is infected with tuberculosis.The radiological findings and Clinical parameters related to pulmonary Tuberculosis can be used for estimation of severity, deterioration and level of response to treatment, predicting to develop drug-resistant organisms in view of treatment failure, so it can be used as an important index for evaluating the efficacy of ATT. Aims and objectives :1.To determine the pattern of weight variation and BMI during treatment of pulmonary tuberculosis. 2. To assess the pattern of chest x-ray changes during the treatment of pulmonary tuberculosis. 3. To determine relationship between weight variation and chest x-ray changes during treatment of pulmonary tuberculosis Materials and Methods : This Cross Sectional observational study was done on 107 PTB patients whose at least one initial sputum sample should be positive for Acid-Fast Bacillus (AFB) in , L.N. Medical College and Research Centre and J. K. Hospital, Bhopal , MP- India , Between December 2019 & July 2021. Apart from demographic data , Body weight, Height, BMI, Sputum AFB smear examination, Chest X-Ray etc. was done in all Patients at Initiation of ATT, at 2 months & at 6 months of ATT. After Data collection, Data analysis were performed using IBM SPSS (SPSS Inc., Chicago, Illinois-USA) ver. 20 software. Microsoft office and PRISM software was used to prepare the graphs. Results :In comparison from initiation of ATT, gain in mean wt , parenchymal clearance in CXR were observed 5.89%, 23.36% at 2 months while 7.66%, 69.16% at 6 months respectively. In comparison from initiation of ATT, gain in mean wt , subside in lymphadenopathy were observed 7.33%, 19.62% at 2 months while 11.80%, 29.91% at 6 months respectively. In comparison from initiation of ATT, gain in mean wt , cavitation clearance in CXR were observed 5.38%, 8.41% at 2 months while 10.38%, 22.43% at 6 months respectively. In comparison from initiation of ATT, gain in mean wt , subside in pleural effusion were observed 11.54%, 4.67% at 2 months while 20.76%, 7.47% at 6 months respectively. Conclusions :A significant increase in mean weight, BMI were observed along with improvement in chest x ray findings including Parenchymal Involvement, cavitation, pleural effusion and lymphadenopathy. This denotes that monitoring in baseline weight, height, Sputum smear and CXR during the first 6 months of treatment can help to identify persons who are more likely to have good or poor outcomes and require some other interventions or require greater medical attention. These inexpensive tools can help to improve outcome and reduce medical expenditure, which ultimately affect national economy.