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Objectives: India's projected silica-dust-exposed workers will be 52 million at the end of 2025. The elimination of tuberculosis (TB) is also targeted in India by 2025. Scientists in India have already pointed out that unless silicosis is controlled, the said elimination will be difficult to achieve. Methods and Results: This study provides evidence of an increasing incidence of tuberculosis (TB) including multidrug-resistant TB (MDR-TB) with mortality owing to treatment failure among the silica dust-exposed workers compared to their unexposed counterpart. It was also observed that TB as well as MDR-TB were directly proportional to the dose and/or duration of silica dust exposure (progression of silica-dust induced lung damage). This means the occurrence of both TB and MDR-TB is lowest in the unexposed group, moderate in the radiologically negative but silica dust-exposed group (subradiological silicosis owing to moderate exposure), and highest in the radiologically confirmed silicotic workers (maximally exposed group). Because India has a huge burden of silicosis cases, the said cases are vulnerable to pulmonary TB, including MDR-TB. The study indicates there will be an emergence of MDR-TB among the silica dust-exposed workers unless appropriate intervention measures are initiated with immediate effect. Failure to do so, it will probably lead to a silent epidemic of silicotuberculosis in India shortly. Conclusions: It is important to have tools to detect silicosis cases quickly and at an early stage to identify a vulnerable population and adopt an effective intervention measure.

Silicosis, the most prevalent pneumoconiosis, is caused by inhalation of crystalline silica particles. The risk of a patient with silicosis for development of tuberculosis, both pulmonary and extrapulmonary, is 2.8 to 39 times higher than that found for healthy persons. HIV coinfection adds further to the risk. Silicotuberculosis is a challenging health problem and deserves attention worldwide. The diagnosis of active tuberculosis superimposed on silicosis is often problematic, especially in initial phases, and chest X-ray and microbiological examination of sputum are particularly important for the diagnosis. Treatment is difficult, directly observed treatment is recommended, and the risk of relapse is higher than in nonsilicosis patients. Tuberculosis prevention in cases with silicosis is essential and include active follow-up of the workers, periodic chest X-rays, tuberculin skin testing or interferon-gamma release assay testing, and adoption of measures to reduce the exposure to silica dust. Preventive treatment of latent tuberculosis infection consists of different regimens and needs to be expanded. [ABSTRACT FROM AUTHOR]

Tuberculosis occurs commonly in silicosis and is difficult to diagnose. We are presenting four cases of silicotuberculosis. The first three cases of silicotuberculosis have occupational risk factors such as borewell driller, construction sites, and quarry presented with silicotuberculosis clinic radiological features with negative sputum acid-fast bacilli and positive results for tuberculosis obtained from bronchoalveolar lavage samples. The last case developed silicosis due to inhalational burned sugarcane crops. Antituberculosis therapy started after microbiological confirmation for tuberculosis. Hence, a vigorous search of tuberculosis in silicosis patients is highly warranted.

Background: Long-term exposure to silica dust makes people prone for silicosis which raises the risk of the individual in developing pulmonary tuberculosis (PTB). Silicosis is a progressive lung disease characterize with shortness of breath, cough, fever, and bluish skin, caused due to inhalation of crystalline silica dust found in abundance in sand, rock, and quartz. Aims and Objectives: The disease is known to effect the functioning of macrophages making it unable to defend mycobacterium species, thus allowing the bacterium to invade and develop tuberculosis. Materials and Methods: A retrospective cross-sectional study is carried out to estimate the prevalence of PTB in newly diagnosed silicosis patients at Madurai Medical College, Madurai, Tamil Nadu. All the patients who got registered in Occupational Lung Diseases Registry from January 2016 to December 2021 are included in the study. Silicosis patients tested positive on sputum CBNAAT are considered as silicotubercular patients, whose prevalence is calculated. Results: Our study included a total of 54 subjects (90.8% males and 8.2% female) with mean SD age of 38±6.7 years ranging from 26 to 53 years. Of which 22 patients, 40.7% tested positive for Mycobacterium tuberculosis (MTB) on sputum CBNAAT. The prevalence of MTB in among silicosis patients was found to be 40.7%. Conclusions: Association of TB and silicosis is very strong with the prevalence of TB among silicosis patients as 40.7%. Our study also observed the male sex and elder age as elevated risk of developing silicotuberculosis. All the people getting exposed to silica dust need to be educated in the usage and usefulness of protective equipment.

Silicosis and tuberculosis (TB) are both global health concerns, with high prevalence among miners from the South African gold mines. Although knowledge has accumulated about these two conditions as distinct diseases since the early 20th century, and despite progress in technology with multiple diagnostic tools and treatment options available for TB, the challenge of distinguishing and therefore efficiently managing these two conditions in this population remains as current as it was 100 years ago. To illustrate the diagnostic and health service problems of distinguishing TB and silicosis clinically and radiologically in former gold miners from the South African mines living in resource‐poor areas, we discuss four cases reviewed for this report by a panel of experts. For each case, occupational history, past and current medical history, physical examination, radiological and laboratory findings are described. Common themes are: (1) poor agreement between radiological and clinical presentation; (2) poor agreement between radiology findings and detection of active TB on sputum Xpert MTB/RIF testing; and (3) difficulty in distinguishing the clinical and radiological presentations of silicosis and tuberculosis. Possible consequences at the population level are undertreatment or overtreatment of TB, and underdiagnosis or overdiagnosis of silicosis. There is a need for training of practitioners who are screening or attending to former gold miners in the clinical and radiological features of combined disease, using a curated database of miners' chest X‐ray images. Investment in protocols for management of both acute and chronic silicotuberculosis in ex‐miners is needed, as is clinical, epidemiologic, and operations research. [ABSTRACT FROM AUTHOR]

Earlier, a study conducted by the Indian Council of Medical Research - National Institute of Occupational Health (ICMR-NIOH), India, evidenced that CC16 may be used as a proxy marker and screening tool for early detection and progression of silica-induced lung damage. Once CC16 indicates early silicosis, it needs to be confirmed by chest radiography. Next, ICMR-NIOH and ICMR-National Institute of Virology (ICMR-NIV) jointly developed a semi-quantitative and pointof-care CC16 detection kit using lateral flow immune chromatography. The said test can be done from one drop of blood collected through a finger prick. All trained peripheral healthcare workers can screen the silica dust-exposed workers periodically, under the national silicosis control program. Once early silicosis is detected, their sputum may be examined periodically by CB-NAAT/True-NAT for early detection of silicotuberculosis. The serum CC-16 detection kit is the first of its kind for early detection of silicosis through periodic screening, which is approved by the Indian Council of Medical Research, Ministry of Health, Govt. of India. Unless silicosis is controlled, elimination of TB appears to be difficult in India as there is a huge burden of silicosis including sub-radiological silicosis in India and considering the fact that silicosis is a stronger risk factor for lung tuberculosis due to its progressive declining effect of lung immunity. Since occupational silica dust exposure facilitates progressive fibrosis of lung tissue, a clinical trial using metformin may be the need of the day as animal experiments have already shown metformin's antifibroblastic effect in silica-induced animals. [ABSTRACT FROM AUTHOR]

Background: Long-term exposure to silica dust makes people prone for silicosis which raises the risk of the individual in developing pulmonary tuberculosis (PTB). Silicosis is a progressive lung disease characterize with shortness of breath, cough, fever, and bluish skin, caused due to inhalation of crystalline silica dust found in abundance in sand, rock, and quartz. Aims and Objectives: The disease is known to effect the functioning of macrophages making it unable to defend mycobacterium species, thus allowing the bacterium to invade and develop tuberculosis. Materials and Methods: A retrospective cross-sectional study is carried out to estimate the prevalence of PTB in newly diagnosed silicosis patients at Madurai Medical College, Madurai, Tamil Nadu. All the patients who got registered in Occupational Lung Diseases Registry from January 2016 to December 2021 are included in the study. Silicosis patients tested positive on sputum CBNAAT are considered as silicotubercular patients, whose prevalence is calculated. Results: Our study included a total of 54 subjects (90.8% males and 8.2% female) with mean SD age of 38±6.7 years ranging from 26 to 53 years. Of which 22 patients, 40.7% tested positive for Mycobacterium tuberculosis (MTB) on sputum CBNAAT. The prevalence of MTB in among silicosis patients was found to be 40.7%. Conclusions: Association of TB and silicosis is very strong with the prevalence of TB among silicosis patients as 40.7%. Our study also observed the male sex and elder age as elevated risk of developing silicotuberculosis. All the people getting exposed to silica dust need to be educated in the usage and usefulness of protective equipment. [ABSTRACT FROM AUTHOR]

Objective To analyze the clinical characteristics of pulmonary tuberculosis in children, and provide the basis for improving the diagnosis and treatment of pulmonary tuberculosis in children. Methods The general data, laboratory examination and imaging examination of 45 children with pulmonary tuberculosis admitted to our hospital were retrospectively analyzed. The results of chest CT and chest X-ray were compared and analyzed. The fiberoptic bronchoscopy and treatment of endobronchial tuberculosis were reviewed. Results There were 28 males and 17 females in the 45 patients. Forty-two cases (93.3%) were definitely vaccinated with Bacille Calmette-Guérin (BCG) vaccine. There were 11 cases (24.4%) with definite recent contact history of active tuberculosis, and 33 cases (73.3%) with past family history of tuberculosis. There were 37 cases (82.2%) with simple pulmonary tuberculosis. Tuberculous pleurisy was more common in patients with extrapulmonary tuberculosis. The common symptoms were fever, cough, wheezing and tuberculosis poisoning symptoms. Pulmonary tuberculosis occurred in different forms in children. There were 29 cases (64.4%) with bronchitis and pneumonia, 3 cases (6.7%) with bronchial asthma, 5 cases (11.1%) with chronic cough, 6 cases (13.3%) with fever, and 2 cases (4.4%) with postoperative trauma. The tuberculin test was moderately positive in 38 cases (84.4%). Chest CT scan can detect tubercular lesions better than chest X-ray examination. Among the 45 cases, 42 cases underwent fiberoptic bronchoscopy, and 13 cases (31.0%) were found to have endobronchial tuberculosis. Patients (n=42) were treated with freezing and linezolid lavage. The endobronchial wall became smooth after 2-3 times of treatment. Conclusion The diagnostic value of chest CT scan is superior to chest X-ray examination. Bronchoscopic freezing and linezolid lavage are effective methods for the treatment of endobronchial tuberculosis. [ABSTRACT FROM AUTHOR]

Background: Silicosis is a lung disease caused by the work because of respirable crystalline silica. Often occurs in workers mining gold, iron, tin, granite, sandstone, slate, foundries, cement, ceramics and glass. The risk of silicosis develop into lung tuberculosis (TB) is higher than patients without silicosis. Another complication of silicosis is secondary spontaneous pneumothorax. Case : A man, 45 years old with a history of work as a bricklayer for 5 years with complaints shortness of breath since three days before admitted to the hospital, chest pain in the right hemithorax, and had chronic cough. Patients is on ATD therapy. From radiographic there is collapse lung, it was shown collapse line on the right hemithorax, and fibroinfiltrat with multiple cavities on both hemithorax. Patients then got chest tube insertion and evaluation for 3 weeks, but the lung has not expanded. From thoracoscopy, there is fibrotic band on the pleural space with conclution right trapped lung. From forcep biopsy on visceral pleura showed a widened alveolar epithelial layer coated with a pile of inflammatory lymphocytes and dust pigments. From broncoscopy, there is chronic lung inflamation. Spectrophotometric analysis from BAL specimens results showed a silica content of 4.25 ppm SiO2 from left BAL an 14.34 ppm SiO2 on the right BAL. Furthurmore, this patient got pleurodesis using betadine agent and continue the ATD. Evaluation the lung is fully expanded. Conclusion : This case illustrates the secondary spontaneous pneumothorax as a complication of silicotuberkulosis. No drug has proven effective for silicosis. Treatment is aimed to the disease complications that occur, in this case is secondary spontaneous pneumothorax and lung TB. Prevention at workplaces that have a risk of silicosis is very important.

Crystalline silica inhalation causes silicosis, one of the ancient occupational lung diseases. It leads to an irreversible fibrotic response in the lung parenchyma and, consequently, causes diffuse interstitial lung disease. Asymptomatic to chronic irreversible forms are various presentations of silicosis, which has a high-risk predisposition to various comorbidities. We documented two cases of rare presentations of silica dust exposure alveolar silicoproteinosis and silicotuberculosis.

Abstract Silicotuberculosis is critical in community settings among workers and employees exposed to silica dust. Older age of entry (>30 years), male sex, infection with human immunodeficiency virus (HIV), exposure duration, smoking, chronic obstructive pulmonary disease, migration, the severity of the silicosis and the intensity of the exposure are potential risk factors. Lack of timely diagnosis and treatment for tuberculosis (TB) may also raise the rate of infection; previous treatment of TB is possibly associated with the development of silicotuberculosis in more than half of patients, increasing with age (>40 years). Identification of risk factors benefits not only the academic research community, but also the workers or employees and policy making. Some strategies can be implemented, such as controlling or reducing exposure to silica dust, ensuring continuity of treatment of TB or extended anti-TB treatment, management of the situation by occupational health professionals, prevention of oscillating migration, providing workers with compensation, training and education in occupational health, improving the quality of life of miners and workers, intensive medical surveillance and TB screening in routine health check ups, and policy making for higher immunity to inhibit inhalation of dust by workers or employees. [ABSTRACT FROM AUTHOR]

The results of long-term dispensary supervision (14 years) of 284 silicosis patients (including 54 silicotuberculosis patients) worked at Kuznetsk Metallurgical Plant have shown that high concentration of dust in air with 5% content of free silicon dioxide promotes the development of non-complicated silicosis as well as silicotuberculosis. This dispensary supervision, has been conducted by the physicians of scientific and consultative department of FSBI "RI CPHOD" SB RAMS in Novokuznetsk. Fast development of silicosis is risk factor for silicotuberculosis (р < 0,05). Slow development of silicosis is much rarely associated by tuberculosis infection. The patients with non-complicated. silicosis and. silicotuberculosis have the signs of pneumonia (oftener in non-complicated silicosis) and. chronic obstructive pulmonary disease (oftener in silicotuberculosis) according to the results of chest radiography.

Introduction. Silicosis, the most prevalent of the pneumoconioses, is caused by inhalation of crystalline silica particles. Silica-exposed workers are at increased risk for tuberculosis and other mycobacterium-related diseases. The risk of a patient with silicosis developing tuberculosis is higher (2.8 to 39 fold higher, depending on the severity of silicosis) than that found in healthy controls. Outline of Cases. The first patient was a 52-year-old male who was admitted in 2002 for the second time with dyspnoea, wheezing and fatigue over the last 11 years. He had worked in an iron smelting factory and was exposed to silica dust for 20 years. First hospitalization chest radiography showed bilateral pleural adhesions, diffuse lung fibrosis with signs of a specific lung process. Second hospitalization chest radiography showed bilateral massive irregular, non-homogenous calcified changes in the upper and middle parts of lungs. The patient died due to respiratory failure and chronic pulmonary heart in 2007. The main causes of his death were silicotuberculosis and chronic obstructive pulmonary disease. The second patient was a 50-year-old male who was admitted in 2005 for the second time with chest tightness, dyspnoea, wheezing and fatigue over the last 10 years. He had worked in an iron smelting factory and was exposed to silica dust for 30 years. First hospitalization chest radiography showed diffuse lung fibrosis and small nodular opacities. The patient was diagnosed with silicosis, small opacities sized level p/q, and profusion level 2/3. Second hospitalization chest radiography and CT showed diffuse lung fibrosis and small nodular opacities predominantly in the upper lobes. The patient was recognized as having an occupational disease, and received early retirement due to disability. Conclusion. In low-income countries, new cases of silicosis and associated lung cancer, chronic obstructive pulmonary disease and tuberculosis are likely to be seen for decades because necessary reduction of silica use will take time to be achieved.

We present a case of complicated silicotuberculosis in a former gold miner with a sufficiently heavy silica dust exposure to cause International Labor Organization grade 2/2 silicosis after a cumulative exposure duration of 11 years. We describe a cascade of complications-active pulmonary tuberculosis despite recent isoniazid prophylactic therapy, non-tuberculous mycobacterial disease, chronic airways obstruction, and spontaneous pneumothorax-and the difficulties, which arose, in diagnosis and management of such combined disease. We highlight three implications of such cases: the need to understand the interaction of silicosis and tuberculosis in this setting, the importance of maintaining continuity of care in the management of these conditions in miners and former miners, and control of silica dust exposure as a primary form of prevention of tuberculosis. Am. J. Ind. Med. 58:697-701, 2015. © 2015 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Silicosis is considered to be among the occupational lung diseases and associated with sandblasting, mining, quarrying and tunneling. Acute silicosis is usually progressive diseaseand despite treatment with corticosteroids it leads to cardio-respiratory failure and death. Alveolar silicoproteinosis is one of it's acute presentations due to exposure to silica dust and lungs filling with proteinaceous material. Here, we have presented a 29 year old male sandblaster with the three conditions of acute silicosis, secondary alveolar proteinosis and pulmonary tuberculosis on four anti tuberculous medications who presented with respiratory distress. [ABSTRACT FROM AUTHOR]

Silicosis is a form of pneumoconiosis. It results from inhalation of dust containing crystalline Silica particles of size 0.5 - 5 microns in diameter. Prevalence of Pulmonary Tuberculosis in Silicotics is more common when compared to prevalence in general population. This entity is called Silico- tuberculosis. Study was conducted in Kamla Nehru Chest Hospital attached with Dr.SNMC Jodhpur, among 300 stone mine workers of sand stone mines of Jodhpur with clinico-radiological evidence of Silico-tuberculosis. Workers were divided into 3 categories cutter / driller involved in blasting and cutting stones, dresser engaged in fine work by chisel and Labourer - Loading and Unloading of Stones in Mines .All studied patients were males, majority of cases belong to 21-55 years (93%) age group. Among these cases maximum no. of patients belong to 46-50 yr. (18%) age group. This is the most economically productive age group in India. With increase in duration of exposure from (0-20 years) to Silica particles there is increase in the no. of silico-tuberculosis. After 20 year of exposure there is decrease in no. of cases because cases do not survive upto that long period. 137 patients out of 300 cases were confirmed Acid Fast Bacilli positive by smear examination. 123 patients out of 300 cases were bacteriologically confirmed by culture. Out of 123 culture positive cases 66 (53.65%) were typical Mycobacteria& 57 (46.34%) were Atypical Mycobacterium. M. Kansasii(28), M. Scrofulaceum ( 9) ,M. Ulcerans(1) M. Fortuitum ( 19), When radiological pattern of Typical Mycobacteria cases and Atypical Mycobacterial cases were confirmed compared we found that Cavity with Nodulation, Pleural Reaction, Progressive Massive Fibrosis, Lower Lobe Involvement, Pnemothorax they all were more common in Atypical than Typical Mycobacteria. M.Kansasii predominantly grown in mining area all around the world. Prevalence of Pulmonary Tuberculosis in Silicotics is more common when compared to prevalence in general population hence all should use prophylactic measures.

Introduction and objective: Pneumoconiosis belongs permanently to serious occupational diseases. They occurred in considerable numbers also in Slovakia, especially in connection with the mining and processing of ores, and construction of railway tunnels in severe working conditions. The diseases often affected young people, and developed even as early as after 3 to 7 years of work at risk. These diseases markedly complicated and shortened the life. The aim of the work was a longitudinal study of the group of patients with acknowledged occupational disease. Material and methods: The entry criteria for selection of the disease: item No. 33 of the List of Occupational Diseases of CSSR, SR time period of 1981 to 2010. Analyzed data: acknowledgement of 33-1 simple silicosis, 33-2 complicated silicosis, 33-3 silicotuberculosis and 33-4 coal workers' pneumoconiosis, the incidence according to age, sex, industrial branch and area of health institutions. The descriptive methods of statistical analysis were used. Results: In the 30 year period 1127 cases of pneumoconiosis were acknowledged in item 33 in the Slovak Republic, 787 of the cases being simple silicosis, 82 cases of complicated silicosis, 166 cases of silicotuberculosis and 92 diseases of coal workers' pneumoconiosis. The annual rate revealed decreasing tendency with the exception of 1991, when the X-ray criteria indicating the limit for acknowledgement of occupational disease in simple and coal workers' pneumoconiosis were reduced. That was the years when occupational diseases were acknowledged additionally in the Slovak Republic in the same way as in the Czech Republic (at the time of politic climate changes after November of 1989) as well as cases of increased risk of occupational diseases of respiratory system in the miner occupations. In the ten years of 1981 to 1990 520 cases of pneumoconiosis were acknowledged with 123 cases of silicotuberculosis (24% of this cohort), whereas in the ten years of 2001 to 2010 there were 214 cases of pneumoconiosis and only 9 cases of silicotuberculosis (4% of this cohort). The numbers of simple and complicated silicosis decreased markedly. The numbers of coal miner pneumoconiosis in the three compared decades were in the range of 30 (years 1981 to 1990) through 37 (years 1991 to 2000) to 31 cases (years 2001 to 2010). Most pneumoconioses were acknowledged in the branch of coal and ore mining. The positive tendency in the years of 2001 to 2010 is suggested by the fact that among 214 cases of pneumoconiosis, 97 pneumoconioses were acknowledged at the age of 60 and higher. In these previous miners at the retirement age, however, there were most - 11 -- cases of silicotuberculosis, which draws attention to importance of epidemiological vigilance. Only 7 cases of pneumoconiosis were acknowledged at the age of up to 40 years and no cases of complicated silicosis was detected. There were 4 women in the cohort, 3 of them with simple silicosis and one with silicotuberculosis 3 years after the acknowledgement of simple silicosis after 60 years of life. The highest number of pneumoconioses was acknowledged in the Košice region, where there were also most cases of silicotuberculosis. The second position in the number of pneumoconioses, mainly silicosis and coal miner pneumoconiosis was occupied by the Trenčín region. The decreasing numbers of pneumoconioses is associated with reduction of coal and ore mining, decreased production in metallurgy, which became manifest in the Slovak Republic after 1990 by decreasing numbers of workers exposed to work at risk. Moreover, more consistent hygienic-technical procedures were introduced including protection and promotion of health of the employees. The decrease of silicotuberculosis follows the decrease of tuberculosis incidence in the Slovak population. Pneumoconioses belong to preventable diseases. It is the task od the society, public health and occupational medicine to contribute of improvement of primary prevention to uncover and reduce the works at risk in so far unregistered working activities with the risk of fibrogenous dust. In the dispensarization of the patients by occupational medicine workplaces is necessary to at least slow down the progress by remedies of secondary prevention including setting right the life style in this group of patients. [ABSTRACT FROM AUTHOR]

Experimental silicosis and silicotuberculosis induced by intravenous injection of silicon dioxide particles are characterized by extensive degenerative and necrotic processes in the liver parenchyma. After 6 months, fibrosis of portal tracts in silicotuberculosis and silicosis was 2.8- and 1.4-fold more pronounced that in BCG granulomatosis and silicosis, respectively. Depression of cellular and intracellular regeneration processes in the liver parenchyma was also observed. [ABSTRACT FROM AUTHOR]

The stimulating effect of silicon dioxide on fibroblast proliferation in granulomas of male CBA mice surpasses that of BCG vaccine mycobacteria. The number of fibroblasts in granulomas after combined treatment with BCG and SiO increased by more than 3 times compared to individual treatment with BCG and by 2 times compared to treatment with SiO alone. In silicosis and silicotuberculosis, collagen and argyrophilic fibers in granulomas during the period from 4 to 6 months after administration of granulomogenic factors occupied more than 90% granuloma volume, which 3-fold surpassed the corresponding parameter in mice infected with BCG vaccine alone. In silicosis, pronounced fibrosis was determined by relatively high proliferative and synthetic activities of fibroblasts, while in silicotuberculosis it was achieved due to significantly higher proliferative activity against the background of lower synthetic activity. [ABSTRACT FROM AUTHOR]

Silicon dioxide in combination with Mycobacterium tuberculosis in BCG vaccine is characterized by a significantly higher granuloma-inducing activity than BCG or silicon dioxide alone. Cell 'dissociation' from granulomas is not characteristic of granulomas induced by silicon dioxide or its combination with BCG (in contrast to BCG-induced granulomas). A steady increase in the counts and size, particularly on days 120-180, mainly at the expense of fibroblast accumulation and subtotal fibrosis, are intrinsic to these granulomas. Monocyte retention in the bone marrow is characteristic starting from day 56 until day 180 after injection of both granulomatous factors alone or in combination, particularly so in BCG granulomatosis. [ABSTRACT FROM AUTHOR]

Background: A recent review in silica dust exposed workers focused on airway obstruction and the variables used were forced vital capacity (FVC), FEV1 and FEV1%. The maximal expiratory flow volume (MEFV) values i.e., peak expiratory flow (PEF), FEF75, FEF 50 and FEF25 are not only useful to differentiate obstructive and restrictive type of functional abnormalities, but also the site of airway obstruction i.e., larger airways by PEF, FEF75 or smaller airways by FEF50, FEF25. Hence, studies on MEFV values are needed. Aims: To identify the site of airway obstruction among female quartz grinders. Settings and Design: Quartz grinding industry workers in Chota Udepur (Gujarat) by cross sectional study. Materials and Methods: The MEFV values were measured among 106 female quartz grinders using SP-10 computerized spirometer and predicted and percentage of predicted values were derived. The average MEF values were compared according to age (<24; 25–34; 35–44 and >45 yrs). The percentage predicted MEFV values were compared between normal and chest X-ray abnormal (silicosis and silico-tuberculosis) workers and between normal and abnormal spirometry (restrictive (R), obstructive (O) and R+O) workers. Statistical Analysis: Summary statistics, ANOVA and X²-test. Results: Significantly high reduction in MEFV values in > 45 yr. Workers; significant loss in silicosis and silicotuberculosis pronouncing higher in silicotuberculosis workers; significantly higher impairment R+O type of functional abnormal than other type of abnormalities. These indicated that site of obstruction is both in larger and smaller airways. Conclusions: The MEFV values indicated that the site of obstruction is in both in smaller and larger airways. [ABSTRACT FROM AUTHOR]

Background: A cohort mortality study of 2670 men in nine North American industrial sand plants resulted in 83 deaths from lung cancer 20 or more years after hire (standardized mortality ratio 139) and 37 deaths from silicosis (including seven from silico-tuberculosis). The lung cancer excess was unrelated to duration of employment and not found in all plants. [ABSTRACT FROM PUBLISHER]

Crystalline silica inhalation causes silicosis, one of the ancient occupational lung diseases. It leads to an irreversible fibrotic response in the lung parenchyma and, consequently, causes diffuse interstitial lung disease. Asymptomatic to chronic irreversible forms are various presentations of silicosis, which has a high-risk predisposition to various comorbidities. We documented two cases of rare presentations of silica dust exposure alveolar silicoproteinosis and silicotuberculosis. [ABSTRACT FROM AUTHOR]

The article discusses research on progressive massive fibrosis (PMF). It describes a case of a 71-year-old male who worked in a coal mine for 12 years, and presented with shortness of breath on moderate exertion, chest discomfort and dry cough for two months. It presents an overview of a study in a Brazilian hospital which discovered 119 undiagnosed cases of silicotuberculosis in persons exposed to silica dust. It describes the pathophysiology and diagnosis of PMF in patients.

The article presents a case study of chronic silicotuberculosis presented with antituberculous therapy treatment failure despite microbiological confirmation. The chronic disease has been diagnosed using the Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA), which is a tool for tuberculous and granulomatous intrathoracic lymphadenopathy. In addition, EBUS-TBNA was used to pinpoint the diagnosis when radiological features were inconclusive of silicosis.

We report a rare case of a 3-year-old male child with scapular bronchogenic cyst. The cyst was excised because of associated pain and discharge from the swelling. Till date, 64 cases of cutaneous bronchogenic cyst have been reported in the literature. Only 12 of these patients had lesion located in periscapular area. The treatment is surgical as it can undergo malignant transformation. [ABSTRACT FROM AUTHOR]

We report an isolated giant solid macronodular tuberculoma in an 8-year-old boy. A large-space-occupying lesion in the right lobe with nodular surface and hard consistency mimicked liver malignancy. This case is unusual as the ultrasonography, computed tomography scan, and aspiration cytology were all suggestive of a malignant tumor. Laparotomy confirmed a 15 × 10 cm nodular tumor present in the right lobe of liver. The segments 5, 6, 7, and 8 were excised. The histopathology revealed tuberculosis. [ABSTRACT FROM AUTHOR]