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Objectives: Ever since the discovery of Mycobacterium tuberculosis in 1882, many diagnostic methods have been developed. However "The gold standard" for the diagnosis of tuberculosis (TB) is still the demonstration of acid fast Bacilli (AFB) by microscopic examination of smear or bacteriological confirmation by culture method., Materials and Methods: In suspected 75 patients with active pulmonary TB, the materials obtained bronchoscopically, were bronchoalveolar lavage (BAL), bronchial brushings, bronchial washings and post bronchoscopic sputum. Four smears were made from each of the specimen. Fluorescent Staining, Ziehl-Neelsen (ZN), Pap and May Grunwald-Giemsa (MGG) stains were carried out for cytological examination., Results: Fluorescent stain yielded maximum AFB positivity in all the methods, that is 36 (48%) in post fibre-optic bronchoscopy (FOB) sputum and 19 (25.33%) by fluorescence microscopy in both bronchial brushings and bronchial washings. Maximum yield of AFB with ZN staining 12 (16%) was equal to the post FOB sputum and bronchial brushings samples. It was followed by 6 cases (8%) in BAL and 4 (5.3%) in bronchial washings. The cytological examination was suggestive of TB in only 8 (10.66%) cases in bronchial washings and 6 (8%) cases in post FOB collection. It was equal in BAL and Bronchial brushings each that is 5 (6.67%)., Conclusion: Bronchoscopy is a useful diagnostic tool and fluorescent microscopy is more sensitive than ZN and cytology. On X-ray examination, other diseases like malignancy or fungus can also mimick TB. So apart from ZN staining or fluorescence microscopy, Pap and MGG stain will be worthwhile to identify other microorganisms.

A descriptive study was conducted in the Department of Respiratory Medicine in a tertiary care center of Ambala. Aim of the study was to determine the prevalence of fungal infection among patient presents with sputum negative old treated pulmonary tuberculosis. The study was carried out among 39 post treated cases of Pulmonary Tuberculosis, whose sputum or bronchial wash showed isolation of Aspergillus. Demographic details and clinical findings were noted. Data collected were entered into Excel spreadsheet and quantitative data were expressed as number and percentage. The presentation of pulmonary aspergillosis in treated cases of pulmonary TB varies from aspergilloma (51.3%) to chronic necrotizing pulmonary aspergillosis (38.4%) to allergic bronchopulmonary aspergillosis (10.3%). Hemoptysis (79.5%) of varying severity was the most common symptom. Most of the patients were farmers by occupation. The most common species were Aspergillus fumigatus; others were Aspergillus flavus, Aspergillus niger and Aspergillus terrus in 23.2%, 20.5%, and 12.8%, respectively. Here we conclude that Aspergillus fumigatus was the most frequently isolated species in our region and aspergilloma was the commonest pulmonary manifestation as post-TB sequel. [ABSTRACT FROM AUTHOR]

Sputum examination is the most widely used test for diagnosis of TB. Under RNTCP two samples of sputum are required for examinations which are preferably 1st spot and early morning sample or two spot samples collected on the same day. Patients usually come from far off places at the tertiary care centre and frequent visits are usually not possible. Giving an early morning sample is usually defaulted by the patient due to various reasons. The present study was aimed at studying the delay in giving the early morning sample and barriers in accessing the sputum smear microscopy services at a tertiary care hospital. In this study 300 presumptive TB patients were studied. Patients were asked to give a 1st spot sample for sputum smear examination and asked to bring early morning sputum sample. Patients who refused to give early morning sample were asked to give 2nd spot sample and the reason for not coming early morning were noted. The patients who did not come despite agreeing to come were noted. If they came after a delay of few days, then also the reason of delay were noted. It was found that nearly one third (31%) of the patients agreed and came on the next day to give early morning sample. A large number of patients (16%) did not come at all to give the early morning sample. [ABSTRACT FROM AUTHOR]

Tuberculosis is an infectious disease. It is caused by bacteria Mycobacterium Tuberculosis. It can be diagnosed by demonstrating AFB by either phenotypic method like sputum smear microscopy, culture or by genotypic method like NAAT or LPA. For better results there should be a good quality sputum sample. Induction of sputum is a method for improving the quality of sample. The most commonly used method is induction using 3% saline. It has been seen that during taking throat swab specimen patients usually produce cough. This induced cough can produce better quality of sputum. The following study was done to know about the role of throat swab as a method of sputum induction. [ABSTRACT FROM AUTHOR]