Volume16,Issue1

Tuberculosis (TB) is a major air-borne infectious bacterial disease. Despite the downward trend of TB, it continues to be a challenging public health problem for its emergent morbidity and mortality worldwide, especially in developing countries. In 2013, nine million people with TB infection estimated by the World Health Organization (WHO), and 1.7 million died from the disease. Ziehl-Neelsen (ZN) smear is widely used for rapid diagnosis of tuberculosis in our country and other developing countries but culture on Lowenstein – Jensen (LJ) medium is more sensitive and cheaper than modern diagnostic techniques in the present settings. This comparative study was carried out in the Department of Microbiology, National Institute of Medical Sciences, Jaipur Rajasthan from January 2019 to June 2019. Study subjects included patient visiting TB OPD clinic and wards of NIMS hospital. A total 240 specimen were processed for both smear & culture. Smear stained with ZN method and culture inoculated on LJ medium after digestion and decontamination of clinical specimen. Out of 240 specimen, 34 (14.1%) were smear positive while 43 (17.9%) were culture positive. Out of 34 smears positive pulmonary tuberculosis cases 29 (85.2%) were found to be positive on LJ culture. A total of 14 (4.8%) pulmonary cases were negative on the smear but found to be positive on LJ culture for Mycobacterium tuberculosis. Although AFB smear is rapid, cheap and specific test for early diagnosis of tuberculosis, but its sensitivity is low and culture medium is still a gold standard method although it takes longer time to grow and provide us positive growth to do drug susceptibility testing.

Aim: To compare the transanal suture rectopexy (TR) with conventional Milligan-Morgan hemorrhoidectomy (MH) in patients of grade II, III and IV hemorrhoids. Methods: From March 2018 to October 2019, 60 patients of hemorrhoids from grade II to IV were randomly selected to undergo either the transanal suture rectopexy (n= 30) or the Milligan-Morgan hemorrhoidectomy (n=30). Results were analyzed during postoperative period and at 1 month. Operative time, post-operative complications, resolution of symptoms and recurrence were taken as variables. Data was analyzed by Open EPI version 2.3. Results: Both the groups were comparable in terms of demographic data. Bleeding per rectum was the major symptom. TR group had more operative time and less intra-op blood loss, post-operative bleeding, pain, anal incontinence, hospital stay and recurrence than MH group. Data was statistically significant (p-value<0.05). In MH group, 16 patients developed postoperative bleeding while this was only 2 in TR group. In MH group 2 patients developed anal incontinence while there were none in TR group. In MH group 6 patients came with prolapse and 7 patients came with bleeding per rectum at 1 month follow up, while count was only 1 in TR group. Conclusion: Transanal suture rectopexy is unique and simple stitching technique appropriate for treating all the grades of hemorrhoids. It offers cheaper, ambulatory and effective alternative to costly newer modalities for the treatment of hemorrhoids. It is better accepted by the patients. More studies are needed to declare it as a standard procedure for the cure of haemorrhoids.