Clinico-radiological profile of new smear positive pulmonary tuberculosis cases among young adult and elderly people in a tertiary care hospital at Deheradun (Uttarakhand).
METHODS
Patients of pulmonary tuberculosis (TB) attending the out and in patient department of pulmonary medicine, Himalayan Institute of Medical Sciences (HIMS), a post graduate institute and a large tertiary care center in Dehradun.


OBJECTIVE
To compare the clinico-radiological pattern of pulmonary tuberculosis in the young adult (18-59 years) and elderly (> or = 60 years) patients.


METHODS
Prospective observational study of pulmonary and associated extra pulmonary tuberculosis cases, diagnosed between October 2005 to September 2006 in pulmonary medicine department of HIMS.


RESULTS
Mean age of young adult and elderly patients was 35.71 +/- 5.7 years and 68.57 +/- 3.03 years respectively. Elderly patients had a higher number of co-morbidities like diabetes mellitus, hypertension, and malignancy. Tuberculin positivity was less among elderly patients (36.0%) as compared to young adults (65.9%). Hemoptysis (29.5% vs. 6%), fever (95.4% vs. 76%) and night sweats (54.5% vs. 18.0%) were significantly higher in the young adult patients than the elderly. As for roentgenographic abnormalities, a higher involvement of lower zone (24.0% vs. 7.9%) and far advanced lesions (32.0% vs. 14.7%) were seen in the elderly patients as compared to young adults. The elderly showed a higher frequency of TB related mortality (8% vs. 1.1%) and associated extra pulmonary involvement (40% vs. 7%).


CONCLUSIONS
Young adults are more likely to have hemoptysis, night sweats and positive PPD response while lower lung field involvement is more common in elderly.
Rawat
Jagdish
J
Department of Community Medicine, Himalayan Institute of Medical Sciences, Dehradun. drjagdishrawat@yahoo.com
Sindhwani
Girish
G
Juyal
Ruchi
R
D000046:Academic Medical Centers; D000328:Adult; D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005334:Fever / Q000453:epidemiology; D006469:Hemoptysis / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007194:India / Q000453:epidemiology; D008297:Male; D009369:Neoplasms / Q000453:epidemiology; D011446:Prospective Studies; D011859:Radiography; D015996:Survival Rate; D014374:Tuberculin Test / Q000706:statistics & numerical data; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology*