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INTRODUCTION
PREVIOUS STUDIES
Studies show that in patients with obstructive
airway impairement, post pulmonary tuberculosis can
be an important cause. It was observed to be an
etiologic factor of both COPD4-7and asthma. 8,9
Cavitation, extensive fibrosis, bulla formation and
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PERSONAL EXPERIENCE
A prospective study was conducted on 92 patients
in the Department of Pulmonary medicine, Chhatrapati
Shahuji Maharaj Medical University, Uttar Pradesh,
Lucknow from September 2007 to August 200820.
Patients diagnosed as a case of pulmonary
tuberculosis, taken a full course of anti tubercular
chemotherapy, with more than 12 years of age, sputum
smear for AFB negative, had healed radiological
lesions at time of presentation and had negative history
of obstructive airway disease before occurrence of
pulmonary tuberculosis were included. Pregnant and
moribund patients were excluded from the study.
The authors found that only 15(16.3%) patients had
obstructive airway disease by spirometry criteria.
Out of the 15 patients, only 3 (20%) were having
reversible phenomenon; 12(80%) having irreversible
phenomenon.21 patients had mixed obstructive with
restrictive disorder (22.80%). Restrictive pathology
was seen in 37 patients (40.21%). Among the 21
patients with mixed defect, 4 patients (19.04%) had
reversible type of obstruction and 17 patients
(80.95%) had irreversible obstruction along with
restrictive defect. After 6 weeks of therapy with
medications, 11 patients showed improvement of post
bronchodilator FEV1<10% and 5 patients had
improvement in post bronchodilator FEV1of >10%.
After 12 weeks of therapy, 14 patients had improved
by <10% and 5 patients sustained their improvement
in post bronchodilator FEV1% of 10%. Patients with
minimal healed lesion had a post bronchodilator
FEV1% of 50-80% in majority (8 patients or 53.6%).
Six patients with minimal healed lesions (40%) had a
post bronchodilator (BD) FEV1% of 31 50% and 1
patient had post bronchodilator FEV1% <30%.
DISCUSSION
Pulmonary impairment associated with obstructive
airways disease is recognised as a common
complication of advanced tuberculosis. Posttuberculosis airway obstruction is a separate clinical
entity. It requires insight, understanding and evaluation
of its evolution, clinical course and management. The
exact pathogenesis of the development of this disorder
is unclear. A hypothesis has been created based on
immunological mechanisms. Both Pulmonary
tuberculosis and obstructive airway disease especially
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18. Lee JH, Chang JH. Lung function in patients with chronic
airflow limitations due to tuberculous destroyed lung. Respir
Med 2003; 97: 1237-1242.
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27. Perez-Padilla R, Perez-Guzman C, Baez-Saldana R, TorresCruz A. Cooking with biomass stoves and tuberculosis: a
case control study. Int J Tuberc Lung Dis 2001; 5: 441-447.