Radiographic Evidences of Smear Positive TB in Patients Admitted in Sina Hospital of Kermanshah(1992-2001)

Introduction: The objective of this study is to determine the degree and/or value of C.X.R usage in the diagnosis of pulmonary tuberculosis (TB). Therefore throughout our findings, the possibilities of diagnosing patient suffering from TB would increase when the most common radiographic evidence has been considered.

Materials & Methods: This study is a descriptive and cross-sectional one in which 500 smear positive TB patients were selected. The information has been obtained from medical  records of 1840 hospitalized TB patients in Sina Hospital in  Kermanshah during 1992 to 2002. The data was collected via census sampling. Final analysis was calculated  by using χ² and  Fisher Exact Test.

Results: In the target group, the male to female ratio was 1.1, which equated to 52.4% of male patients and 47.6% of female patients. The average age was 40.9 years. The pattern of lung involvement was; paranchymal opacification (57%), Cavitation (51.8%) and consolidation (30.6%) and  in many patients the changes were observed in more than one pulmonary zone. Most changes were detected in the upper zones of the lungs (RUZ 66.6% - LUZ 63.6%). 3.8% of the target group have HIV-positive. No significant difference was observed in the radiographic evidence in these HIV⁺ patients in comparison with the others. 6% of the patients had diabetes mellitus, of these, the type of pulmonary involvement mostly observed was Cavitation (80%), specially in the upper zones, compared with non-diabetic patients.

Conclusion: As for the main objective of this study, the obtained results were similar to those obtained by  other studies. However in HIV⁺ and diabetic patients, the results were significantly different. These differences may be due to the small sample size of HIV⁺ and diabetics (19 and 30 respectively). Also the  majority of  HIV⁺ patients had not yet reached the end stages of AIDS and as this study was limited to positive smear TB, the negative smear HIV⁺/^{TB were not included. According to the obtained results, it seems that as the duration between the appaerance signs and symptoms and the diagnosis increases the radiographic changes would match more closely with classic TB. This finding is also applicable in the cases of heavy smokers. However, there were no statically significant differences between these groups and the others.}