Simultaneous occurrence of leprosy and pulmonary tuberculosis is reported infrequently in the modern era. We report a case of pulmonary tuberculosis diagnosed in patient being treated with glucocorticoids for complications of leprosy (type II reaction). Physicians should recognize that the leprosy patients treated with glucocorticoid may develop tuberculosis.

Trends in Pulmonary Function Testing Before Noncardiothoracic Surgery Preoperative pulmonary function tests (PFTs) assess the severity of known pulmonary disease, diagnose causes of respiratory symptoms, and may help identify patients who are at risk for postoperative pulmonary complications. While useful in selected patients, unnecessary testing is costly.1 Few guidelines for the appropriate u...

The classic findings of a patent ductus arteriosus in a young individual are familiar to most physicians. However, it has been appreciated that several factors, principally pulmonary hypertension or pulmonary artery dilatation in the absence of appreciable hypertension, may significantly alter the classic image and lead to the erroneous diagnosis of ventricular septal defect. In 10 surgically p...

OBJECTIVE To evaluate documentation of compliance with the National Asthma Education and Prevention Program publication Guidelines for the Diagnosis and Management of Asthma. DESIGN A retrospective review of 114 charts coded as asthma. Fourteen chart evaluation questions were developed based on the 4 management components in the guidelines: assessment and monitoring of asthma, control of asth...

In an interesting article Wieteke van Dijk and colleagues argue that societal developments and values influence the practice of medicine, and thus can result in both medicalisation and overdiagnosis. They provide a convincing argument that overdiagnosis emerges in a social context and that it has socially constructed implications. However, they fail to show that overdiagnosis per se is socially...

Guidelines versus clinical practice in the treatment of chronic obstructive pulmonary disease. N. Roche, T. Lepage, J. Bourcereau, P. Terrioux. #ERS Journals Ltd 2001. ABSTRACT: The main purpose of this study was to assess whether pharmacological treatments prescribed by respiratory physicians to patients with chronic obstructive pulmonary disease (COPD) were consistent with the guidelines. The...

BACKGROUND In resource- poor settings, verbal autopsy data are often reviewed by physicians in order to assign the probable cause of death. But in addition to being time and energy consuming, the method is liable to produce inconsistent results. The aim of this study is to evaluate the performance of the InterVA 3.2 model for establishing pulmonary tuberculosis as a cause of death in comparison...

Pulmonary arterial hypertension in children. A. Widlitz, R.J. Barst. #ERS Journals Ltd 2003. ABSTRACT: For physicians to admit that a group of patients remains for whom no cure is available in modern medicine is intellectually unsatisfying. Pulmonary arterial hypertension is a rare condition. Because the symptoms are nonspecific and the physical finding can be subtle, the disease is often diagn...

BACKGROUND Pulmonary embolism (PE) is a serious clinical entity carrying significant morbidity and mortality. Clinically, it is a difficult condition to diagnose and remains under treated condition in Pakistan due to non-availability of objective tests and lack of awareness among physicians. This study was conducted to determine the chest radiographic presentation in known cases of acute PE pre...

Most physicians believe that to provide the best possible care to their patients, they must commit to continuous learning. For the most part, it appears the learning activities currently available to physicians do not provide opportunities for meaningful continuous learning. At the same time there have been increasing concerns about the quality of health care, and a variety of groups within org...