Gomal Journal of Medical Sciences
PREVALENCE, DISTRIBUTION AND DETERMINANTS OF INTESTINAL TUBERCULOSIS IN ADULT INDOOR PATIENTS WITH ACUTE SMALL INTESTINAL OBSTRUCTION IN POPULATION OF PESHAWAR DIVISION, PAKISTAN
Abstract
Background: Acute small intestinal obstruction (ASIO) is one of the commonest causes of emergency hospital admissions, morbidity and mortality. Intestinal tuberculosis (ITB) is common cause of ASIO in developing countries leading to significant morbidity and mortality. Our objectives were to determine prevalence, distribution and determinants of ITB in adult indoor patients with ASIO in population of Peshawar Division, Pakistan.
Materials & Methods: This cross-sectional study was conducted at Department of Surgery Peshawar Medical College, Peshawar, Pakistan from January 2019 to June 2020. The data was collected from its three affiliated hospitals; Mercy Teaching Hospital, Kuwait Teaching Hospital & Prime Teaching Hospital, Peshawar. 207 ASIO subjects were selected from population at risk consecutively. Sex, age groups and presence of ITB were variables. Prevalence and distribution were described by count, percentage and confidence intervals for proportion for population. Hypotheses for distribution were tested by chi-square goodness of fit and of association by chi-square test of association.
Results: Out of 207 patients with ASIO, 128 (61.84%) were men and 79 (38.16%) women, 87 (42.03%) were in age group 18-40 and 120 (57.97%) in 41-60 years. Out of 207 patients with ASIO, 41 (19.81%) had ITB, while 166 (80.19%) had no ITB. Out of 41 ITB patients, 25 (12.08%) were men and 16 (7.73%) women, 17 (8.21%) in age group 18-40 and 24 (11.60%) in 41-60 years. The prevalence of ITB was similar to expected (p=.5695). The distribution across sex (p=.00001) was different and across age groups (p=.12501) was similar to expected. Presence of ITB was not associated to sex (p=.8992) and age groups (p=.9347).
Conclusion: Prevalence of intestinal TB in adult indoor acute small intestinal obstruction (ASIO) population of Peshawar Division, Pakistan was 19.81%. Prevalence was higher in men than women and higher in 41-60 years than 18-40 years age group population. Overall prevalence of intestinal TB was similar to expected. Observed distribution across sex was different and across age groups was similar to expected. Presence of intestinal TB was not associated to sex and age groups respectively.
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Mucha P Jr. Small intestinal obstruction. Surg Clin North Am 1987 Jun; 67(3):597-620. https://doi.org/10.1016/S0039-6109(16)44234-9
Miller G, Boman J, Shrier I, Gordon PH. Natural history of patients with adhesive small intestinal obstruction. Br J Surg 2000 Sep; 87(9):1240-7. https://doi.org/10.1046/j.1365-2168.2000.01530.x
Miller G, Boman J, Shrier I, Gordon PH. Etiology of small intestinal obstruction. Am J Surg 2000 Jul; 180(1):33-6. https://doi.org/10.1016/S0002-9610(00)00407-4
Cappell MS, Batke M. Mechanical obstruction of the small intestinal and colon. Med Clin North Am 2008 May; 92(3):575-97. https://doi.org/10.1016/j.mcna.2008.01.003
Gore RM, Silvers RI, Thakrar KH, Wenzke DR, Mehta UK, Newmark GM, et al. Intestinal Obstruction. Radiol Clin North Am 2015 Nov; 53(6):1225-40. https://doi.org/10.1016/j.rcl.2015.06.008
Ray NF, Denton WG, Thamer M, Henderson SC, Perry S. Abdominal adhesiolysis: inpatient care and expenditures in the United States in 1994. J Am Coll Surg 1998 Jan; 186(1):1-9. https://doi.org/10.1016/S1072-7515(97)00127-0
Markogiannakis H, Messaris E, Dardamanis D, Pararas N, Tzertzemelis D, Giannopoulos P. Acute mechanical intestinal obstruction: clinical presentation, etiology, management and outcome. World J Gastroenterol 2007 Jan 21; 13(3):432-7. https://doi.org/10.3748/wjg.v13.i3.432
Adhikari S, Hossein MZ, Das A, Mitra N, Ray U. Etiology and outcome of acute intestinal obstruction: a review of 367 patients in Eastern India. Saudi J Gastroenterol 2010 Oct-Dec; 16(4):285-7. https://doi.org/10.4103/1319-3767.70617
World Health Organization. Global tuberculosis report 2019 [accessed 2020 Apr 8]. Available at: https://www.who.int/tb/publications/global_report/en/
National TB Control Program. National guidelines for control of tuberculosis in Pakistan [revised and updated 2019, cited 2020 Apr 24]. Available at: http://ntp.gov.pk/ntp-old/uploads/National_Guidelines_for_TB_Revised_2019
McQueen KR. Gastrointestinal disorders. In: Papadakis MA, McPhee SJ, Rabow MW, editors. Current medical diagnosis & treatment. 57th ed. New York: McGraw-Hill; 2018.p.586-684.
Kim MP, Janz BA, Kasparian AS. Tuberculosis enteritis presenting as a small intestinal obstruction. J Am Coll Surg 2005 Sep; 201(3):478-9. https://doi.org/10.1016/j.jamcollsurg.2005.02.032
Ha HK, Ko GY, Yu ES, Yoon K, Hong WS, Kim HR. Intestinal tuberculosis with abdominal complications: radiologic and pathologic features. Abdom Imaging 1999 Jan-Feb; 24(1):32-8. https://doi.org/10.1007/s002619900436
Choudhary L, Bhat NS, Shahi KS. Clinico-Pathological profile and surgical management of tubercular small intestinal obstruction. Int Surg J 2018; 5(11):3553-7. https://doi.org/10.18203/2349-2902.isj20184621
Nguyen VH. Intestinal obstruction due to tuberculosis. Asian J Surg 2002 Apr; 25(2):145-8. https://doi.org/10.1016/S1015-9584(09)60163-9
Chitumalla PK, Vemulapally NK, Reddy SN. Clinical study of intestinal obstruction in relation to etiological factors. Int Surg J 2017; 4(2):485-90. https://doi.org/10.18203/2349-2902.isj20164846
Tasnim T, Rahman MM, Alam A, Laila R, Matin A, Nafisa A. Current spectrum of intestinal obstruction in a teaching hospital. TAJ: J Teachers Assoc [Internet] 2019 Jun [cited 2020 May 21] ; 32(1):62-9. https://doi.org/10.3329/taj.v32i1.42737
Malik MA, Shah M, Sufi K. Pattern of acute intestinal obstruction: is there a change in the underlying etiology. Saudi J Gastroenterol 2010; 16(4):272-4. https://doi.org/10.4103/1319-3767.70613
Sultan A, Hassan M, Ali M. Role of multidetector computed tomography with multiplanar and curved multiplanar reformations in the detection of cause of intestinal obstruction: A tertiary care experience. Cureus 2020 Mar 29; 12(3):e7464. https://doi.org/10.7759/cureus.7464
Ghori MR, Khan H, Marwat M. Distribution of non-malignant hematological disorders by sex, age groups and type of disease based on bone marrow aspiration in population of Khyber Pa¬khtunkhwa, Pakistan. Gomal J Med Sci 2019 Apr-Jun; 17 (2): 29-36. https://doi.org/10.46903/gjms/17.02.1926
Ain N, Khan S, Marwat M, Khan N, Ahmad I, Ramzan F, et al. Frequency, distribution and determinants of hypertension in adult stroke population of D.I.Khan Division, Pakistan. Gomal J Med Sci 2019 Jul-Sep; 17 (3):81-9. https://doi.org/10.46903/gjms/17.03.2076
Khalid MK, Ahmad I, Khan MA, Sharjeel M, Irfan M. Marwat M. Distribution of pediatric cataracts by sex, age groups, laterality, type and presentation in population of D.I.Khan District, Pakistan. Gomal J Med Sci 2019 Oct-Dec; 17 (4):123-30. https://doi.org/10.46903/gjms/17.04.2025
Marwat M, Ahmad I, Ashiq F, Ali S, Zamir S, Rehman MU, et al. Frequency, distribution and determinants of diabetes mellitus in adult acute coronary syn¬drome population of D.I.Khan Division, Pakistan. Gomal J Med Sci 2019 Oct-Dec; 17 (4):131-43. https://doi.org/10.46903/gjms/17.04.2106
Raosoft® sample size calculator [internet]. Seattle, WA, USA: Raosoft Inc.; 2004. [accessed 2020 Apr 13]. Available at: http://www. raosoft.com/samplesize.html
Statistics Kingdom. Proportion confidence interval calculator [internet]. Statistics Kingdom; Melbourne, Australia 2007. [accessed 2020 May 7]. Available at: http://www.statskingdom.com/41_proportion_confidence_interval.html
Zar JH. Biostatistical Analysis. 5thed. New York: Prentice-Hall, Inc.
Daniel WW. Biostatistics: A Foundation for Analysis in the Health Sciences. 7th ed. Singapore: John Wily; 2005.
Social Science Statistics. Statistical Tests Calculators [Internet]. [accessed 2020 May 12]. Available at: https://www.socscistatistics.com/tests/goodnessoffit/default2.aspx
Social Science Statistics. Statistical Tests Calculators [Internet]. [accessed 2020 Apr 12]. Available at: https://www.socscistatistics.com/tests/chisquare2/default2.aspx
DOI: https://doi.org/10.46903/gjms/18.03.832
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Copyright (c) 2020. Aftab Hussain, Sheikh Muhammad Ibqar Azeem, Imran Ullah, Shahidullah Ahmad, Muhammad Faisal Khan, Muddasar Shahzad
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