Background: Coronavirus disease 2019 (COVID-19) pandemic has disrupted tuberculosis (TB) care and prevention around the world. The aim of this study is to review literature on the impact of COVID-19 on TB preventive services and discuss their policy options during and after the pandemic. Methods: We conducted a rapid review of scientific literature on the impact of COVID-19 on TB preventive services and their recovery strategies. After conducting a line-by-line open coding, their codes were applied in the descriptive theme building process, which was guided by the End TB strategy. TB preventive measures were selected and classified into five analytical categories: 1) vaccination against TB, 2) detection and treatment of latent TB infection (LTBI), 3) screening and diagnostics, 4) active case finding and contact tracing, and 5) surveillance. Results: We identified 93 articles, of which 65 were research articles. During the pandemic, we observed decrease in Bacillus Calmette-Guérin (BCG) coverage, TB diagnostic services, case finding activities, and LTBI management. TB case detection was declined, which was not resumed to the pre-pandemic level after loosening the lock-down. Several recommendations were highlighted: 1) secure BCG stocks and its supply chains, 2) consider catch-up activities of routine immunization and LTBI screening, 3) maintain minimal TB health services, infection prevention and control, and surveillance, 4) leverage laboratory capacity and contact tracing mechanisms, 5) consider simultaneous testing for TB and COVID-19, and 6) Incorporate digital health technologies. Conclusions Our findings and lessons learnt from the pandemic can aid in the development of future national TB control program.

We present a rare case of critically compromised airway secondary to a massively dilated sequestered colon conduit after several revision surgeries. A 71-year-old male patient had several operations after the diagnosis of gastric cancer. After initial treatment of pneumonia in the pulmonology department, he was transferred to the surgery department for feeding jejunostomy because of recurrent aspiration. However, he had respiratory failure requiring mechanical ventilation. The chest computed tomography (CT) scan showed pneumonic consolidation at both lower lungs and massive dilatation of the substernal interposed colon compressing the trachea. The dilated interposed colon was originated from the right colon, which was sequestered after the recent esophageal reconstruction with left colon interposition resulting blind pouch at both ends. It was treated with CT-guided pigtail catheter drainage via right supraclavicular route, which was left in place for 2 weeks, and then removed. The patient remained well clinically, and was discharged home.
Aged ; Catheters ; Colon* ; Diagnosis ; Dilatation* ; Disease Management ; Drainage ; Humans ; Jejunostomy ; Lung ; Male ; Pneumonia ; Pulmonary Medicine ; Respiration, Artificial ; Respiratory Insufficiency ; Stomach Neoplasms ; Thorax ; Trachea

Specialists of developing countries are facing the epidemic growth of noncommunicable diseases (NCDs). From 2011 to 2013, I, as a Korean volunteer doctor, had been working in a local primary healthcare center in Bangladesh, assessing rates of NCDs. Proportion of patients with NCDs was increased from 74.96% in 1999 to 83.05% in 2012, particularly due to the spreading of diabetes mellitus, cardiovascular diseases, and tuberculosis. To succeed in medical mission in developing countries, volunteer doctors have to take measures for preventing chronic diseases along with proper treatment.
Bangladesh/epidemiology ; Cardiovascular Diseases/epidemiology ; Chronic Disease/*epidemiology ; Diabetes Mellitus/epidemiology ; Global Health/trends ; Humans ; *Medical Missions, Official ; Primary Health Care ; Tuberculosis/epidemiology

PURPOSE: To report a case of delayed orbital cellulitis with subperiosteal abscess after orbital floor fracture repair using an absorbable sheet implant (Macropore®, Medtronic Inc., Minneapolis, MN, USA). CASE SUMMARY: A 16-year-old male visited the oculoplastic clinic for left eye pain, lower eyelid swelling and vertical diplopia for 1 day. The patient had a history of inferior orbital wall fracture repair surgery using Macropore® 20 months prior. The orbital computed tomography scan showed a subperiosteal cystic mass with surrounding infiltration at the left orbital floor, and ethmoidal and maxillary sinusitis; however, sheet implant was not clearly observed. Despite systemic antibiotic treatment for 3 days, his clinical findings did not improve, thus we decided to drain the subperiosteal abscess through a transconjunctival approach. Intraoperatively, the Macropore® sheet was almost dissolved, but small pieces remained. The culture of drained contents showed no microorganisms. Systemic antibiotics were continued for 18 days after surgery, and clinical symptoms completely improved. CONCLUSIONS: Delayed orbital cellulitis should be considered in patients with extraocular muscle movement limitation and painful orbital swelling if the patient has a history of orbital wall fracture repair, even if a bioresorbable implant was used. Prompt imaging evaluation should be emphasized for early diagnosis and proper treatment.
Abscess ; Absorbable Implants* ; Adolescent ; Anti-Bacterial Agents ; Diplopia ; Early Diagnosis ; Eye Pain ; Eyelids ; Humans ; Male ; Maxillary Sinus ; Maxillary Sinusitis ; Orbit* ; Orbital Cellulitis* ; Orbital Fractures

STUDY DESIGN: A case report. OBJECTIVES: To report a case of thoracic spinal meningioma and lumbar spinal schwannoma found in one patient. SUMMARY OF LITERATURE REVIEW: patients with different types of spinal cord tumor, specifically meningioma and schwannoma, are rare in medical literature. MATERIALS AND METHODS: A 66 year-old female presented with complaints of walking difficulty. She had masses on the thoracic and lumbar spine and underwent open excision and biopsy. RESULTS: Three months after operation, the patient could walk independently and no recurrence was found at 1-year follow up. CONCLUSIONS: Thoracic spinal meningioma and lumbar spinal schwannoma occurring in one individual were treated successfully by operative management.
Female ; Humans ; Meningioma ; Neurilemmoma ; Recurrence ; Spinal Cord ; Spinal Cord Neoplasms ; Spine ; Walking

Obstructive sleep apnea (OSA) is a prevalent disorder characterized by repeated episodes of obstructive apnea and hypopnea due to repetitive collapse of the upper airway during sleep. OSA should be suspected in patients that are obese, hypertensive, habitual snorers, and hypersomnolent. Standard overnight polysomnography is essential for proper diagnosis. OSA is a chronic disease that requires long-term multidisciplinary care. Management of this condition begins with patient education. Behavior modifications, such as weight loss, exercising, changing the sleep position, abstaining from alcohol, and avoiding certain medications, are essential for most patients with OSA. Positive airway pressure (PAP) is the mainstay therapy for OSA, and its initiation requires selection of an appropriate device and mode of PAP. The optimal pressure is determined by titration during the second polysomnography. Continuous positive airway pressure (CPAP) is the first-line therapy for moderate to severe OSA. Due to low compliance rates of CPAP, it is important to educate patients and manage complications associated with mask and pressure-related discomfort as early as possible. Bi-level PAP or auto-titrating PAP is an acceptable options for patients that cannot tolerate CPAP. In cases of mild to moderate OSA, an oral appliance can be used as a reasonable alternative therapy.
Apnea ; Behavior Therapy ; Chronic Disease ; Compliance ; Continuous Positive Airway Pressure ; Diagnosis ; Humans ; Masks ; Patient Education as Topic ; Polysomnography ; Sleep Apnea, Obstructive* ; Weight Loss

In order to eliminate tuberculosis worldwide by 2050, effective management of latent tuberculosis infection is essential, and policy-makers have begun to recognize the importance of scaling up preventive therapy. The current guideline recommends targeted latent tuberculosis infection testing that identifies high-risk groups based on risk stratification for progression from latent infection to active disease. Both the tuberculin skin test and interferon-gamma releasing assay have a similar diagnostic efficacy for predicting progression to active tuberculosis. The Korean guideline recommends 9-month isoniazid monotherapy as the standard treatment; however, more evidence supports that short course rifampicin-based regimen is both more effective and tolerable than isoniazid monotherapy.

In order to eliminate tuberculosis worldwide by 2050, effective management of latent tuberculosis infection is essential, and policy-makers have begun to recognize the importance of scaling up preventive therapy. The current guideline recommends targeted latent tuberculosis infection testing that identifies high-risk groups based on risk stratification for progression from latent infection to active disease. Both the tuberculin skin test and interferon-gamma releasing assay have a similar diagnostic efficacy for predicting progression to active tuberculosis. The Korean guideline recommends 9-month isoniazid monotherapy as the standard treatment; however, more evidence supports that short course rifampicin-based regimen is both more effective and tolerable than isoniazid monotherapy.
Diagnosis ; Interferon-gamma ; Interferon-gamma Release Tests ; Isoniazid ; Latent Tuberculosis ; Skin Tests ; Tuberculin ; Tuberculosis