---

Background & Objective: Tuberculosis (TB) is still one of the most common causes of death in the world. The incidence of TB, included extra pulmonary variant has been increasing in developed countries for 2 past decades and also has a high incidence and prevalence in underdeveloped countries. To determine the type of involved organ by extra pleuro-pulmonary TB in Shahid Beheshti Hospital in Babol, the present study was carried out. Materials & Methods: Pathological reports of extra pleuro-pulmonary TB in Babol Shahid Beheshti Hospital during performed 1990-2003 have been studied. Sex, age and involved organs were determined, and subsequently the appropriate table was set up. Results: During 14 years, we diagnosed 82 cases of extra pleuro-pulmonary TB, 44 were men and 38 women, with age ranges of 8 months-79 years. TB lymphadenitis was the most common form (45 cases), followed by soft tissue 14 cases, bone 4, intestine 3, and 2 cases for endometrium, skin, testis and epididymis, and one case for ovary, tonsil, larynx, prostate, parotid gland, synovium, stomach, and kidney. The diagnosis was confirmed by presence of acid-fast bacillus in tissue section by Ziehl Neelsen staining and good response to anti-TB treatment. Conclusion: Although the TB lymphadenitis was the most common type, but in regions with high rate of TB, considering extra pleuro-pulmonary TB in unusual clinical setting is important and using appropriate diagnostic procedures and treatment if it is necessary.

---

Background&Objective: 15-20% of TB cases are extra pulmonary tuberculosis (EPTB). Abdominal TB is the most common type of extra intestinal TB. Signs and symptoms of abdominal TB are unspecific. In this study, we identified all GITB cases in Golestan province (Iran) between 1999 and 2003 and determined their demographic characteristics. Materials&Methods: We reviewed all new cases of TB reported during 1999-2003 from TB centers of Golestan province .Then EPTB and especially GI and abdominal TB cases were selected. We completed a questionnaire containing demographic information for each of them. The information entered the computer in SPSS-13 was used to analyze the data. Results: 30 patients had been treated for GI and abdominal TB, most of them were females (22 cases, 73.3%). Mean age of the patients was 32.03±13.73 with higher incidence in age before 40 years old (70%). Most common complaints of the patients were fatigue, weight loss, anorexia, fever and abdominal pain, respectively. In 66.7% of patients the diagnosis was pathologically documented. Conclusion: Our data suggest that 38.46% of all TB cases in Golestan province were EPTB, and this scale is higher than other studies. In this study, 5.27% of EPTB cases were GI and abdominal TB, higher than the world reports (3%).

---

Background and Objective: Previous studies have shown that vitamin D is involved in host immune response toward Mycobacterium tuberculosis (MTB). The aim of this study was to determine if administration of vitamin D can improve treatment outcome and whether is able to increase the rate of sputum clearance of MTB in patients with pulmonary tuberculosis (PTB). Materials and Methods: This randomized clinical trial study was conducted on 96 patients with lung tuberculosis in Ahvaz, Iran during 2008-09. The patients were 18>=years old with sputum positive for acid fast bacillus. Patients were placed in two equal groups as cases and controls. Cases were treated by standard anti TB regimen plus 800 IU/day vit D orally. Controls were treated only by standard anti TB regimen. Follow up sputum examination for presence AFB was performed at the end of month 1, 2, 3, 4 and treatment period. Data were analyzed in SPSS-16 by using descriptive statistics test, chi square and fisher exact test. Results: Mean±SD age of cases and controls was 39.1±17.8 and 38.3±17.6 years, respectively. Overall cure rate in case and control was 93.8% and 95.8% respectively, with no significant difference. The rate of negative sputum of cases in the end of months 1, 2, 3, 4 and treatment period was 66.7%, 78.5%, 93.8% and 93.8% respectively, and for controls was 35.4%, 66.7%, 91.7% and 95.8% respectively. There was significant difference between two groups in the end of first and second month (P<0.05). Conclusion: This study showed that vitamin D as a supplemental drug does not improve the overall treatment outcome among lung TB patients, but it may be able to increase the rate of sputum clearance of Mycobacterium tuberculosis.

---

Background and Objective: Since accurate and quick clinical and paraclinical diagnostic methods are not available, in some cases diagnosis of active pulmonary tuberculosis occurs after considerable time from the onset of disease. This study was designed to determine the diagnostic value of High Resolution Computed Tomographic (HRCT) scan in active pulmonary tuberculosis, in Gorgan, Golestan province, North of Iran. Materials and Methods: This diagnostic screening study was carried out on 135 (79 male and 56 female) hospitalized patients suspected with active pulmonary tuberculosis, and HRCT was used in their course of treatment as recommendation of their clinician. The patients were chosen from 5th Azar hosptial during 2009-10. Also it should be mentioned that patients were selected on avaliabity bases, and they were examined by smear, and sputum culture. The patients with negative smear and culture were set up as true healthy group (64 subjects). The lung or small nuddles in HRCT was considered as proper position of lung involvument in active lung pulmonary. The HRCT findings between the case group (71 subjects) and healthy group were compared. According to HRCT findings, the sensitivity and specifity were determined for each patient. Data were analyzed using SPSS-16 and Chi-Square test. Results: In this study, sensitivity, specificity, positive predictive value and negative predictive value of HRCT in active pulmonary tuberculosis were equal to 97.2%, 71.9%, 79.3% and 95.8% respectively. Involvement of upper and middle lobe of the right lung and upper lobe of the left lung were significantly higher than the control group (P<0.05). Conclusion: This study showed that HRCT has high sensitivity and specificity in diagnosis of active pulmonary tuberculosis and can be used as a quick diagnostic way in active pulmonary tuberculosis, especially in patients with strong clinical suspicion and negative smear.

---

Background and Objective: Due to the increase of incidence of extrapulmonary tuberculosis in Iran, This study was conducted to determine the epidemiological pattern of extrapulmonary tuberculosis in the Mazandaran province, northern Iran. Methods: This descriptive-analytic study was carried out on medical record of 3313 tuberculosis patients in Mazandaran province, northern Iran during 2001-11. Age, gender, affected year, area and affected organ were gathered for each patient. Results: 843 (25.4%) of subjects were diagnosed with extrapulmonary tuberculosis. The incidence of extrapulmonary tuberculosis increased by 4% for every unit increase in incidence year (P<0.05). The mean age of patients with extrapulmonary tuberculosis was significantly less than patients with pulmonary tuberculosis (42.8±20.6 years vs. 48.7±21.2, P<0.05). Extrapulmonary tuberculosis was significantly higher in women (P<0.05). The chance of extrapulmonary tuberculosis in women was 1.7 times of men. Lymph node (33%) was the most common affected organ followed by pleura (18.9%) and bone (17.7%). Conclusion: The trend of incidence of extrapulmonary tuberculosis was ascending during 2001 to 2011. The most affected organ in extra pulmonary tuberculosis was lymph nodes.