Shipra Anand

Chronic obstructive pulmonary disease (COPD) is a prevalent and debilitating condition, increasingly recognized for its complex interaction with psychiatric disorders such as anxiety and depression. This study assesses and compares the prevalence of anxiety and depression among COPD patients, including those with a history of pulmonary tuberculosis (TB), and examines their associations with COPD severity. This descriptive, cross-sectional study included 100 patients diagnosed with COPD, aged 40 to 80 years. Patients underwent comprehensive clinical evaluation, including spirometry and COPD assessment tests, and were assessed for anxiety and depression using the Hospital Anxiety and Depression Scale. Participants were classified based on their COPD status and history of TB. Data on sociodemographic and clinical characteristics were collected, and associations between psychiatric illnesses and COPD status were analyzed. The study population was predominantly male (73%), with a mean age of 56.33 years. The COPD assessment score was medium in 65% of participants, with 30% of patients exhibiting high levels. Anxiety was present in 21% of the cohort, while 30% had depression. Analysis revealed a significant association between high COPD scores and increased prevalence of both anxiety and depression (p<0.05). Additionally, patients with a history of pulmonary TB showed higher rates of psychiatric comorbidities. Specifically, anxiety was more prevalent among patients with severe COPD and a history of TB. These findings highlight a substantial burden of anxiety and depression among COPD patients, particularly those with severe disease and a history of TB. These results align with the existing literature, suggesting a strong link between COPD severity, psychiatric comorbidities, and the impact of historical TB on mental health. These insights underscore the need for integrated management strategies addressing both respiratory and psychiatric aspects of COPD care.

This review presents a comprehensive examination of the contemporary landscape pertaining to latent tuberculosis infection (LTBI) diagnostics, with a particular emphasis on the global ramifications and the intricacies surrounding LTBI diagnosis and treatment. It accentuates the imperative of bolstering diagnostic, preventive, and treatment modalities for tuberculosis (TB) to fulfill the ambitious targets set forth by the World Health Organization aimed at reducing TB-related mortalities and the incidence of new TB cases. The document underscores the significance of addressing LTBI as a means of averting the progression to active TB, particularly in regions burdened with high TB prevalence, such as India. An in-depth analysis of the spectrum delineating latent and active TB disease is provided, elucidating the risk factors predisposing individuals with LTBI to progress towards active TB, including compromised immune functionality, concurrent HIV infection, and other immunosuppressive states. Furthermore, the challenges associated with LTBI diagnosis are elucidated, encompassing the absence of a definitive diagnostic assay, and the merits and demerits of tuberculin skin testing (TST) and interferon-γ release assays (IGRAs) are expounded upon. The document underscores the necessity of confronting these challenges and furnishes a meticulous examination of the advantages and limitations of TST and IGRAs, along with the intricacies involved in interpreting their outcomes across diverse demographics and settings. Additionally, attention is drawn towards the heritability of the interferon-γ response to mycobacterial antigens and the potential utility of antibodies in LTBI diagnosis.

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