scholarly journals Usefulness of COVID-19 screen-and-test approach in pregnant women: an experience from a country with low COVID-19 burden

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Anja Šterbenc ◽  
Tanja Premru Sršen ◽  
Miha Lučovnik ◽  
Marijana Vidmar Šimic ◽  
Lili Steblovnik ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Medical Records ◽  
Maternity Hospital ◽  
Clinical Suspicion ◽  
Protective Equipment ◽  
Test Results ◽  
Hospital Database ◽  
Test Strategies ◽  
Universal Testing ◽  
High Clinical Suspicion

AbstractObjectivesInformation on the usefulness of screen-and-test strategies of pregnant women for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is lacking.MethodsWe retrospectively reviewed the Ljubljana Maternity Hospital database and searched for pregnant women, who were admitted to the hospital between March 15 and May 16, 2020, for a planned procedure or hospitalization. Their medical records were examined and SARS-CoV-2 test results were retrieved.ResultsDuring the two-month period analyzed, there were a total of 265 scheduled admissions of pregnant women to our hospital. Two hundred two (76.2%) were tested for SARS-CoV-2 1 day prior to admission. All tested negative for SARS-CoV-2 RNA, regardless of having coronavirus disease 2019 (COVID-19)-compatible signs or symptoms (n=28) or not (n=174).ConclusionsIn a population with a low SARS-CoV-2 burden, usefulness of universal testing of pregnant women before admission to the hospital is limited. We recommend that obstetric units in regions with low SARS-CoV-2 burden enforce rational use of personal protective equipment and diligent screening protocols using targeted questionnaires, whereas SARS-CoV-2 laboratory testing should be performed only in screen-positives: those with high clinical suspicion of COVID-19 and/or suspected epidemiological history.

scholarly journals Haemostatic and thrombo-embolic complications in pregnant women with COVID-19: a systematic review and critical analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Juliette Servante ◽  
Gill Swallow ◽  
Jim G. Thornton ◽  
Bethan Myers ◽  
Sandhya Munireddy ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Pregnant Women ◽  
Clinical Evidence ◽  
Case Reports ◽  
Standard Form ◽  
Test Results ◽  
Maternal Deaths ◽  
High Clinical Suspicion ◽  
Increased Risk ◽  
Definition Of

Abstract Background As pregnancy is a physiological prothrombotic state, pregnant women may be at increased risk of developing coagulopathic and/or thromboembolic complications associated with COVID-19. Methods Two biomedical databases were searched between September 2019 and June 2020 for case reports and series of pregnant women with a diagnosis of COVID-19 based either on a positive swab or high clinical suspicion where no swab had been performed. Additional registry cases known to the authors were included. Steps were taken to minimise duplicate patients. Information on coagulopathy based on abnormal coagulation test results or clinical evidence of disseminated intravascular coagulation (DIC), and on arterial or venous thrombosis, were extracted using a standard form. If available, detailed laboratory results and information on maternal outcomes were analysed. Results One thousand sixty-three women met the inclusion criteria, of which three (0.28, 95% CI 0.0 to 0.6) had arterial and/or venous thrombosis, seven (0.66, 95% CI 0.17 to 1.1) had DIC, and a further three (0.28, 95% CI 0.0 to 0.6) had coagulopathy without meeting the definition of DIC. Five hundred and thirty-seven women (56%) had been reported as having given birth and 426 (40%) as having an ongoing pregnancy. There were 17 (1.6, 95% CI 0.85 to 2.3) maternal deaths in which DIC was reported as a factor in two. Conclusions Our data suggests that coagulopathy and thromboembolism are both increased in pregnancies affected by COVID-19. Detection of the former may be useful in the identification of women at risk of deterioration.

Two-Tier Lyme Disease Serology Test Results Can Vary According to the Specific First-Tier Test Used

2019 ◽  
Vol 9 (2) ◽  
pp. 128-133 ◽  
Author(s):  
Alexandra B Maulden ◽  
Aris C Garro ◽  
Fran Balamuth ◽  
Michael N Levas ◽  
Jonathan E Bennett ◽  
...  
Keyword(s):  
Emergency Department ◽  
Lyme Disease ◽  
Serum Sample ◽  
Erythema Migrans ◽  
Clinical Suspicion ◽  
Test Results ◽  
Number Of Children ◽  
High Clinical Suspicion ◽  
Serology Test ◽  
Test Result

Abstract Background Variability in 2-tier Lyme disease test results according to the specific first-tier enzyme immunoassay (EIA) in children has not been examined rigorously. In this study, we compared paired results of clinical 2-tier Lyme disease tests to those of the C6 peptide EIA followed by supplemental immunoblotting (C6 2-tier test). Methods We performed a prospective cohort study of children aged ≥1 to ≤21 years who were undergoing evaluation for Lyme disease in the emergency department at 1 of 6 centers located in regions in which Lyme disease is endemic. The clinical first-tier test and a C6 EIA were performed on the same serum sample with supplemental immunoblotting if the first-tier test result was either positive or equivocal. We compared the results of the paired clinical and C6 2-tier Lyme disease test results using the McNemar test. Results Of the 1714 children enrolled, we collected a research serum sample from 1584 (92.4%). The clinical 2-tier EIA result was positive in 316 (19.9%) children, and the C6 2-tier test result was positive or equivocal in 295 (18.6%) children. The clinical and C6 2-tier test results disagreed more often than they would have by chance alone (P = .002). Of the 39 children with either a positive clinical or C6 2-tier test result alone, 2 children had an erythema migrans (EM) lesion, and 29 had symptoms compatible with early disseminated Lyme disease. Conclusions Two-tier Lyme disease test results differed for a substantial number of children on the basis of the specific first-tier test used. In children for whom there is a high clinical suspicion for Lyme disease and who have an initially negative test result, clinicians should consider retesting for Lyme disease.

scholarly journals Perfil das gestantes de alto risco hospitalizadas em uma maternidade: estudo descritivo

2017 ◽  
Vol 16 (2) ◽  
pp. 218
Author(s):  
Rosangela De Oliveira Azevedo ◽  
Helen Campos Ferreira ◽  
Zenith Rosa Silvino ◽  
Barbara Pompeu Christovam
Keyword(s):  
General Practice ◽  
High Risk ◽  
Pregnant Women ◽  
Medical Records ◽  
Maternity Hospital ◽  
Descriptive Statistics ◽  
Metropolitan Region ◽  
N 93 ◽  
Living Children ◽  
Region Ii

Aim:  to describe  the  profile  of  high-risk  pregnant  women  attending the  HUAP  maternity  hospital.  Method:  descriptive,  retrospective  and  documentary research, with a quantitative approach, performed at a hospital in Niterói/RJ. Data were collected in 2013, through 148 medical records of high-risk pregnant women admitted to the  hospital, from  July  1, 2011 to  June  30,  2012,  and treated  by  descriptive  statistics. Results:  the majority  of  the  pregnant  women were  young  (up  to 30 years  old),  with  a companion  and  resided  in  the  metropolitan  region  II/RJ.  Half  of  them  had  one  or  two living children; 59.5% were multigravida; 79.1% had never aborted; and, among those who  showed  previous  delivery  (n=93),  64.5%  had  submitted  to  cesarean  section. Regarding prenatal care, 93.3% presented attendance to the appointments. Most of the pregnant  women  went  to  the  hospital  through  their  own  choice (42.6%)  as  they presented  symptoms  of  general  practice. Fifty-nine cases  were identified 59 causes  for hospitalization,  with  higher  occurrence  due  to  premature  amniorrexis  and  arterial hypertension.  Conclusion:  the  presented  results  can  trigger  proposals  of  protocols  of attendance and monitoring of this clientele.

scholarly journals Covid-19 and pregnancy: the experience of a tertiary maternity hospital

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Panagiotis Antsaklis ◽  
Konstantinos Tasias ◽  
Alexandros Psarris ◽  
Marianna Theodora ◽  
George Daskalakis ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Medical Records ◽  
Clinical Status ◽  
Maternity Hospital ◽  
Neonatal Outcomes ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Neonatal Deaths ◽  
Maternal And Neonatal Outcomes ◽  
Polymerase Chain

Abstract Objectives The aim of our study is to present the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pregnancy and evaluate its impact on maternal and neonatal outcomes. Methods We retrospectively reviewed the medical records of all COVID-19 positive pregnant women who were admitted to “Alexandra” maternity hospital from March to December 2020 (n=40). The infection status was determined via real-time polymerase chain reaction (RT-PCR) of nasopharyngeal swab specimen. We documented the demographic features, clinical status, pregnancy characteristics and maternal and fetal outcomes. Results Forty COVID-19 positive pregnant women were admitted to our clinic during the study period. Mean maternal age was 27.6 years. Gestational age (GA) ranged from 10–42 weeks of pregnancy with mean GA calculated at 38+3 weeks. Associated comorbidities included hypertension, hypothyroidism, epilepsy, hepatitis B and asthma. Thirty-five out of 40 women delivered within the study period. Cesarean section was performed in 57.1% of the cases. Most of the cases (87.5%) were asymptomatic while ventilation was required for only one patient. All neonates tested negative for SARS-CoV-2. Neither maternal nor neonatal deaths occurred. Conclusions In alignment to other studies, our data show that the course of coronavirus disease 2019 (COVID-19) during pregnancy in the majority of cases is mild and neonatal outcomes also appear favorable.

scholarly journals Otolaryngology Providers Must Be Alert for Patients with Mild and Asymptomatic COVID-19

2020 ◽  
Vol 162 (6) ◽  
pp. 809-810 ◽  
Author(s):  
Xiaoting Cheng ◽  
Jialin Liu ◽  
Ning Li ◽  
Eric Nisenbaum ◽  
Qing Sun ◽  
...  
Keyword(s):  
Occupational Exposure ◽  
Personal Protective Equipment ◽  
High Efficiency ◽  
Clinical Suspicion ◽  
Protective Equipment ◽  
Disease Course ◽  
Asymptomatic Patients ◽  
High Clinical Suspicion ◽  
Protective Strategies

More than half of COVID-19 patients are afebrile early in the disease course, yet mildly ill or asymptomatic patients can still spread SARS-CoV-2 with high efficiency. Atypically presenting patients may be seen in noninfectious disease settings such as otolaryngology, which is a specialty prone to occupational exposure. Otolaryngologists have been infected with COVID-19 at higher rates than other specialties in China and other countries. Otolaryngology providers should maintain high clinical suspicion for mild and asymptomatic COVID-19 patients. Protective strategies should be implemented including preappointment screening, triaging, restriction of nonurgent visits and surgeries, telemedicine, and appropriate personal protective equipment use.

scholarly journals Universal SARS-Cov-2 Screening in Women Admitted for Delivery in a Large Managed Care Organization

2020 ◽  
Vol 37 (11) ◽  
pp. 1110-1114 ◽  
Author(s):  
Michael J. Fassett ◽  
Lawrence D. Lurvey ◽  
Lyn Yasumura ◽  
Marielle Nguyen ◽  
Joseph J. Colli ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Southern California ◽  
Hospital Inpatient ◽  
Care Organization ◽  
Test Results ◽  
Kaiser Permanente ◽  
Universal Testing ◽  
Outpatient Physician ◽  
Key Points ◽  
Integrated Health Care System

Objective The coronavirus disease 2019 (COVID-19) pandemic has created a need for data regarding the prevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pregnant women. After implementing universal screening for COVID-19 in women admitted for delivery, we sought to describe the characteristics of COVID-19 in this large cohort of women. Study Design An observational study of women admitted to labor and delivery units in Kaiser Permanente Southern California (KPSC) hospitals between April 6 and May 11, 2020 who were universally offered testing for SARS-CoV-2 infection (n = 3,963). Hospital inpatient and outpatient physician encounter, and laboratory records were used to ascertain universal testing levels, test results, and medical and obstetrical histories. The prevalence of SARS-CoV-2 infection was estimated from the number of women who tested positive during labor per 100 women delivered. Results Of women delivered during the study period, 3,923 (99.0%) underwent SARS-CoV-2 testing. A total of 17 (0.43%; 95% confidence interval: 0.23–0.63%) women tested positive, and none of them were symptomatic on admission. There was no difference in terms of characteristics between SARS-CoV-2 positive and negative tested women. One woman developed a headache attributed to COVID-19 3 days postpartum. No neonates had a positive test at 24 hours of life. Conclusion The findings suggest that in pregnant women admitted for delivery between April 6 and May 11, 2020 in this large integrated health care system in Southern California, prevalence of SARS-CoV-2 test positive was very low and all patients were asymptomatic on admission. Key Points

scholarly journals Aspectos relacionados às internações por intercorrências gestacionais

2021 ◽  
Vol 11 (4) ◽  
Author(s):  
Flávia Daniele de Alencar Medeiros ◽  
Monaliza De Goes e Silva ◽  
Jaqueline Carvalho e Silva Sales ◽  
Samila Gomes Ribeiro ◽  
Fernando José Guedes da Silva Júnior ◽  
...  
Keyword(s):  
High Risk ◽  
Marital Status ◽  
Pregnant Women ◽  
Pregnancy Complications ◽  
Medical Records ◽  
Maternity Hospital ◽  
Severe Preeclampsia ◽  
P Value ◽  
Las Mujeres ◽  
And Control

Objetivo: Analisar aspectos relacionados às internações por intercorrências gestacionais.  Método: Estudo quantitativo, retrospectivo, realizado em maternidade pública de Teresina, Piauí, Brasil, com 367 prontuários de gestantes internadas na ala de alto risco, no período de 2015-2016. Realizou-se análises descritivas e inferenciais. Resultados: Gestantes possuíam média de 25,1 anos (Desvio padrão=7,2), a maioria com companheiro (68,4%), ensino fundamental incompleto (32,7%), do lar (58,6%) e procedentes do interior do Piauí (47,7%). As intercorrências gestacionais mais frequentes foram: Pré-eclâmpsia Grave (33,9%), Amniorrexe Prematura (16,4%) e Oligohidramnio (16,1%). Os aspectos relacionados à Pré-eclâmpsia Grave foram faixa etária (p-valor=0,03) e situação conjugal (p-valor=0,03); à Amniorrexe Prematura foram situação conjugal (p-valor=0,01), procedência (p-valor=0,03) e Infecção do Trato Urinário (p-valor<0,01); e, ao Oligohidramnio associado à procedência (p-valor=0,01). Conclusão: A assistência no período pré-natal, parto e puerpério deve ser recurso utilizado na prevenção e controle de intercorrências que podem atenuar danos ao binômio mãe e filho.Descritores: Gestantes; Complicações na Gravidez; Gravidez de Alto Risco; Enfermagem.Related aspects with hospitalizations due to pregnancy complications Objective: To analyze aspects related to hospitalizations due to pregnancy complications. Method: Quantitative, retrospective study, carried out in a public maternity hospital in Teresina, Piauí, Brazil, with 367 medical records of pregnant women hospitalized in the high-risk ward, in the period 2015-2016. Descriptive and inferential analyzes were carried out. Results: Pregnant women had an average of 25.1 years (standard deviation = 7.2), most with a partner (68.4%), incomplete elementary school (32.7%), home (58.6%) and coming from from the interior of Piauí (47.7%). The most frequent gestational complications were: Severe Preeclampsia (33.9%), Premature Amniorrexis (16.4%) and Oligohydramnios (16.1%). The aspects related to severe preeclampsia were age group (p-value = 0.03) and marital status (p-value = 0.03); Premature Amniorrexis were marital status (p-value = 0.01), origin (p-value = 0.03) and Urinary Tract Infection (p-value <0.01); and the Oligohydramnium associated with the origin (p-value = 0.01). Conclusion: Assistance in the prenatal, childbirth and puerperium period should be a resource used in the prevention and control of complications that can mitigate damage to the mother and child.Descriptors: Pregnant Women; Pregnancy Complications; Pregnancy, High-Risk; Nursing.Aspectos relacionados con hospitalizaciones por complicaciones del embarazo Objetivo: analizar aspectos relacionados con las hospitalizaciones por complicaciones del embarazo. Métodos: Estudio cuantitativo, retrospectivo, realizado en un hospital público de maternidad en Teresina, Piauí, Brasil, con 367 registros médicos de mujeres embarazadas hospitalizadas en la sala de alto riesgo, en el período 2015-2016. Se realizaron análisis descriptivos e inferenciales. Resultados: las mujeres embarazadas tuvieron un promedio de 25.1 años (desviación estándar = 7.2), la mayoría con una pareja (68.4%), escuela primaria incompleta (32.7%), desde casa (58.6%) y provenientes de del interior de Piauí (47.7%). Las complicaciones gestacionales más frecuentes fueron: preeclampsia severa (33.9%), amniorrexis prematura (16.4%) y oligohidramnios (16.1%). Los aspectos relacionados con la preeclampsia severa fueron el grupo de edad (valor p = 0.03) y el estado civil (valor p = 0.03); La amniorrexis prematura fue el estado civil (valor p = 0.01), el origen (valor p = 0.03) y la infección del tracto urinario (valor p <0.01); y el oligohidramio asociado con el origen (valor p = 0.01). Conclusión: La asistencia en el período prenatal, de parto y puerperio debe ser un recurso utilizado en la prevención y el control de complicaciones que pueden mitigar el daño a la madre y al niño.Descriptores: Mujeres embarazadas; Complicaciones del embarazo; Embarazo de alto riesgo; Enfermería.

scholarly journals MATERNAL OBESITY INCREASES RISK OF PREECLAMPSIA AND DIABETES MELLITUS

2021 ◽  
Vol 31 (2) ◽  
pp. 44
Author(s):  
Naura Ega Kahayani ◽  
Hermanto Tri Joewono ◽  
Rio Wironegoro
Keyword(s):  
Pregnant Women ◽  
Sample Size ◽  
Medical Records ◽  
Maternal Obesity ◽  
Sample Size Calculation ◽  
Test Results ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test ◽  
Grade Iii

Background: Obesity in pregnant women has been linked to negative outcomes for both the mother and the fetus. Gestational diabetes, preeclampsia, and postpartum haemorrhage are all threats for mothers during pregnancy. These may also affect labor outcomes because fat accumulation in the pelvis makes obese pregnant women more likely to have a caesarean section. Objective: To analyze the outcome of maternal obesity in pregnancy in 2017. Materials and Methods: This was an analytic cross-sectional, observational study in pregnant women with obesity in Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, within the period of January 1st – December 31st 2017 using medical records. Sample size was determined using cross-sectional sample size calculation with the result of n=162. After receiving approval of ethical clearance, medical records were collected and analyzed. The statistical analysis was done using chi-square test. Results: From a total of 162 subjects, most of the patients were 21-34 y/o (56.8%), under graduate (90.7%) and 58% of the subjects worked. Proportion of grade I, II and III were 60.5%, 22.2%, and 17.3%, and 67% suffered from complications such as PE, DM, PE with DM with percentages as follows: 56.2%, 4.9%, and 6.2%. Neonatal complications were preterm 42.6%, macrosomia 4.3%, stillbirth 4.9%, and low Apgar score 48.1%. No association was identified between maternal age and complications in grade I (p=0.764) and grade III (p=0.716). Obesity grades I and III had correlation with complications (p=0.035). Conclusion: No significant association was found between age and complications in grade III obesity, while there was significant correlation between obesity levels (grade I and grade III) and complications.

scholarly journals AB0430 CONTRIBUTION OF SCLERODERMA/MYOSITIS-RELATED ANTIBODIES DETECTED BY IMMUNOBLOT TO THE DIAGNOSIS OF SYSTEMIC AUTOIMMUNE RHEUMATIC DISEASES IN 134 PATIENTS FROM A SINGLE REFERRAL CENTER

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1243.2-1244
Author(s):  
D. Prieto-Peña ◽  
B. Atienza-Mateo ◽  
M. A. González-Gay ◽  
R. Blanco ◽  
M. Lopez-Hoyos
Keyword(s):  
Rheumatic Diseases ◽  
Lupus Erythematosus ◽  
Medical Records ◽  
Inflammatory Diseases ◽  
Clinical Suspicion ◽  
Autoimmune Rheumatic Diseases ◽  
High Clinical Suspicion ◽  
Necrotizing Myositis ◽  
Specific Symptoms

Background:Immunoblot assays are increasingly used in clinical practice as part of the diagnostic armamentarium of systemic autoimmune rheumatic diseases (SARDs).Objectives:To assess the contribution of an extended scleroderma/myositis-related antibodies (Ab) determination by immunoblot to the diagnosis of patients with SARDs.Methods:We reviewed all medical records of patients with positive scleroderma/myositis-related Ab line blot determinations (Euroimmune AG, Lübeck, Germany) in our center from November 2017 to September 2020. These assays were requested due to high suspicion of SARDs in patients presenting with non-specific symptoms.Results:134 patients (37men/97women; mean age 59.6 ± 14.8 years) were positive for at least 1 Ab, 25 of them were positive for 2 Abs. Main clinical features at the time of immunoblot requests were: arthralgia/arthritis (n=88), Raynaud’s phenomenon (n=59), rash (n=27), sicca syndrome (n=14.9%), myopathy (n=18). During follow-up, 28 patients were diagnosed with undifferentiated connective tissue disease (UCTD), 26 scleroderma, 23 overlap myositis, 18 interstitial pneumonia with autoimmune features (IPAF), 8 other inflammatory diseases, 8 Sjögren’s syndrome, 7 systemic lupus erythematosus, 5 dermatomyositis, 1 necrotizing myositis. In 10 patients the diagnosis of SARD was finally ruled out (Figure 1). Interstitial lung disease (ILD) was present in 50 patients, being particularly frequent in those with anti-PL12, anti-PL7 and anti-MDA5 Abs. Cancer was detected in 9 (6.7%) patients, 6 of them were anti-Ro52 + (Table 1).Conclusion:Immunoblot assays are of great help in the diagnosis of patients with high clinical suspicion of SARDs. While some Abs, such as anti-Ro52, anti-Ku and anti-PMScl75/100, remain to be nonspecific, other Abs including anti-PL12, anti-PL7 or anti-MDA5 are particularly helpful in detecting SARDs patients with associated ILD.References:Table 1.Mi-2 (n=5)PL-7(n=6)PL-12(n=4)Jo-1(n=6)MDA5(n=1)antiRo52(n=57)SRP (n=3)Scl-70(n=12)CENP(n=14)Th(n=2)Ku(n=14)Fibrilarina (n=2)PM-Scl75/100 (n=23)NOR90(n=8)RNA pol(n=2)ILD04 (66.7)4 (100)3 (50)1 (100)19 (33.3)07 (58.3)1 (7.1)07 (50)1 (50)9 (39.1)5 (62.5)0Cancer1 (20)00006 (10.5)1 (33.3)0001 (7.1)0000Disclosure of Interests:None declared

A Rare Case of Tuberculous Prostatitis

2016 ◽  
Vol 1 (2) ◽  
pp. 33
Author(s):  
Nurul Yaqeen Mohd Esa ◽  
Mohammad Hanafiah ◽  
Marymol Koshy ◽  
Hilmi Abdullah ◽  
Ahmad Izuanuddin Ismail ◽  
...  
Keyword(s):  
Rare Case ◽  
Correct Diagnosis ◽  
Immunocompetent Patient ◽  
Clinical Suspicion ◽  
Tuberculosis Infection ◽  
Advanced Age ◽  
Immunocompromised Patients ◽  
Prostatic Biopsy ◽  
High Clinical Suspicion

Tuberculous prostatitis is an uncommon form of tuberculosis infection. It is commonly seen in immunocompromised patients and in those of middle or advanced age. The diagnosis is often not straight forward due to the nature of its presentation. We report a case of tuberculous prostatitis in a young, healthy and immunocompetent patient, who initially presented with respiratory features, followed by episodes of seizures and testicular swelling. He was finally diagnosed with tuberculous prostatitis after prostatic biopsy. This case illustrates that in a high TB prevalence environment, when symptoms warrant, there should be a high clinical suspicion coupled with a thorough approach in order to arrive at a correct diagnosis of TB prostatitis.

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