A study to know the various causes of pleural effusion and role of pleural fluid adenosine deaminase enzyme in tuberculous pleural effusion

Background: India has the maximum burden of both non MDR tuberculosis (TB) and Multidrug-Resistant (MDR) TB, as per data reported in Global TB Report 2018 and tuberculosis is remains one of the most common cause of pleural effusions.Methods: This was a cross-sectional study conducted in Department of Respiratory Diseases and a total of 110 patients with pleural effusion were included in the study, which were enrolled for treatment from July 2018 to June 2019.Results: One hundred and ten patients with pleural effusion were enrolled during the study period. There were 65 males (59%) and 45 (40.9%) females. The overall mean age for males and females were 44.4±18.84 years (35-87 years) and 38.28±17.66 years (35-87 years) respectively. Tuberculous Pleural Effusion group (TPE) seen in 82 patients. Right sided pleural effusion (69.5 %) were more common than left sided (30.4 %). In TPE group the mean pleural fluid ADA level were 86.41±38.08 IU/L (range: 14-195 IU/L). The Malignant Pleural Effusion (MPE) group included 21 patients. In MPE group the mean pleural fluid ADA level were 34.10±32.88 IU/L (range: 8-144 IU/L). The difference in pleural fluid ADA levels between TPE and MPE group was statistically highly significant.Conclusions: Tuberculous pleural effusion was the most common cause of pleural effusion in present study and observed in 74.5% cases.

Download Full-text

IDENTIFICATION OF Mycobacterium tuberculosis BY POLYMERASE CHAIN REACTION (PCR) TEST AND ITS RELATIONSHIP TO MGG STAINING OF PLEURAL FLUID IN PATIENTS WITH SUSPECTED TUBERCULOUS PLEURAL EFFUSION

Nusantara Medical Science Journal ◽

10.20956/nmsj.v3i2.5778 ◽

2018 ◽

Vol 3 (2) ◽

pp. 18

Author(s):

Shelly Salmah ◽

Ariani Said Culla

Keyword(s):

Mycobacterium Tuberculosis ◽

Pleural Effusion ◽

Pleural Fluid ◽

Research Unit ◽

Cross Sectional Study ◽

Cross Sectional ◽

Tuberculous Pleural Effusion ◽

Cell Percentage ◽

The Difference ◽

Pcr Test

Pleural effusion is a condition characterized by the accumulation of excessive pleural fluid in pleural cavity as a result of transudation and exudation. The most commonly reported cause of exudative pleural effusion is Mycobaterium tuberculosis. This study was aimed to identify Mycobacterium tuberculosis in pleural fluid through PCR test and to examine the relationship between PCR test and MGG staining of pleural fluid in patients with suspected tuberculous pleural effusion, which was performed in Clinical Pathological Laboratory Installation of dr. Wahidin Sudirohusodo hospital in Makassar and Faculty Research Unit Laboratory in Hasanuddin University from March to November 2012. This study was a cross sectional study. Subjects in this study consisted of 75 patients (41 males and 34 females[AA1] ) with average age of 40-49 years (30.7%). Pleural effusion patients with suspected tuberculosis who had a positive PCR result was 58.7%, negative PCR result was 41.3% and positive rivalta result in 82.7%, negative rivalta result in 17.3%. Statistical analysis using independent T-test indicated a non-significant relationship between PCR test and average MN and PMN cell percentage in MGG staining (P > 0.005). This study concluded that in MGG staining, average MN cell percentage was higher in PCR TB (+) group compared to PCR (-) group, but the difference was not significant.

Download Full-text

Knowledge and practice of health workers about control and prevention of multidrug-resistant tuberculosis in referral hospitals, Ethiopia: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2018-022948 ◽

2019 ◽

Vol 9 (2) ◽

pp. e022948 ◽

Cited By ~ 3

Author(s):

Kefyalew Addis Alene ◽

Akilew Awoke Adane ◽

Sisay Yifiru ◽

Bikes Destaw Bitew ◽

Aynishet Adane ◽

...

Keyword(s):

Health Workers ◽

Multidrug Resistant ◽

Cross Sectional Study ◽

Cross Sectional ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis ◽

Mdr Tb ◽

History Of ◽

The Mean ◽

Knowledge And Practice

ObjectiveThe aim of this study was to assess the knowledge and practice of health workers about multidrug-resistant tuberculosis (MDR-TB) prevention and control.Study design and settingsA cross-sectional study was conducted at Gondar University Referral Hospital and Felege Hiwot Referral Hospital.ParticipantsRandomly selected health workers (ie, medical doctor, nurse, health officer, pharmacy, medical laboratory and midwifery) were the study participants.Outcome measuresThe main outcomes were knowledge and self-reported practice of health workers about MDR-TB.ResultsA total of 377 health workers (with a response rate of 93.7%) participated in the study. The majority of respondents were nurses (52.5%, n=198) and medical doctors (15.6%, n=59). The mean knowledge score was seven out of 10; 149 (39.5%) of respondents scored seven or more which was considered as good knowledge. MDR-TB knowledge of health workers was significantly associated with having a postgraduate degree (adjusted odds ratio (AOR)=5.78; 95% CI 2.33 to 14.33), taking infection prevention training (AOR=1.79; 95% CI 1.00, to 3.17) and having a history of tuberculosis (TB) (AOR=1.85; 95% CI 1.12, to 3.03). The mean self-reported practice score was four out of seven; one-fifth (19.6%) of respondents scored four or more which was considered as good practice. Self-reported practice of health workers was significantly associated with working at internal medicine (AOR=4.64; 95% CI 1.99, to 10.81) and paediatrics (AOR=3.85; 95% CI 1.11, to 13.34) wards, being in the age groups of 26–30 years (AOR=2.70; 95% CI 1.27, to 5.76), and 30 years and above (AOR=4.42; 95% CI 1.77, to 11.00).ConclusionsThis study found low knowledge and self-reported practice score among health workers. MDR-TB knowledge of health workers was significantly associated with educational status, infection prevention training and previous history of TB. This finding highlights the potential of providing MDR-TB training for health workers to increase their knowledge about MDR-TB.

Download Full-text

Comparison of Heffner Criteria and Light Criteria in Differentiating Exudative and Transudative Pleural Effusion

Nepal Medical College Journal ◽

10.3126/nmcj.v22i3.32638 ◽

2020 ◽

Vol 22 (3) ◽

pp. 141-145

Author(s):

Krishna Chandra Devkota ◽

S Hamal ◽

PP Panta

Keyword(s):

Pleural Effusion ◽

Cross Sectional Study ◽

Pleural Space ◽

Sectional Study ◽

Inclusion Criteria ◽

Cross Sectional ◽

Medical College ◽

The Common ◽

The Mean ◽

Exudative Pleural Effusion

Pleural effusion is present when there is >15ml of fluid is accumulated in the pleural space. It can be divided into two types; exudative and transudative pleural effusion. Tuberculosis and parapneumonic effusion are the common cause of exudative pleural effusion whereas heart failure accounts for most of the cases of transudative pleural effusion. This study was a hospital based cross sectional study performed at Nepal Medical College during the period of January 2016-December 2016. A total of 50 patients who fulfilled the inclusion criteria were enrolled. Pleural effusion was confirmed by clinical examination and radiology. After confirmation of pleural effusion, pleural fluid was aspirated and was analysed for protein, LDH, cholesterol. The Heffner criteria was compared with Light criteria to classify exudative or transudative pleural effusion. Among 50 patients, 30 were male and 20 were female. The mean age of patient was 45.4±21.85 years. The sensitivity and specificity of using Light criteria to detect the two type of pleural effusion was 100% and 90.9%, whereas using Heffner criteria was 94.87%, 100% respectively(P<0.01). There are variety of causes for development of pleural effusion and no one criteria is definite to differentiate between exudative or transudative effusion. In this study Light criteria was more sensitive whereas Heffner criteria was more specific to classify exudative pleural effusion. Hence a combination of criteria might be useful in case where there is difficulty to identify the cause of pleural effusion.

Download Full-text

Influence ofABCC2andABCC4Polymorphisms on Tenofovir Plasma Concentrations in Thai HIV-Infected Patients

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.04930-14 ◽

2015 ◽

Vol 59 (6) ◽

pp. 3240-3245 ◽

Cited By ~ 26

Author(s):

Kanokrat Rungtivasuwan ◽

Anchalee Avihingsanon ◽

Narukjaporn Thammajaruk ◽

Siwaporn Mitruk ◽

David M. Burger ◽

...

Keyword(s):

Body Weight ◽

Multivariate Analysis ◽

Plasma Concentration ◽

Protease Inhibitors ◽

Demographic Data ◽

Plasma Concentrations ◽

Multidrug Resistant ◽

Cross Sectional Study ◽

Cross Sectional ◽

The Mean

ABSTRACTTenofovir (TFV) is eliminated by renal excretion, which is mediated through multidrug-resistant protein 2 (MRP2) and MRP4, encoded byABCC2andABCC4, respectively. Genetic polymorphisms of these transporters may affect the plasma concentrations of tenofovir. Therefore, the aim of this study was to investigate the influence of genetic and nongenetic factors on tenofovir plasma concentrations. A cross-sectional study was performed in Thai HIV-infected patients aged ≥18 years who had been receiving tenofovir disoproxil fumarate at 300 mg once daily for at least 6 months. A middose tenofovir plasma concentration was obtained. Multivariate analysis was performed to investigate whether there was an association between tenofovir plasma concentrations and demographic data, including age, sex, body weight, estimated glomerular filtration rate (eGFR), hepatitis B virus coinfection, hepatitis C virus coinfection, duration of tenofovir treatment, concomitant use of ritonavir-boosted protease inhibitors, and polymorphisms ofABCC2andABCC4. A total of 150 Thai HIV-infected patients were included. The mean age of the patients was 43.9 ± 7.2 years. The mean tenofovir plasma concentration was 100.3 ± 52.7 ng/ml. In multivariate analysis, a low body weight, a low eGFR, the concomitant use of ritonavir-boosted protease inhibitors, and theABCC44131T → G variation (genotype TG or GG) were independently associated with higher tenofovir plasma concentrations. After adjusting for weight, eGFR, and the concomitant use of ritonavir-boosted protease inhibitors, a 30% increase in the mean tenofovir plasma concentration was observed in patients having theABCC44131 TG or GG genotype. Both genetic and nongenetic factors affect tenofovir plasma concentrations. These factors should be considered when adjusting tenofovir dosage regimens to ensure the efficacy and safety of a drug. (This study has been registered at ClinicalTrials.gov under registration no. NCT01138241.)

Download Full-text

Cross-sectional study to compare the biochemical parameters in low normal versus high normal plasma glucose levels in euglycemic individuals

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20202117 ◽

2020 ◽

Vol 7 (6) ◽

pp. 997

Author(s):

Dharmendra Jhavar ◽

Neha Kirti ◽

Sumit Kumar Vishwakarma ◽

Umesh Kumar Chandra ◽

Vinod Verma

Keyword(s):

Uric Acid ◽

Total Cholesterol ◽

General Medicine ◽

Cross Sectional Study ◽

Normal Group ◽

P Value ◽

Sectional Study ◽

Cross Sectional ◽

The Mean ◽

The Difference

Background: Since a long time ago, the experts have realized that determination of cut-off point for diagnosing diabetes will be revised over time with the lower blood glucose level as the more sensitive diagnosis for detecting the occurring complication and biochemical changes.Methods: This cross sectional study was carried out in the department of medicine, M.G.M. Medical College and M.Y. Hospital Indore from July, 2016 to August, 2017 in 200 individuals and patients having euglycemic status attending General Medicine OPD.Results: In the low and high normal group 2 (2.0%) and 8 (8.0%) were having abnormal total cholesterol (TC) level respectively. The mean total cholesterol in the low normal group was 117.16±26.94mg/dl and it was 154.74±28.38mg/dl in the high normal group. The difference was found to be statistically significant (p value 0.000). In the low and high normal group, 4 (4.0%) and 17 (17.0%) were having abnormal triglyceride (TG) levels respectively. The mean TG levels in the low and high normal group were 96.93±22.64mg/dl and 110.55±32.37mg/dl respectively. The difference was found to be statistically significant (p value 0.001). In the low and high normal group, 6 (6.0%) and 14 (14.0%) patient was having abnormal uric acid levels respectively. The mean uric acid levels in the low and high normal group was 4.88±1.10mg/dl and 5.31±1.31mg/dl respectively. The difference was found to be statistically significant (p value 0.013).Conclusions: Higher levels of Cholesterol and Triglycerides were found more commonly in high normal euglycemic group compared to low normal euglycemic group. Mean cholesterol and mean triglyceride levels were higher in high normal euglycemic group.

Download Full-text

Association of 12-Month Contraceptive Supply Policy and Months of Oral Contraception Prescribed by Obstetrics and Gynecology Physicians: An Exploratory Cross-Sectional Study

10.21203/rs.3.rs-1050772/v1 ◽

2021 ◽

Author(s):

Megan Fuerst ◽

Kaitlin Schrote ◽

Bharti Garg ◽

Maria Rodriguez

Keyword(s):

The United States ◽

Cross Sectional Study ◽

Oral Contraception ◽

Physician Education ◽

Cross Sectional ◽

Convenience Sample ◽

Supply Policy ◽

The Mean ◽

The Difference ◽

United States Standard

Abstract Objective This study sought to determine if there was a difference in the months of oral contraception prescribed by physicians living in U.S. states with a 12-month supply policy compared to physicians in states without a policy. Methods We conducted an exploratory descriptive study using a convenience sample of Obstetrics & Gynecology resident physicians (n=275) in the United States. Standard bivariate analyses were used to compare the difference between groups. Results Few physicians in both groups (3.8% with a policy and 1.4% without a policy) routinely prescribed a 12-month supply of contraception. The mean coverage prescribed by providers in states with and without a policy was 2.81 and 2.07 months (p<0.05). Conclusions The majority of physicians were unaware of 12-month contraceptive supply policies and unable to correctly write a prescription for 12-months of contraception, regardless of whether they lived in a state with a 12-month contraceptive supply policy. Physician education may be needed to effectively implement 12-month contraceptive supply policies.

Download Full-text

Feasibility of Identifying Household Contacts of Rifampin-and Multidrug-resistant Tuberculosis Cases at High Risk of Progression to Tuberculosis Disease

Clinical Infectious Diseases ◽

10.1093/cid/ciz235 ◽

2019 ◽

Vol 70 (3) ◽

pp. 425-435 ◽

Cited By ~ 1

Author(s):

Amita Gupta ◽

Susan Swindells ◽

Soyeon Kim ◽

Michael D Hughes ◽

Linda Naini ◽

...

Keyword(s):

High Risk ◽

Multidrug Resistant ◽

Cross Sectional Study ◽

Preventive Therapy ◽

Interferon Gamma Release Assay ◽

Cross Sectional ◽

Household Contacts ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis ◽

Mdr Tb

Abstract Background We assessed multidrug-resistant tuberculosis (MDR-TB) cases and their household contacts (HHCs) to inform the development of an interventional clinical trial. Methods We conducted a cross-sectional study of adult MDR-TB cases and their HHCs in 8 countries with high TB burdens. HHCs underwent symptom screenings, chest radiographies, sputum TB bacteriologies, TB infection (TBI) testing (tuberculin skin test [TST] and interferon gamma release assay [IGRA]), and human immunodeficiency virus (HIV) testing. Results From October 2015 to April 2016, 1016 HHCs from 284 MDR-TB cases were enrolled. At diagnosis, 69% of MDR-TB cases were positive for acid-fast bacilli sputum smears and 43% had cavitary disease; at study entry, 35% remained smear positive after a median MDR-TB treatment duration of 8.8 weeks. There were 9 HHCs that were diagnosed with TB prior to entry and excluded. Of the remaining 1007 HHCs, 41% were male and the median age was 25 years. There were 121 (12%) HHCs that had new cases of TB identified: 17 (2%) were confirmed, 33 (3%) probable, and 71 (7%) possible TB cases. The TBI prevalence (defined as either TST or IGRA positivity) was 72% and varied by age, test used, and country. Of 1007 HHCs, 775 (77%) were considered high-risk per these mutually exclusive groups: 102 (10%) were aged <5 years; 63 (6%) were aged ≥5 and were infected with HIV; and 610 (61%) were aged ≥5 years, were negative for HIV or had an unknown HIV status, and were TBI positive. Only 21 (2%) HHCs were on preventive therapy. Conclusions The majority of HHCs in these high-burden countries were at high risk of TB disease and infection, yet few were receiving routine preventive therapy. Trials of novel, preventive therapies are urgently needed to inform treatment policy and practice.

Download Full-text

Assessment of Knowledge and Attitude of Tuberculosis Patients in Direct Observation Therapy Program towards Multidrug-Resistant Tuberculosis in Addis Ababa, Ethiopia: A Cross-Sectional Study

Tuberculosis Research and Treatment ◽

10.1155/2020/6475286 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Firew Tadesse Kusheno ◽

Teklehaimanot Mezgebe Nguse ◽

Gebremedhin Beedemariam Gebretekle

Keyword(s):

Addis Ababa ◽

Multidrug Resistant ◽

Cross Sectional Study ◽

Cross Sectional ◽

Therapy Program ◽

Resistant Tuberculosis ◽

Multidrug Resistant Tuberculosis ◽

Health Centres ◽

Mdr Tb ◽

Knowledge And Attitude

Background. Multidrug-resistant tuberculosis (MDR-TB) is becoming a major challenge of tuberculosis (TB) control program globally but more serious in developing countries like Ethiopia. In 2013, a survey result showed that in Ethiopia, tuberculosis patients from new cases and retreatment cases had resistance to at least isoniazid and rifampicin with a significant increase over time. Inadequate knowledge and wrong perception about MDR-TB by patients were detrimental to TB control programs. The study aimed at assessing the knowledge and attitude of TB patients of direct observation therapy program towards multidrug-resistant tuberculosis in health centres of Addis Ababa, Ethiopia. Methods. A cross-sectional study was conducted in 10 health centres of Addis Ababa which were selected by simple random sampling technique. A total of 422 TB patients were included in the study, and participants from each health centres were taken proportional to the number of clients in each health centres. Data was entered and analyzed using SPSS version 20. Association between outcome and independent variables was explored using logistic regression. Results. The level of knowledge of TB patients about MDR-TB was poor and only 55.0% of TB patients attained good overall knowledge. A significant association was found between good knowledge and attending tertiary level of education (AOR=4.3, 95%CI=1.9, 9.8), gender (AOR=1.62, 95%CI=1.1, 2.4), income of respondents’ family (OR=0.4, 95%CI=0.2, 0.9), and sleeping practice (AOR=8.0, 95%CI=4.0, 15.7). Nearly three-fourths (73.5%) of TB patients had a favourable attitude towards MDR-TB. Occupational status (AOR=4.4, 95%CI=2.5, 7.6) and sleeping practices (AOR=2.4, 95%CI=1.2, 5.0) were significantly associated with the attitude of the TB patients. Conclusions. Knowledge of TB patients toward MDR-TB was poor. Although a large proportion of patients had a favourable attitude, it still needs to be improved. Hence, efforts should be made to implementing health education to improve awareness of TB patients about MDR-TB.

Download Full-text

Prevalence of Extensively Drug Resistant Tuberculosis among Archived Multidrug Resistant Tuberculosis Isolates in Zimbabwe

Tuberculosis Research and Treatment ◽

10.1155/2014/349141 ◽

2014 ◽

Vol 2014 ◽

pp. 1-8 ◽

Cited By ~ 4

Author(s):

Tichaona Sagonda ◽

Lucy Mupfumi ◽

Rumbidzai Manzou ◽

Beauty Makamure ◽

Mqondisi Tshabalala ◽

...

Keyword(s):

Genetic Diversity ◽

Drug Resistance ◽

Multidrug Resistant ◽

Cross Sectional Study ◽

Second Line ◽

Cross Sectional ◽

Resistant Tuberculosis ◽

Resistance Patterns ◽

Mdr Tb ◽

Definition Of

We conducted a cross-sectional study of second line drug resistance patterns and genetic diversity of MDR-TB isolates archived at the BRTI-TB Laboratory, Harare, between January 2007 and December 2011. DSTs were performed for second line antituberculosis drugs. XDR-TB strains were defined as MDR-TB strains with resistance to either kanamycin and ofloxacin or capreomycin and ofloxacin. Strain types were identified by spoligotyping. No resistance to any second line drugs was shown in 73% of the isolates, with 23% resistant to one or two drugs but not meeting the definition of XDR-TB. A total of 26 shared types were identified, and 18 (69%) matched preexisting shared types in the current published spoligotype databases. Of the 11 out of 18 clustered SITs, 4 predominant (>6 isolates per shared type) were identified. The most and least abundant types were SIT 1468 (LAM 11-ZWE) with 12 (18%) isolates and SIT 53 (T1) with 6 (9%) isolates, respectively. XDR-TB strains are rare in Zimbabwe, but the high proportion of “pre-XDR-TB” strains and treatment failure cases is of concern. The genetic diversity of the MDR-TB strains showed no significant association between SITs and drug resistance.

Download Full-text

Difference of Maternal Serum Interleukin-8 in Preterm Labor and Full Term Labor

Indonesian Journal of Obstetrics and Gynecology ◽

10.32771/inajog.v2i4.404 ◽

2016 ◽

Author(s):

Komang W Budiartha

Keyword(s):

Preterm Labor ◽

Cross Sectional Study ◽

Maternal Serum ◽

T Test ◽

Full Term ◽

Interleukin 8 ◽

Cross Sectional ◽

The Mean ◽

The Difference ◽

Term Labor

Objective: To determine the difference of maternal interleukin-8 (IL-8) in preterm labor and full term labor. Method: This is a cross sectional study with 68 samples, 29 subjects with preterm labor and 39 subjects with full term labor. IL-8 concentration was obtained from blood samples of the subjects, which were examined at Prodia Laboratory Denpasar. Data was analyzed using t-test for independent samples with =0.05. Result: The mean IL-8 level for the preterm labor group was 23.56 10.69 pg/ml and 12.19 5.79 pg/ml for the full term labor group. Statistical analysis using independent samples t-test showed that the average IL-8 level of both groups were significantly different (p=0.001). Conclusion: We concluded from this study that serum IL-8 concentration in women who had preterm labor is significantly higher in comparison to women who had full term labor. [Indones J Obstet Gynecol 2014; 4: 185-187] Keywords: full term labor, interleukin-8, preterm labor

Download Full-text