scholarly journals A study to assess the cholesterol levels in pleural fluid and its role in differentiate between exudative and transudate pleural effusion

2021 ◽  
Vol 6 (3) ◽  
pp. 165-168
Author(s):  
Raghurama Sharvegar ◽  
Chandrik Babu S R

The pathophysiology of the transudate pleural effusion occurs when the systemic factors are involved in the formation and absorption of plural effusion, where the source of pleural fluid is originating from Lung, Peritoneal or Pleural Cavity. The origin of exudative pleural fluid effusion is when capillaries or the pleural surfaces where the fluid originates gets altered. Hence when we the pleural fluid is found to be transudate further diagnostic evaluation is not required and treat the systemic disease affecting it and if the fluid is exudate we need to investigate further to find out the cause of effusion. To assess the role of pleural fluid cholesterol in differentiating exudative and transudative pleural effusion. : The present cross sectional study was conducted by the Department of Chest and Respiratory Medicine at Chamarajanagara Institute of Medical Sciences from March 2019 to December 2019. A total of 100 cases of clinically confirmed cases of pleural effusion cases were selected for the purpose of the study. Based on the Light’s Criteria the Pleural Fluid was analyzed and 94% of them were classified as exudates and 6% of them to be transudates and Pleural fluid cholesterol of more than 45mg/dl 74% of them were exudates and 26% of them were transudates. In the present study based on final diagnosis out of 74 subjects who were classified as exudates, 72 subjects were classified as exudates and misclassified 2 cases as transudate. Lights Criteria diagnosed only 4 cases as transudate pleural fluid among the 26 cases of transudate pleural fluid based on final diagnosis Light‘s criteria is the most accepted criteria for differentiating between exudates and transudate in pleural effusion. By the Present study we could conclude that the estimation of Pleural Cholesterol Level has good sensitivity, Positive Predictive Value than lights criteria in diagnosing exudative and transudate Pleural Fluid.

2019 ◽  
Vol 5 (4) ◽  
pp. 185-189
Author(s):  
Mohammadreza Emamhadi ◽  
◽  
Hamid Behzadnia ◽  
Seifollah Jafari ◽  
Mohammadreza Zamanidoust ◽  
...  

Background: Postoperative pain is a common phenomenon, and its management affects considerably on the recovery process, and patients’ satisfaction. Apotel and pethidine are two conventional medicines used to relieve pain after operation. Objectives: The present study aimed to compare the effect of intravenous injection of Apotel and intramuscular injection of pethidine in relieving pain after hemilaminectomy. Materials & Methods: In the present cross-sectional study, 150 patients who underwent hemilaminectomy were recruited between May 2015 and November 2015. They were taking either Apotel (n=75) or pethidine (n=75) after the operation, which was done at Poursina Hospital affiliated to Guilan University of Medical Sciences, Rasht City, Iran. The patients’ pain levels were measured using visual analog scale (VAS), and the results were compared between the 2 groups. Results: There was no significant difference in the total VAS score between the Apotel and pethidine groups (P=0.189). However, there was a significant reduction in VAS score hours 2 (P=0.03) and 4 (P=0.004) hours after the injection of Apotel in this group, compared with those scores in the pethidine group. Also, VAS scores at other times (8, 12, 20, 28 hours after the injection) were lower than those in the pethidine group, but the difference was not significant. Conclusion: Apotel was better pain-killer in the early hours after the first injection compared to pethidine. But its effect was similar to pethidine at the late hours after the first injection. Therefore it seems that Apotel is better painkiller after laminectomy, especially in the early hours after the operation.


Author(s):  
Avdhesh Kumar ◽  
Brijesh Kumar ◽  
Sanjay Kumar Verma ◽  
Anand Kumar ◽  
R. K. Mathur ◽  
...  

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.


2013 ◽  
Vol 5 (1) ◽  
pp. 26-27
Author(s):  
Mahmudul Hasan ◽  
Md Rafiqul Islam ◽  
Abdul Matin ◽  
Ranjit Ranjan Roy ◽  
Md Abdullah Yusuf ◽  
...  

Background: Pleural effusion occurs in many reasons. Laboratory tests are necessary to find out the causes. Objective: This study was an attempt to know the laboratory findings of pleural effusion. Methodology: This cross-sectional study of thirty (30) admitted cases with pleural effusion confirmed by chest radiography and aspiration of pleural fluid from one (1) year to twelve (12) years age of either sex were collected purposively. This study was carried out from July 2009 to February 2010 in the Department of Pediatrics at Rajshahi Medical College Hospital. All information were recorded in pre tested semi structured questionnaire. Results: Color of pleural fluid was straw in 56.7%, clear in 30.0%, blood stained in 13.3%. In this study, lymphocyte predominance among 56.7% cases, acid fast bacilli in 3.3% cases and raised protein of more than 3gm/dl and sugar less then 60mg/dl in 93.3% cases in pleural fluid. Conclusion: In almost all cases protein is raised and sugar is less in pleural fluid. DOI: http://dx.doi.org/10.3329/jssmc.v5i1.16201 J Shaheed Suhrawardy Med Coll, 2013;5(1):26-27


2018 ◽  
Vol 3 (2) ◽  
pp. 18
Author(s):  
Shelly Salmah ◽  
Ariani Said Culla

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. 


Author(s):  
Efelina Sutanto ◽  
Liong Boy Kurniawan ◽  
Fitriani Mangarengi

The aimed of this study is to compare the diagnostic value of pleural fluid total cholesterol and Light’s criteria to determine exudate or transudate. The samples used in this cross-sectional study were pleural fluid specimens sent to the Clinical Pathology Laboratory of the Dr.Wahidin Sudirohusodo Hospital Makassar during the period of August-September 2016. Data were grouped according to the type of effusion then statistically analyzed using nonparametric Mann Whitney U-test. The result of this study showed from 55 samples, there were 22 transudates and 33 exudates. The mean total cholesterol levels of exudate is higher than transudate (p=0.006). By using cut-off value of total cholesterol pleural fluid 56 mg/dL, it had sensitivity 72.7%; specificity 78.8%; Positive Predictive Value (PPV) 81.3% and Negative Predictive Value (NPV) 69.6% while Light’s criteria had sensitivity 97%; specificity 63.6%; PPV 80% and NPV 93.3%. Pleural fluid total cholesterol level with cut-off 56 mg/dL is proposed to be used for differentiating exudate and transudate because it is easier and more simple to perform than Light’s criteria.  


2019 ◽  
Author(s):  
Ali Almasi ◽  
Alireza Zangeneh ◽  
Shahram Saeidi ◽  
Arash Ziapour ◽  
Raziyeh Teimouri ◽  
...  

Abstract Background: Children are among the most vulnerable groups in society, whose health is of prominent significance. Moreover, as a group of clients with special needs in the health care system, they require special attention. Therefore, the present study aimed to investigate the 0-14-year-old children’s access to health centers in rural areas of Kermanshah Province, Iran. Methods: In the present cross-sectional study, both the latest published demographic statistics related to the Population and Housing Census, announced by the Statistical Center of Iran in 2011, and the information about the public and private hospitals in the province, collected by Kermanshah University of Medical Sciences, were used as the basis for the analyses. Additionally, given the importance of spatial nature of the research, GIS was used for data analysis, and a buffer model was also applied. Results: The results revealed that out of the total population of 0-14-year-old children residing in rural areas within 15,000 and 30,000-Kilometer radii of Kermanshah Province, 87.94% and 75.11% of girls versus 88.15% and 75.38% of boys lacked access to health centers, respectively. Conclusion: It was found out that the 0-14-year-old children’s access to health centers was in poor condition in rural areas of Kermanshah Province, which would endanger the health of this age group.


2012 ◽  
Vol 4 (1) ◽  
pp. 7-9
Author(s):  
M Hasan ◽  
MR Islam ◽  
A Matin ◽  
R Khan ◽  
M Rahman ◽  
...  

Background: Pleural effusion is a problem commonly encountered by chest physicians. Objective: This study was an attempt to know the clinical presentation in order to avoid delay in diagnosis that may influence treatment and outcome. Methods: This cross-sectional study of thirty (30) admitted cases with pleural effusion were confirmed by chest radiography and aspiration of pleural fluid from one (1) year to twelve (12) years age of either sex the patientdwere selected purposively, was studied from July 2009 to Feb 2010 in the Department of Pediatrics, Rajshahi Medical College Hospital . All information were recorded in pre tested semi structured questionnaire. Results: Positivity was higher in male children, (66.7%). Completely immunized were 56.7%. One third of cases were severely malnourished. History of respiratory distress & fever was present in 96.7%, cough in 90%. All cases had diminished chest movement, sub costal recession, and diminished breath sound on the affected side. Lobar consolidation was observed in 33.3% cases, patchy opacities in 53.3% cases. Fluid levels were observed in 76.7% cases. Color of pleural fluid was straw in 56.7%, clear in 30.0%, blood stained in 13.3%. Conclusion: History and good clinical examination can diagnose pleural effusion. DOI: http://dx.doi.org/10.3329/jssmc.v4i1.11995 J Shaheed Suhrawardy Med Coll, 2012;4(1):7-9


Author(s):  
Praveen Radhakrishnan ◽  
S Mathanraj

Introduction: Pleural effusions, the result of the accumulation of fluid in the pleural space, are a major diagnostic problem due to its anatomical nature with no direct access. There is variation in management, depending on the pleural disease. The pleural effusion can either exhibit specific or nonspecific characteristics. Aim: To determine the clinical significance and diagnostic role of pleural fluid C-Reactive Protein (CRP) level in the aetiological diagnosis of exudative pleural effusion. Materials and Methods: This was a cross-sectional study performed during the study period of September 2013 to December 2014. A total of 53 Patients identified with pleural effusion were recruited in the study and pleural fluid was subjected for the measurement of CRP level. Pleural fluid CRP was assessed with CRP-Turbilatex-Quantitative turbidimetric immunoassay method which is based on the principle agglutination reaction. The data was subjected to statistical analysis using Epi info software version 3.4.3. The Receiver Operating Characteristic (ROC) curve was plotted to illustrate the diagnostic ability. The smallest cut-off value was the minimum observed test value minus 1, and the largest cut-off value was the maximum observed test value plus 1. All the other cut-off values were the averages of two consecutive ordered observed test values. Results: Among the 53 patients in the study, 42 had exudative effusions (79.20%) and 11 had transudative effusions (20.80%). The common cause of exudative effusion was tuberculosis 26 (61.90%), followed by 9 malignancy (21.40%) and 7 parapneumonic effusion (16.70%). In our study, the pleural fluid CRP was statistically significant (p<0.001) marker to differentiate exudative effusions with CRP-value <30 suggestive of malignancy, CRP-value 30-50 mg/L suggestive of tuberculosis and CRP-value >70 mg/L suggestive of parapneumonic effusions. Conclusion: Determination of pleural fluid CRP is a useful diagnostic marker for differentiating exudative and transudative effusions. Also, Pleural fluid CRP is a statistically significant marker in differentiating tubercular effusions from nontubercular exudative effusions.


2021 ◽  
Vol 6 (3) ◽  
pp. 169-172
Author(s):  
Raghurama Sharvegar ◽  
Chandrik Babu S R

The cause of pleural effusion is due to systemic or localized pathology and based on the etiology involved the pleural effusion is either classified into transudate and exudate supported by Light’s Criteria. Other than the marker used in Lights Criteria C reactive protein is said to be studied to determine its role in classifying exudate and transudate. The present study was done to assess the role of C reactive protein in diagnosing pleural effusion.The cross-sectional study was conducted by the Department of Chest and Respiratory Medicine at Chamarajanagara Institute of Medical Sciences from June 2019 to May 2020. A total of 120 cases of clinically confirmed cases of Pleural Effusion Cases were selected for the purpose of the study among the outpatient and inpatient in the Department of General Medicine and Respiratory Medicine Department. The Mean CRP of 1.05±1.09 was found to be cut off value for differentiating between transudate and exudate Pleural fluid. At the Cut off value of 1.05 CRP it was found to be having a sensitivity of 75.4% and 77.6% of sensitivity. From the present study we could conclude that the CRP Value of 1.05mg/dl was found to be having a good specificity and sensitivity in classifying the pleural fluid into transudate and exudate. Finally we could conclude that CRP can be used as a Biomarker to differentiate between Transudate and Exudate when Lights criteria falls in borderline.


2021 ◽  
Vol 8 (4) ◽  
pp. 492
Author(s):  
Venny Singgih ◽  
Ketut Suryana ◽  
Ida Ayu Jasminarti Dwi Kusumawardani ◽  
Ni Wayan Candrawati ◽  
I. Gede Ketut Sajinadiyasa ◽  
...  

Background: Pleural effusion is caused by various disease, including tuberculosis infection and malignancy. To determine the etiology, immunologic parameters are needed to distinguish tuberculous and malignant pleural effusions, including pleural fluid interleukin-6 (IL-6), neutrophil-lymphocyte ratio (NLR), and monocyte-lymphocyte ratio (MLR).Methods: This was a cross-sectional study, conducted at Sanglah General Hospital in Denpasar from March 2020 to September 2020. Pleural fluid IL-6 and leucocyte differential count were measured from subjects with tuberculous and malignant pleural effusions.Results: There were 22 tuberculous pleural effusion subjects with mean pleural fluid IL-6 9269.017±902.211 pg/ml, median (range) pleural fluid NLR 0.123 (0.044-9.449), and MLR 0.065 (0.044-0.355). There were 31 subjects with malignant pleural effusions, with mean pleural fluid IL-6 8212.146±2022.350 pg/ml, median pleural fluid NLR 0.189 (0.015-2.599), and MLR 0.065 (0.010-0.254). Pleural fluid IL-6 in tuberculous pleural effusions were significantly higher (p=0.014). With a pleural fluid IL-6 cut-off ≥9147.959 pg/ml, sensitivity of 63.6% and specificity of 64.5% were obtained. Pleural fluid NLR and MLR of the two groups were not significantly different (p=0.807 and p=0.116).Conclusions: Pleural fluid IL-6 in tuberculous pleural effusions is higher than malignant pleural effusions, with a cut-off of ≥9147.959 pg/ml, tuberculous pleural effusions can be diagnosed with sensitivity of 63.6% and specificity of 64.5%. There is no difference in pleural fluid NLR and MLR in tuberculous and malignant pleural effusions.  


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