scholarly journals 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

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. 

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

2020 ◽  
Vol 8 (4) ◽  
pp. 1231
Author(s):  
Avdhesh Kumar ◽  
Brijesh Kumar ◽  
Sanjay Kumar Verma ◽  
Anand Kumar ◽  
R. K. Mathur ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Multidrug Resistant ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Common Cause ◽  
Tuberculous Pleural Effusion ◽  
Mdr Tb ◽  
The Mean ◽  
The Difference

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.

scholarly journals Diagnostic Accuracy of Pleural Fluid Adenosine Deaminase Level Test in Tuberculous Pleural Effusion

2017 ◽  
Vol 37 (4) ◽  
pp. 278-282
Author(s):  
Puspa Rosfadilla ◽  
Widirahardjo Widirahardjo ◽  
Fajrinur Syarani ◽  
Erna Mutiara
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Pleural Effusion ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Predictive Value ◽  
Exclusion Criteria ◽  
Diagnostic Modality ◽  
Cross Sectional ◽  
Tuberculous Pleural Effusion ◽  
Hospital Research

Background: Tuberculous pleural effusion is a paucibacillary manifestation of tuberculosis, so isolation of Mycobacterium tuberculosis is difficult, biomarkers being an alternative for diagnosis. Adenosine deaminase has the potential to optimize the diagnostic approach of tuberculous pleural effusion. Methods: This study is a diagnostic test observational (cross-sectional), which included 35 inpatient samples that meet inclusion and exclusion criteria from H. Adam Malik Medan General Hospital. Research began on February 1st until July 31st 2016 to examine 10 cc of pleural fluid specimens for the levels of Adenosine deaminase. Results: There are significant differences in the levels of adenosine deaminase from tuberculous and non-tuberculous pleural effusion (P=0.001). In the cut-off point 36.55 IU/L, level of sensitivity 95.8%, specificity 90.99%, positive predictive value 95.8%, negative predictive value 90.99%, and accuracy 94.2% of pleural fluid adenosine deaminase level test in tuberculous pleural effusion. Conclusion: Adenosine deaminase pleural fluid can be a diagnostic modality that is easy, fast, relatively affordable and applicable in the diagnosis of tuberculous pleural effusion. (J Respir Indo. 2017; 37(4): 278-82)

scholarly journals Laboratory Profiles of Pleural effusion Collected from Children: Experience at a Tertiary Care Hospital in Bangladesh

2013 ◽  
Vol 5 (1) ◽  
pp. 26-27
Author(s):  
Mahmudul Hasan ◽  
Md Rafiqul Islam ◽  
Abdul Matin ◽  
Ranjit Ranjan Roy ◽  
Md Abdullah Yusuf ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
College Hospital ◽  
Laboratory Findings ◽  
Cross Sectional ◽  
Medical College ◽  
Almost All

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

Clinical and laboratory differences and role of gene xpert in tuberculous pleural effusion

2021 ◽  
Vol 10 (1) ◽  
pp. 4-7
Author(s):  
Manoj Kumar Shah ◽  
Sushil Baral ◽  
Tulsi Bhattarai
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Mean Value ◽  
P Value ◽  
Common Symptom ◽  
Cross Sectional ◽  
Fluid Analysis ◽  
Laboratory Investigations ◽  
The Difference

Background: The diagnosis of pleural effusion and its cause are essential for pleural fluid analysis. We have evaluated clinical and laboratory differences among the tubercular pleural effusion. Methods: The cross-sectional, observational hospital based study was conducted in Bir hospital, Nepal. All patients were evaluated by clinically and laboratory investigations. Patients enrolled for study have pleural effusion and pleural fluid analysis indicative of an exudative pleural effusion using lights criteria. The criteria of enrollment of the patients were pleural fluid for Adenosine deaminizes value more than 40 IU/L, positive for gene xpert test and pleural effusion of any cases with sputum positive pulmonary tuberculosis. Patients were divided into two groups lymphocytic and neutrophilic predominant pleural effusion. Results: Among 100 patients with diagnosis of exudative tubercular pleural effusion, the most common symptom was pleuritic chest pain in 85%, followed by fever in 84% and cough in 82%. Among the tubercular pleural effusion, 21% had neutrophils predominant and 79% had Lymphocytes predominant. The patients with neutrophil predominant Tubercular pleural effusion had higher fever rates (90.5vs.82.5%) than those with lymphocyte-predominant Tubercular pleural effusion. The mean value of Neutrophil predominant pleural fluid for lactate dehydrogenase (LDH) level was 1657.5 IU/L and protein was 5.3gm/dl and in lymphocyte predominant pleural fluid for LDH value was 610.2 IU/L and protein was 4.6 gm/dl; the difference was statistically significant with P value of <0.001. Only 15% of patients had sputum positive for Acid fast bacilli. Among the sputum positive patients, 47% had positive for pleural fluid for gene xpert test with all patients had rifampicin sensitive. The sensitivity of pleural fluid for gene xpert test was 46.6%, and specificity was 90%. Conclusion: In pleural effusion, the positivity of gene xpert for pleural fluid was higher among the sputum positive patients. The prevalence of Neutrophil-predominant pleural effusion was common in tubercular pleural effusion.

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
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Systemic Disease ◽  
Final Diagnosis ◽  
Cross Sectional Study ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Cholesterol Levels ◽  
Present Cross Sectional Study ◽  
Systemic Factors

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.

scholarly journals Clinical Profile of Children with Pleural Effusion Admitted In a Tertiary Care Hospital of Bangladesh

2012 ◽  
Vol 4 (1) ◽  
pp. 7-9
Author(s):  
M Hasan ◽  
MR Islam ◽  
A Matin ◽  
R Khan ◽  
M Rahman ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
College Hospital ◽  
Cross Sectional ◽  
Delay In Diagnosis ◽  
Medical College ◽  
History Of

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

scholarly journals Role of Pleural Fluid C-Reactive Protein in the Aetiological Diagnosis of Exudative Pleural Effusion

2020 ◽  
Author(s):  
Praveen Radhakrishnan ◽  
S Mathanraj
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Cross Sectional Study ◽  
Direct Access ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Aetiological Diagnosis ◽  
Exudative Pleural Effusion

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.

A study to assess the role of C reactive protein as a marker in diagnosing pleural effusion

2021 ◽  
Vol 6 (3) ◽  
pp. 169-172
Author(s):  
Raghurama Sharvegar ◽  
Chandrik Babu S R
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
General Medicine ◽  
Cross Sectional Study ◽  
Respiratory Medicine ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Specificity And Sensitivity

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.

scholarly journals Diagnostic Accuracy of Adenosine deaminase enzyme (ADA) in the diagnosis of tuberculous pleural effusion

2020 ◽  
Vol 24 (4) ◽  
pp. 311-315
Author(s):  
Haroon Ur Rasheed ◽  
Ejaz Hassan Khan ◽  
Mohsin Shafi ◽  
Ahmad Rafiq ◽  
Ambreen Ali ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Accuracy ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Predictive Value ◽  
Colorimetric Method ◽  
Pleural Effusions ◽  
Cross Sectional ◽  
Tuberculous Pleural Effusion ◽  
Systemic Examination

Objective: To study the diagnostic accuracy of Adenosine deaminase enzyme (ADA) in the diagnosis of tuberculous pleural effusion (TPE).Material and Methods: It was a cross-sectional descriptive study conducted in the Pulmonology departments of Lady Reading and Khyber Teaching Hospital Peshawar and department of Pathology, Khyber Medical College, Peshawar from April 2015 to Jan 2016. A total of 210 tuberculous and non-tuberculous pleural effusion patients were selected through consecutive non-probability sampling techniques. After physical and systemic examination, 3cc of pleural fluid was taken. ADA was estimated by Non-Guisti and Galanti method through the simple colorimetric method. All the data was entered in a specially designed proforma and SPSS v16 was used for statistical analysis.Results: Out of 210 tuberculous and non-tuberculous pleural effusions, the commonest cause of pleural effusion was tuberculosis followed by malignancy. In our study, Pleural fluid ADA levels have sensitivity, specificity, positive predictive value( PPV), and negative predictive value (NPV) of 95.5%, 92.3%, 92.4%, and 96% respectively in differentiating tuberculous pleural effusions from non-tuberculous lymphocytes predominant pleural effusions. Conclusion: Tuberculosis is the commonest infectious disease worldwide. A pleural fluid ADA level of ≥ 35 U/L in lymphocyte-predominant effusions makes mycobacterium tuberculosis most likely etiology. This test is not only very sensitive and specific but also it is very cheap, quick, and easy to perform by routine colorimetric method.  

scholarly journals Evaluation of Adenosine Deaminase (ADA) Activity for Diagnosis of Tubercular Pleural Effusion

2014 ◽  
Vol 6 (2) ◽  
pp. 40-48
Author(s):  
SK Bhoumik ◽  
MM Rahman ◽  
M Ibrahim ◽  
MM Hiron ◽  
M Ahamad
Keyword(s):  
Pleural Effusion ◽  
Cross Sectional Study ◽  
Activity Level ◽  
P Value ◽  
Specific Marker ◽  
Sectional Study ◽  
Cross Sectional ◽  
Tuberculous Pleural Effusion ◽  
Very High ◽  
Test Result

To find out a sensitive and specific marker for early diagnosis of tubercular pleural effusion, this cross sectional study was carried out in the of National Institute of Diseases of the Chest and Hospital (NIDCH), Dhaka. One hundred and three pleural effusion cases were enrolled in the study. Out of the 103 cases, 62 were tubercular pleural effusion cases and 49 were nontubercular cases. Among the nontubercular cases, 30 cases were due to malignancy, 8 were due to pneumonia and rest 3 cases were due to nephrotic syndrome, congestive cardiac failure and rheumatoid arthritis. Considering 40 U/L as a cut off value for ADA level, the test result was positive in 58 out of 62 patients of tuberculosis indicating sensitivity of the test as 94%; however, among 41 non-tuberculous patients, 5 presented ADA activity level more than 40U/L, which lowers the specificity of the test to 88%. ADA levels were significantly higher in tuberculous than in nontuberculous cases (p value <0.001). It may be concluded that ADA levels are significantly high in patients with tuberculous pleural effusion compared to that in non-tubercular group. Sensitivity (94%) and specificity (88%) of the test in tuberculous pleural effusions are very high, when cut off value set at 40U/L. The result indicated that the analysis of ADA levels in pleural effusion constitute a very useful marker for the diagnosis of tubercular pleural effusion (TPE) which, in addition, can be made quickly in a noninvasive way. DOI: http://dx.doi.org/10.3329/bjmb.v6i2.17642 Bangladesh J Med Biochem 2013; 6(2): 40-48

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