scholarly journals DIAGNOSTIC YIELD OF ABRAMS PLEURAL BIOPSY IN PATIENTS PRESENTING WITH LYMPHOCYTIC EXUDATIVE PLEURAL EFFUSION.

2019 ◽  
Vol 26 (07) ◽  
pp. 1014-1019
Author(s):  
Kashif Sardar ◽  
Nasir Javed ◽  
Sufyan Saleem Safdar
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Yield ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Definitive Diagnosis ◽  
Care Hospital ◽  
Pleural Biopsy ◽  
Cross Sectional ◽  
Medical Thoracoscopy ◽  
Exudative Pleural Effusion

Background: Pleural effusion is the one of the most common clinical conditions encountered in pulmonology clinics and the routinely performed tests on pleural fluid do not provide definitive diagnosis in majority of the cases. Medical thoracoscopy with pleural biopsy under direct vision of the abnormal area provides the highest diagnostic yield. Abrams closed needle pleural biopsy is a conventional and cheaper procedure which can help in the definitive diagosis in cases of undiagnosed pleural effusion. Objectives: To determine the diagnostic yield of abrams pleural biopsy in patients presenting with lymphocytic exudative pleural effusion. Study Design: Cross Sectional Study. Setting: Department of Pulmonology Nishtar Hospital Multan; Tertiary care hospital of 1180 beds. Period: Six months. Results: There were 145 patients diagnosed with lymphocytic exudative pleural effusion. Of these 145 study cases, males were 83/145 (57.2%) whereas females were 62/145 (42.8%). Mean age of our patients was 41.62 ± 13.63 years while mean duration of illness was 7.0 ± 3.24 weeks. When the frequencies of various diagnosis established on the basis of histopathology results obtained from the tissue specimen obtained with Abrams pleural biopsy was noted, Tuberculosis was the major cause of lymphocytic exudative pleural effusion as its frequency was noted to be in 81/145 (55.9%) of our patients while malignancy was present in 26/145 (17.9%) of our study cases whereas the histopathology turned out to be inconclusive in 38/145 (26.2%) showing non-specific inflammation. The diagnostic yield of Abrams pleural biopsy turned out to be 73.8% whereas it was unable to establish diagnosis in 26.2%. Conclusion: Abrams needle pleural biopsy is simple, reliable and safe method of diagnosis with a good diagnostic yield. Routine use of this procedure in patients with lymphocytic exudative pleural effusion can lead to a definitive diagnosis in majority of patients.

scholarly journals Medical Thoracoscopy for Undiagnosed Exudative Pleural Effusion: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (223) ◽  
pp. 158-164
Author(s):  
Bishow Kumar Shrestha ◽  
Shital Adhikari ◽  
Binay Kumar Thakur ◽  
Dipen Kadaria ◽  
Kishor Kumar Tamrakar ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Yield ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
High Yield ◽  
Metastatic Adenocarcinoma ◽  
Sectional Study ◽  
Cross Sectional ◽  
Medical Thoracoscopy ◽  
Exudative Pleural Effusion

Introduction: Medical thoracoscopy has recently gained renewed interest due to its minimal invasive nature and high yield diagnostic outcome. This study aims to observe diagnostic yield and safety of medical thoracoscopy in undiagnosed exudative pleural effusion. Methods: This is a descriptive cross-sectional study conducted in two tertiary care hospitals in Chitwan from March 2018 to May 2018. Ethical approval from the Institutional Review Board was obtained. Convenient sampling was done that included all the patients who met criteria for undiagnosed exudative pleural effusion after diagnostic thoracocentesis. Patients having contraindication to procedure and who refused consent were excluded. Statistical analysis was performed using IBM SPSS Statistics 20 and data are presented as mean (±SD) and frequency (percentage). Results: A total of 14 patients underwent rigid medical thoracoscopy. All 14 patients had unilateral pleural effusion. The overall diagnostic yield was 100%. Malignancy was the most frequent histopathology diagnosis seen in 11 (78.57%) patients, the commonest being metastatic adenocarcinoma in 8 (57.1%).  Pleural tuberculosis and acute-on-chronic pleuritis were seen in 2 (14.3%) and 1 (7.1%) patients, respectively. Pleural deposits and hemorrhagic pleural fluid were the two commonest findings, seen in 10 (70.1%) and 9 (64.3%) patients, respectively. Two (14.3%) patients clinically treated as tuberculous pleural effusion was re-diagnosed to have metastatic adenocarcinoma.  Common procedure-related minor complications observed were mild to moderate pain and mild bleeding, observed in 3 (21.4%) and 2 (14.3%) patients, respectively. Conclusions: Medical thoracoscopy is a safe, well-tolerated and high yield procedure in undiagnosed exudative pleural effusion. This art of medicine should be promoted in daily medical practice.

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

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 Comparison of diagnostic yield and complications of bronchoscopy, closed pleural biopsy and medical thoracoscopic pleural biopsies in undiagnosed pleural effusions

2017 ◽  
Vol 5 (2) ◽  
pp. 388
Author(s):  
Kizhakkepeedika Davis Rennis ◽  
Jaboy Bibin ◽  
Vadakkan Thomas ◽  
Easwaramangalath Venugopal Krishnakumar
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Yield ◽  
Safe Procedure ◽  
Pleural Effusions ◽  
Pleural Biopsy ◽  
Predictive Values ◽  
Medical Thoracoscopy ◽  
Sensitivity Specificity ◽  
Blunt Trocar ◽  
Exudative Pleural Effusion

Background: Undiagnosed exudative pleural effusion is a commonly encountered clinical scenario, which requires further evaluation. This study was aimed to analyze the diagnostic yield and complications of three procedures- Bronchoscopy, closed (Abram’s) pleural biopsy and medical thoracoscopy. Further, this study assessed whether combining closed pleural biopsy with bronchoscopy can be a substitute for medical thoracoscopy.Methods: An observational study was conducted among people with undiagnosed exudative pleural effusion. Initially, closed pleural biopsies were performed with Abrams needle and multiple tissue fragments were taken through the incision and the samples were sent in formalin to the laboratory for histopathology examination. For thoracoscopy, a cannula of 10 mm diameter with blunt trocar was inserted into the pleural cavity and semi rigid thoracoscope was introduced through the trocar. Bronchoscopy was performed 48 hours after thoracoscopy. Sensitivity, specificity and positive and negative predictive values were calculated and compared.Results: Out of 25 people, 14 were diagnosed to have malignancy and 7 were diagnosed tuberculosis. The overall sensitivity of the three procedures were 28.5% for closed pleural biopsy, 14.2% for bronchoscopy, 95.2% for medical thoracoscopy, 42.8% for the combined pleural biopsy and bronchoscopy. The complication rate was lowest for bronchoscopy (4%), followed by medical thoracoscopy (8%) and closed pleural biopsy (16%).Conclusions: Medical thoracoscopy is a comparatively safe procedure which has got the highest sensitivity for the diagnosis of undiagnosed exudative pleural effusions. Bronchoscopy combined with closed pleural biopsy, the diagnostic yield was increased (than that of individual yield), but cannot be a substitute for medical thoracoscopy.

scholarly journals Lymphocyte-Neutrophil Ratio in the Diagnosis of Tubercular Pleural Effusion in a Tertiary Care Centre: A Descriptive Cross Sectional Study

2021 ◽  
Vol 6 (2) ◽  
pp. 1517-1521
Author(s):  
Rajneesh Jha ◽  
Ram Kumar Mehata ◽  
Puru Koirala
Keyword(s):  
Pleural Effusion ◽  
Extrapulmonary Tuberculosis ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Categorical Variables ◽  
P Value ◽  
Care Hospital ◽  
Continuous Variables ◽  
Tertiary Care Centre ◽  
Cross Sectional

Introduction: Tuberculosis is a common infection in our community. Tubercular pleural effusion is the second most common form of extrapulmonary tuberculosis. Among the several causes of exudative pleural effusison tubercular remains the most common form in clinical practice. The aim of this study was to evaluate the significance of lymphocyte-neutrophil ratio(LN ratio) in cases of exudative effusion for diagnosis of tubercular effusion. Methods: This was a hospital based cross sectional studydone in Patients at tertiary care hospital from 1st September 2020 to 1st april 2021after taking ethical clearance from institutional reviw committee. Convienience samplingwas done. Statistical Analysis of data like percentages and frequencies  were used for categorical variables. Mean and SD (standard deviation) were used for describing continuous variables. Inferential statistical tools like Chi-Square test and Student’s t-test were used. P-value of <0.05 was considered statistically significant. Results: out of 200 cases 75% were tubercular pleural effusion and these cases were found have high levels of LN ratio (0.89 ± 0.11 for females and 0.97 ± 0.14 for males) and ADA (137.79 ± 44.61for females and 147.61 ± 51.64 for males) and more than 90% sensitivity and specificity of LN ratio and ADA level. Conclusion: Exudative pleural fluid L/N ratio >0.75 is an efficient means of diagnosing tuberculous pleural effusion and its combination with ADA level gives us more accuracy and surety about the diagnosis of tubercular pleural effusion.

scholarly journals Closed Pleural Biopsy is Still Useful in the Evaluation of Malignant Pleural Effusion

2012 ◽  
Vol 4 (01) ◽  
pp. 035-038 ◽  
Author(s):  
Somnath Bhattacharya ◽  
Tapan D Bairagya ◽  
Anirban Das ◽  
Abhijit Mandal ◽  
Sibes K Das
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Malignant Pleural Effusion ◽  
Tertiary Care ◽  
Care Hospital ◽  
Malignant Cells ◽  
Pleural Biopsy ◽  
Medical Thoracoscopy ◽  
Indeterminate Cytology ◽  
Fluid Cytology

ABSTRACT Background: Pleural fluid cytology for malignant cells is the easiest way to diagnose malignant pleural effusion with good sensitivity and specificity. With the introduction of medical thoracoscopy, the use of closed pleural biopsy for the diagnosis of cytology negative malignant pleural effusion is gradually decreasing. However use of thoracoscopy is limited due to its high cost and procedure related complications. Aims: The aim was to assess the usefulness of closed pleural biopsy in the diagnosis of malignant pleural effusion. Materials and Methods: Sixty-six patients of pleural effusion associated with malignancy were selected from the patients admitted in the chest ward of a tertiary care hospital over a period of 1 year. Pleural fluid aspiration for cytology and closed pleural biopsy were done in all the patients. Results: Out of 66 patients, 46 (69%) patients showed malignant cells in pleural fluid cytology examination. Cytology was positive in 35 (52%), 10 (15%), and 1 (1.5%) patients in the first, second, and third samples respectively. Closed pleural biopsy was positive in 32 (48%) patients. Among them, 22 also had positive cytology. Additional 10 cytology negative patients were diagnosed by pleural biopsy. Cytology–histology concordance was seen in 12 patients. Definite histological diagnosis could be achieved in five patients with indeterminate cytology. Pleural biopsy was not associated with any major postoperative complication. Conclusion: Closed pleural biopsy can improve the diagnostic ability in cytology negative malignant pleural effusion. Closed pleural biopsy has still a place in evaluation of malignant pleural effusion especially in a resource-limited country like India.

scholarly journals EXUDATIVE PLEURAL EFFUSION

2016 ◽  
Vol 23 (08) ◽  
pp. 970-974
Author(s):  
Nosheen Saifullah ◽  
Saifullah Baig ◽  
Niaz Hussain Soomro ◽  
Nadeem Rizvi
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Yield ◽  
Medical Center ◽  
Cross Sectional Study ◽  
Inclusion Criteria ◽  
Pleural Biopsy ◽  
Cross Sectional ◽  
Female Ratio ◽  
Specific Diagnosis ◽  
Male To Female

Objectives: To compare the pleuroscopic and closed pleural biopsy by Abramsneedle in terms of diagnostic yield and obtaining specific diagnosis in cases of exudative pleuraleffusion. Study Design: Cross sectional study. Period: August 2014 to February 2015. Setting:Department of Thoracic Medicine Jinnah Post Graduate Medical Center Karachi. Methodology:All patients with pleural effusion who were admitted and fulfilling the inclusion criteria wereincluded in the study .Closed pleural biopsy using Abrams needle followed by pleuroscopy witha flexible pleuroscope was performed from the same incision, in the same sitting. The sampleswere sent for histopathology. To control bias samples were coded as A and B and the codewas not known to the histopathologist. Results: Among 60 patients, Mean age was 42.85 yearswith ±18.2 standard deviation and male to female ratio was 1.6 :1. Specific diagnosis throughpleuroscopic biopsy had shown 27 (45%) cases of tuberculosis, 25 (41.7%) of adenocarcinoma,5 (8.3%) of chronic non specific inflammation, one (1.7%) case of lymphoma and 2 (3.3%)cases could not be reached for any diagnosis. Conclusion: Pleuroscopy has better yield thanthe Abrams needle biopsy in terms of both diagnostic yield and specific diagnosis

Confidence toward vaccination as reported by parents of children admitted to a tertiary care hospital in Riyadh, Saudi Arabia: A cross sectional study

Vacunas ◽  
2020 ◽  
Vol 21 (2) ◽  
pp. 95-104 ◽  
Author(s):  
Y.M. AlGoraini ◽  
N.N. AlDujayn ◽  
M.A. AlRasheed ◽  
Y.E. Bashawri ◽  
S.S. Alsubaie ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional
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