scholarly journals Significance of Adenosine Deaminase in Diagnosing Tuberculous Pleural Effusion in Nepalgunj Medical College Teaching Hospital Kohalpur

2017 ◽  
Vol 14 (1) ◽  
pp. 21-23
Author(s):  
B.K. Shyam ◽  
Sujeet Kumar Shah ◽  
Sumit Pandey ◽  
Sushil Baral ◽  
Sandeep Gupta
Keyword(s):  
Pleural Effusion ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Teaching Hospital ◽  
College Teaching ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Pleural Biopsy ◽  
Medical College ◽  
Highly Sensitive

Background: Tuberculosis (TB) is a major public health problem in developing countries including Nepal. One of the common presentations of TB is pleural effusion. The diagnosis of tubercular pleural effusion can be difficult because of the low rate of detecting tubercular bacilli by direct stain and culture of pleural fluid for acid-fast bacilli (AFB). Pleural biopsy can be useful but is invasive and requires experts. In this context, pleural fluid Adenosine Deaminase (ADA) level has been proposed as easy, cheap and highly sensitive test for diagnosis of TB pleural effusion.Objectives: The present study was undertaken to define the role of pleural fluid ADA value in accurate diagnosis of Tubercular pleural effusion.Methods: A Prospective analysis of 68 patients admitted in Nepalgunj Medical College teaching Hospital was done from January 2014 to December 2015 with pleural effusion. Pleural fluid ADA level was evaluated in all patients, and significance of pleural fluid ADA level in TB pleural effusion was studied.Results: Age of patients were between 20 to 80 years, with the minimum being 20 years and maximum being 79 years. In this study 85% of cases had pleural effusion due to tuberculosis. Out of the 68 patients with pleural effusion, 58(85%) were finally diagnosed to be due to tuberculosis, 2 were diagnosed to be due to malignancy, 4 due to pneumonia leading to parapneumonic effusion, 1 due to congestive heart failure and 3 due to nephrotic syndrome.Conclusion: It is difficult to diagnose TB pleural effusion by other conventional methods, as it has also been shown in our study also. Previous literatures have also mentioned AFB detection rate to be low from pleural fluid sample. Determination of ADA is a cheap and easy test which we now consider in the early routine evaluation of patients with pleural effusions, particularly if diagnosis of tuberculosis is suspected and in places where prevalence of the disease is still high as is in our country. The other method considered for diagnosing TB pleural effusion is pleural biopsy which is invasive blind procedure and requires high expertise as well. JNGMC Vol. 14 No. 1 July 2016

scholarly journals Prevalence of Pulmonary Tuberculosis among the suspected patients visiting tertiary care hospital in Birgunj, Nepal

2013 ◽  
Vol 1 (1) ◽  
pp. 48-52
Author(s):  
S Shrestha ◽  
B Shakya ◽  
P Shrestha
Keyword(s):  
Pulmonary Tuberculosis ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
College Teaching ◽  
High Morbidity ◽  
Major Public Health Problem ◽  
Care Hospital ◽  
National Medical College ◽  
Medical College ◽  
National Medical

Background and Objectives: Mycobacterial disease continues to cause high morbidity and mortality and is a major public health problem in Nepal. Bacteriological examination of sputum is the cornerstone in the diagnosis of pulmonary tuberculosis in the developing world. This prospective study was carried out with an objective to evaluate the prevalence of pulmonary tuberculosis among the patients visiting National Medical College Teaching Hospital by Ziehl- Neelsen (Zn) staining microscopy. Material and Methods: The study was cross-sectional study. Three consecutive early morning sputum collected from 626 patients were subjected to Zn staining and observed under oil immersion. Results: Among 626 patients, 85 (13.57%) were found to be Acid fast positive by Zn staining microscopy. Of total suspected patients,16.0% of male and 8.7% of female were infected, common among 41-60 years group (17.2%) followed by 21-40 years (12.6%) and multibacillary cases was 71.8%. Conclusion: The prevalence of pulmonary tuberculosis among National medical college teaching hospital was found to be higher than the Nation pulmonary tuberculosis detection rate, most commonly infecting males. DOI: http://dx.doi.org/10.3126/jmcjms.v1i1.7886 Janaki Medical College Journal of Medical Sciences (2013) Vol. 1 (1):48-52

scholarly journals A study on malaria cases in hilly areas and Terai belt of Nepal

2017 ◽  
Vol 13 (1) ◽  
pp. 4-12 ◽  
Author(s):  
KRN Singh ◽  
Ram Bilakshan Sah ◽  
PK Pokharel
Keyword(s):  
Plasmodium Vivax ◽  
College Teaching ◽  
Public Health Problem ◽  
Peripheral Blood Smear ◽  
Vivax Infection ◽  
Research Center ◽  
Major Public Health Problem ◽  
Cross Sectional ◽  
Hilly Area ◽  
Medical College

Introduction: Malaria is a well-known disease and it continues to be a major public health problem at the start of new millennium. The problem is persistent not only amongst the city dwellers but also amongst the rural population.Objective: To identify the magnitude of malaria cases and to compare the malaria cases between hilly area and Terai belts.Methods: This cross-sectional study was carried out in Terai belt of Morang District Nepal at Nobel Medical College & Research Center Biratnagar from March to Oct 2007 and hilly area around Lumbini Medical College Teaching Hospital & Research Center Pravas, Tansen, Palpa of Nepal between March to December 2008. Blood samples were collected from all the cases and malaria parasites were examined by Peripheral Blood Smear Examination and Rapid Card Method Screening.Results: Thirty-five cases were malaria positive from hilly area of whom 80% had Plasmodium vivax infection. Whereas in Terai belt 231 positive cases ware recorded. Out of them (62.8%) cases were affected by Plasmodium vivax infection. That most vulnerable age group was 15 years and above. Males were more affected than females.Conclusion: It was observed that in hilly areas the numbers of positive cases are less than the Terai belt. The magnitude of malaria cases are found high in July. A steady decline has been observed till September to October Health Renaissance 2015;13 (1): 4-12

scholarly journals Pleural effusion: Role of pleural fluid cytology, adenosine deaminase level, and pleural biopsy in diagnosis

2016 ◽  
Vol 33 (3) ◽  
pp. 159 ◽  
Author(s):  
Biswajit Biswas ◽  
SudershanKumar Sharma ◽  
RameshwarSingh Negi ◽  
Neelam Gupta ◽  
VirenderMohan Singh Jaswal ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Pleural Biopsy ◽  
Fluid Cytology

scholarly journals Role of pleural biopsy in diagnosis of unilateral pleural effusion:study of 50 cases in Rangpur Medical College & Hospital, Rangpur

2016 ◽  
Vol 27 (2) ◽  
pp. 62-67
Author(s):  
AKM Shaheduzzaman ◽  
Devendra Nath Sarkar ◽  
Md Ferdous Wahid ◽  
Md Shafiul Alam ◽  
Md Mahfuzer Rahman ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Pleural Fluid ◽  
Granulomatous Inflammation ◽  
Histopathological Study ◽  
Pleural Biopsy ◽  
College Hospital ◽  
Medical College ◽  
General Physical Examination ◽  
General Physical

Background: Pleural effusion remains the most common manifestation of pleural pathology. Sometime it is difficult to differentiate between tuberculous and malignant pleural effusion on routine cytological and biochemical examination. So pleural biopsy is an important tool for evaluating undiagnosed pleural effusion.Aim: To find out the role of pleural biopsy in the diagnosis of unilateral pleural effusion.Methods: This observational study was conducted in the Indoor patient department of Medicine in Rangpur Medical College Hospital from 01.01.2014 to 30.06.2014. All patients having unilateral pleural effusion above the age of 15 years irrespective of sex, race and religion was enrolled in this study.Results: Total fifty cases were enrolled in this study. Age of the patients varied from 16 to 78 years (Mean ±SD, yrs: 47±31.0). Thirty six (72%) patients were male and fourteen (28%) were female. 9 patients (18%) were of higher socio-economic status, 13 (26%) patients were from lower class, and 28 (56%) were from middle class. Majority (36%) of the patients were farmer, followed by 22% were businessman, 18% were service holder and 16% were housewives. Out of 50 patients, Nineteen patients (38%) were smoker and rests (62%) were non-smoker. Common presenting complaints were fever (78%), respiratory distress (62%), cough (56%), chest discomfort (38%) and weight loss (32%). General physical examination findings revealed 62% having different grades of anaemia followed by clubbing in 22% cases. Respiratory system examination revealed 56% having left sided pleural effusion followed by 44% right sided pleural effusion. 36% shows shifting of trachea. Regarding pleural fluid analysis, color of pleural fluid was straw in most cases (42%) and sixteen cases (32%) had hemorrhagic fluid. Mean total cell count in pleural fluid was 1449.1/c.mm. Most (88%) had lymphocyte predominance. Mean protein in pleural fluid was 5.6 gm/liter. Radiological examination revealed that maximum patient (56%) having left sided effusion and total 18 patients having shift of trachea. Close pleural biopsy for histopathological study revealed maximum (36%) were different types of malignancy, 24% chronic granulomatous inflammation consistent with tuberculosis, 16% shows non-specific chronic inflammation and 24% cases showed no abnormal findings or pleural tissue not available or inadequate tissue for histological report. Out of total 18 cases of malignancy, 08 revealed adenocarcinoma, 03 revealed metastatic adenocarcinoma, 02 revealed non-hodgkin’s lymphoma, 02 malignant mesothalioma and 03 of them revealed poorly differenciated carcinoma.Conclusion: In this study male are predominant. Most of the respondent was non-smoker. Most common presenting complains were fever, respiratory distress, cough, chest discomfort and weight loss. Most of general physical examination findings were anamia and clubbing. Respiratory system examination findings were features suggestive of pleural effusion (56% left sided and 44% right sided), 36% having shift of trachea. chest x-ray findings of most (56%) of the study population were left sided pleural effusion. Close pleural biopsy for histopathological study revealed maximum (36%) were different types of malignancy followed by chronic granulomatous inflammation consistent with tuberculosis (24%).Bangladesh J Medicine Jul 2016; 27(2) : 62-67

scholarly journals Prevalence and Clinico- Laboratory Profile of Tuberculosis in Children in Nobel Medical College, Biratnagar

2019 ◽  
Vol 17 (1) ◽  
pp. 47-49
Author(s):  
Vijay Kumar Sah ◽  
Arun Giri ◽  
Niraj Niraula
Keyword(s):  
College Teaching ◽  
Public Health Problem ◽  
Screening Tests ◽  
Mantoux Test ◽  
Published Data ◽  
Major Public Health Problem ◽  
Medical College ◽  
Childhood Morbidity ◽  
Laboratory Profile ◽  
Tuberculosis In Children

Introduction: Tuberculosis infection is very common, and it continues to be the major public health problem in Nepal. Published data about the epidemiology of TB in children is scarce in Nepal, though it is considered one of the most common causes of childhood morbidity in the country. Aims and objectives: To calculate the prevalence of tuberculosis in children aged 0-15 years and to study their clinico-laboratory profile. Methodology: This is a hospital based study conducted in Nobel Medical College Teaching Hospital, Biratnagar over a period of one year. We analyzed 289 children aged 0-15 years suspected of having tuberculosis on clinical grounds and subjected to further screening tests. Results: Majority of the children were males and most of the children were 5-15 years of age. 15 of the cases were diagnosed as tuberculosis out of which one case was bacteriologically confirmed pulmonary tuberculosis and be 5.2 %. Fever and cough were the most common clinical presentations and mantoux test and chest X-ray were most suggestive in majority of the cases. Conclusions: This study supports the use of history and thorough clinical examination and high index of clinical suspicion for diagnosis of childhood tuberculosis.

Diagnostic value of adenosine deaminase in tuberculous pleural effusion: a meta-analysis

2003 ◽  
Vol 40 (4) ◽  
pp. 374-381 ◽  
Author(s):  
Masashi Goto ◽  
Yoshinori Noguchi ◽  
Hiroshi Koyama ◽  
Kenji Hira ◽  
Takuro Shimbo ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Pleural Biopsy ◽  
Tuberculous Pleural Effusion ◽  
Test Characteristics ◽  
Tuberculous Pleurisy ◽  
Gold Standards

Background: Many studies have investigated the usefulness of adenosine deaminase activity (ADA) in pleural fluid for the early diagnosis of tuberculous pleurisy. To summarize the diagnostic characteristics of ADA we undertook a meta-analysis using a summary receiver operating characteristic (SROC) curve method. Methods: Data sources were MEDLINE (1966-1999), the Cochrane Library and bibliographies of review and original articles. Studies were included if the absolute numbers of true positive, false negative, true negative and false positive observations were available or could be derived from the data presented; gold standards were described explicitly; and the criteria for a positive ADA result were reported. We constructed an SROC curve based on these extracted data to estimate the test characteristics. Results: Forty articles were available for analysis. The gold standards used were pleural biopsy histology, microbiological examination of pleural fluid, pleural biopsy and sputum and the patient's clinical course or combinations of these. The sensitivity of ADA reported in the articles ranged from 47·1% to 100% and the specificity from 50·0% to 100%. The summary measure of test characteristics derived from the SROC curve was 92·2% for both sensitivity and specificity. Conclusions: The test performance of ADA in tuberculous pleural effusion is reasonably good. Measurement of pleural ADA is thus likely to be a useful diagnostic tool for tuberculous pleurisy.

scholarly journals Contributing factors of utero-vaginal prolapse among women attending in Lumbini Medical College and Teaching Hospital

2017 ◽  
Vol 5 (3) ◽  
pp. 32-39
Author(s):  
S Acharya
Keyword(s):  
Teaching Hospital ◽  
Cultural Beliefs ◽  
Public Health Problem ◽  
Vaginal Prolapse ◽  
Early Marriage ◽  
Major Public Health Problem ◽  
Contributing Factors ◽  
Medical College ◽  
Pregnancy And Postpartum ◽  
Heavy Work

Uterine prolapse- is a major public health problem in Nepal. It is a medical and social problem, deeply rooted with poor health services and socio-cultural beliefs. The objective of this study was to find out the contributing factors of utero -vaginal prolapse among women attending at Lumbini Medical College and Teaching Hospital. Descriptive study design was used. A total of 40 women diagnosed with utero-vaginal prolapse were selected as the cases by using purposive sampling technique. Data were collected from 2071/07/8 to 2071/10/30. Data processing and analysis was done using SPSS version 16.The study reveals that 92% of women were involved in agriculture and 80% of them were illiterate. Ninety five percent of the women got marriage before the age of 20, 92.5% women became pregnant more than 3 times, 70% of babies were born at. Ninety two percent of the women gave birth to first child before the age of 20 and 90% respondents reported that they were involved in heavy work during pregnancy and postnatal period. Contributing factors depicted by our study were heavy work, illiteracy, early marriage/child birth, inadequate food during pregnancy and postpartum period, multi parity, home delivery and less rest period during post partum.

scholarly journals Role of adenosine deaminase in monitoring tubercular pleural effusion

2019 ◽  
Vol 6 (6) ◽  
pp. 2426
Author(s):  
Basanta Hazarika ◽  
Suresh Sharma ◽  
Ritesh Kumar ◽  
Jogesh Sarma
Keyword(s):  
Pleural Effusion ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Malignant Cell ◽  
P Value ◽  
Pulmonary Medicine ◽  
Medical College ◽  
Microbiological Parameters

Background: Tuberculosis is a common cause of pleural effusion especially in countries like India. ADA (adenosine deaminase) is predominantly an enzyme, that catalyses the conversion of adenosine to ionosine. Usually patients with tuberculous pleural effusion have ADA level >40 U/L.Methods: This is a prospective, observational study conducted in Department of Pulmonary Medicine, Gauhati Medical College and Hospital, Guwahati from September 2016 to September 2017. 45 patients with pleural fluid ADA levels >40 U/L were selected with diagnosis of tubercular pleural effusion. Pleural fluid was analysed for cytological, biochemical and microbiological parameters along with ADA and malignant cell cytology. Anti-tubercular treatment (ATT) was started and pleural fluid ADA level were repeated after 15 days of ATT.Results: Pleural fluid ADA levels before the start of ATT intake and after 15 days of ATT intake were statistically analysed. Among 45 patients, 38 were male and 7 females.  Mean age of the patients was 45.42±16.43 years. Mean pleural fluid ADA level before starting ATT was 64.49±31.78 U/L. After 15 days of ATT intake mean pleural fluid ADA level was 36.11±10.42 U/L, p value was statistically significant (p<0.05).Conclusions: Pleural fluid ADA significantly decreased after 15days of initiation of anti-tubercular treatment. Pleural fluid ADA can be a useful tool as a follow up biomarker in cases of tubercular pleural effusion. 

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