scholarly journals Comparison of Led Fluorescent Microscopy and the Gene Xpert MTB/RIF Assay in Diagnosis of Pulmonary and Extrapulmonary Tuberculosis

2019 ◽  
Vol 6 ◽  
pp. 127-132
Author(s):  
Sanam Thapa Magar ◽  
Gokarna Ghimire ◽  
Pradeep Kumar Shah

Objectives: The objective of this study was to evaluate Gene Xpert MTB/RIF Assay and anid fast staining (AFB) for rapid detection of Mycobacterium tuberculosis in specimen of patients suspected of pulmonary tuberculosis (PTB) and extra pulmonary tuberculosis (EPTB). Methods: A comparative cross-sectional study of 400 samples (PTB-365 and EPTB-35) of patients visiting National Tuberculosis Centre (NTC) was conducted from July 2018 to December 2018. Gene Xpert MTB/ RIF Assay, smear microscopy were performed under standard guideline inside biosafety cabinet class II. The result obtained from both the tests were analyzed using SPSS 20.0 software and Excel 2019. Results: Of the total samples, 18% (72/400) and 39% (156/400) were positive by AFB smear microscopy and Xpert MTB/RIF assay respectively. Prevalence of MTB positive was highest in the age group 35-44 years, 33 cases (17.74%) were detected in total, with a male to female ratio of 2.3:1. Pleural fluid, pus, and CSF fluid also yielded positive results with the Gene Xpert MTB/RIF assay accounting 1.28%, 0.64% and 1.28% of MTB positive case respectively. Rifampicin resistance was observed in 1.28% of the cases. Conclusion: The key findings of this study suggest that Gene Xpert test should be implemented as primary diagnostic test for PTB and EPTB.

2021 ◽  
Vol 15 (9) ◽  
pp. 2841-2843
Author(s):  
Muhammad Omer Farooq ◽  
Niaz Ahmed ◽  
Hassan Nadeem ◽  
Kashif Rafi ◽  
Sadia Jabbar ◽  
...  

Objective: To determine the frequency of high MELD score in cirrhotic patients undergoing liver resection due to hepatocellular carcinoma also compare the frequency of mortality in patients with high or low MELD score. Study Design: Cross sectional study Place and Duration: Department of Gastroenterology, Shaikh Zayed Hospital, Lahore. Duration: 6months i.e. 23 12-2017 to 22-06-2018. Methodology: 75 patients were enrolled. Then blood sample was obtained. Reports assessed and MELD score calculated. Scores were labeled as high or low. Patients underwent liver resection according to BCLC. The mortality was noted. All the collected data was entered and analyzed on SPSS version 22. Results: In this study out of total 75 cases 60 were males and 15 females. The mean age of patients was 39.44±9.76 years, male to female ratio was 4:1. Low MELD class was noted in 45 (60%) cases and high MELD class noted in 30(40%) cases. Mortality occurred in 27(36%) cases. Insignificant difference found between the MELD class with mortality. Conclusion: High MELD score was seen in 40% cirrhotic patients undergoing liver resection due to HCC. Post HCC resection, mortality occurred in 36% patients within three months of surgery. No significant association was found between the mortality and MELD score. Keywords: MELD, Hepatocellular Carcinoma, Mortality, Cirrhosis


1994 ◽  
Vol 24 (3) ◽  
pp. 527-535 ◽  
Author(s):  
Giovanni Rezza ◽  
Stefania Salmaso ◽  
Damiano Abeni ◽  
Giovanna Brancato ◽  
Alessandra Anemona ◽  
...  

We conducted a study to describe current patterns of drug-related behaviors, and to identify characteristics that may distinguish injecting drug users entering treatment from those out of treatment, in five Italian cities. Overall, 1,180 subjects were recruited — 568 entering treatment and 612 out of treatment. Male to female ratio was 6.6:1. The median age was similar in the two groups. A high proportion of injecting drug users recruited out of treatment had been in treatment at least once. HIV prevalence among injecting drug users entering treatment was not higher than that of those who were out of treatment. Furthermore, a large proportion of injecting drug users who still were out of treatment reported having adopted safe behaviors. The results of the study emphasize the need to implement outreach programs aimed at harm reduction.


2021 ◽  
Vol 4 (03) ◽  
Author(s):  
Abaid ur Rehman ◽  
Muhammad Imran Khan ◽  
Omer Sabir ◽  
Muhammad Mohsin Riaz ◽  
Mubashar Dilawar ◽  
...  

The initiation of hemodialysis in patients with chronic kidney disease (CKD) requires vascular access formation. The choice of vascular access for individual patient depends on various factors however arteriovenous fistula (AVF) is conventionally considered to be the vascular access of choice. Once hemodialysis is initiated through a mature AVF, there is an ongoing need for surveillance of the AVF to ensure adequate function and prevent vascular access issues among which flow obstruction (both inflow and outflow) remains the most important. AVF stenosis can potentially lead to inadequate dialysis delivery and thrombosis thus leading to access loss. Physical examination and AVF Doppler ultrasonography (DUS) are useful for evaluation of stenosis in the  arteriovenous connection and the outflow tract. Periodic assessment of the AVF with Static Intra access Pressure (SIAPR) determination may be a reliable means of predicting vascular access stenosis. Material & Methods  A cross sectional study carried out at Department of Nephrology, Fatima Memorial Hospital, Lahore from July 2018 to December 2018. In total 113 patients were included, and all patients underwent SIAPR assessment and Doppler Ultrasound of AVF. Results Mean age of the patients was 56.81±9.38 years, male to female ratio of the patients was 1.8:1. In this study the SIAPR was suggestive of  stenosis in 87(76.99%) patients. The sensitivity, specificity and diagnostic accuracy of SIAPR against Doppler US of the AVF for detection of stenosis was 75.86%, 22.62% & 36.28% respectively Conclusion SIAPR has low specificity and diagnostic accuracy compared to Doppler US for detection of AVF stenosis.


2003 ◽  
Vol 33 (1) ◽  
pp. 7-11 ◽  
Author(s):  
Anthony D Harries ◽  
Nicola J Hargreaves ◽  
John H Kwanjana ◽  
Felix M Salaniponi

There is little information on a country-wide basis in sub-Saharan Africa about how the diagnosis of extra-pulmonary tuberculosis (EPTB) is made. A country-wide cross-sectional study was carried out in 40 non-private hospitals in Malawi which register and treat (TB) patients in order to assess diagnostic practices in adults registered with EPTB. All patients aged 15 years and above in hospital on treatment for EPTB were reviewed using TB registers, case note files and clinical assessment. There were 244 patients, 132 men and 112 women whose mean age was 36 years. In 138 (57%) patients, all appropriate procedures and investigations, commensurate with hospital resources, had been carried out. Of 171 EPTB patients with cough for 3 weeks or longer, 138 (81%) submitted sputum specimens for smear microscopy of acid-fast bacilli (AFB). A confirmed diagnosis of TB was made in 15 (6%) patients based on finding AFB or caseating granulomas in specimens. In 157 (64%) patients, the diagnosis of EPTB was considered to be correct. In 46 (19%) patients the diagnosis was considered to be TB, although different from the type of EPTB with which the patient was registered. In 39 (16%) patients an alternative non-TB diagnosis was made and in two (1%) patients it was not possible to make a decision. Diagnostic practices need to be improved, and ways of doing this are discussed.


2014 ◽  
Vol 41 (1) ◽  
pp. 50-52
Author(s):  
N Ahmed ◽  
MZ Islam ◽  
S Farjana

Disease pattern in a given population is generally determined by different ecological factors. Thus the objective of this cross-sectional study was to determine the pattern of skin diseases in a selected rural community of Dhamrai Upazila under Dhaka district. Out of 2645 patients attending a medical camp showed 410(15.5%) patients with dermatological problems. Among all, 260(63.4%) patients were males and 150(36.6%) were females with a male to female ratio of 1.7:1. Of these patients, 178(43.4%) had cutaneous infections and 234(56.6%) had non-infectious dermatoses. Few patients (2.7%) had more than one dermatoses. Fungal infection was the commonest infection seen (22.9%) and eczemas took an upper hand in non-infectious group (32.2%). Improvement in the standard of living, health education, improvement in the environmental sanitation and good nutritious food may help the people to bring down the skin disease in the rural part of country. DOI: http://dx.doi.org/10.3329/bmj.v41i1.18784 Bangladesh Medical Journal 2012 Vol. 41 No. 1; 50-52


Author(s):  
Nida Anwar ◽  
Muhammad Nadeem ◽  
Sana Khurram ◽  
Naveena Fatima ◽  
Tahir Shamsi ◽  
...  

Abstract Objectives: To evaluate the presence and characteristics of additional karyotype abnormalities in chronic myeloid leukaemia cases. Method: The cross-sectional study was conducted at the Department of Cytogenetics and Molecular Pathology, National Institute of Blood Diseases and Bone Marrow Transplant, Karachi, from May 2010 to September 2016 and comprised diagnosed chronic myeloid leukaemiapatients regardless of age and gender.Baseline cytogenetic evaluation was done on overnight, 24-hrs un-stimulated and 72-hrs stimulated bone marrow cultures, and karyotypes were defined according to the International System for Human Cytogenetic Nomenclature2013. Data was analysed using SPSS 23. Results: There were 222 cases with a median age of 38 years (range: 12-84 years). The male-to-female ratio was 1.8:1. Chronic myeloid leukaemiawas detected in 18(8.1%) patients havingadditional cytogenetic abnormalities. Among the patients found positive, cytogenetic type was minor in 10(55.55%), major 3(16.66%), complex 3(16.66%), and variant 2(11.11%). . Conclusion: Additional cytogenetic abnormalitieswere found in 8% of the sample. Key Words: Additional cytogenetic abnormalities, Chronic myelogenous leukaemia, Bone marrow, Cytogenetics.


2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Konjit Getachew ◽  
Tamrat Abebe ◽  
Abebaw Kebede ◽  
Adane Mihret ◽  
Getachew Melkamu

Background. Despite its lower sensitivity, smear microscopy remains the main diagnostic method for pulmonary tuberculosis (PTB) in resource-limited countries as TB culturing methods like LJ (Lowenstein-Jensen) are expensive to use as a routine base. This study aimed to evaluate the performance of LED-FM for the diagnosis of PTB in HIV positive individuals.Methods. Cross-sectional study was conducted in Zewditu Memorial Hospital and Teklehaimanot Health Center HIV/ART clinics in Addis Ababa, Ethiopia. Each sample was stained with ZN and Auramine O staining and examined with bright-field microscope and LED-FM microscope, respectively. LJ culture was used as a reference.Results. Out of 178 study participants, twenty-four (13.5%) patients were confirmed as positive for MTB with LJ culture. The yield of ZN microscopy and LED-FM in direct and concentrated sample was 3.9%, 8.4%, 6.2%, and 8.4%, respectively. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of direct ZN microscopy were 29.2%, 100%, 100%, and 90.1%, respectively, and of LED-FM microscopy in direct sputum sample were 62.5%, 100%, 100%, and 94.5%, respectively.Conclusion. LED-FM has better sensitivity for the diagnosis of PTB in HIV positive individuals as compared to conventional ZN microscopy. LED-FM can be used as an alternative to conventional ZN microscopy.


Author(s):  
Danish Zahoor ◽  
Anjum Farhana ◽  
Farhath Kanth ◽  
Munazah Bha

Background: Tuberculosis is a global health problem associated with high morbidity and mortality. Rapid diagnosis of tuberculosis is essential for early disease management. Conventional methods like microscopy and culture are associated with low sensitivity and longer time to positivity respectively. The GeneXpert is an integrated device for the rapid detection of Mycobacterium tuberculosis and its sensitivity to rifampicin. We evaluated the performance of gene expert MTB/ RIF assay for the diagnosis of pulmonary and extrapulmonary tuberculosis.Methods: A prospective cross sectional study was carried out in the Department of Microbiology. Samples were subjected to smear microscopy by ZN staining, culture on solid (LJ) and liquid media (BacT Alert) and GeneXpert assay.Results: 122 pulmonary samples and 153 extrapulmonary samples collected from 275 patients were included in the study. Out of these, 48 samples were positive by both culture and Xpert assay and 2 samples were culture positive only. Out of 225 culture negative samples, 3 were positive by GeneXpert. The sensitivity for GeneXpert was much higher compared to smear micrscopy (96 Vs 46% respectively). The Xpert assay also detected 3 rifampcin resistant cases.Conclusions: The test appeared to be as sensitive as culture for the detection of tuberculosis in smear positive, smear negative and extrapulmonary tuberculosis. We recommend the use of GeneXpert assay for the early detection of tuberculosis. We conclude that the test is simple and routine staff can perform the test with minimal training.


2022 ◽  
Vol 8 (1) ◽  
pp. 16-20
Author(s):  
Yusak Mangara Tua Siahaan ◽  
Pricilla Yani Gunawan ◽  
Jeffry Foraldy Haryanto ◽  
Veli Sungono

Background: Plantar fasciitis is a common problem caused by thickening of the plantar fascia. The normal plantar fascia thickness ranged between 2-3 mm and it was generally accepted that value more than 4mm was considered pathologic. Objective: to identify normal plantar fascia thickness in adults using ultrasonography. Methods: This is a cross sectional study measuring the thickness of plantar fascia in 145 subjects with no history of heel pain. Plantar fascia thickness was measured in both feet using an ultrasound. Age, height and weight were recorded and analysed. Results: As much as 145 subjects were included in this study. Male to female ratio was 0.7. Mean age was 44 and body mass index (BMI) was mostly within normal range. Plantar fascia thickness in male was 2.71 ± 0.48 mm in right foot, and 2.74 ± 0.47 mm in left foot. Fascia thickness in female was 2.55 ± 0.50 mm in right foot, and 2.57 ± 0.45 mm in left foot. There was a significant plantar fascia thickness difference between male and female (p = 0.035 in right foot, and p=0.04 in left foot). Age, weight and BMI had a significant correlation towards plantar fascia thickness. In multivariate analysis, age and BMI revealed to have a linear correlation to plantar fascia thickness Conclusion: Age and BMI were found to be the best predictive factor of plantar fascia thickness.


2021 ◽  
Vol 59 (238) ◽  
Author(s):  
Suman Thapa ◽  
Anupam Bista ◽  
Prashant Subedi ◽  
Aaradhana Adhikari ◽  
Sunil Pokharel

Introduction: Tuberculosis has high burden in developing countries like Nepal. This study aims to determine the prevalence of tuberculosis among patients admitted in the department of medicine of a tertiary hospital. Methods: A descriptive cross-sectional study of all the patients admitted to the tertiary care hospital from 1st January 2017 to 31st December 2019 was done. Ethical approval was obtained from Institutional Review Committee (Ref: drs2006181387). Convenience sampling method was used. A descriptive analysis of demographic, clinical and laboratory profile of patients was made using Microsoft Excel version 2016. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 6829 patients admitted to the department of medicine, 209 (3.06%) (2.65-3.47 at 95% CI) patients were diagnosed with tuberculosis. Among them, 147 (70.33%) were males and the mean age was 49.77 years. Pulmonary and extra-pulmonary tuberculosis were present in 153 (73.20%) and 56 (26.79%) patients, respectively. Bacteriological confirmation was limited to 107 (70%) of pulmonary tuberculosis and 3 (5%) of extrapulmonary tuberculosis. Fever was the commonest presentation in 166 (79.42%) followed by cough in 164 (78.46%), anorexia in 108 (51.67%), weight loss 104 (49.76%), and others. Conclusions: The study showed that the prevalence of tuberculosis among admitted patients was higher than national prevalence.


Sign in / Sign up

Export Citation Format

Share Document