ROLE OF CBNAAT IN DIAGNOSIS OF GENITAL TUBERCULOSIS IN WOMEN

Objective: Female genital TB referring to TB of the uterus,fallopian tubes and/or Ovaries.It poses a diagnostic dilemma because of its varied presentations and lack of sensitive and specific methods of diagnosis,though CBNAAT gives rapid result. India is a country sharing one fourth of the global incidence of tuberculosis. It is much easier to diagnose pulmonary cases, but challenges are with extrapulmonary cases. Genital tuberculosis is considered as an important cause of infertility in young females in India and difficult to diagnose.It requires incorporation of different modalities that should correctly,timely and rapidly diagnose the case.Methods:This study was conducted prospectively from October 2016 to June 2018 on 200 endometrial samples from reproductive age group females attending Obstetrics and Gynaecology OPD in obstetrics and gynaecology department of SSH, BHU. Nucleic acid amplification technique was done and their sensitivity in diagnosis of genital tuberculosis was ascertained. Results: Out of 200 samples, 1 samples were found positive with CBNAAT.Unlike Pulmonary TB, role of CBNAAT in the diagnosis of female genital TB is limited. Conclusion: Infertility in young female per se is usually heart breaking and distressing. Therefore, it is essential to diagnose and treat the cases of genital tuberculosis before irreversible damage of tube may happen. Although, advancement in diagnostic field is there from microscopy to molecular method,but still diagnosis of genital tuberculosis is challenging. Correct diagnosis prevents young female from mental trauma and toxicity of anti-tuberculosis drugs given on suspicion in high prevalence country like India.

A study to know the prevalence of genital tuberculosis in female’s pulmonary tuberculosis patients and role of cartridge based nucleic acid amplification test in genital tuberculosis from North India

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20210413 ◽

2021 ◽

Vol 9 (2) ◽

pp. 395

Author(s):

Anand Kumar ◽

Aparjot Singh ◽

Sudhir Chaudhri ◽

Sanjay Kumar Verma ◽

Kiran Pandey ◽

...

Keyword(s):

Nucleic Acid ◽

Pulmonary Tuberculosis ◽

Nucleic Acid Amplification Test ◽

Reproductive Age ◽

Nucleic Acid Amplification ◽

Genital Tuberculosis ◽

Tuberculosis Patients ◽

Histopathology Examination ◽

Background: Mycobacterium tuberculosis, most commonly, infects the lungs (pulmonary TB). Most cases of female genital TB (FGTB) are found in premenopausal women, theoretically because an atrophic endometrium provides a poor milieu for mycobacterial growth. Female genital TB generally occurs secondary to pulmonary (commonest) and more common in women with reproductive age group. The present study was designed to know the prevalence of genital tuberculosis in female’s pulmonary tuberculosis patients and role of cartridge based nucleic acid amplification test (CBNAAT) in genital tuberculosis.Methods: The patients of female’s pulmonary tuberculosis were picked up from out-patient and in patients’ section of the hospital at random. After ruling out pregnancy, the endometrial samples were collected from premenstrual endometrium (approximately 2-3 days before menstruation) and were subjected to histopathological examination and CBNAAT. Day 1 or 2 menstrual blood of unmarried females and patients not giving consent for biopsy were taken.Results: Seventy married and 20 unmarried patients of female pulmonary tuberculosis patients were evaluated for genital tuberculosis. The mean age of married population was 29±7.68 years. Cough with expectoration was most common respiratory symptoms and seen in 94% cases. In present study 89% cases were sputum positive and 11% were sputum negative. The percentage of non MDR and MDR TB cases were respectively 95.7 and 4.2% respectively. Among the gynecological symptom’s irregular menstruation, vaginal discharge and pelvic pain were present in 68, 60 and 52% of the study patients respectively. The diagnosis of FGTB by histopathology examination and CBNAAT were 28.6 and 17.1% respectively.Conclusions: In present study FGTB diagnosed by histopathology examination and CBNAAT were 28.6 and 17.1% respectively and which was statistically significant (c2=28.25 and p value=0.00001).

Comparison of diagnostic accuracy of bactec culture, gene-xpert and histopathology in the diagnosis of genital tuberculosis in women with infertility

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20201233 ◽

2020 ◽

Vol 9 (4) ◽

pp. 1614

Author(s):

Rachna Chaudhary ◽

Vandana Dhama ◽

Manisha Singh ◽

Shakun Singh

Keyword(s):

Endometrial Biopsy ◽

Reproductive Age ◽

Specific Method ◽

Suspected Case ◽

Genital Tuberculosis ◽

Diagnostic Dilemma ◽

Medical College ◽

Actual Incidence ◽

Background: Female genital tuberculosis (FGTB) is often a silent disease sparing no age group but majority of patients are in the reproductive age. In infertility patient’s incidence of FGTB varies from 3-16% in India but the actual incidence of genital tuberculosis may be under reported due to asymptomatic presentation and paucity of investigations.Methods: Prospective case control study was conducted from June 2018 to May 2019 in LLRM Medical College Meerut. A total 100 Endometrial samples were collected during diagnostic laparoscopy from all suspected case of genital TB, presented with either primary or secondary infertility and samples sent for histopathology, Gene-xpert and Bactec culture.Results: Out of 100 samples Bactec culture was positive in 2 samples, Gene-xpert positive in 3 samples. On histopathology out of 100 cases, non-specific endometritis was found in 1 case, tubercular-endometritis in 1 case, proliferative enometrium (anovulatory) in 40 cases and secretory endometrium found in 58 cases.Conclusions: Female genital TB poses a diagnostic dilemma because of its varied presentation and lack of sensitive and specific method of diagnosis. Culture though remains the gold standard of diagnosis of female genital TB, gene-xpert, histopathology, Bactec culture or laparoscopy can be used for starting treatment. Endometrial biopsy on histopathology shows not only Tubercular endometritis but also gives hormone response on endometrium, local factors of endometrium concerning non-specific and specific infections and anovulatory cycles.

Etiopathogenesis, Challenges and Remedies Associated With Female Genital Tuberculosis: Potential Role of Nuclear Receptors

Frontiers in Immunology ◽

10.3389/fimmu.2020.02161 ◽

2020 ◽

Vol 11 ◽

Author(s):

Shalini Gupta ◽

Pawan Gupta

Keyword(s):

Nuclear Receptors ◽

Potential Role ◽

Genital Tuberculosis ◽

Female Genital Tuberculosis

Faridpur Medical College Journal ◽

10.3329/fmcj.v13i1.38022 ◽

2018 ◽

Vol 13 (1) ◽

pp. 53-55

Author(s):

Shahana Ahmed ◽

Dipti Rani Shaha ◽

Poly Begum ◽

Tahmina Akter

Keyword(s):

Young Women ◽

Reproductive Age ◽

Age Group ◽

Genital System ◽

Genital Tuberculosis ◽

The Social ◽

Anti Tubercular Therapy ◽

Reproductive Age Group ◽

The incidence of genital tuberculosis varies widely with the social status of the patient and her environment. The incidence is about 1% amongst gynecological patients attending the outpatient department in the developing country. Genital TB may be asymptomatic and the majority of women are diagnosed during investigations of infertility. Genital system TB represents 15-20% of extrapulmonary TB and is usually asymptomatic affecting mainly young women in the reproductive age group. Here we presented a case of genital TB which was diagnosed during laparotomy. After confirmation of diagnosis by histopathology, the case was successfully managed by anti-tubercular therapy for 9 months.Faridpur Med. Coll. J. Jan 2018;13(1): 53-55

OL-006 Role of polymerase chain reaction in the diagnosis of female genital tuberculosis

International Journal of Infectious Diseases ◽

10.1016/s1201-9712(09)60103-x ◽

2008 ◽

Vol 12 ◽

pp. S36

Author(s):

C.P. Baveja ◽

C. Sahu ◽

U. Manaktala ◽

V. Kamal

Keyword(s):

Polymerase Chain Reaction ◽

Chain Reaction ◽

Genital Tuberculosis ◽

Polymerase Chain ◽

Role Of C-Reactive Protein in Diagnosis of Acute Appendicitis

Journal of Islamabad Medical & Dental College ◽

10.35787/jimdc.v10i4.660 ◽

2021 ◽

Vol 10 (4) ◽

pp. 210-214

Author(s):

Mirza Tassawar Hussain ◽

Muhammad Kashif Khan ◽

Syed Shamsuddin ◽

Aabid Ali ◽

Erum Khan ◽

...

Keyword(s):

Acute Appendicitis ◽

Correct Diagnosis ◽

C Reactive Protein ◽

Diagnostic Dilemma ◽

Senior Registrar ◽

Predictive Values ◽

Reactive Protein ◽

Highly Sensitive ◽

Sensitivity Specificity

Background: Appendicitis is a common surgical emergency and diagnostic dilemma. Making the correct diagnosis is often difficult as the clinical presentation varies according to the age of the patient and the position of appendix. The objective of this study was to identify clinical applicability of C- reactive protein, as a diagnostic test for appendicitis. Methods: This prospective study was carried out in Federal government Polyclinic hospital, Islamabad from January to July 2019, 114 patients underwent appendectomy for clinically diagnosed acute appendicitis. The decision to operate the patient was given by senior registrar. The blood samples for C-reactive protein were drawn before taking the patient to the operating theatre. Removed appendices were sent for histopathological confirmation of diagnosis. The C-reactive protein was then compared with the results of histopathology to determine its validity. The data was entered and analysed in SPSS 23. Results: The sensitivity, specificity, positive and negative predictive values of C-reactive protein in patients with clinical diagnosis of acute appendicitis were found to be 94%, 78%, 93% and 74 % respectively. Conclusion: CRP is helpful in making diagnosis of acute appendicitis. It is highly sensitive but has a relatively low specificity.

Isolated Right Ventricle Mass: The Role of Echocardiography in Diagnostic Dilemma

Journal of Cardiac Critical Care TSS ◽

10.1055/s-0038-1671679 ◽

2018 ◽

Vol 02 (01) ◽

pp. 044-047

Author(s):

Suruchi Ladha ◽

Usha Kiran ◽

Santanu Bora

Keyword(s):

Right Ventricle ◽

Transesophageal Echocardiography ◽

Female Patient ◽

Surgical Management ◽

Young Female ◽

The Other ◽

Diagnostic Dilemma ◽

Invaluable Tool ◽

Associated Mass

AbstractThe presence of a right ventricle mass is uncommon, especially if there is no associated mass in the other chambers of the heart. Right ventricle mass is usually due to thrombi or vegetations; however, a variety of tumors may also present similarly. The authors report the presence of an isolated right ventricle mass in a young female patient and the intraoperative use of transesophageal echocardiography in diagnostic dilemma. Echocardiography helps in assessing the characteristics of the mass, such as the size, shape, attachment points, and composition, and continues to remain an invaluable tool for guiding both the anesthetic and the surgical management of the case.

HYSTEROSCOPY FOR DIAGNOSIS OF FEMALE GENITAL TUBERCULOSIS IN INFERTILE WOMEN: AN ESSENTIAL TOOL IN MINIMALLY INVASIVE ERA.

10.36106/gjra/0205464 ◽

2021 ◽

pp. 73-76

Author(s):

Vinita Sarbhai ◽

Aafreen Naaz ◽

Vikram Sarbhai

Keyword(s):

Prospective Observational Study ◽

Uterine Cavity ◽

Endometrial Biopsy ◽

Genital Tuberculosis ◽

Infertile Women ◽

The Common ◽

Basic Evaluation ◽

INTRODUCTION: Female genital tuberculosis (FGTB) is difcult to diagnose due to asymptomatic presentation and paucity of denitive investigations. Hysteroscopy can be utilized for the diagnosis of genital tuberculosis in infertile women. This study was done to study the role of hysteroscopy in the diagnosis of genital tuberculosis. METHODS: Prospective observational study was performed on 50 infertile women after basic evaluation of infertility. The women with tubal factors for infertility or unexplained infertility were selected for the study. Premenstrual endometrial biopsy (EB) was done for mycobacteria (AFB) detection. Hysteroscopy was performed in the next cycle if no AFB was detected on EB. ATT was given if genital TB was diagnosed on EB, and hysteroscopy was performed after completion of ATT. Hysteroscopic observations were compared with endometrial biopsy results. RESULTS: A total of 4 (8%) cases were diagnosed as bacteriologically positive for genital tuberculosis in endometrial samples. They were given anti-tubercular treatment. On hysteroscopy, pale endometrium (16%), Intrauterine adhesions (46%), and osteal obliteration (18%) were the common abnormal observations. 12 patients had mild adhesions, 6 had moderate and 5 patients had severe adhesions. Overall, 26 (52%) patients had features of intrauterine brosis, like intra-uterine adhesions or ostial obliteration, which could be suggestive of chronic infection like tuberculosis. Hysteroscopic adhesiolysis was performed in 46% and the cavity was restored. CONCLUSION: Endometrial Biopsy and Hysteroscopy are complementary procedures that together can help in the diagnosis of FGTB. Hysteroscopy is not only the gold standard for diagnosing uterine adhesions, distortion of the uterine cavity and tubal ostia, but it can also be a prognostic and therapeutic tool.

Female genital tuberculosis and the role of hysterosalpingography

Seminars in Roentgenology ◽

10.1016/0037-198x(79)90026-9 ◽

1979 ◽

Vol 14 (4) ◽

pp. 295-304 ◽

Cited By ~ 7

Author(s):

Alvin M. Siegler ◽

Vasilios Kontopoulos

Keyword(s):

Genital Tuberculosis ◽

The incidence detection of tuberculosis in patients with infertility and abnormal uterine bleed: a study in North Indian population

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20193109 ◽

2019 ◽

Vol 8 (8) ◽

pp. 3041

Author(s):

Simmanjit Kaur ◽

Unmesh Santpur ◽

Sunita Mor

Keyword(s):

Female Genital Tract ◽

Uttar Pradesh ◽

Reproductive Age ◽

Genital Tuberculosis ◽

Immunodeficiency Virus ◽

Acute Form ◽

Reproductive Age Group ◽

Hiv Negative ◽

Background: Tuberculosis (TB) remains a major global health problem, responsible for ill health among millions of people each year. TB ranks as the second leading cause of death from an infectious disease worldwide, after the human immunodeficiency virus (HIV). The latest estimates included in this report are that there were 9.0 million new TB cases in 2013 and 1.5 million TB deaths (1.1 million among HIV-negative people and 0.4 million among HIV-positive people). In India the incidence of genital tuberculosis is nearly about 18%. And in female genital tract it is estimated that 18% in India suffer from genital TB.Methods: The study was carried-out during November 2014 to March 2016 at Maharishi Markandeshwar deemed to be University, MMIMSR Mullana (Ambala). A total of 100 females of reproductive age attending the Gynaecology Outpatient were finally recruited on the basis of inclusion and exclusion criteria.Results: In our study majority i.e. 39 (39.0%) patient were found in the group of 20-29 years of age followed by 38 (38.0%) patients in the group of 30-39 years of age. Only 23 (23.0%) were found in the group of 40-49 years of age. In our study majority i.e. 54 (54.0%) patients were from Haryana followed by 44 (44.0%) patients were from Uttar Pradesh and only 2 (2.0%) patients were from Punjab. Out of 100 patients majority i.e. 76 (76.0%) patients had negative TB with either of investigation and only 24 (24.0%) patients had positive TB with either of investigation.Conclusions: Female genital tuberculosis affects the females of reproductive age group. The disease manifests itself as pelvic inflammatory disease in its acute form with menstrual irregularities and later infertility, and is almost always secondary to a primary lesion elsewhere.