scholarly journals Estimation of cerebrospinal fluid cortisol level in tuberculous meningitis

2015 ◽  
Vol 06 (04) ◽  
pp. 541-544 ◽  
Author(s):  
Rohan R. Mahale ◽  
Anish Mehta ◽  
Sudhir Uchil
Keyword(s):  
Cerebrospinal Fluid ◽  
Cortisol Level ◽  
Tuberculous Meningitis ◽  
Morbidity And Mortality ◽  
Cns Involvement ◽  
Tubercular Meningitis ◽  
Cross Sectional ◽  
Delay In Diagnosis ◽  
Appropriate Treatment ◽  
Csf Findings

ABSTRACT Background: Central nervous system (CNS) involvement in tuberculosis is around 5–10%. Of the various manifestations of CNS tuberculosis, meningitis is the most common (70–80%). Delay in diagnosis and treatment results in significant morbidity and mortality. Objective: To study the cerebrospinal fluid (CSF) cortisol levels in tubercular meningitis and compare the levels with controls. Methods: Cross-sectional, prospective, observational, hospital-based study done in 20 patients of tubercular meningitis, 20 patients of aseptic meningitis (AM) and 25 control subjects without any preexisting neurological disorders who have undergone lumbar puncture for spinal anesthesia. Results: Cortisol was detected in all 40 CSF samples of patients (100%). Mean CSF cortisol level was 8.82, 3.47 and 1.05 in tubercular meningitis, AM and controls, respectively. Mean CSF cortisol level in tubercular meningitis was significantly higher as compared to AM and controls (P < 0.0001). Conclusion: Cortisol level estimation in CSF is one of the rapid, relatively inexpensive diagnostic markers in early identification of tubercular meningitis along with CSF findings of elevated proteins, hypoglycorrhachia and lymphocytic pleocytosis. This aids in earlier institution of appropriate treatment and thereby decreasing morbidity and mortality. This is the first study on the estimation of CSF cortisol level in tuberculous meningitis.

scholarly journals Role of cerebrospinal fluid adenosine deaminase activity in the diagnosis of tuberculous meningitis in children

2017 ◽  
Vol 4 (2) ◽  
pp. 411
Author(s):  
T. Hima Bindu ◽  
R. Maheshwara Reddy
Keyword(s):  
Cerebrospinal Fluid ◽  
Adenosine Deaminase ◽  
Tuberculous Meningitis ◽  
Mean Value ◽  
Successful Outcome ◽  
Correct Treatment ◽  
Cross Sectional ◽  
Adenosine Deaminase Activity ◽  
The Mean ◽  
Meningitis In Children

Background: Early and correct treatment is essential for successful outcome in patients of tuberculous men-ingitis. Adenosine deaminase activity in the cerebrospinal fluid has been found to be a simple and useful investigation in the diagnosis of tuberculous meningitis in children.Methods: It is a cross sectional observational hospital based study conducted at the Department of Paediatrics, Deccan College of Medical Sciences, Kanchanbagh, Hyderabad, India. Children aged 2 months to 12 years were included in the study during April 2016 to October 2016.Results: The mean value of adenosine deaminase activity in the cerebrospinal fluid of tuberculous meningitis cases was 13.3±14.49. The mean cerebrospinal fluid adenosine deaminase levels in tuberculous meningitis patients was significantly higher than non-tuberculous meningitis patients with P <0.01.Conclusions: The mean cerebrospinal fluid adenosine deaminase level was significantly raised in tuberculous meningitis patients.

scholarly journals KESAHIHAN PEMERIKSAAN COMPLEX SPECIFIC COCKTAIL ANTIGEN TB (ESAT-6, CFP-10, MPT-64) METODE CEPAT IMMUNOCHROMATOGRAPHY PADA CAIRAN SEREBROSPINAL PASIEN MENINGITIS TUBERKULOSIS {Validity of Rapid Immunochromatography Complex Specific Cocktail Antigen TB (Esat-6, Cfp-10, Mpt-64) Using Cerebrospinal Fluid of Tuberculous Meningitis Patient}

2018 ◽  
Vol 22 (1) ◽  
pp. 48
Author(s):  
Livia Noviani ◽  
Ida Parwati ◽  
Ganiem AR ◽  
Turbawati DK
Keyword(s):  
Cerebrospinal Fluid ◽  
Tuberculous Meningitis ◽  
Clinical Pathology ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Definite Diagnosis ◽  
Sectional Study ◽  
Cross Sectional ◽  
Extra Pulmonary ◽  
Low Sensitivity

The early diagnosis of definite tuberculous meningitis (TBM) is very important in reducing its mortality. The current gold standard ofTBM relies on the isolation of M. tuberculosis from cerebrospinal fluid (CSF) either with direct staining or M. tuberculosis culture, but theseexamination have a low sensitivity due to the pausibasilary condition. Recently there is an assay using rapid Immunochromatography(ICT) cocktail antigen TB in CSF to diagnose TBM. This method can detect ESAT-6, CFP-10 and MPT-64 antigen as an important virulencefactor for the spreading of bacteria to extra pulmonary which is secreted by M. tuberculosis in CSF from TBM patient. The aim of thisstudy was to know the validity of rapid ICT cocktail antigen TB using CSF against MODS culture and acid-fast bacili as a gold standardto diagnose TBM by analyzing. This study iscarried out by a descriptive observational study using cross sectional study design. Thesubjects are patients who were diagnosed as suspected TBM based on Marais criteria and were obtained from the Department of NeurologyHospital Dr. Hasan Sadikin. The examination was done at the Clinical Microbiology Department of Clinical Pathology Dr. Hasan Sadikinhospital since January 2014 until May 2014. A total of 41 subjects which consisted of six (6) subjects with a definite diagnosis of TBM,26 with probable TBM and nine (9) with possible TBM were enrolled in this study. The result of this assay againts acid-fast bacili has the100% sensitivity, 64.1% specificity, 12.5% PPV, 100% NPV, LR(+) 2.78, LR(–)0 and 65.8% accuracy. The result of this assay againtsM. tuberculosis culture has the 83.3% sensitivity, 68.5% specificity, PPV 31.2%, NPV 96%, LR(+) 2.65, LR(–)0.24, accuracy 70.7% andprevalence ratio 7.8. Based on this study, it can be concluded that the validity of this assay againts acid-fast bacili has a high sensitivity,moderate specificity, low PPV, high NPV and moderate accuracy. The result of this assay againts M. tuberculosis culture has a moderatesensitivity and specificity, low PPV, high NPV and moderate accuracy.

scholarly journals Cerebrospinal Fluid analysis in Suspected Subarachnoid Haemorrhage

2006 ◽  
Vol 5 (1) ◽  
pp. 17-19
Author(s):  
Stephen Hill ◽  
◽  
Ashwin Pinto ◽  
Keyword(s):  
Cerebrospinal Fluid ◽  
Subarachnoid Haemorrhage ◽  
Neurological Disorder ◽  
Morbidity And Mortality ◽  
Aneurysmal Subarachnoid Haemorrhage ◽  
Cerebrospinal Fluid Analysis ◽  
Delay In Diagnosis ◽  
Fluid Analysis ◽  
Specialist Referral ◽  
Life Threatening

Aneurysmal subarachnoid haemorrhage (SAH) is an acute life-threatening neurological disorder. A delay in diagnosis can lead to substantial and avoidable morbidity and mortality. It is important to identify patients with SAH promptly, to enable specialist referral to neurosurgical centres. This review aims to provide an up-to-date practical guide concerning the interpretation of spinal fluid results in patients with suspected SAH.

scholarly journals Evaluation of Cerebrospinal fluid adenosine deaminase activity as a complimentary tool in the early diagnosis of tuberculous meningitis in children

2012 ◽  
Vol 8 (2) ◽  
pp. 17-23 ◽  
Author(s):  
A Pan ◽  
A Biswas ◽  
A Chaterjee ◽  
R Kumar
Keyword(s):  
Cerebrospinal Fluid ◽  
Adenosine Deaminase ◽  
Tuberculous Meningitis ◽  
Laboratory Diagnosis ◽  
Clinical Findings ◽  
Medical Sciences ◽  
Delay In Diagnosis ◽  
Csf Analysis ◽  
Adenosine Deaminase Activity ◽  
Meningitis In Children

The diagnosis of tuberculous meningitis cannot be made or excluded on the basis of clinical findings. Definite laboratory diagnosis is cumbersome and time consuming. Delay in diagnosis and institution of proper treatment is directly related to poor outcome and sequalae. Adenosine deaminase activity (ADA) was estimated in cerebrospinal fluid (CSF) in addition to routine CSF analysis of 32 patients of tuberculous meningitis (TBM) and 7 patients of partially treated pyomeningitis (PTM), 10 patients aseptic meningitis (AM) and 13 patients pyogenic meningitis (PM). Mean ADA levels in CSF of TBM patients were higher (15.42 U/L) as compared to 7.21 U/L, 6.41 U/L and 7.50 U/L in PTM, AM and PM respectively. This difference of ADA values in CSF between TBM and other types of meningitis was statistically significant (p<0.01). ADA values were also compared with other biochemical and cytological parameters of CSF & a positive correlation was found with CSF protein level. Sensitivity and specificity of ADA levels in CSF of children to diagnose tuberculous meningitis was 75% and 90% respectively at 10 U/L cut off of ADA levels in CSF. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-2, 17-23 DOI: http://dx.doi.org/10.3126/jcmsn.v8i2.6833

scholarly journals Frequency of BCG vaccination in children with tuberculous meningitis at Liaquat University Hospital Hyderabad.

2019 ◽  
Vol 26 (10) ◽  
pp. 1665-1671
Author(s):  
Shamaeel ◽  
Farzana Shiakh ◽  
Ghulam Shabbir Laghari ◽  
Yasmeen Memon
Keyword(s):  
Tuberculous Meningitis ◽  
Protective Efficacy ◽  
University Hospital ◽  
Axillary Temperature ◽  
Cross Sectional ◽  
Bcg Vaccination ◽  
History Of ◽  
Continued Use ◽  
Study Setting ◽  
Csf Findings

Objectives: To determine the frequency of BCG vaccination in children with tuberculous meningitis of age 01 to 12 years at Liaquat University Hospital Hyderabad. Study Design: Cross sectional descriptive study. Setting: Department of Pediatrics, Liaquat University Hospital, Jamshoro / Hyderabad. Period: Six months from 20-08-2016 to 20-02-2017. Material and Methods: A total of 189 children with history of fever (axillary temperature >37.2°C) for ≥14 days duration with presentation, CT scan and CSF findings consistent with tuberculous meningitis were selected in this study. The data was collected on pre-structured proforma (attached). Results: There were 86(45.5%) male and 103(54.5%) female. Frequency of BCG vaccination in children with tuberculosis meningitis was found in 130(68.78%) cases. Conclusion: Our results show effectiveness of BCG vaccine in preventing TBM. Regardless of the protective efficacy of BCG in preventing pulmonary tuberculosis, in areas in which tuberculosis affects a significant percentage of the population, continued use of BCG may be warranted to prevent tuberculous meningitis.

scholarly journals Use of Roche AMPLICOR Mycobacterium tuberculosis PCR in Early Diagnosis of Tuberculous Meningitis

1998 ◽  
Vol 36 (5) ◽  
pp. 1251-1254 ◽  
Author(s):  
Alec Bonington ◽  
J. I. George Strang ◽  
Paul E. Klapper ◽  
Steven V. Hood ◽  
William Rubombora ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Mycobacterium Tuberculosis ◽  
Tuberculous Meningitis ◽  
Laboratory Findings ◽  
Antituberculosis Treatment ◽  
Few Data ◽  
A Prospective Study ◽  
Specific Diagnostic Test ◽  
Pcr Test ◽  
Csf Findings

Several nucleic acid-based amplification tests are available for the detection of Mycobacterium tuberculosis, but few data are available on their use in the diagnosis of tuberculous meningitis (TBM). We performed a prospective study to assess the Roche AMPLICORMycobacterium tuberculosis PCR test (TB AMPLICOR) for use in the diagnosis of TBM and compared it with direct Ziehl-Neelsen staining of smears, radiometric culture for M. tuberculosis, and clinical and cerebrospinal fluid (CSF) findings. Eighty-three CSF specimens collected from 69 patients with suspected meningitis in South Africa were tested by TB AMPLICOR. On the basis of clinical and laboratory findings, 40 of these patients were treated for TBM and 29 patients were not treated for TBM. Ten CSF samples from 10 patients were positive by TB AMPLICOR. Seven of these 10 patients were classified as having definite TBM, 2 were classified as having probable TBM, and 1 was classified as having possible TBM. The sensitivity of TB AMPLICOR for detecting cases of definite and probable TBM in patients from whom CSF specimens had been collected less than 10 days into antituberculosis treatment was 60.0%. Specimens from all 29 patients not treated for TBM were negative by the TB AMPLICOR, giving a 100% specificity. TB AMPLICOR is therefore more sensitive than the combination of Ziehl-Neelsen staining of smears and radiometric culture for M. tuberculosis and is a rapid and highly specific diagnostic test for TBM.

scholarly journals Presentation of Tuberculous Meningitis Patients : Study of 30 Cases

2013 ◽  
Vol 25 (1) ◽  
pp. 32-35
Author(s):  
DN Sarkar ◽  
MI Hossain ◽  
AKM Shoab ◽  
FA Quraishi
Keyword(s):  
Tuberculous Meningitis ◽  
Laboratory Finding ◽  
Clinical Manifestations ◽  
High Rate ◽  
Response To Treatment ◽  
Physical Sign ◽  
Neck Stiffness ◽  
Cross Sectional ◽  
Delay In Diagnosis ◽  
Gcs Score

Tuberculosis is creating immense adverse social and economic burden in Bangladesh. Tuberculous Meningitis results from the haematogenous spread of primary or postprimary pulmonary disease or from the rupture of a subependymal tubercle into the subarachnoid space. Infection of the CNS is one of the most devastating clinical manifestations of tuberculosis This study aimed to see the presentation of tuberculous meningitis patients in tertiary level hospital of Bangladesh. This cross sectional study was carried out in the Department of Neurology, SSMC, Dhaka from June 2011 to July 2012. In the present study, thirty meningitis patients were enrolled, among the subjects 11.7 % were aged below 20 years, 53.3% were aged between 20 - 39 years, 16.7% were aged between 40 - 49 years and 18.3% were aged above 50 years. Regarding sex 56.7% were male and 43.3% were female. Most prevalent symptom was fever (91.7%). Among others, headache (70%), altered consciousness (45%), vomiting (43.3%) and neck stiffness (28.9%) were notable. The distribution of the study subjects by physical sign 55.0% had anemia, 95.0% had neck rigidity, 10.0% had cranial nerve palsy, 46.7% had kernig's sign and 20.0% had long tract sign. Regarding GCS score 10.0 % had GCS score less than 8, 18.3 % had between 9 – 12 and 71.7% had over> 12.The Laboratory finding among the study subjects 3.3% showed positive gram stain and 43.7% showed MT over 10 mm. In response to treatment 93.3% responded to anti TB out of 30 TBM subjects. This study demonstrated that presentation of tubercular meningitis is different in different patient.TBM is the severe form of extra-pulmonary tuberculosis occurring in 7.0- 12.0% of TB patients in developing countries with high rate of mortality due to delay in diagnosis and proper treatment. DOI: http://dx.doi.org/10.3329/medtoday.v25i1.16069 Medicine Today 2013 Vol.25(1): 32-35

scholarly journals Spinal tuberculosis in a case of tubercular meningitis with hydrocephalus

2016 ◽  
Vol 4 (2) ◽  
pp. 46
Author(s):  
Shriram Gautam ◽  
Vinod Kumar Singh Gautam
Keyword(s):  
Tuberculous Meningitis ◽  
Spinal Tuberculosis ◽  
Delayed Diagnosis ◽  
Clinical Work ◽  
Morbidity And Mortality ◽  
Neurological Recovery ◽  
Tubercular Meningitis ◽  
Work Up ◽  
The Brain

Delayed diagnosis of tuberculosis of the brain and spine is associated with morbidity and mortality. Authors present a case to highlight the significance of thorough clinical work up, neuro-radiology and appropriate and prompt anti-tuberculous therapy in patients of CNS TB. Timely neurosurgical interventions in this patient who had developed spinal tuberculosis during the course of treatment for tuberculous meningitis (TBM) helped in reducing the morbidity and led to complete neurological recovery.

Characteristics of Polycystic Ovarian Syndrome in Sub-fertile Woman Attending to GOPD in ShSMCH

2019 ◽  
Vol 11 (1) ◽  
pp. 17-23
Author(s):  
Jinnat Ara Islam ◽  
Fatema Ashraf ◽  
Eva Rani Nandi
Keyword(s):  
Polycystic Ovarian Syndrome ◽  
Polycystic Ovaries ◽  
Cross Sectional ◽  
Medical College ◽  
Appropriate Treatment ◽  
Pcos Group ◽  
Symptom Complex ◽  
Ovarian Syndrome ◽  
Selection Of ◽  
Fertile Women

Background: Polycystic ovarian syndrome (PCOS) is a condition characterized by menstrual abnormalities (oligo/amenorrhea) and clinical or biochemical features of hyperandrogenism and may manifest at any age. It is a common cause of female subfertility. All the dimensions of PCOS have not been yet completely explored. Methods: It was a cross sectional comparative study carried out at-GOPD of Shaheed Suhrawardy Medical College & Hospital from January, 2016 to December 2016 on 162 subfertile women. Among them 54 were PCOS group and 108 were non PCOS group. PCOS was diagnosed by (Rotterdam criteria 2003) (i) Oligo or anovulation (ii) hyperandrogenism (iii) Polycystic ovaries. Study was done to evaluate and compare the demographic characteristics, clinical, biochemical and ultrasoundgraphic features of sub-fertile women with and without PCOS. Results: A total of 162 sub-fertile women aged 16-36 years. Mean age was 29.5±5.4. There were significant differences between the two groups in terms of (oligo/amenorrhea), hirsutism, WHR and ovarian ultrasound features. There were no significant differences between two groups in correlations between the level of obesity with the incidence of anovulation, hyperandrogenism or with hormonal features. Conclusion: PCOS is one of the important factors causing Infertility. It is an ill-defined symptom complex needed due attention. There is a need to increase awareness regarding. The clinical features of PCOS are heterogenous thus can be investigated accordingly of selection of appropriate treatment modality. J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 17-23

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