Kaushal Bhavsar

Abstract

Background and Aim: Fibre optic video bronchoscopy (FOB) is a very safe and highly sensitive investigation for patients in whom we suspect lung malignancy. Bronchoscopy revolutionized early diagnosis of lung cancer by providing cytological and histological specimen in form of bronchoalveolar lavage and bronchial biopsy. In present study we describe our experience of performing bronchoscopy in patients of suspected lung malignancy. Methodology: Present study is retrospective observational study performed at tertiary care hospital, Sola, Ahmedabad over a period of one year. In this study 40 patients with suspected lung mass in CT underwent bronchoscopy after obtaining well informed written consent. A detailed clinical history, physical examination and necessary investigations were also done. Results: Of the 40 cases, 30 (75%) were male and 10 (25%) were female. The mean age in this study was 63 years. Squamous cell carcinoma was most common type present in 17.5% of participant, while second most common was adenocarcinoma. Small cell carcinoma was present in 4% and carcinoid was present in 5%. Undifferentiated non-small cell carcinoma was present in 20%. The yield of the study was 60%.  Conclusions: Lung cancer is common malignancy. Bronchial biopsy has very high diagnostic yield. Bronchoscpoic techniques are safe and most precise tool for early diagnosis of suspected lung mass. Keywords: Biopsy, Bronchoalveolar lavage, Fibreoptic bronchoscopy, Lung cancer.

View Article

Abstract

Introduction and Aim: The World Health Organisation (WHO) TB statistics for India for 2016 give an estimated incidence of 2.79 million cases. CBNAAT (Cartridge based nucleic acid amplification Test) helps to diagnose upfront drug resistance within two hours of sample submission. Materials and Methods: We collected data from RNTCP laboratory for all newly diagnosed cases of Pulmonary TB registered from December 2018 to July 2019 who underwent sputum microscopy by LED FM and CBNAAT testing. Result: Out of 333 patients, 241 (72%) were sputum microscopy positive while CBNAAT detected Mycobacterium TB (MTB) in 289 (86.8%) patients of whom Rifampicin resistance was detected among 15 patients (4.5%). This included 12/240 sputum positive patients in whom MTB was detected by CBNAAT and 3/49 sputum negative patients in whom MTB was detected by CBNAAT. There is moderate agreement for diagnosis of MTB by CBNAAT and sputum microscopy (Kappa = 0.55, CI: 0.449 to 0.655). Conclusion: Universal upfront sputum CBNAAT in all new suspected cases of pulmonary TB according to current guidelines of RNTCP shows moderate agreement with LED-FM and yields a elevated percentage of patients being diagnosed with pulmonary sputum positive TB. Keywords: New Pulmonary TB, Sputum Microscopy, CBNAAT, Drug Resistant TB.

View Article