Manju M D

Background : Cytology, Ziehl Neelsen staining and Mantoux test are conventionally used to test and treat lymph node tuberculosis. Cartridge Based Nucleic Acid Amplification Test (CBNAAT) is being now recommended for diagnosis of all extrapulmonary tuberculosis including tubercular lymphadenitis.  Aims and Objectives : To asses efficacy of various diagnostic tools for diagnosis of lymph node tuberculosis in solid state (non-caseating stage). Material and Methods : It was a prospective study conducted by including all consecutive patients with lymph node swelling suggestive of tuberculosis. Fine needle aspirate was subjected for cytology and CBNAAT. If both turned negative, excision biopsy was performed and subjected for histology. Results were tabulated. Results : Sixty patients were included after excluding certain patients with caseous aspiration. Thirtyone (51.67%) had mycobacterium detected in CBNAAT. Remaining patients after histology had following diagnosis; Tuberculosis in eight, nonspecific reactive hyperplasia in 11, metastasis and lymphoma in four and Non Tubercular Mycobacteria and actinomycosis in one each patient. Conclusion : CBNAAT is an effective tool for diagnosing lymph node tuberculosis even in early stages of pathology. Relying solely on cytology to diagnose tuberculosis should be discouraged. Keywords: Caseation, CBNAAT, Cytology, Excision biopsy, Lymphadenopathy, Tuberculosis.

Introduction: Multiple agents are being used for the purpose of chemical pleurodesis with varied success and risks. Povidone iodine was also a successful agent in inducing pleurodesis in pleural effusions and pneumothoraces. Aims and Objectives: To evaluate the efficacy and safety of povidone iodine pleurodesis through intercostal tube drainage (ICD) in patients with spontaneous pneumothorax. Materials and Methods: This was a prospective study where povidone iodine was infused into pleural cavity through ICD in patients with spontaneous pneumothorax. Success of procedure and adverse events recorded. Patients were followed up for 12 months for recurrence of pneumothorax. Results: A total of 38 patients with mean age of 58.6 12.5 years were included in study. 28 patients had successful first procedure, six patients required repeat pleurodesis, three had failed pleurodesis and two had recurrent pneumothorax after 6 months. All patients experienced chest pain of varying severity. Two patients had ARDS. Conclusion: Povidone iodine can be used as effective and safe agent for chemical pleurodesis in spontaneous pneumothorax. Keywords: Pleurodesis, Pneumothorax, Povidone iodine, ARDS, Intercostal tube drainage, Talc.