M Sridevi

Abstract

Introduction: Ascites is the accumulation of fluid within the peritoneal cavity. Normally, 5-20ml of peritoneal fluid is found between the layers of peritoneum, acting as a lubricant and reducing the friction of organ movement during digestion and bodily movements. The use of serum ascites albumin gradient has out dated the total protein measurement in differentiating transudate from exudate fluid. Analysis is done in two broad spectrums: (1) Biochemical analysis (2) Clinical pathology and Cytological analysis Aim & Objectives: This study was done with the objective to evaluate the ascitic fluid analysis for differentiating transudate versus exudate and also the characteristics of the peritoneal fluid in various causes of ascites. Materials and Methods: In this study, 100 patients of ascites were evaluated for ascitic fluid total protein (AFTP) and Serum Albumin Ascitic Gradient (SAAG) along with ultrasound and other required investigations. Ascitic fluid was obtained by Paracentesis, an invasive sampling procedure to remove fluid or air from the peritoneal cavity for diagnostic or therapeutic purposes. The fluid obtained is sent for analysis. Ascitic fluid analysis is a group of tests used to diagnose the etiology of fluid accumulation. Result: Study shows that ascites due to various aetiology is common among 31-50 years of age group with a slight male predominance. The present study suggests that transudative ascites are more common than exudative ascites with a percentage of 52%. Conclusion: Serum Albumin Ascitic Gradient (SAAG) is much more superior to ascitic fluid total protein (AFTP) in the differential diagnosis of Ascites. Ascitic fluid analysis helps in diagnosing the aetiology of ascites based on the cytological and biochemical parameters. The common aetiology for ascites reported in India is liver cirrhosis. The development of ascites in cirrhotic patients is associated with a mortality of 15% and 44% at one-year and five-year follow-up periods, respectively. Keywords: Ascitic fluid total protein (AFTP), Serum Albumin Ascitic Gradient, (SAAG), Paracentesis, Cirrhosis.

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Abstract

Introduction: Pleural fluid is defined as the fluid that is found between the two layers of pleura, (i.e. the parietal and visceral pleura) the membranes which line the cavity and surround the lungs. Normally, 10-20ml of pleural fluid, similar in composition to plasma but lower in protein ( over the layers of pleura, facilitating the movement between lungs and chest wall. The pleural fluid enters the systemic capillaries in the parietal pleura and exits via the parietal pleural stoma and lymphatics. (1) Pleural fluid accumulates when too much fluid enters or too little fluid exits the pleural cavity. Pleural fluid analysis is used to diagnose the cause of accumulation of pleural fluid in the chest cavity (Pleural effusion). Pleural effusion may be Transudative or Exudative. Analysis is done in three broad spectrums (1) Biochemical analysis (2) Microbiological analysis (3) Clinical pathology or cytology analysis. Materials and Methods: Pleural fluid is obtained by Thoracocentesis. Thoracocentesis or pleural tap is an invasive procedure to remove fluid or air from the pleural space for diagnostic or therapeutic purposes. The fluid obtained is sent for analysis. Pleural fluid analysis is a group of tests used to diagnose the cause of fluid build-up such as CHF, Cirrhosis, Infection etc. Result: Study shows that pleural effusions are common among 40-60 years of age group with a slight male predominance. The present study suggests that exudative effusions are more common than transudative effusions with a percentage of 61%. Conclusion: Pleural fluid analysis helps in diagnosing the etiology of the effusion based on the appearance and biochemical parameters. The common etiology for pleural effusion reported in India is Tuberculosis. WHO statistics shows India accounted for 27% of the total new infections in 2017, which is the highest among the top 30 high TB burden countries in the world. Keywords: Exudative, Pleural fluid, Transudative, Thoracocentesis.

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Abstract

Introduction: Fungal lesions are common in immunocompromised patients like Diabetic Mellitus, patients on anticancer drug and radiotherapy, HIV and transplant recipients. Although tissue culture being the gold standard for diagnosing fungal infections, histopathological examination gives better idea about tissue invasion. Materials and Methods: This study was done over 47 cases for a period of four years. This study was done to analyze the clinicopathological spectrum of fungal infections, morphology and their distribution according to age, sex and site of involvement in histopathological specimens in our hospital setup. Results: In this study, the most common fungal organism was found to be Phaeohypomycosis and most of these cases of phaeohypomycosis presented as ganglion and dermoid cyst .Most common site was foot. Conclusion: In this study we attempted to determine the etiological diagnosis of fungal infections in histopathological specimens received in our department. Keywords: Fungal lesions, Dermoid cyst, Ganglion, Gomori methenamine silver stain, Immunocompromised patients, Phaeohypomycosis.

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