S Laxmi Kumari

Abstract

Background: Pulmonary Tuberculosis (PTB) is the commonest opportunistic infection and leading cause of death among people living with HIV (PLHIV). The role of cartridge based nucleic acid amplification test (CBNAAT) has potential to diagnose PTB and rifampicin resistance within two hours in PLHIV is promising. Methodology: 100 PLHIV patients with age of >18years having signs and symptoms greater than or equal to two weeks of duration and / or Chest X-ray findings suggestive of pulmonary tuberculosis who are attending to the department of Pulmonary Medicine, Guntur Medical College, Guntur from November 2016 to October 2017 are included in the study. Sputum samples sent for CBNAAT, AFB stain. Positive samples of CBNAAT and AFB stain are sent for conventional culture. Results: Out of 100 sputum samples, 45 were positive in CBNAAT, and 16 were AFB smear positive. All these 16 smear positive samples have 100% sensitivity in CBNAAT. These positive samples (45) were sent for culture. In culture out of 16 smear positive samples 15 are culture positive 1 is culture negative, which is false positive in CBNAAT also. In culture out of 45 CB-NAAT positive samples 29 culture positive, 16 culture negative. Sensitivity, specificity, PPV, NPV of smear in sputum samples are 46.88%, 98.5%, 93.75%, 79.76%, while that of CB-NAAT are 90.6%, 76.47%, 64. 44%, 94.55% respectively. Primary rifampicin resistance was detected in 1 case (2.22%) in CBNAAT and culture. Conclusions: CBNAAT is a rapid, reliable tool with least bio-safety concern and requires minimally trained staff, is best alternative to conventional methods of tubercular diagnosis and detects rifampicin resistance simultaneously within 2 hours. Keywords: CBNAAT; Sputum; TB.

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Abstract

Background: Lung cancer is the most common type of cancer in males and the leading cause of death in both sexes. It accounts for 11.3% of all new cancers in India and also associated with a mortality rate of 13.7%. This desolate mortality necessitates for the early diagnosis of lung cancer. The study was conducted to evaluate incidence, gender and age wise distribution of lung cancer and its association with smoking. Methodology: This study was done in the department of pulmonary medicine in Guntur Medical College from September 2016 to august 2017. The study includes 52 patients having clinical and radiological suspicion of lung cancer. All the cases were subjected to USG guided transthoracic needle aspiration was sent for cytology. Inconclusive and malignant cases were further subjected to histopathological examination for confirmation. Results: Out of the 52 patients suspicious of malignancy, 32 patients were finally diagnosed as malignant, 5 patients had benign/inflammatory lesions, 6 cases had no evidence of malignancy/non-specific inflammation, 8 had no opinion possible. Most common type is adenocarcinoma followed by squamous cell carcinoma with an incidence rate of 71.8% & 15.7% respectively. The highest incidence of lung malignancies is seen in 5th decade in both sexes. Conclusions: There is increase in the incidence of lung malignancies in females, throwing light on the causes other than smoking like bio-mass fuel exposure and second-hand smoking. Adenocarcinoma is the most common type. Further, USG guided transthoracic needle aspiration has a good sensitivity in detecting lung malignancies. Keywords: Adenocarcinoma; Transthoracic fine needle aspiration; Lung malignancy.

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