Shilpa G

Abstract

Introduction: Lymphadenopathy is a common, nonspecific clinical sign. Fine Needle Aspiration Cytology (FNAC) is the first line of investigation in the evaluation of lymphadenopathy. FNAC material can be used for cytological evaluation and other ancillary tests in Tuberculous Lymphadenopathy. Aims and Objectives To evaluate the role of FNAC as a diagnostic tool in lymphadenopathy. To assess the role of Cartridge based nucleic acid amplification test (CBNAAT) in suspected cases of tuberculous lymphadenopathy. Materials and methods: The study conducted at department of Pathology in MVJMC &RH, Hoskote, Bangalore from January 2017 to June 2018 A total of 104 cases of lymphadenopathy were subjected to FNAC. In each case at least 3 smears for H & E, Giemsa stain and Special stain like AFB done for tuberculous lymphadenopathy. FNAC material sent for CBNAAT in suspected cases of Tuberculosis . Results: The age ranged from 1-90years, Male:Female of ratio1.26 :1. Most common site was cervical and cytological pattern was granulomatous -41(39.4%) followed by reactive -38(36.5%).Majority of them presented with solitary node (77%) and followed by bilateral/multiple (23%). One case of reactive (11%), two cases of suppurative (50%) and ten cases of granulomatous (37%) were found  to be positive for Tuberculosis by CBNAAT. Conclusion: FNAC is simple, cost effective diagnostic tool with high degree of accuracy.FNAC coupled with AFB staining  is the first line of investigation for Tuberculous lymphadenopathy. According to New Revised National TB Control Programme (RNTCP) guidelines CBNAAT sputum is a must for paediatric cases. The present study highlights the utility of CBNAAT from FNAC material as one of the rapid and adjuvant diagnostic tool in tuberculous lymphadenopathy. Keywords: FNAC, Tuberculous lymphadenopathy, CBNAAT.

Open full article page

Abstract

Introduction: Septicaemia is one of the major causes of mortality and morbidity during the neonatal period especially in developing countries. Early diagnosis of neonatal sepsis is a diagnostic problem due to non-specific clinical features. Blood culture is the gold standard, but it takes several days and is expensive. Hence there is a critical need for laboratory tests that aid in the rapid diagnosis of neonatal sepsis. Aims and Objectives: To measure the role of Haematological Scoring System and C-reactive protein as an early diagnostic tool for neonatal sepsis. Materials and Methods: This was a prospective study performed on 116 neonates, who were clinically suspected cases of septicaemia, admitted at Neonatal Intensive Care Unit, Yenepoya Hospital, Mangalore. Each hematologic parameter like total leukocyte count, polymorphonuclear neutrophil (PMN) count, immature PMN count, platelet count etc. were analysed in all cases using the Haematological Scoring System (HSS) formulated by Rodwell et al. Blood cultures were performed as a gold standard. C-reactive protein (CRP) was also estimated. Results: Out of 116 neonates, 61(52%) were male neonates and 55(48%) were female neonates. 18(15%) cases were with proven sepsis, 58(50%) cases with probable sepsis and 40(35%) cases were on the safer side. The HSS was found to have a sensitivity of 94.4%, specificity of 75.5%, positive predictive value was 41.4% and negative predictive value was 98.6%. Conclusions: HSS is a rapid, simple and easily affordable screening tool for early detection of neonatal septicaemia. It also provides an effective guideline to make decisions regarding judicious use of antibiotics.  Keywords: Blood culture, Haematological Scoring System, Neonates, Septicaemia, Rapid diagnosis

Open full article page