Background: According to Revised National Tuberculosis Control Program (RNTCP), diagnosis of pulmonary tuberculosis (TB) in India requires examination of two sputum samples collected over 2 days, that is, “spot” and next day “morning” samples. Objective: To assess the feasibility of diagnosing pulmonary TB by examining two spot sputum samples in 1 day and to compare this approach with the current RNTCP protocol. Materials and Method: A total of 375 subjects having cough >2 weeks were enrolled into the study. Three sputum samples were collected from each of the study participant; first spot (S1), second extra-spot (S2) sample 1 h after collection of the first sample, and third morning (M) sample collected next day morning. These specimens were subjected to standard sputum smear microscopy for acid-fast bacilli as per RNTCP guidelines. For 1-day protocol, results of “S1 and S2” samples and for 2-day protocol results of “S1 and M” samples were considered. Results: The number of sputum-positive pulmonary TB cases diagnosed with standard 2-day protocol was 119, whereas the experimental 1-day protocol diagnosed 120 cases ( P = 0.7). Comparing with standard 2-day protocol, this new 1-day protocol had sensitivity 98.32%, specificity 100%, positive predictive value 100%, and negative predictive value 99.17%. Conclusion: Single-day method can be adopted as the standard diagnostic approach for pulmonary TB after large-scale multicenter randomized controlled trials.
BACKGROUNDEmpyema Thoracis (ET), the accumulation of pus in pleural cavity due to infective origin, is a perpetual clinical entity since Hippocratic era. The incidence and prevalence varies depending on different countries, type of infections, age and immune status of the host.
Pulmonary Alveolar Microlithiasis (PAM) is a very rare diffuse lung disease, affecting both lungs by intra-alveolar deposition of calcium phosphates in form of microliths. There have been about 700 cases of PAM recorded in the medical literature. The etiopathogenesis of the disease is unknown. It is now thought to be an autosomal recessive disease caused by deletion of Na-Pi cotransporter (Npt2b) in alveolar epithelial cells due to defective DNA mutation in the gene SLC34A2. The disease is slowly progressive, usually detected in 3 rd /4 th decades of life and death is due to cardiorespiratory failure. The patients detected with PAM in pregnancy are exceptional. Very few cases were reported till date. We report a pregnant lady presenting with PAM delivering vaginally a healthy female child in spite of cardiomegally and severe PAH.
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