Background The most prevalent clinical entity of extra pulmonary tuberculosis is tuberculous lymphadenitis. However, it resembles other granulomatous conditions pathologically and obtaining tissue for microbiological diagnosis is also difficult. Thus it is a challenging task for diagnosis and early initiation of management. Fine needle aspiration cytology and biopsy are the diagnostic methods generally used to obtain the lymph node samples for histopathological and microbiological diagnosis. Mycobacterium culture on Lowenstein-Jensen medium remains the gold standard for definitive diagnosis, but its major limitations is a prolonged turn-around time of 2–4 weeks. The GeneXpert Mtuberculosis/RIF assay is a novel molecular diagnostic method for rapid diagnosis of tuberculosis and rifampicin resistance in clinical specimens. Methods This was a cross sectional analytical study conducted on 67 cases of suspected tubercular lymphadenitis at R.L Jalappa Hospital and Research Centre, Tamaka, Kolar. The study was carried out between December 2017 to June 2019. The samples were collected using excision biopsy and subjected to GeneXpert Mtuberculosis/RIF assay and histopathology. Further, sensitivity, specificity, positive predictive value and negative predictive value was measured and compared with histopathology. Results The average age of the patients was 37.04 ± 19.27 and majority was males. The lymph nodes were predominantly present in cervical region. Histopathology analysis reveals 46 positive cases of tuberculosis Lymphadenitis and GeneXpert Mtuberculosis/RIF assay detects 42 cases of tuberculosis Lymphadenitis. In the present study, GeneXpert Mtuberculosis/RIF assay had a sensitivity of 82.60% and specificity of 85% when compared to histopathology. Further the PPV and NPV was found to be 92.68% and 68% respectively. GeneXpert Mtuberculosis/RIF showed 2 cases of rifampicin resistance out of 67 cases. In this study, the GeneXpert Mtuberculosis/RIF showed the results in 0.79 days. Conclusion The present study showed that GeneXpert Mtuberculosis/RIF is a simple and reliable technique for diagnosing tuberculosis Lymphadenitis with high specificity and sensitivity as compared histopathology. Further, the methods elicit rapid diagnosis and also detected rifampicin resistance. It is thus a reliable and useful diagnostic modality in rapid detection of the causative agent and initiation of appropriate category anti-tubercular therapy when necessary.
Background: Peritonitis is classified as primary, secondary and tertiary. In primary peritonitis and continuous ambulatory peritoneal dialysis-associated peritonitis, the source of the infection is not due a breach in the gastrointestinal tract and usually caused by a single organism. Secondary peritonitis ensues, which may be localized and contained or diffuse carrying a high mortality in the absence of surgical intervention and appropriate antimicrobial therapy. In contrast, secondary peritonitis following perforation of the gastrointestinal tract or an infection originating in an intra-abdominal structure. Tertiary peritonitis is an ill-defined entity, which occurs despite adequate treatment of primary or secondary peritonitis.Methods: This is a prospective clinical study conducted on 140 consecutive patients who presented to the surgical department of RL Jalappa Hospital and Research Centre, Tamaka, Kolar with peritonitis secondary to hollow viscus perforation.Results: A total of 140 patients who presented with peritonitis secondary to hollow viscus perforation, admitted and treated in RL Jalappa Hospital and Research Centre attached to Sri Devaraj Urs Medical College, Kolar were studied during the period of December 2015 to June 2017.There was decrease in postoperative complications and hospital stay in Group B.Conclusions: In present study peritonitis is more common in men compared to women. The most common age group is in between 21-40 years in cases of peritonitis with the mean age of 37 years. Duodenal ulcer perforation is the commonest site of perforation. Escherichia coli is the most common organism isolated in the peritoneal fluid. usage of three antimicrobials (p<0.05) is beneficial in reduction in postoperative complications and hospital stay when compared to usage of two antimicrobials which is statistically significant.
Background: Helicobacter pylori infections have proven to be associated with gastritis and peptic ulcer, adenocarcinoma, gastric lymphoma. But its association with peptic ulcer perforations has not been completely proved. This study is intended to find out the association and give clarity of the pathology. The objective of the study was to observe the presence or absence of H. pylori in perforated peptic ulcer disease by obtaining biopsy from ulcer margin for rapid urease test, giemsa staining as well as serological method (antibodies IgA and IgG)Methods: This is an observational non-blinded study carried out in all cases of perforated peptic ulcer reporting in surgical wards, Emergency Department of the medical college during 2016-2018. Biopsy was taken from the ulcer margin and the tissue was subjected to histo-pathological examination, rapid urease test and blood sample was sent for serological examination.Results: Of the 46 patients participated in our study, 41 (89.1%) happened to be male, 5 (10.9%) were female. Only 2.2% of the patients were positive for H. pylori and remaining 95.7% were negative for H. pylori. The difference in the age group and H. pylori infection was found to be not statistically significant (p>0.05).Conclusions: In our study, frequency of H. pylori in perforated peptic ulcer cases was found to be only 2.2% which proves that there may be other contributing factors in perforated peptic ulcer cases, which need to be further evaluated.
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