BackgroundThe diagnosis of abdominal tuberculosis is a major health challenge. Limited data are available to support the use of GeneXpert MTB/RIF in the diagnosis of abdominal tuberculosis. The current study is an analysis of the sensitivity and specificity of GeneXpert MTB/RIF for the diagnosis of abdominal tuberculosis, keeping histopathology as the gold standard.Materials and methodsA prospective study was conducted in Surgery Unit-I of Holy Family hospital in the year 2017. Data of 21 patients presenting with abdominal tuberculosis were collected. The samples collected were ascitic fluid for GeneXpert and acid-fast bacilli (AFB) and a tissue sample for histopathology, which included either the enlarged lymph nodes or the involved gut segment.ResultsOut of a total of 21 patients, 10 were male and 11 were female. The predominant age group was less than 30 years with 76.2% cases. Of the 21 samples analyzed, all were positive for tuberculosis (TB) by histopathology. GeneXpert was positive in six and negative in 15 patients. The sensitivity of GeneXpert was 28.57% and specificity was 0%. The positive predictive value was 100%. The diagnostic accuracy was found to be 28.57%.ConclusionIn our study, GeneXpert has shown poor sensitivity and specificity for the detection of abdominal TB from ascitic fluid samples. On the basis of this data, we lay stress on finding new tests and biomarkers for the rapid diagnosis of abdominal TB.

IMPORTANCE Total thyroidectomy is associated with risks related to temporary hypocalcemia and vocal quality dysfunction. Dexamethasone has been proposed to have a physiological effect on hypocalcemia and voice quality.OBJECTIVE To assess the effect of preoperative dexamethasone used to improve hypocalcemia and postthyroidectomy voice dysfunction.

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Aim Total thyroidectomy, being a common surgical option, for multinodular goitre and selective cases of Graves’ disease, is associated with risks related to temporary hypocalcaemia and vocal quality dysfunction. Dexamethasone, as a steroid, has well-established anti-inflammatory and immune-modulating effects. As researchers continue to understand its pathophysiology on hypocalcaemia and voice quality, we aim to assess the effect of preoperative dexamethasone used to improve hypocalcaemia and vocal cord function/post-thyroidectomy voice disorder. Methods We conducted a single-centre, non-randomised, double-blinded placebo-controlled, parallel-group study with short follow-up in a public sector hospital from January 2014 to December 2019. Patients were equally distributed in two groups to compare the effect of dexamethasone with placebo on hypocalcaemia and vocal cord function/post-thyroidectomy voice disorder Results Out of 192 patients, 36 (18.75) male patients while 156 (81.25) were female. Age range was 18 to 60. Eighteen patients had both low calcium level at 24 hours after the operation and hypocalcemic symptoms, of which 4 remain to have hypocalcaemia on third postoperative day. Forty patients defined as having voice dysfunction at 24 hours after being scored using Voice scale. Of these 40 patients with voice dysfunction, 8 had low calcium level in blood at 24 hours while only 2 of these remained with low calcium level on third postoperative day. 6/8 patients had symptomatic hypocalcaemia on first postoperative day. Conclusions Single-dose dexamethasone, during the preoperative period, is as safe and as effective in improving transient postoperative hypocalcaemia and Temporary vocal quality dysfunction/post-thyroidectomy voice disorder.

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