Introduction: Tuberculosis has high burden in developing countries like Nepal. This study aims to determine the prevalence of tuberculosis among patients admitted in the department of medicine of a tertiary hospital. Methods: A descriptive cross-sectional study of all the patients admitted to the tertiary care hospital from 1st January 2017 to 31st December 2019 was done. Ethical approval was obtained from Institutional Review Committee (Ref: drs2006181387). Convenience sampling method was used. A descriptive analysis of demographic, clinical and laboratory profile of patients was made using Microsoft Excel version 2016. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 6829 patients admitted to the department of medicine, 209 (3.06%) (2.65-3.47 at 95% CI) patients were diagnosed with tuberculosis. Among them, 147 (70.33%) were males and the mean age was 49.77 years. Pulmonary and extra-pulmonary tuberculosis were present in 153 (73.20%) and 56 (26.79%) patients, respectively. Bacteriological confirmation was limited to 107 (70%) of pulmonary tuberculosis and 3 (5%) of extrapulmonary tuberculosis. Fever was the commonest presentation in 166 (79.42%) followed by cough in 164 (78.46%), anorexia in 108 (51.67%), weight loss 104 (49.76%), and others. Conclusions: The study showed that the prevalence of tuberculosis among admitted patients was higher than national prevalence.
Introduction: Light's criteria had been the standard method for distinguishing exudative and transudative pleural effusions which misidentify 15-20% of transudates as exudates. This study aims to find out the role of combined pleural fluid cholesterol and total protein in distinguishing exudative from transudative pleural effusions and its applicability in Nepalese populations. Materials and Methods: Patients with pleural effusions were enrolled for the study. The combined pleural fluid cholesterol and total protein were compared with Light’s criteria and also compared with the diagnosis on discharge to find out their usefulness in categorizing the pleural effusions. Results: A total of 81 patients enrolled in the study, 42 (51.9%) were male. Based on Light’s criteria, 88.8% pleural effusions were found to be exudates and 11.1% were found to be transudates. Within the criteria, Light’s criteria categorized more pleural fluids as exudates than the diagnosis on discharge. Based on pleural fluid cholesterol >60mg/dL and protein >3g/dL for the classification of exudative and transudative pleural fluid, 62.9% out of 81 samples felled under the exudates and 37.03% pleural effusions under transudates with the sensitivity 87.9% and specificity 100%. Conclusions: Though Light’s criteria remain the gold standard to differentiate transudates and exudates, combined pleural fluid cholesterol and total protein give nearly comparable results without the need for simultaneous blood investigations.
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