Background: India has one of the highest tuberculosis (TB) burdens globally. However, few studies have focused on TB in young children, a vulnerable population, where lack of early diagnosis results in poor outcomes.Methods: The present study was undertaken to assess the sensitivity and specificity of tuberculin test (Mantoux) and BCG test in diagnosis of childhood tuberculosis and to compare above tests as a diagnostic tool and to assess the impact of factors affecting the test. Mantoux test was done with 1 TU contained in 0.1 ml of PPD R23 with tween 80 solution. BCG test was done using a heat stable freeze-dried vaccine, after fresh reconstitution and injected intradermally in left deltoid region with a tuberculin syringe and 27 G hypodermic needle.Results: Tuberculous cases were more common in malnourished subjects more so with severe malnutrition. While maximum positivity 89% was obtained with BCG test, it was only 63% with Mantoux test, done with 5TU of PPD-RT-23. BCG was always positive whenever PPD was positive in any group of children. Sensitivity of Mantoux test was around 63% whereas that of BCG test was 89%. BCG test was more significantly associated with disease than tuberculin test (p <0.001).Conclusions: BCG test is a very sensitive and specific test for diagnosis of childhood tuberculosis. Mantoux test is affected by malnutrition and severity of disease whereas BCG test is affected only minimally. BCG test is more sensitive than Mantoux test (with 5TU PPD RT 23 Tween 80). A BCG induration of ≥10 mm or Mantoux induration ≥15 mm or an accelerated BCG test is indicative of active disease, irrespective of vaccination status of the patient.
Background: Placenta is essential for maintenance of pregnancy and for promoting normal growth and development of fetus. It forms the morphological record of anatomical condition, intrauterine events and intrapartum events of gestation. Present study has been undertaken to record the data on the morphology and histology of placenta from mothers with hypertension and diabetes.Methods: This study showed several significant morphological and histological differences in the placenta of the mother with GDM and hypertensive placenta. The histological study of the placenta was done under microscope and number of syncytial knots, cytotrophoblastic cellular proliferation, fibrinoid necrosis, endothelial proliferation, calcified and hyalinised villous spots were noted per low power field in the diabetics and hypertensive group in comparison to control group.Results: All other parameters including area, thickness, diameter, and circumference of GDM placenta show a significant increase when compared with normal placenta. The gross anatomic features of placentae e.g infarcted areas, calcified areas and marginal insertion of the umbilical cord in the study group show significant increase in value (p>0.01) in diabetic and hypertensive groups when compared to that of the control or normal group.Conclusions: In present study we found that hypertensive placentae tend to be slightly smaller in size, weight, volume, area, thickness, diameter, circumference and feto-placental ratio than normal placentae but the parameters were found to be significantly greater than that of normal placentae in case of diabetic placentae. No significant differences were found in umbilical cord insertion. In normal pregnancy cases we found several histological findings which were increased in hypertensive and diabetic cases.
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