Clinical profile of patients with pleural effusion admitted to KMCTH

Kr, Dhital; Acharya, R; Bhandari, Rishi; Kharel, Prakash; Kp, Giri; Tamrakar, Rikesh

doi:10.3126/kumj.v7i4.2772

Cited by 10 publications

(15 citation statements)

References 21 publications

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“… 7 23 29 30 The second leading cause of PE was a malignancy and this result is similar to other observation 18 20 21 22 and is in contrast to other studies that reported pneumonia. 19 20 These etiological differences in PE causes could be explained by the fact that TB, HIV endemicity, and low socioeconomic status which are the risk factors for TB development are very common in this settings compared to the developed countries. In those studies that reported a contrasting result, this can be explained by the epidemiologic transition from communicable diseases to noncommunicable diseases such as cancer.…”

Section: Discussionsupporting

confidence: 89%

“… 8 18 19 20 21 22 26 27 28 On the other hand, this result is different from what is reported in Lagos, Nigeria, the Islamic Republic of Iran, and other developed countries. 7 23 29 30 The second leading cause of PE was a malignancy and this result is similar to other observation 18 20 21 22 and is in contrast to other studies that reported pneumonia. 19 20 These etiological differences in PE causes could be explained by the fact that TB, HIV endemicity, and low socioeconomic status which are the risk factors for TB development are very common in this settings compared to the developed countries.…”

Section: Discussioncontrasting

confidence: 73%

“…The demography in this study showed that the median age of the cases with PE was 38 years and this figure is similar to 37.8 years which was reported in Lagos, Nigeria, 7 and 34.7 years reported from our center earlier, 8 but it was less what was report from another part of the world. 18 19 20 21 22 These variations may be attributed to the variation in the study population and the etiology and frequency of predisposing factors for PE in the different parts of the world. We also found a predilection for males in our study and this is in agreement with many other studies.…”

Section: Discussionmentioning

confidence: 99%

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Etiology, clinical characteristics, and management of pleural effusion in Ilorin, Nigeria

et al. 2017

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Background:Pleural effusion (PE) is a primary manifestation or secondary complication of many disorders. This study reviews the pattern and management of PE in a Nigerian hospital.Materials and Methods:The medical records of 213 patients with clinical diagnosis of PE over a period of 3 years were reviewed.Results:PE accounted for 0.5% of the total hospital admissions. The most common cause of PE was tuberculosis (TB) (32.9%), followed by malignancy (29.1%) and pneumonia (15.0%). The male to female ratio was 1.3:1. TB was the leading cause of effusion in males, while it was malignancy in females. Pneumonia accounted for 61.9% of PE in preschool age and 66.7% in school age. Breathlessness (50.0%), cough (39.4%), and chest pain (24.9%) were the common presentations. Most (90.1%) of them were exudative effusion and with half in the right lung. Chest radiography (91.6%), pleural fluid for Ziehl–Neelsen stain (74.7%), cytology (59.2%), and tissue biopsy (57.8%) were the common diagnostic investigations. The majority (92.0%) had closed thoracostomy tube drainage, while 9.9% had chemical pleurodesis. The intra-hospital mortality was 10 (4.7%).Conclusion:TB, malignancy, and pneumonia are the leading causes of PE. A multidisciplinary approach is needed for optimal management.

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Section: Discussionsupporting

confidence: 89%

Section: Discussioncontrasting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

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Etiology, clinical characteristics, and management of pleural effusion in Ilorin, Nigeria

et al. 2017

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“…In Dhital KR (27) study pleural fluid mean ADA value in tuberculous, malignant, congestive cardiac failure and renal effusions were 181.37, 52, 16 and 12 IU/L, in present study the ADA levels were 73.92, 18.83, 11.45 and 16.38 IU/L respectively. The mean ADA levels in present study were much lower as compared to Dhital et al, but sensitivity and specificity were comparable to remaining reference studies.…”

Section: Discussionsupporting

confidence: 53%

Pleural Fluid Ada in the Diagnosis of Pleural Effusion

Duggal¹,

Yannawar²,

Dharmadhikari³

2017

jemds

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BACKGROUND Evaluation of pleural effusion is a common medical problem and despite the use of standard pleural fluid measurements and pleural biopsy the aetiology remains uncertain in a considerable number of cases. In our study, we assessed the importance of ADA activity in the diagnosis of pleural effusion. MATERIALS AND METHODS We studied 100 cases of pleural effusions of varying aetiology. Analysis of pleural fluid biochemistry cytology, ADA levels, ZN stain and results of pleural biopsy were analysed. This was a descriptive study. Statistical Analysis-Data were summarised using descriptive statistics such as percentages for categorical variables and mean with standard deviation for quantitative variables. For inferential statistics, two sample t-test was applied. A 'p' value of < 0.05 was considered significant. Sensitivity, specificity, positive predictive value and negative predictive values were calculated for using ADA as a screening test of TB pleural effusion. RESULTS We found Tubercular and Parapneumonic effusions in a younger age group (20-50 yrs.), whereas malignant effusions and those due to cardiac failure were found in an older subset (50-80 yrs.). Pleural biopsy positivity rate was 60%-80% in tuberculosis and 50%-85% in malignant effusions. ZN smear for AFB gave poor yield in sputum and pleural fluid. In all our patients, pleural fluid ADA was above 41.5 U/L with a mean value of 73.92 U/L. CONCLUSION Pleural fluid ADA in tubercular pleural effusion has a sensitivity, specificity, positive predictive value and negative predictive value at a cutoff of 41.5 U/L of 100%, 87%, 90%, 100% respectively.

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“…In Nepal [14], Dhital and his colleagues found that the commonest cause of unilateral pleural effusion is tuberculosis followed by parapneumonic effusions and most of these cases occurred at younger ages of 21 -30 years.…”

Section: Discussionmentioning

confidence: 99%

Aetiology and Demographic Attributes of Common Pleural Collections in an African Population

Ogunleye¹,

Thomas²,

Olusoji³

2013

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Background: Fluids collect in the pleural space under different conditions and they are of different types. Detailed study of demographic attributes and aetiology of pleural collections has not been well reported in Africa. Aims and Objectives: This study was conducted to determine the demographic attributes and aetiology of common pleural space fluid collections. Methods: The sample population consisted of referrals received via clinics, admission through the emergency centre and wards. We noted their biodata, hospital identification numbers, ages and gender and other relevant parameters. Data analysis was done with special interest in gender-based diseases like ovarian carcinoma prostatic carcinoma and the like. Results: There were 372 patients over a 55-month period. The M:F ratio was 1:1 approximately. The combined mean age was 37.8 ± 0.92 years at 95% confidence interval. Their distribution was negatively skewed and it was leptokurtic. The age bracket of 20 - 49 had 65.6% of cases. There was gender based disparity in ages. Discussion: Malignant effusions constituted majority of sample size and the right side was consistently affected more often than the left side. Conclusion: Advanced malignancies are the commonest causes of pleural effusion. There is ongoing epidemiologic transition of diseases as the burden of non-communicable diseases is now juxtaposed with that of communicable diseases in Africa.

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Clinical profile of patients with pleural effusion admitted to KMCTH

Cited by 10 publications

References 21 publications

Etiology, clinical characteristics, and management of pleural effusion in Ilorin, Nigeria

Etiology, clinical characteristics, and management of pleural effusion in Ilorin, Nigeria

Pleural Fluid Ada in the Diagnosis of Pleural Effusion

Aetiology and Demographic Attributes of Common Pleural Collections in an African Population

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