ABSTRACT
Background: Lymph node tuberculosis (TB) is the most common form of extrapulmonary TB in India. Standards for TB care in India recommend microscopy/culture/CBNAAT/molecular test/histopathology examination and drug sensitivity testing on appropriate specimens from the presumed sites of involvement for all patients with presumptive extrapulmonary TB. Objectives: To analyze the utility of Xpert MTB/ Rif assay in lymph node TB. Methods: All patients who underwent lymph node sampling between July 2014 and June 2017 and for whom Xpert MTB/Rif assay was done were included. Demographic profile, Xpert MTB/Rif assay result, histopathology/cytology findings, smear acid-fast bacillus (AFB), and AFB culture results were noted. A composite reference score (CRS) was made. Results: Xpert MTB/Rif assay was positive in 63 of the 81 patients. Xpert had a sensitivity of 82.14% and specificity of 86.18%when compared against AFB culture and 75.61% and 98.97% when compared against CRS. Conclusion: Xpert MTB/Rif assay is a valuable test for rapid diagnosis of lymph node TB.
ABSTRACT
Background: The coexistence of obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) is termed “Overlap syndrome (OS).” Objectives: The present study aimed at estimating the prevalence of OS among patients diagnosed with OSA. Methods: It was a prospective observational study conducted on patients presenting to respiratory medicine outpatient department (sleep clinic) with symptoms of sleep-disordered breathing and was found to have OSA by overnight polysomnography. These patients were then subjected to spirometry to diagnose COPD. Results: The prevalence of OS in the study population was found to be 41.3%. Excessive daytime sleepiness was found to be higher in overlap group patients (P = 0.033), the difference was statistically significant. The mean age (59.9 ± 9.6 years) was found to be high in the OS group compared to those without the same. The mean forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and FEV1/FVC (pre? and postbronchodilator) spirometry parameters were found to be lower in patients with OS. Conclusion: The study showed that the prevalence of OS in the present study was 41.3%. Excessive daytime sleepiness and age >60 years were risk factors for OS in a patient with OSA. OS patients had lower pulmonary function values.
ABSTRACT
Background: In order to prevent the downstream effects of metabolic syndrome, it is essential to identify the disease in its early stage and to initiate early treatment. Objective: To analyze the relationship of the adipocyte-derived hormones (adiponectin and leptin) with indices of metabolic syndrome diagnosis in Gujarati adult population. Design and setting: In this cross-sectional study, total 87 consecutive patients (44 metabolic syndrome positive and 43 metabolic syndrome negative) were recruited. Clinical evaluation included anthropometry, blood pressure, serum insulin (by electrochemiluminescence), adiponectin (by ELISA), leptin (by ELISA), and related parameters such as blood pressure, lipids and fasting blood glucose. Presence of the metabolic syndrome was assessed according to the joint statementgiven by international groups (2009). Results: Of the enrolled participants (n: 87), individuals with metabolic syndrome (n: 44) had lower adiponectin, but higher leptin, insulin resistance index and insulin levels than participants with no metabolic syndrome (n: 43). On bivariate correlation analysis with Pearson’s correlation coefficient (r), leptin and adiponectin were positively and negatively linked, respectively, with waist circumference, BMI, triglyceride and fasting insulin. However, with respect to HDL-C, a strong negative and positive correlation (p<0.001) was found between leptin and adiponectin respectively. Leptin/Adiponectin ratio had a largest AUC (0.892) suggesting its better diagnostic utility with 91% sensitivity and 81% specificity in studied population compare to leptin (0.875) and adiponectin (0.684).