Role of surgery and laparoscopy in management of abdominal tuberculosis

Tuberculosis [TB] considered as the most communicable disease world wid. Among extra pulmonary TB the prevalence of abdominal TB shows rising tendency. Abdominal TB is defined as an infection of one or more common of two or more of the following sites; peritoneum, mesentery, gastrointestinal tract and or solid organs. Reported incidence of abdominal TB varies from country to country. The most common clinical features are abdominal pain, fever and weight loss. To evaluate the role of surgery in the management of abdominal TB especially with the advent of minimal access surgery [laparoscopy] in the diagnosis of this disease. Prospective study was conducted in Al-Kadhymia Teaching Hospital over three years [2007-2010], fifty six patients with abdominal TB were included, the patients were managed by full surgical and or medical teams, results was analyzed by appropriate statistical measures. Most patients were in the 2[nd], 3[rd] and 4[th] decades of life. Female to male ratio was 1.5:1. Most of the patients [82%] considered to have primary abdominal TB. Diagnostic laparoscopy was done for 21 patients and proved TB in 19 patients. Explorative laparotomy was done in 19 patients, the commonest operative finding was ascites and peritoneal tubercles. Abdominal TB should be considered in all patients who presented with unexplained abdominal symptoms and signs. Laparoscopy is an effective modality for diagnosis of abdominal TB

Vaginal washing fluid B-IICG levels for detecting premature rupture of membranes

Pre-labour rupture of the membrane is a common clinical problem, and the assessment of the woman with possible membrane rupture is management issue faced in every day practice. When premature rupture of membrane [PROM] occurs, the fetus loses the relative isolation and protection afforded within the amniotic cavity. To evaluate the reliability of vaginal washing fluid Beta-human chorionic gonadotropin for the detection of premature rupture of membrane and to determine a cut-off value. A prospective case-study includes 79 pregnant women subdividing into three groups [group A: 20 pregnant women with confirmed premature rupture of membranes, group B: 19 pregnant women with suspected premature rupture of membranes, group C: apparently healthy pregnant women without any complaint] for which speculum examination for amniotic pooling, nitrazine paper test, measurement of vaginal washing fluid Beta-human chorionic gonadotropin were performed. There was significant differences in mean vaginal washing fluid fl-HCG concentration among the three groups [p= 0.000], being higher in group A than the other two groups and the time interval between sampling and delivery was significantly shorter among patient in group A than group B and C. Vaginal fluid 3-HCG determination is reliable, simple and rapid test for the detection of PROM