ABSTRACT
Background: Studies are required to establish the utility and safety of use of the procedure of the flexible bronchoscopy under various circumstances and the various settings. Aim: To study outcome of pediatric non resolving pneumonias with the aid of pediatric flexible bronchoscopy Material and Methods: Present study was hospital based prospective study. We selected 100 cases in 1 year to 8 years age group, with radiological features persisting after 3 weeks of optimal antibiotics, their sputum for AFB, and gastric lavage for AFB was negative, sputum culture was sterile. We did pediatric flexible bronchoscopy (Olympus BF3C30, outer diameter of 3.2 mm), under short general anesthesia. All the procedures were uneventful, no reported morbidity or mortality after the procedure, Followed after the procedure till radiological shadows disappear. Results: The most common finding of the flexible bronchoscopy was normal airway anatomy – with thick mucopurulent secretions was found in 55% of the cases. In the normal airway anatomy – with thick mucopurulent secretions, 20 showed TB gene positive. In the normal airway anatomy with thick mucus plug obstructing total lumen of affected air way was sterile in all 18 cases. Foreign body impacted in bronchus in 12 cases. Mediastinal lymph node compressing main stem bronchus was identified in 6 cases. Conclusion: Paediatric flexible bronchoscopy is very useful investigation in non-resolving pneumonias.
ABSTRACT
Background: To obtain the good amount of specimen by biopsy for proper diagnosis, thoracoscopy is a very good tool. Using thoracoscopy the diagnostic accuracy can reach 100% whereas the diagnostic accuracy of the closed pleural biopsy is around 51-79%. Aim: To study role of thoracoscopic pleural biopsy in low Adenosin DeAminase pleural effusions. Material and Methods: A hospital based cross sectional study was carried out among 50 study subjects aged > 45 years. All were cases of pleural effusion. Thoracoscopic pleural biopsy was performed in all cases. The samples were sent for histopathology after biopsy. Results: Majority of the study subjects were found to be in the age group of 45-55 years i.e. 60%. Males outnumbered females as the pleural effusion may be more common in males above the age of 45 years than among the females. Tuberculosis was more in females (60%) than males (40%). But malignancy – adenocarcinoma spreading to pleura was more common in males (90.5%) than females (9.5%). Only one female was found to have Meigs syndrom (ovarian tumor with secondaries pleura). Mesothelioma was seen in three cases and all of them were males. Normal histopathology finding was seen in five cases and all of them were males. It has been documented that pleural effusion due to tuberculosis was more common in females in the present study. Kiran Grandhi, Jayasri Helen Gali, Kokiwar PR. Role of thoracoscopic pleural biopsy in low Adenosin DeAminase pleural effusions: A hospital based cross sectional study. IAIM, 2019; 6(1): 83-88. Page 84 Conclusion: Thoracoscopic pleural biopsy diagnostic yield is high. Low ADA level in pleural fluid does not rule out kochs, incidence more in females.