Diagnostic role of closed pleural biopsy in the investigation of exudative pleural effusions.

Closed pleural biopsy is known to be diagnostic in approximately 75% of pleural effusion undiagnosed by thoracocentesis or pleural fluid evaluation. The purpose of this study was to determine the efficacy of closed pleural biopsy in a teaching hospital, Eastern India. The study was undertaken in all patients with exudative pleural effusion who were admitted in the department of chest medicine, Burdwan Medical College and Hospital, Burdwan, during the period from January 2001 to December 2005. Abram's needle was used for closed pleural biopsy in every case. One hundred and thirty-three pleural biopsies were performed with the needle. Twenty-three cases were excluded due to obtaining no pleural tissue. Specific diagnoses were obtained in 64 cases giving a diagnostic yield of 48.12%. Of these 17 revealed malignancy, 37 tuberculosis, and 10 empyema. A non-specific diagnosis was obtained in 46 cases (34.58%). By closed pleural biopsy 48.12% of undiagnosed exudative pleural effusions could be diagnosed which shows that closed pleural biopsy is still of value as a diagnostic procedure, and should be carried out prior to invasive procedures such as thoracoscopy or open pleural biopsy.

Neurocognitive impairment in early HIV-positive individuals.

The study was carried out to find out the cognitive impairment if any, in early stages of human immunodeficiency virus-positive patients and if there is any cognitive impairment, then its association with duration of illness detection. Fifty patients with early stages of HIV and 50 matched controls were compared in various neuropsychological tests along with demographic profiles. Seropositive patients had poorly performed in digit symbol substitution test, trail making test and controlled word association test. This impairment had no association with duration of detection of illness. It is not known whether mild neurocognitive disorder predisposes patients to the development of frank dementia. Cognitive impairment should be identified early in order to maximise functional status, enhance quality of life and survival time.