RESUMEN
Background: It is still difficult to diagnose tuberculosis as a source of abdominal pain. Due to the lack of non-invasive diagnostic testing, the diagnosis remains a problem. Determining the role of polymerase chain reaction (PCR) in ascitic fluid in the diagnosis of abdominal tuberculosis, we can conclude whether it is sensitive/specific or not and further its use in the diagnosis of abdominal tuberculosis. Objective: The objective of the study was to determine the role of PCR in ascitic fluid in the diagnosis of abdominal tuberculosis and also to correlate the ADA levels of ascitic fluid with the PCR report. Materials and Methods: This prospective comparative study includes 41 clinically suspected abdominal tuberculosis patients (age range 15–65 years) over a period of 2 years. A detailed history, clinical evaluation, and relevant investigations, including radiology, were done in all patients. Bacteriological or histological approaches had to support the diagnosis of abdominal tuberculosis, and PCR was also tested for Mycobacterium tuberculosis in ascitic fluid. Results: The mean age of patients was 31.71±12.32 years with male:female ratio was 1.4:1. PCR was positive in 24 (58.8%) cases. A receiver operating characteristic curve showed that a cutoff value of 35.3 IU/L (AUC 0.998, P < 0.001) for the ADA level produced the best results as a diagnostic test for abdominal tuberculosis, yielding the following parameter values: Sensitivity 100%, specificity 94.1%, positive predictive value 96%, negative predictive value 100%, and diagnostic accuracy 97.56%. ADA values were significantly elevated during abdominal tuberculosis, indicating that ADA can still be a valuable diagnostic tool. Conclusion: Our findings indicate that ascitic fluid PCR is a safe tool for diagnosing it and should be tried at least before surgical intervention.
RESUMEN
Background: Incidence of head injuries/ traumatic brain injuries (TBI) is increasing day by day, and this is the major cause of morbidity and mortality in developing countries. Aims & Objective: To evaluate the incidence, nature of injury and clinical outcomes of head injuries in North eastern part of India. Material and Methods: 1300 patients of head injury were included in the study. On presentation a patient’s clinical status was grossly assessed with the Glasgow Coma Scales (GCS). X-ray cervical spine in suspicious cases and Non contrast computed tomography scan was done of all head injury patients. Results: 21-40 years age group (40.0%) was most commonly affected and most of patients (74%) were male. Road traffic accident (47.07%) was most common cause of head injury followed by fall from height (32%). Overall mortality in total head injury patient was 13%. According to GCS al 368 (43.5%) patients of severe head injury patient expired while mortality in moderate grade injury was 5.6% and 100% of mild head injury patients were saved. A total of 532 (40.92%) patients had skull bone fracture and among bone fracture simple bone fracture was most common. Conclusion: Most of the injuries occur more commonly in certain age groups, at certain localities and mostly in male. So the knowledge about the causes and pattern of head injury may be extremely helpful in making preventive policies.