Adenosine Deaminase (ADA) Level in Tubercular Pleural Effusion.

STUDY OBJECTIVE: To study the value of adenosine deaminase level in tuber-cular pleural effusion. DESIGN: A hospital based observational study. SETTING: Out and In patients service of department of Tuberculosis & Chest Diseases, MLN Medical College Allahabad. PATIENTS: 50 consecutive patients of pleural effusion, who were above the age of 12 years, were studied. RESULTS: Pleural fluid adenosine deaminase was more than 36 IU/L (36 to 229.7 IU/L) in tubercular pleural effusion (34 patients). In case of malignancy no. of patients was 08 and pleural fluid adenosine deaminase was more than 18.5 IU/L (18.5 to 87.6 IU/L). While in one case of hypoprotenemiea pleural fluid adenosine deaminase was 8.21 IU/L. If 36 IU/L is taken as cut of limit the sensitiv-ity and specificity of ADA for tuberculosis is 100 % and 77.7 %. More than 100 IU/L was exclusively seen in tubercular pleural effusion. CONCLUSION: ADA > 100IU/L was observed in TB only.

Isoniazid induced neuropathy in slow versus rapid acetylators: an electrophysiological study.

Clinical, biochemical and nerve conduction studies were performed in 100 cases of tuberculosis taking isonicotinic acid hydrozide (isoniazid) for more than 12 weeks. Electro-physiological studies were carried out in a similar number of normal age and sex matched controls. In 16 percent of cases an abnormality was documented in the motor nerve conduction velocity, amplitude and terminal latency of the common peroneal, ulnar and median nerves; of these, only two patients had objective evidence of neuritis. The occurrence of isoniazid neuropathy was found to be more in the fourth decade of life (10 of 16), in those who had taken the drug for over six months (13 of 16), and in 'slow' inactivators (10 of 16).

Psycho-social study of cigarette smoking.

The present study has been carried out to assess the smoking habit among medical students and its relationship to demographic, social and psychological characteristics. Prevalence of smoking was found to be 30.79% in 854 students who responded to the questionnaire adequately. Smoking habit was more common among student who were married hailed from rural areas and the intensity of smoking increased with advancement in the career in medical profession. A strong association was observed between the habit and family history of smoking. The psychological factors associated with smoking were worry about examination unhappiness without justified cause and failure in friendship.

Smoking habits of the medical students.

Smoking habits of the medical students, both undergraduates and postgraduates, were evaluated by self-administering a predesigned proforma. 854 (66.05%) of the 1293 students responded, of whom, 30.7% of them were smokers. The number of smokers and the intensity of smoking increased with the advancement of their career at college. There were more smokers amongst the married and those with a history of smoking in their family. There was no systematic correlation between the socio-economic or rural/urban background and the smoking habit.

Histo-functional status of kidney in leprosy.

A study of 64 cases of leprosy (44 lepromatous and 20 nonlepromatous) revealed that the duration of the disease has a significant relationship with renal involvement (chi 2 = 16.9, P less than 0.001). Proteineuria, microscopic haematuria, granular and hyaline casts are mainly seen in lepromatous cases and specially with lepra reaction (100%) while few of the non-lepromatous (2%) cases may show these abnormalities. Impaired renal functions are mostly observed in lepromatous leprosy (62.9%) specially those with lepra reaction (100%) while 2% nonlepromatous cases have these impaired renal functions. Histo-pathological studies revealed non-specific changes in 44.4% of cases and those of chronic pyelonephritis in 15.5% of the cases. Renal amyloidosis is less common occurrence (4.4%). The specific lesion, that is 'leproma kidney', is rare and seen in one patient only. Acid fast bacilli could not be seen in any of the kidney tissue. It is therefore, concluded that the renal involvement in the form of inflammatory lesions and non-specific changes in the glomeruli and tubules are very common in lepromatous leprosy specially during the reactive phase.

The association of leprosy and pulmonary tuberculosis.

The association of leprosy with pulmonary tuberculosis was seen in 20 cases during January 1972 to October 1977. Of these 20 cases, 15 were of lepromatous, 3 of dimorphous and 2 of tuberculoid leprosy. Maximum number of cases were from 3rd decade of life with male to female ratio of 3 : 1. Patients were suffering from the disease for a very long time (8 cases of lepromatous leprosy with duration of illness 10-15 years). The symptoms of leprosy seemed to have preceded to the symptoms of pulmonary tuberculosis. Duration of tuberculosis in most of them was within 6 months (55%). The predominent presenting symptom was cough with expectoration (100%) and fever (80%). Anaemia (75%) and crepitations (60%) were the presenting physical sign mainly. Radiologically bilateral extensive pulmonary lessons were seen in 14 cases (70%). Sputum for acid fast bacilli was positive in 80% of cases. The general condition and nutritional status was poor and death was resulted in 4 cases (3 of lepromatous and 1 of dimorphous leprosy).