Abstract

 Introduction: Tuberculosis (TB) is a major cause of mortality and morbidity in developing countries. TubercularPleural effusion is the second most common form of extra pulmonary tuberculosis (EPTB), superseded in Prevalence only by lymph node tuberculosis. Pleural effusion occurs in approximately 5% of patients with TB. The purpose of this study was to assess the demographic characteristics of patients presenting with pleural effusion in rural Nepal.
 
 Methods: A retrospective study was conducted with all the cases diagnosed and admitted with pleural effusion at Lumbini Medical College And Teaching Hospital from April 2011 to March 2013 of all the cases diagnosed andadmitted with pleural effusion were included in the study. Hundred cases diagnosed with pleural effusion by clinical Examination or chest X-ray or ultrasonography’s (USG) of the chest were included in the studied. The following parameters patients demographic profile, causes of pleural effusion, location (unilateral/bilateral), hemoglobin and complete blood count, sputum stain and culture sensitivity, Monteux test, chest X-ray and USG findings and Pleural fluid analysis (biochemical, hematological, microbiological and cytological) were analyzed by using SPSS 21.
 
 Results: Out of 100 cases, the cause of pleural effusion in 59 patients was tuberculosis, 14 by malignancy, next 14 by Para pneumonic Effusion, 12 by congestive cardiac failure and three cases by alcoholic liver disease. Patients with tuberculous pleural effusion were younger, predominantly males, had unilateral effusion, lower blood hemoglobin, lower Pleural fluid neutrophils, higher pleural fluid Adenosine Deaminase (ADA) levels and higher level of pleural fluid to serum protein ratio as compared to the patients with non-tuberculous effusion.
 
 Conclusion: Tuberculosis is the most common cause of pleural effusion in patients of rural Nepal.
Highlights
Tuberculosis (TB) is a major cause of mortality and morbidity in developing countries
Exudative pleural effusions require further evaluation to differentiate among tuberculosis, malignancy and para pneumonic effusion which are the major causes in patients.[4,5,6]
Fifty nine patients were diagnosed as tuberculous pleural effusion, 14 had malignant pleural effusion, 14 had parapneumonic effusion, 10 had effusion due to congestive cardiac failure and three had liver disease
Summary
Tuberculosis (TB) is a major cause of mortality and morbidity in developing countries. Tubercular Pleural effusion is the second most common form of extra pulmonary tuberculosis (EPTB), superseded in Prevalence only by lymph node tuberculosis. The purpose of this study was to assess the demographic characteristics of patients presenting with pleural effusion in rural Nepal. The following parameters patients demographic profile, causes of pleural effusion, location (unilateral/bilateral), hemoglobin and complete blood count, sputum stain and culture sensitivity, Monteux test, chest X-ray and USG findings and Pleural fluid analysis (biochemical, hematological, microbiological and cytological) were analyzed by using SPSS 21. Conclusion: Tuberculosis is the most common cause of pleural effusion in patients of rural Nepal. Tuberculous pleural effusion is the second most common form of extrapulmonary tuberculosis(EPTB), superseded in a - Lecturer b - Medical Officer c - Department of Medicine, Lumbini Medical College Teaching Hospital d - Department of OBG, Lumbini Medical College Teaching Hospital e - Department of Pathology, Lumbini Medical College Teaching Hospital. Pleural effusions are classified into transudative or exudative.[2,3] Exudative pleural effusions require further evaluation to differentiate among tuberculosis, malignancy and para pneumonic effusion which are the major causes in patients.[4,5,6]
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