Abstract
Introduction: Tuberculosis is a common infection in our community. Tubercular pleural effusion is the second most common form of extrapulmonary tuberculosis. Among the several causes of exudative pleural effusison tubercular remains the most common form in clinical practice. The aim of this study was to evaluate the significance of lymphocyte-neutrophil ratio(LN ratio) in cases of exudative effusion for diagnosis of tubercular effusion.
 Methods: This was a hospital based cross sectional studydone in Patients at tertiary care hospital from 1st September 2020 to 1st april 2021after taking ethical clearance from institutional reviw committee. Convienience samplingwas done. Statistical Analysis of data like percentages and frequencies were used for categorical variables. Mean and SD (standard deviation) were used for describing continuous variables. Inferential statistical tools like Chi-Square test and Student’s t-test were used. P-value of <0.05 was considered statistically significant.
 Results: out of 200 cases 75% were tubercular pleural effusion and these cases were found have high levels of LN ratio (0.89 ± 0.11 for females and 0.97 ± 0.14 for males) and ADA (137.79 ± 44.61for females and 147.61 ± 51.64 for males) and more than 90% sensitivity and specificity of LN ratio and ADA level.
 Conclusion: Exudative pleural fluid L/N ratio >0.75 is an efficient means of diagnosing tuberculous pleural effusion and its combination with ADA level gives us more accuracy and surety about the diagnosis of tubercular pleural effusion.
Highlights
Pleural effusion is defined as the abnormal collec on of fluid in the pleural cavity
Result out of 200 cases 75% were tubercular pleural effusion and these cases were found have high levels of LN ra o (0.89 ± 0.11 for females and 0.97 ± 0.14 for males) and adenosine deaminase (ADA) (137.79 ± 44.61for females and 147.61 ± 51.64 for males) and more than 90% sensi vity and specificity of LN ra o and ADA level
We analysed 200 par cipant's samples and categorized them into female and male groups so as to further observe the age groups, ADA, LN ra o values. we found different mean values for tuberculous and nontuberculous pleural effusion samples among males and females
Summary
Pleural effusion is defined as the abnormal collec on of fluid in the pleural cavity. It is classified into transudates and exudates based on the Light's criteria.[1] Common causes of exuda ve pleural effusions found in clinical prac ces are tuberculosis, para pneumonic, malignancy primary or metastasis, associated with collagen vascular disease, liver abscess, subphrenic abscess, pancrea s.2. Tuberculous pleural effusion is seen in many cases in our region. Tuberculosis has high prevalence in asian countries like Nepal anad India. It is the one of the most common form of extra pulmonary tuberculosis.[3]
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