Etiology Of Pleural Effusion Research Articles

Aetiology of pleural effusion among patients with chronic kidney disease

Background: Pleural effusion is common in patients with chronic kidney disease (CKD). Aetiology of pleural effusion is diverse like heart failure, tuberculosis (TB), pneumonia, uraemia etc. Proper diagnosis of the cause is necessary as treatment plan varies from case to case. This study was designed to evaluate the aetiology of pleural effusion in patients with CKD. Methods: This cross-sectional study was conducted in the Departments of Nephrology and Dialysis, Internal Medicine and Respiratory Medicine of BIRDEM General Hospital, Dhaka, from July to December, 2022. Sixtytwo patients, aged e_18 years with CKD stage 3 to 5 with pleural effusion were included in this study. Patients having bleeding disorder, recent myocardial infarction or patients unwilling for thoracocentesis were excluded. Patients were evaluated clinically and by aspiration of pleural fluid. Results: Of the 62 patients, 42 (67.7%) were male and 20 (32.3%) were female. The mean age was 52 years. Commonest symptom was dyspnea (47, 75%), cough (33, 53%), weight loss (23, 37%) anorexia (22, 35%), fever (16, 25%), pleuritic chest pain (15, 24%), bilateral basal crepitations (15, 24%), abdominal swelling (9, 14%), engorged neck veins (7, 11%). Diabetes mellitus (DM) (50, 80%) was the commonest comorbidity in our patients. A previous history of TB was present in 9 (14%) patients (most of whom completed treatment) and 7 patients had history of malignancy (including 2 on treatment). In our study, 38 (61%) patients were in CKD stage 4, 6 (9%) patients were on dialysis. In most cases (51, 81%), effusions were bilateral transudative. Fluid overload (32, 62%), heart failure (29, 56%) and nephrotic syndrome (11/21%) were common transudative effusion. Etiology of exudative pleural effusion were TB, uremia, empyema and hypothyroidism. Conclusion: Aetiologiy of pleural effusion in CKD are mostly fluid overload, heart failure, nephrotic syndrome, TB and empyema. BIRDEM Med J 2025; 15(1): 39-43

Current Situation and Management of Pleural Effusion in PHI Clinical Hospital Tetovo

Introduction: Pleural effusion is a disturbance in the balance between fluid production and elimination in the pleural space, resulting in abnormal fluid accumulation. It can result from various medical conditions related to the lungs and pleura or systemic diseases. Identifying the etiology of pleural effusion is essential for effective treatment. According to Light's criteria, pleural effusions are transudative and exudative. Material and Methods: For this research, we collected data from the existing documentation in the Department of Pulmonology and Respiratory Allergology at PHI Clinical Hospital Tetovo from June 2022 to June 2023. This study included 133 patients with dyspnea, persistent chest pain, fatigue, hemoptysis, cough, a history of past illnesses, and other comorbid conditions. The data collection process was rigorous, and we followed ethical guidelines to ensure the reliability of our findings. Results: The patients included in our study were between 36 to 84 years old. Of them, 72,9% were males, and 27,1% were females. 85,7% were smokers, and 14,3% were non-smokers. 75,0% of patients complained of dyspnea, and 24,8% had hemoptysis. From the ultrasonography findings, 15,0% had an alteration in the left lung, 11,3% in the right lung, 20,3% of patients were punctuated to the left side, and 24,8% were punctuated to the right lung. In comparison, 1,5% were punctuated to both sides. In 2,3% of the subjects, computed tomography described an effusion in the left lung. Conclusion: The results suggest that pleural effusion is associated with various diseases, especially heart failure and malignant diseases. Our study underscores the importance of early detection of the cause of pleural effusion and the underlying disease for successfully managing and treating the disease. The insights from our research can guide healthcare professionals in developing effective treatment strategies and improving patient outcomes.

Medical thoracoscopy combined with intrapleural injection of urokinase for treatment of pleural infection-a multicenter, prospective, randomized controlled study: study protocol

BackgroundPleural diseases is a common respiratory disorder, mainly characterized as pleural effusion and patients with pleural effusion caused by pneumonia and empyema constituted 29% of the cohort, which suggests pleural infection as the predominant etiology of pleural effusion in China. Medical thoracoscopy (MT) combined with intrapleural injection of Urokinase holds significant therapeutic value for patients with early to moderate-stage empyema. However, there remains a lack of high-quality evidence regarding the efficacy and safety of combining MT with intrapleural injection of Urokinase administration in patients with pleural infections.MethodsThis study is a prospective, multicenter, randomized controlled clinical trial involving patients with pleural infections. The intervention involves medical thoracoscopy. The control group receives conventional treatment involving intrapleural urokinase injection followed by chest tube placement for drainage. The study outcomes include efficacy and health economic benefits. The estimated minimum sample size for each group is 64 cases, totaling 128 cases. The study groups are delineated as follows: patients in group A receives intrapleural urokinase injection followed by chest tube placement for drainage, while patients in group B undergoes MT to remove multiple septa and necrotic tissue followed by chest tube placement for drainage, and then intrapleural urokinase injection the day after MT. It is recommended that the diameter of the chest tube be 12–14 F, with three daily flushes of 30 ml normal saline to ensure optimal drainage. Subsequently, comprehensive statistical analyses will be conducted to compare treatment effects and complications across all groups, ultimately leading to conclusive findings.DiscussionThe study is the first prospective, multicenter clinical trial on the efficacy and safety of medical thoracoscopy combined with intrapleural urokinase injection for the treatment of pleural infection. This study aims to offer clinical guidance for the management of pleural infection.Registration numberChiCTR2300078352 (Registration Date: 2023/12/06).

Clinical presentation and aetiology of pleural effusion among patients with chronic kidney disease referred to the Respiratory Unit of National Hospital, Sri Lanka

Clinical presentation and aetiology of pleural effusion among patients with chronic kidney disease referred to the Respiratory Unit of National Hospital, Sri Lanka

Characterization of Markers in Blood Tests of Patients With Pleural Effusion and Their Correlation to Different Etiologies.

To investigate the etiology of pleural effusion, a variety of examinations are performed, including invasive ones: Thoracentesis is an invasive procedure to remove fluid or air from the pleural cavity for diagnostic or therapeutic purposes. Until now, there are no blood markers that can help us diagnose the type of pleural effusion without the need for pleural puncture or drainage. The aim of this study was to investigate the relationship and the utility of the new inflammatory markers taken from complete blood count (CBC) to differentiate between the various types of pleural effusion before the invasive procedure decision. This is an observational retrospective study. Data was collected from medical records of patients aged 18-90 admitted in Ziv Medical Center, Safed, Israel that were diagnosed with pleural effusion from 2013 to 2019. Of those patients, of whom inflammatory markers from blood counts and thoracentesis results were obtained, the outcomes were compared with the diagnosis type of pleural effusion. This study involved 391 patients, 256 suffered from exudate type effusion, their median age was 72 years, while 135 suffered from transudate effusion, their median age was 80 years. Those with exudate effusion had higher levels of CRP, platelets, neutrophils, and lymphocytes in blood, whereas those with transudate effusion had higher levels of MPV and RDW in blood. Other blood markers such as NLR and PLR were not statistically significant, but were also higher in the blood of patients with exudate effusion. An evaluation of simple and inexpensive measurements of blood count such as platelets, neutrophils, lymphocytes, MPV, RDW may provide insight into the etiology of pleural effusion.

Aetiology of pleural effusions in children living in a high TB endemic setting.

<sec id="st1"><title>BACKGROUND</title>Confirming the aetiology of pleural effusion in children may be difficult in TB-endemic settings. We investigated the role of polymerase chain reaction (PCR) and routine biochemical tests in discriminating pleural effusion caused by bacteria from other aetiologies.</sec><sec id="st2"><title>METHODS</title>This is a cross-sectional post-hoc analysis among children with pleural effusion in a tertiary hospital in South Africa, incorporating new data from PCR testing of stored pleural fluid. Aetiological classification was defined by microbiological confirmation.</sec><sec id="st3"><title>RESULTS</title>Ninety-one children were enrolled; the median age 31 months (IQR 12-102). The aetiology of pleural effusion was 40% (36/91) bacteria, 11% (10/91) TB, 3% (3/91) viruses, 11% (10/91) polymicrobial and 35% (32/91) had no pathogen identified. The most common pathogen was Staphylococcus aureus (27/91, 30%) with similar yields on culture and PCR, followed by Streptococcus pneumoniae (12/91, 13%), detected more commonly by PCR. PCR reduced the number of children with unconfirmed aetiologies from 48 to 32. Characteristics of children with no pathogen most resembled those with TB. Pleural fluid lactate dehydrogenase ≥1,716 U/L best discriminated bacterial pleural effusion from other aetiologies (sensitivity of 86%; specificity 95%).</sec><sec id="st4"><title>CONCLUSION</title>PCR improved detection of pathogens and reduced number of children with unconfirmed aetiologies in presumed exudative pleural effusion.</sec>.

Prospective Evaluation of Safety and Diagnostic Efficacy of Medical Thoracoscopy in Undiagnosed Exudative Pleural Effusion: Experience From a Tuberculosis High-Burden Country.

Pleural effusion is due to the pathological accumulation of pleural fluid in the pleural space, 25%-30% of which may remain undiagnosed despite the combination of biochemical, microbiological, and pathological tests and closed pleural biopsy. Medical thoracoscopy may help physicians diagnose such cases. We aimed to study the diagnostic yield of medical thoracoscopy in patients with undiagnosed exudative pleural effusion and assess the safety profile of the medical thoracoscopy. A cross-sectional descriptive study was conducted on 105 patients with undiagnosed pleural effusion. Medical thoracoscopy was performed using an Olympus semi-rigid thoracoscope (LTF 160 Evis Pleurovideoscope, Japan) as per standard protocol. Multiple pleural biopsies were taken and sent for histopathology examination, NAAT (nucleic acid amplification test), and MGIT (mycobacteria growth indicator tube). Post-procedure, the patients were evaluated for any complications. A total of 105 patients were enrolled in the study. The mean ± SDage was 55.1 ± 13.6 years. Sixty-three (60%) patients were males. The diagnostic utility of medical thoracoscopy was found in 94 (89.5%) patients. The diagnosis of tuberculosis (TB) was made in 34 (32.3%) patients, and 48 (45.7%) patients were diagnosed with malignant pleural effusion. Adenocarcinoma of the lung was the most common malignancy diagnosed (32 patients, 66.6%). Five (5.31%) patients had dual etiology of pleural effusion:tubercular and malignancy. The most common complication was chest pain following the procedure (99.4%). One patient developed pneumomediastinum and was managed conservatively. There were no major adverse events after the procedure. Medical thoracoscopy has a high diagnostic yield and favorable safety profile with minimal complications. Excessive reliance on the level of ADA (adenosine deaminase) may further delay the diagnosis. Dual etiologies like TB coexisting with malignancy should be considered in TB high-burden countries.

Serum KL-6 : A Predictive Marker for Post Tubercular Fibrosis

The accurate diagnosis of pleural effusion remains a challenging clinical problem. Medical thoracoscopy has an established role in achieving the aetiology of pleural effusion. Pleural biopsies provide best results, but if cytological results can be shown to give concordant results, therapy can be instituted early.

Clinical importance of SUPAR and Dickkopf-1 level in the etiology of pleural effusion

Clinical importance of SUPAR and Dickkopf-1 level in the etiology of pleural effusion

Short comparison of talc poudrage and tetracycline pleurodesis within patients suffering from malignant pleural effusion.

Objective: To compare talc poudrage and tetracycline pleurodesis within patients suffering from malignant pleural effusion. Study Design: Controlled Clinical Trial. Setting: Division of Pulmonology, Jinnah Hospital Lahore. Period: September, 2022 up until May, 2023. Material &amp; Methods: 100 individuals, both male and female, ranging in age from 20 to 80 years, diagnosed with malignant pleural effusion confirmed on biopsy were included by nonprobability consecutive sampling. Patients with active pleural infection, hemodynamic instability, systemic infection, serum hematocrit &lt; 25%, hemothorax, chylothorax, multiple etiologies of pleural effusion, prior chemical pleurodesis, sensitivity to study drugs, life expectancy &lt; 1 month, pregnancy and chest X-ray displaying trapped lung post chest tube drainage on the affected side were excluded. The patients were allocated into two groups at random using a lottery system. In group 1, patients received pleurodesis with talc poudrage and in group 2, patients received pleurodesis alongside tetracycline. Success was assessed after 4 weeks of pleurodesis. Results: In this study, mean age in talc group was 58.94±13.6 years and in tetracycline group it was 59.26±13.7 years.65% patients were male and 35% were females.Success was 94% in talc group and 76% in tetracycline group with p-value = 0.012. In terms of adverse effects, there is no statistically significant difference between the two groups. Conclusion: Talc pleurodesis has a higher success rate than the tetracycline pleurodesis. Talc pleurodesis also has less adverse effects than tetracycline pleurodesis.

To correlate clinical and biochemical profile of pleural effusion: a retrospective study in tertiary care centre of central India

BackgroundPleural effusion indicates an imbalance between pleural fluid formation and removal. Classified into exudative and transudative, with common symptoms of dry cough, dyspnea and pleuritic chest pain. Confirmed etiology has to be established for effective treatment. ObjectiveCorrelate clinical and biochemical profile of various etiologies of pleural effusion. Materials & methodsRetrospective observational study of 2 years in the department of respiratory medicine, GMC Bhopal on 280 cases of pleural effusion. ResultsMost common etiology was tubercular 202 (72.4%) followed by malignant in 36 (12.8%). With respect to tubercular, malignant pleural effusion has relative risk (RR) of 0.138 (p value < 0.05) in the age group of 51–60 years, which is statistically significant. Patients of tuberculosis complained of fever 158 (78.2%) whereas with malignancy complained of chest pain 16 (44.4%) followed by hemoptysis 12 (33.3%). For hemoptysis, with respect to tubercular, malignant effusion has RR of 5.68 (p value < 0.05) which is significant. History of smoking was significant in malignant effusion with RR of 2.57 (p value < 0.05) as compared to tubercular. Pleural fluid ADA was >70 in 83.7% in tubercular effusion, glucose was <60 mg/dl in 79% tubercular, malignant and bacteriological cause, LDH was >1000 in 88.4% in bacteriological and 72.3% in malignant effusion. ConclusionLack of tools for confirming diagnosis leads to diagnostic dilemma and delay in treatment initiation, leading to deterioration and untoward fatality in some cases. Our goal is early diagnosis by correlating clinical symptoms with biochemical profile and help initiate rapid treatment.

Study on etiological profile of pleural effusion in tertiary care centre in Dakshin Kannada

Background: Pleural effusion (PE) is a pathological state that often develops in patients with thoracic or systemic diseases and if not diagnosed and treated early, heralds a serious prognosis. Aim of the study was to determine the etiological profile of PE from exudative and transudative pleural fluid. Methods: This cross-sectional study was conducted in participants admitted with PE in the general medicine ward of Yenepoya medical college hospital between the period of January 2021 and December 2021. The patients were analyzed for the socio-demographic characteristics; examination was done with focus on general physical examination, respiratory system, cardiovascular system and gastrointestinal system. SPSS was used for analysis. Results: A total of 80 participants fulfilling inclusion criteria were included in the study. The mean age of participants was 50.28±15.85 years. Among the participants, 36.3% were female and 63.8% were male, with male preponderance in the study. PE, according to Light’s criteria, was differentiated into exudative effusion which accounted for 63.8% and the rest 36.3% were transudative. The most common cause of PE was TB followed by malignancy. The most common malignancy causing effusion was carcinoma of the lung. All the etiologies of PE showed a male preponderance and it was statistically significant (p&lt;0.05). Conclusions: In males, PE was more frequently observed. The main causes of PE were TB and cancer. One of the Clinical indicators including pallor demonstrated a strong correlation with malignant and tuberculous effusions. Malignancy and empyema were substantially correlated with clubbing.

Deep learning for diagnosis of malign pleural effusion on computed tomography images

BackgroundThe pleura is a serous membrane that surrounds the lungs. The visceral surface secretes fluid into the serous cavity and the parietal surface ensures a regular absorption of this fluid. If this balance is disturbed, fluid accumulation occurs in the pleural space called “Pleural Effusion”. Today, accurate diagnosis of pleural diseases is becoming more critical, as advances in treatment protocols have contributed positively to prognosis. Our aim is to perform computer-aided numerical analysis of Computed Tomography (CT) images from patients showing pleural effusion images on CT and to examine the prediction of malignant/benign distinction using deep learning by comparing with the cytology results. MethodsThe authors classified 408 CT images from 64 patients whose etiology of pleural effusion was investigated using the deep learning method. 378 of the images were used for the training of the system; 15 malignant and 15 benign CT images, which were not included in the training group, were used as the test. ResultsAmong the 30 test images evaluated in the system; 14 of 15 malignant patients and 13 of 15 benign patients were estimated with correct diagnosis (PPD: 93.3%, NPD: 86.67%, Sensitivity: 87.5%, Specificity: 92.86%). ConclusionAdvances in computer-aided diagnostic analysis of CT images and obtaining a pre-diagnosis of pleural fluid may reduce the need for interventional procedures by guiding physicians about which patients may have malignancies. Thus, it is cost and time-saving in patient management, allowing earlier diagnosis and treatment.

Efficacy of Pleural Brush Cytology in the Diagnosis of Pleural Diseases

Background: The accurate diagnosis of pleural effusion remains a challenging clinical problem. Medical thoracoscopy has an established role in achieving the etiology of pleural effusion. Pleural biopsies provide us with best results, but if cytological results can be shown to give concordant results, therapy can be instituted early. Aim: The aim was to study the efficacy of pleural brush in diagnosing pleural diseases. Study Design: This is a prospective study. Patients and Methods: The study was done between December 2015 and June 2017 in all patients of undiagnosed exudative effusions who were taken for thoracoscopy. Both pleural biopsy and pleural brushings were obtained in each patient. Results: We present the data of 45 patients. The mean age was 59.68 years. Nodule was the most common finding on thoracoscopic examination. Pleural brush cytology was positive in 26 patients with malignancy, 13 for infection and 6 were inadequate. However, forceps biopsy was positive in 42 cases out of 45 (93.3%) in detecting malignancy and infectious diseases. Conclusion: Pleural brush cytology can help in increasing the diagnostic yield. It can also be used to commence early treatment of the patient.

Clinical and Etiological Profile of an Exudative Pleural Effusion in a Tertiary Care Center

Background: Pleural effusion is common clinical entity in day-to-day clinical practice. There are various etiologies for pleural effusion. Among those tubercular pleural effusion, parapneumonic effusion, malignant effusion, and congestive heart failure were the most common causes of pleural effusion. Here, we have done a retrospective study to see the etiology of pleural effusion in our tertiary care center. Patients and Methods: This retrospective study conducted in a tertiary care center over 1 year period. A total of 63 patients were included in this study after verifying in patient records of all patients who were admitted with exudative pleural effusion. The demographic data collected and complete history was obtained. Investigations such as complete hemogram, random blood sugar; renal function tests, serum proteins, chest x-ray, and pleural fluid analysis and investigations such as ultrasonogram of the chest and abdomen, echocardiogram, computed tomography scan of chest, fine-needle aspiration cytology, and pleural biopsy reports (if done) were collected. Results: Among the study participants, 40 were male and 23 were female patients with male-to-female ratio of 1.7:1. Mean age of the study population was 48.8 ± 18.7 years. The most common presenting symptom was dyspnea (84%) followed by cough (80%), fever (65%), and chest pain (43%). The most frequent cause of pleural effusion was tuberculosis in 38% of patients, followed by parapneumonic effusion (28.5%) and malignant pleural effusion (22.2%). Three patients had chylothorax, two patients had pancreatic pleural effusion and the diagnosis was unknown in two patients. Mean ± standard deviation (SD) adenosine deaminase (ADA) value of the study population was 45.3 ± 28.1. Mean ± SD of ADA values in tuberculous, parapneumonic, and malignant pleural effusion was 54.5 ± 16.8, 65.2 ± 30.7, and 18.2 ± 11.0, respectively. Conclusions: Tuberculosis is one of the common causes of exudative effusions along with parapneumonic effusions and malignancy. Pleural fluid ADA levels are highly sensitive with good specificity for the diagnosis of etiology of tubercular effusions. However in view of high levels of ADA in pleural fluid in parapneumonic effusions also, other measures such as clinical evaluation, lymphocyte to neutrophil ratio, and glucose levels are necessary to separate both these entities.

Diagnostic utility of LDH measurement for determining the etiology of modified transudate pleural effusion in cats.

Fluid analysis is an initial approach for determining the underlying causes of body cavity effusions. Modified transudate is commonly diagnosed in pleural effusion in cats, however, it provides limited diagnostic information. Aims of this study were to investigate common etiologies causing different pleural fluid types and to evaluate the usefulness of lactate dehydrogenase (LDH) for differentiating the etiology in modified transudates in cats. Pleural effusion samples from 122 cats were analyzed and classified into three types: transudate, modified transudate, and exudate. Causes of pleural effusion were classified into four conditions: cardiac disease, neoplasia, feline infectious peritonitis (FIP), and pyothorax. The relationship of underlying etiology and fluid types was described. The LDH levels in pleural fluid and plasma were compared between the causes in the samples classified as modified transudate. The fluid analysis of pleural effusion showed that modified transudate was the most common fluid type (44.2%). Neoplasia was predominantly diagnosed (38.5%) as the etiology of pleural effusion. There was no significant correlation between pleural fluid and plasma LDH level in any type of pleural fluid, suggesting that pleural fluid LDH does not appear to be affected by plasma LDH. The occurrence of modified transudate was not associated to its etiologies, however, the LDH level in modified transudates showed significant differences between etiologic groups. The LDH level in modified transudate was excellent in separating cardiac from non-cardiac diseases with a cut-off value of <535 U/L and separating FIP from non-FIP diseases with a cut-off value of >641 U/L. Based on the current findings, pleural fluid LDH can be a useful adjunctive marker for differentiating some causes of modified transudate pleural effusion and should be added in the routine diagnostic work-up of feline patients with pleural effusions.

Tubercular pleural effusion with epithelioid cells– A rare cytological case presentation

Tuberculosis is one of the most prevalent disease of the developing countries resulting in significant morbidity. Extra pulmonary tuberculosis results in pleurisy among predilection to other organ and organ systems like lymph nodes. Pleurisy results in tubercular pleural effusion. Pleural effusions are mostly seen in immunocompetent patients. Here we present a case of tubercular pleural effusion which was diagnosed by cytology examination of pleural fluid in a 22-year-old female, who presented with shortness of breath, generalized weakness with decreased appetite. Radiological investigations revealed a unilateral pleural effusion. Pleural tapping was done and sent for cytological examination. Cytospin aspirate smear showed degenerated mesothelial cells, histiocytes, few epithelioid cells, mature lymphocytes and lymphocytes with splintered chromatin. A diagnosis of tubercular pleural effusion was made with further tests like CBNAAT for confirmation of diagnosis. CBNAAT was positive with a strain of Rifampicin sensitive mycobacterial tuberculosis identified. Patient was started on anti tubercular drugs according to the National Tuberculosis Elimination Program. To conclude, cytology is a fast inexpensive method for diagnosing the etiology of pleural effusions by pointing us in the right direction.

Clinicopathological Study of Pleural Effusion In A Tertiary Care Hospital.

Background: Pleural effusion is an excess fluid that accumulates between two pleural layers. Pleural fluid analysis and cytology are the mainstays for diagnosing various pulmonary diseases. Levels of adenosine deaminase (ADA) are particularly useful in areas where the prevalence of tuberculosis is high. Objectives: To find the clinical profile and various etiology of pleural effusion in respect of age and sex and level of adenosine deaminase in the different causes of pleural effusion. Materials and Methods: This was an observational study carried out in the Department of Laboratory Medicine of a tertiary level teaching hospital, Khwaja Yunus Ali Medical College &amp; Hospital (KYAMCH), Enayetpur, Sirajganj, Bangladesh. Biochemical analysis was done by Olympus AU-400 and cytology was done by Papanicolaou stain. Result: A total of 173 cases of diagnosed pleural effusion was taken in the present study. Tuberculosis was the primary etiology of the total 82 cases (47.39%), followed by malignancy accounting to 30 cases (17.34%). These two were followed by parapneumonic effusion (10.40%). ADA level is highest in TB (167U/L) in comparison with malignancy, transudative cause and other causes. Conclusion: Most common cause of pleural effusion in the tertiary hospital setting is tuberculosis, followed by malignant pleural effusion and ADA level is highest in TB than any other cause. KYAMC Journal Vol. 13, No. 02, July 2022: 98-101

Diagnostic presentations of different pleural effusion patients to a tertiary care centre

BACKGROUND-Pleural effusion is defined as collection of fluid between the two pleural covering. OBJECTIVE-To evaluate the different etiologies of pleural effusion according to laboratory report. METHODOLOGY-Data was collected in a nonprobability convenience technique with descriptive cross- sectional study in indoor patient of pulmonary medicine department of Balangir Bhima Bhoi medical college from 2017 nov to 2020 nov,202 patients included in this technique.Diagnosis was confirmed by chest -x-Ray, and USG Chest in some cases, .Pleural fluid is aspirated from all and analysed with necessary investigation carried out ,like pleural fluid cytology, Biochemical and culture .computed tomography ,echocardiography and connective tissue profile for evaluating the underlying cause of pleural effusion. RESULT- Out of 202 patients 145 (73%) were male and 57(26)% were female Mean age was 44.8years with 19,832 SD .Among patients of pleural effusion most common cause was tuberculosis (65.3%). followed by Para pneumonic effusion/empyema (11.4%), malignancy both metastatic and primary accounted for (15%), heart failure also showed its presence in 5% of cases. Connective tissue disorder was found to be the cause in only one case (0.5%). In one case (0.5%) pleural effusion remained undiagnosed.

Comparison of clinical manifestation among Australian Indigenous and non-indigenous patients presenting with pleural effusion.

There is sparse evidence in the literature in relation to the nature and causes of pleural effusion among Australian Indigenous population. To investigate the clinical and demographic characteristics of adult indigenous patients presenting with pleural effusion in the Northern Territory of Australia. In this retrospective study, indigenous and non-indigenous adults diagnosed to have pleural effusion over a 2-year study period were included for comparative analysis. Of the 314 patients, 205 (65%) were non-indigenous and 52% were male. In comparison with non-indigenous patients, the indigenous patients were younger (50 years (interquartile range (IQR) 39-60) vs 63 years (IQR 52-72); P < 0.001), female (61% vs 41%; P = 0.001), had a higher prevalence of renal and cardiovascular disease and tended to have exudative effusion (93% vs 76%; P = 0.032). Infections were judged to be the most common cause of effusion in both groups, more so among the indigenous cohort. Effusion secondary to renal disease was higher (13% vs 1%; P < 0.001) among Australian Indigenous patients, but in contrast, malignant effusions were higher (13% vs 4%; P = 0.004) among non-indigenous patients. Length of hospital stay was longer for indigenous patients (P = 0.001), and a greater proportion received renal dialysis (13% vs 1%; P < 0.001). Intensive care unit admission rates were higher with infective aetiology of pleural effusion (82% vs 53% indigenous and 44% vs 39% non-indigenous respectively). Re-presentations to hospital were higher among indigenous patients (46% vs 33%; P = 0.046) and were associated with renal and cardiac disease and malignancy in non-indigenous patients. There are significant differences in the way pleural effusion manifests among Australian Indigenous patients. Understanding these differences might facilitate approaches to management and to implementation of strategies to reduce morbidity and mortality in this population.