Annals of Tropical Medicine and Public Health
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ORIGINAL ARTICLE
Year : 2013  |  Volume : 6  |  Issue : 2  |  Page : 192-196

Is diagnostic protocol a cause of overestimation of extra-pulmonary tuberculosis in Himachal Pradesh? A report from a high-prevalence tuberculosis unit


1 Department of Community Medicine, Dr. R.P. Government Medical College, Tanda, Himachal Pradesh, India
2 Department of Pulmonary Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
3 Department of Community Medicine, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India

Correspondence Address:
S K Raina
Department of Community Medicine, Dr. R.P. Government Medical College, Tanda, Himachal Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.116519

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Aims and Objectives: To study the diagnostic practices for diagnosis of extra-pulmonary tuberculosis (EPTB) in a high-prevalence tuberculosis unit (TU). Material and Methods: It was a cross-sectional study using a pre-designed and pre-tested structured questionnaire. The information was collected from new EPTB cases registered in Rampur TU between 1 July 2007 and 31 March 2008. Diagnostic practices of the medical practitioners for establishing the diagnosis of different types of EPTB were studied. Results: For the diagnosis of pleural TB the main tools used were X-ray chest (37 cases; 100.0%) and aspiration of pleural fluid (pleural tap) for color of pleural fluid (35 cases; 94.6%). For establishing the diagnosis of lymph node TB, eight (66.6%) cases were subjected to fine needle aspiration cytology (FNAC) examination of involved lymph nodes. Excision biopsy of lymph nodes was undertaken in the remaining four (33.3%) cases. The diagnosis of abdominal TB was primarily established on the basis of X-ray (six cases; 85.7%) and ultrasonography (USG) of abdomen for the presence of ascites in five (71.4%) cases. The patients of tubercular meningitis were diagnosed predominantly on clinical grounds whereas in bone and genitourinary TB, all appropriate investigations were performed for confirmation of EPTB of these organs. Conclusions: Except for lymph node TB and the patients in whom the diagnosis had been established in tertiary care institutions of the state, patients were being diagnosed on clinical grounds.


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