8/14/2019 09 ArijitD Medicine Summary

1/2

SUMMARY

he present s tudy comprised of 40 cases of pleural effusion admit ted

i n t he d if fe re nt m ed ic in e u ni ts o f A ss am M ed ic al C ol le ge &

Hospi ta l dur ing the per iod of 1 s t June 2003 to 31 s t May 2004. Among

the 40 cases 75% were males & 25% females. The age ranged from 13-

83 years with maximum number of cases in the

3 r d decade.

t

D ia gn os is o f p le ur a l e ff us io n w as f ir st m ad e b y c li ni ca l &

radio logica l examinat ion of chest & confi rmed by aspira t ion of

pleural fluid.

Aetiological diagnosis was made by pleural f luid examination for

cy to logy & cu ltu re , h is topa tho logical examina t ion o f p l eu ral

b iopsy t i ssue in s e lec ted ( i .e . i n 11 cases ) & o the r s t anda rd

radiological & laboratory procedures.

Standard methods of est imation of pleural f luid & serum protein,

Lactate Dehydragenase & Albumin were fol lowed.

R ev ie w o f r el ev an t l it er at ur es w er e d on e & r ev ea le d t ha t

d if f erent i al d i agnos is o f p l eu ral e ffus ions in to t r ansuda te o r

exudate is important & pleural f luid & serum protein est imation

can d i fferent ia te 80% of t ransudates & 82% of exudates wi th amisclassif icat ion rate of 21%. Pleural f luid LDH est imation can

differentiate 84% of exudates & 82.3% of t ransudates with total

misc la s si f ica tion o f 21.6% whi l e p l eu ral f l uid LDH to se rum

LDH have a to ta l misc lass i f ica t ion ra te of 15%. The reviewed

li teratures mentioned that Serum-Effusion albumin gradient have

a minimal total misclassif icat ion rate around 0-2%.

8/14/2019 09 ArijitD Medicine Summary

2/2

Results of pleural f luid & serum protein, LDH & Serum-Effusion

albumin gradient were s tudied & analyzed and compared to the

Etiological diagnosis.

The parameter of pleural f luid protein> 3g/dl & P/S protein rat io

>0 .5 a re u se ful pa ramete rs i n d i ff e rent i al d i agnosi s & the i r

combinat ion can different iate 82% of exudates correct ly & 83.3%

transudates correct ly with total misclassif icat ion of 17.5%.

The pa rame te r o f p l eu ra l f l u id LDH of 200 U/L can co r rec t ly

c lass i fy 83 .3% of exudates & 81.25% of t ransudates wi th to ta lmisclassif icat ion of 17.5%.

The pa rame te r o f P /S LDH of 0 .6 co r rec t ly c l a s s i fy 88 .8% as

exuda te s & 84.6% t r ansudate s w i th tot a l mi sc l as s if i ca t ion o f

12.5%.

Combinat ion of p leura l f lu id LDH of 200 U/L &P/S LDH of .6

correct ly classif ied 93% of exudates & 88% of t ransudates with

total misclassif icat ion of 10%.

The parameter of Serum-Effus ion a lbumin gradient of 1 .2g/d l

correc t ly c lass i f ied 96 .15% of exudates & 94% of t ransudates

with a total misclassification of only 5%.

T he r es ul ts o bt ai ne d w it h t he p ar am et er o f p ro te in , L DH i n

pleural fluid & serum are found to be suitable parameters, but the

Se rum-Effus ion a lbumin g rad ien t o f 1 .2 g /dl has t he h ighestdifferent iat ing abi l i ty with a sensi t ivi ty and specif ici ty of 96.1%

& 93% with total misclassification of only 5%.

usu

S U M M A RY 82