Role of induced sputum with hypertonic saline in the early diagnosis of no / inadequate sputum or sputum smear negative suspected cases of pulmonary tuberculosis

Background: Pulmonary Tuberculosis is one of the common infections in the world, especially in developing countries like India and is a leading cause of morbidity and mortality worldwide. Therefore, early diagnosis and microbiological confirmation of pulmonary TB is important. This study was done to assess the role of induced sputum with hypertonic saline in suspected pulmonary TB patients who produce no or inadequate sputum or who are sputum for AFB smear negative.Methods: 100 patients with clinical and radiological evidence of pulmonary TB with no or inadequate sputum or who are smear negative with spontaneous sputum were included in the study. Sputum was induced with 5ml of 3% hypertonic saline delivered through nebulizer and then was sent for Ziehl Neelsen staining examination.Results: 96 patients could produce adequate sputum after sputum induction. In 47 patients, sputum for AFB smear was found positive after induction.Conclusions: Sputum induction is a safe, cheap and non-invasive procedure and offers an alternative or additional approach in the diagnosis of sputum smear-negative suspected pulmonary tuberculosis patients and would enhance sensitivity for the diagnosis of tuberculosis.

Trigeminocardiac Reflex during Maxillary Reconstruction Surgery: A Case Report

Systemic hypotension, cardiac dysrhythmia especially bradycardia, apnoea, and gastric hypermotility occurring presumably after stimulation of any of the sensory branches of trigeminal nerve is coined as trigeminocardiac reflex (TCR). It has been described to occur in various surgeries like cerebello-pontine angle and pituitary fossa surgeries. Such bradycardic reflex responses have also been observed during maxillofacial surgeries. The TCR presents as a challenge to both the Anaesthesiologist and the Surgeon in view of its varied presentations, diagnosis, prevention and appropriate management

Antitubercular Therapy—An Uncommon Side Effect

A 43-year-old female presented with complaints of chest pain, non-productive cough, shortness of breath, diarrhoea, loss of weight and appetite, and generalised malaise for a period of one month [...