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<strong>Chest</strong> & <strong>Heart</strong> JournalVol. <strong>35</strong>, <strong>No</strong>. 2, July <strong>2011</strong>ORIGINAL ARTICLEAdenosine Deaminase Activity inBronchoalveolar Lavage in Patients with SmearNegative Pulmonary TuberculosisMd. Khairul Anam 1 , Saroj Kanti Chowdhury 2 , Taposh Bose 2 , Mahmud Rahim 3 ,S.M. Abdur Razzaque 3 , Md. Naimul Hoque 3 , Biswas Akhtar Hossain 3 , Md. Abu Raihan 3 ,Narayan Ch<strong>and</strong>ra Datta 3 , Md. Mohiuddin Ahmad 4 , Nihar Ranjan Saha 1 ,AKM Mustafa Hussain 5 , Mirza Mohammad Hiron 6 .Abstract:Background: Tuberculosis (TB) is still one <strong>of</strong> the major health problems acrossthe world <strong>and</strong> a leading cause <strong>of</strong> preventable morbidity <strong>and</strong> mortality from aninfectious agent. TB most commonly involves lungs <strong>and</strong> its diagnosis is mostlybased on acid-fast bacilli (AFB) in sputum smear or a positive sputum culture forAFB. <strong>The</strong> sputum smear negative patients have been a diagnostic challenge worldwide. Adenosine deamianase (ADA) activity has been shown to rise in variousbody fluids <strong>of</strong> patients with TB. This study was carried out to determine thediagnostic value <strong>of</strong> ADA activity in bronchoalveolar lavage (BAL) in patientshighly suggestive <strong>of</strong> pulmonary TB but with negative sputum smear for AFB. Wedecided to measure the ADA activity in BAL fluid <strong>and</strong> compare it with Sputum<strong>and</strong> BAL fluid cultures for AFB.Materials <strong>and</strong> methods: A cross-sectional study was performed at the NationalInstitute <strong>of</strong> Diseases <strong>of</strong> the <strong>Chest</strong> <strong>and</strong> Hospital (NIDCH), Mohakhali, Dhaka fromJanuary 2010 to December 2010. Total 100 (one hundred) patients with smearnegative suspected pulmonary TB & non-tuberculous pulmonary diseases wereincluded in the study. By Fiber Optic Bronchoscopy (FOB), BAL fluid was obtainedfrom all patients. As per final diagnosis the patients were categorized in twogroups, pulmonary TB group <strong>and</strong> non-tuberculous pulmonary diseases group.Patients with positive sputum culture <strong>and</strong> /or BAL fluid culture for AFB wereconsidered as pulmonary TB group <strong>and</strong> the patients with negative results for TB,having lung diseases other than TB were considered as non-tuberculous pulmonarydiseases group. ADA levels in BAL fluids were measured in both groups <strong>and</strong> thencompared with each other.1. Registrar (Respiratory Medicine), National Institute <strong>of</strong> Diseases <strong>of</strong> the <strong>Chest</strong> <strong>and</strong> Hospital, Mohakhali, Dhaka.2. Emergency Medical Officer, National Institute <strong>of</strong> Diseases <strong>of</strong> the <strong>Chest</strong> <strong>and</strong> Hospital, Mohakhali, Dhaka.3. Assistant Pr<strong>of</strong>essor (Respiratory Medicine), National Institute <strong>of</strong> Diseases <strong>of</strong> the <strong>Chest</strong> <strong>and</strong> Hospital,Mohakhali, Dhaka.4. Associate Pr<strong>of</strong>essor (Respiratory Medicine), Dhaka Medical College & Hospital, Dhaka.5. Director & Associate Pr<strong>of</strong>essor (Respiratory Medicine), National Institute <strong>of</strong> Diseases <strong>of</strong> the <strong>Chest</strong> <strong>and</strong>Hospital, Mohakhali, Dhaka.6. Former Director & Pr<strong>of</strong>essor (Respiratory Medicine), National Institute <strong>of</strong> Diseases <strong>of</strong> the <strong>Chest</strong> <strong>and</strong> Hospital,Mohakhali, Dhaka.Correspondence to: Dr. Md. Khairul Anam, Registrar (Respiratory Medicine), National Institute <strong>of</strong> Diseases <strong>of</strong>the <strong>Chest</strong> <strong>and</strong> Hospital, Mohakhali, Dhaka, Email- dr.anam_mk@yahoo.com
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