Volume. 35, No. 2 july. 2011 - The Chest and Heart Association of ...

Adenosine Deaminase Activity in Bronchoalveolar Lavage in PatientsMd. Khairul Anam et al.the diagnostic value of this tests which is elucidatedthe possible applicability of the ADA activity in BALfluid in the early detection of patients with AFBsmear negative, who are strongly suspected tohave pulmonary tuberculosis and thereby initiatingtreatment without undue delay.Materials and Methods:An observational cross-sectional study was carriedout in National Institute of Diseases of the Chestand Hospital (NIDCH), Mohakhali, Dhaka,Bangladesh from January 2010 to December 2010for a period of one (1) year. Samples were collectedfrom both outpatient department (OPD) &inpatient department of NIDCH. Total 100 (onehundred) patients of 14-80 years of age, both malesand females of suspected pulmonary tuberculosiswith negative sputum smear for AFB and nontuberculouspulmonary diseases were enrolled inthe study. Prior to the commencement of thisstudy, the research protocol were approved by theethical committee of the NIDCH, Dhaka; informedconsents were taken from the respondents priorto interview.A pretested semi-structured questionnaire and achecklist developed by using selected variablesaccording to the objectives. Laboratory findingswere collected from the record. The questionnairewas prepared in English and expressed to thepatients in Bengali. Conventional investigationslike complete blood counts (CBC), Chest X-ray P/Aview, mantoux test (MT), sputum smear for AFBwere done for the patients attended in NIDCH.After excluding the positive cases of sputum smearfor AFB. 100 patients with negative sputum smearfor AFB suspected of having pulmonary TB andother pulmonary diseases were included in thestudy.The sputum samples of all patients included in thestudy were sent to the laboratory for culture forAFB. According to the standard approach FOB wascarried out of all (100) patients. Bronchoalveolarlavage (BAL) fluid was obtained and sent tolaboratories for smear for AFB, Culture for AFB,ADA level, cytology and malignant cell. Otherrelated investigations were performed to reach thediagnosis of the patients. Those Patients who hadpositive sputum cultures or BAL fluid cultures forAFB, considered as pulmonary TB group. Thosewho had other forms of pulmonary diseases andnegative for TB, were considered as nontuberculouspulmonary diseases group. ADA levelsin BAL fluids were measured and compared amongthe groups. The laboratory technicians were notapprised of the tentative diagnosis of each patient;furthermore, the clinicians were unaware of theADA level when the diagnosis were decided.All data were compiled and statistical analysis wasperformed by using SPSS for windows version 15.0.95% confidence limit was taken. Probability value