<strong>Chest</strong> & <strong>Heart</strong> Journal Vol. <strong>35</strong>, <strong>No</strong>.-2, July <strong>2011</strong>Adenosine deaminase activity in sputum Inpulmonary tuberculosis, Respir Med 2002; 96:632-634.10. Ungerer JPJ, Oosthuizen HM, Bissbort SH,Vermaac WJH. Serum adenosine deaminase:isoenzymes <strong>and</strong> diagnostic application, ClinChem 1992; 38(7): 1322-1326.11. Yew WW, Leung CC. Update in Tuberculosis2006, Am J Respir Crit Care Med 2007; 175:541-546.12. Rao SK. Kumar HA, Rudresh BM, SrinivasT, Bhat KH. A Comparative study <strong>and</strong>evaluation <strong>of</strong> serum adenosine deaminaseactivity in the diagnosis <strong>of</strong> pulmonarytuberculosis, Biomedical Research 2010; 21(2):189-194.13. Wong CF, Yew WW, Chan CY, Au LY, ChengAF. Rapid diagnosis <strong>of</strong> smear-negativepulmonary tuberculosis via fiberopticbronchoscopy: utility <strong>of</strong> polymerase chainreaction in bronchial aspirates as an adjunctto transbronchial biopsies. Respir Med 1998;92: 815-819.14. Kubota M, Katagiri M, Imasaki T, Yanase N,Soma K, Tomita T. Adenosine deaminaseactivity in bronchoalveolar lavage fluid <strong>of</strong>sarcoidosis patients, Nihon Kokyuki GakkaiZasshi 1999; 37(5): 374-379.15. Halvani A, Binesh F. Adenosine DeaminaseActivity in Bronchoalveolar Lavage Fluid inPatients with Smear-Negative PulmonaryTuberculosis, Tanaffos 2008; 7(2): 45-49.16. Haslam PL. BAL st<strong>and</strong>ardization <strong>and</strong>measurement <strong>of</strong> acellular components. EurRespir Rev 1998; 8: 1066-1071.102
<strong>Chest</strong> & <strong>Heart</strong> JournalVol. <strong>35</strong>, <strong>No</strong>. 2, July <strong>2011</strong>ORIGINAL ARTICLEFluorescein Diacetate (FDA)” A staining basedmethod for early diagnosis <strong>of</strong> Category IITreatment Failure Tuberculosis PatientFahmida Rahman 1 , Most<strong>of</strong>a Kamal 2 , Md Ruhul Amin Mia 3 , Narayan Ch<strong>and</strong>ra Dutta 4 ,Jewel Ahmed 5 , Md Shamim 6AbstractObjectives: Rapid diagnosis <strong>of</strong> true treatment failure tuberculosis patient amongsuspected cat II treatment failure tuberculosis patients.Design: Prospective type <strong>of</strong> study among ZN smear positive suspected cat IIfailure TB patients to find out true treatment failure by FDA staining <strong>and</strong>conventional culture.Result: Total 100 patients <strong>of</strong> cat II failure ZN positive were included. 90 patientswere FDA positive. Eighty seven (87%) were culture positive. Eighty six (95.5%)were positive by both culture <strong>and</strong> FDA staining. Sensitivity <strong>of</strong> FDA staining was98.5%.Conclusion: FDA staining on fresh sputum can be used for early <strong>and</strong> accuratediagnosis <strong>of</strong> true treatment failure. This early information is <strong>of</strong> great advantagein clinical settings to choose an appropriate drug regimen.[<strong>Chest</strong> & <strong>Heart</strong> Journal <strong>2011</strong>; <strong>35</strong>(2) : 103-106]Introduction:Tuberculosis is a major health problem inBangladesh. In 2007 Bangladesh ranked 6 th on thelist <strong>of</strong> 22 highest TB burden countries in the world1 . Estimates suggest that in Bangladesh about 880new TB cases <strong>and</strong> 176 TB deaths occur daily 2 .<strong>The</strong> estimated prevalence <strong>of</strong> all forms <strong>of</strong> TB <strong>and</strong>incidence rates in Bangladesh was 425 <strong>and</strong> 225respectively per 1, 00,000 per year <strong>and</strong> themortality rate was 51 per 1,00,000 per year 3 .Diagnosis <strong>of</strong> Pulmonary tuberculosis in developingcountries mainly depends on result <strong>of</strong> ZN stainedsputum smear. Treatment regimens are usuallyprescribed without assessing the drug susceptibilitypr<strong>of</strong>ile <strong>of</strong> infecting strain 4 .Category I treatment are given to those patientswho are newly diagnosed TB patients <strong>and</strong> havenever taken anti-TB drug or have taken anti-TBdrug for less than one month. Treatment durationis six months. If any patient remains smearpositive after 5 th month or later during treatment<strong>of</strong> category I, is called category I failure. CategoryII treatments are given to those patients who arepreviously treated with anti-TB drug for more thanone month, relapse cases, category I failure, <strong>and</strong>patients with history <strong>of</strong> drug default. Treatmentduration is eight (8) months. If any patient remainssmear positive after 5 th month or later duringtreatment <strong>of</strong> category II, that patient is calledcategory II failure. <strong>The</strong>se patients will be treated1. Clinical Pathologist, NICVD2. (Associate pr<strong>of</strong>), NTRL ,NIDCH3. Pr<strong>of</strong>. Abu Ahmed Saleh, Dr. Ch<strong>and</strong>on Kumar Roy, Dept <strong>of</strong> Microbiology & immunology,BSMMU4. Asstt. Pr<strong>of</strong>, Respiratory medicine , NIDCH.5. Specialist- Laboratory, University Research Co. LLC, Bangladesh.6. NTRL, NIDCHCorrespondence to: Dr. Fahmida Rahman, Clinical Pathologist, NICVD
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