iosr-JDMS   Volume-17 ~ Issue-1 ~ January-2018

Abstract: This study was done to know the various benign and malignant ovarian lesions in Patients presenting with ovarian mass in RIMS, Ranchi. Total 115 Ladies with clinical feature of ovarian mass coming to Gynecology OP D were included in the study. Staining of smear done by pap and H&E staining. 24 cases were non neoplastic ,45 cases benign neoplastic and 27 were found malignant. Benign tumor were common in early age group, where as malignant were more common in late age group. Our study recommend U&G guided fnacand pathologicalcorrelation with history for early initiation of treatment.

[1]. Jinawath N, Shihi. Biology and Pathology of ovarian cancer. In: briston R, Armstrong D, editors Early Diagnosis and treatment of cancer overian cancer philadelphia.pa U.S.A saun ders, 2011,PP 17-32.
[2]. Russel P. Bannatyep. surgical pathology of the ovaries, edinburg, charchill living stone 1989.
[3]. Basu P, dep, Mandals, Rayak, Biswas J, study of patterns of care of ovarian cancer 2009,46.28-33
[4]. Vargas A,N natural history of ovarian cancer, ecancer medical science 2014,8:465 doi-10 3332/e cancer 2014.465]
[5]. Ganjei, nadjim Aspiration cytology of ovarian neoplasm; A review. Acta cytol1984:28:329-332
[6]. Malvany NJ: Aspiration cytology of ovarian cysts and cystic neoplasms A study of 235 aspivates. Acta cytol 1996,40,911-920

Abstract: We report the case of a 49 year old female who presented in our emergency department with abdominalpain, vomiting and blood in stools. Patient was evaluated and investigations including CT and ultrasound abdomen revealed intestinal obstruction. Emergency exploratory laparotomy revealed an ileo-colo-colic intussusception which was resected and right hemicolectomy and ileo transverse colic anastomosis was done. Intussusception is a common abdominal emergency in paediatric age group. Occurrence of intussusception in an adult patient always should give rise to suspicion about an underlying sinister pathology. Commonest variant of intussusception is an ileo-colic type. Ileo-colo-colic intussusception is one of the rarest variants with an incidence of less than 0.5%.

Keywords: Intussusception, Intestinal obstruction, Hemicolectomy, Anastomosis

[1]. Sabiston Textbook of Surgery The Biological Basis of Modern Surgical Practice, 20th edition 2016
[2]. Bailey & Love's Short practice of Surgery, 26th Edition
[3]. Maingot's Abdominal Operations 12th Edition.
[4]. Noble I. Master surgeon: John Hunter. J.Messner: New York; 1971. P. 185.
[5]. Hutchinson H, Hutchinson J. Jonathan Hutchinson, life and letters. 1st ed. Wm Heinemann Medical Books: London; 1946.
[6]. Takeuchi K, Tsuzuki Y, Ando T, Sekihara M, Hara T, Kori T, Kuwano H. The diagnosis and treatment of adult intussusception. J Clin Gastroenterol. 2003;36:18-21..

Abstract: Background Granulosa Cell Tumours of Ovary (GCT )are slow growing, of low malignant potential with a well-known predilection to spread beyond the ovary. Aims: To stage all GCTs which is the most significant prognostic factor and to correlate with the clinical and pathological prognostic factors along with the follow up of patients . Materials and Methods: A prospective descriptive study was done on 30 GCT Ovary cases with FIGO Staging from January 2003 to June 2006 analyzing the case records .13 patients were followed up with the data . Results: The median age at diagnosis was 48 years ( 25-65 years). Bleeding was the most common symptom( 40% ) . The median diameter of tumor was 10 cm ( 4–28 cm) with no evidence of tumour rupture .56.6% of the patients presented with Stage I a.8 patients with stage I had better survival (mean duration 11-25 months) and five patients..........

Keywords: Granulosa cell tumour Ovary, FIGO Staging, Follow up, Prognosis

[1]. Himanshumehta et al., Clinico pathological prognostic factors of adult GCTofthe ovary - a study of 37 cases; Indian J PatholMicrobiol,
[2]. vol 48, No. 4, October 2005.
[3]. Henry J. Norris and Herbert B. Taylor, Prognosis of GCT; Cancer,Vol. 21. 255-263. February 1968.
[4]. Henry S. Cronje et al., Review of the GCTs from the Emil Novak OvariaTumour Registry; Am J ObstetGynaecol, 323-7, 1999.
[5]. Iwahashi et al., Increased serum concentrations of type IV Collagen andlaminin associated with GCT; J. ClinPathol50; 77-79, 1997...

Abstract: Lumbar Hernias have always been difficult to manage because of nonavailability of anchoring points and poor fascial support. Every surgeon gets many such complicated cases in his career and if one is not versed with the complexities of lost fascial planes & severely scarred abdomen then management of hernias in such a deranged anatomy becomes very difficult. We have had a vast experience in managing complex ventral and lumbar hernias over the last 2 decades, we have decided to review 10 recently operated cases of complex paramedian and lumbar hernias in surgical ward 6 & 7 of Guru Nanak Dev Hospital, Amritsar in the last one year. Midline and inguinal hernias were excluded and so were the defects smaller than the 6cms.What prompted us to share our experience of managing such cases was that the cases that we dealt with had extra ordinary presentation and almost all the cases were...........

Keywords: management; complex; lumbar hernia; paramedian hernia

[1]. Watson L. Hernia. 3rd ed. CV Mosby; St Louis: 1948. Lumbar hernia; p. 446
[2]. Heniford BT, Iannitti DA, Gagner M. Laparoscopic inferior and superior lumbar hernia repair. Arch Surg. 1997;132(10):1141–1144
[3]. Burick AJ, Parascandola SA. Laparoscopic repair of a traumatic lumbar hernia: a case report. J Laparoendosc Surg. 1996;6(4):259–262
[4]. Meinke AK. Totally extraperitoneallaparoendoscopic repair of lumbar hernia. SurgEndosc 2003; 17: 734-7
[5]. Moreno-Egea A, Enrique G. BaenaMiquel C. Calle, José Antonio T. Martínez, ; José Luis A. Albasini, Controversies in the Current Management of Lumbar Hernias Arch Surg. 2007;142(1):82-88..

Abstract: Heterotopic pregnancy is defined as combined existence of intrauterine and extrauterine pregnancy.It occurs in 1:30000 of natural conceptions.With increasing prevalence of assisted reproduction,the frequency of heterotopic pregnancies was cited to be between 1:100 to 1:500.Futhermore,these are a diagnostic and therapeutic challenge for obstetricians.If undiagnosed,a life threatening situation may occur even when timely surgical intervention with laparotomy is performed. Here we report a case series of five patients having five different scenarios, who were diagnosed with heterotopic pregnancies in the first trimester and managed successfully.

Keywords: Ectopic pregnancy, Heterotopic pregnancy, Intrauterine pregnancy, Laparotomy, Rupture

[1]. Mishra A, Youssefzadeh D, Pare nte JT. Heterotopic preg-nancy. Female Patient 1998;23:39-42.
[2]. Maalt ME, Dabbas MMN. Advanced heterotopic pregnancy. J Obstet Gynaecol 1999;19:677-678.
[3]. Scheiber MD, Cedars MI. Successful non-surgical management of a heterotopic an abdominal pregnancy following embryo transfer
with cryopreserved-thawed embryos. Hum Reprod 1999;14:1375-1377.
[4]. Mistry BM, Balasubramaniam S, Silverman R, Sakabu SA, Troop BR. Heterotopic pregnancy presenting as an acute abdomen: a
diagnostic masquerader. Am Surg 2000;66(3): 307-308.
[5]. Dessole S, Ruiu GA, Cherchi PL. Coexistence of a heterotopic pregnancy associated with a homolateral ovarian cyst in a patient
submitted to elective abortion. Gynecol Obstet Invest 2000;49:277-278

Abstract: Thyroid disorders are one of the very common health problems that we come across in our day to day practice. However benign lesions are far more common than the malignant ones. FNA plays a very important role to help distinguish them. Also FNA is a very simple, cheap and quick process, so it has emerged as an important step in further management of patients with thyroid disorders..

Keywords: Carcinoma, Colloid goitre, Fine needle aspiration, Iodine deficiency, Thyroid

[1]. Prasad A, Kumari T, Sinha KK and Bharti MLG: Proportion of Thyroid Diseases in Jharkhand. Int J Pharm Sci Res 2016; 7(9): 3843-47.doi: 10.13040/IJPSR.0975-8232.7 (9).3843-47.
[2]. Klemi PJ, Joensuu H. FNAC in the diagnosis of the thyroid nodules. ActaCytol 1991;35:434-38.
[3]. Cibas ES, Ali SZ. The Bethesda system for reporting thyroid cytopathology. Am J Clin Pathol. 2009;132:658–665. doi: 10.1309/AJCPPHLWMI3JV4LA. [PubMed] [Cross Ref]
[4]. Prasad A, Kumari T, Sinha KK and Bharti MLG: Proportion of Thyroid diseases in Jharkhand. Int J Pharm Sci Res 2016; 7(9): 3843-47.doi: 10.13040/IJPSR.0975-8232.7(9).3843-47.
[5]. Ford G, La Franchi SH. Screening for congenital hypothyroidism: a worldwide view of strategies. Best Practice & Research Clinical Endocrinology & Metabolism. 2014 ; 28:175-87..

Abstract: The incidence of adnexal masses in pregnancy ranges from 1 in 81 to 1 in 8000 pregnancies. The incidence of ovarian cyst in pregnancy is increased with the use of dating ultrasound in the first trimester and also due to an increase in ovulation induction. Associated complications-torsion, rupture, infection, malignancy, impaction of cyst in the pelvis causing retention of urine, obstructed labor and malpresentation of the fetus. Here, we have presented 10 different cases of ovarian cyst in pregnancy, there managementeither conservatively or surgical and there outcome.This study showed Asymptomatic and benign cysts can be managed conservatively and typically resolve through the pregnancy or in the postnatal period. However at any time, if there is any complications intervention is needed were laparoscopy is warranted until 16-23 weeks, after whichlaparotomy is the most evaluated method. Caesarean section is warranted only if a cyst in the pelvis will obstruct labour and during which removal of a cyst should be performed. Prospective study during period – 2015 april-2017 april.

[1]. Int J Gynecol Cancer. 2006 Jan-Feb;16(1):8-15.
[2]. ObstetGynecolSurv. 2006 Jul;61(7):463-70.
[3]. Pan Afr Med J.2016 Oct 25;25:113. doi: 10.11604/pamj.2016.25.113.9170. eCollection 2016.
[4]. GynécologieObstétrique&Fertilité 41 · January 2013..

Abstract: Background: The incidence of disaster in Indonesia is dominated by hydrometeorological activity, and 75% of total disaster is the flood. Preparedness is the critical phase in the range of disaster management because this phase will determine the independence, success of responsive response, level of suffering the victim, and the safety of the victim's life in the event of the disaster. Purpose: to analyze factors related to the preparedness of Puskesmas nurse in facing flood disaster in Kendari City of Southeast Sulawesi. .Method: This research uses descriptive analytic design with Cross-sectional approach. The number of respondents in this research are 176 nurses of...........

Keywords: Knowledge, attitude, self-efficacy, family preparedness, government policy, infrastructure facilities, nurse preparedness

[1]. Adams, L. M., & Berry, D. (2012). Who will show up? Estimating ability and willingness of essential hospital personnel to report to work in response to a disaster. The Online Journal of Issues in Nursing Vol. 17 (2): 1-18.
[2]. Alamsyah. (2017). Pengaruh sumber daya organisasi terhadap kesiapsiagaan petugas BPBD Kabupaten Jeneponto. Tesis Magister Biomedik Universitas Hasanuddin Makassar.
[3]. Alwisol. (2009). Psikologi Kepribadian. Malang : UMM Press
[4]. Ansthobar. D., & Miellen. C. (2013). Disaster Nursing Management. Delhi: Janpoor Company.
[5]. Arsenijevic, O., Trivan, D., Podbregar, I., Sprajc, P. (2017).Strategic aspect of knowledge management.Organizacija, 50 (2): 163-177...

Abstract: Introduction: Acute cholecystitis is one of the common conditions leading to cholecystectomies. Distinguishing simple cholecystitis from severe cholecystitis is difficult. The role of neutrophil to lymphocyte ratio in predicting severity of cholecystitis has been recently studied. Aim: To observe the patterns of preoperative Neutrophil-to lymphocyte Ratio in simple and severe cholecystitis. Materials And Methods: In this hospital based observational study, data were collected from patients undergoing cholecystectomies at a single institution from June 2016 to August 2016. Each patient's Neutrophil to Lymphocyte Ratio (NLR) was calculated as the absolute neutrophil count divided by the absolute lymphocyte count............

Keywords: neutrophil to lymphocyte ratio, cholecystitis

[1]. Garden OJ. Fischer's Mastery of Surgery. Sixth edition. Fischer JE, Jones DB, Pomposelli FB et al (eds). Lippincott Williams and Wilkins, a Wolters Kluwer business. Philadelphia, PA 19103 USA. 2012. 1254-1264
[2]. Kelly K, Weber S. Blumgart's Surgery of The Liver, Biliary Tract and Pancreas. Fifth edition. Jarnagin WR, Buchler MW, Chapman WC et al (eds). Saunders, an imprint of Elsevier Inc. Philadelphia USA. 2012. 487-493
[3]. Niemeier OW. Acute Free Perforation of the Gall Bladder. Ann Surg 1934; 99: 922-924.
[4]. Bedirli A, Sakrak O, Sözüer EM et al. Factors effecting the complications in the natural history of acute cholecystitis. Hepatogastroenterology 01 Sep 2001; 48(41):1275-8.
[5]. Bennett GL, Rusinek H, Lisi V et al. CT findings in acute gangrenous cholecystitis. AJR Am J Roentgenol 2002; 178(2):275–281..

Abstract: Glaucoma is a potentially blinding disease of global importance. It is second leading cause of blindness after cataract. In secondary angle closure glaucoma, the underlying cause can close the angle directly by local iris and angle factors or by acting to move the crystalline lens forward causing pupillary block (secondary pupillary block). The aim of our study is to find the common causes, demographics and clinical features and outcomes of therapy in various secondary angle closure glaucomas in Bundelkhand region. A total of 137 Patients who were diagnosed as a case of secondary angle closure glaucoma, included in this analytical study conducted in the Department of Ophthalmology, MLBMC Jhansi. Patients with recently diagnosed as a case of secondary angle closure glaucoma were included in this study. This analytical study mainly focused on secondary angle closure glaucoma in which..............

Keywords: Cataract, Drug-induced glaucoma, Pupillary block, Phacomorphic glaucoma, Secondary angle closure glaucoma.

[1]. Quigley HA. The number of people with glaucoma worldwide. Br J Ophthalmol. 1996; 80: 389-93.
[2]. Krishnadas R, Ramakrishnan R. Secondary Glaucomas. The Tasks ahead. Community eye health. 2001; 14: 40-2.

[3]. Van Herick W, Shaffer RN, Schwartz A. Estimation of width of angle of anterior chamber. Incidence and significance of the narrow angle. Am J Ophthalmol 1969;68:626-9.
[4]. Perkins ES. Family studies in glaucoma. Br J Ophthalmol 1974;58:529-3

[5]. Foster PJ, Baasanhu J, Alsbirk PH, et al. Glaucoma in Mongolia. A population-based survey in Hovsgol province, northern Mongolia. Arch Ophthalmol. 1996;114:1235-41...

Abstract: Bcakground :Solitary thyroid nodule is a challenge for surgeons and pathologists. The prevalence of these nodule depends on age,sex,and iodine deficiency. The clinical and cytological evaluation of the nodule is important for the management. Fine needle aspiration cytology is important for preoperative diagnosis of benign and malignant thyroid lesions thus decreasing the incidence of surgeries. Objectives: The present study was to understand the role of FNAC in the diagnosis of solitary thyroid nodule and to know the incidence of malignancy and to evaluate the the management of the solitary nodule. Methods: This study was conducted in Government General hospital Guntur over a period of two years.About 140 patients were evaluated . Patients with goiter were excluded from study...........

Keywords: FNAC , Solitary thyroid nodule, sensitivity, specificity , clinical examination.

[1]. Gita J ,Orell SR. Thyroid In :Orell SR, Sterrett GF, editors. Fine Needle Aspiration Cytology. 5th ed.Philadelphia: Churchill Livingstone; 2012.118-55.
[2]. Gharib H, GoelIner JR. Fine needle aspiration biosy of the thyroidian appraisal. Ann Intern Med 1993;118:282-9.
[3]. SinnaEA ,Ezzat N. Diagnostic accuracy of fine needle aspiration cytology in thyroid lesions. J Egypt NatI Cancer Inst. 2012;24 (2) :63-70. DOI:10.1016/j.nci.2012.01.001.
[4]. Uma H, Sukant G, Hrash M, Nitin N. Role of fine needle aspiration cytology in diagnosis and management of thyroid lesions: A study on 434 patients. J Cytol 2008; 25(1):13-7.
[5]. Roman SA. Endocrine tumors: Evaluation of the thyroid nodule. CurrOpinOncol 2003; 15:66-70..

Abstract: Introduction: Anal stenosis is a disabling but fortunately uncommon disease that is mostly caused by anorectal surgery ,open hemorrhoidectomy is responsible for about 90% of cases. The aim of this study is to analyze whether certain patient and procedure related factors are related to higher risk of stenosis. Methods: A retrospective study carried out in Prince Hashem Hospital and comprising of all patients who underwent hemorrhoidectomy between 2014 and 2016.Only patients with at least one follow up are included. Data related to many patient and procedure characteristics were collected and analyzed using SPSS 16. Results: 250 patients were included, 159 males and 91 females with mean age of 33 years. Stenosis was found in 7.2% of cases in a mean follow up period of 4.8 months. Only the presence of previous history of hemorrhoid surgery and the removal of more than 3 piles at one session were associated with higher risk of stenosis (P value 0.038 and 0.001 respectively)..........

[1]. Casadesus D, Villasana LE, Diaz H, Chavez M, Sanchez IM, Martinez PP, Diaz A. Treatment of anal stenosis: a 5-year review. ANZ J Surg. 2007;77:557–559
[2]. Giuseppe Brisinda, Serafino Vanella, Federica Cadeddu, Gaia Marniga, Pasquale Mazzeo, Francesco Brandara, and Giorgio Maria.Surgical treatment of anal stenosis. World J Gastroenterol. 2009 April 28; 15(16): 1921–1928
[3]. Brisinda G. How to treat haemorrhoids. Prevention is best; haemorrhoidectomy needs skilled operators. BMJ. 2000;321:582–583
[4]. Katdare MV; Ricciardi R.Anal stenosis.Surg Clin North Am. 2010 Feb;90(1):137-45
[5]. Angelita Habr-Gama; Carlos Walter Sobrado; Sergio Eduardo Alonso de Araújo; Sergio Carlos Nahas; Ingrid Birbojm; Caio Sergio Rizkallah Nahas; Desidério Roberto Kiss.Surgical treatment of anal stenosis: assessment of 77 anoplasties.Clinics vol.60 no.1 São Paulo Jan./Feb. 2005..

Abstract: Due to profound decline in cellular immunity, patients develop various opportunistic infections and neoplasms. The opportunistic infections of HIV / AIDS depend upon the organisms and parasites endemic in that country. The aim of the present study is to know the opportunistic infections in HIV patients and its correlation with CD4 count. All HIV patients who are under ART were regularly followed by CD4 evaluation at VCTC centre were included. Details pertaining to patient's history taken and Systemic examination was done to all patients and advised to undergo further investigations. Based on investigations, patients were diagnosed with opportunistic manifestations. Predominantly HIV patients had Candidal infections and Pulmonary TB infections followed by Extrapulmonary.............

Keywords: CD4 count, HIV, Opportunistic infections

[1]. DL. Robertson, JP. Anderson, JA. Bradac et al, HIV -1 nomenclature proposal. In: Human Retroviruses and AIDS, LOS Alamos National Laboratory, 1999.
[2]. MK. Jain, TJ. John, GT. Keusch, Epidemiology of HIV and AIDS in India, AIDS, 8(2), 1994,S6-75.
[3]. TJ. John, PG. Babu, NK. Saraswathi et al, The epidemiology of AIDS in Vellore region, South India, AIDS, 7, 1993, 421-424.

[4]. Sead Ahmetagic, HumeraPorobicJahic, DilistaPiljic, AmerCustovic, DamirSabitovic, Denis Zepic, Clinical and Epidemiological Characteristics of HIV Infection/AIDS in Hospitalized Patients, Mater Sociomed, 27(1), 2015 Feb, 27-30.

[5]. MK. June, JC. Goon, KH.Sung, HC. Kyung, SC. Joo, HC. Young, GS. Young, H. Aejung, SY Joon, SL. Kkot, YC. Jun, Epidemiology and Clinical Features of HIV Infection/AIDS in Korea, Yonsei Med J, 44(3), 2003, 363–370...

Abstract: Majority of the anatomical studies have found that Mandibular Central Incisors are single rooted teeth with single canal. Permanent Mandibular Central Incisor is rarely affected by tooth shape anomalies of crown and root. This Paper aims in providing anatomical variations and anomalies in mandibular Central incisor teeth as failure to recognize unusual root canal anatomy may lead to unsuccessful endodontic treatment. Hence it is mandatory for a dentist to be updated with this kind of variations and anomalies in teeth.

Keywords: Central Incisors, Teeth, Anatomical Variations

[1]. The mandibular central incisor is single-rooted (Figures 1-3). The external form of the root is broad labiolingually and narrow mesiodistally.
[2]. Longitudinal depressions are present on both the mesial and the distal surfaces of the root. A cross section of the root is ovoid to hourglass in shape due to the developmental depressions on each side 8,9
[3]. The overall average length of the mandibular central incisor is 21.5 mm with an average crown length of 9
[4]. mm and an average root length of 12.5 mm..

Abstract: Backround:Obstetric services in the Niger Delta area of Nigeria is offered by both skilled and hugely unskilled practitioners. The Delta is therefore heralded with high maternal and perinatal mortality and morbidity. Objectives:The aim of the study is to determine the categories of obstetric practitioners in the Niger Delta, evaluate their association with maternal and perinatal outcomes and if there are shortcomings in their care, to recommend urgent need for their structured training. Method:This was a descriptive cross-sectional study. Data on obstetric qualification of carers were collected from 58 health facilities in four local Government areas of Rivers State. A 4-year review of pregnancy outcomes for both booked and unbooked patients with the University of Port Harcourt Teaching Hospital using the annual report for the years 2011-2014 was also conducted.........

Keywords:Maternal healthcare, Niger Deltatraining, Unskilled practitioners, Referral cascade

[1]. WHO, ICM and FIGO. Making pregnancy safer: The critical role of the skilled attendant. A joint statement. Department ofReproductive Health and Research World Health Organization , Geneva. 2004, Page 1.
[2]. Millennium Development Goals end-point report 2015. Nigeria. Chapter 4.5
[3]. The United Nations Millennium Declaration. The Millennium Assembly. New York: United Nations, Sept. 6 – 8, 2000. [http://www.un.org/millennium/]

[4]. Nigerian WHO statistical profile, 2015.
[5]. Trends in Maternal Mortality: 1990 – 2013. Estimates by WHO, UNICEF, UNFPA, The World Bank and the United Nations Population Division. Page 33..

Abstract: Background: Tuberculous Pleural Effusion (TPE) is the most common form of the extra pulmonary tuberculosis (EPTB) in India. The pleural fluid adenosine deaminase (ADA) is one of the best marker providing reliable basis for a treatment decision in TPE, due to its high sensitivity. The aim of this study was to evaluate the diagnostic usefulness of ADA along with other laboratory data using prediction models for TB decision in high prevalence of tuberculosis (TB) and HIV.Methods:100 patients with suspected pleural effusion (41TB and 59 non TB) were analyzed retropectively. Two predictive models, one with pleural fluid ADA, lymphocyte %(model 1) and other with pleural fluid ADA, lymphocyte % and GeneXpert (model 2) were analyzed in 31 culture confirmed cases out of 41 suspected Tuberculous Pleural Effusion. The statistical modelling used analysis adjusted for the following covariates: gender, fever............

Keywords: Adenosine deaminase, Predictive model, tuberculous plural effusion

[1]. Light RW: Update on tuberculous pleural effusion. Respirology 2010, 15(3):451–458.
[2]. Koegelenberg CF, Diacon AH: Pleural controversy: close needle pleural biopsy or thoracoscopy-which first? Respirology 2011, 16(5):738–746.
[3]. Gecia-monco J C CNS Tuberculosis. Neurologic clinics. Marra C.M. ed.; 1999. 17(4):737-60
[4]. Piras MA, Gakis C, Budroni M, Andreoni G. Adenosine deaminase activity in pleural effusions: an aid to differential diagnosis. Br Med J 1978; 2: 1751–1752
[5]. Ocaña I, Martínez Vázquez JM, Segura RM, Fernández de Sevilla T, Capdevila JA. Adenosine deaminase in pleural fluids: test for diagnosis of tuberculous pleural effusion. Chest 1983; 84: 51–53..