PURPOSE: Sputum examination for AFB is the mainstay in the diagnosis of pulmonary tuberculosis. Despite all efforts only 50% cases are diagnosed as sputum positive cases. Rest 50% poses diagnostic difficulties. We carried out this study to know whether sputum induction by inhaled salbutamol increases the yield of sputum positive cases. We compared the results with the yield of morning and spot samples.
METHODS: This crossover study was carried out in the department of TB and Respiratory diseases, J. N. Medical College, AMU, Aligarh, India. Five hundred patients of pulmonary tuberculosis were included in this study. Morning and spot sputum samples of each patient were collected as per current guide lines and induced sputum samples were obtained after giving inhaled salbutamol by nebulizer. Samples were examined For AFB by Ziehl Neelsen method.
RESULTS: Four hundred fifty (90%) patients generated sputum by their own and 10 (2%) more generated sputum after salbutamol inhalation. Yield of sputum positive cases was highest (52%)when induced sputum samples were examined and lowest (37%) by spot samples. By examining morning samples, 46% patients were diagnosed as sputum positive cases. The combined yield of all the three samples was 59%. The combined yield of induced and morning samples was 54% and that of morning and spot samples was 48%.
CONCLUSIONS: Sputum induction by inhaled salbutamol gave significantly higher yield of sputum positive cases than that of spot samples. No significant difference in positive cases was found between induced and morning samples. The combined yield of induced and morning samples was also significantly higher than that of morning and spot samples.
CLINICAL IMPLICATIONS: The yield of sputum positive cases can be increased by examining induced and morning sputum samples instead of examining morning and spot samples.
DISCLOSURE: The following authors have nothing to disclose: Zuber Ahmad, Rakesh Bhargava, Deepak Pandey, Mohammad Shameem
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