European Journal of Molecular & Clinical Medicine

Background: The proper evaluation of ascitic fluid helps in narrowing the diagnostic dilemma faced by the physicians and helps in better management of the patients. Early and accurate diagnosis often depends on appropriate ascitic fluid analysis. The aim of this study to correlate the cytological features of the ascitic fluid with clinical data at newly established tertiary care center.
Materials & Methods: A prospective study was conducted in the Department of Pathology, in a tertiary health care centre over a period of one year. Cytological examination was performed to reveal important information regarding the causes of ascites and classified as benign (with or without infection/ spontaneous bacterial peritonitis), suspicious or malignant conditions. Cytomorphology of the cells was studied and documented paying attention to cellular arrangement, cytoplasmic features and nuclear characteristics. Clinical information of the patient and cytomorphological features of the smears were studied and the samples were categorized into benign (with or without infection/ SBP), suspicious of malignancy or malignant.
Results: Our study showed that the mean age was 55.67 years. Out of 30 cases, 14 were males and 16 were females, with male to female ratio being 7:8. Out of 30 samples, 26 (86.66%) were benign, 2 (6.66%) were suspicious of malignancy, and 2 (6.66%) were positive for malignancy. The most frequent clinical diagnosis was Alcoholic Liver disease comprising of 8 (26.66%) cases. The predominant cell type was Lymphocyte in 14 (46.66%) of cases, Neutrophil in 9 (30%) of cases, Reactive mesothelial cell in 5 (16.66%) of cases and atypical/malignant cells in 2 (6.66%) of cases. Histiocytic cells were also seen.
Conclusion: We concluded that non neoplastic and neoplastic conditions causing ascites can be diagnosed on ascitic fluid cytology. Increased neutrophil count is strongly suggestive of spontaneous bacterial peritonitis (SBP). The careful cytomorphological examination of ascitic fluid is a valuable, simple, rapid, inexpensive and reliable technique in the differential diagnosis of ascites, particularly in resource limited settings.

Background of the Study: Bacterial and Viral infections are often hard to be distinguished in daily clinical practice. Biological markers obtained from a routine examination play an important role to minimize time in providing diagnose and giving therapy. Recently, the use of Neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR) is greatly considered to differentiate types of infection found in the patients presenting with fever.
Method: This study uses prospective cohort study design and involves patients presenting with fever who are admitted to the ICU. The initial NLR, MLR, and PLR is examined and categorized into types of infection found. The ANOVA test and t-test are performed to find out the difference among study groups with the value of α = 0,05.
Result : This study involves 207 patients (92 male patients [44%]) presenting with fever with the average age of 45,6 ± 14,6 years old. The majority of cases (135 cases [66,5%]) in patients with fever results from bacterial infection; The study also finds 47 cases (34,8%) of typhoid fever and 30 cases (22,2%) of pulmonary tuberculosis. Dengue hemorrhagic fever (DHF) is the most commonly found viral infection with 52 cases (76,4%). The significant diagnose of bacterial infection shows higher value of NLR and MLR than that of viral infection (P < 0,001); Urinary tract infection has the highest value of NLR and MLR, amounting to 9,4 ± 3,6 and 0,23 ± 0,20, respectively. In general, the value of PLR is lower than that of viral infection (P < 0,001).
Conclusion: Neutrophil-lymphocyte ratio, MLR and PLR have benefit to predict diagnosis for the patients presenting with a fever. Bacterial infection is associated with the high value of NLR and MLR, and PLR generally has a lower value in viral infection cases.