Faheem Din Awan, Zafar Ahmed, Syed Ali Arsalan.
To study the various etiologies of pleural effusion.
Pak J Chest Med Jan ;21(1):20-5.

pleural space. The etiological spectrum of pleural effusion depends on the geographical location and local incidence of different diseases that cause pleural effusions. In developed countries the most common causes of pleural effusion are cardiac failure, malignancy and pneumonia whereas in developing countries, tuberculosis and para pneumonic effusion are more prevalent. OBJECTIVE: To study the various etiologies of pleural effusions in a tertiary care hospital of Pakistan. METHODOLOGY: This was a prospective study of 4 months duration, carried out in the Department of Pulmonology, Liaquat National Hospital Karachi from the period September 2013 to December 2013. This study included all patients >15 years age who were admitted in chest unit or visited chest medicine Outdoor Department (OPD). Clinical records of the patients were reviewed for risk factors, more than 90% patients underwent thoracocentesis in which pleural fluid was aspirated and sent for biochemical, cytological and microbiological studies and additional clinical and radiological examinations were performed. RESULTS: During the study period, total 70 cases of pleural effusions were identified;. There were 45 males (64.28%) and 25 females (35.71%) having a mean age of 54 years. Pleural effusion was exudative in 45 (64.28%) and transudative in 21 cases (30%) (total 70: also give characteristics of remaining 4 patients: borderline, empyema or hemorrhagic etc). Radiological results showed right sided pleural effusion in 33 (47.14%), left sided in 12 (17.14%), and bilateral pleural effusions in 21 cases (30%). The most frequent cause of pleural effusion was tuberculosis in 29 cases (42%), malignancy in 13 (18%), Congestive heart failure (CCF) in 10 (14%), pneumonia in 06 (08%), Chronic liver disease (CLD) in 04 (06%), Chronic Kidney Disease (CKD) with liver abscess, sepsis & pneumonia in 04 cases (06%) similar problem, trauma in 01 case (1.42%); while 04 cases remained undiagnosed (06%) and expired during the study period. CONCLUSION: Our study confirms Tuberculosis being the most common cause of exudative pleural effusions while CCF remains the most common cause of a transudative pleural effusion in patients coming to Liaquat National Hospital Karachi.

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