~ 298 ~ ISSN Print: 2394-7500 ISSN Online: 2394-5869 Impact Factor: 5.2 IJAR 2017; 3(9): 298-301 www.allresearchjournal.com Received: 12-07-2017 Accepted: 13-08-2017 Nitin Agarwal Assistant Professor, Department of Medicine, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India Ankit Chaturvedi Resident, Department of Medicine, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India Shweta Agarwal Assistant Professor, Department of Medicine, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India Darshan Mehra Assistant Professor, Department of Medicine, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India Anoop Kumar Professor, Department of Medicine, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India Mahendra Sharma Statiction Department of Community Medicine, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India Correspondence Nitin Agarwal Assistant Professor, Department of Medicine, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India Prevalence of tubercular pericardial effusion in Rohilkhand region, a prospective study Nitin Agarwal, Ankit Chaturvedi, Shweta Agarwal, Darshan Mehra, Anoop Kumar and Mahendra Sharma Statiction Abstract Tuberculous pericardial effusion is common in India. Since, the introduction of HIV infection, the incidence of tuberculous pericardial effusion has increased not only in India but also the world over. It presents with the usual features of tuberculous infection (low grade fever, loss of appetite, loss of weight) along with features of pericardial effusion (dyspnea, cough and enlarged heart). The salient features of pericardial effusion are low volume pulse or even pulsus paradoxus, raised jugular venous pressure Kussmaul’s sign, congestive hepatomegaly, ascites and edema over legs. In massive pericardial effusion, patient may go into cardiac tamponade when patient is breathless, restless with poor volume pulse (typical paradoxus), engorged neck veins, sinus tachycardia, fall in blood pressure. Urgent pericardial paracentesis is warranted to reverse the hemodynamic changes with improvement in symptoms and signs. Laboratory tests reveal raised absolute lymphocyte count, raised ESR, cardiomegaly on X-ray chest, low voltage and sinus tachycardia on ECG, Echo-free space seen between two pericardial layers on 2D-echo with heart floating in pericardial sac. Diagnostic pericardial paracentesis shows that pericardial fluid is lymphocytic exudate, with elevated ADA and IFN-g levels. Keywords: Tuberculous Pericardial Effusion, paracentesis, Biochemical study and cytological study Introduction Tuberculosis (TB) is a leading cause of pericarditis in India and a number of other developing countries [1, 2] . This is in contrast to first-world countries where TB is responsible for less than 4% of acute pericarditis [1] . In spite of economic developments and the availability of effective chemotherapy, the burden of TB is increasing. This increase has been partially attributable to the spread of human immunodeficiency virus (HIV) and is characterized by an increasing proportion of extrapulmonary cases [3] . Tubercle bacilli may be isolated on culture, guinea pig inoculation and nowadays by PCR technique. For management of tuberculous pericardial effusion, antituberculous treatment with four standard drugs is started (HRZE). Pericardial paracentesis with needle or even open drainage is useful in relieving symptoms and rapid recovery. Adjunctive corticosteroids are useful for rapid recovery and for prevention of development of constrictive pericarditis. Aims and objectives To study the prevalence of Tuberculous pericardial effusion patients in a tertiary care Hospital in Rohilkhand region. Material and methods A prospective study was carried out at Rohilkhand Hospital, Bareilly. Patients presenting with pericardial effusions between June 2015 to May 2017 were enrolled. All patients gave written informed consent for participation in the study which was approved by the Ethics Committee of Rohilkhand. A pericardial tap was performed under echocardiographic guidance through a pigtail catheter and fluid sent for biochemistry, microbiology, cytology and differential white cell count. Patients were allocated to diagnostic groups based on pre- determined criteria. Pericardial effusions were considered to be tuberculous in origin when diagnosed by one or more of the following criteria: International Journal of Applied Research 2017; 3(9): 298-301