title: Role of therapeutic thoracentesis in tuberculous pleural effusion.
abstract: BACKGROUND
  Prevalence of tuberculous pleural effusion is very high in the Asian subcontinent but very few studies have come up from this part of the world about the course of recovery of pulmonary functions after institution of anti-tubercular therapy (ATT) and thoracentesis.
  
  
  OBJECTIVE
  To study initial lung function impairment, changes over time after institution of ATT and thoracentesis and residual abnormalities left at the end of six months of treatment.
  
  
  METHODS
  Randomized open level interventional study over two years in 52 patients at a tertiary level teaching hospital.
  
  
  METHODS
  The study population was divided into two equal groups, A (therapeutic thoracentesis) and B (diagnostic thoracentesis). Spirometry, chest radiograph and ultrasonography of thorax were done initially and at each follow-up visit up to six months. Statistical analysis was done (P value < 0.05 considered significant).
  
  
  RESULTS
  Both groups were comparable initially. After six months none in group A and five patients in group B had minimal pleural effusion. During follow up, mean percentage predicted of FEV1 and FVC increased more in A than in B and the differences were statistically significant (P < 0.05). Pleural thickening, initially absent in both groups, was found to be more in B as compared to A at subsequent follow-up visits and this was statistically significant (P < 0.05).
  
  
  CONCLUSIONS
  Thoracentesis should be considered in addition to anti-TB treatment, especially in large effusions, in order to relieve dyspnea, avoid possibility of residual pleural thickening and risk of developing restrictive functional impairment.
authors.affiliation: Department of Pulmonary Medicine, Midnapore Medical College and Hospital, WestMidnapore, India.
authors.forename: Sourin
authors.initials: S
authors.lastname: Bhuniya
authors.forename: Datta C
authors.initials: DC
authors.lastname: Arunabha
authors.forename: Sabyasachi
authors.initials: S
authors.lastname: Choudhury
authors.forename: Indranil
authors.initials: I
authors.lastname: Saha
authors.forename: T Sumit
authors.initials: TS
authors.lastname: Roy
authors.forename: Mita
authors.initials: M
authors.lastname: Saha