Introduction Tuberculosis is a major health probIem in India which accounts for the major burden of this disease worldwide. India accounts for maximum number of both TB and MDR TB cases. The disease presents itself in pulmonary and extra pulmonary sites and results in significant morbidity and mortality resulting in great economic burden on the country . Many techniques are used for diagnosis of pulmonary and extrapulmonary tuberculosis that includes microscopy (Ziehl Neelsen staining and fluorescent staining), line probe assay, nucleic acid amplification technique (NAAT) and culture.

1,2,3 Microscopy remains the most popular and widely applied method of detection of tuberculosis . Presence of acid fast bacilli in ZN staining method offers a speedy diagnosis and also helps in assessing infectiousness. In developing countries , microscopy offers an advantage of being cheap and rapid method.

4,5,6 However ZN staining has its own disadvantages. It has low sensitivity, particularly for cytological specimens and in paediatric and HIV cases. There is risk to the laboratory worker if a biosafety cabinet is not available.

2,5,6 The presence of cellular debris may also hinder the screening of the smears resulting in missing the positive cases. Many studies have proposed liquefaction and concentration of sputum before ZN staining to increase the diagnostic sensitivity. Liquefaction results in efficient release of bacilli . Liquefaction with chemicals like N acetyl L cysteine-sodium hydroxide (NaLC-NaOH), sodium hypochlorite , chitin , chymotrypsin have been proposed by various authors. . However cost of these reagents is a limiting factor in resource constrained setting.

Modified bleach method using the sodium hypochlorite offers many advantages. It is simple , cheap , economical , more sensitive ; and also disinfects the specimen because of action of hypochlorite. 5,6,7,8 Materials and methods :- This prospective study was carried out in department of microbiology in association with department of pathology from March 2013- January 2014. A total of 115 patients suspected of pulmonary tuberculosis and 53 patients suspected of having tubercular lymphadenitis were enrolled in the study. Informed consent was taken from each patient


 

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