Application Value of SAT-TB Combined with Acid-Fast Staining in the Diagnosis and Treatment of Pulmonary Tuberculosis

Objectives. This study is aimed at evaluating the clinical application value of RNA simultaneous amplification and testing method for Mycobacterium tuberculosis (SAT-TB) combined with acid-fast staining in the diagnosis and treatment of pulmonary tuberculosis (PTB). Methods. This paper included 168 suspected and confirmed PTB sufferers admitted to The Sixth People’s Hospital of Wenzhou from December 2018 to December 2019, whose sputum was collected and tested using SAT-TB, smear acid-fast staining method, and the BACTEC MGIT 960 system. With the MGIT 960 culture test method as the gold standard, the application value of SAT-TB, acid-fast staining, or SAT-TB combined with acid-fast staining in the diagnosis and treatment of PTB was assessed. Results. With the MGIT 960 culture as the gold standard, the sensitivity, specificity, positive predictive value, and negative predictive value of SAT-TB for the diagnosis of PTB were 57.3%, 92.5%, 84.3%, and 73.5%, respectively. The conformity was 76.8%, and the Kappa value was 0.515, suggesting a statistically significant difference ( χ 2 = 7.314 , p < 0.05 ) and a general consistency degree. Additionally, the sensitivity, specificity, positive predictive value, and negative predictive value of SAT-TB combined with sputum smear acid-fast staining were 81.3%, 86.0%, 88.4%, and 80.8%, respectively, with the MGIT 960 culture still the gold standard. The conformity and Kappa value were 83.9% and 0.672, respectively, showing no statistically significant difference ( χ 2 = 0.438 , p > 0.05 ) and a relatively high consistency degree. Conclusion. SAT-TB combined with acid-fast staining had a similar detection rate to that of the MGIT 960 culture test with a high consistency degree, which could be applied in the diagnosis of PTB efficiently and accurately.

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Comparison of Auramine Phenol and ZN Staining in Diagnosis of Pulmonary Tuberculosis with GeneXpert MTB/RIF as Gold Standard

Journal of Islamabad Medical & Dental College ◽

10.35787/jimdc.v9i3.435 ◽

2020 ◽

Vol 9 (3) ◽

pp. 190-194

Author(s):

Naureen Saeed ◽

Fatima-tuz-zuhra ◽

Nadeem Ikram ◽

Farhana Shaukat ◽

Fareeha Sardar

Keyword(s):

Pulmonary Tuberculosis ◽

Positive Predictive Value ◽

Predictive Value ◽

Gold Standard ◽

Sputum Sample ◽

False Negative ◽

Smear Microscopy ◽

Predictive Values ◽

Pulmonary Tb ◽

Sensitivity Specificity

Background: Pakistan faces an immense burden of pulmonary tuberculosis (TB) due to large number of cases and limited resources. Despite the recent advancement in the diagnostic techniques for pulmonary TB, smear microscopy is still a useful technique for the diagnosis of this disease. This study was conducted in order to compare the diagnostic value of Auramine stain with the conventional Ziehl-Neelsen (ZN) stain on the sputum smear for the diagnosis of pulmonary TB, keeping GeneXpert MTB/RIF as the gold standard. Method: This cross-sectional study was conducted on 356 suspected patients of pulmonary TB referred to the Pathology laboratory from TB ward and OPD of District Head Quarter (DHQ) teaching hospital Rawalpindi, Pakistan. Sputum specimen were collected and two smears were prepared from each sputum sample on which Auramine phenol and Ziehl-Neelsen staining were carried out as per WHO recommendations. All these samples were further tested using Gene Xpert MTB/RIF technique. The sensitivity, specificity, Positive predictive value (PPV) and Negative predictive values (NPV) of ZN and Auramine stain were calculated and compared with GeneXpert MTB/RIF technique. Results: Out of the total 356 samples, 64(18%) were positive and 291(82%) were negative by GeneXpert which was taken as the gold standard. On comparison with GeneXpert, percentage of true positive was greater in case of Auramine than ZN stained samples (16.29% versus 12.92%), while the percentage of false positive was same for both staining techniques (0.28%). There were lesser false negative cases observed in samples stained by Auramine as compared to the ones stained by ZN (1.68% versus 5.05%). The sensitivity, specificity, positive predictive value and negative predictive values were 97.87%, 94.17%, 71.88 and 99.66%, respectively for the ZN staining and 98.31%, 97.98%, 90.63% and 99.66% respectively, for the Auramine phenol staining. Conclusion: Smear microscopy using Auramine phenol stain is a useful technique for the diagnosis of pulmonary TB. The Auramine phenol staining with fluorescent microscopy is found to be superior to ZN staining because of higher sensitivity and specificity. Keywords: Auramine phenol, Fluorescence microscopy, GeneXpert, Mycobacterium tuberculosis, Ziehl-Neelsen

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Reliability of digital panoramic radiography in the diagnosis of carotid artery calcifications

Radiologia Brasileira ◽

10.1590/s0100-39842014000100011 ◽

2014 ◽

Vol 47 (1) ◽

pp. 28-32 ◽

Cited By ~ 3

Author(s):

Vilson Lacerda Brasileiro Junior ◽

Aníbal Henrique Barbosa Luna ◽

Marcelo Augusto Oliveira de Sales ◽

Tânia Lemos Coelho Rodrigues ◽

Priscilla Lopes da Fonseca Abrantes Sarmento ◽

...

Keyword(s):

High Risk ◽

Carotid Artery ◽

Positive Predictive Value ◽

Predictive Value ◽

Carotid Arteries ◽

Panoramic Radiography ◽

Digital Panoramic Radiography ◽

Significant Difference ◽

Mcnemar’S Test ◽

Sensitivity Specificity

Objective The present study evaluated the reliability of digital panoramic radiography in the diagnosis of carotid artery calcifications. Materials and Methods Thirty-five patients under high-risk for development of carotid artery calcifications who had digital panoramic radiography were referred to undergo ultrasonography. Thus, 70 arteries were assessed by both methods. The main parameters utilized to evaluate the panoramic radiography reliability in the diagnosis of carotid artery calcifications were accuracy, sensitivity, specificity and positive predictive value of this method as compared with ultrasonography. Additionally, the McNemar's test was utilized to verify whether there was a statistically significant difference between digital panoramic radiography and ultrasonography. Results Ultrasonography demonstrated carotid artery calcifications in 17 (48.57%) patients. Such individuals presented with a total of 29 (41.43%) carotid arteries affected by calcification. Radiography was accurate in 71.43% (n = 50) of cases evaluated. The degree of sensitivity of this method was 37.93%, specificity of 95.12% and positive predictive value of 84.61%. A statistically significant difference (p < 0.001) was observed between the methods evaluated in their capacity to diagnose carotid artery calcifications. Conclusion Digital panoramic radiography should not be indicated as a method of choice in the investigation of carotid artery calcifications.

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Comparison of International Federation of cervical pathology and colposcopy nomenclature (2011) and Swede score for assessment of cervical lesions

10.21203/rs.3.rs-169936/v1 ◽

2021 ◽

Author(s):

Bindiya Gupta ◽

Rashmi Shreya ◽

Shalini Rajaram ◽

Anshuja Singla ◽

Sandhya Jain ◽

...

Keyword(s):

Positive Predictive Value ◽

Prospective Study ◽

Negative Predictive Value ◽

Predictive Value ◽

Gold Standard ◽

International Federation ◽

Objective Method ◽

Cervical Lesions ◽

Sensitivity Specificity ◽

Strength Of Association

Abstract Purpose: Standardization of colposcopic evaluation is important as it is observer dependent.The aim of the study was to compare the strength of association of colposcopic findings by International Federation of Colposcopy and Cervical Pathology (IFCPC) nomenclature and Swede score. Methods: In the prospective study, 150 women aged 30 to 60 years with abnormal screening results underwent colposcopy, the findings were evaluated using both IFCPC and Swede score and biopsy was taken from abnormal areas. Performances by both the methods were calculated taking biopsy as gold standard. Results: Nineteen ≥ CIN2 lesions were detected. The sensitivity, specificity, positive predictive value and negative predictive value for detecting ≥ CIN2 lesion by IFCPC scoring was 63.6%, 96.0%, 78.7%, 91.9%. Using Swede score, sensitivity, specificity, positive predictive value and negative predictive value at cut off of 8 were 42.4, 95%, 96.6% and 81.8% while at cut-off of 5, these were 96%, 88.3%,76.7% and 93.6%. The agreement between IFCPC major lesion and Swede score ≥ 8 for ≥ CIN2 was 0.626 (p<0.01). Conclusion: Swede score is an easier and more objective method for colposcopic evaluation and a score >8 can be applied to the screen and treat programme.

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Agreement of Enzyme-Linked Immunosorbent Assay With Rapid Plasma Reagin and Treponema pallidum Hemagglutination Assay for Screening and Diagnosis of Syphilis at National Blood Bank Service in Addis Ababa, Ethiopia

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqz131.007 ◽

2019 ◽

Vol 152 (Supplement_1) ◽

pp. S153-S154

Author(s):

Jemal Ibrahim ◽

Ejigayehu Afework ◽

Mintewab Hussein

Keyword(s):

Positive Predictive Value ◽

Predictive Value ◽

Addis Ababa ◽

Treponema Pallidum ◽

Blood Bank ◽

Enzyme Linked Immunosorbent Assay ◽

Rapid Plasma Reagin ◽

Hemagglutination Assay ◽

Kappa Value ◽

Sensitivity Specificity

Abstract Objectives To determine the agreement of enzyme-linked immunosorbent assay (ELISA) with rapid plasma reagin (RPR) and Treponema pallidum hemagglutination assay (TPHA) at the National Blood Bank Service in Addis Ababa, Ethiopia. Methods The study was conducted from January to June 2016 on 190 syphilis ELISA positive and 190 negative samples stored at the National Blood Bank Service (NBBS) laboratory, Addis Ababa, Ethiopia, from July 2015 to December 2015. A systematic random sampling method was used to select samples. The data were analyzed by SPSS version 20 software. The overall percent agreement, kappa value, sensitivity, specificity, positive predictive value, and negative predictive value of the tests were calculated. Results From 190 positive sera, 151 (80%) were confirmed as positive by TPHA, and 39 (20%) were found false positive; 59 (31.1%) of them were positive and 131 (68.9%) were false positive by RPR. From 190 negative sera, all were negative by RPR and TPHA. The sensitivity, specificity, positive predictive value, and negative predictive value of TPHA were 99.9%, 85%, 79%, and 100%, respectively, while RPR was 62%, 99%, 100%, and 63%, respectively. Overall percent agreement of ELISA with TPHA was 90% and corresponding kappa value was 0.795, and ELISA with RPR was 66% with a kappa value of 0.375. Conclusion TPHA was very sensitive; there was substantial agreement with ELISA. Whereas RPR was highly specific and less sensitive, there was fair agreement with ELISA. TPHA can be used interchangeably with ELISA to screen blood in blood bank laboratories.

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Evaluation of GeneXpert MTB/RIF for detecting Mycobacterium tuberculosis in a hospital in China

Journal of International Medical Research ◽

10.1177/0300060517698618 ◽

2017 ◽

Vol 45 (2) ◽

pp. 816-822 ◽

Cited By ~ 12

Author(s):

Tingyu Tang ◽

Fang Liu ◽

Xiaoling Lu ◽

Qingdong Huang

Keyword(s):

Mycobacterium Tuberculosis ◽

Predictive Value ◽

Rate Sensitivity ◽

Turnaround Time ◽

Cross Sectional Study ◽

Cross Sectional ◽

Significant Difference ◽

Kappa Value ◽

Positive Rate ◽

Sensitivity Specificity

Objective To evaluate the performance of GeneXpert MTB/RIF in diagnosing pulmonary tuberculosis (TB) in China. Methods This cross-sectional study included sputum specimens of 240 suspected TB cases. Specimens were examined by light microscopy for the presence of acid-fast bacilli, which were cultured by the BACTEC MGIT 960 (M960) system and detected by the GeneXpert MTB/RIF assay. The positive rate, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and average turnaround time of methods were evaluated. Results The positive rate was 36.6% (87/238) for the GeneXpert MTB/RIF assay and 34.0% (81/238) by M960 culture, with no significant difference between methods (χ2 = 0.33, p > 0.05). According to culture results, sensitivity of the GeneXpert MTB/RIF assay was 84.0% (68/81), specificity was 87.8% (129/147), the PPV was 78.2% (68/87), and the NPV was 87.2% (129/148). The agreement for results between Gene Xpert MTB/RIF and the M960 system was 82.8% and the Kappa value was 0.73. Conclusion The GeneXpert MTB/RIF assay is a simple, rapid, and accurate test for detecting Mycobacterium tuberculosis in sputum specimens.

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Computed tomography versus ureteroscopy in identification of renal tract stone with ureteral stent in situ

Annals of The Royal College of Surgeons of England ◽

10.1308/003588411x13165261993996 ◽

2011 ◽

Vol 93 (8) ◽

pp. 639-641 ◽

Cited By ~ 4

Author(s):

VCY Tang ◽

A Attwell-Heap

Keyword(s):

Computed Tomography ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Gold Standard ◽

Ureteral Stent ◽

The Difference ◽

Contrast Ct ◽

Sensitivity Specificity

INTRODUCTION The aim of this study was to validate the use of non-contrast computed tomography (CT) with a ureteral stent in situ instead of ureteroscopy for identification of renal tract stones. METHODS All patients who had stents inserted for renal tract stones and underwent non-contrast CT with the stent in situ followed by ureteroscopy between May 2008 and October 2009 at The Canberra Hospital, Australia, were analysed retrospectively. Statistical analysis was performed to compare any differences between CT and ureteroscopy in the identification of stones. RESULTS Overall, 57 patients were included in the study. The difference between CT and ureteroscopy findings was statistically significant. CT identification of stones with a stent in situ had a sensitivity of 86%, a specificity of 46%, a positive predictive value of 63%, a negative predictive value of 76% and an accuracy of 67%. CONCLUSIONS Our study suggests that non-contrast CT is inferior to the ‘gold standard’ of ureteroscopy. It lacks sensitivity, specificity, positive predictive value, negative predictive value and accuracy. Therefore, we cannot recommend using non-contrast CT to replace ureteroscopy.

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IgM and IgG Antibodies in Tuberculosis

Journal of Institute of Medicine ◽

10.3126/jiom.v31i3.2995 ◽

1970 ◽

Vol 31 (3) ◽

pp. 34-40

Author(s):

N. Bam ◽

R. Karn

Keyword(s):

Pulmonary Tuberculosis ◽

Positive Predictive Value ◽

Predictive Value ◽

Extrapulmonary Tuberculosis ◽

University Teaching ◽

Institute Of Medicine ◽

Igg Antibodies ◽

Igg Antibody ◽

Tuberculosis Diagnosis ◽

Sensitivity Specificity

Introduction: The diagnosis of tuberculosis relies on the identification of acid-fast bacilli on unprocessed sputum smears using conventional light microscopy. Microscopy has high specificity in tuberculosis-endemic countries, but modest sensitivity which varies among laboratories (range 20% to 80%). Moreover, the sensitivity is poor for paucibacillary disease (e.g., pediatric and HIVassociated tuberculosis). Many supportive investigations including serolological tests being utilized for tuberculosis diagnosis have wide variations in sensitivity, specificity in different studies. The aim of study was to evaluate the recombinant 38 KDa antigen from M. tuberculosis - based Enzyme Immunoassays (EIA) test for its sensitivity, specificity and other statistical parameters. Methods: This hospital based prospective cross-sectional study was conducted at Tribhuvan University Teaching Hospital, Kathmandu, from April 28, 2009 to November 30,2009. Sera from total 90 patients, pulmonary tuberculosis, extrapulmonary tuberculosis and non-tubercular chest infection patients who did not have past TB or exposure history , 30 in each group were used for Pathozyme Myco kit evalution to determine the IgM and IgG antibodies activity against the recombinant 38 KDa antigen of Mycobacteria Results: In overall tuberculosis, IgM TB had sensitivity 48.3%,specificity 76.7%, positive predictive value 80.6% which was statistically significant(p=0.025) . The IgG TB had sensitivity 66.7%,specificity 83.3%,positive predictive value 88.9% which is statistically highly significant(p<0.001) to diagnose tuberculosis. Utilizing IgM and IgG both together, sensitivity decreased to 44.3%, but specificity increased to 90.0% and positive predictive value 88.5%, which was statistically significant (p=0.006) for the diagnosis of tuberculosis. Conclusions: IgG TB antibody has high sensitivity and specificity for tuberculosis diagnosis, but IgM antibody should also be evaluated along with IgG antibody to increase specificity. Keywords: Extrapulmonary tuberculosis (EPTB), 38 kDa antigen, IgM, IgG TB antibody, Pathozyme-Myco, Pulmonary tuberculosis (PTB). DOI: 10.3126/joim.v31i3.2995 Journal of Institute of Medicine, December, 2009; 31(3) 34-40

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Diagnostic Performance of Xpert MTB/RIF Assay Versus Ziehl-Neelsen Method for the Diagnosis of Pulmonary Tuberculosis in Addis Ababa, Ethiopia

The Open Microbiology Journal ◽

10.2174/1874285801812010390 ◽

2018 ◽

Vol 12 (1) ◽

pp. 390-396

Author(s):

Boja D. Taddese ◽

Daniel M. Desalegn ◽

Abay S. Misganaw ◽

Kumera T. Kitila ◽

Tinsae Kidanemariam Hailu ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Predictive Value ◽

Gold Standard ◽

Addis Ababa ◽

Public Health Problem ◽

Sputum Smear ◽

Smear Microscopy ◽

Sputum Smear Microscopy ◽

Cross Sectional ◽

Sensitivity Specificity

Background: Worldwide Tuberculosis (TB) is the ninth leading cause of death from a single infectious agent, positioning on top of Human Immuno Deficiency Virus (HIV) and it is still an eminently serious public health problem. In developing countries, Ziehl-Neelsen (ZN)-stained sputum smear microscopy is the most widely used diagnostic method in diagnosing Pulmonary Tuberculosis (PTB). This study was aimed to compare the diagnostic performances of ZN-method with Xpert MTB/RIF assay for the diagnosis of PTB in Addis Ababa, Ethiopia. Methods: Facility-based cross-sectional study design was conducted from September 2016 to June 2017 on a total of 244 sputum samples collected from presumptive TB patients. The L-J sputum culture was used as a gold standard to compare the diagnostic performances of Xpert MTB/RIF assay and ZN-methods. Kappa values were analyzed by using statistical package for Social Science (SPSS) version 20 software at 95% Confidence Interval (CI). The Sensitivity, Specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) of ZN-stained sputum smear microscopy and Xpert MTB/RIF assay were calculated against the gold standard. Results: The Sensitivity, Specificity, PPV and NPV of ZN-stained sputum smear microscopy were 68.38%, 95.28%, 93.02% and 76.58% respectively, while for Xpert MTB/ RIF assay were 88.89%, 81.89%, 81.89% and 88.89% respectively. The results of the two diagnostic approaches were concordant with the gold standard with a kappa value of ZN 0.650 and 0.743 for Xpert MTB/RIF assay. Conclusion: This study concludes that the sensitivity of Xpert MTB/RIF assay was better than ZN-stained direct sputum smear microscopy for the diagnosis of pulmonary tuberculosis.

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The impact on case findings by transferring clinical breast examination skills to female community health volunteers in limited resources country like Nepal.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.e11094 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. e11094-e11094

Author(s):

Sanjiv Kumar Hyoju

Keyword(s):

Breast Cancer ◽

Positive Predictive Value ◽

Predictive Value ◽

Gold Standard ◽

Clinical Breast Examination ◽

Limited Resources ◽

Breast Examination ◽

Clinical Breast ◽

Sensitivity Specificity ◽

Kappa Agreement

e11094 Background: In limited resources countries, patients with breast cancer present to the hospital in the late stage because of lack of awareness, screening program. Clinical Breast Examination (CBE) may be the only means of detecting the breast cancer early in countries with limited resources since mammography is less likely to be cost effective approach and CBE by surgeons are also not possible because of limited health care facility. Hence CBE by FCHVs seems to be more feasible. This study was conducted to observe the skill transfer to FCHVs for detection of clinical abnormalities in breast by determining kappa agreement, sensitivity, specificity, positive predictive value and negative predictive value of CBE by FCHVs considering CBE by the Surgeon as gold standard. Methods: It is a cross-sectional study conducted in Eastern Nepal for period of one year from June 2008 to May 2009. Total 1238 women were examined by both a FCHV and the Surgeon. The results were analyzed to find out interobserver kappa agreement, sensitivity, specificity, positive predictive value and negative predictive value for detection of clinical abnormalities in breast following CBE by FCHVs considering CBE by the Surgeon as gold standard. Results: Total 1238 women received CBE by both a FCHV and the Surgeon. The interobserver kappa agreement for the detection of clinical abnormalities in breast was 67% indicating a good agreement exists between the FCHVs and the Surgeon’s CBE Sensitivity, specificity, positive predictive value and negative predictive values of “FCHVs’ CBE” to detect clinical abnormalities in breast in comparison to “the Surgeon’s CBE” as gold standard were 70%, 95%, 74% and 94% respectively. Conclusions: In view of good CBE skills transfer to FCHVs for detection of clinical abnormalities in breast, the effective training of FCHVs may diagnose and refer the women with clinical breast abnormalities to the hospital for further investigation and treatment.

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Assessment of occlusive disease of lower extremity arteries on the basis of anatomic region: Value of 128-slice multidetector CT angiography in comparison with digital subtraction angiography

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v12i4.16416 ◽

2017 ◽

Vol 12 (4) ◽

pp. 179-186

Author(s):

Roshan Pangeni ◽

Ping Han ◽

Feng Pan ◽

Laxmi Pangeni Lamsal ◽

Zhen Zhang ◽

...

Keyword(s):

Positive Predictive Value ◽

Lower Extremity ◽

Digital Subtraction Angiography ◽

Negative Predictive Value ◽

Predictive Value ◽

Multidetector Ct ◽

Digital Subtraction ◽

Significant Difference ◽

Arterial Occlusive Diseases ◽

Sensitivity Specificity

Background & Objectives: The Previous studies of multidetector CT (MDCT) of the lower extremities for the detection of peripheral vascular disease showed high diagnostic accuracy but were performed with older generation systems. Our study aimed at assessing the diagnostic value of 128 MDCTA compared with that of digital subtraction angiography (DSA) in the grading of focal arterial disease of lower extremity arteries on the basis of anatomic regions.Materials & Methods: Forty-two patients with peripheral arterial occlusive diseases underwent both MDCTA and DSA. Lower extremity arteries depicted at MDCTA and DSA were graded separately for the degree of stenosis into 3 anatomic regions and 33 segments. Grading by MDCTA and DSA was done independently. Homogeneity analysis was used between MDCTA and DSA measurements in each patient. The sensitivity, specificity, positive predictive value and negative predictive value for detection of stenotic lesions were calculated for all anatomic regions, with findings at DSA used as the reference standard. Results: No statistically significant difference (P>.05) between DSA and MDCTA was present in Aorto-iliac and poplitiofemoral regions while there was statistically significant difference (P<.05) in the infrapopliteal region. The Sensitivity, Specificity, Positive Predictive Value and Negative Predictive Value based on a reading of MDCTA were 84.3%, 93.8%, 89.4% and 90.6% for aorto-iliac 86.6%, 94.7%, 84.1% and 94.7% for poplitiofemoral and 95.7%, 86.1%, 85.6% and 95.9% for infra-popliteal region respectively.Conclusion: MDCTA is excellent alternative in diagnosing lower extremity arterial occlusive diseases above the knee. DSA remains better on illustrating distal runoff vessels.

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