scholarly journals An office-based fix-and-follow grading system assessing visual function in preverbal children

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hyeshin Jeon ◽  
Jae Ho Jung ◽  
Hee-young Choi
Keyword(s):  
Visual Function ◽  
Cross Sectional Study ◽  
Kappa Coefficient ◽  
Observer Agreement ◽  
Grading System ◽  
Cross Sectional ◽  
Pursuit Movement ◽  
Ocular Movement ◽  
Grade 3 ◽  
Preverbal Children

Abstract Background Assessing visual function in infants is usually challenging. Fix-and-Follow is a simple and popular method for assessing early development of visual perception in infants, currently however, there is no formal reproducible method for grading the capacity of fix-and-follow. This study was to develop and validate a new fix-and-follow grading system for assessing visual function development in preverbal children. Methods In this cross-sectional study, the fix-and-follow grades was evaluated in 21 consecutive preverbal children. Fixation was categorised as grade 1 if there was no response to the target and grade 2 if there was a response but only for < 3 s. Grades of 3 and 4 were assigned based capacities to (1) fix on a moving target for ≥3 s, and (2) shift fixation from one target to another. If only one of these two criteria was met, grade 3 was assigned. If both were met, grade 4 was assigned. Following was evaluated using smooth pursuit movement, where grade 1 indicated no movement, grade 2 partial movement, and grade 3 complete movement. Two ophthalmologists independently applied the grading method in all patients. Then one of two examiners repeated the examinations to investigate the intra-observer agreement of the grading system. Results Intra-observer agreement was excellent (Kappa coefficient = 0.823) and inter-observer agreement was good (Kappa coefficient = 0.625). All patients who exhibited abnormal ocular movement had score discrepancy between a new fix-and-following grading examination. Conclusions The new fix-and-follow grading scale can be applied easily in preverbal children in an office setting, and it proved reliable and reproducible.

scholarly journals Pterygium and associated factors among adults: a hospital-based prospective study

2020 ◽  
Vol 6 (1) ◽  
pp. 32-37
Author(s):  
Chhimi Wangmo ◽  
Nor Tshering Lepcha
Keyword(s):  
Associated Factors ◽  
Cross Sectional Study ◽  
Referral Hospital ◽  
Adult Patients ◽  
Age Group ◽  
Cross Sectional ◽  
Systematic Random Sampling ◽  
High Prevalence ◽  
Grade 3 ◽  
National Referral Hospital

Introduction: The aim of this hospital-based study was to assess the prevalence and associated factors of pterygium among adult patients visiting the Ophthalmology Outpatient Department (OPD) in the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH), Thimphu. Methods: A cross sectional study was carried out in the ophthalmology OPD in the national referral hospital, Thimphu from 1st January, 2018 to 31st December, 2018, during which 1599 adult patients were selected through systematic random sampling. Results: The prevalence of pterygium was 12.8% (95% CI: 11.2 -14.5). Among 271 eyes with pterygium, the distribution of grade 1, grade 2 and grade 3 pterygium was 34.7%, 56.1% and 9.2% respectively. Pterygium wasmost common in the age group of 36-55 years. The significant factors associated with pterygium were age group, occupation and usage of sunglasses. Individuals who were 36-55 years (adjusted OR 2.70, 95% CI 1.82-4.0) and >55 years (adjusted OR 2.17, 95% CI 1.34-3.50) had significantly higher risk than 18-35 years (p< 0.002), and not using sunglasses (adjusted OR 1.97, 95% CI1.17-3.33, p = 0.007) significantly increased the risk of pterygium. Indoor occupation, particularly being a student was protective against pterygium (OR 0.08, 95% CI 10.02-0.33, p< 0.001). Only 14.1% used sunglasses and among them, 27.6% were aware that sunglasses can protect from ultraviolet radiation. Conclusion: This study found a high prevalence of pterygium among adults aged 18 years and above. Those aged 36-55 years and an occupation involving outdoor activities were affected more. Encouraging usage of sunglasses may reduce pterygium

scholarly journals Diagnostic Methods of Metabolic Syndrome in Children

2019 ◽  
Author(s):  
Shahin Koohmanaee ◽  
Afagh Hassanzadeh Rad ◽  
Seyyedeh Forough Jafari ◽  
Marjaneh Zarkesh ◽  
Ehsan Kazemnejad Leili ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Cross Sectional Study ◽  
Kappa Coefficient ◽  
Diagnostic Methods ◽  
Descriptive Statistics ◽  
Public Health Care ◽  
Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Coefficient Corrélation

Abstract- We aimed to define Metabolic Syndrome (METs) from different viewpoints to determine the most appropriate method that could be used for early METs' diagnosis in general population and treat them immediately. This study was an analytic cross-sectional study which was conducted on 725, twelve year-old-girls and boys from Rasht city in Iran. METs was defined based on 7 different methods. Data were reported by descriptive statistics (number, percent, mean, and standard deviation) and analyzed by Cohen's kappa coefficient correlation and chi-square in SPSS version 19. The highest and lowest percentages of METs were obtained by DE Ferranti (17.5%) and viner et al., (0.8%) methods, respectively. Results showed that viner et al., had the highest degree of agreement with NCEP ATPIII and the lowest with DE Ferranti. Furthermore, De Ferranti showed the highest degree of agreement with NHANESIII and the lowest with Viner et al., According to results, the identification of the cut off points of obesity could help to promote public health care.

scholarly journals HEPATITIS “C”

2016 ◽  
Vol 23 (09) ◽  
Author(s):  
Muhammad Iqbal ◽  
Adnan Ahmed ◽  
Muhammad Rafique Hingoro
Keyword(s):  
Hepatitis C ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Age Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Grade 3 ◽  
Chronic Hcv ◽  
Study Setting

Objectives: To determine incidence of steatosis in non-responder casesof chronic HCV. Study Design: Cross-sectional study. Setting: Tertiary Care Sanatorium inMedicine Department of LIAQUAT University Hospital Hyderabad/Jamshoro. Period: 26-9-2011to 25 August 2012. Material & Methods: Total 144 non-responders cases of Hepatitis C wereintegrated. Both gender, age 18 to 50 yrs, chronic HCV non-responder cases as well as cases fitfor hepatic biopsy were integrated in study. Grading of Inflammation was carried out as indicatedby histopathological measures. Results: Mean age was 48.5 + 5.2years. Uppermost prevalenceof chronic HCV disease was 65(45.13%) at 41 to 50 years age interval whereas 42(29.1%) caseswere noticed in 31 to 40 yrs age group and 25(17.3%) cases were observed in 20 to 30 yearsof young age group. In this study hepatic steatosis occurrence was observed in 103 (71.5%)cases and these were categories as: grade 1, grade 2, grade 3, as (<33%) 45/103(43.68%), (33to 66%) 35/103(33.98%), (>66%) 23/103(22.33%) respectively. Conclusion: Hepatic steatosisis a important risk factor the cases of HCV to decreased response to antiviral therapy and forprogression toward fibrosis as observed in cases related to metabolic steatosis.

Observer variability in grading patients with subarachnoid hemorrhage

1982 ◽  
Vol 56 (5) ◽  
pp. 628-633 ◽  
Author(s):  
Kenneth W. Lindsay ◽  
Graham Teasdale ◽  
Robin P. Knill-Jones ◽  
Lilian Murray
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Clinical Condition ◽  
Systemic Disease ◽  
Observer Variation ◽  
Observer Agreement ◽  
Grading System ◽  
Kappa Statistics ◽  
Observer Variability ◽  
Content Type ◽  
Grade 3

✓ The management of individual patients with subarachnoid hemorrhage depends greatly on assessment of the patient's clinical condition. Difficulty in applying current grading systems prompted the authors to conduct studies of observer variability and to attempt to identify sources of inconsistency. Observers graded 15 patients by both the Hunt and Hess and Nishioka systems. Considerable observer variability was found, with up to four different grades being selected for the same patient. Kappa statistics were used to evaluate the data. This method determines observer agreement occurring in excess of chance. Kappa values for each grading system showed observer agreement to be significantly better than chance, yet revealed marked observer variation. Most variation occurred when Grade 3 was selected, irrespective of the system used. In a further study where observers graded clinical summaries, similar variation occurred; therefore, inconsistency was due mainly to difficulty in matching patients with levels described in the grading system, rather than to fluctuation in the patients' clinical condition or difference in the observers' examination technique. Variability was high when patients with systemic disease or vasospasm on angiography were graded with the Hunt and Hess system. The studies show that a simpler and more reliable grading system is required, and emphasize the need for caution when interpreting the results from different published series.

Orthodontic Treatment Need at Nishter Institute of Dentistry

2021 ◽  
Vol 15 (8) ◽  
pp. 1903-1905
Author(s):  
Muhammad Azeem ◽  
Zubair Hassan Awaisi ◽  
Sohaib Hassan ◽  
Farhan Ahmad ◽  
Saadia Ata ◽  
...  
Keyword(s):  
Orthodontic Treatment ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Treatment Need ◽  
Grade 5 ◽  
Present Cross Sectional Study ◽  
Grade 3 ◽  
Keywords Treatment ◽  
Plaster Models ◽  
Orthodontic Need

Background: The Index of Orthodontic Treatment Need (IOTN) is one of the important index to find out orthodontic need of patients. Aim: To find out the need of orthodontic treatment in patients visiting Nishter Institute of Dentistry, Multan (NID). Method: The index was applied using plaster models and intraoral examination. The measurements of various components of IOTN index was taken with the help of digital vernier calliper. Results: The results of various measurements of IOTN index was taken, recorded and analyzed statistically. Result of the present cross-sectional study showed that 65% patients were in grade 4 and 5 of IOTN. The analysis showed that 13% were in grade 4 of IOTN, 52% were in grade 5, 15% were in grade 3, 16% were in grade 2 and 4% patients was in grade 1 of IOTN index. Conclusion: No significant sex differences were shown for the need of orthodontic therapy in any category of IOTN. The need of orthodontic treatment is very high in patients of Southern Punjab, Pakistan. Keywords: Treatment Need; IOTN; Orthodontics.

scholarly journals Renal Echogenicity as a Predictor of Human Immunodeficiency Virus–Associated Nephropathy: A Cross-Sectional Study at a Tertiary Hospital in Lagos, Southwest Nigeria

2018 ◽  
Vol 34 (4) ◽  
pp. 261-272
Author(s):  
Cletus Uche Eze ◽  
Charles Ugwoke Eze ◽  
Adekunle A. O. Adeyomoye
Keyword(s):  
Human Immunodeficiency Virus ◽  
Serum Creatinine ◽  
Area Under The Curve ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Cd4 Count ◽  
Cross Sectional ◽  
Immunodeficiency Virus ◽  
Southwest Nigeria ◽  
Grade 3

The objective of this study was to determine the accuracy of sonography in a human immunodeficiency virus–associated nephropathy (HIVAN) diagnosis. A sample of 340 HIVAN patients underwent laboratory CD4+ count, serum creatinine/glomerular filtration rate (GFR) estimation, and sonographic echogenicity grading. The accuracy of sonography in predicting an HIVAN diagnosis was calculated. Mean CD4+ count, serum creatinine, and GFR for male and female HIVAN patients was 153.1 ± 103.2 cells/mm3 and 121.9 ± 91.0 cells/mm3, 218.4 ± 147.4 mmol/L and 222.0 ± 150.4 mmol/L, and 50.1 ± 23.6 mL/min/1.73 m2 and 39.3 ± 20.6 mL/min/1.73 m2, respectively; 56.9% of patients had echogenicity grade 3. On the basis of CD4+ count, serum creatinine, and GFR, the area under the curve was 0.76 and ≈ 1, respectively; the area under the curve was 0.63, 0.79, 0.70, 0.79 and 0.91, 0.99, 1, 1 for grades 0, 1, 2, and 3 echogenicity, respectively. With a high level of apathy to voluntary HIV/AIDS screening and late patient presentation, sonography (grade 3 renal echogenicity) can assist in predicting an HIVAN diagnosis.

Behavior of fetal longitudinal myocardial fibers assessed by speckle tracking to obtain strain and strain rate values for low-risk pregnancies

2020 ◽  
Vol 48 (2) ◽  
pp. 144-152
Author(s):  
Mariana Biancardi ◽  
Renato Augusto Moreira de Sa
Keyword(s):  
Strain Rate ◽  
Gestational Age ◽  
Speckle Tracking ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Observer Agreement ◽  
Cross Sectional ◽  
Strain And Strain Rate ◽  
Significant Difference ◽  
Myocardial Fibers

AbstractObjectiveTo analyze the behavior of fetal longitudinal myocardial fibers assessed by speckle tracking (STE) after fetal viability.MethodsA cross-sectional study was performed in 156 women with normal singleton pregnancies from 22 to 31 weeks of gestation. Strain (S) and strain rate (SR) values were measured in both ventricles during the fetal cardiac cycle. The population was divided into five gestational age groups based on 2-week intervals. The correlations of maternal variables with the S and SR variables and intra-observer analysis were performed.ResultsThere was a significant difference in the S and SR values of the left ventricle (LV) among the gestational age groups (P = 0.007). Significantly higher S and SR values were observed in early age groups demonstrating reductions in LV S and SR values at 26 weeks, followed by stabilization. For the right ventricle (RV), there was no significant difference between gestational age groups. Significant intra-observer agreement was observed for S values of the RV (P = 0.008) and LV (P = 0.0004) and SR values of the RV (P = 0.0001) and LV (P = 0.015).ConclusionDecreases in the S and SR values of the LV occurred after 26 weeks, followed by stabilization. No significant difference was observed in the S or SR value of the RV among the gestational age groups, and no significant association of any maternal variable evaluated with S and SR values was observed. Significant intra-observer agreement was obtained among the results.

scholarly journals The growth of foot arches and influencing factors

2016 ◽  
Vol 45 (3) ◽  
pp. 111
Author(s):  
Ferial Hadipoetro Idris
Keyword(s):  
Influencing Factors ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Positive Influence ◽  
Older Age ◽  
Optimal Time ◽  
Flat Foot ◽  
Cross Sectional ◽  
Foot Arch ◽  
Grade 3

Background Foot arches are important components for body sup-port. Foot arch deformity caused by growth abnormalities causeserious limitations in daily activities.Objectives To determine the patterns of foot arch growth, factorsinfluencing foot arch growth, and the timing for intervention in er-rant growth patterns.Methods A cross-sectional study evaluated the foot arches of chil-dren aged 0-18 years according to age and sex. Subjects includedhad no evidence of physical abnormality other than flat foot, knock-knee, or bow leg. Subjects were grouped per year of age. Data onfoot arch class, age, sex, weight, height, medial intercondylar dis-tance, and medial intermalleolar distance were recorded. Chi-square test, correlation, binary and linear regressions, general lin-ear model, and contrast matrix were performed.Results In 8376 children aged 0-18 years, flat foot grade 3 hadstable proportions in all age groups. Flat foot grade 2 and 1 hadsmaller proportions in older age groups than in younger ones. Theproportions of normal foot was greater in older age groups. Boysat the age of 7 and girls at 9 have a small percentage of pes cavus.The mean foot arch measurements were consistent with flat footgrade 2 at age 0-3 years, flat foot grade 1 at 4 years, and normalfoot at age 18. Median foot arch measurement of children 0-10years old was consistent with flat foot grade 1, while that of chil-dren 11 years old was consistent with normal foot. Age and heightgave positive influence. Based on these measurements we inferthat the optimal time for intervention is 0-7 years for boys and 0-3years for girls.Conclusion The proportion of flat foot grade 3 is stable through-out age groups, that of flat foot grade 2 and 1 are smaller in olderage groups, and that of normal foot is greater in older age groups.Overgrowth happens in very small percentages after age of 7 inboys and 9 in girls. Age, sex, height, weight, and growth of theknees are influencing factors

Keratoconus staging by decades: a baseline ABCD classification of 1000 patients in the Homburg Keratoconus Center

2020 ◽  
pp. bjophthalmol-2020-316789
Author(s):  
Elias Flockerzi ◽  
Kassandra Xanthopoulou ◽  
Susanne Christiane Goebels ◽  
Elena Zemova ◽  
Sonia Razafimino ◽  
...  
Keyword(s):  
Age Groups ◽  
Cross Sectional Study ◽  
Grading System ◽  
Matched Pairs ◽  
Corneal Curvature ◽  
Cross Sectional ◽  
Stage Distribution ◽  
Significant Difference ◽  
Advanced Stages

BackgroundThis retrospective cross-sectional study aims to analyse the keratoconus (KC) stage distribution at different ages within the Homburg Keratoconus Center (HKC).Methods1917 corneae (1000 patients) were allocated to decades of age, classified according to Belin’s ABCD KC grading system and the stage distribution was analysed.Results73 per cent (n=728) of the patients were males, 27% (n=272) were females. The highest KC prevalence occurred between 21 and 30 years (n=585 corneae, 294 patients). Regarding anterior (A) and posterior (B) curvature, the frequency of A was significantly higher than B in all age groups for stage 0, 1 and 2 (A0>B0; A1>B1; A2>B2; p<0.03, Wilcoxon matched-pairs test). There was no significant difference between the number of A3 and B3, but significantly more corneae were classified as B4 than A4 in all age groups (p<0.02). The most frequent A|B combinations were A4|B4 (n=451), A0|B0 (n=311), A2|B4 (n=242), A2|B2 (n=189) and A1|B2 (n=154). Concerning thinnest pachymetry (C), most corneae in all age groups were classified as C0>C1>C2>C3>C4 (p<0.04, Wilcoxon matched-pairs test). For the best distance visual acuity (D), a significantly higher number of corneae were classified as D1 compared to D0 (p<0.008; D1>D0>D2>D3>D4).ConclusionThe stage distributions in all age groups were similar. Early KC rather becomes manifest in the posterior than the anterior corneal curvature whereas advanced stages of posterior corneal curvature coincide with early and advanced stages of anterior corneal curvature. Thus, this study emphasises the necessity of posterior corneal surface assessment in KC as enabled by the ABCD grading system.

scholarly journals Reliability of Hallux Rigidus Radiographic Grading System

2015 ◽  
Vol 8 (4) ◽  
pp. 125-134
Author(s):  
Ryan C. Pate ◽  
John W. Fanning ◽  
Naomi N. Shields ◽  
Alexander C.M. Chong
Keyword(s):  
Weight Bearing ◽  
Hallux Rigidus ◽  
Observer Agreement ◽  
Grading System ◽  
Foot And Ankle ◽  
Substantial Agreement ◽  
Radiographic Images ◽  
Observer Reliability ◽  
Grade 3 ◽  
Radiographic Grading

Introduction. The purpose of this study was to determine the inter- and intra-observer reliability of a clinical radiographic scale for hallux rigidus. Methods. A total of 80 patients were retrospectively selected from the patient population of two foot and ankle orthopaedic surgeons. Each corresponding series of radiographic images (weight-bearing anteroposterior, weight-bearing lateral, and oblique of the foot) was randomized and evaluated. Re-randomization was performed and the corresponding radiograph images re-numbered. Four orthopaedic foot and ankle surgeons graded each patient, and each rater reclassified the re-randomized radiographic images three weeks later. Results. Sixty-one out of 80 patients (76%) were included in this study. For intra-observer reliability, most of the raters showed “excellent” agreement except one rater had a “substantial” agreement. For inter-observer reliability, only 14 out of 61 cases (23%) showed total agreement between the eight readings from the four surgeons, and 11 out of the 14 cases (79%) were grade 3 hallux rigidus. One of the raters had a tendency to grade at a higher grade resulting in poorer agreement. If this rater was excluded, the results demonstrated a “substantial” agreement by using this classification. Conclusion. The hallux rigidus radiographic grading system should be used with caution. Although there is an “excellent” level of intra-observer agreement, there is only “moderate” to “substantial” level of inter-observer reliability.

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