scholarly journals Evaluation of semi-quantitative compared to quantitative cultures of tracheal aspirates for the yield of culturable respiratory pathogens – a cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Salima Rattani ◽  
Joveria Farooqi ◽  
Ghazala Jabeen ◽  
Saeeda Chandio ◽  
Qaiser Kash ◽  
...  

Abstract Background Diagnosis of lower respiratory tract infections (LRTI) depends on the presence of clinical, radiological and microbiological findings. Endotracheal suction aspirate (ETSA) is the commonest respiratory sample sent for culture from intubated patients. Very few studies have compared quantitative and semi-quantitative processing of ETSA cultures for LRTI diagnosis. We determined the diagnostic accuracy of quantitative and semi-quantitative ETSA culture for LRTI diagnosis, agreement between the quantitative and semi quantitative culture techniques and the yield of respiratory pathogens with both methods. Methods This was a cross-sectional study conducted at the Aga Khan University clinical laboratory, Karachi, Pakistan. One hundred and seventy-eight ETSA samples sent for routine bacteriological cultures were processed quantitatively as part of regular specimen processing method and semi-quantitatively. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy was calculated for both methods using clinical diagnosis of pneumonia as reference standard. Agreement between the quantitative and semi quantitative methods was assessed via the kappa statistic test. Pathogen yield between the two methods was compared using Pearson’s chi-square test. Results The quantitative and semi-quantitative methods yielded pathogens in 81 (45.5%) and 85 (47.8%) cases respectively. There was complete concordance of both techniques in 155 (87.1%) ETSA samples. No growth was observed in 45 (25.3%) ETSA specimens with quantitative culture and 37 (20.8%) cases by semi-quantitative culture. The diagnostic accuracy of both techniques were comparable; 64.6% for quantitative and 64.0% for semi-quantitative culture. The kappa agreement was found to be 0.84 (95% CI, 0.77–0.91) representing almost perfect agreement between the two methods. Although semi-quantitative cultures yielded more pathogens (47.8%) as compared to quantitative ETSA cultures (45.5%), the difference was only 2.3%. However, this difference achieved statistical (chi-square p-value < 0.001) favoring semi-quantitative culture methods over quantitative culture techniques for processing ETSA. Conclusion In conclusion, there is a strong agreement between the performances of both methods of processing ETSA cultures in terms of accuracy of LRTI diagnosis. Semi-quantitative cultures of ETSA yielded more pathogens as compared to quantitative cultures. Although both techniques were comparable, we recommend processing of ETSA using semi-quantitative technique due to its ease and reduced processing time.

Diagnostics ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. 1011
Author(s):  
Sofia Nevander ◽  
Eva Landberg ◽  
Marie Blomberg ◽  
Bertil Ekman ◽  
Caroline Lilliecreutz

Gestational diabetes mellitus (GDM) is a common complication with negative impacts on mother and child. The primary aim of this study was to examine whether plasma glucose cutoffs for GDM diagnosis based on venous sampling can be replaced by cutoffs based on capillary sampling. A prospective cross-sectional study was performed at an antenatal care clinic including 175 pregnant women undergoing an oral glucose tolerance test (OGTT). Duplicate samples were collected by capillary and venous puncture while fasting and 1 h and 2 h after an OGTT. Both samples were analyzed on Accu-Chek Inform II. The cutoffs for a GDM diagnosis using capillary samples were corrected from 5.1 to 5.3 mmol/L for the fasting sample, from 10.0 to 11.1 mmol/L for the 1 h sample, and from 8.5 to 9.4 mmol/L for the 2-h sample using half of the dataset. Applying these cutoffs to the remaining dataset resulted in a sensitivity, specificity, and accuracy of 85.0%, 95.0%, and 90.3%, respectively, with a positive predictive value (PPV) of 83%, an negative predictive value (NPV) of 96%, and a positive negative likelihood ratio (LHR) of 16.4 using capillary sampling for the GDM diagnosis at fasting and 2-h after. Corrected cutoffs and capillary samples can be used for the diagnosis of GDM with maintained diagnostic accuracy using Accu-Chek Inform II.


2011 ◽  
Vol 6 (05) ◽  
pp. 373-377 ◽  
Author(s):  
Vineeta Mittal ◽  
Amita Jain ◽  
Yashodhara Pradeep

Introduction:  Bacterial vaginosis (BV) is the commonest cause of abnormal vaginal discharge in women of child-bearing age and is associated with increased susceptibility to HIV-AIDS and sexually transmitted diseases. In obstetrics, BV has been implicated in causing various complications. In clinical practice, BV is diagnosed using Amsel criteria and Nugent scoring. Using modified Amsel criteria, we determined that the fulfilling of any two instead of three criteria can be diagnostic of BV. Methodology:  This prospective cross-sectional study involved pregnant females complaining of excessive vaginal discharge admitted in a tertiary health centre in central India. Four vaginal swabs were collected for the diagnosis of BV by Amsel criteria, modified Amsel criteria, and Nugent scoring on Gram stain. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of each individual criterion and combinations of criteria were calculated by using Nugent scoring as the gold standard and by chi square test. Results: In the present study overall prevalence of BV was 12%. The sensitivity of individual or a combination of two criteria was almost same or higher than that of Amsel criteria. Specificity of each combination of criteria was comparable to that of Amsel criteria. However, a combination of high pH and amine odor test had the highest sensitivity (88%) and highest PPV (62%). Diagnostic accuracy of all combinations in our study was equal to or slightly higher than that of Amsel criteria. Conclusion: Diagnostic accuracy of new modified Amsel criteria is as reliable as that of Amsel criteria.


2021 ◽  
Vol 20 (3) ◽  
Author(s):  
Adi Syazni Muhammed ◽  
Randeep Singh ◽  
Shahrun Niza Abdullah Suhaimi ◽  
Nani Harlina Muhammad Latar

INTRODUCTION: This study aims to evaluate the diagnostic reliability of the American College of Radiology Thyroid Imaging Report and Data System (ACR-TIRADS) and Total Malignancy Score (TMS) scoring system, in differentiating benign and malignant thyroid nodules. MATERIALS AND METHODS: This is a cross-sectional study involving patients with thyroid nodules treated at Hospital Canselor Tuanku Muhriz from October 2017 until October 2019. Ultrasound findings were scored according to the ACR[1]TIRADS and TMS scoring system. They were then correlated with the FNAC or histopathology report. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of both scoring system were calculated for analysis. RESULTS: A total of 150 patients with 223 thyroid nodules were included. 17% or 38 nodules were found to be malignant. The sensitivity, specificity, PPV, NPV and accuracy of ACR-TIRADS and TMS were 97.37% vs. 84.21 % , 52.97% vs. 62.70%, 29.84% vs. 31.68%, 98.99% vs. 95.08% and 61% vs. 66% respectively. According to the ACR-TIRADS, only hypoechoic nodules was a strong predictor of malignancy. Comparatively, in the TMS, strong predictors of malignancy include single nodule, hypoechogenicity, irregular margin, and nodules with peri and intranodular vascularity. CONCLUSION: Both ACR-TIRADS and TMS score had good diagnostic accuracy in predicting malignant thyroid nodule. TMS is comparable and not inferior to ACR[1]TIRADS however, the latter is more practical for use as growth and Doppler characteristic are not included in the assessment.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ikunda Dionis ◽  
Omary Chillo ◽  
George M. Bwire ◽  
Calvin Ulomi ◽  
Manase Kilonzi ◽  
...  

Abstract Background Jaundice is common among neonates and if untreated can lead to kernicterus. Diagnosing neonatal jaundice (NJ) using Kramer’s method (visual assessment) is considered user-friendly in resource-limited areas. However, there are conflicting findings on reliability of the Kramer’s method in the diagnosis of NJ, particularly of black descent. Therefore, study aimed to determine the accuracy of Kramer’s method in comparison to the total serum bilirubin (TSB) test in the diagnosis of NJ among neonates of black descent in Tanzania. Methods A cross-sectional study was conducted between June and July 2020 at Muhimbili National Hospital (MNH) in Dar es Salaam Tanzania. A total of 315 neonates were recruited consecutively. In each neonate, jaundice was assessed using Kramer’s method and TSB test. NJ A total of 315 neonates were recruited i. A 2 X 2 table was created for the determination of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive and negative likelihood ratios (+LR/−LR), and diagnostic accuracy (effectiveness) of Kramer’s method. Cohen kappa (κ) was used to analyze the agreement between Kramer’s method and TSB. Association between independent variables and presence of jaundice were assessed using the chi-square test and the p < 0.05 was considered to be statistically significant. Results The prevalence of NJ was 49.8% by Kramer’s method and 63.5% by TSB. The Sensitivity, Specificity, PPV, and NPV of Kramer’s method were 70.5, 86.1, 89.8, and 62.6%, respectively. The +LR and –LR were 5.07 and 0.34, respectively. The diagnostic accuracy of Kramer’s method was 76.1%. There was a moderate agreement between Kramer’s method and TSB results (κ = 0.524, P<0.001). No significant relationship was observed between the independent variables and the presence of NJ. Conclusion Kramer has a good positive predictive value. However, due to low sensitivity and NPV one cannot say that overall predictive ability is good. Also, clinical assessment by Kramer’s method should not be used for screening of NJ. Further studies are needed to investigate the utility of other non-invasive techniques in detecting NJ among neonates of black descent.


2017 ◽  
Vol 6 (2) ◽  
pp. 129
Author(s):  
Entia Nopa ◽  
Ranissa Dwi Imansari ◽  
Irwandi Rachman

Faktor Risiko Kejadian Penyakit Kulit Pada Pekerja Pengangkut Sampah Di Kota Jambi 1Entianopa, 2Ranissa Dwi Imansari, 3Irwandi Rachman       123Program Studi Kesehatan Masyarakat STIKES Harapan Ibu, Jambi   Abstrak Latar Belakang: Kulit merupakan organ terbesar pada tubuh manusia yang membungkus otot-otot dan organ-organ dalam serta merupakan jalinan jaringan pembuluh darah, saraf, dan kelenjar yang tidak berujung, semuanya memiliki potensi untuk terserang penyakit yang salah satunya adalah penyakit kulit. Penyakit kulit merupakan salah satu gangguan kesehatan yang sering dialami oleh pekerja pengangkut sampah. Berdasarkan komposisi sampah yang diangkut serta waktu paparan kerja. Tujuan penelitian ini untuk mengetahui hubungan antara masa kerja, pemakaian Alat Pelindung Diri (APD), dan personal hygiene dengan kejadian penyakit kulit pada pekerja pengangkut sampah di Kota Jambi. Metode: Penelitian ini merupakan penelitian kuantitatif dengan desain penelitian cross sectional study. Sampel penelitian yaitu sebanyak 62 pekerja pengangkut sampah yang berada di Kantor Pekerjaan Umum dan Penata Ruang, yang mana seluruh populasi dijadikan sampel. Data dikumpulkan berdasarkan pemeriksaan kesehatan oleh dokter dan dengan kuesioner, kemudian dianalisa menggunakan uji statistik chi-square. Hasil: Hasil menunjukan bahwa pekerja yang mengalami penyakit kulit sebanyak 35 pekerja (56,5%). Berdasarkan hasil analisis chi-square didapatkan bahwa ada hubungan yang bermakna antara masa kerja dengan kejadian penyakit kulit pada pekerja pengangkut sampah dimana nilai (p-value= 0,006), Pemakaian Alat Pelindung Diri (APD) nilai (p-value= 0,008), personal hygiene nilai (p-value= 0,008). Kesimpulan: Untuk meminimalisir risiko terjadinya penyakit kulit pada pekerja pengangkut sampah disarankan perlunya disusun standar operasional prosedur yang aman, penyediaan sarana sanitasi agar dapat mengurangi resiko terkena penyakit kulit. Pentingnya pemakaian APD dan perilaku hidup bersih dan sehat selama bekerja, serta diharapkan pekerja menggunakan APD pada saat bekerja dan lebih memperhatikan personal hygiene.   Kata kunci      : Masa Kerja, APD, Personal Hygiene


2018 ◽  
Vol 2 (1) ◽  
pp. 30-35
Author(s):  
Ayatullah Harun

Tujuan dilakukan penelitian untuk mengetahui hubungan antara umur dan obesitas pada kejadian Diabetes Gestasional di Puskesmas Dahlia Makassar 2017. Penelitian ini menggunakan metode penelitianan analitik dengan melakukan pendekatan Cross Sectional Study untuk mengetahui hubungan antara umur dan obesitas pada kejadian Diabetes Gestasional di Puskesmas Dahlia Makassar 2017 dengan jumlah populasi 374 orang dengan dan jumlah sampel 374 orang dengan menggunakan teknik Total  Sampling.Dari hasil uji statistic dengan menggunakan uji Chi-Square (Pearson chi-square) diperoleh untuk variabel umur ibu nilai p = 0,162 > a = 0,05 artinya tidak ada hubungan antara umur ibu dengan kejadian Diabetes Gestasional pada ibu hamil.   Untuk variabel obesitas nilai p = 0,003 < a = 0,05 artinya ada hubungan antara obesitas dengan kejadian Diabetes Gestasional pada ibu hamil.Kesimpulan dari dua variabel yaitu umur dan obesitas, hanya variabel obesitas yang berhubungan dengan kejadian Diabetes Gestasional pada ibu hamil di Puskesmas Dahlia Makassar 2017. Saran diharapkan penelitian ini dapat dijadikan sebagai salah satu bahan masukan atau sumber data untuk penelitian selanjutnya.


2019 ◽  
Author(s):  
Stephen Banda

BACKGROUND Occupational conditions are deadly health hazards especially where dust exposure is inevitable causing chronic disabilities, impaired respiratory function and ultimately leading to death if no intensive measures are put in place. Unhealthy practices and negative attitudes rise in the number of cases of pneumoconiosis due to poor health education and awareness strategies. Pneumoconiosis is not only a health problem but also a social and economic burden on the livelihood of people living in mining areas around the globe. OBJECTIVE to assess knowledge, attitude and practices of miners and post-occupational miners towards pneumoconiosis in Wusakile Township, Kitwe, Zambia. METHODS A cross-sectional study was employed to conduct a research in Wusakile Township and a questionnaire was customized in order to syphon data relevant to the study as well to be brief. The study was conducted among 73 participants who were randomly selected among miners and post-occupational miners and all satisfied the inclusion criteria. Both quantitative and qualitative methods were used to collect data. The data was entered and analysed using IBM SPSS software version 23. RESULTS Among 73 participants interviewed, 33.99% of participants had poor knowledge on the complications of pneumoconiosis. However, despite this poor knowledge, all participants had an idea about pneumoconiosis particularly silicosis. 13.70% of the respondents had bad practices towards pneumoconiosis while 86.30% had some good practices towards pneumoconiosis. Of the total participants, 19.18% of the participants had a negative attitude towards pneumoconiosis. Correlation between the level of education and practices of participants using Pearson Chi-Square, a p value of 0.021 (significant) was found ruling out the null hypothesis. CONCLUSIONS Information about pneumoconiosis and awareness programs towards pneumoconiosis are not widely disseminated among miners and post-occupational miners. There is still a significant number of participants who need to be educated more about pneumoconiosis and its complications so that attitude and practices are improved and also promote full community participation by involving competent health professionals to help in implementing preventive measures.


2018 ◽  
Vol 3 (3) ◽  
pp. 440
Author(s):  
Sri Handayani ◽  
Puteri Fannya ◽  
Putri Nazofah

<p><em>Based on data from the Indonesia Ministry of Health in 2015, In Indonesia, new professional nurses were just 2% of the total nurses. This figure was much lower than the Philippines which has reached 40% with bachelor and master level as their education. The purpose of this study was to determine the relationship between age, and leadership with the performance of health personnel</em><em>. </em><em>The design of this research was analytical research with Cross Sectional Study. The population in this study was all nurses and doctors who served in the internal room, children, surgery and midwifery</em><em>. </em><em>Sampling using total sampling</em><em> </em><em>by questionnaires. The data was processed by univariate and bivariate analysis using Chi-square test</em><em>. </em><em>The result showed that 57,8% nurses had poor performance, 56,3% doctors had poor performance, 64,4% nurses had average age 26-35 years, 56,2% doctors had average age  36-45 years, 64.4% nurses have poor leadership, </em><em>and </em><em>50.0% of doctors have less good leadership</em><em>.</em><em> There is a relationship between age</em><em> and </em><em>leadership with the performance of health personnel.</em><em></em></p><p><strong><em> </em></strong></p><p>Berdasarkan data kemenkes RI tahun 2015 jumlah tenaga kesehatan terbanyak yaitu perawat sebanyak 147.264 orang (45,65%). Di Indonesia, perawat profesional baru mencapai 2% dari total perawat yang ada. Angka ini jauh lebih rendah dibandingkan dengan Filipina yang sudah mencapai 40% dengan pendidikan strata satu dan dua. Tujuan penelitian ini untuk mengetahui hubungan antara umur, kepemimpinan dengan kinerja tenaga kesehatan. Jenis penelitian yang digunakan adalah desain penelitian analitik dengan Cross Sectional Study. Populasi pada penelitian ini adalah semua perawat dan dokter. Pengambilan sampel dengan menggunakan Total Sampling. Pengambilan data menggunakan kuesioner. Data diolah dengan analisis univariat menggunakan statistik deskriptif dan analisis bivariat menggunakan uji Chi-square. Hasil penelitian didapatkan 57,8% perawat memiliki kinerja kurang baik, 56,3% dokter memiliki kinerja kurang baik, 64,4% perawat memiliki umur rata-rata 26-35 tahun 64,4%, 56,2% dokter memiliki umur rata-rata 36-45 tahun, 64,4% perawat memiliki kepemimpinan kurang baik, 50,0% dokter memiliki kepemimpinan kurang baik. Terdapat hubungan antara umur dan kepemimpinan dengan kinerja tenaga kesehatan.</p>


2019 ◽  
Vol 4 (3) ◽  
pp. 464
Author(s):  
Endang Sulastri ◽  
Yulastri Arif ◽  
Utari Christhya Wardhani

<p>Intensi turnover pada institusi pelayanan kesehatan merupakan masalah serius dan harus segera ditindaklanjuti, karena akan berdampak terhadap kualitas sumber daya manusia yang dapat mempengaruhi dalam pemberian pelayanan kesehatan kepada pasien. Intensi turnover di Rumah Sakit  Awal Bros Batam sejak lima tahun terakhir diatas standar rata-rata turnover dan Rumah Sakit belum mempunyai stategi yang efektif untuk mencegahnya. Tujuan penelitian ini untuk menganalisis hubungan budaya organisasi dengan risiko intensi turnover di Rumah Sakit Awal Bros Batam. Metode penelitian menggunakan desain kuantitatif dengan cross sectional study. Pengambilan sampel kuantitatif menggunakan kuesioner berdasarkan proposional random sampling, Chi Square dan Uji Regresi Logistic Berganda (Binary Logistic). Hasil penelitian menunjukkan bahwa budaya organisasi di Rumah Sakit Awal Bros Batam  mempunyai hubungan yang bermakna dengan intensi turnover dengan nilai pValue 0.005. Saran yang dapat diberikan peneliti adalah  menciptakan suasana kerja yang kondusif dengan menjaga hubungan interpersonal dan komunikasi yang baik antar karyawan maupun atasan.</p><p> </p><p>The intention of turnover in health care institutions is a serious problem and must be followed up immediately, because it will have an impact on the quality of human resources that can affect the delivery of health services to patients. The intention of the turnover in Batam Awal Bros Hospital since the last five years is above the average turnover standard and the Hospital does not yet have an effective strategy to prevent it. The purpose of this study was to analyze the relationship between organizational culture and risk of turnover intention at Awal Bros Batam Hospital. The research method uses quantitative design with cross sectional study. Quantitative sampling using a questionnaire based on proportional random sampling, data processing using the mean, Chi Square and Binary Logistic Regression Test. The results showed that the organizational culture in Batam Awal Bros Hospital had a significant relationship with turnover intention with a pValue 0.005. Suggestions that can be given by researchers is establish a conducive work atmosphere by maintaining interpersonal relationships and good communication between employees and superiors</p>


Author(s):  
AA Toubasi ◽  
BR Khraisat ◽  
RB AbuAnzeh ◽  
HM Kalbouneh

Objective Medicine is considered one if not the most stressful educational field. Thus, the aim of this study is to investigate the prevalence of stress and poor sleeping quality among medical students and the association between them. Method This cross-sectional study was conducted at the University of Jordan on second- and third-year medical students. The questionnaire consisted of: 1) Demographics; 2) The assessment tools which were Pittsburgh Quality of Sleep Index (PSQI) and Kessler Psychological Distress Status (K10). Binary logistic regression, chi-square and linear regression were used to investigate the association between PSQI, K10, and their determinants. Results The mean for PSQI score was 6.76 ± 3.32. PSQI scores interpretation revealed that 61.7% of the 282 participants of this study were poor sleepers. Logistic regression results showed that only the category of not napping at all from the napping hours variable was significantly associated with sleeping quality. Furthermore, the mean of K10 scores was 24.5 ± 8.5. K10 scores revealed that 66.3% of the participants were stressed. Logistic regression results showed that gender and regular exercise were significantly associated with psychological distress. Additionally, chi-square test, logistic regression and linear regression showed that PSQI was significantly associated with K10 (P <0.01). Conclusions Stress and poor sleeping quality in medical students at the University of Jordan were highly prevalent and strongly associated. What determined PSQI was daytime napping, and for K10 were regular exercise and gender. Further investigations into stress and sleep quality in the Arabian region are needed.


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