Diagnostic efficacy of Light-Emitting Diode (LED) Fluorescence based Microscope for the diagnosis of Tuberculous lymphadenitis

Background The comparatively straightforward and cheaper light-emitting diode fluorescent microscope (LEDFM) was suggested by WHO to replace conventional microscope in tuberculosis (TB) laboratories. However, the comparable efficacy of each of those techniques differs from laboratory to laboratory. We investigated the efficacy of LEDFM for the diagnosis of tuberculous lymphadenitis (TBLN) patients. Methods A cross-sectional study was conducted on 211 samples from clinically suspected tuberculous lymphadenitis patients. Three smears were prepared from FNA on microscope slides for cytomorphology study, Auramine O (AO), and for Ziehl-Neelsen (ZN) staining. The left-over samples were inoculated onto Lowenstein-Jensen (LJ) media. Statistical analysis was done using STATA version 11. The sensitivity, specificity, positive and negative predictive values were calculated by considering the culture results as the gold standard using a 95% confidence interval. Results Among 211 samples 49.7% (105) were positive by cytomorphology, 32.7% (69) by LEDFM, 23.69% (50) by LJ culture, and 13.7% (29) by ZN. Compared to the gold standard sensitivity of ZN, LEDFM, and cytomorphology were 30% [95% CI: 17.9–44.6], 66% [95% CI: 51.2–78.8] 78% [95% CI: 64–88.5], respectively. The specificity of ZN, LEDFM, and cytomorphology was 91.3% [95% CI: 85.8–95.2], 77.6% [95% CI: 70.4–83.8], 58.8% [95% CI: 50.7–66.5], respectively. Conclusion LED fluorescence microscopy gives a legitimate option in contrast to conventional ZN techniques in terms of its higher sensitivity, a bit lower specificity, time-saving, and minimal effort.

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Assessing the irradiance levels of phototherapy devices in Jos, north central, Nigeria

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20181261 ◽

2018 ◽

Vol 6 (4) ◽

pp. 1088

Author(s):

Akinyemi O. D. Ofakunrin ◽

Udochukwu M. Diala ◽

Bose O. Toma ◽

David D. Shwe ◽

Sanusi Gidado ◽

...

Keyword(s):

Light Emitting Diode ◽

Significant Proportion ◽

Neonatal Morbidity ◽

Cross Sectional Study ◽

Optimum Level ◽

Cross Sectional ◽

Middle Income ◽

North Central ◽

Light Emitting ◽

Routine Assessment

Background: Neonatal jaundice (NNJ) remains a major cause of neonatal morbidity and mortality in Nigeria with significant contribution to the global figures. Effective phototherapy can reduce the complications associated with NNJ. The effectiveness of a phototherapy device (PD) depends mainly on the emitted irradiance of the device. We, therefore, assessed the irradiance of the PDs in Jos, North Central Nigeria in order to determine the effectiveness of the devices and to highlight the need for routine assessment of irradiance levels of PDs in low-middle income settings.Methods: This was a cross- sectional study involving 14 hospitals with a total of 38 functional PDs comprising of 25 (65.8%) locally fabricated, eight (21.0%) light- emitting diode (LED) and five (13.2%) conventional patented devices. The irradiance was measured using the BiliBlanket® light meter II.Results: The irradiance of the PDs ranged from 2 to 102μW/cm2/nm with a median value of 10.6 (IQR 6-18μW/cm2/nm). Sixteen devices (42.1%) had a suboptimal irradiance (<10μW/cm2/nm); while only five (13.2%) provided irradiance at the intensive level (≥30μW/cm2/nm). The mean distance between the babies and phototherapy lights was 35.1±12.7cm (range 15-70cm).Conclusions: A significant proportion of the PDs in Jos delivered suboptimal irradiance which could reduce the effectiveness of the phototherapy. The irradiance of PDs needs to be assessed regularly and measures should be instituted to improve the irradiance to the optimum level in order to reduce the burden of kernicterus.

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The Efficacy of CT Scan in Evaluation of Hepatic Tumors taking Histopathology as Gold Standard

10.53350/pjmhs211571906 ◽

2021 ◽

Vol 15 (7) ◽

pp. 1906-1909

Author(s):

Muhammad Nauman Akram ◽

Nazahat Pasha ◽

Hafeez ur Rehman ◽

Asim Ali ◽

Nudrat Waqar ◽

...

Keyword(s):

Sensitivity And Specificity ◽

Gold Standard ◽

Statistical Significance ◽

Percutaneous Biopsy ◽

Cross Sectional Study ◽

Ct Scans ◽

Hepatic Tumors ◽

Cross Sectional ◽

Predictive Values ◽

Medical College

Background and Aim: The prevalence of hepatic tumors is most common among developing countries of Asia compared to Europe and Western countries. In Pakistan, hepatic tumors are the 4thcommon disorder. The current study aims to evaluate the efficacy of hepatic tumors taking histopathology as a gold standard. Materials and Methods: This cross-sectional study wascarried out on 120 patients who underwent CT scans for hepatic tumors inradiology department of Sughra Shafi Medical Complex / Sahara Medical College, Narowal and Children Hospital &Institute of Child Health,Multan during the period of six months from 1st September 2020 to 2nd March 2021. The age range for all the patients was 29 to 80 years with mean ±SD(52±5.32) followed by hepatic tumors diagnosed based on histopathology as agold standard and assessed with CT. The prevalence of colorectal carcinoma was 22(18.33%), while other common parameters were pancreas, stomach adenocarcinoma, and biliarytree 13 (10.83%), and hepatocellular carcinoma 85 (70.84%). Unresectable tumors inpatients were assessed with percutaneous biopsy of the hepatic lesion and correlatedwith CT results. Resectability predictionwas assessed with CT findings accuracy in all the patients who had tumors onthe basis of CT images and had surgery. Results: All the patients of hepatic tumors were assessed with CT scans and histopathology was taken from each participant. Accuracy, sensitivity and specificity of CT scans was 67.33%, 62.35% and 73.85% respectively. The positive and negative predictive values were about 75.71% and 60% respectively. Statistical significance was (P<0.05) set as a standard.SPSS version 20 was used for data analysis. Conclusion:Our study found that hepatic tumors can be assessed byarterial portography with resectability by CT scans. In our study, out of 120 patientshad spared surgery and only 17% of patients were considered as resectable duringarterial portography on CT scans findings. CT scanplays a pivotal role in assessing hepatic tumors. Accuracy, sensitivity and specificity of CT scans was 67.33%, 62.35% and 73.85% respectively. The positive and negative predictive values were about 75.71% and 60% respectively. Keywords:Hepatic Tumors, CT scans,Histopathology

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COMPARISON OF VALIDITY OF FNACAND ZIEHL–NEELSEN STAINS IN DIAGNOSING CERVICAL TUBERCULOUS LYMPHADENITIS

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v1i1.7928 ◽

2021 ◽

Vol 71 (Suppl-3) ◽

pp. S484-86

Author(s):

Aisha Qaiser ◽

Muhammad Babar Sohail Niazi ◽

Zaheer Ul Hassan ◽

Shahid Farroq Khattak ◽

Shahid Iqbal ◽

...

Keyword(s):

Gold Standard ◽

Positive Culture ◽

Needle Aspiration ◽

Cross Sectional Study ◽

Tuberculous Lymphadenitis ◽

Sectional Study ◽

Specific Test ◽

Cross Sectional ◽

Cervical Lymph Nodes ◽

Mycobacterial Culture

Objective: To compare the validity of FNAC & ZN staining in diagnosing tuberculous lymphadenitis taking mycobacterial culture as gold standard. Study Design: Cross sectional study. Place and Duration of Study: Pathology department, Fauji Foundation Hospital Peshawar, from Oct 2019 to Sep 2020. Methodology: This study includes 100 patients with enlarged cervical lymph nodes who presented as outdoor patients. After routine baseline & radiological investigations, FNAC & ZN staining was carried out, followed by mycobacterial culture. Results: FNAC of tuberculous patients was positive in 56 (56%) patients while 24 (24%) patients revealed posi-tive mycobacterial culture. Inpatients with positive culture, 77 (77%) were FNAC positive and 23 (23%) were negative on cytology. Conclusion: Fine needle aspiration is more sensitive & specific test than Ziehl-Neelsen staining.

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Validation of the ISAAC Standardized Questionnaire Used by Schoolchildren from Mexicali, Baja California, Mexico

Epidemiology Research International ◽

10.1155/2013/490906 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Karla Gorozave-Car ◽

Albino Barraza-Villarreal ◽

Consuelo Escamilla-Núñez ◽

Leticia Hernandez-Cadena ◽

Luz Helena Sanín-Aguirre ◽

...

Keyword(s):

Gold Standard ◽

Respiratory Symptoms ◽

Allergic Diseases ◽

Epidemiological Studies ◽

Cross Sectional Study ◽

Clinical Testing ◽

Sectional Study ◽

Cross Sectional ◽

Predictive Values ◽

Sensitivity Specificity

Background. In Mexico, several studies have been conducted under the ISAAC methodology; nevertheless, no validation studies of the ISAAC questionnaire based on objective clinical testing in our country have been published. Aims of the Study. To validate the ISAAC questionnaire, used in a study of prevalence of allergic diseases, based on medical, respiratory, and allergic evaluations of schoolchildren being 11 to 16 years old in Mexicali, Mexico. Material and Methods. We conducted a cross-sectional study to validate the ISAAC questionnaire through the generation of an index (considered as gold standard) using pre- and postbronchodilator spirometry test, exhaled nitric oxide measurements, and atopic evaluations. 114 schoolchildren were included (23 asthmatics with respiratory symptoms and 91 nonasthmatics without respiratory symptoms) and we evaluated the sensitivity, specificity, and positive and negative predictive value of the questionnaire using discriminant analysis. Results. We observed sensitivity of 35.2% and specificity of 93.3% and the positive and negative predictive values were 82.6% and 61.5%, respectively. Conclusions. Our findings indicate that the ISAAC Mexican version questionnaire was less sensitive and more specific when compared to the gold standard; however, it is adequate and able to discriminate children with and without asthma and a useful tool to use in epidemiological studies.

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Knowledge and Attitude of Dental Clinicians towards Light-Curing Units: A Cross-Sectional Study

International Journal of Dentistry ◽

10.1155/2021/5578274 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Dana Al-Senan ◽

Fatin Ageel ◽

Amani Aldosari ◽

Haifa Maktabi

Keyword(s):

Light Emitting Diode ◽

Statistical Significance ◽

Cross Sectional Study ◽

Cross Sectional ◽

Light Emitting ◽

Electronic Survey ◽

Inadequate Knowledge ◽

Light Curing ◽

Knowledge And Attitude ◽

Composite Resin Restorations

Objectives. Light curing is crucial when applying composite resin restorations. Complete polymerization of the resin depends on delivering adequate light energy to it. Dental clinicians may be unaware of the importance of proper light-curing techniques. This study aimed at evaluating and comparing the level of knowledge of general practitioners (GPs) and specialists (SPs) regarding light-curing units. Materials and Methods. An electronic survey was conducted online among GPs and SPs of various specialties, working in the governmental sector in Riyadh, Saudi Arabia. Collected data were analyzed for statistical significance. Results. 310 dentists were included in the study. Nearly half of the GPs (45.9%) and more than half of SPs (56.8%) use light-emitting diode (LED) type light-curing units (LCUs). 36.9% of GPs and 29.6% of SPs were unsure about the type of LCUs they use in their dental clinics. 10.8% of GPs and 8.5% of SPs knew the proper term of the power output of LCU. 52.2% of the GPs and 55.7% of SPs were wrong about advancements in technology of LED LCUs. Regarding the use of radiometer, 48.2% of SPs and 35.1% of GPs had responded wrongly, and 37.7% of SPs and 52.3% of GPs were not familiar with the device, showing a statistical significance p = 0.040 . There was no statistical significance observed in the responses pertaining to their years of experience, expected for two questions. Conclusion. Both GPs and SPs displayed inadequate knowledge regarding the use of LCUs. Further educational programs are recommended to spread awareness about the handling of LCUs among dental clinicians.

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NEONATAL SEPSIS;

The Professional Medical Journal ◽

10.29309/tpmj/2019.26.04.3362 ◽

2019 ◽

Vol 26 (04) ◽

Author(s):

Mohammad Irshad ◽

Mohsin Hayat ◽

Hina Parvez ◽

Ihsan Ullah ◽

Zia ur Rehman

Keyword(s):

Neonatal Sepsis ◽

Gold Standard ◽

Antibiotic Use ◽

Cross Sectional Study ◽

Blood Cultures ◽

C Reactive Protein ◽

Cross Sectional ◽

Predictive Values ◽

Female Ratio ◽

Reactive Protein

Objectives: To determine the diagnostic accuracy of C-reactive protein in the diagnosis of neonatal sepsis keeping blood cultures as gold standard. Study Design: Descriptive cross-sectional study. Setting: Pediatric Unit of Lady Reading Hospital Peshawar Pakistan. Duration: Six months from 09-06-2012 to 08-12-2012. Methodology: Total of 196 patients meeting the required inclusion criteria with clinical suspicion of sepsis. Those neonates were subjected to investigations. C.R.P. was tested using the Quantitative method according to the instructions provided with the kit. By keeping blood culture as gold standard, patients with both positive and negative cultures were taken and the results compared to the results of C.R.P. in these subjects being positive or negative. Results: Among the 196, majority of the neonates included were less than a week old having a mean age of 4.5 days. There were 57 (29%) females and 139 (71%) males, with male to female ratio of 2.4:1. Blood cultures were positive in 85 (43%) and negative in 111 (57%) cases, while C.R.P. was positive in 95 (48%) and negative in 101 (52%) cases. Sensitivity, specificity, and positive and predictive values of C-reactive protein were calculated using formulas, and they turned out to be 77.6%, 73.8%, 69.4%, and 81.2% respectively with accuracy being 0.41%. Conclusion: An accurate and timely diagnosis of early onset neonatal sepsis remains challenging to the clinician as well as laboratory. Physicians can prevent unnecessary antibiotic use by performing the qualitative estimation CRP as a single, rapid and inexpensive test with a negative predictive value of 81.2%.

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Evaluation of SARS-CoV-2 antigen-based rapid diagnostic kits in Pakistan: formulation of COVID-19 national testing strategy

Virology Journal ◽

10.1186/s12985-021-01505-3 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Umar Saeed ◽

Sara Rizwan Uppal ◽

Zahra Zahid Piracha ◽

Azhar Rasheed ◽

Zubair Aftab ◽

...

Keyword(s):

Gold Standard ◽

Injection Drug Users ◽

Drug Users ◽

Diagnostic Testing ◽

False Negative ◽

Cross Sectional Study ◽

Nasopharyngeal Swab ◽

Rt Pcr ◽

Cross Sectional ◽

Negative Results

AbstractRapid diagnosis of SARS-CoV-2 during pandemic enables timely treatment and prevention of COVID-19. Evaluating the accuracy and reliability of rapid diagnostic testing kits is crucial for surveillance and diagnosis of SARS-CoV-2 infections in general population, injection drug users, multi-transfused populations, healthcare workers, prisoners, barbers and other high risk populations. The aim of this study was to evaluate performance and effectiveness of nasopharyngeal swab (NSP) and saliva based rapid antigen detection testing kits in comparison with USFDA approved triple target gold standard real-time polymerase chain reaction. A cross-sectional study was conducted on 33,000 COVID-19 suspected patients. From RT-PCR positive patients, nasopharyngeal swab (NSP) and saliva samples were obtained for evaluation of rapid COVID-19 testing kits (RDT). 100/33,000 (0.3%) of specimens were RT-PCR positive for SARS-CoV-2. Among RT-PCR positive, 62% were males, 34% were females, and 4% were children. The NSP-RDT (Lepu Medical China) analysis revealed 53% reactivity among males, 58% reactivity among females, and 25% reactivity among children. However saliva based RDT (Lepu Medical China) analysis showed 21% reactivity among males and 23% among females, and no reactivity in children. False negative results were significantly more pronounced in saliva based RDT as compared to NSP-RDT. The sensitivity of these NSP-RDT and saliva based RDT were 52% and 21% respectively. The RDTs evaluated in this study showed limited sensitivities in comparison to gold standard RT-PCR, indicating that there is a dire need in Pakistan for development of suitable testing to improve accurate COVID-19 diagnosis in line with national demands.

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Diagnostic Accuracy of HRCT Chest in Detection of Covid-19 Infection Taking PCR as Gold Standard

10.53350/pjmhs211561679 ◽

2021 ◽

Vol 15 (6) ◽

pp. 1679-1681

Author(s):

Afaque Ali ◽

Majid Shaikh ◽

Ahsanullah . ◽

Adeel Ahmed ◽

Abid Ali Sahito ◽

...

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Diagnostic Accuracy ◽

Predictive Value ◽

Gold Standard ◽

Cross Sectional Study ◽

Radiology Department ◽

High Resolution Computed Tomography ◽

Cross Sectional ◽

Head Of Department

Objective: To determine the diagnostic accuracy of High-resolution computed tomography (HRCT) chest in detection of covid-19 infection taking PCR as gold standard. Study Design: Cross-sectional study Setting: Radiology department of Tabba Hospital, Karachi. Duration: From March 2019 to September 2020 Material and Methods: All the clinically suspected patients of covid-19, of any age, both genders and those referred to radiology for High-resolution computed tomography (HRCT) chest to detect the covid-19 infection were included. After two days, patients’ PCR reports were collected from the ward, after taking informed consent and permission from head of department. The diagnostic accuracy of HRCT was established with respect to sensitivity, PPV, NPV, and specificity by taking PCR as gold standard. All the information was collected via study proforma. Results: Total 70 patients suspected for COVID-19 were studied, and the patients’ mean age was 58.23±9.52 years. Males were in majority 54(77.1%). As per HRCT findings, COVID-19 infection was positive in 46 patients, however, 48 patients were detected positive for COVID-19 infection as per PCR findings. In the detection of COVID-19 infection, HRCT chest showed sensitivity of 91%, specificity of 90%, PPV of 83%, NPV of 84% and diagnostic accuracy of 94%; by taking PCR as gold standard. Conclusion: High-resolution computed tomography (HRCT) is a reliable diagnostic approach in promptly detecting the COVID-19; with 91% sensitivity, 90% specificity, 83% positive predictive value, 84% negative predictive value and 94% diagnostic accuracy. Keywords: Accuracy, HRCT, COVID-19

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Liver ultrasound elastography for the evaluation of periportal fibrosis in schistosomiasis mansoni: A cross-sectional study

10.1101/450494 ◽

2018 ◽

Author(s):

Joelma Carvalho Santos ◽

Andrea Dória Batista ◽

Carla Maria Mola Vasconcelos ◽

Roberto Souza Lemos ◽

Valter Romão de Souza ◽

...

Keyword(s):

Shear Wave ◽

Shear Wave Elastography ◽

Cross Sectional Study ◽

Cutoff Point ◽

Sectional Study ◽

Cross Sectional ◽

Predictive Values ◽

Cutoff Value ◽

Periportal Fibrosis ◽

Schistosomiasis Mansoni

AbstractBackgroundARFI elastrography has been used as a noninvasive method to assess the severity of liver fibrosis in viral hepatitis, although with few studies in schistosomiasis mansoni. We aimed to evaluate the performance of point shear wave elastography (pSWE) for predicting significant periportal fibrosis (PPF) in schistosomotic patients and to determine its best cutoff point.Methodology/Principal findingsThis cross-sectional study included 358 adult schistosomotic patients subjected to US and pSWE on the right lobe. Two hundred two patients (62.0%) were women, with a median age of 54 (ranging 18-92) years. The pSWE measurements were compared to the US patterns of PPF, as gold standard, according to the Niamey classification. The performance of pSWE was calculated as the area under the ROC curve (AUC). Patients were further classified into two groups: 86 patients with mild PPF and 272 patients with significant PPF. The median pSWE of the significant fibrosis group was higher (1.40 m/s) than that of mild fibrosis group (1.14 m/s, p<0.001). AUC was 0.719 with ≤1.11 m/s as the best cutoff value for excluding significant PPF. Sensitivity and negative predictive values were 80.5% and 40.5%, respectively. Whereas, for confirming significant PPF, the best cutoff value was >1.39 m/s, with specificity of 86.1% and positive predictive value of 92.0%.Conclusions/SignificancepSWE was able to differentiate significant from mild PPF, with better performance to predict significant PPF.Author summaryIn the developing world, over 207 million people are infected with parasitic Schistosoma worms. Among the species of Schistosoma that infect humans Schistosoma mansoni is one of the most common causes of illness. Here, we investigated the performance of point shear wave elastography (pSWE) for predicting significant periportal fibrosis (PPF) in schistosomotic patients and to determine its best cutoff point. We examined 358 people from northeast of Brazil for Schistosoma infections. The present study showed that pSWE was able to differentiate significant from mild PPF, with better performance to predict significant PPF.

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National Trends in Diagnostic Imaging for Appendicitis: A Cross-Sectional Analysis Using NSQIP

The American Surgeon ◽

10.1177/000313481908500627 ◽

2019 ◽

Vol 85 (6) ◽

pp. 625-630

Author(s):

Alexandra Z. Agathis ◽

Michael Miller ◽

Celia M. Divino

Keyword(s):

Diagnostic Imaging ◽

Cross Sectional Study ◽

Patient Specific ◽

Childbearing Age ◽

Cross Sectional ◽

Predictive Values ◽

Chi Squared ◽

Underweight Patients ◽

Acs Nsqip Database ◽

National Trends

Prior studies elucidate a high predictive value of imaging to diagnose appendicitis in small, regional cohorts. This cross-sectional study uniquely analyzes diagnostic imaging in a national appendectomy population. Using the 2016 ACS NSQIP database, positive predictive values (PPVs) for CT, ultrasound (US), and MRI were evaluated using chi-squared tests. Univariate and multivariate analyses considered patient-specific factors. Imaging was performed in 94.63 per cent of 11,841 appendectomy cases; most frequently via CT (78.69%), then combination CT and US (7.52%), US (7.15%), and MRI (0.30%). CT PPV was higher in overweight (98.70%) versus underweight patients (94.85%) ( P = 0.01). Gender and age did not impact CT PPV. Imaging from a referral site did not change CTor US PPV. Our study describes imaging frequencies and confirms high PPV. We found imaging equally predictive in women of childbearing age and elderly individuals compared with the general population. Furthermore, repeat scanning is unnecessary with prior positive imaging at outside sites.

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