Evaluation of WHO criteria to determine degree of dehydration in children with acute diarrhea

Objective To evaluate the diagnostic accuracy and agreementbetween the 1980 and 1990 WHO criteria for determining the de-gree of dehydration in children with acute diarrhea.Methods This prospective study was conducted in two hospitalsfrom October 2002 to February 2003. Clinical signs of dehydrationall patients were recorded. The degree of dehydration based onthe 1980 and 1990 WHO criteria was determined and comparedwith fluid deficit measured by the difference of body weight on ad-mission and on discharge. Chi-square test and kappa value analy-ses were performed. Sensitivity, specificity, predictive values, andaccuracy of each WHO criteria were assessed. The prevalence ofdehydration was also determined.Results Sixty-five patients, comprising 40 boys and 25 girls, werestudied. There was a significant difference between the two WHOcriteria in differentiating between dehydration and non-dehydra-tion (P<0.05). Based on the 1980 WHO criteria the prevalence ofdehydration was 62.2%. Its sensitivity, specificity, and accuracy indiagnosing dehydration were 100.0%, 55.5%, and 86.2%, respec-tively. Based on the 1990 WHO criteria, the prevalence of dehy-dration was 60.0%. Its sensitivity, specificity, and accuracy in diag-nosing dehydration were 94.9%, 46.1%, and 75.4%, respectively.There was also a significant difference between both criteria indetermining severe dehydration (P<0.05). Based on the 1980 cri-teria, the prevalence of severe dehydration was 15.4%. Its sensi-tivity, specificity, and accuracy in diagnosing severe dehydrationwere 30.0%, 94.5%, and 84.6%, respectively. Based on the 1990criteria, these results were 40.0%, 94.5%, and 86.2%, respectively.The prevalence was 15.4%. Kappa value comparing the two WHOcriteria was 0.852 in diagnosing dehydration and 0.915 in diag-nosing severe dehydration. There was no significant differencebetween the two criteria in their sensitivity and specificity (P>0.05).Conclusion Both WHO criteria can be applied to determine de-hydration in patients with acute diarrhea, although we feel that the1990 criteria is simpler

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Effects of endothelial defects and venous interposition grafts on the acute incidence of thrombus formation within microvascular procedures

Scientific Reports ◽

10.1038/s41598-021-88324-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Lucas M. Ritschl ◽

Marie-Kristin Hofmann ◽

Constantin T. Wolff ◽

Leonard H. Schmidt ◽

Klaus-Dietrich Wolff ◽

...

Keyword(s):

Free Flap ◽

Thrombus Formation ◽

Indocyanine Green Videoangiography ◽

Predictive Values ◽

Flap Transfer ◽

Clinical Scenarios ◽

Free Flap Transfer ◽

Significant Difference ◽

The Difference ◽

Sensitivity Specificity

AbstractEndothelial defects (ED) and the usage of interposition vein grafts (IVG) are known risk factors for free flap failure. This experimental study aimed to compare both situations of thrombus formation and fluorescence angiographic behavior. Indocyanine green videoangiography (ICGVA) with the FLOW 800 tool was systematically performed in groups I = ED, II = IVG, and III = ED and IVG (each n = 11). ICGVA was able to detect thrombosis in five animals and safely ruled it out in 26 with two false-positive cases (sensitivity, specificity, and positive and negative predictive values were 100%, 90%, 62%, and 100%, respectively). The difference between visually and ICGVA-assisted ED measurements was significant (p = 0.04). The areas of thrombosis showed no significant difference. Moreover, ICGVA detected a decrease of all parameters at the ED area and/or within the IVG section in all groups. The presence of an endothelial defect had a higher impact on thrombus formation than the IVG usage. ICGVA is qualitatively able to detect endothelial defects and clinically evident thrombosis. However, the quantitative values are not yet attributable to one of the clinical scenarios that may jeopardize free flap transfer.

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COVID-19 Seroprevalence among Healthcare Workers of a Large COVID-19 Hospital in Rome Reveals Strengths and Limits of Two Different Serological Tests

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18052650 ◽

2021 ◽

Vol 18 (5) ◽

pp. 2650

Author(s):

Giuseppe Vetrugno ◽

Daniele Ignazio La Milia ◽

Floriana D’Ambrosio ◽

Marcello Di Pumpo ◽

Roberta Pastorino ◽

...

Keyword(s):

Blood Test ◽

Healthcare Workers ◽

Point Of Care ◽

Venous Blood ◽

Administrative Staff ◽

Serological Tests ◽

Predictive Values ◽

Work From Home ◽

Significant Difference ◽

Sensitivity Specificity

Healthcare workers are at the forefront against COVID-19, worldwide. Since Fondazione Policlinico Universitario A. Gemelli (FPG) IRCCS was enlisted as a COVID-19 hospital, the healthcare workers deployed to COVID-19 wards were separated from those with limited/no exposure, whereas the administrative staff were designated to work from home. Between 4 June and 3 July 2020, an investigation was conducted to evaluate the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin (IgG) antibodies among the employees of the FPG using point-of-care (POC) and venous blood tests. Sensitivity, specificity, and predictive values were determined with reverse-transcription polymerase chain reaction on nasal/oropharyngeal swabs as the diagnostic gold standard. The participants enrolled amounted to 4777. Seroprevalence was 3.66% using the POC test and 1.19% using the venous blood test, with a significant difference (p < 0.05). The POC test sensitivity and specificity were, respectively, 63.64% (95% confidence interval (CI): 62.20% to 65.04%) and 96.64% (95% CI: 96.05% to 97.13%), while those of the venous blood test were, respectively, 78.79% (95% CI: 77.58% to 79.94%) and 99.36% (95% CI: 99.07% to 99.55%). Among the low-risk populations, the POC test’s predictive values were 58.33% (positive) and 98.23% (negative), whereas those of the venous blood test were 92.86% (positive) and 98.53% (negative). According to our study, these serological tests cannot be a valid alternative to diagnose COVID-19 infection in progress.

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Accuracy of the fluorescence-aided identification technique (FIT) for detecting tooth-colored restorations utilizing different fluorescence-inducing devices: an ex vivo comparative study

Clinical Oral Investigations ◽

10.1007/s00784-021-03826-7 ◽

2021 ◽

Author(s):

W. Leontiev ◽

E. Magni ◽

C. Dettwiler ◽

C. Meller ◽

R. Weiger ◽

...

Keyword(s):

Multivariate Analysis ◽

Ex Vivo ◽

Predictive Values ◽

Composite Restorations ◽

Significant Difference ◽

Identification Technique ◽

Illumination Method ◽

Sensitivity Specificity ◽

Entire Procedure ◽

Higher Sensitivity

Abstract Objectives The aim of the present study was to compare the accuracy of the conventional illumination method (CONV) and the fluorescence-aided identification technique (FIT) for distinguishing between composite restorations and intact teeth using different fluorescence-inducing devices commonly used for FIT. Materials and methods Six groups of six dentists equipped with one of six different FIT systems each independently attempted to identify composite restorations and intact teeth on a full-mouth model with 22 composite restorations using CONV and, 1 h later, FIT. The entire procedure was repeated 1 week later. Sensitivity, specificity, and positive (PPV) and negative (NPV) predictive values, including 95% confidence intervals (CI), were calculated for CONV and FIT overall and for each device. The influence of examiner age, method, and device on each parameter was assessed by multivariate analysis of variance. Results The sensitivity (84%, CI 81–86%), specificity (94%, CI 93–96%), PPV (92%, CI 90–94%), and NPV (90%, CI 88–91%) of FIT was significantly higher than that of CONV (47%, CI 44–50%; 82%, CI 79–84%; 66%, CI 62–69%, and 69%, CI 68–71%, respectively; p<0.001). The differences between CONV and FIT were significant for all parameters and FIT systems except VistaCam, which achieved no significant difference in specificity. Examiners younger than 40 years attained significantly higher sensitivity and negative predictive values than older examiners. Conclusions FIT is more reliable for detecting composite restorations than the conventional illumination method. Clinical relevance FIT can be considered an additional or alternative tool for improving the detection of composite restorations.

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386 An Exploratory Study of Bedtime Procrastination and Emotional Regulation Strategies in Insomnia compared to healthy individuals

SLEEP ◽

10.1093/sleep/zsab072.385 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A153-A153

Author(s):

Goeun Kim ◽

Hyojin Nam ◽

Huisu Jeon ◽

Sooyeon Suh

Keyword(s):

Emotional Regulation ◽

Severity Index ◽

Ministry Of Education ◽

Chi Square ◽

Healthy Group ◽

Significant Difference ◽

Regulation Strategies ◽

The Difference ◽

The Republic ◽

Bedtime Procrastination

Abstract Introduction Bedtime Procrastination (BP) is defined as the behavior of voluntarily delaying going to bed, without having external reasons for doing so. Recent research on procrastination behavior suggests that when negative emotions are elevated, procrastination behaviors can be triggered in order to find pleasure to avoid and alleviate them. Procrastination can also occur when there is difficulty regulating emotions. In addition, the reason for bedtime procrastination may be different depending on whether the individuals present with insomnia. According to previous studies, patients with insomnia may exhibit more pronounced negative avoidance of bedtime due to prolonged sleeplessness. Therefore, this study compared the difference between of the bedtime procrastination and the emotional regulation strategies between the insomnia group and the healthy group. Methods This study was conducted in 582 adults (mean age 23.06 ±2.16 years), 81.6% females. Individuals scoring higher than 15 on the Insomnia Severity Index (ISI) were classified into the insomnia group (n=375), and those less than 15 were classified into the healthy group (n=207). Participants completed the Bedtime Procrastination Scale (BPS), Emotional Regulation Strategies Checklist. Data was analyzed using descriptive statistics, chi square test, and independent t tests. Results The insomnia group had significantly higher bedtime procrastination scores than the healthy group (t=-6.241, p<.001), and also the avoidant/distractive regulation style score was significantly higher (t=-1.969, p<.05). In addition, the score of active regulation style was significantly lower in the insomnia group than in the healthy group (t=3.050, p<.01). There was no significant difference between the two groups in the support-seeking regulation style. Conclusion Based on these results, it was confirmed that there was a difference in the bedtime procrastination and the emotional regulation strategies between the insomnia group and the healthy group. Support (if any) This work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea(NRF-2018S1A5A8026807)

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Analysis of livestock breeders’ perceptions and their adaptation measures to climate change in Morocco‘s arid rangelands

Change and Adaptation in Socio-Ecological Systems ◽

10.1515/cass-2020-0100 ◽

2020 ◽

Vol 6 (1) ◽

pp. 1-25

Author(s):

Wadii Snaibi

Keyword(s):

Climate Change ◽

Local Level ◽

Small Scale ◽

Climate Data ◽

Chi Square ◽

Adaptation Measures ◽

Significant Difference ◽

The Difference ◽

Eastern Morocco ◽

Climate Analysis

AbstractThe high plateaus of eastern Morocco are already suffering from the adverse impacts of climate change (CC), as the local populations’ livelihoods depend mainly on extensive sheep farming and therefore on natural resources. This research identifies breeders’ perceptions about CC, examines whether they correspond to the recorded climate data and analyses endogenous adaptation practices taking into account the agroecological characteristics of the studied sites and the difference between breeders’ categories based on the size of owned sheep herd. Data on perceptions and adaptation were analyzed using the Chi-square independence and Kruskal-Wallis tests. Climate data were investigated through Mann-Kendall, Pettitt and Buishand tests.Herders’ perceptions are in line with the climate analysis in term of nature and direction of observed climate variations (downward trend in rainfall and upward in temperature). In addition, there is a significant difference in the adoption frequency of adaptive strategies between the studied agroecological sub-zones (χ2 = 14.525, p <.05) due to their contrasting biophysical and socioeconomic conditions, as well as among breeders’ categories (χ2 = 10.568, p < .05) which attributed mainly to the size of sheep flock. Policy options aimed to enhance local-level adaptation should formulate site-specific adaptation programs and prioritise the small-scale herders.

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Performance of Abbreviated Protocols Versus Unenhanced MRI in Detecting Occult Breast Lesions of Mammography in Patients with Dense Breasts

10.21203/rs.3.rs-1122604/v1 ◽

2021 ◽

Author(s):

Suhong Zhao ◽

Peipei Chen ◽

Guangrui Shao ◽

Baijie Li ◽

Huikun Zhang ◽

...

Keyword(s):

Reading Time ◽

Area Under The Curve ◽

Lesion Size ◽

Lower Sensitivity ◽

Chi Square ◽

Dense Breast Tissue ◽

Negative Findings ◽

Chi Square Test ◽

The Difference ◽

Sensitivity Specificity

Abstract Objective: To assess the diagnostic ability of abbreviated protocols of MRI (AP-MRI) compared with unenhanced MRI (UE-MRI) in mammographically occult cancers in patients with dense breast tissue.Materials and Methods: The retrospective analysis consisted of 102 patients without positive findings on mammography who received preoperative MRI full diagnostic protocols (FDP) between January 2015 and December 2018. Two breast radiologists read the UE, AP, and FDP. The interpretation times were recorded. The comparisons of the sensitivity, specificity and area under the curve of each MRI protocol, and the sensitivity of these protocols in each subgroup of different size tumors used the Chi-square test. The paired sample t-test was used for evaluating the difference of reading time of the three protocols.Results: Among 102 women, there were 68 cancers and two benign lesions in 64 patients and 38 patients had benign or negative findings. Both readers found the sensitivity and specificity of AP and UE-MRI were similar (p>0.05), whereas compared with FDP, UE had lower sensitivity (Reader 1/Reader 2: p=0.023, 0.004). For different lesion size groups, one of the readers found that AP and FDP had higher sensitivities than UE-MRI for detecting the lesions ≤10 mm in diameter (p=0.041, p=0.023). Compared with FDP, the average reading time of UE-MRI and AP was remarkably reduced (p < 0.001).Conclusion: AP-MRI had more advantages than UE-MRI to detect mammographically occult cancers, especially for breast tumors ≤10 mm in diameter.

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Abstract 14721: Impact of Covid-19 on Cardiology Consultation in Tertiary Care Hospital of a Developing Country

Circulation ◽

10.1161/circ.142.suppl_3.14721 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

ghufran adnan ◽

Osman Faheem ◽

Maria Khan ◽

Pirbhat Shams ◽

Jamshed Ali

Keyword(s):

Emergency Department ◽

Tertiary Care ◽

Reduction Rate ◽

Care Hospital ◽

Chi Square ◽

Coronary Syndrome ◽

Significant Difference ◽

Drastic Increase ◽

Chi Square Test ◽

The Difference

Introduction: COVID-19 pandemic has overwhelmed the healthcare system of Pakistan. There has been observation regarding changes in pattern of patient presentation to emergency department (ED) for all diseases particularly cardiovascular. The aim of the study is to investigate these changes in cardiology consultations and compare pre-COVID-19 and COVID-19 era. Hypothesis: There is a significant difference in cardiology consultations during COVID era as compared to non-COVID era. Method: We collected data retrospectively of consecutive patients who visited emergency department (ED) during March-April 2019 (non-COVID era) and March-April 2020 (COVID era). Comparison has been made to quantify the differences in clinical characteristics, locality, admission, type, number, and reason of Cardiology consults generated. Results: We calculated the difference of 1351 patients between COVID and non-COVID era in terms of cardiology consults generated from Emergency department, using Chi-square test. Out of which 880 (59%) are male with mean age of 61(SD=15). Analysis shows pronounced augmentation in number of comorbidities [Hypertension(6%), Chronic kidney disease (6%), Diabetes (5%)] but there was 36% drop in total cardiology consultations and 43% reduction rate in patient’s ED visit from other cities during COVID era. There was 60% decrease in acute coronary syndrome presentation in COVID era, but fortuitously drastic increase (30%) in type II myocardial injury has been noted. Conclusion: There is a remarkable decline observed in patients presenting with cardiac manifestations during COVID era. Lack in timely care could have a pernicious impact on outcomes, global health care organizations should issue directions to adopt telemedicine services in underprivileged areas to provide timely care to cardiac patients.

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Analysis of the Specificity, Sensitivity and Accuracy of Goniometry Method Compared to Tape Method for Measuring Trunk Mobility in Normal Adults

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i32b31755 ◽

2021 ◽

pp. 138-145

Author(s):

Purvi Patel

Keyword(s):

Range Of Motion ◽

Standard Technique ◽

Cross Sectional Study ◽

P Value ◽

Chi Square ◽

Cross Sectional ◽

Spine Mobility ◽

The Difference ◽

Sensitivity Specificity ◽

Normal Adults

Measurement of lumbar range of motion (LROM) is a routine method in the examination of patients with low back pain. There is no standard technique which may be used to accurately describe the range of motion in the different plane. So in present study, an attempt has been made to compare goniometric measurement with tape measurement for its sensitivity, specificity and accuracy for measuring spine mobility in normal adults. In this cross sectional study, 137 healthy adults between the ages of 18-26 years of age were included consecutively and assessed using Tape method and goniometry for trunk mobility in all planes (sagittal, frontal and transverse). The association of goniometry with tape method was assessed using chi square test. The study showed that the difference between goniometry and tape method was statistically significant (p value <0.05) for all movements except flexion (p value 0.215). Also the sensitivity, specificity and accuracy of goniometry is not as good as tape method except for flexion compared to tape method. So, from this study we can conclude that Goniometry was not as good as tape method for all movements except forward flexion where both can be equally used.

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Significance of serum-pleural effusion albumin gradient in differentiating transudative and exudative pleural effusions in comparison to light’s criteria

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20171041 ◽

2017 ◽

Vol 4 (2) ◽

pp. 457

Author(s):

Sujatha G. ◽

Vindhya P. ◽

Kalyan Kumar K.

Keyword(s):

Pleural Effusion ◽

Clinical Outcome ◽

Pleural Fluid ◽

Venous Blood ◽

P Value ◽

Protein Ratio ◽

Clinical Disorder ◽

Significant Difference ◽

The Difference ◽

Sensitivity Specificity

Background: Approximately one million patients develop pleural effusion every year. It is a common clinical disorder and is either a manifestation or a complication of one or other respiratory or non-respiratory disorders. It leads to serious prognosis, if not diagnosed and treated properly. To calculate SEAG and Light’s criteria and to compare SEAG with Light’s criteria in analyzing pleural effusions.Methods: A total of hundred patients were selected for the study. Pleural fluid of patients who met the inclusion and exclusion criteria were collected, when pleural fluid is being tapped for diagnostic thoracocentesis. Venous blood sample was collected along with diagnostic thoracocentesis or within 24 hours of thoracocentesis. Written informed consent was obtained from them for thoracocentesis.Results: In our study we compared the clinical outcome with outcome as per Pleural fluid/Serum protein ratio (p value of <0.0001), pleural fluid/serum LDH (p value of <0.0001) and pleural fluid LDH (p value of <0.0001) separately and the p values were statistically significant. The sensitivity, specificity, PPV and NPV of Light’s criteria were 77.2%, 100%, 100%, 93.9% respectively. We compared Light’s criteria outcome with clinical outcome and the difference was statistically significant (p value of <0.0001). SEAG showed 100% sensitivity, 97.43% specificity, 91.6% PPV and is 91.66% and NPV is 100%. We compared the clinical outcome with SEAG and there was statistically significant difference (p value of <0.0001). We compared SEAG with Light’s criteria and the difference was statistically significant (p <0.0001). We compared Light’s plus pleural fluid protein gradient with SEAG and the difference is statistically significant (p value of <0.0001).Conclusions: SEAG is more sensitive for classifying transudates and more specific for exudates than Light’s criteria.

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DIASTASIS RECTI AMONG PREGNANT AND POSTPARTUM WOMEN IN KANO, NIGERIA: A CROSS-SECTIONAL STUDY

Pakistan Journal of Rehabilitation ◽

10.36283/pjr.zu.6.1/003 ◽

2017 ◽

Vol 6 (1) ◽

pp. 15-20

Author(s):

Fatima Bichi ◽

Dr. Shumaila Hanif

Keyword(s):

Post Partum ◽

Sampling Technique ◽

Cross Sectional Study ◽

Postpartum Women ◽

Chi Square ◽

Cross Sectional ◽

Common Location ◽

Diastasis Recti ◽

Significant Difference ◽

The Difference

Diastasis Recti (DR) is a common muscular condition often present during and after pregnancy. This cross-sectional correlational study investigated the prevalence of DR among pregnant and postpartum women. A total of 250 pregnant and postpartum women were recruited using convenience sampling technique from obstetrics and gynaecology department, Aminu Kano Teaching Hospital, Kano, Nigeria. Age, body mass, height, BMI, parity, trimester, duration of DR postpartum, location of DR and DR status was recorded for each participant. Presence of DR was confirmed using the finger width method. Descriptive statistics of mean, SD, percentage were used to describe the data and determine the prevalence. Inferential statistics of Pearson’s and Spearman’s correlation were used to analyse the relationship between prevalence of DR and age, parity and duration of DR postpartum. Chi square was computed to determine the difference in prevalence of DR across trimesters. The result of this study indicated high prevalence of DR in post-partum and pregnant women (84% and 64.7% respectively); the most common location of DR was at the umbilicus in both pregnant and postpartum women. Prevalence of DR was high among the multigravida; and a significant relationship was found between prevalence of DR and age and parity of participants. There was a significant difference in prevalence of DR across the trimesters. It can be concluded that prevalence of DR among pregnant and postpartum women is high; age and parity are determinants of DR prevalence. Evaluation of DR should be considered as routine assessment in both pregnant and postpartum women.

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