scholarly journals Evaluation of swede score and reid score to improve the predictive value of colposcopy and its correlation with histology

2020 ◽  
Vol 9 (5) ◽  
pp. 2059
Author(s):  
Urmila Karya ◽  
Azme Zehra ◽  
Anupam Rani
Keyword(s):  
Cervical Carcinoma ◽  
Predictive Value ◽  
Scoring System ◽  
Predictive Accuracy ◽  
Public Health Problem ◽  
Positive Association ◽  
Screening Methods ◽  
Histological Findings ◽  
Dysplastic Lesion ◽  
Cross Sectional

Background: Cervical carcinoma is the second most common malignancy amongst women in India. It is regarded as a public health problem and a priority in cancer control programmes by the WHO. Colposcopy has proven to be very useful in identifying and guiding the biopsy of dysplastic lesion. To minimize inter-observer variation, colposcopic scoring system has been introduced.Methods: A prospective cross- sectional study including 250 women in whom the prevalence of different grades CIN was done. Co-relation of Pap (cytology) with colposcopy scoring system viz. Reid’s and Swede scores, has been made in this study. The two screening methods were compared and their statistical association with histological findings were analyzed.Results: Per speculum examination performed in 250 sexually active women with suspicious looking cervix, belonging to 25-60 years of age, with most common presenting complaints of pain abdomen (38.8%) followed by leucorrhoea, irregular cycles and Post coital bleed. Unhealthy cervix (49.2%) and persistent discharge (28%) were the most common indications for colposcopy. An assessment of both SWEDE score and Reid score as a function of histological findings was done, while Swede score of >5 showed slightly more sensitivity (100%) for diagnosing CIN1+ lesions, Reids score of >5 was more specific (100%) with a higher positive predictive value (100%) for diagnosing  CIN 1, 2, 3 and invasive cervical carcinoma. There was a marked positive association between Reid score and SWEDE score.Conclusions: The colposcopic scoring systems and histopathology showed significant compliance. Predictive accuracy of colposcopy increased with increasing severity of disease.

scholarly journals A comparison of Tzanakis and Alvarado scoring system in the diagnosis of acute appendicitis

2019 ◽  
Vol 6 (6) ◽  
pp. 2080
Author(s):  
R. Anupriya ◽  
C. P. Ganesh Babu ◽  
K. V. Rajan
Keyword(s):  
Acute Appendicitis ◽  
Predictive Value ◽  
Scoring System ◽  
Histopathological Examination ◽  
Cross Sectional Study ◽  
Alvarado Score ◽  
Cross Sectional ◽  
Abdominal Emergency ◽  
Gandhi Medical College ◽  
Research Institute Hospital

Background: Appendicitis is the most common abdominal emergency worldwide. Lifetime risk of acute appendicitis is 8.6% and 6.7% for man and women respectively. Clinical examination is helpful in diagnosis of acute appendicitis in only 70-87% of the cases. To compare Tzanaki and Alvarado scoring system in diagnosing acute appendicitis.Methods: This was a prospective, comparative, cross-sectional study, which was conducted at the Mahatma Gandhi Medical College and Research Institute Hospital. Patients with acute appendicitis were included in the study. Relevant history, examination and laboratory investigations done. Patients were scored according to both Alvarado scoring system and Tzanakis scoring, and both were documented in the proforma. Sensitivity, specificity, positive predictive value, negative predictive value were assessed and compared for both scoring systems.Results: 70 patients were included in this study. 54.3% of patients have Tzanakis score more than 8. 35.7% of patients have Alvarado score more than 7. 82.9% of patients had evidence of appendicitis in histopathological examination. Tzanakis score: sensitivity– 65.52%, specificity- 100%, PPV–  100%, NPV– 37.50%, accuracy– 71.43%. Alvarado score: sensitivity– 36.21%, specificity– 66.67%, PPV- 84%, NPV– 17.78%, accuracy– 41.43%.Conclusions: Tzanakis scoring system is an effective scoring system in diagnosing acute appendicitis.

scholarly journals Correlation of CRP level with glycemic control in diabetic foot patients and its sequelae

2017 ◽  
Vol 4 (12) ◽  
pp. 4006
Author(s):  
Anand A. ◽  
Maragathamani .
Keyword(s):  
Blood Sugar ◽  
Diabetic Foot ◽  
Public Health Problem ◽  
Positive Association ◽  
Final Analysis ◽  
Lower Limbs ◽  
P Value ◽  
Major Public Health Problem ◽  
Cross Sectional ◽  
Study Population

Background:Diabetes mellitus is a major public health problem globally and in Indian population and diabetic foot is reported as the most common cause of non-traumatic amputation of the lower limbs in India. There is renewed interest in various inflammatory markers and their association with various chronic complications of diabetes mellitus. There is a scarcity of data on the subject in Indian population.Methods: The current study was a cross sectional study of 100 patients admitted to a Diabetic foot in Department of General Surgery, Stanley medical college and Hospital between January 2012-November 2012. The CRP level and fasting and plasma glucose levels were considered as the relevant variables for statistical analysis.Results:A total of 100 patients were included in the final analysis. The proportion of subjects with Wagners, grade 1, grade 2, 3, 4 and 5 ulcers were 48%, 27%, 16%, 3% and 6% respectively. Among the study population, 73% of patients had CRP value greater than 40 and 27% patients had CRP value less than 40. The proportion of subjects with Higher CRP level (>40) showed increasing trend with increasing level of fasting blood sugar and post prandial blood sugar in the study population. The proportion of people who underwent amputation was 27.5% in people with CRP value >40 and it was only 6.85% of people with CRP value <40, the association between CRP values and amputation was statistically significant. (P value 0.046).Conclusions:The study has established a strong positive association between poor blood sugar control and elevated CRP levels in the study population. The study has also documented a positive association between higher CRP levels and amputation.

scholarly journals A novel method of grading gastric intestinal metaplasia based on the combination of subtype and distribution

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ning Wei ◽  
Zhiheng Zhong ◽  
Ruihua Shi
Keyword(s):  
Intestinal Metaplasia ◽  
Roc Curve ◽  
Predictive Value ◽  
Scoring System ◽  
Benign Lesion ◽  
Gastric Antrum ◽  
Lesion Group ◽  
Type I ◽  
Cross Sectional ◽  
Gastric Intestinal Metaplasia

Abstract Background Studies have shown the value of subtypes and distribution of gastric intestinal metaplasia (GIM) for prediction of gastric cancer. We aim to combine GIM subtypes and distribution to form a new scoring system for GIM. Methods This was a cross-sectional study. No GIM, type I, II, and III GIM of gastric antrum and corpus scored 0–3 points respectively. Then the severity of the whole stomach was calculated in two ways: 1. The gastric antrum and corpus scores were added together, with a score ranging from 0 to 6, which named “Subtype Distribution Score of Gastric Intestinal Metaplasia (SDSGIM)”. 2. Direct classification according to a table corresponding to that of OLGIM. We compared the SDSGIM among benign lesions, dysplasia, and cancer and drew receiver operating characteristic (ROC) curve to determine the optimal cut-off value. According to the cut-off value and the classification from the table, the predictive ability of these two methods were calculated. Results 227 patients were included. For SDSGIM, benign lesion group was significantly different from dysplasia or cancer group. Area under curve of ROC curve was 0.889 ± 0.023. The optimal cut-off value was 3. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of SDSGIM for malignancy were 89.5%, 78.0%, 74.6%, 91.2% and 82.8%. And those for the second classification method were 84.2%, 82.6%, 77.7%, 87.9%, and 83.3% respectively. Conclusions This study firstly combined GIM subtypes with its distribution forming a novel scoring system, which showed high prediction accuracy for malignant lesions.

scholarly journals Comparison of Ranson’s and Glasgow criteria with revised Atlanta in prediction of mortality in acute pancreatitis patients

2019 ◽  
Vol 6 (5) ◽  
pp. 1629
Author(s):  
Deepa Nambi ◽  
Bhanumati Giridharan
Keyword(s):  
Acute Pancreatitis ◽  
Predictive Value ◽  
Scoring System ◽  
Surgical Intervention ◽  
Predictive Accuracy ◽  
Statistical Significance ◽  
P Value ◽  
Operating Characteristics ◽  
Icu Admission ◽  
Prediction Of Mortality

Background: To compare the performance of Ranson’s Score (RS) and Glasgow Score (GS) with Revised Atlanta Classification (RAC) in prediction of mortality, and to check their suitability to replace RAC for surgical intervention of gallstone induced acute pancreatitis (GAP).Methods: A hospital based prospective study was conducted between April 2014 and May 2017 with patients presenting with GAP. RS and GS was evaluated using data in first 24 hours and at 48 hours post admission. Patients were classified into mild, moderate and severe based on RAC at the time of hospital stay. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for each scoring system. Receiver Operating Characteristics (ROC) curves for mortality, ICU admission, Organ Failure (OF) and Gallstone Recurrence (GR) were plotted and predictive accuracy of each scoring system was measured by the Area under Curve (AUC). AUC values were compared for statistical significance using De Long test. A p-value of <0.05 was considered statistically significant.Results: Of 81 patients, 15 patients had OF and local complication classified as SAP, with persistent OF (16.0%). The AUC for RS was consistently the highest for predicting mortality (0.943), recurrence of gallstone (0.766), ICU-admission (0.801) and OF (0.852). RS had high specificity (61.9%), PPV (88.2%), Accuracy (90.1%) for predicting mortality, recurrence of gallstone and OF. Glasgow criteria had high sensitivity (85.1%), NPV (79.4) in predicting ICU-admission.Conclusions: RS in comparable with RAC in predicting mortality, GR in patients with GAP and early referral for surgical intervention.

scholarly journals Comparison of MR Hysterography and Sonohysterography in Women with Abnormal Uterine Bleeding: An Interventional Study

2021 ◽  
Author(s):  
Tsella Lachungpa ◽  
Radha Sarawagi ◽  
Sunitha Vellathussery Chakkalakkombil
Keyword(s):  
Cervical Carcinoma ◽  
Predictive Value ◽  
Endometrial Hyperplasia ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Reproductive Age ◽  
Public Health Issue ◽  
Diagnostic Modality ◽  
Cross Sectional ◽  
Endometrial Pathology

Introduction: Abnormal Uterine Bleeding (AUB) is very common and major public health issue. AUB along with its sub-group often affects 14.25% women of reproductive age and have major impact on their physical, social, emotional and material quality of life. It not only has direct impact on the woman and her family, but also on both economy and health services. Aim: To compare Magnetic Resonance (MR) hysterography and Sonohysterography (SSHG) for detection of uterine pathologies in women with AUB. Materials and Methods: An interventional cross-sectional study was conducted over a period from July 2019 to July 2020, among 30 patients with severe AUB. SSHG and MR hysterography were used to assess endometrial pathology, and endometrial pathology was assessed by both the diagnostic modality and considering histopathology as gold standard. We calculate sensitivity, specificity, positive predictive value and negative predictive value for both the diagnostic modalities. Results: Very good agreement was noted in case of the cervical carcinoma whilst fibroid and endometrial hyperplasia showed good and fair agreement respectively by both the diagnostic modality. Sensitivity of fibroid and cervical carcinoma was 100%, polyp was 33.33%, and endometrial hyperplasia was 87.50%. Whereas specificity of fibroid was 91.67%, endometrial hyperplasia was 86.30% and cervical carcinoma was 100%. Polyp and submucosal fibroid both showed 96.30% specificity. For pathology like cervical carcinoma, endometrial hyperplasia, fibroid had very high agreement with kappa value 1, 0.684 and 0.814 respectively, whereas agreement for two tests for pathology like submucous fibroid, dual pathology was less. Conclusion: MR Hysterography and Sonohysterography were having almost equal sensitivity and specificity for abnormal uterine bleeding and can be used as per patient preference, patient discomfort, and availability of investigation.

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

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.

scholarly journals Evaluation of Reid’s Combined Colposcopic Index as a predictor of cervical intraepithelial lesion

2018 ◽  
Vol 7 (9) ◽  
pp. 3724
Author(s):  
Indu Verma ◽  
Pratibha Pundhir ◽  
Tejinder Kaur ◽  
Veena Jain ◽  
Dinesh Sood
Keyword(s):  
Predictive Accuracy ◽  
False Negative ◽  
False Negative Rate ◽  
Invasive Disease ◽  
Cross Sectional Study ◽  
Histological Diagnosis ◽  
Screening Methods ◽  
Low Grade ◽  
Cross Sectional ◽  
Sensitivity Specificity

Background: Carcinoma cervix is the commonest cancer among women worldwide and in India it accounts for 80% of all genital cancers. Screening methods include cervical cytology, human papilloma virus testing and colposcopy. Objective of present study was to evaluate suspicious cervix colposcopically using Reids Colposcopic Index (RCI) and to correlate RCI with histopathological findings.Methods: This was a prospective cross sectional study done on 125 women with clinical diagnosis of suspicious cervix. Colposcopy was performed and grading of the disease was done according to RCI. Positive cases were subjected to cervical biopsy and endocervical curettage was performed in unsatisfactory colposcopy.Results: Colposcopy was done on 125 women with suspicious cervix. Out of 125, sixty two showed abnormal colposcopic findings which were graded according to RCI into Low grade disease predicting histological diagnosis of CIN1 in 47, Intermediate grade disease predicting histological diagnosis of CIN1/2 in 11 and High grade disease predicting histological diagnosis of CIN2/3 in 4 women. Colposcopy of one women suggested invasive carcinoma and was confirmed on histopathology to be microinvasive squamous cell carcinoma. Six women with unsatisfactory colposcopy showed benign histopathology. Sensitivity, specificity, predictive value and false negative rate of colposcopy for invasive disease was 50%, 100%, 100% and 1.60% respectively with 98.40% diagnostic accuracy. Colposcopic diagnosis of invasive disease and histopathology report showed 100% correlation.Conclusions: Correlation between RCI and histopathology was good. Predictive accuracy of colposcopy increased with increasing severity of disease.

scholarly journals Surgeon Performed Ultrasound in Assessing Thyroid Nodule Using American College of Radiology Tirads and Total Malignancy Score (TMS): A Validation Cross Sectional Study

2021 ◽  
Vol 20 (3) ◽  
Author(s):  
Adi Syazni Muhammed ◽  
Randeep Singh ◽  
Shahrun Niza Abdullah Suhaimi ◽  
Nani Harlina Muhammad Latar
Keyword(s):  
Diagnostic Accuracy ◽  
Thyroid Nodule ◽  
Predictive Value ◽  
Scoring System ◽  
Thyroid Nodules ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Diagnostic Reliability ◽  
Sensitivity Specificity

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.

scholarly journals Domestic injuries among geriatric population: a study in a rural community of Bankura district

2019 ◽  
Vol 6 (12) ◽  
pp. 5100
Author(s):  
Arindam De ◽  
Indu Padmey ◽  
Debakar Halder ◽  
Eashin Gazi ◽  
Aditya Prasad Sarkar ◽  
...  
Keyword(s):  
Random Sampling ◽  
Sampling Method ◽  
Longitudinal Design ◽  
Public Health Problem ◽  
Positive Association ◽  
Simple Random Sampling ◽  
Common Type ◽  
Cluster Sampling ◽  
Geriatric Population ◽  
Cross Sectional

Background: Domestic injury is an injury, which takes place in the home or in its immediate surroundings and more generally, all injury not connected with traffic, vehicles or sport. It is a worldwide public health problem. Geriatric population is more vulnerable to domestic injury. Objectives of this study are to estimate the incidence and to identify the correlates, if any, of domestic injuries among geriatric population and to study the consequences of domestic injuries among study subjects.Methods: Community-based descriptive study with longitudinal design. Multistage random sampling was adopted in the study. One block was selected by simple random sampling method then cluster sampling method (30/7) was used considering village as cluster. Three cross-sectional surveys were conducted in study subjects. Data was collected with the help of pre-designed, pre-tested, semi-structured schedule by paying house-to-house visits and review of records.Results: The subjects under study comprised of 210 elderly individuals, out of which 27 faced domestic injuries and three study subjects faced injury twice in study period. So, total number of injured was 30. Incidence rate was calculated to be 142.85 injuries per thousand persons per year. Fall was most common type of domestic injury. According to the consequence of injury, impairment was found in 13 cases out of them two injured cases were suffered from permanent disability.Conclusions: Incidence was estimated to be higher than what was found in other studies. Fall was the most common type of domestic injury. Marital status, use of central nervous system depressant drugs and co-morbidities were found to have positive association with injury. 

scholarly journals A study to compare RIPASA (Raja Isteri Pengiran Anak Saleha Appendicitis) and Alvarado scores in diagnosing acute appendicitis in Indian population

2018 ◽  
Vol 5 (5) ◽  
pp. 1826
Author(s):  
Dijo S. Joseph ◽  
Alfie J. Kavalakat ◽  
John M. Mandumpala ◽  
Suresh V. Mayyattil
Keyword(s):  
Acute Appendicitis ◽  
Predictive Value ◽  
Scoring System ◽  
Iliac Fossa ◽  
Asian Population ◽  
Scoring Systems ◽  
Alvarado Score ◽  
Cross Sectional ◽  
Study Results ◽  
Ripasa Score

Background: Acute appendicitis is one of the most common surgical emergencies. Various clinical scoring systems have been used for early diagnosis of acute appendicitis, of which Alvarado score is the most popular but it is found to be less accurate when applied to Asian population compared to RIPASA score. Radiological modalities such as computed tomography (CT) imaging may aid in making a definite diagnosis but will inflate the cost of treatment. This study aims to compare RIPASA and Alvarado scoring system in the diagnosis of acute appendicitis in our population.Methods: It was a comparative cross-sectional study done in 100 patients. RIPASA and Alvarado scores were applied to each patient. Our inclusion criteria were patients presenting with Right iliac fossa pain who subsequently underwent Appendicectomy in the same admission. Exclusion criteria included patients admitted under other specialties, those who underwent previous appendicectomy, elective appendicectomy and those not willing for the study.  Results: The sensitivity and specificity of RIPASA score was 95.12% and 66.67% and that of ALVARADO score was 64.63% and 77.78%. The positive predictive value (PPV) and negative predictive value (NPV) of RIPASA score was 92.86% and 75% and that of Alvarado score was 92.98% and 32.5%. The diagnostic accuracy of Alvarado and RIPASA scores were 67.0% and 90.0% respectively.Conclusions: RIPASA scoring system is more accurate and specific scoring system for our population than Alvarado in diagnosing acute appendicitis.

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