scholarly journals Modified triple assessment in the diagnosis of breast lump in Saurashtra region of Gujarat

2020 ◽  
Vol 7 (10) ◽  
pp. 3289
Author(s):  
Pradipkumar V. Solanki ◽  
Iliyas A. Juneja ◽  
Nileshbhai D. Chaudhari
Keyword(s):  
Clinical Examination ◽  
Diagnostic Tool ◽  
Predictive Value ◽  
Definitive Treatment ◽  
Diagnostic Tools ◽  
P Value ◽  
Radiological Imaging ◽  
Breast Lump ◽  
Triple Assessment ◽  
Breast Lumps

Background: Breast lump is a common complaint of women presenting to surgeons. Most of them are benign, careful evaluation, exact diagnosis and definitive treatment is mandatory to rule out cancer. The diagnosis of breast cancer is suggested on clinical examination. Currently a combination of three tests, i.e. clinical examination, radiological imaging (mammography, ultrasonography) and pathology called as triple assessment test is used to accurately diagnose all palpable breast lumps. Together they give sensitivity of 100%. The triple assessment is taken as positive if any of the three components, two are positive or positive report of FNAC and negative only if all of its components are negative for malignancy.Methods: This study was conducted in the Department of Surgery, P.D.U Medical College, Rajkot, Gujarat over a period of 2 years. A total of 100 patients with a breast lump were selected more than 15 years of age. A detailed history, focused clinical examination, radiological imaging and FNAC were used as diagnostic tools for screening of the patients. The aim of this study was to evaluate accuracy of modified triple assessment in the preoperative diagnosis of patients with breast carcinoma.Results: Results shows sensitivity and specificity of all the modalities used in triple assessment when combined together was 100% and 99.3%, respectively. Positive predictive value was 93.3%, negative predictive value was 100%, p-value was highly significant (p<0.0001). We conclude that modified triple assessment is a very useful diagnostic tool to evaluate patients with breast lumps and an overall accuracy of 98%.Conclusions: Thus, triple assessment is an easily available, cost effective, least invasive, rapid and patient compliant diagnostic tool for diagnosis of breast lump.

scholarly journals Clinical study of breast lump-triple assessment does help in diagnosing it better

2018 ◽  
Vol 5 (4) ◽  
pp. 1246
Author(s):  
Priti Prasad Shah ◽  
Shama Shaikh ◽  
Sunil Panchbhai ◽  
Bahul Vakhariya
Keyword(s):  
Clinical Study ◽  
Physical Examination ◽  
Clinical Examination ◽  
Early Stage ◽  
Prospective Clinical Study ◽  
Histopathological Diagnosis ◽  
Breast Lump ◽  
Triple Assessment ◽  
Breast Lumps ◽  
Mammographic Examination

Background: Breast cancer is most frequently diagnosed cancer among women and also most common cause of cancer death among women. Early stage detection is still low and is the major reason for poor treatment outcomes in our country. Most of the breast lumps are benign. However, it is important to rule out malignancy. This prospective clinical study is done to evaluate role of triple assessment (clinical examination, mammography and histopathology) in diagnosing breast lump.Methods: All women admitted with the symptoms and signs of breast lump at our hospital were studied in the period of 2 years from July 2014 to June 2016. The findings of physical examination and mammographic examination with histopathological diagnosis were noted n compared.Results: Physical examination of breast lumps is overall less accurate as compared to mammography. There is a tendency to over diagnose malignancy on physical examination. Mammography is more sensitive and specific in the diagnosis of palpable breast lumps as compared to physical examination. Histopathology confirms the diagnosis.Conclusions: It is better to do all three that is clinical examination, mammography and histopathology for all breast lumps diagnosis.

scholarly journals A CORRELATIVE STUDY OF FNAC AND RADIOLOGICAL IMAGING OF BONY LESION IN THE TERTIARY HEALTH CENTRE RIMS, RANCHI, JHARKHAND: A PROSPECTIVE STUDY

2019 ◽  
pp. 1-3
Author(s):  
Nisha Kumari ◽  
K. P Sinha ◽  
Amarnath Nayak
Keyword(s):  
Predictive Value ◽  
Health Centre ◽  
Needle Aspiration ◽  
Definitive Treatment ◽  
Cytological Diagnosis ◽  
Radiological Imaging ◽  
Female Ratio ◽  
Bony Lesions ◽  
Bony Lesion ◽  
Sensitivity Specificity

INTRODUCTION :. Nowadays; fine needle aspiration cytology (FNAC) is gaining increasing popularity in the diagnosis of bony lesions (1).In the majority of patients,the combined evaluation of clinical and radiologic data together with the FNAC result has been sufficient for making treatment decisions. Only in a minority of patients, it has been necessary to perform biopsy before definitive treatment (2, 3). Many specific bone tumors either benign or malignant can be diagnosed correctly by FNAC alone (4). AIM : To determine the correlation between different FNAC and Radiological Imaging of Bony lesion. MATERIAL AND METHODS: We have selected fifty cases that suspected to be bony lesion either clinically or radiologically.Prior doing FNAC,radiologic imaging done on these patients.Then FNAC was done in the Cytopathology section of department of Pathology,RIMS,Ranchi. RESULTS: Out of 50 cases cytological diagnosis made possible in 47 cases.Maximum no of cases 20 (40%) were in the age group 11-20 years. Male: female ratio of 1.6:1. Most common bone involved was tibia followed by femur. Osteoclastoma (46%) was the most common benign bony whereas Osteosarcoma (43%) was most malignant bone tumor followed by Ewing's sarcoma (36%). Out of 50 cases radiological diagnosis was available only in 40 cases. In 40 cases,23 cases (57.50%) have similar Cytological diagnosis as that of radiological diagnosis.The sensitivity,specificity, positive predictive value and negative predictive value were 80%, 88%, 86.9% and 81.4% respectively. The accuracy was 84%.

scholarly journals ROLE OF ULTRASOUND STRAIN ELASTOGRAPHY FOR THE EVALUATION OF BREAST LESIONS

2020 ◽  
pp. 4-6
Author(s):  
Deoyani S Sarjare ◽  
Arti Anand ◽  
Soumya Agrawal ◽  
Shanas K. P. ◽  
Sandhya Yeshwante
Keyword(s):  
Predictive Value ◽  
Breast Biopsy ◽  
Mammographic Screening ◽  
P Value ◽  
Breast Lesions ◽  
Chi Square ◽  
Cross Sectional ◽  
Strain Elastography ◽  
Malignant Breast ◽  
Breast Lumps

Introduction: Ultrasound (US) elastography is an emerging technique that can be used during breast US examination. Guidelines recommend mammographic screening and US for diagnosis of breast cancer. The specificity of these techniques is not high enough to prevent unnecessary biopsies. Hence there is need for a more specific technique to overcome this problem. This study aimed to evaluate the value of strain elastography (SE) for breast lesions. Materials and Methods: In this cross sectional observational study over 18 months, 60 women with palpable breast lumps were evaluated with conventional US and SE. Results obtained were correlated with histopathological findings for statistical analysis. Result: A statistically significant correlation was found between SE and histopathological outcome with a p value of 0.03(<0.05). The positive predictive value (PPV) was 76.92% and the negative predictive value (NPV) was 76.47% with Chi square= 8.4. Conclusion: Ultrasound with SE can substantially improve the possibility of differentiating benign from malignant breast lesions thereby limiting recourse to biopsy and considerably reducing the number of benign breast biopsy diagnoses.

scholarly journals Clinical Diagnosis of COVID-19: a Prompt, Feasible, Costless, and Highly Sensitive Diagnostic Tool for COVID-19 Based on a 1,757-Patient Cohort (The AndroCoV Clinical Scoring for COVID-19 Diagnosis).

2021 ◽  
Author(s):  
Flavio A. Cadegiani ◽  
Rute Alves Pereira ◽  
Ricardo Ariel Zimerman ◽  
Bruno Campello de Souza ◽  
John McCoy ◽  
...  
Keyword(s):  
Clinical Diagnosis ◽  
Diagnostic Tool ◽  
Predictive Value ◽  
False Negative ◽  
Herd Immunity ◽  
Positive Likelihood Ratio ◽  
Diagnostic Tools ◽  
Major Barrier ◽  
Household Contacts ◽  
Clinical Scoring

Abstract Importance: A major barrier for successful therapeutic approaches to COVID-19 is the inability during the viral replication stage, when drugs with potential antiviral activity could demonstrate efficacy and preclude progression to more severe stages. Reasons that hamper an earlier diagnosis of COVID-19 include the unspecific and mild symptoms during the first stage, the delay in the diagnosis and specific management caused by the requirement of a rtPCR-SARS-CoV-2 for the diagnosis of COVID-19, and the insufficient sensitivity of the a rtPCR-SARS-CoV-2, oppositely to what is recommended for a screening test during an outbreak. More sensitive and earlier diagnostic tools for COVID-19 should be unraveled as a key strategy for an breakthrough change in the disease course and response to specific therapies, particularly those that target the blockage of viral shedding. We aimed to create an accurate, sensitive, easy-to-perform and intuitive clinical scoring for the diagnosis of COVID-19 without the need of a rtPCR-SARS-CoV-2 (termed as The AndroCoV Clinical Scoring for COVID-19 Diagnosis), resulted from a 1,757 population cohort, eo eventually encourage the management of patients with high pre-clinical likelihood of presenting COVID-19, independent of a rtPCR-SARS-COV-2 test, to avoid delays and loss of appropriate timing for potential therapies.Materials and methods: This is a post-hoc analysis of clinical data prospectively collected of the Pre-AndroCoV and AndroCov Trials, that resulted in scorings for clinical diagnosis of COVID-19, based on the likelihood of presenting actual COVID-19 according to the number of symptoms, presence of anosmia, and known positive household contact. Sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and accuracy were calculated for subjects screened in two different periods and both periods together, for females, males and both, in a total of nine different scenarios, according to combinations between one, two, or three or more symptoms, or presence of anosmia in subjects without known positive household contacts, and no symptoms, one, two, or three or more symptoms, or presence of anosmia or ageusia in subjects with known positive household contacts. Scorings that yielded the highest pre-test probability, sensitivity and accuracy were selected.Results: Of the 1,757 patients screened, 1,284 were diagnosed for COVID-19. The scoring that required: 1. Two or more symptoms, or anosmia or ageusia alone, for subjects without known contact; or 2. One or more symptoms, including anosmia or ageusia alone, when with known positive contacts presented the highest accuracy (80.4%) among all combinations attempted, and higher sensitivity (85.7%) than rtPCRSARS-CoV-2 commercially available kit tests.Conclusion: The AndroCoV Clinical Scoring for COVID-19 Diagnosis demonstrated to be a feasible, easy, costless, and sensitive diagnostic tool for clinical diagnosis of COVID-19. Because clinical diagnosis of COVID-19 avoids delays in specific treatments, particularly for high-risk populations, prevents false-negative diagnosis, and reduces diagnostic costs, this diagnostic tool should be considered as an option for COVID-19 diagnosis, at least while SARS-CoV-2 is the prevailing circulating virus and vaccination rate is below the required for herd immunity.

scholarly journals Value of sonographic pseudogestational sac sign in the diagnosis of Meckel diverticulum in children presenting with bleeding per rectum: a 15-year prospective study

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Samar M. El-Maadawy ◽  
Nesreen Alaaeldin ◽  
Vassil N. Zefov
Keyword(s):  
Clinical Practice ◽  
Likelihood Ratio ◽  
Diagnostic Tool ◽  
Predictive Value ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
International Standards ◽  
Diagnostic Tools ◽  
Meckel Diverticulum ◽  
Bleeding Per Rectum

Abstract Background Meckel diverticulum is the most common congenital abnormality of the gastrointestinal tract. Gastrointestinal bleeding is the most common complication of Meckel diverticulum in the paediatric population; the bleeding mostly occurs in the first 2 years of life. Because the diverticulum is seldom seen in clinical practice, misdiagnosis and delayed diagnosis are not uncommon. CT and nuclear studies are the most used diagnostic tools in clinical practice. However, radiation and sensitivity concerns remain an issue. Ultrasound has been suggested as an alternative diagnostic tool in diagnosing Meckel diverticulum with mixed results. The aim of our study is to assess the value of using a new sonographic sign, the pseudogestational sac sign in diagnosing Meckel diverticulum in children presenting with bleeding per rectum. Ultrasound was performed for all children. Results were correlated with nuclear studies, histopathology and clinical follow-up findings. Results Seventy-three children were included in our study. The pseudogestational sac sign was present in 46 (63%) and absent in 27 (37%) cases. Forty-five children were ultimately diagnosed as Meckel diverticulum. The age ranged from 2 months to 9 years with a mean of 2.3 years. The boy-to-girl ratio was 4.6:1 with 60% of children presenting during their first 2 years of life. The ultrasound performance using the pseudogestational sac sign revealed a sensitivity of 91.1%, specificity of 82.1%, positive predictive value of 89.1%, negative predictive value of 85.2%, positive likelihood ratio of 5.1, negative likelihood ratio of 0.11 and accuracy of 87.7%. Conclusion The sonographic pseudogestational sac sign is a reliable diagnostic tool for diagnosing Meckel diverticulum in children presenting with bleeding per rectum. The sonographic diagnosis of Meckel diverticulum complies with the international standards of “Image Gently”.

scholarly journals Accuracy of Triple Test Score in The Diagnosis of Palpable Breast Lump

2008 ◽  
Vol 47 (172) ◽  
Author(s):  
Bikal Ghimire ◽  
MI Khan ◽  
T Bibhusal ◽  
Y Singh ◽  
P Sayami
Keyword(s):  
Diagnostic Test ◽  
Test Score ◽  
Needle Aspiration ◽  
Definitive Treatment ◽  
Breast Diseases ◽  
Clinical Tool ◽  
Breast Lump ◽  
Triple Test ◽  
Test Study ◽  
Breast Lumps

Breast lump is a very sensitive issue for the patient so a reliable, non invasive and prompt diagnosishelps to lessen the associated anxiety and leads to early definitive treatment. The aim of this studywas to evaluate the acuracy of Triple Test Score (TTS) as a clinical tool for the diagnosis of a palpablebreast lump. This diagnostic test study was carried out in the Department of Surgery of TribhuvanUniversity Teaching Hospital. Of the 117 patients admitted with breast diseases from the breastclinic over thirteen months, 87 had breast lump. Fifty patients underwent Triple Test Score ( physicalexamination, mammography and fine needle aspiration cytology) and were categorized into benign,suspicious and malignant. This was later correlated with the histopathological findings. Nineteenpatients with breast lumps interpreted by TTS as benign correlated with the histopathologicalfindings whereas of 31 malignant lumps, 30 turned out to be malignant and one benign. This givesTTS an over all accuracy of 98% with 100% sensitivity, 95.2% specificity and positive predictive valueof 96.7%. Carcinoma was seen in 29 (58%) cases in the age group of 35 to 70 years. The mean age atdiagnosis of benign and malignant disease was 41.8 and 45.1 years respectively. In conclusion, TTS isan accurate and least invasive diagnostic test based on which definitive treatment can be initiated.Key words : breast lump, carcinoma breast, triple test score

scholarly journals Validity of Barium Enema as Hirschsprung’s Disease Diagnostic Tools for Infant in Sanglah Hospital Denpasar

2021 ◽  
Vol 5 (1) ◽  
pp. 16
Author(s):  
I Made Darmajaya ◽  
I Ketut Subhawa
Keyword(s):  
Negative Predictive Value ◽  
Barium Enema ◽  
Diagnostic Tool ◽  
Predictive Value ◽  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Total Sample ◽  
Diagnostic Tools ◽  
Cross Tabulation ◽  
Sensitivity Specificity

Aim: To determine the validity (sensitivity, specificity, likelihood ratio) of barium enema as Hirschsprung's disease diagnostic tool in infants. Methods: This study was a diagnostic test of barium enema compared with postoperative histopathology examinations as the gold standard. The population were all patients with indigestion symptom be discovered at the pediatric surgical clinic of Sanglah Hospital Denpasar. The sampling method was consecutive sampling, satisfy inclusion criteria (< 12 months old, indicate classic symptoms of Hirschsprung’s disease). The total sample of the study was 52 patients. Sensitivity, specificity, positive and negative predictive value were analysed using cross-tabulation test of barium enema and postoperative histopathology. Results: A total of 52 patients were evaluated during the study period, mean of age was 3.31 months old, and boys:girls (75%:25%). Based on symptoms, 98.08% of patients were delayed release of meconium more than 24-48 hours and abdominal distention. Among all the patients reviewed, sensitivity, specificity, positive and negative predictive value of barium enema for diagnostic of Hirschsprung’s disease was 95.5%, 87.5%, 97.7%, and 77.8%. Conclusion: Barium enema can be used as an early diagnostic tool for infants suspected of Hirschsprung’s disease.

Comparison between sensitivity and specificity of thyroid elastography and fine needle aspiration cytology in differentiating the nature of thyroid nodules

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Khalid Esmat Allam ◽  
Sherihan Said Madkour ◽  
Noha Abdelrahman El-Ghitany
Keyword(s):  
Sensitivity And Specificity ◽  
Diagnostic Tool ◽  
Predictive Value ◽  
Thyroid Nodules ◽  
Ultrasound Elastography ◽  
P Value ◽  
Thyroid Malignancy ◽  
Aspiration Cytology ◽  
Predictive Values ◽  
Non Invasive

Abstract Background Nodular goiter is the most frequent disease of the thyroid gland, it may affect up to 50% of adults and elderly people, Although malignancy only occurs in about 5% of thyroid nodules, the detection rate of papillary thyroid carcinoma has increased consistently both in women and men and in all ethnic groups Thus, the task of differentiating malignant from benign nodules is necessary. Ultrasound elastography (USE) is a non-invasive, completely painless for the patient and can be easily performed even during routine ultrasound examinations. It assesses lesion stiffness by evaluating tissue distortion in response to stress. Objective Study the role of strain elastography in the characterization of benign and malignant nature of the thyroid nodule Compare the sensitivity and specificity of ultrasound elastography (USE) and fineneedle aspiration cytology (FNAC) as preoperative predictor of malignancy in order to decrease the need for FNAC. Cytology report is the gold standard/ histopathology report if available. Patients and Methods Type of Study: Cross-sectional study. Study Setting: The study was conducted at Ain Shams University Hospitals. Patients: 32 patients, 16 benign, and 16 malignant Patients with thyroid nodules proven by FNAC referred to Ain Shams University Radiology Unit. Results After analysis of strain index (SI) and the elasto score with FNAC we found the cut of point for thyroid malignancy was &gt;1.4 and &gt;2 respectively. The sensitivity and specificity of strain index (SI) for thyroid malignancy diagnosis were 100% and 75%, respectively. The positive and negative predictive values were 80% and 100%, respectively its p-value was 0.000, being a highly significant test.The US-elastography score’s sensitivity and specificity for thyroid malignancy diagnosis both were 81.25%. The positive and negative predictive values both were 81.2%, its pvalue was 0.000, being a highly significant test. After the Postoperative histopathology which is done to only ten patients of the 32 patients with available results (31.3%), 4 of them were benign (12.5%), and six were malignant (18.8%), We conclude that the Elasto ratio is the most sensitive diagnostic test with NPP (negative predictive value) of 100 % being the best screening test while the FNAC is the most specific test with PPV(positive predictive value) of 100 % being the best diagnostic test while the elasto score’s p-value was 0.065, being a a non-significant test. Despite this good diagnostic performance, USE with SI assessment not yet meets all requirements for an optimal diagnostic tool as its specificity is only 75%, while that of FNAC is almost reaching 100% compared to the postoperative histopathology Conclusion Strain elastography was highlighted as a good tool for pre-operative differentiation of benign from malignant lesions showing high sensitivity and moderate specificity compared to other studies, thus further decreasing thyroid biopsies and surgeries. The most reliable tool in our study was the elasto ratio having the highest sensitivity. Ultrasound examination in combination with elastography is a well-tolerated, non-invasive, and cost-effective diagnostic tool in the pre-operative assessment of thyroid nodules, which is able to enhance the accuracy of assessing the risk of malignancy in thyroid nodules and for selecting nodules for FNAC, thus can be used to postpone the FNAC to decrease the amount of the unnecessary FNAC.

Predictive Value of History and Clinical Examination in Diagnosing Female Stress Incontinence

1998 ◽  
Vol 65 (4) ◽  
pp. 522-525
Author(s):  
M. Moretti ◽  
A. Cichero ◽  
B. Malcangi ◽  
P. Pittaluga ◽  
M. Varaldo
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Clinical Examination ◽  
Predictive Value ◽  
Female Stress Urinary Incontinence ◽  
Diagnostic Tools ◽  
Specific Test ◽  
Female Stress Incontinence ◽  
Pad Test ◽  
Tip Test

History, clinical examination, imaging and urodynamics are useful steps in diagnosing female stress urinary incontinence; there is however no single specific test for grading and staging incontinence. We studied 75 patients with stress urinary incontinence to evaluate the predictive value of history and clinical examination in diagnosis, compared to imaging and urodynamics. We considered parity, concurrent pathologies and therapies or surgery, 24-hour PAD-test, Q-tip test and pubo-coccigeal test versus translabial introital ultrasonography and urodynamics. Patients were divided into one group with cysto-rectocele and another without prolapse; we found no meaningful correlations except for 7 patients with sphincter damage. In the other women, history and clinical examination may only be helpful to choose proper diagnostic tools.

scholarly journals TRIPLE ASSESSMENT

2012 ◽  
Vol 19 (05) ◽  
pp. 620-624
Author(s):  
MARYAM ISHRAT NIAZ ◽  
OMER FAROOQ ◽  
FARHAN HAIDER TIRMAZI
Keyword(s):  
Primary Treatment ◽  
Lymph Node Status ◽  
Age Group ◽  
Breast Lump ◽  
Breast Clinic ◽  
Lump Size ◽  
Presenting Symptoms ◽  
Triple Assessment ◽  
Malignant Breast ◽  
Breast Lumps

Objectives: To determine the efficacy of triple assessment in diagnosis of malignant breast lumps in female patients taking corebiopsy as a gold standard. Setting: Breast Clinic, Unit-III, Department of Surgery, Nishtar Hospital, Multan. Period: October 2007 to March2008. Material & Methods: A total 0f 100 patients of breast lump, above the age of 14 years, having palpable lump of any size in breast wereselected according to inclusion criteria. Results: Out of 100 patients included in the study most of the patients were in the age group 45-54years i.e. 46 (46%) followed by 32 (32%) in the age group 35-44 years. According to occupation 67 (67%) were house wives, 13 (13%) wereteachers and 5 (5%) were nurses. In 48 (48%) patients the lump size was 2 cm, 35 (35%) patients had lump size from, 2-4 cm while in 17 (17%)patients lump size was > 4 cm. Presenting symptoms like lump was present in 50 (50%) patients, pain alone 25(25%) patients, discharge in 20(20%) patients and discharge with pain in 5 (5%). Lymph node status like grade-0 was seen in 60 (60%) patients, grade-1 in 21 (21%) patients,grade-2 in 15 (15%) patients and grade-3 in 4 (4%) patients. Conclusions: Triple assessment is a valuable tool for an accurate non surgicaldiagnosis of breast lump, allows assessment of breast cancer patient for conservative and neo-adjuvant primary treatment before surgicaltreatment.

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