scholarly journals Cord blood bilirubin used as an early predictor of hyperbilirubinemia

2018 ◽  
Vol 5 (4) ◽  
pp. 1280
Author(s):  
Kannan Ramamoorthy ◽  
M. S. Abilash
Keyword(s):  
Positive Predictive Value ◽  
Cord Blood ◽  
Negative Predictive Value ◽  
Bilirubin Level ◽  
Predictive Value ◽  
Early Discharge ◽  
Neonatal Hyperbilirubinemia ◽  
Medical College ◽  
Discharge From Hospital ◽  
Early Predictor

Background: Neonatal hyperbilirubinemia is among the commonest symptoms found in neonates. The information about risk of high bilirubin in infants allows simpler methods for reduction of bilirubin to be implemented before hyperbilirubinemia becomes significant and could help to take a decision for early discharge from Hospital. Thus, the authors were aimed at the assessment of the usefulness of the cord blood bilirubin as an early predictor of neonatal hyperbilirubinemia and the usefulness of 1st day bilirubin in predicting the neonatal hyperbilirubinemia.Methods: The present study was planned to conduct in Department of Pediatrics, Government Thiruvarur Medical College and Hospital, Thiruvarur among neonates delivered from 1st August 2011 to 1st December 2013. These neonates were followed from birth to 2nd postnatal day. Cord blood was collected at birth and bilirubin estimation was done within 12 hours of collection of the blood.Results: Cord blood bilirubin level of ≥2.15 mg/dl has a sensitivity of 73.08% and specificity of 59.49%, positive predictive value 14.6% and negative predictive value of 95.88% in predicting the risk of neonatal hyperbilirubinemia. 1st day bilirubin level of ≥5 mg/dl has a sensitivity of 92.3% and specificity of 71.16% and positive predictive value of 23.3% and negative predictive value of 98.9% in predicting the risk of neonatal hyperbilirubinemia.Conclusions: The use of the critical cord bilirubin level of 2 mg/dl in all healthy term newborns will predict significant hyperbilirubinemia.

scholarly journals Utility of cord blood bilirubin as a predictors of significant neonatal Hyperbilirubinemia in healthy term neonate

2019 ◽  
Vol 6 (5) ◽  
pp. 2058
Author(s):  
Rajkumar M. Meshram ◽  
Saira Merchant ◽  
Swapnil D. Bhongade ◽  
Sartajbegam N. Pathan
Keyword(s):  
Positive Predictive Value ◽  
Cord Blood ◽  
Negative Predictive Value ◽  
Bilirubin Level ◽  
Predictive Value ◽  
Serum Bilirubin ◽  
Mode Of Delivery ◽  
Neonatal Hyperbilirubinemia ◽  
Term Neonates

Background: Clinical jaundice is evident in more than two-third neonates in their early neonatal life. Early identification of neonates at risk might allow early intervention and prevent complication. Objective of the study was to assess the cord blood bilirubin level as a tool to screen the risk of development of subsequent significant neonatal hyperbilirubinemia in term neonates.Methods: A prospective observational study was conducted over a period of 2 years on 1040 healthy term neonates. Demographic profile, relevant maternal and neonatal information were recorded. Measurement of cord blood bilirubin, blood group/Rh typing and serum bilirubin at the end of 24 & 72 hours was done to predict significant hyperbilirubinemia.Results: Incidence of significant hyperbilirubinemia was 11.53%. Gender, gestational age, mode of delivery and birth weight had no correlation with development of significant jaundice. 800 (76.93%) neonates had cord blood bilirubin level ≤3.0mg/dl and 240 (23.07%) neonate had cord blood bilirubin level >3.0mg/dl. Out of 240 (23.07%) neonates with higher cord bilirubin (>3.0 mg/dl), 108 (45%) had significant hyperbilirubinemia at the end of 24 hours with sensitivity 90.00%, specificity 85.65%, positive predictive value 45.00% and negative predictive value 98.50% while 110 (45.83%) neonates were observed with serum bilirubin >17mg/dl at the end of 72 hours with cord blood bilirubin >3mg/dl with sensitivity 91.67%, specificity 84.52% positive predictive value 45.83% and negative predictive value-98.61% and this difference was statistically significant.Conclusions: Neonates with cord blood bilirubin level ≤3mg/dl can be safely discharged early whereas neonates with bilirubin >3mg/dl will need close follow up to check for development of subsequent significant jaundice. Hence cord blood bilirubin levels help to determine and predict the possibility of significant jaundice among healthy term neonates.

scholarly journals Study of Correlation of Cord Blood Bilirubin with Neonatal Hyperbilirubinemia

2016 ◽  
Vol 3 (1) ◽  
pp. 60 ◽  
Author(s):  
Nilesh Ahire ◽  
Ravindra Sonawane ◽  
Rajendra Gaikwad ◽  
Suhas Patil ◽  
Tushar Sonawane
Keyword(s):  
Cord Blood ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Serum Bilirubin ◽  
Early Discharge ◽  
Neonatal Hyperbilirubinemia ◽  
Research Centre ◽  
Preterm Neonates ◽  
College Hospital ◽  
Term Newborns

<strong>Introduction</strong>: Neonatal Hyperbilirubinemia (NH) is a universal problem affecting nearly 60% of term and 80% of preterm neonates during first week of life. Early discharge of healthy term newborns is a common practice because of medical, social and economic constraints. Insignificant number (6.5%) of babies, NH is a cause for readmission. The present study was conducted to correlate the Cord Blood Bilirubin (CBB) level with subsequent NH. <strong>Methods:</strong> Study was performed at the Department of Pediatrics in a Medical College Hospital and Research Centre. Intramurally delivered, 113 Healthy full-term newborns during 1-year period were prospectively enrolled. CBB was estimated. Serum Bilirubin estimation was done at 48 hours and 5 day of age and later if required. <strong>Results:</strong> Significant NH in our study is 3.5%. Mean total bilirubin on second postnatal day was 10.58 mg/dl and on fifth post natal day was 10.81 mg/dl. Using CBB level of ≥3 mg/dl as a cut-off, NH can be predicted with sensitivity of 100%, specificity of 98.17%, positive predictive value of 66.67% and negative predictive value of 100%. <strong>Conclusion:</strong> A 100% Negative Predictive Value in the present study suggests that in Healthy Term babies (without RH and ABO incompatibility with Cord Blood Bilirubin ≤3mg/dl) cord serum bilirubin can help to identify those newborns who are unlikely to require further evaluation and intervention. These newborns can be discharged with assurance to Parents. Babies with CBB level ≥3mg/dl should be followed more frequently.

scholarly journals Comparison of RMI 3 and RMI 4 in pre-operative evaluation of ovarian masses

2019 ◽  
Vol 8 (9) ◽  
pp. 3602
Author(s):  
Badugu Rao Bahadur ◽  
Gangadhara Rao Koneru ◽  
Prabha Devi Kodey ◽  
Jyothi Melam
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Malignant Tumors ◽  
Clinical Approach ◽  
Ovarian Mass ◽  
Medical College ◽  
Operative Evaluation ◽  
Sensitivity Specificity ◽  
Final Confirmation

Background: To differentiate ovarian mass as benign or malignant could change clinical approach. Finding a screening and diagnostic method for ovarian cancer is challenging due to high mortality and insidious symptoms. Risk malignancy index (RMI) has the advantage of rapid and exact triage of patients with ovarian mass.Methods: Prospective study carried for 2 years at NRI Medical College and General Hospital, Chinakakani, Mangalagiri, Andhra Pradesh, India. 79 patients with ovarian mass were investigated and risk malignancy index (RMI-3 and RMI-4) calculated. Final confirmation was done based on histopathological report. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for RMI 3 and RMI 4 taking histopathology as control and comparison was done.Results: (n=79); 50 (63.29%) cases were benign and 29 (36.70%) were malignant based on histopathology. RMI 4 is more sensitive (68.96%) than RMI 3 (62.06%), but RMI 3 is more specific (94%) than RMI 4 (92%).The positive predictive value of RMI-3 and RMI-4 were 85.71%  and 83.33% respectively. The negative predictive value for RMI-4 and RMI-3 were 83.63% and 81.03% respectively.Conclusions: With increasing age, chance of malignancy increases. RMI 4 was more sensitive than RMI-3, however less specific than RMI 3 in differentiating benign and malignant tumors. The positive predictive value is slightly more for RMI 3, than RMI 4. Negative predictive value is slightly more for RMI 4, than RMI 3. 

scholarly journals A study of quantitative and qualitative analysis of standardized speech samples in persons suffering from dysarthria due to various neurological disorder

2020 ◽  
Vol 7 (10) ◽  
pp. 1527
Author(s):  
Somesh Maheshwari
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Normal Population ◽  
Software Tool ◽  
Cross Sectional ◽  
Medical College ◽  
Subject Variability ◽  
Ataxic Dysarthria ◽  
The Central Nervous System

Background: Dysarthria is manifested as a disorder of movement, it is important to recognize that sensori-motor integration (with tactile, proprioceptive, and auditory feed-back representing the crucial sensory components) is essential to speech motor control, from this standpoint, most or all dysarthria localized to the central nervous system should be thought of as sensori-motor rather than simply motor disturbances.Methods: This non-interventional, cross-sectional comparative, observational study, conducted in 100 study subjects (50 cases and 50 controls) from March 2016 to February 2017 at MGM medical college and MY hospital Indore, MP, India.Results: The mean age of normal population was 53 years and that of dysarthric population was 55 years. Among the dysarthric group, there were 10 cases of ataxic dysarthria, 23 cases of spastic dysarthria, and 9 cases of hypo kinetic dysarthria. There were 20 cases of mild dysarthria 19 cases of moderate dysarthria and 10 cases of severe dysarthria. In ataxic dysarthria, pitch break was found in 6 out of 10 subjects. It was found that there is negative predictive value 93.33%, and positive predictive value, 77.14% in spastic dysarthria and negative predictive value, 83.33% and positive predictive value, 90.90% in ataxic, whereas negative predictive value, 85.71% and positive predictive value, 95.34% in hypo kinetic dysarthria.  Conclusions: Different types of dysarthria when analyzed with software tool after extracting pitch and formants showed specific patterns. These patterns correlated with the clinical diagnosis. And Pattern recognition of different dysarthria will help to identify the types of dysarthria in scientific way and prevent inter-subject variability.

scholarly journals Accuracy of High Resolution Sonography in Diagnosis of Fibroadenosis Compared with Histopathological Diagnosis

2018 ◽  
Vol 8 (3) ◽  
pp. 139-142
Author(s):  
Mashah Binte Amin ◽  
Tarana Yasmin ◽  
Khaleda Parvin Rekha ◽  
Rushaida Haque Leeba ◽  
Nasima Akhter ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Linear Array ◽  
Histopathological Diagnosis ◽  
Fibrocystic Disease ◽  
Medical College ◽  
Breast Condition ◽  
Sensitivity Specificity ◽  
Test Result

Background: Fibrocystic breast condition is a common, non-cancerous condition that affects premenopausal woman between 20 and 50 years of age. Because of non-specific nature of clinical presentation, diagnosis is not that easy. Linear array sonography has been helpful for detection of mammary dysplasia.Objective: The purpose of this study was to determine the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of superficial sonography in the diagnosis of chronic cystic mastitis.Materials and Methods: This study was carried out in department of Radiology & Imaging of Enam Medical College and Hospital during June 2013 to October 2017. Sonography was done in 1350 women suspected of having fibrocystic disease. Among them FNAC was done only in 1020 cases. Ultrasonographic findings and histopathological reports were analyzed using SPSS 13.0.Results: According to our study the sensitivity of superficial sonography was 92.4%, specificity 88.8%, positive predictive value 93.8%, negative predictive value 86.4% and accuracy 91% in the diagnosis of fibrocystic changes.Conclusion: With the validity test result, it can be concluded that high frequency sonography provides an accurate diagnosis of fibroadenosis.J Enam Med Col 2018; 8(3): 139-143

scholarly journals Magnetic Resonance Imaging Evaluation of Spinal Tumors and Its Comparison with Histopathological Findings

2018 ◽  
Vol 26 (2) ◽  
pp. 162-166
Author(s):  
Gopal Chandra Saha ◽  
Prodip Kumar Biswas ◽  
Md Motlabur Rahman ◽  
Mohammed Shahadat Hossain ◽  
Mohammad Zaid Hossain ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Spinal Tumor ◽  
Spinal Tumour ◽  
Spinal Tumors ◽  
Histopathological Findings ◽  
Medical College ◽  
Diagnostic Usefulness ◽  
Sensitivity Specificity

Objective: The objective of the study was to assess the diagnostic usefulness of MRI in evaluation of spinal tumors.Methodology: This cross-sectional study was carried out in Dhaka Medical College Hospital, Dhaka. The data was collected from July 2011 to June 2013 and total 51 patients were included in the study. Data was collected from MRI diagnosed spinal tumors who attended at Radiology and Imaging department of DMCH from OPD and indoor patients. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of MRI for evaluation of spinal tumors were detected.Results: Out of 51 patients 26 (51%) was intradural extramedullary, 13 (25.5%) was extradural and 12 (23.5%) was intramedullary. Distribution of patients according to MR diagnosis. Among the 51 patients 40 were diagnosed spinal tumor and 11 were not spinal tumor by MRI. Among the 40 spinal tumuor diagnosed 12 (23.5%) were schwannoma, 02 (3.9%) were neuro fibroma, 11(21.6%) were meningioma, 07(13.7%) were ependymoma, 05(9.8%) were astrocytoma, 02(3.9%) were metastasis and 1 (2.0%) was osteoblastoma. Out of all cases 40 were diagnosed as spinal tumour by MRI and among them 39 were confirmed by histopathological evaluation. They were true positive. One case was diagnosed as having spinal tumour by MRI but not confirmed by histopathological findings. That was false positive. Out of 11 cases of non tumour which were confirmed by MRI, 3 were confirmed as spinal tumour and 8 were non-tumour by histopathological findings. They were false negative and true negative respectively. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the MRI in the diagnosis of spinal tumour were 92.86%, 88.89%, 97.50%, 72.73% and 92.15% respectively.Conclusion: The present study conducted to assess the diagnostic usefulness of MRI in evaluation of spinal tumors among the Bangladeshi population. Study revealed high sensitivity, specificity and accuracy of the MRI in the diagnosis of spinal tumour. MRI should be the initial procedure in the evaluation of suspected tumors of the spine.J Dhaka Medical College, Vol. 26, No.2, October, 2017, Page 162-166

scholarly journals Interleukin 21 as a diagnostic marker of rheumatoid arthritis.

2019 ◽  
Vol 26 (08) ◽  
pp. 1229-1232
Author(s):  
Khadija Kiran ◽  
Amtul Huda ◽  
Zuhair Bhatti
Keyword(s):  
Rheumatoid Arthritis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Diagnostic Marker ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Medical College ◽  
Sensitivity Specificity

To investigate the role of IL-21 as diagnostic marker in diagnosis of rheumatoid arthritis. Study Design: Cross sectional study. Setting: Department of Physiology and Orthopedic Gujranwala Medical College, Gujranwala. Period: October 2017 to October 2018 in one year duration. Materials and Methods: A total of 150 patients were included in the study, main variables assessed in this study were positive predictive value negative predictive value, sensitivity, specificity and accuracy of IL-21 in diagnosis of rheumatoid arthritis. SPSS version 23 was used to analyze the data. P value less than or equal to 0.05 was taken as significant. Study was started after permission from hospital ethical committee and patients were informed in detail about disease and procedure to be done. Non probability consecutive sampling was used. Results: The estimated sensitivity was 93.6%. The estimated specificity was 50%. Positive predictive value was 96.3% and negative predictive value was 35.7%. The overall accuracy was 90.6% for diagnosing rheumatoid arthritis. Conclusion: IL-21 induces MMP3 in rheumatoid arthritis patients, identification of IL-21 from synovium of patients indicates the presence of rheumatoid arthritis. We observed 90.6% diagnostic accuracy of IL-21 for rheumatoid patients taking RA factor as gold standard of diagnostic tool.

scholarly journals Role of laparoscopy in the Etiologic Diagnosis of Ascites of Unknown Origin

2017 ◽  
Vol 13 (1) ◽  
pp. 13-16
Author(s):  
Anup Sharma ◽  
P. Thapa ◽  
S. N. Gupta
Keyword(s):  
Positive Predictive Value ◽  
Peritoneal Carcinomatosis ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
College Teaching ◽  
Unknown Origin ◽  
Peritoneal Tuberculosis ◽  
Medical College ◽  
Etiologic Diagnosis

Introduction: Ascites is a consequence of many different etiologies, such as liver cirrhosis, neoplasm, tuberculous peritonitis, pyogenic peritonitis, congestive heart failure, renal and pancreatic diseases but, in some situations, ascites is of unknown cause in spite of comprehensive study. The aim of this study was to identify the role of laparoscopy in the etiological diagnosis of ascites of unknown origin.Methods: This was a prospective study of the patients who underwent diagnostic laparoscopy to determine the causes of ascites of unknown origin in the Department of Surgery, Nepalgunj Medical College Teaching Hospital from April 2012 to May 2014. All the patients underwent laparoscopy for the evaluation of ascites after appropriate clinical and laboratory examinations, which failed to reveal the cause.Results: Peritoneal tuberculosis and carcinomatosis peritonei were the two most common causes found in 37.14% and 57.14% of cases respectively. The average age of the patients was 52 years. Distension of abdomen, abdominal pain and weight loss were the most frequently observed symptoms in 33 patients (100%), 26 patients (74.28%) and 18 patients (51.42%) respectively. The CT scan findings, were a omental thickening in 28 cases (80%), peritoneal nodules in 7(20%) patients and the intraabdominal lymph nodes in 13 patients (39.39%). Ovarian mass was found in 4 patients (11.42%). The histological diagnosis was a peritoneal carcinomatosis in 13 (37.14%) patients and peritoneal tuberculosis in 20 (57.1%) patients and in two patients nonspecific inflammation. The sensitivity and specificity of laparoscopic diagnosis in the diagnosis of peritoneal tuberculosis were 78.67% and 98.6% respectively and in the diagnosis of peritoneal carcinomatosis were 94.78% and 72.2% respectively. The positive predictive value was 97.3% and the negative predictive value was 73.7% for peritoneal tuberculosis and for peritoneal carcinomatosis the positive predictive value was 83.7% and negative predictive value was 94.87%.Conclusion: The etiologic diagnosis of ascites of unknown origin is difficult despite the availability of several tests. Laparoscopy with peritoneal biopsy has still got a role in diagnosing these types of ascites where the other laboratory and imaging studies fail to reveal the cause.Journal of Nepalgunj Medical College Vol.13(1) 2015: 13-16

scholarly journals C-reactive protein, as a marker for predicting acute appendicitis and its severity in KVG medical college and hospital, Sullia

2021 ◽  
Vol 8 (10) ◽  
pp. 3002
Author(s):  
Abhirup H. Ramu ◽  
Priyanka Kenchetty ◽  
Aishwarya K. Chidananda
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
False Negative ◽  
Clinical Suspicion ◽  
C Reactive Protein ◽  
Common Procedure ◽  
Medical College ◽  
Reactive Protein

Background: Appendicectomy for suspected acute appendicitis is a common procedure. The rate of normal appendices unnecessarily removed remains high despite several techniques and investigations used to improve the diagnostic accuracy. This study emphasizes the value of C reactive protein (CRP) in three groups of patients operated for clinical suspicion of acute appendicitis with different finding at appendicectomy namely an un-inflamed appendix, uncomplicated acute appendicitis or complicated acute appendicitis.Methods: This prospective study was performed on 100 consecutive patients who were operated on for treatment of acute appendicitis in KVG medical college and hospital between 01 August 2019 to 01 February 2021. Clinically proven by a surgeon, patients underwent appendicectomy. Serum CRP results of all patients were determined. Sensitivity, specificity, positive predictive value and negative predictive value were calculated. Statistical analysis will be made using descriptive statistic and SPSS version 21 was used for analysis.Results: The percentage of negative laparotomies was 13% and surgeon ‘s clinical suspicion was true in 87%. Preoperative CRP values were false negative in 21 patients with appendicitis and false positive in 2 patients with normal appendix. The difference of true and false results between CRP tests and surgeon’s diagnosis was statistically significant (p=0.001). Present study revealed, sensitivity=76%, specificity=87.5%, positive predictive value=96% and negative predictive value=41%.Conclusions: Serum C reactive protein when elevated supports the surgeon’s clinical diagnosis of acute appendicitis. It can be used frequently to diagnosis the acute appendicitis, so that the complication rate and negative laparotomies can be avoided. 

scholarly journals Comparision of ultrasonographic diagnosis with ‘Tzanakis’ Score in acute appendicitis

2016 ◽  
Vol 19 (1) ◽  
pp. 9-12
Author(s):  
Ashish Prasad Rajbhandari ◽  
Nischal Dhakal ◽  
Robin Koirala ◽  
Manohar Lal Shrestha
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
College Teaching ◽  
Medical College ◽  
Ultrasonographic Diagnosis ◽  
Ultrasound Findings ◽  
Sensitivity Specificity ◽  
Better Than

Introduction: Acute appendicitis is one of the most common acute surgical abdominal conditions requiring surgery. Ever since the inflamed appendix was demonstrated in the 1980’s by Ultrasonography, it has been used as an aid to clinically diagnose acute appendicitis. Tzanakis scoring system is a combination of clinical examination, Ultrasonography and inflammatory markers. Methods: A retrospective non-randomized observational study was conducted from April 2014 to March 2015 on all cases of acute appendicitis, which underwent preoperative ultrasound before appendectomy (open/laparoscopic) at the Department of surgery, Nepal Medical College Teaching Hospital. Ultrasound findings and Tzanaki score were compared in the cases. No studies could be found in literature comparing ultrasound diagnosis with Tzanaki score in appendicitis. Results: The sensitivity, specificity, positive predictive value and negative predictive value of ultrasound were 73%, 50%, 95% and 12% respectively. The sensitivity, specificity, positive predictive value and negative predictive value of Tzanaki were 87%, 50%, 96% and 23% respectively. Tzanaki score is better than ultrasound alone as a diagnostic test for acute appendicitis. Conclusion: Tzanaki score is better than ultrasound in diagnosis of acute appendicitis.  

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