scholarly journals Validation of modified sick neonatal score, a simple clinical score for assessment of severity of illness and outcome in new-borns for resource poor settings

2021 ◽  
Vol 9 (1) ◽  
pp. 53
Author(s):  
N. Shivaramakrishna Babji ◽  
Cheruku Rajesh ◽  
Aparajitha Mekala ◽  
Bharathi Rani Siddani
Keyword(s):  
Disease Severity ◽  
Predictive Value ◽  
Scoring Systems ◽  
Cutoff Score ◽  
Axillary Temperature ◽  
Prognostic Information ◽  
College Hospital ◽  
Cross Sectional ◽  
Neonatal Disease ◽  
Resource Poor

Background: India contributes to 25% of the neonatal deaths worldwide each year. Neonatal disease severity scoring systems are needed to make standardized comparison between performances of different units and also give prognostic information. Existing scoring systems are unsuitable for resource-limited settings which lack investigations like pH, pO2/FiO2 ratio and base excess. Modified sick neonatal score (MSNS) is based on eight routinely measured clinical variables in NICUs namely respiratory effort, heart rate, axillary temperature, capillary refill time, random blood sugar, pulse oximeter saturation, gestational age and birth weight found to be useful in resource poor settings. The aim of the study was to validate MSNS score for its clinical utility in predicting mortality.Methods: This was a cross sectional study done at NICU of Mamata Medical College Hospital. The parameters required for the score were recorded immediately at admission in NICU from 1 January 2020 to 1 January 2021 and scored using Modified sick neonatal score (MSNS). The total score was calculated and outcome was noted. The data collected were coded and analzed using SPSS Statistics for Windows, v21.0 Chi square test, Mann-Whitney U test and ROC analysis.Results: Total of 355 neonates got discharged, while 45 neonates expired. For a cutoff score of ≤10, sensitivity and specificity were 85.9% and 51.1%, respectively. Positive predictive value and negative predictive value were 93.3% and 31.5%, respectively. The Area under the curve (AUC) was 0.811 (95%CI: 0.788-0.835), which indicates the accuracy of 81.1%.Conclusions: MSNS is a better suited neonatal disease severity score for resource poor settings.

scholarly journals Modified Sick Neonatal Score (MSNS): A Novel Neonatal Disease Severity Scoring System for Resource-Limited Settings

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
K. P. Mansoor ◽  
S. R. Ravikiran ◽  
Vaman Kulkarni ◽  
Kiran Baliga ◽  
Suchetha Rao ◽  
...  
Keyword(s):  
Disease Severity ◽  
Severity Score ◽  
Scoring Systems ◽  
Cutoff Score ◽  
Disease Severity Score ◽  
Resource Limited Settings ◽  
Convenience Sample ◽  
Severity Scoring ◽  
Neonatal Disease ◽  
Resource Limited

Neonatal disease severity scoring systems are needed to make standardized comparison between performances of different units and to give prognostic information to parents of individual babies admitted. Existing scoring systems are unsuitable for resource-limited settings which lack investigations like pH, pO2/FiO2 ratio, and base excess. This study was planned to evaluate Modified Sick Neonatal Score (MSNS), a novel neonatal disease severity score designed for resource-constrained settings. It was a facility-based cross-sectional analytical study, conducted in the “Special Newborn Care Unit” (SNCU) of government district hospital, attached to Kasturba Medical College, Mangalore, India from November 2016 to October 2017. A convenience sample of 585 neonates was included. Disease severity was assessed immediately at admission using MSNS. MSNS had 8 parameters with 0, 1, and 2 scores for each. 41% of study population was preterm (n=240), and 84.1% had birth weight less than 2500 grams (n=492). The mean (SD) of the total MSNS scores for neonates who expired and discharged was, respectively, 8.22 (2.96) and 13.4 (2.14), a difference being statistically significant at P<0.001. Expired newborns had statistically significant frequency of lower scores across each of the parameters. An optimum cutoff score of ≤10 with 80% sensitivity and 88.8% specificity in predicting mortality was obtained when the ROC curve was generated with the MSNS score as the test variable. Area under the curve was 0.913 (95% CI: 0.879–0.946). In conclusion, MSNS is a practicable disease severity score in resource-restricted settings like district SNCUs. It is for application in both term and preterm neonates. Total score ≤10 has a good sensitivity and specificity in predicting mortality of admitted neonates when used early during the course of hospitalization. MSNS could be used as a tool to compare performance of SNCUs and also enable early referral of individual cases to units with better facilities.

scholarly journals Validity of Immunochromatographic Test for Antibody in Diagnosis of Typhoid Fever in Children Admitted in A Tertiary Care Hospital

2018 ◽  
Vol 16 (2) ◽  
pp. 20-24
Author(s):  
Zabeen Choudhury ◽  
Mohammed Rezaul Karim ◽  
Rasheda Samad ◽  
Shanjana Islam
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Predictive Value ◽  
Tertiary Care ◽  
False Negative ◽  
Care Hospital ◽  
Immunochromatographic Test ◽  
True Negative ◽  
College Hospital ◽  
Cross Sectional

Background: To determine the Validity of Immunochromatographic Test (ICT) in diagnosis of typhoid fever in children admitted in a tertiary care hospital.Methods: This cross sectional study was carried out the in Pediatric & Medicine wards of Chittagong Medical College Hospital (CMCH), Chittagong during the period July 2012 to June 2013. A total number of 150 clinically suspected cases of typhoid fever (Age >6 months to18 years) were enrolled in this study. After taking informed written consent, detailed history & clinical examination were completed. A blood culture sample was taken on the day of admission before starting antibiotic. On the 5th day onwards of appearance of fever, blood sample was taken to perform ICT. Patients received standard medical treatment of the admitting wards.Results: Blood C/S for Salmonella typhi was found positive in 16(10.7%) cases. Positive ICT for typhoid fever was found in 37(24.7%) cases. Among then, IgM was 18(12.0%) IgM+IgG were 8(5.3%) and IgG was 11(7.3%). ICT found true positive in 14, false positive in 23, false negative in 2 and true negative in 111 cases, where blood culture considered as gold standard. The difference was statistically significant (p<0.05) between two groups. Immunochromatographic Test (ICT) showed sensitivity 87.5%, specificity 82.8%, accuracy 83.3%, positive predictive value 37.8% and negative predictive value 98.2% for identification of typhoid fever.Conclusion: The present study has shown high sensitivity & specificity of ICT, it can be used as a useful & prospectful diagnostic tool.Chatt Maa Shi Hosp Med Coll J; Vol.16 (2); July 2017; Page 20-24

A Comparison between the Diagnostic Accuracy of Alvarado and Tzanaki Scoring Systems in Acute Appendicitis

2021 ◽  
Vol 15 (12) ◽  
pp. 3175-3177
Author(s):  
Anum Iftikhar ◽  
Muhammad Arsalan ◽  
Sheeza Azaz ◽  
S H Waqar ◽  
Sajid Ali Shah ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Scoring Systems ◽  
Negative Appendectomy ◽  
Alvarado Score ◽  
Cross Sectional

Aim: To find out how accurate the Alvarado and Tzanaki scoring systems are in diagnosing acute appendicitis taking histopathology as gold standard. Methods: A cross-sectional prospective study was conducted from August 2019 to July 2020 at Department of General Surgery, Pakistan Institute of Medical Sciences Islamabad. Sixty patients were included, all of whom had appendectomies after a clinical diagnosis of acute appendicitis. Samples were submitted for histopathology, which was used as the gold standard for the definitive diagnosis of acute appendicitis. The specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy and negative appendectomy rate of Alvarado and Tzanaki scoring systems was calculated using SPSS version 23. Results: The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of Alvarado score at optimal cut-off threshold of ≥7.0, were calculated as 74%, 55%, 90%, 27% and 71.66% respectively. The cut-off threshold point of Tzanaki score was set at more than 8, which yielded a 94.11% sensitivity and an 88.88% specificity. The positive predictive value was 99.95% and the negative predictive value was 72.72%. The Alvarado and Tzanaki scoring systems had negative appendectomy rates of 9.5% and 2.04%, respectively. Conclusion: The Tzanaki scoring system has a better diagnostic accuracy for acute appendicitis as compared to the Alvarado score. Keywords: Acute appendicitis, Alvarado score, Tzanaki score

scholarly journals Comparison of transvaginal and transabdominal ultrasonography in the diagnosis of ectopic pregnancy

2014 ◽  
Vol 39 (3) ◽  
pp. 104-108 ◽  
Author(s):  
MN Nahar ◽  
MA Quddus ◽  
A Sattar ◽  
M Shirin ◽  
A Khatun ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Ectopic Pregnancy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Transvaginal Ultrasonography ◽  
Histopathological Diagnosis ◽  
College Hospital ◽  
Diagnostic Modality ◽  
Cross Sectional ◽  
Transabdominal Ultrasonography

This cross sectional study was carried out in the department of Radiology and Imaging, Dhaka Medical College Hospital from July 2008 to June 2010 to compare the accuracy of transvaginal ultrasonography and transabdominal ultrasonography in the diagnosis of clinically suspected cases of ectopic pregnancy. Initially 60 patients with clinical suspicion of ectopic pregnancy were included in this study after analyzing selection criteria 30 patients underwent both transvaginal and transabdominal ultrasonography. ‘Histopathological diagnosis’ was considered gold standard against which accuracies of two diagnostic modalities were compared. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of transabdominal ultrasonography as a diagnostic modality in evaluation of suspected ectopic pregnancy were 73.1%, 75%, 95%, 30% and 73.3% respectively where as transvaginal ultrasonography was found to have 92.3% sensitivity, 75% specificity, 96% positive predictive value, 60% negative predictive value and 90% accuracy. Transvaginal ultrasonography was superior to transabdominal ultrasonography in the evaluation of suspected ectopic pregnancies .so, transvaginal ultrasonography is important for early and accurate diagnosis of ectopic pregnancy. DOI: http://dx.doi.org/10.3329/bmrcb.v39i3.20309 Bangladesh Med Res Counc Bull 2013; 39: 104-108

scholarly journals Diagnostic and Prognostic Significance of CA 19-9 as Tumour Marker in Pancreatic, Hepatobiliary and Other Gastrointestinal Cancers

2021 ◽  
Author(s):  
Mitsu Vinay Vaishnav ◽  
Sameep Shyamlal Garg ◽  
Mayur Jitubhai Kokani
Keyword(s):  
Pancreatic Carcinoma ◽  
Predictive Value ◽  
Tertiary Care ◽  
Prognostic Significance ◽  
Tumour Marker ◽  
Enzyme Linked Immunosorbent Assay ◽  
Care Hospital ◽  
Prognostic Information ◽  
Cross Sectional

Introduction: The CA 19-9 antigen isolated by Koprowski and colleagues in 1979 is a lacto-N-fucopentaose II-like substance and one of the tumour-associated antigens present in serum in the mucin fraction. Close attention has been paid to the role CA 19-9 in the diagnosis of digestive tract tumours. In this study, serum analysis of CA 19-9 levels in 91 patients with gastrointestinal, hepatobiliary and pancreatic carcinoma was done. These data was used to evaluate the clinicians with adequate information on use of CA 19-9 as tumour marker- both diagnostic and prognostic. Aim: To study the role of tumour marker, CA 19-9 as a diagnostic and prognostic tool, and also to monitor the response of gastrointestinal, hepatobiliary and pancreatic cancer to treatment. Materials and Methods: This cross-sectional study was done on 91 cases of gastrointestinal, hepatobiliary and pancreatic carcinomas conducted in tertiary care hospital associated with medical college in Jamnagar, Gujarat, India were studied from September 2012 to March 2015 for two years and five months. The sample size was of 91 patients. Statistical method used was sensitivity, specificity, positive predictive value and negative predictive value. The material used was serum of the patient both pre as well as postoperatively and CalBiotech CA 19-9 Elisa Kit was used to determine the Value. The collected data were entered into Microsoft Excel spread sheet. The statistical methods used for variables were Mean and median along with Sensitivity and Specificity. Software used was “Epi Info”, version 7.0. Results: Total 91 cases of gastrointestinal, hepatobiliary and pancreatic carcinomas were studied. Enzyme Linked Immunosorbent Assay (ELISA) was used preoperatively and post operatively to determine the CA 19-9 values in patients of gastrointestinal, hepatobiliary and pancreatic carcinomas. It was found that CA 19-9 is an important tumour marker with sensitivity of 76.31% and specificity of 73.33% for diagnosis of the gastrointestinal, hepatobiliary and pancreatic carcinoma. When aided with Fine Needle Aspiration Cytology (FNAC) and histopathological findings it helps in giving a sure shot diagnosis. It also provides useful prognostic information for the same. Conclusion: This study helps to understand the role of CA 19-9 as diagnostic and prognostic marker for pancreatic, hepatobiliary and gastrointestinal carcinomas.

scholarly journals Performance of Distress Thermometer and Associated Factors of Psychological Distress among Chinese Cancer Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Sudip Thapa ◽  
Huihui Sun ◽  
Gaurab Pokhrel ◽  
Bangyan Wang ◽  
Sanuja Dahal ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Cancer Patients ◽  
Predictive Value ◽  
Clinical Utility ◽  
Depression Scale ◽  
Distress Thermometer ◽  
Cutoff Score ◽  
Characteristic Analysis ◽  
Cross Sectional ◽  
Factors Associated

Objective. We aimed to examine the performance of the distress thermometer (DT) and identify the prevalence and risk factors associated with psychological distress (PD) in heterogeneous cancer patients. Methods. This cross-sectional study enrolled 1496 heterogeneous cancer patients from the inpatient and outpatient departments. Receiver operating characteristic analysis (ROC) of DT was evaluated against the Hospital Anxiety and Depression Scale-Total (HADS-T ≥15). An area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and clinical utility index were calculated. Multiple binary logistic regression was used to identify the factors associated with PD. Results. Referring to ROC analysis, DT showed good discriminating accuracy (AUC = 0.88). A cutoff score of 4 was established, and it yielded sensitivity (0.81), specificity (0.88), PPV (0.87), NPV (0.82), and clinical utility indexes (screening utility = 0.71 and case-finding utility = 0.73). 46.5% of our participants was distressed. Lower education levels (odd ratio (OR) = 1.39), advanced stage (OR = 1.85), active disease status (OR = 1.82), lack of exercise (OR = 3.03), diagnosis known (OR = 0.64), emotional problems (OR = 3.54), and physical problems (OR = 8.62) were the predictive factors for PD. Conclusion. DT with a cutoff score (≥4) is a comprehensive, appropriate, and practical initial screener for PD in cancer patients. Predicting factors should be considered together for effective management of PD in such population.

Association between MRI parameters and the MS severity scale: a 12 year follow-up study

2009 ◽  
Vol 15 (5) ◽  
pp. 632-637 ◽  
Author(s):  
A Minneboo ◽  
BMJ Uitdehaag ◽  
P Jongen ◽  
H Vrenken ◽  
DL Knol ◽  
...  
Keyword(s):  
Disease Severity ◽  
Predictive Value ◽  
Brain Mri ◽  
Multiple Regression Model ◽  
Lesion Load ◽  
Term Outcome ◽  
Cross Sectional ◽  
Relapsing Remitting ◽  
Magnetic Resonance Imaging Mri

Background Several magnetic resonance imaging (MRI) parameters are known to be associated with short-term outcome in multiple sclerosis (MS) patients. MS-related disability typically progresses over decades, stressing the need for longer follow-up studies. Until now, these studies are relatively sparse and, therefore, the predictive value of MRI parameters for clinical disability remains largely unknown. Objective To assess the predictive value of brain MRI parameters, which are obtained during the first 3.3 years of the study for overall disease severity as measured by the MS Severity Score (MSSS) after 12.2 years follow-up. Methods Forty-six MS patients were included in the study. MRI parameters included both lesion loads and atrophy measures. Average and change parameters were calculated for MRI parameters and subsequently used as independent variables in regression models, while MSSS was the dependent variable. Results Follow-up (FU) was obtained in 43/46 patients (94%) and median expanded disability status scale (EDSS) score increased significantly from 2.5 to 4.0. At last FU median MSSS was 4.3 (range 2.2–6.9). In univariate analyses, both change and cross-sectional T1-hypointense lesion load and ventricular atrophy measures were associated with MSSS. A multiple regression model included the change parameter of hypointense T1-lesion load (BHLL). This model explained 20% of variance in MSSS, which increased to 34% when type of disease (relapsing remitting or secondary progressive), age, and sex were entered additionally. Conclusion MRI measures of axonal loss are associated with higher overall disease severity in MS patients.

scholarly journals An Experience of 436 COVID-19 Patients in Bangladesh

2021 ◽  
Vol 15 (2) ◽  
pp. 53-57
Author(s):  
MM Shahin Ul Islam ◽  
Syeda Nur E Jannat ◽  
Ahmed Sami Al Hasan ◽  
Mohammad Tanvir Ahmed Chowdhury ◽  
Mst Naznin Sarker ◽  
...  
Keyword(s):  
Disease Severity ◽  
Blood Group ◽  
Family Members ◽  
Nasopharyngeal Swab ◽  
College Hospital ◽  
Cross Sectional ◽  
Male Predominance ◽  
Presenting Symptoms ◽  
Source Of Infection ◽  
Disease Spectrum

SARS-CoV-2 corona virus infection (COVID-19) is a public health emergency of international concern causing many deaths. The aim of this study was to assess demography, clinical presentation, blood group, disease severity and outcome of COVID-19 infected patients in Bangladesh. This is a cross sectional, observational study of 436 COVID- 19 infected patients, confirmed by RT-PCR assay's on nasopharyngeal swab specimens, presented at Faridpur Medical College Hospital and Kurmitola General Hospital during the month of May to September, 2020. Data were collected in a preformed data sheet and analyzed for variables included demography, source of infection, spreading within family, clinical features, blood group, disease severity and outcome. Study showed mean age 41.27±16.65 years with slight male predominance (1.87:1), most were service holder (47%), source of infection was unknown (40%), from infected family members (35%) and working place (23%). In 44% cases, family members of infected index cases were unaffected. Common co-morbidities were Diabetes Mellitus (19.7%) and Hypertension (19%). Blood group of most (41.29%) was B positive. Disease spectrum ranged from asymptomatic (15%), mild (53%), moderate (19%) and severe (13%) disease. Common presenting symptoms were fever (72.2%), cough (42.9%) dyspnoea (29.6%), myalgia (22.9%), anorexia (17.9%), fatigue (17.4%), diarrhea (13.5%), headache (12.4%) and anosmia (12.4%). Majority (75.2%) had nonspecific (fever, mayalgia, fatigue) symptoms and in 16.28% cases it was the only presentation. Respiratory (61.9%) and GI (28.4%) symptoms presented either concomitantly or with nonspecific symptoms (55%). Majority (95%) of patients recovered and only 5% died. Faridpur Med. Coll. J. Jan 2020;15(2): 53-57

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