scholarly journals Evaluation of platelet count/spleen diameter ratio for detection of oesophageal varices in patients with cirrhosis of liver: a cross-sectional study

2021 ◽  
Author(s):  
Ashok Mysore Lakshminarayana ◽  
Shweta Mallikarjun Kumbar ◽  
Manohara Melur Chandregowda ◽  
Kiran Warrier
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Cross Sectional Study ◽  
Current Evidence ◽  
Oesophageal Varices ◽  
Sectional Study ◽  
Cross Sectional ◽  
Gastroesophageal Varices ◽  
Predictive Values ◽  
Sensitivity Specificity

Background: Gastroesophageal varices due to portal hypertension in patients with liver cirrhosis is an important cause of morbidity and mortality. Gold standard investigation for varices is esophagogastroduodenoscopy and patients are advised to undergo regular follow up based on the risk stratification. But the invasive nature, risk of procedure-related complication and lack of accessibility and affordability makes it important to identify simpler methods to screen patients. Platelet count/spleen diameter (PSD) ratio has been validated as a marker for oesophageal varices (OV) in multiple studies but with varying results. The present study was conducted to evaluate the accuracy of PSD ratio in OV.Methods: A cross-sectional study was conducted in patients diagnosed with liver cirrhosis. Clinical examination, relevant laboratory investigations, abdominal ultrasound and endoscopy were performed and data were recorded. PSD was calculated. Receiver-operator characteristics curves were plotted to determine cut-off values. Sensitivity, specificity, positive and negative predictive values were calculated.Results: Total 100 patients were included in this study, out of which 25% of patients did not have varices on endoscopy. The mean PSD was for patients without varices 1242.82 (253.45) and 883.51 (582.38467) for patients with OV. The area-under-curve was 0.823, 95% CI=0.734-0.912, p value=0.000001. The cut-off value for PSD was calculated from the ROC analysis was 1077. The sensitivity, specificity, positive and negative predictive values were 76%, 88%, 95% and 55% respectively.Conclusions: PSD ratio is not an efficient parameter for detection of varices in patients with liver cirrhosis. The current evidence does not support its role as a screening test for identification of patients with OV.

scholarly journals Serum Liver Fibrosis Markers for Predicting the Presence of Gastroesophageal Varices in Liver Cirrhosis: A Retrospective Cross-Sectional Study

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Xingshun Qi ◽  
Hongyu Li ◽  
Jiang Chen ◽  
Chunlian Xia ◽  
Ying Peng ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Liver Fibrosis ◽  
Cross Sectional Study ◽  
Upper Gastrointestinal Endoscopy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Gastroesophageal Varices ◽  
Predictive Values ◽  
Amino Terminal

Background and Aims. A retrospective cross-sectional study was conducted to evaluate the role of hyaluronic acid (HA), laminin (LN), amino-terminal propeptide of type III procollagen (PIIINP), and collagen IV (CIV) in predicting the presence of gastroesophageal varices (GEVs) in patients with liver cirrhosis.Methods. We enrolled 118 patients with liver cirrhosis who underwent the tests for the four serum liver fibrosis markers and upper gastrointestinal endoscopy at the same admissions. The predictive values of the four serum liver fibrosis markers were evaluated by the areas under the receiving operator characteristics curves (AUROCs) with 95% confidence intervals (CIs).Results. The prevalence of GEVs was 88% (104/118). The AUROCs for HA, LN, PIIINP, and CIV levels in predicting the presence of GEVs were 0.553 (95% CI: 0.458 to 0.644,P=0.5668), 0.490 (95% CI: 0.397 to 0.584,P=0.9065), 0.622 (95% CI: 0.528 to 0.710,P=0.1099), and 0.560 (95% CI: 0.466 to 0.652,P=0.4909). The PIIINP level at a cut-off value of 31.25 had a sensitivity of 73.1% and a specificity of 57.1%.Conclusions. The present study did not recommend HA, LN, PIIINP, and CIV levels to evaluate the presence of GEVs in liver cirrhosis.

scholarly journals Platelet Count/Spleen Diameter Ratio as a Predictor of Esophageal Varices in Patients with Liver Cirrhosis

2017 ◽  
Vol 15 (2) ◽  
pp. 37-40
Author(s):  
Dipendra Khadka ◽  
Sudhamshu KC ◽  
Sandip Khadka ◽  
Kiran Regmi ◽  
Pooja KC
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Esophageal Varices ◽  
Complete Blood Count ◽  
Liver Function Tests ◽  
Cross Sectional Study ◽  
Diameter Ratio ◽  
Cross Sectional ◽  
Predictive Values ◽  
Non Invasive

Introduction: Upper gastro-intestinal endoscopy still remains the gold standard for screening of patients suspected to have esophageal varices but not without limitations. So, this study was conducted to access the diagnostic validity and correlation between non-invasive parameters like platelet count, spleen diameter and their ratio with esophageal varices (EV) in patients with liver cirrhosis. Methods: A hospital based descriptive cross-sectional study was carried out in Liver unit of National Academy of Medical Sciences, Bir Hospital, from October 2016 to September 2017. Complete blood count, liver function tests, liver ultrasound and UGI endoscopy were done for all patients included in the study to detect esophageal varices and the platelet count/spleen diameter (PC/SD) ratio was calculated and analyzed to determine whether it can predict the presence of esophageal varices or not. Results: Total patients of liver cirrhosis studied after exclusion were 191 EV was present in 125 patients (65.4%). The platelet count/spleen diameter ratio using a cutoff value of ≤ 909 to detect EV independent of the grade had 93% sensitivity and 100% specificity and positive and negative predictive values of 100% and 91% respectively. Conclusions: PC/SD ratio now can be used as a predictor of presence of esophageal varices in liver cirrhosis.

scholarly journals Diagnostic Accuracy of Fine needle Aspiration Cytology of Thyroid Nodules at two tertiary Hospitals in Zambia: a cross-sectional study

2020 ◽  
Vol 4 (2) ◽  
pp. 6-13
Author(s):  
Jackson Chipaila ◽  
◽  
Alex Makupe ◽  
Evans Malyangu ◽  
Daniel Maswahu ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Needle Aspiration ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Aspiration Cytology ◽  
Cross Sectional ◽  
Predictive Values ◽  
Tertiary Hospitals ◽  
Needle Aspiration Cytology ◽  
Sensitivity Specificity

Introduction: Thyroid nodules are one of the common surgical presentations in Africa and are of great concern because of their potential to be malignant. Zambia is not excluded from these common surgical conditions. However, there are no pre-operative cellular or intra-operative tissue diagnoses of the thyroid nodules done before thyroidectomy making it difficult to plan for an optimal and definitive management. Fine needle aspiration cytology (FNAC) is known to play a pivotal role in the screening and management of thyroid swellings. This study serves to assess the diagnostic accuracy of FNAC on thyroid nodules in patients at two tertiary hospitals in Zambia in order to establish a basis for introducing its use in the management of thyroid nodules at the institutions. Objectives: To evaluate the accuracy of FNAC, as compared to histopathology, in the diagnosis of thyroid nodules at University Teaching Hospital (UTH) and Ndola Central Hospital (NCH) in Zambia. Methods: This was a prospective cross-sectional study conducted in UTH and NCH surgery department from June 2014 to March 2015. Seventy-three patients, who presented with palpable thyroid nodules and underwent thyroidectomy, were enrolled in the study. The FNAC diagnosis of the patients was compared to the histopathology finding following thyroidectomy. Results: Females made up the majority of the patients (n=67, 91.8%). The ages of the patients ranged from 18 to 78 years. The mean age was 44.3 years and the peak age of incidence was in the fourth decade. All patients were clinically euthyroid at the time of enrolment. The FNAC findings included 23 cases reported as unsatisfactory (31.5%); 29 cases benign (39.7%); 2 cases atypical (2.7%); 6 cases suspicious (8.2%); and 13 cases malignant (17.8%). Histopathology findings were available from all 73 tissue samples of participants, of which 55 (75.3%) and 18 (24.7%) were reported as benign and malignant respectively. Of the 18 malignant cases identified by histology, the most common cancer was follicular carcinoma (n=9, 50%), followed by papillary carcinoma (n=6, 33.3%) and undifferentiated carcinoma (n=3, 16.7%). FNAC, in this study, had sensitivity, specificity, negative and positive predictive values, and accuracy of 83.33%, 89.09%, 94.23 and 71.42%, and 87.67% respectively. Conclusion: In this study, FNAC of thyroid nodules had a high sensitivity, specificity, predictive values and accuracy, and can therefore be recommended to be adopted as a pre-operative tool for screening of thyroid nodules.

scholarly journals Reliability of Visual Assessment for Diagnosis of Neonatal Jaundice Among Neonates of Black Descent: A Cross-Sectional Study From Tanzania.

2021 ◽  
Author(s):  
Ikunda Dionis ◽  
Omary Chillo ◽  
George M Bwire ◽  
Manase Kilonzi ◽  
Calvin Ulomi ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Neonatal Jaundice ◽  
Visual Assessment ◽  
Cross Sectional Study ◽  
Total Serum ◽  
Sectional Study ◽  
Cross Sectional ◽  
Predictive Values ◽  
Independent Variables ◽  
Sensitivity Specificity

Abstract Background: Jaundice is common among neonates and if untreated can lead to kernicterus. Diagnosing of jaundice in neonates using Kramer’s method (visual assessment) is considered user friendly in resource limited areas. However, there are conflicting finding on reliability of the Kramer’s method in diagnosis of neonatal jaundice (NJ) particularly of black descent. Therefore, this study aimed to determine diagnostic accuracy of Kramer’s method in comparison with total serum bilirubin (TSB) test in diagnosis of NJ among neonates of black descent in Tanzania. Methods: A cross-sectional study was conducted between June and July 2020 at Muhimbili National Hospital (MNH) in Dar es Salaam Tanzania. A total of 315 neonates were recruited consecutively. In each neonates’ jaundice was assessed by using Kramer’s method and TSB test. A 2 X 2 table was created for determination of sensitivity, specificity, positive predictive values (PPV), negative predictive value (NPV), positive and negative likelihood ratios (+LR/-LR) and diagnostic accuracy (effectiveness). Cohen kappa (κ) was used to analyze the agreement between Kramer’s method and TSB. Association between independent variables and presence of jaundice were assessed using chi-square test and the p ˂ 0.05 was considered to be statistical significance. Results: The prevalence of NJ was 49.8% by Kramer’s method and 63.5% by TSB. The Sensitivity, Specificity, PPV, and NPV of the Kramer’s method were 70.5%, 86.1%, 88.8%, and 62.6%, respectively. The +LR and –LR were 5.07 and 0.34 respectively. The diagnostic accuracy of the Kramer’s method was 76.1%. There was a moderate agreement between Kramer’s method and TSB results (κ= 0.524, P˂0.001). No significance relationship between the independent variables and presence of NJ. Conclusion: Kramer’s method was found to be inefficient in detecting NJ among neonates of black descent. However, it can be used as a predictor of NJ and whenever available invasive techniques should be applied.

scholarly journals Validation of the ISAAC Standardized Questionnaire Used by Schoolchildren from Mexicali, Baja California, Mexico

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Karla Gorozave-Car ◽  
Albino Barraza-Villarreal ◽  
Consuelo Escamilla-Núñez ◽  
Leticia Hernandez-Cadena ◽  
Luz Helena Sanín-Aguirre ◽  
...  
Keyword(s):  
Gold Standard ◽  
Respiratory Symptoms ◽  
Allergic Diseases ◽  
Epidemiological Studies ◽  
Cross Sectional Study ◽  
Clinical Testing ◽  
Sectional Study ◽  
Cross Sectional ◽  
Predictive Values ◽  
Sensitivity Specificity

Background. In Mexico, several studies have been conducted under the ISAAC methodology; nevertheless, no validation studies of the ISAAC questionnaire based on objective clinical testing in our country have been published. Aims of the Study. To validate the ISAAC questionnaire, used in a study of prevalence of allergic diseases, based on medical, respiratory, and allergic evaluations of schoolchildren being 11 to 16 years old in Mexicali, Mexico. Material and Methods. We conducted a cross-sectional study to validate the ISAAC questionnaire through the generation of an index (considered as gold standard) using pre- and postbronchodilator spirometry test, exhaled nitric oxide measurements, and atopic evaluations. 114 schoolchildren were included (23 asthmatics with respiratory symptoms and 91 nonasthmatics without respiratory symptoms) and we evaluated the sensitivity, specificity, and positive and negative predictive value of the questionnaire using discriminant analysis. Results. We observed sensitivity of 35.2% and specificity of 93.3% and the positive and negative predictive values were 82.6% and 61.5%, respectively. Conclusions. Our findings indicate that the ISAAC Mexican version questionnaire was less sensitive and more specific when compared to the gold standard; however, it is adequate and able to discriminate children with and without asthma and a useful tool to use in epidemiological studies.

scholarly journals Comparative analysis of the long-term effect of two families of high-flux polysulfone dialysers on platelet count: a retrospective cross-sectional study

2017 ◽  
Vol Volume 13 ◽  
pp. 1415-1422 ◽  
Author(s):  
Rosaria Del Giorno ◽  
Lorenzo Berwert ◽  
Silvio Pianca ◽  
Giorgia Bianchi ◽  
Olivier Giannini ◽  
...  
Keyword(s):  
Platelet Count ◽  
Comparative Analysis ◽  
Cross Sectional Study ◽  
Term Effect ◽  
High Flux ◽  
Sectional Study ◽  
Cross Sectional ◽  
Long Term Effect

scholarly journals Liver ultrasound elastography for the evaluation of periportal fibrosis in schistosomiasis mansoni: A cross-sectional study

2018 ◽  
Author(s):  
Joelma Carvalho Santos ◽  
Andrea Dória Batista ◽  
Carla Maria Mola Vasconcelos ◽  
Roberto Souza Lemos ◽  
Valter Romão de Souza ◽  
...  
Keyword(s):  
Shear Wave ◽  
Shear Wave Elastography ◽  
Cross Sectional Study ◽  
Cutoff Point ◽  
Sectional Study ◽  
Cross Sectional ◽  
Predictive Values ◽  
Cutoff Value ◽  
Periportal Fibrosis ◽  
Schistosomiasis Mansoni

AbstractBackgroundARFI elastrography has been used as a noninvasive method to assess the severity of liver fibrosis in viral hepatitis, although with few studies in schistosomiasis mansoni. We aimed to evaluate the performance of point shear wave elastography (pSWE) for predicting significant periportal fibrosis (PPF) in schistosomotic patients and to determine its best cutoff point.Methodology/Principal findingsThis cross-sectional study included 358 adult schistosomotic patients subjected to US and pSWE on the right lobe. Two hundred two patients (62.0%) were women, with a median age of 54 (ranging 18-92) years. The pSWE measurements were compared to the US patterns of PPF, as gold standard, according to the Niamey classification. The performance of pSWE was calculated as the area under the ROC curve (AUC). Patients were further classified into two groups: 86 patients with mild PPF and 272 patients with significant PPF. The median pSWE of the significant fibrosis group was higher (1.40 m/s) than that of mild fibrosis group (1.14 m/s, p<0.001). AUC was 0.719 with ≤1.11 m/s as the best cutoff value for excluding significant PPF. Sensitivity and negative predictive values were 80.5% and 40.5%, respectively. Whereas, for confirming significant PPF, the best cutoff value was >1.39 m/s, with specificity of 86.1% and positive predictive value of 92.0%.Conclusions/SignificancepSWE was able to differentiate significant from mild PPF, with better performance to predict significant PPF.Author summaryIn the developing world, over 207 million people are infected with parasitic Schistosoma worms. Among the species of Schistosoma that infect humans Schistosoma mansoni is one of the most common causes of illness. Here, we investigated the performance of point shear wave elastography (pSWE) for predicting significant periportal fibrosis (PPF) in schistosomotic patients and to determine its best cutoff point. We examined 358 people from northeast of Brazil for Schistosoma infections. The present study showed that pSWE was able to differentiate significant from mild PPF, with better performance to predict significant PPF.

scholarly journals Platelet count can predict the grade of esophageal varices in cirrhotic patients: a cross-sectional study

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 101
Author(s):  
Anum Afsar ◽  
Muhammad Nadeem ◽  
Syed Asim Ali Shah ◽  
Huma Hussain ◽  
Aysha Rani ◽  
...  
Keyword(s):  
Platelet Count ◽  
Negative Correlation ◽  
Esophageal Varices ◽  
Significant Negative Correlation ◽  
Cross Sectional Study ◽  
Variceal Hemorrhage ◽  
Sectional Study ◽  
Cross Sectional ◽  
Grade Ii ◽  
Cirrhotic Patients

Background: Bleeding from esophageal varices is a life-threatening complication in cirrhosis. Screening endoscopy is recommended in cirrhotic patients to identify patients at risk of variceal hemorrhage, but this is an invasive procedure and has limitations. Therefore, thrombocytopenia has been proposed to predict the existence and grade of esophageal varices. The aim of the current study was to determine a correlation between platelet count and grades of esophageal varices in patients with liver cirrhosis. Methods: This cross-sectional study was conducted at the POF Hospital, Wah Cantt from 1st October, 2017 to 30th May, 2018. Newly diagnosed cases of cirrhosis having varices of any grade on endoscopy were included. Endoscopic findings of patients were standardized using Paquet grading system. On the basis of platelet count, patients were divided into four subgroups. Platelet count groups were correlated with grading of esophageal varices using Spearman rank correlations. Chi Square test was used to see association between the platelet count and grade of esophageal varices. Results: 110 patients were included in the study, 55.5% (n=61) were male. Mean age of the patients was 59.89±9.01 years. Platelet count was <50,000/uL in 35.5% patients, 50,000-99,000/uL in 26.4%, 100,000-150000 in 12.7%, and >150,000/uL in 25.5% patients. Grade I esophageal varices were found in 23.6% of patients, whereas grade II, III and IV were found in 24.5%, 33.6% and 18.2% of patients, respectively. Mean platelet count was 213884.62/mm3 in patients with grade I varices, whereas it was 119518.52/mm3, 58386.49/mm3 and 21600.00/mm3 in patients with grade II, III and IV varices, respectively (p=<0.0001). A significant negative correlation between platelet count and grades of esophageal varices was found (p<0.001). Conclusion: Platelet count can predict the grade of esophageal varices in cirrhotic patients. There is significant negative correlation between platelet count and grades of esophageal varices.

scholarly journals Comparison of Novel, Bach Mai Boston Tool (BBT) and the Patient-Generated Subjective Global Assessment (PG-SGA) for Oncology Inpatients

2019 ◽  
Vol 26 (1) ◽  
pp. 107327481986376 ◽  
Author(s):  
Binh Pham Van ◽  
Linh Nguyen Thuy ◽  
Hoa Nguyen Thi Thanh ◽  
Anh Nguyen Le Tuan ◽  
Phuong Duong Thi ◽  
...  
Keyword(s):  
Global Assessment ◽  
Cross Sectional Study ◽  
Subjective Global Assessment ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nutrition Screening ◽  
Kappa Value ◽  
Risk Patients ◽  
The Mean ◽  
Sensitivity Specificity

Oncology inpatients are at high risk of malnutrition. Identification of at risk patients by nutrition screening requires a practical and easy to use tool. The aim of this study was to determine the validity of the Bach Mai Boston Tool (BBT) compared to a ‘gold standard’ full nutrition assessment using the Patient-Generated Subjective Global Assessment (PG-SGA). A cross-sectional study was conducted on 270 oncology inpatients from January to December 2016. Cohen’s Kappa, sensitivity, specificity and ROC analyses were performed. 270 inpatients were included in this study with a mean age of 56.3 ± 12.1 years old. Of these patients, 51.8% were male, and 74.1% had gastrointestinal cancer. The mean body mass index of patients was 20.6 ± 3.0 kg/m2. The PG-SGA tool identified 146 (54.1%) malnourished patients, while the BBT identified 105 (39.9%) malnourished patients. The BBT had a medium consistency, with a Kappa value of 0.6. Using a cut-off point of ≥ 4, the BBT had a sensitivity of 87.7% and a specificity of 72.6%. On the other hand, a BBT with a cut-off point ≥ 5 resulted in a sensitivity of 67.1%, a specificity of 94.4%, and an AUC of 0.81. The BBT is a practical, informative and valid tool for detecting malnutrition in hospitalized oncology patients. We recommend using a cut-off point of 4 for screening the risk of malnutrition for oncology inpatients.

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