scholarly journals Overview of longstanding bronchial foreign bodies and role of virtual bronchoscopy

Author(s):  
Arun P. Ajith ◽  
Aishwarya Ullal ◽  
Sanjeev Mishra

<p><strong>Background:</strong> Virtual bronchoscopy (VB) is a software based, three-dimensional visualization format created from non-invasive medical imaging methods such as CT and magnetic resonance imaging, with the goal of creating views similar to minimally invasive bronchoscopy procedure. The aim of the study was to find the usefulness of VB in diagnosing vegetative and non-vegetative longstanding intra bronchial foreign bodies (FB).</p><p><strong>Methods</strong>: This was a retrospective and prospective cross-sectional study conducted in the department of otorhinolaryngology M. G. M. M. C and M. Y. hospital Indore for a period of 5 years. The medical records of patients with FB aspiration from august 2006 to September 2015 were reviewed. Data was collected regarding their clinical presentation examination and chest x-ray findings. Patients with suspected FB aspiration were subjected to VB and rigid bronchoscopy was performed.<strong></strong></p><p><strong>Results: </strong>In the subjects, we observed that chest radiograph were normal in as many as 40% cases. Hence negative chest radiographs do not rule out FB.  In 48 patients with FB aspiration, which was detected by VB, 46 patients were diagnosed to have FB on rigid bronchoscopy. This amounts to a positive predictive value of 98%, which was similar to the gold standard, which is rigid bronchoscopy which had a positive predictive value of 99%.</p><p><strong>Conclusions: </strong>VB is the only imaging modality which gives 99.9% reassurance about the presence or absence of a FB, because of its high sensitivity and specificity, hence proves to be a lifesaving tool.</p>

2021 ◽  
pp. 173-177
Author(s):  
Shivprasad Jaybhay ◽  
Madhuri Misal

Purpose: Patients with recurrent shoulder instability often present with osseous injury to the glenoid and humeral head. Glenoid bone loss can easily be quantied on a three-dimensional computed tomography scan by modeling the inferior portion of the glenoid contour as a true circle on an en face view. This study investigated the accuracy of CT in determining the presence and severity of glenoid bone loss in patients with unilateral recurrent shoulder dislocation. Methodology: This prospective cross-sectional study was done among patients with unilateral recurrent shoulder dislocation. Forty patients with anterior shoulder dislocation underwent shoulder CT examination before arthroscopy. Results: Glenoid bone loss was evident in 38 (95%) of the 40 patients at arthroscopy. Compared with arthroscopy, CT had sensitivity in detecting glenoid bone loss of 92.1%; specicity, 100%; positive predictive value, 100%; and negative predictive value, 40.0%. Three false-negative CT assessments had 5%, 5%, and 20% glenoid bone loss, respectively, at arthroscopy. There was a strong correlation between CT and arthroscopy with respect to the severity of glenoid bone loss (r = 0.73). Conclusion: CT has both a high sensitivity and a high specicity for detecting glenoid bone loss, and agreement with arthroscopy regarding the severity of glenoid bone loss is good. CT can be used to assess glenoid bone loss and the need for bone augmentation surgery.


2021 ◽  
Vol 8 (10) ◽  
pp. 1494
Author(s):  
Nyamnyei Konyak ◽  
Linda Marangmei ◽  
Medo M. Kuotsu ◽  
Laishram Chittaranjan Singh ◽  
L. Shaini Devi ◽  
...  

Background: The overlap of clinical presentation between sepsis and SIRS has presented diagnostic difficulty in these two close common scenarios. Blood culture remains the gold standard for detection of specific micro-organism, the non-availability of culture report early and difficulty in culture of many organisms is a challenge in differentiation of sepsis from its mimickers. Keeping this background, a simple tool is needed to guide sepsis management while awaiting the culture report. Therefore, the present study is conducted to determine the procalcitonin level in the setting suspicious of sepsis and to differentiate it from SIRS. The objective of the study was to determine Serum procalcitonin level as a biomarker of early diagnosis of sepsis and also to differentiate sepsis from severe inflammatory response syndrome.Methods: Cross sectional study on 79 patients aged above 18 years with suspected sepsis admitted in medicine ward. Serum procalcitonin levels were measured and analysed to look for any association with sepsis.Results: Culture was positive in 41 patients and 38 patients were procalcitonin positive. The sensitivity, specificity, positive predictive value and negative predictive values of serum procalcitonin were found as 96.68%, 94.74%, 95% and 92.30% respectively.Conclusions: There was a significant association between serum procalcitonin and culture positivity. Procalcitonin levels was found to have high sensitivity and high positive predictive value which may aid in the early diagnosis and guide initiation of anti-microbial therapy in sepsis.


2012 ◽  
Vol 20 (01) ◽  
pp. 132-138
Author(s):  
MUHAMMAD ATIF ◽  
MUHAMMAD ABDULLAH ◽  
MUHAMMAD JAVAD YOUSAF ◽  
Khalid Buland

Objective: To compare the accuracy of Upper lip bite test with modified Mallampati classification for predicting the difficultlaryngoscopic intubation. Study Design: Cross sectional Study. Place and duration of study: The study was carried out at Department ofAnaesthesiology, Intensive Care and Pain management, Combined Military hospital, Rawalpindi from September 2008 to August 2009.Patients and Methods: Four hundred patients undergoing elective surgery meeting the inclusion/exclusion criteria were enrolled afterwritten informed consent. The airways of the patients were evaluated by using the modified Mallampati classification (MMP) and theUpper lip bite test (ULBT). MMP class 3 or 4 and ULBT class 3 were considered as indicators of difficult intubation. The laryngeal view wasgraded by Cormack and Lehane classification (Gold standard). Grade 1 or 2 was considered to represent easy intubation and grade 3 or 4to represent difficult intubation. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy werecalculated for both the tests separately by using the 2×2 table. Results: ULBT had a higher accuracy of 94%, specificity of 99.2% andpositive predictive value 70% compared to MMP accuracy of 82.7%, specificity of 84.4% and positive predictive value of 22.7%.Conclusions: The diagnostic accuracy of the Upper lip bite test was more than the modified Mallampati classification. We suggest that itbe compared with the other prevailing tests as well which are often used to assess difficult intubations.


2021 ◽  
Vol 24 (2) ◽  
pp. 196-203
Author(s):  
Elahe Fini ◽  
◽  
Neda Nasirian ◽  
Bahram Hosein Beigy ◽  
◽  
...  

Background and Aim: Ovarian cancer is among the most common cancers in women worldwide. CA125 is the most frequent biomarker used in the screening for ovarian cancer. CA125 has no high sensitivity and specificity as a screening test in the medical community; however, because of being simple and noninvasive, it is almost always requested for evaluation and ruling out cancer. It plays an important role in the treatment and post-treatment process, the prediction of prognosis, and the relapse of the disease. The present study aimed to determine the relationship between a high level of CA125 tumor marker and ovarian cancer by detecting spesivity, sensivity, positive and negative predictive values. Methods & Materials: In this cross-sectional study, all cases undergoing CA125 test in Velayat Hospital in 2017-1028 were evaluated for having ovarian cancer. In addition, the CA125 level was compared between healthy individuals and patients with ovarian cancer. Finally, the obtained data were analyzed using SPSS. Ethical Considerations: The present study was approved by the Qazvin University of Medical Sciences (Ethics Code: IR.QUMS.REC.1396.316). Results: In this study, 35.3% of the study participants received a definite diagnosis of ovarian cancer. Generally, CA125 values were negative in 41.8% and positive in.58.2% of the study subjects. The sensitivity of the test was measured as 80.1%, the specivity as 53.6%, the positive predictive value equaled 48.4%, and the negative predictive value was measured as 83%. There was a significant relationship between age and the presence of ovarian cancer, and serum CA125 levels. Conclusion: The present study suggested that age and the serum level of CA125 were statistically significant. Finally, CA125 levels were significantly related to ovarian cancer. It provided moderate specivity and specivity as well as low positive predictive value and high negative predictive value as a tumor marker; it is valuable for ruling out of tumor but not appropriate as a screening test.


2021 ◽  
Vol 71 (11) ◽  
pp. 2559-2562
Author(s):  
Saadia Perwaiz ◽  
Muhammad Waqar Afzal ◽  
Ghulam Fatima

Objective: To compare accuracy of manual muscle testing in detection of strength differences across grade 4 and 5 at different percentage deficits of dynamometric mean in shoulder flexors of young females.  Methods: Cross sectional research design, conducting primary analysis of strength of shoulder flexors measured through manual muscle testing and hand-held dynamometer. Three hundred young healthy females without any ailment of upper extremity or generalized health problem were selected from University of South Asia and Association of Fatima Jinnah Old Graduates, Lahore. Non-probability convenient sampling technique was used. The age group selected was 18-39 years. The strength of shoulder flexors measured through manual muscle testing and hand-held dynamometer was main outcome measure. Results: The overall diagnostic accuracy of manual muscle testing showed better results at 10% dynamometric measures. It was 63.33%(95% CI: 57.74%, 68.59%) in non-dominant shoulder flexors and 61.67% (95% CI: 56.05%, 66.99%) in dominant shoulder flexors. The positive predictive value (PPV) and specificity of manual muscle testing was better at 10% strength deficit in comparison with dynamometric measures, whereas negative predictive value (NPV) and sensitivity was better at 20% strength deficit. Contrasting association was found between positive predictive value (PPV) and sensitivity, negative predictive value and specificity.  Conclusion: The subjective area of grade 4 and 5 showed better, although not ideal, diagnostic worth at 10% deficit of dynamometric measures in shoulder flexors. Further exploration through study of contrasting trends between PPV and sensitivity by subgroup analysis is required. Continuous...


1997 ◽  
Vol 9 (1) ◽  
pp. 38-41
Author(s):  
Nugroho Abikusno ◽  
Rachel Novotny

This cross-sectional study was done in July 1990 at health posts of two subdistricts in Cilandak, South Jakarta, Indonesia. The purpose of this study was to assess the sensitivity and specificity of maternal anthropometric measures against the functional outcome of infant nutritional status (weight-for-age). The study population consisted of 175 mother-infant pairs, who were between 14-45 years old, and their infants, who were 0-6 months old. The indicators that identified women at risk of their infant being poor nutritional status (weight-for-age less than −1 SD) were maternal weight (sensitivity 33%, specificity 89%, and positive predictive value 26%), height (sensitivity 39%, specificity 83% and positive predictive value 21%), and calf circumference (sensitivity 50%, specificity 85% and positive predictive value 28%).


2014 ◽  
Vol 128 (12) ◽  
pp. 1078-1083 ◽  
Author(s):  
G Behera ◽  
N Tripathy ◽  
Y K Maru ◽  
R K Mundra ◽  
Y Gupta ◽  
...  

AbstractObjectives:Multidetector computed tomography virtual bronchoscopy is a non-invasive diagnostic tool which provides a three-dimensional view of the tracheobronchial airway. This study aimed to evaluate the usefulness of virtual bronchoscopy in cases of vegetable foreign body aspiration in children.Methods:The medical records of patients with a history of foreign body aspiration from August 2006 to August 2010 were reviewed. Data were collected regarding their clinical presentation and chest X-ray, virtual bronchoscopy and rigid bronchoscopy findings. Cases of metallic and other non-vegetable foreign bodies were excluded from the analysis. Patients with multidetector computed tomography virtual bronchoscopy showing features of vegetable foreign body were included in the analysis. For each patient, virtual bronchoscopy findings were reviewed and compared with those of rigid bronchoscopy.Results:A total of 60 patients; all children ranging from 1 month to 8 years of age, were included. The mean age at presentation was 2.01 years. Rigid bronchoscopy confirmed the results of multidetector computed tomography virtual bronchoscopy (i.e. presence of foreign body, site of lodgement, and size and shape) in 59 patients. In the remaining case, a vegetable foreign body identified by virtual bronchoscopy was revealed by rigid bronchoscopy to be a thick mucus plug. Thus, the positive predictive value of virtual bronchoscopy was 98.3 per cent.Conclusion:Multidetector computed tomography virtual bronchoscopy is a sensitive and specific diagnostic tool for identifying radiolucent vegetable foreign bodies in the tracheobronchial tree. It can also provide a useful pre-operative road map for rigid bronchoscopy. Patients suspected of having an airway foreign body or chronic unexplained respiratory symptoms should undergo multidetector computed tomography virtual bronchoscopy to rule out a vegetable foreign body in the tracheobronchial tree and avoid general anaesthesia and invasive rigid bronchoscopy.


2019 ◽  
Vol 26 (08) ◽  
pp. 1229-1232
Author(s):  
Khadija Kiran ◽  
Amtul Huda ◽  
Zuhair Bhatti

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.


Author(s):  
G Sindhujha Sekar ◽  
A Esther Ruby ◽  
P Lalitha

Introduction: In perimenopausal age group particularly, 70% of all gynaecological consultations are for Abnormal Uterine Bleeding (AUB). About 30% of women seek medical assistance for AUB during their reproductive age group and about one third of hysterectomies are carried out for AUB alone. Aim: To determine the sensitivity, specificity, positive predictive value and negative predictive value of Transvaginal Ultrasonography (TVS) versus hysteroscopy in detecting uterine abnormalities Materials and Methods: A cross-sectional study in patients with AUB, admitted to the Department of Obstetrics and Gynaecology at RGGWCH, Puducherry between February 2016 and February 2017 who met the inclusion criteria were included. Sample size was 85 cases. After taking detailed history and physical examination the patient was investigated to rule out organic causes of AUB and then TVS and hysteroscopy were done. Any intrauterine pathology was looked for and endometrial sampling was taken from the abnormal sites for Histopathological Examination (HPE). Both TVS and hysteroscopy results were compared with histopathology which is the gold standard. Results: The sensitivity of TVS in diagnosis of uterine fibroid in comparison to hysteroscopy was 94.74% and the specificity was 71.21%. The sensitivity of hysteroscopy in diagnosis of endometrial hyperplasia in comparison to HPE was 75% and the specificity was 87.01%. The sensitivity of TVS in diagnosis of endometrial hyperplasia in comparison to HPE was 37.5% and the specificity was 90.91%. The sensitivity of hysteroscopy in diagnosis of polyp in comparison to HPE was 100% and the specificity was 97.3%. The sensitivity and specificity of TVS in diagnosis of polyp in comparison to HPE were 9.09% and 93.24%, respectively. Conclusion: TVS had a high sensitivity to detect fibroids but its value in detecting hyperplasia and polyps was in question in this study. But hysteroscopy had a maximum sensitivity to detect polyps and high sensitivity to detect endometrial hyperplasia compared to histopathology which is a gold standard investigation.


2019 ◽  
Vol 6 (6) ◽  
pp. 2593
Author(s):  
Nayantara R. Gandra ◽  
Kalavathy Jasmine Masillamoni

Background: Even though there are many programs run by Government to tackle the problem of malnutrition in India, problem of malnutrition is still there. Malnutrition leads to infections and even can lead to death of child in severe cases. The mortality rate is very high compared to other countries. The objective of the study to study validity of age independent various nutritional status indices in comparison to gold standard of weight for ageMethods: Present study was institution based cross sectional study carried out at SDA high school, from January 2019 to July 2019 among 58 school children aged 34-92 months of age. Anthropometric measurements like weight, height, head circumference, chest circumference, mid arm circumference were recorded as per the standard guidelines. Weight for height, weight of age, Kanawati Index, Jeliffe’s ratio, Rao index, and Dugdales index was calculated. Gold standard used was weight for age. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for these indices.Results: Majority of the children belonged to 48-60 months and 61-72 months i.e. 29.3% each. Males were more than females. Prevalence of malnutrition was 60.3%, 48.3%, 51.7%, 91.4%, and 56.8% based on weight for age, Kanawati index, Rao index, Jeliffe’s ratio and Dugdale’s index respectively. Dugdale’s index was found to have high sensitivity (85.7%) and specificity (86.9%) compared to all other indices.Conclusions: Among age independent indices of nutritional status available, Dugdales index can be used as it has been found that it has remarkably higher sensitivity and specificity compared to other age independent indices of nutritional status.


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