scholarly journals Prospective study to estimate the role of different infertility factors in prediction of unsuccessful IVF outcome

2021 ◽  
pp. 14-21
Author(s):  
V.O. Berestovyi ◽  
A. Mahmood ◽  
A.M. Martych ◽  
A.B. Prylutska ◽  
O.O. Berestovyi ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Embryo Transfer ◽  
Optical Density ◽  
Predictive Value ◽  
Embryo Implantation ◽  
Controlled Study ◽  
Implantation Failure ◽  
Ivf Outcome

Research objective: in a prospective controlled study to investigate the role of HSP60, GroEl and other infertility factors as predictors of successful IVF outcome. Materials and methods. 106 female patients were divided into two groups: 54 individuals who received conventional treatment for infertility (using ICSI techniques for IVF) and 52 individuals who received conventional therapy with intravenous IgG, enoxaparin and aspirin. All collected blood samples were tested for HSP60 and GroEl antibodies using immunofluorescence and ELISA techniques at the time of admission, after treatment (and before embryo transfer), and after embryo transfer. We analyzed the factors that can be helpful as prognostic parameters to estimate the risk of implantation failure.Results. The risk of implantation failure is predicted when HSP60 level decreases from the first to the second measurement by less than 0.02 optical density units, with a sensitivity of 62% (95% confidence interval (CI) 47.2–75.3), and a specificity of 87.5% (95% CI 75.9–94.8), the positive predictive value was 81.6% (95% CI 68.2–90.2), the negative predictive value was 72.1% (95% CI 64.1–78.8). The GroEl value for the second dimension was more than 0.411 optical density units, which suggests a risk of treatment failure with a sensitivity of 64% (95% CI 49.2–77.1) and a specificity of 85.6% (95% CI 73.8–93.6), the positive predictive value was 80.0% (95% CI 67.1–88.7), the negative predictive value was 72.7% (95% CI 64.5–79.7). The highest (p < 0.05) value was observed at the beginning of treatment, and the lowest (p < 0.05) – during the third measurement.Treatment of the underlying cause of infertility led to a decrease in HSP60 and GroEl levels, which ensured a positive in vitro fertilization result. It was found that HSP60 and GroEl have a strong association with embryo implantation. The risk of implantation failure was strongly associated with twelve factors, the area under the curve (AUC) was 0.85 (95% CI 0.76–0.91).Conclusions. HSP60 and GroEl are good prognostic factors for predicting a successful IVF outcome in patients undergoing infertility treatment. The measurement of these parameters during the initial infertility examination may help in the immediate diagnosis of autoimmune infertility. Embryo implantation is a multifactorial process. The risk of implantation failure should be evaluated with multiple factors (twelve factors).

scholarly journals Role of diffusion-weighted magnetic resonance imaging in assessment of mammographically detected asymmetric densities

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Mohamed Zidan ◽  
Shimaa Ali Saad ◽  
Eman Abo Elhamd ◽  
Hosam Eldin Galal ◽  
Reem Elkady
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Benign Lesions ◽  
Adc Value ◽  
Dce Mri ◽  
Diffusion Weighted ◽  
Breast Asymmetries ◽  
Malignant Lesions

Abstract Background Asymmetric breast density is a potentially perplexing finding; it may be due to normal hormonal variation of the parenchymal pattern and summation artifact or it may indicate an underlying true pathology. The current study aimed to identify the role of diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) values in the assessment of breast asymmetries. Results Fifty breast lesions were detected corresponding to the mammographic asymmetry. There were 35 (70%) benign lesions and 15 (30%) malignant lesions. The mean ADC value was 1.59 ± 0.4 × 10–3 mm2/s for benign lesions and 0.82 ± 0.3 × 10–3 mm2/s for malignant lesions. The ADC cutoff value to differentiate between benign and malignant lesions was 1.10 × 10–3 mm2/s with sensitivity 80%, specificity 88.6%, positive predictive value 75%, negative predictive value 91%, and accuracy 86%. Best results were achieved by implementation of the combined DCE-MRI and DWI protocol, with sensitivity 93.3%, specificity 94.3%, positive predictive value 87.5%, negative predictive value 97.1%, and accuracy 94%. Conclusion Dynamic contrast-enhanced MRI (DCE-MRI) was the most sensitive method for the detection of the underlying malignant pathology of breast asymmetries. However, it provided a limited specificity that may cause improper final BIRADS classification and may increase the unnecessary invasive procedures. DWI was used as an adjunctive method to DCE-MRI that maintained high sensitivity and increased specificity and the overall diagnostic accuracy of breast MRI examination. Best results can be achieved by the combined protocol of DCE-MRI and DWI.

scholarly journals ROLE OF HYSTEROSALPINGOGRAPHY IN MANAGEMENT OF FEMALE INFERTILITY AND ITS LAPAROSCOPIC CORRELATION

2019 ◽  
pp. 1-2
Author(s):  
(prof.) Alka Agrawal
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Uterine Cavity ◽  
Fallopian Tubes ◽  
Radiographic Technique ◽  
Invasive Techniques ◽  
Work Up ◽  
Tubal Pathology

BACKGROUND : Infertility nowadays has become a medical as well as social problem.Laboratory findings alone is inconclusive in diagnosing infertility.HSG is the radiographic technique for evaluation of uterine cavity & fallopian tubes..Direct visualization of abdominal and pelvic organs in laparoscopy allows a definite diagnosis where clinical examination & less invasive techniques such as ultrasound & HSG fail to identify the abnormality. AIMS & OBJECTIVES :To determine the role of HSG in the evaluation of infertility & to correlate its findings with laparoscopy. METHODS : 75 infertile females aged between 20-40 years were included. HSG & laparoscopy was performed in all patients & findings were analysed. RESULTS : Sensitivity of HSG was 80 %,specificity was 76 % with positive predictive value 63%, negative predictive value 88 % in detecting tubal pathology. Sensitivity of HSG in detecting uterine pathology was 67%, specificity 73%, positive predictive value 39% and negative predictive value 89%. CONCLUSION : HSG has reasonably good sensitivity & specificity in diagnosing tubal & uerine pathology while laparoscopy has diagnostic as well as therapeutic approach.Hence they are complimentary to each other in infertility work up.

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 Role of ascitic fluid adenosine deaminase (ADA) and serum CA-125 in the diagnosis of tuberculous peritonitis

2015 ◽  
Vol 40 (3) ◽  
pp. 89-91 ◽  
Author(s):  
N Ali ◽  
NC Nath ◽  
R Parvin ◽  
A Rahman ◽  
TM Bhuiyan ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Diagnostic Test ◽  
Ascitic Fluid ◽  
Predictive Value ◽  
Ca 125 ◽  
Histopathological Diagnosis ◽  
Diagnostic Modality ◽  
Cross Sectional

This cross sectional study was carried out in the department of gastroenterology, BIRDEM, Dhaka from January 2010 to May 2011 to determine the role of ascitic fluid ADA and serum CA-125 in the diagnosis of clinically suspected tubercular peritonitis. Total 30 patients (age 39.69±21.26, 18M/12F) with clinical suspicion of tuberculosis peritonitis were included in this study after analyzing selection criteria. Laparoscopic peritoneal biopsy with ‘histopathological diagnosis’ was considered gold standard against which accuracics of two biomarkers (ADA & CA-125) were compared. Cut off value of ADA and CA-125 are 24 u/l, 35 U/ml respectively. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ADA as a diagnostic modality in tuberculos peritonitis were 87.5%, 83.33%, 95.45%, 62.5% and 86.67% respectively where as CA-125 was found to have 83.33% sensitivity, 50% specificity, 86.9% positive predictive value, 42.85% negative predictive value and 76.6% accuracy. Both biomarkers are simple, non-invasive, rapid and relatively cheap diagnostic test where as laparoscopy is an invasive procedure, costly & requires trained staff and not without risk and also not feasible in all the centre in our country. So ascitic fluid ADA and serum CA-125 are important diagnostic test for peritoneal tuberculosis.Bangladesh Med Res Counc Bull 2014; 40 (3): 89-91

scholarly journals EVALUATION OF ACUTE APPENDICITIS USING ULTRASOUND

2021 ◽  
Vol 9 (02) ◽  
pp. 315-321
Author(s):  
Abdullah Hamdan ◽  
◽  
Nasraldeen Alnaeem M. Alkhidir ◽  
Abdelmoneim Saeed ◽  
◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Clinical Diagnosis ◽  
Predictive Value ◽  
Sensitivity Specificity ◽  
Histopathological Report

The diagnosis of acute appendicitis is mainly clinical and to confirm the clinical diagnosis ultrasonography (USG) of the abdomen is being used to help in diagnosis of the disease. To find out the role of USG in the diagnosis of acute appendicitis in clinically equivocal cases and to correlate USG findings with histopathological reports (HPR) of removed appendix.Total numbers of 100 patients were included in the study from 12March 2019 to 5 December 2019. Findings on ultrasound were finally compared with histopathological report of appendices removed on surgery. Those cases with alternate diagnosis were followed up and proved with other means of investigation. The sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of ultrasound in diagnosis of acute appendicitis in our study were found to be 79 %, 84.20 %, 95.50%, 48.40% and 80% respectively.

scholarly journals Clinicopathological evaluation of acute appendicitis and the role of ultrasound in diagnosis: a prospective study

2019 ◽  
Vol 6 (5) ◽  
pp. 1471
Author(s):  
Tony Mathew ◽  
Amit Shivshankar Ammanagi
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Prospective Study ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Scoring System ◽  
Lower Abdominal Pain ◽  
Negative Appendicectomy ◽  
A Prospective Study

Background: Acute appendicitis is the most common acute surgical condition of the abdomen. Delay in treatment of acute appendicitis causes lot of complication. Study was done with the objective to study the clinical and pathological presentations of acute appendicitis, to evaluate the role of ultrasound in early diagnosis of acute appendicitis and to reduce negative appendicectomy in patients.Methods: This is a prospective study done on 100 patients with acute right lower abdominal pain clinically presumed to be of appendicular origin. A thorough history, clinical examination and ultrasound scan, was done for all cases. All ultrasound positive cases were subjected to surgery and some negative cases were also taken for surgery based on clinical suspicion. The ultrasound diagnosis was compared with clinical findings, operative findings and histopathological examination reports.Results: The overall accuracy of clinical diagnosis (Alvarado scoring system) with histopathology findings was 72%. The overall sensitivity and specificity was 70.3% and 81.3% respectively and positive predictive value of was 95.2% whereas the negative predictive value was 34.2%. The overall accuracy of ultrasound with histopathology report was 93%, with a sensitivity of 96.4%, specificity of 75%, and a positive predictive value of 95% and a negative predictive value of 80%. Negative appendicectomy rate was 8.82% in females and 3.63% in males.Conclusions: The Alvarado scoring system combined with ultrasound can therefore be used as a cheap and inexpensive way of confirming acute appendicitis thus reducing negative appendicectomy rate.

Prognostic Role of PET-FDG Before Autologous Stem Cell Transplantation in Advanced Hodgkin's Lymphoma.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1548-1548
Author(s):  
Alessandro Pulsoni ◽  
Elena Cavalieri ◽  
Saveria Capria ◽  
Fabio Torelli ◽  
Giorgia Annechini ◽  
...  
Keyword(s):  
Stem Cell ◽  
Positive Predictive Value ◽  
Stem Cell Transplantation ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Prognostic Role ◽  
Resistant Disease ◽  
Extranodal Disease

Abstract Abstract 1548 Poster Board I-571 PET-FDG (PET) has assumed in recent years a relevant role in the management of patients with Hodgkin Lymphoma (HL). In advanced stage HL, PET performed after two courses of ABVD chemotherapy has demonstrated a very high negative predictive value (NPV) and positive predictive value (PPV), and is presently considered the most relevant available prognostic factor in correlation with outcome. The aim of our study was to investigate the prognostic role of PET performed before autologous stem cell transplantation (ASCT) in resistant or relapsed HL. From June 2002 to December 2008, 32 patients with resistant or relapsed HL underwent a salvage chemotherapy program consisting of 3 or 4 courses of IEV or IGEV chemotherapy with peripheral blood stem cell collection followed by BEAM conditioned ASCT. Eight patients were consolidated with the BEACOPP regimen (2 to 4 courses) before transplantation. Median age was 30.4 years (range 21.6 – 61.4); 19 were males. At the time of enrolment, B symptoms were present in 4 patients and bulky and/or extranodal disease was recorded in 7 patients; the International Prognostic Score (IPS) was ≥2 in 15 patients. Sixteen patients were resistant to first-line chemotherapy, 13 were in first relapse (in 6 cases occurred earlier than 12 months), 3 were in second or subsequent relapse. Pre-transplant PET evaluation was negative in 21 cases: of these, 16 are currently in continuous complete remission (CCR) after a median follow-up of 30 months (range 7.0 – 59.0), while 5 have relapsed after a median of 10 months from transplant (range 3.0 – 11.0). Among the 11 patients autografted after a positive PET, 9 have relapsed after a median of 8.3 months (range 3.3 – 18.6). In the figure is shown the progression free survival of the patients stratified by pre-transplant PET. On the entire population the negative predictive value (NPV) of pre-transplant PET was 76.2%, while the positive predictive value (PPV) was 81.8%. Analyzing separately patients enrolled with a primary resistant disease, the NPV was 62.5% and the PPV was 75.0%. In the group of patients enrolled in relapse NPV was 84.6% and PPV was 100%. The prognostic value of the following parameters at the time of enrolment was evaluated: presence of bulky and/or extranodal disease, number of previous chemotherapy lines, chemoresistance/chemosensitivity to pre-transplant therapy evaluated by CT scan: no statistically significant correlation with the outcome was recorded. In conclusion, our preliminary results show a relevant prognostic role of pre-transplant PET in patients with advanced phase HL: 76% of patients with a negative pre-transplant PET obtained a CCR compared to only 18% of those with a positive pre-transplant PET (p = 0.003). The predictive role of pre-transplant PET is superior in patients undergoing the transplant program for a relapsed disease with respect to those with a primary resistant disease. Other prognostic factors need to be considered, although none of those so far examined showed a statistically significant role. These data need to be conclusively confirmed on a larger number of patients and a longer follow-up. Disclosures No relevant conflicts of interest to declare.

scholarly journals Role of Resistance Index in Differentiation of Benign and Malignant Breast Masses Compared with Histopathological Diagnosis

2019 ◽  
Vol 9 (2) ◽  
pp. 97-103
Author(s):  
Mashah Binte Amin ◽  
Tarana Yasmin ◽  
Samar C Sarkar ◽  
Khaleda Parvin Rekha ◽  
Rushaida Haque Leeba ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Vascular Resistance ◽  
Predictive Value ◽  
Resistance Index ◽  
Diagnostic Methods ◽  
Breast Masses ◽  
Malignant Breast ◽  
Breast Lumps

Background: Breast tumor remains a worldwide public health problem for women. Linear array sonography is currently one of the main diagnostic methods for detecting breast lumps. Duplex color Doppler sonography has been helpful to distinguish malignant from benign breast disease and also to predict the disease prognosis. Objectives: The purpose of this study was to evaluate the role of spectral Doppler as a method to measure the vascular resistance index in differential diagnosis between the benign and malignant breast neoplasm. Materials and Methods: This cross-sectional study was carried out in department of Radiology & Imaging of Enam Medical College & Hospital during January 2015 to December 2017. Sonography was done in 153 women having breast lumps. Among them histopathology was done in 105 cases. Ultrasonographic findings and histopathological report analyses were done using SPSS 13.0. Results: The study was done in 105 women with mean age 31.6 ± 4.5 years. On ultrasonogram, lesions were diagnosed as benign in 65 (62%) cases and malignant in 40 (38%) cases. Out of sonographically diagnosed 65 benign lesions having peripheral vascularity and decreased RI, 63 (97%) were proved benign histopathologically. With these criteria for diagnosis of benign lesion, sensitivity was 94%, specificity 92%, positive predictive value 95%, negative predictive value 89% and accuracy 93%. Sonographically 40 lesions were diagnosed as malignant. Among them 37 (92.5%) cases were proven malignant histopathologically and showed central vascularity and increased RI having sensitivity of 92%, specificity 94%, positive predictive value 89%, negative predictive value 95% and accuracy 93%. Conclusion: The analysis of vascular resistance index combined with findings on grayscale sonographic images correlates well with histopathological reports and can be of great assistance in the assessment of breast masses with high sensitivity and specificity. J Enam Med Col 2019; 9(2): 97-103

scholarly journals The Role of Laparoscopic Ultrasonography in the Evaluation of Suspected Choledocholithiasis. A Single-Center Experience

Medicina ◽  
2020 ◽  
Vol 56 (5) ◽  
pp. 246
Author(s):  
Kristaps Atstupens ◽  
Maksims Mukans ◽  
Haralds Plaudis ◽  
Guntars Pupelis
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
False Negative ◽  
Diagnostic Methods ◽  
Laparoscopic Ultrasonography ◽  
Biliary Stones ◽  
Single Center Experience

Background and objectives: Opinions differ regarding the optimal diagnostic methods for patients with suspected choledocholithiasis. The aim of this study was to assess the diagnostic accuracy of laparoscopic ultrasonography (LUS) and compare it to pre-operative magnetic resonance cholangio-pancreatography (MRCP); Materials and Methods: In all patients with suspected choledocholithiasis LUS was performed during laparoscopic cholecystectomy to evaluate biliary stones. According to availability, part of the patients had pre-operative MRCP. Data for diagnostic accuracy and main outcomes were collected prospectively and analyzed retrospectively; Results: Choledocholithiasis was detected in 178 of 297 patients by LUS (59.93%) and in 39 of 87 patients by MRCP (44.8%), p = 0.041. LUS yielded a sensitivity of 99.4%, a specificity of 94.3%, a positive predictive value of 96.1% and a negative predictive value of 99.1%. However, pre-operative MRCP had a sensitivity of 61.7%, a specificity of 92.3%, a positive predictive value of 94.9% and a negative predictive value of 51.1%. Moreover, of the 47 patients with no choledocholithiasis by MRCP, in 23 cases it was later detected by LUS (a false negative MRCP finding—38.3%), p < 0.001. Median duration of hospitalization was significantly shorter in patients evaluated without pre-operative MRCP—8 days (interquartile range – IQR 11–6) vs. 11 days (IQR 14–9), p = 0.001; Conclusions: LUS may reduce the role of pre-operative MRCP and can become a rational alternative to MRCP as a primary imaging technique for the detection of choledocholithiasis.

scholarly journals Added value of diffusion-weighted MRI in assessment of pleural lesions

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Youssriah Yahia Sabri ◽  
Ikram Hamed Mahmoud ◽  
Lamis Tarek El-Gendy ◽  
Mohamed Raafat Abd El-Mageed ◽  
Sally Fouad Tadros
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Diagnostic Value ◽  
Added Value ◽  
Adc Value ◽  
Pleural Diseases ◽  
Conventional Mri ◽  
Malignant Lesions

Abstract Background There are many causes of pleural disease including variable benign and malignant etiologies. DWI is a non-enhanced functional MRI technique that allows qualitative and quantitative characterization of tissues based on their water molecules diffusivity. The aim of this study was to evaluate the diagnostic value of DWI-MRI in detection and characterization of pleural diseases and its capability in differentiating benign from malignant pleural lesions. Results Conventional MRI was able to discriminate benign from malignant lesions by using morphological features (contour and thickness) with sensitivity 89.29%, specificity 76%, positive predictive value 89%, negative predictive value 76.92%, and accuracy 85.37%. ADC value as a quantitative parameter of DWI found that ADC values of malignant pleural diseases were significantly lower than that of benign lesions (P < 0.001). Hence, we discovered that using ADC mean value of 1.68 × 10-3 mm2/s as a cutoff value can differentiate malignant from benign pleural diseases with sensitivity 89.3%, specificity 100%, positive predictive value 100%, negative predictive value 81.2%, and accuracy 92.68% (P < 0.001). Conclusion Although DWI-MRI is unable to differentiate between malignant and benign pleural effusion, its combined morphological and functional information provide valid non-invasive method to accurately characterize pleural soft tissue diseases differentiating benign from malignant lesions with higher specificity and accuracy than conventional MRI.

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