scholarly journals Comparison of Ultrasound and 99mTc-DMSA Scan Findings with Voiding Cystourethrography in Detecting Vesicoureteral Reflux in Children

2020 ◽  
Author(s):  
Ahmad Ramezani Farkhani ◽  
Sepideh Hekmat ◽  
Jilla Armandeh ◽  
Mahmoud Khodadost ◽  
Elham Zarei
Keyword(s):  
Urinary Tract ◽  
Vesicoureteral Reflux ◽  
Cross Sectional Study ◽  
Voiding Cystourethrography ◽  
High Grade ◽  
Cross Sectional ◽  
The Us ◽  
Dmsa Scan ◽  
Sensitivity Specificity ◽  
Kappa Agreement

Abstract Background: Vesicoureteral reflux (VUR) is a common urinary tract disorder in pediatrics and could increase the risk of severe complications. The aim of this study is to assess the efficacy of ultrasound (US) and 99mTc-DMSA scan in detecting VUR in comparison with voiding cystourethrography (VCUG) among children hospitalized with urinary tract infection (UTI).Methods: In this cross-sectional study, the total numbers of 540 children with UTI referred to Ali-Asghar children’s hospital were enrolled, from April 2017 to May 2019. All patients underwent US and VCUG , 99mTc-DMSA performed for some of them to detect VUR. Accuracy, sensitivity, specificity, negative predicted value (NPV), positive predicted value (PPV) and Kappa agreement coefficient was used to compare the US and 99mTc-DMSA with VCUG results. Results: Among 540 patients, VUR was detected in 143 children on VCUG including 90 (63 %) with grades III –V. US was abnormal in 97 of 143 patients (67.8 %) with confirmed VUR on VCUG and 99mTc-DMSA scan was abnormal in 41 of 69 (59 %) with VUR detected by VCUG. The overall accuracy, sensitivity, specificity, NPV and PPV for US were 61.30%, 67.83%, 58.94%, 37.31 and 83.57%, respectively. Among children with high grade VUR (grade III –V) on VCUG, the sensitivity, specificity and NPV of US were 80%, 58.2% and 93.60 respectively. However, when using both US and 99mTc-DMSA scan results for detecting the high grade VUR, the sensitivity, specificity and NPV were 92%, 42.30% and 93.20% respectively. Conclusion: Although neither the US nor the 99mTc-DMSA scan can alone be sufficiently accurate to detect all grades of VUR, US, especially when combined with 99mTc-DMSA scan has enough sensitivity and NPV for ruling out high-grade VUR. These results indicate that there is no need to do VCUG in children with normal US and 99mTc-DMSA scans.

scholarly journals Role of complementary cytology, colposcopy and histopathology in detecting premalignant and malignant lesions of cervix

2016 ◽  
Author(s):  
Akanksha Mangla ◽  
Renuka Sinha
Keyword(s):  
Predictive Value ◽  
False Positive Rate ◽  
False Negative ◽  
False Negative Rate ◽  
Cross Sectional Study ◽  
High Grade ◽  
Cervical Lesions ◽  
Cross Sectional ◽  
Positive Rate ◽  
Sensitivity Specificity

Objective: Cervical cancer is the second most common gynecologic malignancy worldwide. India alone accounts for one fifth of total number of cases worldwide. The aim of our study was to calculate sensitivity, specificity, positive predictive value, negative predictive value, false positive rate and false negative rate of complementary cytology and colposcopy with histopathology as gold standard for detection of premalignant and malignant cervical lesions. Methods: A cross sectional study was conducted at Vardhman Mahavir Medical College and Safdarjung hospital, Delhi, India. 100 non pregnant females with complaint of post coital or irregular vaginal bleeding and those who had unhealthy cervix on visual inspection were included in study. Results: Colposcopy exhibited a high degree of accuracy in diagnosis of high grade lesions. Overall sensitivity of cytology was 50% whereas that of colposcopy was 83.3%. Cytology had specificity of 93.4% whereas colposcopy had specificity of 89.4%. 100% of high grade and invasive cancers on colposcopy were associated with similar findings on histology. The degree of agreement between cytology and colposcopy with histology was significant (p<0.001). Conclusion: Colposcopy is sensitive method as compared to cytology, especially in the higher grade lesions and combination of both methods appears to be of higher diagnostic importance.

scholarly journals Evaluation of the Performance of Health Extension Workers in HIV-1/2 Screening Tests: A Comparative Cross-Sectional Study, Addis Ababa, Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Mulatu Gashaw ◽  
Samuel Kindie ◽  
Minale Fekadie ◽  
Kassu Desta ◽  
Dawit Wolday
Keyword(s):  
Cross Sectional Study ◽  
Screening Tests ◽  
Hiv Screening ◽  
Sectional Study ◽  
Health Extension Workers ◽  
Cross Sectional ◽  
Laboratory Personnel ◽  
Sensitivity Specificity ◽  
Kappa Agreement ◽  
Hiv 1

Background. Human resources for health-care delivery are essential for attaining global health and development goals. Especially in developing countries, health extension workers are frontline health personnel who can play a key role in preventing and controlling HIV/AIDS. This study aimed to evaluate the performance of health extension workers in HIV-1/2 screening tests. Methodology. A comparative cross-sectional study was carried out to evaluate the performance of health extension workers in HIV-1/2 screening tests. Study participants had performed HIV screening tests on the prepared sample panels. Finally, the percentage of accuracy, error rate, sensitivity, specificity, predictive values, and measure of agreement (kappa) were calculated using SPSS version 26. Result. Totally, 1600 HIV screening tests were performed, and of these, 684 and 235 tests were done by HEWs (n = 15) and laboratory personnel (n = 5), respectively, with three discordant results by HEWs from a single sample panel which was weak reactive for HIV antibody test. The sensitivity, specificity, PPV, and NPV of HIV screening tests by HEWs were 97.4%, 100%, 100%, and 97.22%, respectively, and 100% for all parameters when it is tested by laboratory professionals. The measure of kappa agreement was 0.971 (95% CI, 0.932–1) for HEWs and 1 for laboratory personnel compared with the reference result. Conclusion. Based on this evidence, we conclude that the potential contribution of HEWs can be invaluable in the expansion of HIV screening tests nationwide to compensate the shortage of laboratory personnel.

scholarly journals Accuracy of urine calprotectin for diagnosis of acute kidney injury in neonates

2019 ◽  
Author(s):  
Nasrin Khalesi ◽  
Shima Mohamadian ◽  
Nakysa Hooman ◽  
Mahmoud Khodadost
Keyword(s):  
Acute Kidney Injury ◽  
Predictive Value ◽  
Area Under The Curve ◽  
Kidney Injury ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Calprotectin Level ◽  
Sensitivity Specificity ◽  
Kappa Agreement

Abstract Background: Urine calprotectin significantly rises in acute kidney injury (AKI) in adult and pediatrics. The aim of the present study was to investigate the accuracy of urine calprotectin as a diagnostic marker for (AKI) in neonates. Methods In this cross sectional study, we assessed urine calprotectin in 100 neonates, in which 80 of them had AKI and 20 were healthy. Random urine calprotectin measured by ELISA and then compared between two groups. We included neonates who had received at least 48 hour intra venous fluid and met our inclusion and exclusion criteria. . Receiver-operating characteristic (ROC) curve used to set a cut of point for urine calprotectin to predict AKI. The overall accuracy and Kappa coefficient was used for assess the agreement between two methods.. P value below 0.05 considered significant. Results: Urine calprotectin levels were not significantly higher in neonates with AKI than healthy ones (146.2 vs 142.4, p=0.1). The results showed an optimal cutoff value of 123.5 mg/dl for urine calprotectin with area under the curve of 0•515 with sensitivity, specificity, positive predictive value and negative predictive value of 77.5%,40%,83.7% and 30.7%, respectively. The overall accuracy was 70% and the Kappa agreement coefficient was 0.15 (P=0.11.). Conclusion: Although urine calprotectin level can predict the AKI, it is not accurate measure comparing the gold standard.

scholarly journals Adherence to guideline recommendations for urinary tract infections in adult women: a cross-sectional study

2021 ◽  
Vol 22 ◽  
Author(s):  
Rian Lelie- van der Zande ◽  
Marcel Bouvy ◽  
Martina Teichert
Keyword(s):  
Urinary Tract ◽  
Clavulanic Acid ◽  
Cross Sectional Study ◽  
Adult Women ◽  
Sectional Study ◽  
Cross Sectional ◽  
First Choice ◽  
Febrile Uti ◽  
Amoxicillin Clavulanic Acid ◽  
Tract Infections

Abstract Aim: To study whether changes in drug preferences in the Dutch guideline for the treatment of Urinary Tract Infection (UTI) for General Practitioners (GPs) in 2013, resulted in corresponding changes in antibiotic dispensing. Background: For the treatment of uncomplicated UTI, nitrofurantoin remained the first choice, while fosfomycin became the second choice and changed ranks with trimethoprim. For a subsequent febrile UTI, ciprofloxacin became the first choice and changed ranks with amoxicillin/clavulanic acid, co-trimoxazole remained the third choice. Methods: In this observational cross-sectional study, routinely collected dispensing data from the Dutch Foundation of Pharmaceutical Statistics from 2012 to 2017 were used. The number of women 18 years and older, treated with one of the guideline antibiotics for uncomplicated UTI and subsequent febrile UTI were analysed annually. Proportions were calculated. Data were stratified for age categories. Failure of uncomplicated UTI treatment was defined as the dispensing of an antibiotic for febrile UTI within 14 days after the dispensing of an antibiotic for uncomplicated UTI. Findings: Data were available from 81% of all pharmacies in 2012 to 89% in 2017. Percentages of women dispensed nitrofurantoin were relatively stable with 87.4% in 2012 and 84.4% in 2017. Percentages of women dispensed fosfomycin increased from 5.4% in 2012 to 21.8% in 2017, whereas percentages of women dispensed trimethoprim decreased from 17.8% to 8.0%. Within age categories, the percentage of women dispensed fosfomycin increased from 12.4% in women 18–30 years old to 36.7% in women above 80 years old. Percentages of women dispensed antibiotics for febrile UTI remained stable at 5% annually. Percentages of women receiving ciprofloxacin increased from 1.9% in 2012 to 3.3% in 2017, while those receiving amoxicillin/clavulanic acid decreased from 2.9% to 1.8%. New guideline recommendations resulted in corresponding changes in dispensed antibiotics for uncomplicated UTI and subsequent febrile UTI. Drug choices differed for age categories.

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