scholarly journals The Diagnostic Value of Neutrophil-Lymphocyte Ratio in Diagnosis of Autism Spectrum Disorders

2020 ◽  
Vol 26 (3) ◽  
Author(s):  
Nurmalia Purnama Sari ◽  
Yudianita K. ◽  
M. Rafli Haiqal ◽  
M. Fadill Akbar
Keyword(s):  
Predictive Value ◽  
Developmental Disorders ◽  
Neurodevelopmental Disorder ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Autism Spectrum ◽  
Cross Sectional ◽  
Neutrophil Lymphocyte Ratio ◽  
Markers Of Inflammation ◽  
Sensitivity Specificity

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder, progressive disruption of brain development and synaptic connections, which causes impaired communication and behavioral disorders. However, the etiology is unknown. A damaged perinatal environment causes chronic nerve inflammation in genetically susceptible children of ASD, dysregulation of the immune system, which leads to ASD. The ratio of Neutrophil to Lymphocyte (NLR) as one of the markers of inflammation is frequently associated with inflammation-related psychiatric diseases and is potentially used as a diagnostic instrument. A cross-sectional study was carried out from June to November 2019 by using medical records of Outpatients with growth and development disorders and ASD and involving 69 children. The diagnosis of ASD was confirmed by the fifth edition Diagnostic and Manual of Mental Disorders criteria (DSM-V). A routine hematology test was carried out with a flow cytometry method. Diagnostic tests were performed in 43 children with developmental disorders (mean NLR 1.01±0.07) and 26 ASD children (mean NLR 1.02±0.06), with a cut-off value of 0.68. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of NLR were 84.62%; 27.9%; 41.51%; 25%; and 50.2%, respectively. Neutrophil to lymphocyte is sensitive to diagnose ASD but its accuracy is low. Immune dysfunction and complex neurodevelopmental disorders that are affected by chronic inflammation play a role in the occurrence of ASD. Other inflammatory markers are needed to improve the accuracy of laboratory tests to diagnose ASD.

scholarly journals An Evaluation of the Arcus Corneae For Age Estimation

2019 ◽  
Vol 9 (3-4) ◽  
pp. 155-162
Author(s):  
Boonsak Hanterdsith
Keyword(s):  
Predictive Value ◽  
Interobserver Reliability ◽  
High Sensitivity ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Likelihood Ratios ◽  
Chi Square ◽  
Cross Sectional ◽  
Predictive Values ◽  
Sensitivity Specificity

Although the arcus corneae (AC) has long been used as an age indicator for forensic purposes, its diagnostic value has not been evaluated. To evaluate the AC as a predictor of chronological age, the author has studied the correlation of AC with respect to age of the deceased. A cross-sectional study was conducted of 342 Thai corpses at the Maharat Nakhon Ratchasima Hospital, Thailand. AC was graded into three levels: no AC, incomplete ring, and complete ring. One-way analysis of variance, chi-square test, binomial logistic regression, sensitivity, specificity, predictive values, and likelihood ratios were used for analysis. The Cohen’s kappa was used to determine the intraobserver and interobserver reliability. The prevalence of AC and the probability of complete AC were significant higher in corpses aged 60 years and above than in those under 60 years. Consequently, this study confirmed that the prevalence of AC was significantly correlated with the age of Thai individuals. If the complete AC is used as an indicator of age of 60 years and above, complete AC has high sensitivity (92.56%) but low specificity (72.85%), low positive predictive value (65.12%), but high negative predictive value (94.71%). For diagnostic value, the presence of AC can be used for age screening but not for absolute confirmation. The absence of AC indicates young age, incomplete AC indicates middle age, and complete AC indicates old age. The high intraobserver and interobserver reliability provides assurance of the value of AC as a means to estimate personal age.

scholarly journals Role of transvaginal sonography in the detection of endometrial carcinoma

2014 ◽  
Vol 39 (2) ◽  
pp. 80-85
Author(s):  
MS Showkat ◽  
S Nabi ◽  
L Khondker ◽  
B Bhowmik ◽  
SN Tushar ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Predictive Value ◽  
Cross Sectional Study ◽  
Transvaginal Sonography ◽  
Histopathological Diagnosis ◽  
Cross Sectional ◽  
Menopausal Women ◽  
Post Menopausal ◽  
Sensitivity Specificity ◽  
Transabdominal Sonography

Transvagival sonography is superior to transabdominal sonography in most cases of pelvic pathology. Objective of this study is to evaluate the clinical usefulness of transvaginal ultrasonography (TVS) in pre, peri and post menopausal women suspected to have endometrial carcinoma. This cross sectional study was done with 40 patients who are clinically suspected having thickened endometrium. The study was carried out January 2007 to November 2008 for a period of two years. The patients having endometrial carcinoma diagnosed by TVS was correlated with histopathological diagnosis following collection of the report from the respective cases. Of total 40 cases, 2(5.0%) cases were endometrial carcinoma and 38(95.0%) were negative for endometrial carcinoma respectively in TVS findings. On the other hand 3(7.5%) cases were endometrial carcinoma and 37 (92.5%) cases were negative for endometrial carcinoma in histopathological findings. The validity of TVS in diagnosis of endometrial carcinoma were studied by calculating sensitivity, specificity, accuracy, positive predictive value and negative predictive value, which were 67 percent, 100 percent, 98 percent, 100 percent and 97 percent respectively. As the TVS findings of the present study correlated well with the histopathology findings and the validity test values were higher than observed by others, it can be concluded that TVS is sensitive and accurate modality in the evaluation of endometrial carcinoma. DOI: http://dx.doi.org/10.3329/bmrcb.v39i2.19647 Bangladesh Med Res Counc Bull 2013; 39: 80-85

scholarly journals ACCURACY OF THE UPPER LIP BITE TEST;

2012 ◽  
Vol 20 (01) ◽  
pp. 132-138
Author(s):  
MUHAMMAD ATIF ◽  
MUHAMMAD ABDULLAH ◽  
MUHAMMAD JAVAD YOUSAF ◽  
Khalid Buland
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Difficult Intubation ◽  
Predictive Value ◽  
Elective Surgery ◽  
Cross Sectional Study ◽  
Military Hospital ◽  
Upper Lip ◽  
Cross Sectional ◽  
Sensitivity Specificity

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.

TLR2 and TLR4 expressions in late-onset neonatal sepsis: Is it a potential novel biomarker?

2020 ◽  
pp. 1-7
Author(s):  
R. Rohsiswatmo ◽  
M. Azharry ◽  
T.T. Sari ◽  
Y. Bahasoan ◽  
D. Wulandari
Keyword(s):  
Blood Culture ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Complete Blood Count ◽  
Late Onset ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Tlr4 Expression ◽  
Cross Sectional ◽  
Reactive Protein

BACKGROUND: Late-onset neonatal sepsis (LONS) detection is problematic as no single examinations (blood culture, c-reactive protein (CRP), procalcitonin (PCT)) are reliable. Toll-like receptors (TLRs), which detect the presence of pathogen-associated molecular patterns is a promising novel biomarker, but less studied in LONS. This study aimed to determine neutrophils and monocytes TLR2 and TLR4 expression in LONS and their diagnostic value. METHODS: A cross-sectional study conducted in May and June 2017 involving 52 neonates with clinical late-onset (>72 hours of age) sepsis. We examine complete blood count, I/T ratio, CRP, PCT, as well as TLR2 and TLR4 expression to compared with blood culture as the gold standard. We classified cases into proven or unproven sepsis. RESULT: The incidence of LONS was 32.6% in the subjects. The expression of TLR2 was low in LONS, while TLR4 was high. TLR4 neutrophil expression has 88.2% sensitivity, 20% specificity, 34.9% positive predictive value (PPV), 77.8% negative predictive value (NPV), and an AUC of 0.541. TLR4 monocyte expression has 92.1% sensitivity, 11.4% specificity, 34% PPV, 80% NPV, and an AUC of 0.528. The AUC of CRP is increased from 0.608 to 0.843 after combination with TLR4, comparable with CRP + PCT (AUC 0.829). CONCLUSION: The increase in TLR4 expression has good sensitivity but low specificity. TLR4 expression, in combination with CRP, could become a reliable biomarker for the diagnosis of LONS.

scholarly journals Performance of LED Fluorescence Microscopy for the Diagnosis of Pulmonary Tuberculosis in HIV Positive Individuals in Addis Ababa, Ethiopia

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Konjit Getachew ◽  
Tamrat Abebe ◽  
Abebaw Kebede ◽  
Adane Mihret ◽  
Getachew Melkamu
Keyword(s):  
Pulmonary Tuberculosis ◽  
Predictive Value ◽  
Addis Ababa ◽  
Sputum Sample ◽  
Cross Sectional Study ◽  
Hiv Positive ◽  
Smear Microscopy ◽  
Lower Sensitivity ◽  
Cross Sectional ◽  
Sensitivity Specificity

Background. Despite its lower sensitivity, smear microscopy remains the main diagnostic method for pulmonary tuberculosis (PTB) in resource-limited countries as TB culturing methods like LJ (Lowenstein-Jensen) are expensive to use as a routine base. This study aimed to evaluate the performance of LED-FM for the diagnosis of PTB in HIV positive individuals.Methods. Cross-sectional study was conducted in Zewditu Memorial Hospital and Teklehaimanot Health Center HIV/ART clinics in Addis Ababa, Ethiopia. Each sample was stained with ZN and Auramine O staining and examined with bright-field microscope and LED-FM microscope, respectively. LJ culture was used as a reference.Results. Out of 178 study participants, twenty-four (13.5%) patients were confirmed as positive for MTB with LJ culture. The yield of ZN microscopy and LED-FM in direct and concentrated sample was 3.9%, 8.4%, 6.2%, and 8.4%, respectively. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of direct ZN microscopy were 29.2%, 100%, 100%, and 90.1%, respectively, and of LED-FM microscopy in direct sputum sample were 62.5%, 100%, 100%, and 94.5%, respectively.Conclusion. LED-FM has better sensitivity for the diagnosis of PTB in HIV positive individuals as compared to conventional ZN microscopy. LED-FM can be used as an alternative to conventional ZN microscopy.

scholarly journals Interleukin 21 as a diagnostic marker of rheumatoid arthritis.

2019 ◽  
Vol 26 (08) ◽  
pp. 1229-1232
Author(s):  
Khadija Kiran ◽  
Amtul Huda ◽  
Zuhair Bhatti
Keyword(s):  
Rheumatoid Arthritis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Diagnostic Marker ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Medical College ◽  
Sensitivity Specificity

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.

scholarly journals The diagnostic value of apparent diffusion coefficient to differentiate benign and malignant meningiomas

2021 ◽  
Vol 40 (2) ◽  
pp. 141-150
Author(s):  
Risa Marissa ◽  
Rachmi Fauziah Rahayu ◽  
Hari Wujoso ◽  
Subandi Subandi ◽  
Prasetyo Sarwono Putro ◽  
...  
Keyword(s):  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Predictive Value ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
High Morbidity ◽  
Cross Sectional ◽  
Adc Value ◽  
Flair Sequence ◽  
Apparent Diffusion

BACKGROUNDMeningiomas are the most common primary extra-axial non-glial intracranial tumors. The severe grade of meningioma, according to WHO, has the highest recurrence rate accompanied by high morbidity and mortality rates. Therefore, it is imperative to perform pre-operative assessments so the clinician can give prompt treatment to gain a better prognosis. It is a novel alternative way of predicting meningioma’s malignancy by calculating the tumor’s apparent diffusion coefficient (ADC) value. The objective of the study was to determine the value of ADC for differentiating benign and malignant meningiomas. METHODSThis cross-sectional study involved 32 subjects with clinically diagnosed or histologically verified meningioma (21 benign and 11 malignant). They underwent a head-magnetic resonance imaging (MRI) examination and biopsy. We calculated the ADC value by creating regions of interest (ROIs) on the solid part of the tumor, guided by contrast and fluid-attenuated inversion recovery (FLAIR) sequence. We analyzed the ADC value with independent t-test and Bland-Altman graphs, calculated the average difference, CI 95%, limit of agreement between observers, and ROC. RESULTSMean ADC of malignant meningiomas (0.877 ± 0.167 x 10-3 mm2/s) was significantly lower than that of benign meningiomas (0.990 ± 0.105 x 10-3 mm2/s) (p<0.05). The ADC threshold is 0.886 x 10-3 mm2/s with sensitivity 63.6%, specificity 85.7%, positive predictive value 70% and negative predictive value 81.8%. CONCLUSIONThe ADC value measurement provides a discriminative feature to differentiate between benign and malignant meningiomas. However, the clinical applicability still needs to be elucidated, as histopathological confirmation remains the mainstay of definitive diagnosis.

scholarly journals Assessment of nutritional status of children aged 34-92 months using various nutritional status indices and validity of age independent indices

2019 ◽  
Vol 6 (6) ◽  
pp. 2593
Author(s):  
Nayantara R. Gandra ◽  
Kalavathy Jasmine Masillamoni
Keyword(s):  
Nutritional Status ◽  
Predictive Value ◽  
Gold Standard ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Nutritional Status Of Children ◽  
Sensitivity Specificity ◽  
Age Independent ◽  
Weight For Age

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.

scholarly journals Comparison of Upper Lip Bite Test with Modified Mallampati Test and Thyromental Distance for Prediction of Difficult Intubation

2020 ◽  
Vol 5 (1) ◽  
pp. 2-9
Author(s):  
Sabin Koirala ◽  
Bigen Man Shakya ◽  
Moda Nath Marhatta
Keyword(s):  
Difficult Intubation ◽  
Predictive Value ◽  
Elective Surgery ◽  
Cross Sectional Study ◽  
Upper Lip ◽  
Cross Sectional ◽  
Airway Assessment ◽  
Total Percentage ◽  
Bedside Test ◽  
Sensitivity Specificity

Introduction: The prediction of difficult intubation using simple bedside test is of great importance to prevent mismanagement of airway. This study was conducted to compare Upper Lip Bite Test (ULBT) with Modified Mallampati Test (MMT) and Thyromental Distance (TMD) for the prediction of difficult intubation. Method: This was descriptive cross-sectional study conducted in 121 patients of  American Society of Anaesthesiologists Physical Status (ASA PS) I and II patients scheduled for elective surgery requiring general anaesthesia with endotracheal tube. The airway assessment of the patients was done one day prior to the surgery using Upper Lip Bite Test (ULBT), Modified Mallampati Test (MMT) and measurement of Thyromental Distance (TMD) . On the day of surgery during laryngoscopy, Cormack-Lehane (CL) grading was recorded. The CL grading of III and IV was labeled as difficult intubation. The Sensitivity, Specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), Likelihood Ratio (LR) of ULBT, MMT and TMD were calculated and compared. Results: The total percentage of difficult intubation, defined by Cormack-Lehane (CL) III and IV was 16.52 %. The sensitivity, specificity, PPV, NPV and accuracy of Upper Lip Bite Test (ULBT) was 50%, 100%, 100%, 91% and 91.74% respectively. ULBT had a significantly higher sensitivity, specificity and PPV when compared to MMT or  TMD or MMT and TMD when combined together. Conclusions:  Upper Lip Bite Test (ULBT) is better   predictor of difficult intubation  and it should be used along with other test during airway assessment.

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