scholarly journals Correlation of magnesium and calcium in the management of cardiac arrhythmia: Perspectives for better outcome

2021 ◽  
Vol 0 ◽  
pp. 1-6
Author(s):  
Usha Harshadkumar Patel ◽  
Nanda N. Jagrit ◽  
Mahesh B. Madole ◽  
Shubham Sanjay Panchal
Keyword(s):  
Confidence Interval ◽  
Cardiac Arrhythmia ◽  
Analytical Study ◽  
Operating Characteristic ◽  
Mean Value ◽  
Control Group ◽  
Characteristic Analysis ◽  
Medical College ◽  
Cardiac Disorders ◽  
Coronary Care

Objectives: To find correlation between serum Mg, serum Ca, and cardiac arrhythmia. Materials and Methods: The present case–control analytical study includes records of 100 participants; 50 patients (both male and female average age: 47 ± 12 years, mean ± SD) admitted during the period of March 2019–March 2020 into the Coronary Care Unit of LG Hospital, AMCMET Medical College who were clinically diagnosed as arrhythmia and 50 subjects for control group from OPD patients coming to the same institution for health check-up. Mg was estimated with xylitol blue colorimetric end-point method and Ca was estimated by NM-BAPTA Method by Roche Cobas c311 instrument. Results: In 50 cases, mean Mg value was 1.454 mg/dl and SD 0.2566 while in control group, mean value was 2.2 mg/dl and SD is 0.3110 with 95% confidence interval of 1.381–1.527 and 2.199–2.375 for cases and controls group, respectively, which was statistically significant (p < 0.0001). In 50 cases, mean Ca value was 8.6426 mg/dl and SD 1.3 mg/dl while in control group, mean value was 9.5 mg/dl and SD 0.47 with 95% confidence interval of 8.268–9.018 and 9.377–9.643 for cases and controls, respectively, which was statistically significant (p < 0.0028) and shows correlation between serum Ca and serum Mg which are low in cardiac arrhythmias. Receiver operating characteristic analysis of Ca: Mg (3.36) ratio showed optimum cutoff in diagnosis of cardiac arrhythmia. Conclusion: We concluded that serum Mg and Ca along with Ca/Mg ratio should be considered as an important parameter for investigation of cardiac disorders, especially for patients of cardiac arrhythmia.

Serum Creatine Kinase Muscle-Brain Fraction (CK-MB) and Lactate Dehydrogenase (LDH) as Markers of Perinatal Asphyxia in Term Neonates

2020 ◽  
Vol 17 (2) ◽  
pp. 2-6
Author(s):  
Piush Kanodia ◽  
Sudesh Shrestha ◽  
Santosh Gautam ◽  
Sachin Chawla
Keyword(s):  
Analytical Study ◽  
Operating Characteristic ◽  
Perinatal Asphyxia ◽  
Significant Rise ◽  
Control Group ◽  
P Value ◽  
Case Group ◽  
Roc Curve Analysis ◽  
Cross Sectional ◽  
Term Neonates

Background: The enzymes CK-MB & LDH are used as potential predictors of timing and grade of HIE in newborns with perinatal asphyxia. Objectives: To differentiate HIE neonates from non-HIE ones on the basis of significant rise of LDH & CK-MB. Methodology: Prospective cross-sectional analytical study. Among 164 newborns, 82 comprising the cases and 82 neonates comprising the controls met the inclusion and exclusion criteria. The umbilical cord blood samples for CK-MB and LDH was drawn and sent for analysis. A serum CK-MB value >92.6 U/L and LDH value >580 U/L was taken as the cut-off level. Descriptive statistical analyses were done to find the significance between two groups. ROC Curve analysis was performed to find the diagnostic performance of CK-MB and LDH. Results: Out of total 164 neonates studied, 18.3% had moderate HIE & 11%had severe HIE while 56.1%had No HIE. Seventy-two newborns were found to have LDH levels >580 U/L out of which 71 were in case group and 1 was in control group. Among the 164 neonates studied, 7.9% from case group were found to have CK-MB levels >92.6 U/L. Both the results of LDH & CK-MB levels were very significant with P value <0.001. Area under ROC (Receiving operating Characteristic) value of LDH when compared to CK-MB is (0.978 vs. 0.731). Conclusion: Estimation of CK-MB and LDH enzymes can help to distinguish asphyxiated from non-asphyxiated term neonates when correlating with their history and clinical features.

Interactive visualization to assist fall-risk assessment of community-dwelling elderly people

2017 ◽  
Vol 18 (1) ◽  
pp. 33-44 ◽  
Author(s):  
Tien-Lung Sun ◽  
Chien-Hua Huang
Keyword(s):  
Risk Assessment ◽  
Confidence Interval ◽  
Elderly People ◽  
Fall Risk ◽  
Operating Characteristic ◽  
Receiver Operating Characteristic Analysis ◽  
Interactive Visualization ◽  
Community Dwelling ◽  
Characteristic Analysis ◽  
Fall Risk Assessment

In fall-risk assessment, clinical experts have to provide accurate assessment of high-risk individuals using vast amounts of collected data. In this article, we propose an interactive visualization approach for clinical experts to improve their interpretation of assessment scores and facilitate the decision-making process. Fall-risk assessment data on a total of 356 community-dwelling elders were collated. The Short-Form Berg Balance Scale and 3-Meter Timed Up and Go test were used to screen elderly people with high fall risks. A series of interactive visualization techniques were conducted. After grouping by the literature and a statistical 5% outlier method, some disputed elderly people were examined through interactive visualization. Finally, receiver operating characteristic analysis was conducted using previous fall experience (faller or non-faller) and the three methods. Receiver operating characteristic analysis revealed that the area under the curve was the highest (0.87, 95% confidence interval: 0.80–0.94) for the interactive visualization process compared to the other methods (literature, 0.81 (95% confidence interval: 0.71–0.90); statistical 5% outlier, 0.80 (95% confidence interval: 0.70–0.90)). Through the interactive visualization approach, the clinical experts were able to determine the screening results and their relationship with the decision boundary more rapidly and accurately, demonstrating that this approach is useful for risk assessment in the medical domain.

scholarly journals Can neutrophil-to-lymphocyte ratio be used as a predictor in acute appendicitis?

2021 ◽  
Vol 2021 (1) ◽  
Author(s):  
Chirag Pereira ◽  
Manohar Martis ◽  
Rohan D'Souza ◽  
Leo F. Tauro
Keyword(s):  
Operating Characteristic ◽  
Receiver Operating Characteristic Analysis ◽  
Abdominal Ultrasound ◽  
Complicated Appendicitis ◽  
Neutrophil To Lymphocyte Ratio ◽  
Characteristic Analysis ◽  
Lymphocyte Ratio ◽  
Medical College ◽  
Uncomplicated Appendicitis ◽  
Ethical Approval

Background: To determine if neutrophil-to-lymphocyte ratio (NLR) can be used to diagnose appendicitis and distinguish complicated from uncomplicated appendicitis. The secondary aim was to determine if the appendix cut-off size on ultrasound matches that of existing literature. Methods: We retrospectively analyzed all cases that underwent appendectomy in Father Muller medical college and hospital from 2014 to 2019. The NLR, histopathology, and ultrasound reports for all patients were reviewed. Recommended cut-off values for NLR and appendicular size on ultrasound were determined using receiver operating characteristic analysis (ROC). Data was analyzed using SPSS version 25. Ethical approval was obtained for this study. Results: We included 1623 patients in this study. The patients’ median age was 24 years, with appendicitis being more common in males than females. NLR>2.4 was statistically associated with appendicitis with sensitivity of 70.1% and specificity of 43.2%. NLR>4.3 was statistically associated with complicated appendicitis with sensitivity of 72.25% and specificity of 54.09%. An appendicular diameter >6.1 mm was suggestive of appendicitis on abdominal ultrasound based on our analysis. Conclusions: NLR is a simple adjunct that can be used to diagnose appendicitis and identify complicated appendicitis.

scholarly journals A comparative and correlative study of serum homocysteine level in gestational diabetes mellitus and normal pregnancy

2019 ◽  
Vol 6 (4) ◽  
pp. 1330
Author(s):  
Manoharan S. ◽  
Sharmila R. ◽  
Natesh Prabhu M.
Keyword(s):  
Diabetes Mellitus ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Normal Pregnancy ◽  
Mean Value ◽  
Control Group ◽  
College Hospital ◽  
Correlative Study ◽  
Medical College ◽  
Serum Homocysteine

Background: An alarming increase in Gestational diabetes mellitus (GDM) cases worldwide elevates concern regarding the consequences including fetal macrosomia, preeclampsia and many more. Plasma homocysteine levels which has direct impact on to endothelial function of blood vessels. The relationship of homocysteine and GDM is yet to be clarified.Methods: This single centre prospective observational study was conducted in Department of Obstetrics and Gynaecology of Thanjavur medical college hospital among 50 pregnant primi and multi gravida patients with normal pregnancy and gestational diabetes mellitus to assess the association and comparison of serum homocysteine levels in both groups.Results: The mean value of homocysteine in control group was 3.8 ± 0.95 and in gestational diabetes patients was 16.30±6.09. On comparison, found that there was hyperhomocysteinemia among GDM patients with normal pregnancy and results were statistically significant (T= -9.024 Df=48.000 <0.05).Conclusions: In this comparative and correlative study, we found that patients with gestational diabetes mellitus have higher serum homocysteine levels in comparison with normal pregnant women. Hyperhomocysteinemia is found to be an independent risk factor for gestational diabetes mellitus patients. Further investigations are needed to follow up for these patients in the postpartum period and later in their life.

Usefulness of Serum Anti-p53 Antibody Assay for Lung Cancer Diagnosis

2011 ◽  
Vol 135 (12) ◽  
pp. 1570-1575 ◽  
Author(s):  
Yongjung Park ◽  
Yoonjung Kim ◽  
Jong-Han Lee ◽  
Eun Young Lee ◽  
Hyon-Suk Kim
Keyword(s):  
Lung Cancer ◽  
Receiver Operating Characteristic ◽  
Tumor Markers ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Control Group ◽  
Cytokeratin 19 ◽  
Characteristic Analysis ◽  
Serum Samples ◽  
Receiver Operating

Context.—Some tumor markers, including carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (CYFRA 21-1), are used for the detection of lung cancer; however, their use is limited because of low sensitivities and high false-positive rates. Objectives.—To investigate the usefulness of an anti-p53 assay in detecting lung cancer and to compare the anti-p53 to CEA and CYFRA 21-1 tumor markers. Design.—Serum samples were collected from 82 patients with lung cancer. Sera were also collected from 79 patients with or without benign pulmonary disease for the control group. All 161 specimens were assayed for CEA, CYFRA 21-1, and anti-p53. The diagnostic performances of these markers were compared using receiver operating characteristic analysis. Results.—The receiver operating characteristic area under the curve values of CYFRA 21-1, CEA, and anti-p53 for discriminating lung cancers from benign or healthy conditions were 0.79, 0.81, and 0.79, respectively. Area under the curve for the 3 markers in combination was 0.90. The sensitivities of those markers for lung cancer detection were respectively 39.0%, 53.7%, and 34.1% at 94.9% specificity, and the cutoff levels at those sensitivities and specificities were 4.5 ng/mL for CYFRA 21-1, 5.4 ng/mL for CEA, and 2.7 U/mL for anti-p53. We found 79.3% positive results for patients with lung cancer by any of the 3 markers, and 12.2% were positive only for anti-p53. All patients without cancer had negative results for 2 or all 3 markers. Conclusions.—Anti-p53 combined with other conventional markers is helpful in increasing the sensitivity and specificity for detecting lung cancer.

Preventing Post-injury Hypothermia During Prolonged Prehospital Evacuation

2002 ◽  
Vol 17 (1) ◽  
pp. 23-26 ◽  
Author(s):  
Hans Husum ◽  
Tone Olsen ◽  
Mudhafar Murad ◽  
Yang Van Heng ◽  
Torben Wisborg ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Hospital Admission ◽  
Penetrating Trauma ◽  
Mean Value ◽  
Control Group ◽  
Prospective Clinical Study ◽  
Trauma Patients ◽  
Post Injury ◽  
Northern Iraq ◽  
Care Protocol

AbstractIntroduction:Post-injury hypothermia is a risk predictor in trauma patients whose physiology is deranged. The aim of the present study was to examine the effect of simple, in-field, hypothermia prevention to victims of penetrating trauma during long prehospital evacuations.Methods:A total of 170 consecutively injured landmine victims were included in a prospective, clinical study in Northern Iraq and Cambodia. Thirty patients were provided with systematic prehospital hypothermia prevention, and for 140 patients, no preventive measures were provided.Results:The mean value for the time from injury to hospital admission was 6.6 hours (range: 0.2–72). The incidence of hypothermia (oral temperature <36°C) before prevention/rewarming was 21% (95% confidence interval: 15% to 28%). The Prevention Group had a statistically significant lower rate of hypothermia on hospital admission compared to the control group (95% confidence interval for difference: 6% to 24%).Conclusion:Simple, preventive, in-field measures help to prevent hypothermia during protracted evacuation, and should be part of the trauma care protocol in rural rescue systems.

Evaluation of a Novel Parent-Rated Scale for Selective Mutism

Assessment ◽  
2018 ◽  
Vol 27 (5) ◽  
pp. 1007-1015 ◽  
Author(s):  
Angelika Gensthaler ◽  
Julia Dieter ◽  
Susanne Raisig ◽  
Boris Hartmann ◽  
Marc Ligges ◽  
...  
Keyword(s):  
Operating Characteristic ◽  
Receiver Operating Characteristic Analysis ◽  
Item Analysis ◽  
Selective Mutism ◽  
Control Group ◽  
Severity Scale ◽  
Characteristic Analysis ◽  
Factor Solution ◽  
Diagnostic Measures ◽  
Sum Scores

Assessment of selective mutism (SM) is hampered by the lack of diagnostic measures. The Frankfurt Scale of Selective Mutism was developed for kindergarteners, schoolchildren, and adolescents, including the diagnostic scale (DS) and the severity scale (SS). The objective of this study was to evaluate this novel, parent-rated questionnaire among individuals aged 3 to 18 years ( n = 334) with SM, social phobia, internalizing disorders, and a control group. Item analysis resulted in high item-total correlations, and internal consistency in both scales was excellent with Cronbach’s α = .90-.98. Exploratory factor analysis of the SS consistently yielded a one-factor solution. Mean sum scores of the DS differed significantly between the diagnostic groups, and the receiver operating characteristic analysis resulted in optimal cutoffs for distinguishing SM from all other groups with the area under the curves of 0.94-1.00. The SS sum scores correlated significantly with SM’s clinician-rated symptom severity.

Risk Factors of Recurrent Ischemic Events after Acute Noncardiogenic Ischemic Stroke

2020 ◽  
Vol 25 (45) ◽  
pp. 4827-4834 ◽  
Author(s):  
Limin Zhang ◽  
Xingang Li ◽  
Dongzhi Wang ◽  
Hong Lv ◽  
Xuezhong Si ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Ischemic Stroke ◽  
Operating Characteristic ◽  
Control Group ◽  
Case Group ◽  
Stroke Patients ◽  
Clopidogrel Therapy ◽  
Ischemic Events

Background: A considerable proportion of acute noncardiogenic ischemic stroke patients continue to experience recurrent ischemic events after standard therapy. Aim: We aimed to identify risk factors for recurrent ischemic event prediction at an early stage. Methods : 286 non-cardioembolic ischemic stroke patients with the onset of symptoms within 24 hours were enrolled. Vascular risk factors, routine laboratory data on admission, thromboelastography test seven days after clopidogrel therapy and any recurrent events within one year were assessed. Patients were divided into case group (patients with clinical adverse events, including ischemic stokes, transient ischemic attack, myocardial infarction and vascular related mortality) and control group (events-free patients). The risk of the recurrent ischemic events was determined by the receiver operating characteristic curve and multivariable logistic regression analysis. Results: Clinical adverse events were observed in 43 patients (case group). The mean levels of Mean Platelet Volume (MPV), Platelet/Lymphocyte Ratio (PLR), Lymphocyte Count (LY) and Fibrinogen (Fib) on admission were significantly higher in the case group as compared to the control group (P<0.001). Seven days after clopidogrel therapy, the ADP-induced platelet inhibition rate (ADP%) level was lower in the case group, while the Maximum Amplitude (MA) level was higher in the case group as compared to the control group (P<0.01). The Area Under the Curve (AUC) of receiver operating characteristic(ROC) curve of LY, PLR, , Fib, MA, ADP% and MPV were 0.602, 0.614, 0.629, 0.770, 0.800 and 0.808, respectively. The logistic regression analysis showed that MPV, ADP% and MA were indeed predictive factors. Conclusion: MPV, ADP% and MA were risk factors of recurrent ischemic events after acute noncardiogenic ischemic stroke. Urgent assessment and individual drug therapy should be offered to these patients as soon as possible.

Assessment and Diagnostic Accuracy Evaluation of the Reflux Symptom Index (RSI) Scale: Psychometric Properties using Optimal Scaling Techniques

2020 ◽  
Vol 129 (10) ◽  
pp. 1020-1029
Author(s):  
Andrea Nacci ◽  
Luca Bastiani ◽  
Maria Rosaria Barillari ◽  
Jerome R. Lechien ◽  
Massimo Martinelli ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
Sensitivity And Specificity ◽  
Reflux Symptom ◽  
Original Version ◽  
Control Group ◽  
Clinical Group ◽  
Accuracy Evaluation ◽  
Reflux Symptom Index ◽  
Characteristic Analysis ◽  
Symptom Index

Objectives: To investigate the psychometric properties of the reflux symptom index (RSI) as short screening approach for the diagnostic of laryngopharyngeal reflux (LPR) in patients with confirmed diagnosed regarding the 24-hour multichannel intraluminal impedance-pH monitoring (MII-pH). Methods: From January 2017 to December 2018, 56 patients with LPR symptoms and 71 healthy individuals (control group) were prospectively enrolled. The LPR diagnosis was confirmed through MII-pH results. All subjects (n = 127) fulfilled RSI and the Reflux Finding Score (RFS) was performed through flexible fiberoptic endoscopy. The sensitivity and the specificity of RSI was assessed by ROC (Receiver Operating Characteristic) analysis. Results: A total of 15 LPR patients (26.8%) of the clinical group met MII-pH diagnostic criteria. Among subjects classified as positive for MII- pH diagnoses, RSI and RFS mean scores were respectively 20 (SD ± 10.5) and 7.1 (SD ± 2.5), values not significantly different compared to the negative MII-pH group. The metric analysis of the items led to the realization of a binary recoding of the score. Both versions had similar psychometric properties, α was 0.840 for RSI original version and 0.836 for RSI binary version. High and comparable area under curve (AUC) values indicate a good ability of both scales to discriminate between individuals with and without LPR pathology diagnosis. Based on balanced sensitivity and specificity, the optimal cut-off scores for LPR pathology were ≥ 5 for RSI binary version and ≥ 15 for RSI original version. Both version overestimated LPR prevalence. The original version had more sensitivity and the RSI Binary version had more specificity. Conclusions: It would be necessary to think about modifying the original RSI in order to improve its sensitivity and specificity (RSI binary version, adding or changing some items), or to introduce new scores in order to better frame the probably affected of LPR patient.

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