scholarly journals Pleural Fluid Cholesterol Level in Differentiating Exudate from Trasudate Pleural Effusion

2020 ◽  
Vol 11 (4) ◽  
pp. 6478-6485
Author(s):  
Babu Rajendran ◽  
Suwetha Babu ◽  
Sheju Jonathan Jha J
Keyword(s):  
Pleural Effusion ◽  
Positive Predictive Value ◽  
Cholesterol Level ◽  
Negative Predictive Value ◽  
Pleural Fluid ◽  
Predictive Value ◽  
P Value ◽  
Cholesterol Levels ◽  
Specificity And Sensitivity

Correlation of pleural fluid cholesterol level with light’s criteria to differentiate exudate from transudate pleural effusion. Classification of transudate and exudate clinically was done independently based on the light's criteria. Pleural fluid cholesterol levels of 100 selected patients were obtained. The cholesterol levels were compared with the earlier obtained data to study its specificity and sensitivity in differentiating exudate from transudate effusion. It was found that pleural fluid cholesterol in comparison to protein values in differentiating exudate from transudate showed a sensitivity of 79.55%, specificity of 91.07%, the positive predictive value of 87.50%, the negative predictive value of 85.00%, with a P-value of <0.001. Comparison of pleural fluid cholesterol with LDH values showed a sensitivity of 86.36% specificity of 94.64%, the positive predictive value of 92.68%, the negative predictive value of 89.83%, with a P-value of <0.001. Also, a comparison of pleural fluid cholesterol to light's criteria showed a sensitivity of 100% and 86.4% in the transudative group and sensitivity of 100% and 91.1 % in the exudative group, respectively. Routine measurement of pleural fluid cholesterol may serve as a valuable diagnostic indicator for differentiating exudate from transudate effusion.

scholarly journals Histopathological Changes in Helicobacter pylori Associated Gastritis and Scope of Special Stain and Immunohistochemistry as Diagnostic Aids

2020 ◽  
Vol 7 (50) ◽  
pp. 3027-3032
Author(s):  
Ruby Elizabeth Elias ◽  
Bindiya Gisuthan ◽  
Sreeganesh A.S
Keyword(s):  
Helicobacter Pylori ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Chronic Gastritis ◽  
Predictive Value ◽  
Diagnostic Methods ◽  
P Value ◽  
Special Stain ◽  
Frequent Finding ◽  
H Pylori

BACKGROUND Helicobacter pylori associated chronic gastritis plays a vital role in the development of majority of gastric adenocarcinomas and most gastric MALT (Mucosa Associated Lymphoid Tissue) lymphomas. Many diagnostic methods are available for the identification of this organism. However, in gastroenterology practice, histopathological examination of biopsy samples provides visual identification of the pathogen and the associated mucosal changes with special stains like Giemsa. The aim of this study was to evaluate the efficacy of three stains H & E- (Haematoxylin and Eosin), Giemsa and IHC (Immunohistochemistry) in the identification of H. pylori. Associated histologic changes were noted and the relationship between the degree of colonisation and the activity and chronicity of gastritis were analysed. METHODS 585 gastric biopsies taken from dyspeptic patients were evaluated for gastritis, based on updated Sydney System. In 250 randomly selected cases, three staining methods were used. RESULTS Out of 585 cases, 413 (70.60 %) had features of chronic gastritis. Mild chronic gastritis was the commonest finding and is seen in most cases of mild H. pylori colonisation. When activity was monitored, mild activity was the most frequent finding [225 (38.46 %)]. Majority of the severe activity cases showed severe H. pylori colonisation. 13.16 %, 4.79 % and 7.35 % showed intestinal metaplasia, atrophy and dysplastic changes respectively. Out of 250 cases, H & E and Giemsa stains showed 45.6 % and 57.2 % positivity while IHC demonstrated maximum number of positivity (156 cases - 62.4 %). Sensitivity and specificity of H & E was found to be 77.90 % and 98.95 %, positive predictive value was 99.13 % and negative predictive value was 69.18 %. For Giemsa stain, sensitivity was 91.67 %, specificity was 100 %, positive predictive value was 100 % and negative predictive value was 87.85 %. DISCUSSION H. pylori gastritis was a frequent finding in dyspeptic patients in southern part of India. When chi-square test was done, a significant statistical relationship between the severity of H. pylori colonisation, activity and chronicity of gastritis was noted. P value was < 0.001. With the use of special stain, Giemsa and ancillary techniques like IHC, the detection rate of H. pylori was enhanced considerably. CONCLUSIONS With increasing number of H. pylori in the mucosa, there was increase in the chronicity and activity of gastritis. Although immunohistochemistry revealed more cases of H. pylori, Giemsa can be a cost-effective substitute, because of its high specificity and positive predictive value. KEYWORDS H. pylori Gastritis, Giemsa, Haematoxylin and Eosin Stain, Immunohistochemistry

scholarly journals Volume of sputum to detect acid-fast bacilli as a measure of quality for the diagnosis of pulmonary tuberculosis at the Dr George Mukhari Hospital, South Africa

2011 ◽  
Vol 3 (1) ◽  
Author(s):  
Iqbal Rashid ◽  
Langalibalele H. Mabuza ◽  
Indiran Govender ◽  
Deidre Pretorius
Keyword(s):  
South Africa ◽  
Pulmonary Tuberculosis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
P Value ◽  
Likelihood Ratios ◽  
Cross Sectional ◽  
Predictive Values ◽  
Acid Fast Bacilli

Background: Optimum sputum results for acid-fast bacilli (AFB) microscopy are linked to a sputum quantity of at least 5.0 mL. This study was aimed at establishing the effect of sputum quantity in the pick-up rate of AFB microscopy by comparing sputum samples of 5.0 mL and 2.0 mL.Methods: An analytical cross-sectional study was carried out at the Dr George Mukhari Hospital (DGMH) in Pretoria, South Africa, from 05 January 2007 to 04 January 2008.Two sputum samples, 5.0 mL and 2.0 mL, were collected from each of the 330 adult PTB (pulmonary tuberculosis) suspects. Fluorescence microscopy was used in the sputum analysis. The yield through microscopy of the 2.0 mL specimen versus the 5.0 mL specimen was compared and analysed, using culture results as the gold standard.Results: From a sample of 330 specimens, 77 tested AFB positive on microscopy. In the 5.0 mL samples, the sensitivity was 76.6% (95% CI, 66.0% – 84.7%), specificity 99.6% (95% CI 97.8% – 99.9%), positive predictive value (PV+) 98.3% (95% CI 91.1% – 99.7%), negative predictive value (PV-) 93.3% (95% CI 89.7% – 95.7%), the likelihood ratio (LR) for a positive microscopy 192 and the LR for a negative test was 0.23. In the 2.0 mL specimens, the sensitivity was 75.3% (95% CI 64.6% – 83.6%), specificity 99.2% (95% CI 97.1% – 99.8%), positive predictive value (PV+) 96.7% (95% CI 88.6% – 99.1%), negative predictive value (PV-) 93.0% (95% CI 89.3% – 95.4%), the LR for a positive microscopy was 94 and 0.25 for a negative microscopy. There was a statistically significant association (p-value < 0.001) between the microscopy and culture tests in both the 5.0 mL and the 2.0 mL specimen categories. The strength of association between the microscopy and culture, as indicated by the kappa test was 0.83 and 0.81 in the 5.0 mL and 2.0 mL categories, respectively.Conclusion: Compared to the 2.0 mL specimen category, the yield for AFB microscopy in the 5.0 mL specimen category was consistently superior, as indicated by the higher sensitivity, specificity, predictive values and the likelihood ratios in the 5.0 mL specimen category. It is recommended that sputum specimen collection for AFB microscopy should aim for a minimum volume of 5.0 mL.

Sensitivity and Specificity of Histoplasma Antigen Detection by Enzyme Immunoassay

2015 ◽  
Vol 51 (5) ◽  
pp. 306-310 ◽  
Author(s):  
Lauren Cunningham ◽  
Audrey Cook ◽  
Andrew Hanzlicek ◽  
Kenneth Harkin ◽  
Joseph Wheat ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Positive Predictive Value ◽  
Enzyme Immunoassay ◽  
Negative Predictive Value ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Kappa Coefficient ◽  
Urine Samples ◽  
Specificity And Sensitivity ◽  
Antigen Assay

The objective of this study was to evaluate the sensitivity and specificity of an antigen enzyme immunoassay (EIA) on urine samples for the diagnosis of histoplasmosis in dogs. This retrospective medical records review included canine cases with urine samples submitted for Histoplasma EIA antigen assay between 2007 and 2011 from three veterinary institutions. Cases for which urine samples were submitted for Histoplasma antigen testing were reviewed and compared to the gold standard of finding Histoplasma organisms or an alternative diagnosis on cytology or histopathology. Sensitivity, specificity, negative predictive value, positive predictive value, and the kappa coefficient and associated confidence interval were calculated for the EIA-based Histoplasma antigen assay. Sixty cases met the inclusion criteria. Seventeen cases were considered true positives based on identification of the organism, and 41 cases were considered true negatives with an alternative definitive diagnosis. Two cases were considered false negatives, and there were no false positives. Sensitivity was 89.47% and the negative predictive value was 95.35%. Specificity and the positive predictive value were both 100%. The kappa coefficient was 0.9207 (95% confidence interval, 0.8131–1). The Histoplasma antigen EIA test demonstrated high specificity and sensitivity for the diagnosis of histoplasmosis in dogs.

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 Potential role of cholesterol in distinguishing malignant from benign pleural effusion

2004 ◽  
Vol 61 (6) ◽  
pp. 607-611
Author(s):  
Goran Plavec ◽  
Ilija Tomic ◽  
Natasa Nidzovic ◽  
Branko Radojcic ◽  
Slobodan Acimovic ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Cholesterol Level ◽  
Pleural Fluid ◽  
Serum Cholesterol ◽  
Predictive Value ◽  
Pleural Effusions ◽  
Mean Values ◽  
Cholesterol Ratio ◽  
The Difference ◽  
Benign Pleural Effusion

Cholesterol and carcinoembryonic antigen (CEA) levels in pleural effusion and sera, were measured in 199 patients with pleural effusions of various origins. Malignant cause was found in 93, and nonmalignant in 106 patients. Mean cholesterol level in sera of patient with malignant disease was 5.0 ? 0.93mmol/L, and in nonmalignant group 4.34 ? 1.32 mmol/L. The difference was not statistically significant. Mean cholesterol level in nonmalignant pleural effusions was higher thAn those in malignant (2.51 ? 1.23 mmol/L; and 2.28 ? 1.06 mmol/L), but the difference was also not significant. Average pleural fluid/serum cholesterol ratio (HolI/S) in nonmalignant group was 0.61 ? 0.32 and in malignant group 0.46 ? 0.22. The difference between those mean values was significant. Higher ratio, at the cut off value of 0.5 was found in 79/106 and in 25/93 malignant patients. Calculated sensitivity was 75%, specificity 73%, positive predictive value 76%, negative predictive value 65% and accuracy 69%. Significant negative correlation between Holi/S and pleural fluid CEA was found (p<0.05). It was assumed that pleural fluid/serum cholesterol ratio lower than 0,5 could be of great benefit, as an additional test in the differentiation of malignant from benign pleural effusion.

scholarly journals Comparison of Specificity and Sensitivity of AMH and FSH in Diagnosis of Premature Ovarian Failure

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Farzaneh Alipour ◽  
Athar Rasekhjahromi ◽  
Mehrnoosh Maalhagh ◽  
Saeid Sobhanian ◽  
Masoumeh Hosseinpoor
Keyword(s):  
Menstrual Cycle ◽  
Serum Level ◽  
Early Diagnosis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Descriptive Study ◽  
Ovarian Failure ◽  
Specificity And Sensitivity ◽  
Menopausal State

Introduction. Anti-Müllerian hormone represents the primitive follicular number and ovarian age. Low level of AMH is in relation to early menopausal state and decreased ovarian reserve. AMH level changes occur prior to FSH level in representing ovarian failure. The aim of this study is to compare sensitivity and specificity of AMH with FSH in diagnosis of POF.Material and Methods. This descriptive study is done on 96 patients referred to Dr. Rasekh Clinic. Serum level of AMH and FSH was measured at Day 3 (3rd day of menstrual cycle) and data were analyzed through SPSS 21 software.Results. Results of AMH and FSH serum level indicate that AMH has more sensitivity (80% versus 28.57%) and almost equal specificity (78.89% versus 78.65%) compared with FSH. Also negative predictive value of AMH (98.61%) and FSH (87.5%) is different. But positive predictive value is the same (17.39%). Diagnostic accuracy of AMH is more than FSH and has significant differences.Conclusion. According to the results of this study, AMH serum level is more sensitive than FSH serum level. Also AMH has more negative predictive value. Besides, this hormone can be measured at any time of menstrual cycle, against FSH. AMH seems to be more useful in early diagnosis of POF.

scholarly journals White blood cell differential fluorescence abnormal scattergram: A useful indicator for early detection of malarial parasite

2022 ◽  
Vol 38 (3) ◽  
Author(s):  
Madeeha Rehan ◽  
Attika Khalid ◽  
Fariha Nasreen
Keyword(s):  
Early Detection ◽  
Positive Predictive Value ◽  
Blood Cell ◽  
Negative Predictive Value ◽  
White Blood Cell ◽  
Predictive Value ◽  
Rapid Test ◽  
Malarial Parasite ◽  
P Value ◽  
Peripheral Smear

Background & Objective: Undiagnosed malarial infectionis associated with significant mortality and morbidity. Laboratory investigations leading to rapid, accurate and timely diagnosis of malaria is still a challenge. This study was done to assess the utility of abnormal White blood cell differential fluorescence (WDF) scattergram for diagnosis of malaria. Our aim was to study the utility of WDF scattergram for early detection of malarial parasite. Methods: All EDTA anti-coagulated blood samples received in laboratory during a period from Dec 2019 to May 2020 were analyzed on anautomated hematology analyzer, Sysmex XN 1000. All abnormal WDF scattergrams pertaining to plasmodium specie were critically evaluated and recorded. Review of Leishman-stained peripheral smears as well as immune-chromatographic assay by rapid test devices (RTD) was done. Accordingly, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for detection of malaria by abnormal scattergram were calculated. Results: Out of total 1, 26,000of samples analyzed, abnormal WDF scattergrams were detected in 96 cases. Amongst these, 95.8% (92) were positive for MP on Leishman-stained peripheral smear as well as on ICT with a p-value of 0.05. WDF scattergram abnormalities typical of malaria showed a sensitivity of 80% and specificity of 93.26%. Positive predictive value of 95.8% whereas negative predictive value of 99.9% was detected. Significant findings of hemolysis, platelet clumps, nucleated RBCS (NRBCs) and RBC agglutination were noted in cases (n=4) with abnormal WDF scattergram negative for malaria on peripheral smear. Conclusion: Interpretation of abnormal WDF scattergram not only increases the early detection rate for malarial parasite but isa strong indicator for presence of hemolysis, RBC agglutination, platelet clumps and leucoerythroblastic blood picture as well. doi: https://doi.org/10.12669/pjms.38.3.4702 How to cite this:Rehan M, Khalid A, Nasreen F. White blood cell differential fluorescence abnormal scattergram: A useful indicator for early detection of malarial parasite. Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.4702 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Assessment of Clinical Examination Validity in Oral Cancer Risk Patients

2020 ◽  
Vol 24 (1) ◽  
pp. 38-44 ◽  
Author(s):  
Bruno Nikolovski ◽  
Danica Popovik Monevska ◽  
Mirjana Popovska ◽  
Vera Radojkova Nikolovska ◽  
Ana Minovska
Keyword(s):  
Oral Cancer ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Screening Method ◽  
Study Groups ◽  
Tissue Biopsy ◽  
Specificity And Sensitivity ◽  
Potentially Malignant ◽  
Tissue Changes

SummaryBackground/Aim: Oral cancer is one of the ten most common cancers in the world, recently positioned as a sixth one, unfortunately with poor prognosis after treatment because of the late diagnostics in advanced stages of the disease. Aim of this study was to present the basic criteria in assessment the accuracy/efficacy, specificity and sensitivity, the positive and negative predicted values of the conventional oral examination (COE) as the easiest and most acceptable procedure in detection of the early changes of the suspicious oral tissue changes compared to the diagnostic gold standard – tissue biopsy in two different groups of examinees.Material and Methods: Sixty patients divided into two study groups (one with potentially malignant oral lesions and a second consisted of clinically suspicious oral cancer lesions) were examined with COE and subjected to histopathological confirmation - tissue biopsy. All examined patients underwent the diagnostic protocol by the American Joint Commission on Cancer, selected under certain inclusion and exclusion criteria.Results: Sensitivity of COE in the group of examinees with oral potentially malignant lesions is 83.33%, its specificity is 20.83%, the positive predictive value is 20.83% and the negative predictive value is 83.33%. The accuracy of the COE method is 33.33%. The sensitivity, in the group of patients with oral cancer is 96.43%, specificity is 0%, the positive predictive value is 93.10% and the negative predictive value is 0%. The accuracy of this method is 90%.Conclusions: The accuracy reaches a value over 90% for the group with lesions with highly suspected malignant potential – oral cancer, and sets the thesis that COE as screening method for oral cancer or premalignant tissue changes is more valuable for the patients with advanced oral epithelial changes, but is recommended to be combined with some other type of screening procedure in order to gain relevant results applicable in the everyday clinical practice.

Comparative study of frozen and permanent section for diagnosis of toxic epidermal necrolysis

2020 ◽  
Author(s):  
Luke Burnett ◽  
Chunyang Wang ◽  
Feng Zhang ◽  
Stephan Adams ◽  
Joan Wilson ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Toxic Epidermal Necrolysis ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Frozen Section ◽  
Clinical Findings ◽  
P Value ◽  
Permanent Section ◽  
Significant Difference

Abstract Background Toxic epidermal necrolysis (TEN) is a severe, life-threatening mucocutaneous reaction, causing widespread sloughing of skin and mucosal surfaces. Accurate and prompt diagnosis is essential for optimal management and subsequent outcome. In this study, frozen sections were used as a rapid examination for initial diagnosis of TEN, and the frozen section diagnoses were assessed compared with permanent sections. Methods One hundred patients of suspected TEN were referred to our burn unit, and 67 had sufficient clinical findings for frozen and permanent biopsies. The accuracy of frozen section relative to permanent section was evaluated by calculating diagnostic accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). And McNemar’s tests were used to analyze the difference between the two methods. Results Fifty-two specimens were classified as TEN by frozen section, 51 of which were confirmed by permanent biopsy. The exception was diagnosed as bullous pemphigoid on permanent section. Fifteen specimens were read as negative for TEN on frozen slides but 4 were changed to positive by permanent biopsy. Overall, the diagnostic accuracy of frozen section was 92.5%, with sensitivity and specificity 92.7% and 91.7% respectively. The positive predictive value, or coherence of positive diagnosis between the two methods, was as high as 98.1%, and the negative predictive value was 73.3%. The p-value of McNemar’s tests was 0.375, indicating there was no significant difference between the two biopsy methods. Conclusion The data suggest that as a rapid histological assessment, frozen section is a reliable tool in the early diagnosis of TEN.

scholarly journals Pleural fluid cholesterol level is an important parameter in differentiating exudative from transudative pleural effusions

2018 ◽  
Vol 5 (3) ◽  
pp. 520
Author(s):  
Chakradhar Majhi ◽  
Butungeshwar Pradhan ◽  
Bikash C. Nanda ◽  
Sagnika Tripathy
Keyword(s):  
Pleural Effusion ◽  
Cholesterol Level ◽  
Pleural Fluid ◽  
Sensitivity And Specificity ◽  
Pleural Effusions ◽  
Biochemical Tests ◽  
Etiological Diagnosis ◽  
Multiple Parameters ◽  
Fluid Analysis ◽  
Cholesterol Levels

Background: The first important step is to decide whether the pleural effusion is transudate or exudates by Light’s criteria. Light’s criteria can misclassify 25% of pleural transudates as exudates. Pleural fluid cholesterol level can differentiate transudates from exudates as a single parameter instead of multiple parameters used in Light’s criteria. Measurement of pleural fluid cholesterol levels to differentiate transudative effusions from exudative effusions.Methods: Consecutive 60 cases of pleural effusion were taken in the study. Pleural fluid analysis was done for parameters of Light’s criteria along with pleural fluid cholesterol levels. First exudative and transudative effusion was classified by Light’s criteria. Other  clinical and relevant  biochemical tests were done to arrive in  the final etiological diagnosis  and data were collected and analysed .Pleural fluid cholesterol levels was  correlated to Light’s criteria.Results: Total 60 cases of pleural effusion were there in the study. There were 43 exudative and 17 transudative effusions. Mean cholesterol level was 64.2± 7.5mg/dl in exudative effusions and 26.05±8.01 mg/dl in transudates. Pleural fluid cholesterol was ≥55mg /dl in 43 cases of exudates and <55mg/dl in 17 cases of transudates.Conclusions: Pleural fluid cholesterol level of ≥ 55mg/dl had similar sensitivity and specificity to Light’s criteria and as a single important parameter to differentiate exudative from transudative pleural effusion

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