scholarly journals Ultrasonography and Magnetic Resonance Cholangiopancreatography in Patients with Obstructive Jaundice

2020 ◽  
Vol 16 (1) ◽  
pp. 6-11
Author(s):  
Pramod Chhettri ◽  
Hari Rana
Keyword(s):  
Obstructive Jaundice ◽  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Treatment Options ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Final Diagnosis ◽  
Cross Sectional Study ◽  
Benign Lesions ◽  
Cross Sectional ◽  
Sensitivity Specificity

Background: Jaundice is a common presenting symptom in patients with hepatobiliary disease. It can be categorized into medical and surgical jaundice and it is important to differentiate due to the different treatment options  Methods: In this cross sectional study from Jan 2017 to June 2018, 84 consecutive patients with          obstructive jaundice who underwent initial USG and then MRCP were included and their respective diagnosis compared keeping surgery and/or histopathology as the gold standard for final diagnosis.  Results: Out of 84 patients, 67.9% were females and 32.1% were males. The most common cause for obstructive jaundice was benign in 72.6% and malignancy in 27.4%. Among the benign lesions            choledocholithiasis was the most common (57.4%) followed by pancreatitis  (26.2%).                      Cholangiocarcinoma was the most common malignant cause (47.8 %) followed by periampullary  carcinoma (26.2%). The sensitivity and specificity of USG in benign lesions was 67.2% and 87%  respectively, and in malignancy 56% and 95% respectively. Similarly sensitivity and specificity of MRCP for benign lesions was 95.2% and 90.9% respectively, and for malignancy 95.75% and 98.45%respectively. Overall diagnostic accuracy of USG in benign and malignant causes was 76.62% and 84.52% respectively. Similarly overall diagnostic accuracy of MRCP for benign and malignant causes was 93.98% and 97.6% respectively.  Conclusions: USG is a good modality for Initial screening and for differentiating  medical and surgical cause of jaundice. MRCP is a better modality with higher sensitivity, specificity and diagnostic accuracy for detecting pathology as compared to USG. Keywords: MRCP; obstructive jaundice; USG.  

scholarly journals Diagnostic accuracy of ultrasound in evaluation of obstructive jaundice with MRCP as gold standard

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Hina Hanif ◽  
Sohail Ahmed Khan ◽  
Sobia Muneer ◽  
Syed Omair Adil
Keyword(s):  
Obstructive Jaundice ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Gold Standard ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Creative Commons ◽  
Positive Predicted Value ◽  
Sensitivity Specificity

Objective: To evaluate the diagnostic accuracy of ultrasound in obstructive jaundice taking MRCP as gold standard. Methods: This cross-sectional study was conducted at Dow Institute of Radiology (DIR), Dow University of Health Sciences (DUHS), Karachi from 2nd May 2018 till 2nd November 2018. Both male and female patients aged 30 to 80 years with suspected obstructive jaundice were included. Patients already diagnosed with obstructive jaundice were excluded. MRCP and ultrasound were performed in suspected patients. Diagnostic accuracy including sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of obstructive jaundice were calculated using contingency tables using MRCP findings as gold standard. Results: Mean age of the patients was 54.73 ± 12.65 years. In causes of obstruction, choledocholothiasis was responsible for 85 (35.1%), stricture 61 (25.2%), carcinoma of head of pancreas 39 (16.1%), periampullary carcinoma 21 (8.7%), cholangiocarcinoma 10 (4.1%) and gallbladder carcinoma 26 (10.7%) of the cases. Diagnostic accuracy of ultrasound in obstructive jaundice taking MRCP findings as gold standard showed sensitivity, specificity, positive predicted value (PPV), negative predicted value (NPV) and overall diagnostic accuracy as 84.57%, 79.10%, 91.36%, 66.25% and 83.06%. Conclusion: Ultrasound has a high sensitivity, moderate specificity, and high diagnostic accuracy in diagnosis of obstructive jaundice. doi: https://doi.org/10.12669/pjms.36.4.1665 How to cite this:Hanif H, Khan SA, Muneer S, Adil SO. Diagnostic accuracy of ultrasound in evaluation of obstructive jaundice with MRCP as gold standard. Pak J Med Sci. 2020;36(4):---------. doi: https://doi.org/10.12669/pjms.36.4.1665 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 Does Static Intra Access Pressure Monitoring of Arteriovenous Fistulas Predicts Intra Access Stenosis?

2021 ◽  
Vol 4 (03) ◽  
Author(s):  
Abaid ur Rehman ◽  
Muhammad Imran Khan ◽  
Omer Sabir ◽  
Muhammad Mohsin Riaz ◽  
Mubashar Dilawar ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Vascular Access ◽  
Doppler Ultrasonography ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Female Ratio ◽  
Arteriovenous Fistulas ◽  
Doppler Us ◽  
Sensitivity Specificity ◽  
Male To Female

The initiation of hemodialysis in patients with chronic kidney disease (CKD) requires vascular access formation. The choice of vascular access for individual patient depends on various factors however arteriovenous fistula (AVF) is conventionally considered to be the vascular access of choice. Once hemodialysis is initiated through a mature AVF, there is an ongoing need for surveillance of the AVF to ensure adequate function and prevent vascular access issues among which flow obstruction (both inflow and outflow) remains the most important. AVF stenosis can potentially lead to inadequate dialysis delivery and thrombosis thus leading to access loss. Physical examination and AVF Doppler ultrasonography (DUS) are useful for evaluation of stenosis in the  arteriovenous connection and the outflow tract. Periodic assessment of the AVF with Static Intra access Pressure (SIAPR) determination may be a reliable means of predicting vascular access stenosis. Material & Methods  A cross sectional study carried out at Department of Nephrology, Fatima Memorial Hospital, Lahore from July 2018 to December 2018. In total 113 patients were included, and all patients underwent SIAPR assessment and Doppler Ultrasound of AVF. Results Mean age of the patients was 56.81±9.38 years, male to female ratio of the patients was 1.8:1. In this study the SIAPR was suggestive of  stenosis in 87(76.99%) patients. The sensitivity, specificity and diagnostic accuracy of SIAPR against Doppler US of the AVF for detection of stenosis was 75.86%, 22.62% & 36.28% respectively Conclusion SIAPR has low specificity and diagnostic accuracy compared to Doppler US for detection of AVF stenosis.

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.

scholarly journals Diagnostic accuracy of magnetic resonance imaging in detection of intra-axial gliomas

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Sohbia Munir ◽  
Sohail Ahmed Khan ◽  
Hina Hanif ◽  
Maria Khan
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Diagnostic Accuracy ◽  
Gold Standard ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Post Contrast ◽  
Sensitivity Specificity

Objective: To evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) in detection of intra-axial gliomas in suspected cases keeping histopathology as gold standard. Methods: This cross-sectional study was conducted at Dow Institute of Radiology, DUHS from October 2017 - April 2018. Patients of either gender aged 30-70 years presenting with headache were included. Patients already diagnosed and referred for follow up were excluded. MRI was performed on 1.5T scanner by a trained MRI technician. T1, T2, FLAIR, diffusion weighted and T1 post contrast images were acquired and reviewed by two radiologists having more than five years post fellowship experience. Sensitivity, specificity, PPV, NPV and diagnostic accuracy of MRI for intraaxial gliomas was calculated taking histopathology findings as gold standard. Results: Mean age of the patient`s was 51.71 ±10.85 years. Positive intraaxial gliomas on MRI were observed in 123 (79.90%) patients while on histopathology, positive intraaxial gliomas were observed in 131 (85.10%) patients. Diagnostic accuracy of MRI in detection of intra-axial gliomas taking histopathology findings as gold standard showed sensitivity, specificity, positive predicted value (PPV), negative predicted value (NPV) and overall diagnostic accuracy as 89.31%, 73.91%, 95.12%, 54.84% and 87.01%. Conclusions: MRI has high sensitivity, moderate specificity and high diagnostic accuracy in detection of intraaxial gliomas. doi: https://doi.org/10.12669/pjms.37.1.2489 How to cite this:Munir S, Khan SA, Hanif H, Khan M. Diagnostic accuracy of magnetic resonance imaging in detection of intra-axial gliomas. Pak J Med Sci. 2021;37(1):125-130. doi: https://doi.org/10.12669/pjms.37.1.2489 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 VAGINAL SONOGRAPHY a HYSTEROSCOPY

2009 ◽  
Vol 16 (03) ◽  
pp. 432-437
Author(s):  
MASOMEH ASGHARNIA ◽  
Zahra Mohammad Tabar ◽  
MARZIEH MEHRAFZA ◽  
Mary am Shakiba ◽  
MONA OUDI ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Uterine Cavity ◽  
Cross Sectional Study ◽  
Therapeutic Modality ◽  
Histological Evaluation ◽  
Complete Evaluation ◽  
Cross Sectional ◽  
Predictive Values ◽  
Infertile Women ◽  
Sensitivity Specificity

B a c k g r o u n d : Hysteroscopy is a valuable diagnostic and therapeutic modality in the management of infertility. A i m : To evaluatethe consistency of hysteroscopy based on a histopathological report from endometrial specimens for intrauterine disorders. Materials andMethods: This is a cross-sectional study. The study included 115 infertile patients. All were admitted for investigation of infertile women beforeassisted reproduction in Mehr infertility institute between 2006 and 2007 hysteroscopy, and histological evaluation of endometrial biopsyperformed.We compared the efficacy of hysteroscopy in the diagnosis of benign intrauterine pathology in infertile women in whom the diagnosiswas confirmed by histologic studies. The women had a complete evaluation with preoperative hysteroscopy, and histological analysis of uterinecavity specimens. Sensitivity, specificity, predictive and negative predictive values were calculated for hysteroscopy considering the histologicalstudy as 100%. Results: Sensitivity and specificity of sonography in diagnosing the polyp were stated 81 % and 64% respectively. Sensitivityand specificity of hysteroscopy showed of polyps revealed 85% and 84% respectively. The results indicated that Sensitivity and specificity ofsonography in diagnosing the myoma were 25% and 98% respectively. Sensitivity and specificity of hysteroscopy in diagnosing the myomawere expressed 50% and 93% respectively. C o n c l u s i o n : Hysteroscopy is a safe and rapid direct visualisation of the uterine cavity. We believeit should be replaced by the diagnostic hysteroscopy as a first line infertility investigation.

scholarly journals Assessment of diagnostic value of different methods (culture, PCR and biopsy) for the diagnosis of tuberculosis in patients with bronchial anthracosis

2020 ◽  
Vol 6 (2) ◽  
pp. e24-e24
Author(s):  
Seyed Shahabedin Mohammad Makki ◽  
Fariba Ghorbani ◽  
Katayoun Najafizadeh ◽  
Shadi Shafaghi ◽  
Hamid Reza Khoddami Vishteh
Keyword(s):  
Diagnostic Accuracy ◽  
Biopsy Specimen ◽  
Incidental Finding ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Bronchial Biopsy ◽  
Pathologic Examination ◽  
Cross Sectional ◽  
The Right ◽  
Sensitivity Specificity

Introduction: Although several studies have shown the relationship between tuberculosis (TB) and anthracosis, few studies have investigated the diagnostic value of various methods of diagnosis of TB in these patients. Objectives: This study was conducted to investigate the diagnostic value of different methods including smear, culture and polymerase chain reaction (PCR) of bronchoalveolar lavage (BAL) sample and bronchial biopsy specimens in the diagnosis of TB in patients with bronchial anthracosis. Patients and Methods: This descriptive cross-sectional study was performed on 67 patients referring for bronchoscopy, and bronchial anthracosis was an incidental finding. The BAL sample and patients’ bronchial biopsies were examined for TB infection. Results: The most affected areas by anthracosis were the right and the left upper lobes. The BAL smear and its culture were positive in 12 (20%) and 10 patients (17%), respectively. The PCR of BAL sample was positive in 37%. Non-specific chronic inflammation followed by bronchial anthracosis was the most common pathologic findings. According to pathological examinations, nine patients (13%) had TB. Sensitivity and specificity of the PCR versus culture were 90% and 70%, respectively, with a diagnostic accuracy of 74%. Sensitivity, specificity and diagnostic accuracy of the pathologic examination of biopsy specimen were 33%, 85% and 74%, respectively. Conclusion: Findings of this study showed that nearly one fifth of patients with bronchial anthracosis suffer from TB simultaneously. In these patients, PCR of the BAL and pathologic examination of the biopsy specimen had the same diagnostic accuracy, but the sensitivity of PCR was three times higher. However, application of PCR and pathologic examination does not seem to have more diagnostic advantages than BAL culture for the diagnosis of TB, although the results by PCR may help to diagnose the disease sooner.

Diagnostic Accuracy of MRC in Benign and ML in Obstructive Jaundice Patients, Taking Histopathology as Gold Standard

2021 ◽  
Vol 15 (12) ◽  
pp. 3421-3423
Author(s):  
Kamran Naseem ◽  
Malik Mudasir Hassan ◽  
Sarah Nisar
Keyword(s):  
Magnetic Resonance ◽  
Obstructive Jaundice ◽  
Diagnostic Accuracy ◽  
Gold Standard ◽  
False Negative ◽  
Magnetic Resonance Cholangiopancreatography ◽  
True Negative ◽  
Cross Sectional ◽  
Standard Material ◽  
Malignant Lesions

Objectives: To find out the diagnostic accuracy of magnetic resonance cholangiopancreatography in benign and malignant lesions in patients of obstructive jaundice, taking histopathology as gold standard. Material and methods: This cross sectional study was conducted at Department of Radiology, Bahawal Victoria Hospital, Bahawalpur October 2019 to April 2020. A total of 164 patients with suspected cases of obstructive jaundice and age 25-65 years of either gender were included. Then magnetic resonance cholangiopancreatography (MRCP) was performed in every patient by 1.5 Tesla MR System using a torso phased-array coil. After this, each patient was undergone operation in the concerned ward. Findings of MRCP were compared with the findings of histopathology. Results: In MRCP positive patients, 78 were true positive (TP) and 13 were false positive (FP). Among 73, MRCP negative patients, 08 were false negative (FN) whereas 65 were True Negative (TN). Overall specificity, sensitivity, NPV, PPV and diagnostic accuracy of magnetic resonance cholangiopancreatography in benign and malignant lesions in patients of obstructive jaundice, taking histopathology as gold standard was 90.70%, 83.33%, 85.71%, 89.04% and 87.20% respectively. Conclusion: This study concluded that magnetic resonance cholangiopancreatography (MRCP) is the non-invasive modality of choice with diagnostic accuracy in diagnosing in benign and malignant lesions in obstructive jaundice patients. Keywords: obstructive jaundice, sensitivity, magnetic resonance imaging.

scholarly journals Accuracy of the Simplified Nutritional Appetite Questionnaire for Malnutrition and Sarcopenia Screening among Older Patients Requiring Rehabilitation

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2738
Author(s):  
Akio Shimizu ◽  
Ichiro Fujishima ◽  
Keisuke Maeda ◽  
Kenta Murotani ◽  
Tatsuro Inoue ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Older Patients ◽  
Older Persons ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Poor Appetite ◽  
Number Of Patients ◽  
Japanese Elderly ◽  
Sensitivity Specificity

This cross-sectional study aimed to examine the accuracy of the Simplified Nutritional Appetite Questionnaire (SNAQ) and the SNAQ for Japanese Elderly (SNAQ-JE) for the Global Leadership Initiative on Malnutrition (GLIM)-defined malnutrition and sarcopenia screening in older persons. We included 380 inpatients aged ≥65 years (mean age, 79.3 ± 7.9; 60.0% women) and admitted to rehabilitation units. Undernutrition and sarcopenia were diagnosed based on GLIM criteria and the Asian Working Group for Sarcopenia, respectively, using bioimpedance analysis. Poor appetite was defined as an SNAQ score of <14 points and an SNAQ-JE score of ≤14 points. The sensitivity, specificity, and accuracy of these tools for detecting poor appetite for GLIM-defined malnutrition and sarcopenia were assessed. The rates of GLIM-defined malnutrition and sarcopenia were 56.8% and 59.2%, respectively. The number of patients with poor appetite was 94 (24.7%) for the SNAQ and 234 (61.6%) for the SNAQ-JE. The sensitivity and specificity of the SNAQ measured against GLIM-defined malnutrition were 32.9% and 73.1%, respectively, and against sarcopenia were 29.8% and 70.2%, respectively. The sensitivity and specificity of the SNAQ-JE measured against GLIM-defined malnutrition were 82.6% and 51.0%, respectively, and against sarcopenia were 86.0% and 53.7%, respectively. The SNAQ-JE showed fair accuracy for GLIM-defined malnutrition and sarcopenia in older patients admitted to rehabilitation units.

The Diagnostic Accuracy of Dynamic MRI in diagnosis of complex adnexal masses

2021 ◽  
Vol 15 (7) ◽  
pp. 1646-1649
Author(s):  
Anum Awais ◽  
Saulat Sarfraz ◽  
Fatima Saleem ◽  
Sidra Sajjad ◽  
Tuba Tariq ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Adnexal Mass ◽  
Dynamic Mri ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Adnexal Masses ◽  
Mri Scans ◽  
The Mean ◽  
Magnetic Resonance Imaging Mri ◽  
Sensitivity Specificity

Background: When ultrasonographic data are restricted, magnetic resonance imaging (MRI) scans can assist identify adnexal mass features. Two European centers have done pioneering work on Dynamic MRI with varied accuracy in diagnosis of complex adnexal lesions. Aim: To evaluate diagnostic accuracy of Dynamic MRI in diagnosing complex adnexal masses, Methods: The Department of Radiology conducted a cross-sectional study. Sheikh Zayed hospital, Lahore for 6 months (September 2017-March 2018). Procedure was done for MRI and histopathology for detecting the adnexal masses. Results of MRI were compared with histopathology results, which are taken as gold standard. Reporting was done by researcher herself under supervision of consultant radiologist. SPSS version 20 was used to enter and evaluate the data. Results: The mean age of patients was 41.57±11.69 years. Dynamic MRI has a 95% sensitivity, specificity, and diagnostic accuracy. 94.37% and 94.7% respectively. Conclusion: Dynamic MRI is reliable and useful tool with high values of responsiveness, for detecting complicated indeterminate adnexal masseson Doppler considering histopathology as gold standard.Specificity and diagnostic accuracy are important. Keywords: Dynamic MRI, Histopathology, Complex Adnexal Mass

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