Efficacy of Yale observation scale to detect serious bacterial infection in febrile children aged one to 36 months

Introductions: In most children aged 1-36 months, the cause of a febrile illness is a self limiting viral infection. It is very difficult to distinguish these from serious bacterial infection. Objective of this study is to assess the efficacy of the Yale Observation Scale (YOS) to detect serious bacterial infection in febrile children aged 1-36 months.Methods: YOS scores were assigned as a part of a cross- sectional study in 100 children presenting in Tribhuvan University teaching hospital with fever to divide the child into well- looking if YOS ≤10 or ill- looking if YOS >10. Then the history, examination and necessary investigation was performed to come to a diagnosis of non- serious illness and serious bacterial infection.Results: Serious bacterial infection was found in 33(33%) of the patients. The sensitivity, specificity, positive and negative predictive values for a YOS score greater than 10 to detect serious bacterial infection were 45.45%, 88.05%%, 65.21% and 76.62%, respectively.Conclusions: A YOS ≤10 predicts non-serious illness while a YOS>10 does not necessarily indicate serious bacterial infection and should undergo further evaluation to confirm serious bacterial infection.

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Diagnostic and Prognostic Validity of Proadrenomedullin among Neonates with Sepsis in Tertiary Care Hospitals of Southern India

International Journal of Pediatrics ◽

10.1155/2018/7908148 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Raja Kannan ◽

Suchetha S. Rao ◽

Prasanna Mithra ◽

B. Dhanashree ◽

Shantharam Baliga ◽

...

Keyword(s):

Clinical Outcome ◽

Neonatal Sepsis ◽

Tertiary Care ◽

Cross Sectional Study ◽

Cross Sectional ◽

Predictive Values ◽

Clinical Sepsis ◽

A Value ◽

Sepsis Screen ◽

Sensitivity Specificity

Introduction. To evaluate Proadrenomedullin (Pro-ADM) as the diagnostic and prognostic marker in neonatal sepsis. Materials and Methods. In this cross-sectional study, Pro-ADM levels were estimated in 54 neonates with clinical sepsis and positive sepsis screen (cases) and 54 controls without clinical sepsis. Repeat Pro-ADM levels were estimated after 72 hours in cases. Pro-ADM levels were compared with the clinical outcome. Results and Discussion. Median Pro-ADM levels in cases were 31.8 (IQR: 27.8-39.4) pmol/ml which was significantly higher than controls 5.1 (IQR; 3.1-7.7) pmol/ml. From the constructed ROC curve, a value of 14.5 pmol/ml was taken as the cut-off for sepsis. Pro-ADM had 100% sensitivity, specificity, and positive predictive values (PPV) in detecting sepsis at 14.5 pmol/ml. Among cases, a decrease in Pro-ADM level by 10 pmol/ml was associated with 99% survival. Pro-ADM value of 35 pmol/ml had 100% specificity and PPV in predicting mortality. Conclusion. Pro-ADM can be used as a single biomarker for detecting neonatal sepsis, predicting clinical outcome and prognosis.

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PROKALSITONIN SEBAGAI PENANDA PEMBEDA INFEKSI BAKTERI DAN NON BAKTERI

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v17i2.1019 ◽

2018 ◽

Vol 17 (2) ◽

pp. 76

Author(s):

Bastiana Bastiana ◽

Aryati Aryati ◽

Dominicus Husada ◽

M.Y. Probohoesodo

Keyword(s):

Bacterial Infection ◽

Roc Analysis ◽

Final Diagnosis ◽

Receiver Operating Curve ◽

Fluorescent Assay ◽

Infection Group ◽

Cross Sectional ◽

Predictive Values ◽

Significant Difference ◽

Sensitivity Specificity

Early diagnosis of an infection and prompt administration of an antibiotic can dramatically reduce morbidity and mortality.Procalcitonin (PCT), a precursor of calcitonin, has been proposed as a marker of bacterial infection. The aim of this study is to assess theefficiency of procalcitonin in children for the diagnosis of bacterial vs. non bacterial infection. This was a prospective, cross-sectional study.The subjects were enrolled consecutively, consisting of feverish children (temperature ³38.5° C) admitted to the Pediatric EmergencyDepartment with ages up to 12 years old. The subjects were divided into two groups according to their final diagnosis, bacterial and nonbacterial infection. Serum PCT concentration was measured by enzyme linked fluorescent assay (ELFA) method. Sensitivity, specificity,positive predictive and negative predictive values, and receiver operating curve (ROC) of PCT were calculated. Out of 54 patients,24 (44.4%) had a final diagnosis of bacterial infection. PCT showed a wide concentration range in the bacterial infection group (median:1.09 ng/mL, lower (L)=0.05 ng/mL, upper (U)=128.7 ng/mL) compared with non bacterial infection group (0.21 ng/mL; L=0.05ng/mL; U=12.15 ng/mL). There was a significant difference in PCT between the 2 groups (p=0.020). ROC analysis demonstrated anarea under curve (AUC) of 0.686 (95% CI, 0.534 to 0.838). Using a cut-off point of 0.5 ng/mL, the sensitivity, and specificity, positivepredictive and negative predictive values of PCT were 66.7%, 76.7%, 69.6%, 74.2%, respectively. In this study, PCT may be useful fordifferentiation of bacterial vs. non bacterial infection in children.

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VAGINAL SONOGRAPHY a HYSTEROSCOPY

The Professional Medical Journal ◽

10.29309/tpmj/2009.16.03.2873 ◽

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.

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Comparing Predictive power of CT-scan Findings among the Malignant Hepatic Mass patients

Journal of Science Foundation ◽

10.3329/jsf.v12i1.23457 ◽

2015 ◽

Vol 12 (1) ◽

pp. 2-6

Author(s):

Wahida Begum ◽

Ahmed Hossain ◽

Waziha A Jahan ◽

Mahbuba Shirin ◽

M Abdullah Yusuf ◽

...

Keyword(s):

Ct Scan ◽

Vena Cava ◽

Cross Sectional Study ◽

Medical College Hospital ◽

College Hospital ◽

Cross Sectional ◽

Predictive Values ◽

Medical College ◽

Hepatic Mass ◽

Sensitivity Specificity

Background: CT-scan is useful for the detection of hepatic mass. Objective: The purpose of the present study was to see the predictive values of CT scan in the diagnosis of malignant hepatic mass. Methodology: This cross sectional study was carried out in the Department of Radiology and Imaging at Mymensingh Medical College Hospital (MMCH), Mymensingh, Banghabandhu Sheikh Mujib Medical University (BSMMU), Dhaka and Dhaka Medical College Hospital (DMCH), Dhaka during the period of 1st January 2006 to 31st December 2007. Patients admitted in the Department of Medicine and Department of Hepatobiliary of MMCH, BSMMU, and DMCH with the clinical diagnosis of fever, abdominal pain, anorexia, nausea/vomiting, loss of appetite, jaundice, weight loss and ascites were selected as study population. CT scan and histopathology were performed to all the patients. Result: A total number of 50 patients were recruited for this study.. The sensitivity for multiplicity was 71.4%, specificity was 63.6%, accuracy was 68%, PPV was 71.4% and NPV was 63.6%. The sensitivity for hypodensity as a sign of malignancy was 60.7%, specificity was 18.2%, accuracy was 42.0%, PPV was 48.6% and NPV was 26.7%. The sensitivity, specificity, PPV, NPV and accuracy of contrast enhancement were 100.0%, 22.7%, 62.2%, 100.0% and 66.0% respectively. Again the sensitivity, specificity, PPV, NPV and accuracy of detection of pressure effect on biliary apparatus by CT-scan were 100.0%, 22.7%, 62.2%, 100.0% and 66.0% respectively. Again the sensitivity, specificity, PPV, NPV and accuracy of detection of Lymphadenopathy by CT-scan were 35.7%, 95.5%, 90.9%, 53.8% and 62.0% respectively. The sensitivity, specificity, PPV, NPV and accuracy of detection of Portal vein invasion by CT-scan were 14.3%, 100.0%, 100.0%, 47.8% and 52.0% respectively. The sensitivity, specificity, PPV, NPV and accuracy of detection of hepatic vein invasion by CT-scan were 10.7%, 100.0%, 100.0%, 46.8% and 50.0% respectively. The sensitivity, specificity, PPV, NPV and accuracy of detection of inferior vena cava (IVC) invasion by CT-scan were 7.1%, 100.0%, 100.0%, 45.8% and 48.0% respectively. Conclusion: CT is a useful diagnostic tool for the detection of malignant hepatic masses.Journal of Science Foundation, 2014;12(1):2-6

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Comparing the accuracy of lay diagnosis of childhood malaria and pneumonia with that of the revised IMCI guidelines in Nigeria

Journal of Public Health ◽

10.1093/pubmed/fdaa103 ◽

2020 ◽

Author(s):

K O Elimian ◽

P R Myles ◽

R Phalkey ◽

A Sadoh ◽

C Pritchard

Keyword(s):

Health Workers ◽

Characteristic Curve ◽

Cross Sectional Study ◽

Childhood Diseases ◽

Cross Sectional ◽

Predictive Values ◽

Benin City ◽

Sensitivity Specificity ◽

Childhood Malaria ◽

Pneumonia Diagnosis

Abstract Background Improving caregivers’ recognition of childhood malaria and pneumonia is crucial to early treatment and improving outcomes. The objective of this study was to assess the accuracy and reliability of caregivers’ recognition of malaria and pneumonia (lay diagnosis) as compared to the revised IMCI guidelines. Methods A cross-sectional study design was used to recruit 903 children aged 2–59 months who were assessed for malaria and pneumonia by health workers at five primary healthcare centres in Benin City, Nigeria. Accuracy of lay diagnosis as compared to the revised IMCI guidelines was assessed using sensitivity, specificity, positive and negative predictive values and area under the receiver operating characteristic curve (AUROC) values. Results The accuracy of caregivers’ ability to recognise malaria (AUROC: 0.60; 95% CI: 0.57–0.64) and pneumonia (AUROC: 0.54; 95% CI: 0.50–0.58) was, respectively, moderate and poor as compared to the IMCI guidelines. Caregivers were better able to identify children without than those with malaria and pneumonia. Agreement between caregivers and the IMCI guidelines for malaria and pneumonia diagnosis was poor (k = 0.14, 95% CI: 0.09–0.19; P = 0.0001). Conclusion Caregivers’ ability to recognise these childhood diseases as compared to the IMCI guidelines was poor overall, which was partly due to the approach used to ascertain lay diagnosis.

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Evaluation of platelet count/spleen diameter ratio for detection of oesophageal varices in patients with cirrhosis of liver: a cross-sectional study

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20212771 ◽

2021 ◽

Author(s):

Ashok Mysore Lakshminarayana ◽

Shweta Mallikarjun Kumbar ◽

Manohara Melur Chandregowda ◽

Kiran Warrier

Keyword(s):

Liver Cirrhosis ◽

Platelet Count ◽

Cross Sectional Study ◽

Current Evidence ◽

Oesophageal Varices ◽

Sectional Study ◽

Cross Sectional ◽

Gastroesophageal Varices ◽

Predictive Values ◽

Sensitivity Specificity

Background: Gastroesophageal varices due to portal hypertension in patients with liver cirrhosis is an important cause of morbidity and mortality. Gold standard investigation for varices is esophagogastroduodenoscopy and patients are advised to undergo regular follow up based on the risk stratification. But the invasive nature, risk of procedure-related complication and lack of accessibility and affordability makes it important to identify simpler methods to screen patients. Platelet count/spleen diameter (PSD) ratio has been validated as a marker for oesophageal varices (OV) in multiple studies but with varying results. The present study was conducted to evaluate the accuracy of PSD ratio in OV.Methods: A cross-sectional study was conducted in patients diagnosed with liver cirrhosis. Clinical examination, relevant laboratory investigations, abdominal ultrasound and endoscopy were performed and data were recorded. PSD was calculated. Receiver-operator characteristics curves were plotted to determine cut-off values. Sensitivity, specificity, positive and negative predictive values were calculated.Results: Total 100 patients were included in this study, out of which 25% of patients did not have varices on endoscopy. The mean PSD was for patients without varices 1242.82 (253.45) and 883.51 (582.38467) for patients with OV. The area-under-curve was 0.823, 95% CI=0.734-0.912, p value=0.000001. The cut-off value for PSD was calculated from the ROC analysis was 1077. The sensitivity, specificity, positive and negative predictive values were 76%, 88%, 95% and 55% respectively.Conclusions: PSD ratio is not an efficient parameter for detection of varices in patients with liver cirrhosis. The current evidence does not support its role as a screening test for identification of patients with OV.

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Diagnostic Accuracy of Fine needle Aspiration Cytology of Thyroid Nodules at two tertiary Hospitals in Zambia: a cross-sectional study

University of Zambia Journal of Agricultural and Biomedical Sciences ◽

10.53974/unza.jabs.4.2.388 ◽

2020 ◽

Vol 4 (2) ◽

pp. 6-13

Author(s):

Jackson Chipaila ◽

◽

Alex Makupe ◽

Evans Malyangu ◽

Daniel Maswahu ◽

...

Keyword(s):

Thyroid Nodules ◽

Needle Aspiration ◽

Cross Sectional Study ◽

Sectional Study ◽

Aspiration Cytology ◽

Cross Sectional ◽

Predictive Values ◽

Tertiary Hospitals ◽

Needle Aspiration Cytology ◽

Sensitivity Specificity

Introduction: Thyroid nodules are one of the common surgical presentations in Africa and are of great concern because of their potential to be malignant. Zambia is not excluded from these common surgical conditions. However, there are no pre-operative cellular or intra-operative tissue diagnoses of the thyroid nodules done before thyroidectomy making it difficult to plan for an optimal and definitive management. Fine needle aspiration cytology (FNAC) is known to play a pivotal role in the screening and management of thyroid swellings. This study serves to assess the diagnostic accuracy of FNAC on thyroid nodules in patients at two tertiary hospitals in Zambia in order to establish a basis for introducing its use in the management of thyroid nodules at the institutions. Objectives: To evaluate the accuracy of FNAC, as compared to histopathology, in the diagnosis of thyroid nodules at University Teaching Hospital (UTH) and Ndola Central Hospital (NCH) in Zambia. Methods: This was a prospective cross-sectional study conducted in UTH and NCH surgery department from June 2014 to March 2015. Seventy-three patients, who presented with palpable thyroid nodules and underwent thyroidectomy, were enrolled in the study. The FNAC diagnosis of the patients was compared to the histopathology finding following thyroidectomy. Results: Females made up the majority of the patients (n=67, 91.8%). The ages of the patients ranged from 18 to 78 years. The mean age was 44.3 years and the peak age of incidence was in the fourth decade. All patients were clinically euthyroid at the time of enrolment. The FNAC findings included 23 cases reported as unsatisfactory (31.5%); 29 cases benign (39.7%); 2 cases atypical (2.7%); 6 cases suspicious (8.2%); and 13 cases malignant (17.8%). Histopathology findings were available from all 73 tissue samples of participants, of which 55 (75.3%) and 18 (24.7%) were reported as benign and malignant respectively. Of the 18 malignant cases identified by histology, the most common cancer was follicular carcinoma (n=9, 50%), followed by papillary carcinoma (n=6, 33.3%) and undifferentiated carcinoma (n=3, 16.7%). FNAC, in this study, had sensitivity, specificity, negative and positive predictive values, and accuracy of 83.33%, 89.09%, 94.23 and 71.42%, and 87.67% respectively. Conclusion: In this study, FNAC of thyroid nodules had a high sensitivity, specificity, predictive values and accuracy, and can therefore be recommended to be adopted as a pre-operative tool for screening of thyroid nodules.

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ORAL SQUAMOUS PAPILLOMA AND SQUAMOUS CELL CARCINOMA

The Professional Medical Journal ◽

10.29309/tpmj/2015.22.11.929 ◽

2015 ◽

Vol 22 (11) ◽

pp. 1494-1498

Author(s):

Rajia Liaqat ◽

Najiya Barkat ◽

Asif Hanif

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Cross Sectional Study ◽

Diagnostic Utility ◽

Cross Sectional ◽

Predictive Values ◽

P53 Expression ◽

Squamous Papilloma ◽

Sensitivity Specificity

Objectives: The objective of this study was to determine the diagnostic utility ofp53 in differentiating oral squamous papilloma and squamous cell carcinoma. Study Design:A cross-sectional study. Setting: Pathology Department of Shaukat Khanum Memorial CancerHospital and Research Center Lahore. Period: Six months (6-10-10 to 6-04-11). Patients andMethods: A total of 100 oral biopsies fulfilling the inclusion criteria were collected. The expressionof P53 was observed in biopsies of squamous papilloma and squamous cell carcinoma. Datawas entered and analyzed on SPSS version 20 and was analyzed in same package. Sensitivity,specificity, positive predictive and negative predictive values were calculated along theirconfidence intervals at 95% level. Results: One hundred oral lesions were studied, of which 90cases were of squamous cell carcinoma and 10 cases were of squamous papilloma. Majorityof the patients were male (60%). Mean age was 46 years. P53 IHC stain had sensitivity of 92%and specificity of 80% and diagnostic utility of 91% in lesions of squamous cell carcinoma.Conclusion: P53 is positively expressed in oral squamous cell carcinoma and is negativein squamous papilloma. Hence evaluation of p53 expression can be a useful adjunct in thediagnosis of squamous cell carcinoma, especially in cases where it is difficult to distinguishbetween these two entities on morphological grounds.

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Accuracy of Ultrasound for Determination of Fetal Gender

10.53350/pjmhs211561237 ◽

2021 ◽

Vol 15 (6) ◽

pp. 1237-1239

Author(s):

A. Ammar ◽

M. A. Z. Husnain ◽

M. Arshad ◽

T. M. Mirza ◽

Z. Arshad ◽

...

Keyword(s):

Sensitivity And Specificity ◽

Ultrasound Examination ◽

Cross Sectional Study ◽

Military Hospital ◽

Inclusion Criteria ◽

Cross Sectional ◽

Predictive Values ◽

Fetal Gender ◽

Sensitivity Specificity

Aim: To evaluate the accuracy of ultrasound in determining the phenotypic foetal gender in all three trimesters. Study design: Cross sectional study. Place and duration of study: Department of Diagnostic Radiology Combined Military Hospital Lahore from 1st January 2020 to 30th April 2020. Methodology: Three hundred and seventy two patients in the inclusion criteria were selected. Ages of patients, gestational ages of foetuses and their genders were determined according to the ultrasonographic signs using ultrasound examination. Patients were contacted 3 weeks after the estimated date of delivery and phenotypic sex recorded. Results: Mean age was 34 years. Median gestational age was 21 weeks 3 days. Accuracy of gender determination by ultrasound in 1st, 2nd and 3rd trimesters was 62%, 97% and 95% respectively. Sensitivity and specificity of ultrasound in 1st trimester for males are 66% and 72%; and for females are 72% and 66% respectively. Positive and negative predictive values for male are 69% and 71%; and for female are 71% and 69% respectively. Sensitivity and specificity of ultrasound in 2nd trimester for males are 95% and 100%; and for females are 100% and 95% respectively. Positive and negative predictive values for male are 100% and 94%; and for female are 94% and 100% respectively. Sensitivity and specificity of ultrasound in 3rd trimester for males are 94% and 96%; and for females are 96% and 94% respectively. Positive and negative predictive values for male are 97% and 93%; and for female are 93% and 97% respectively. Conclusion: There is a high accuracy of ultrasound in determination of fetal gender in second and third trimesters. Keywords: Ultrasound, Gender, Trimester, Sensitivity, Specificity, Predictive Value

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An Evaluation of the Arcus Corneae For Age Estimation

Academic Forensic Pathology ◽

10.1177/1925362119891708 ◽

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.

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