scholarly journals Procalcitonin – A Reliable Marker for Diagnosis of Neonatal Sepsis in Compare to CRP

2018 ◽  
Vol 42 (1) ◽  
pp. 19-25
Author(s):  
Jesmin Akter ◽  
Forrukh Ahammad ◽  
Tahmina Begum
Keyword(s):  
Early Diagnosis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Early Recognition ◽  
Care Hospital ◽  
Suspected Sepsis ◽  
Reliable Marker ◽  
Serum Crp

Background: Early recognition and diagnosis of neonatal sepsis are difficult because of the variable and non-specific clinical presentation of this condition. It is extremely important to make an early diagnosis of neonatal sepsis for prompt institution of antimicrobial therapy. So the objective of the study was to evaluate the efficacy of serum procalcitonin as a reliable marker in diagnosis of neonatal sepsis.Methodology: This cross sectional analytical study was carried out in the Special Care Baby Unit of a tertiary level care hospital in Bangladesh from September 2012 to May 2013. Total 75 newborn with suspected sepsis were included in the study. Specimens of blood were obtained from each neonate prior to commencement of antibiotic for sepsis work up. Serum CRP and procalcitoninlevels were measured. The data from blood cultures were used as the gold standard to evaluate the optimum sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the Receiver Operative Characteristic (ROC) curves.Results:Among total 75 newborns included in this study, 49.3% (37) newborn were diagnosed as proven sepsis and 50.7% (38) newborn as clinical sepsis.The procalcitonin (PCT) was high in 58.7% (500-<2000 pg/ml) newborn and remarkably high (2000-<10000) in 36% newborn with sepsis. At a cut-off value > 500pg/ml, the sensitivity of PCT in detecting sepsis was 48.6%, its specificity 76.3%, positive predictive value was 66.7%, and negative predictive value was 60.4% whereas the sensitivity of CRP for predicting sepsis was 35.1%, specificity 78.9%, positive predictive value 61.9% and negative predictive value was 55.6%. The area under the ROC curve for procalcitonin(0.653) was significantly higher than CRP (0.571).Conclusion:Serum PCT was superior to serum CRP level in terms of early diagnosis of neonatal sepsis, in detecting the severity of sepsis. PCT is a reliable marker than CRP in the diagnosis of neonatal sepsis.Bangladesh J Child Health 2018; VOL 42 (1) :19-25

scholarly journals Diagnostic accuracy of septic markers for neonatal sepsis

2016 ◽  
Vol 48 (5) ◽  
pp. 299
Author(s):  
Thermiany AS ◽  
W Retayasa ◽  
M Kardana ◽  
IN Lila
Keyword(s):  
Blood Culture ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Likelihood Ratio ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Gold Standard ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Suspected Sepsis

Background Neonatal sepsis is a major cause of morbidity andmortality. A positive blood culture is the gold standard fordiagnosis of neonatal sepsis. The signs and symptoms suggestingneonatal sepsis are non-specific. There is no rapid and reliablelaboratory test findings for confirmation of etiologic diagnosis.Clinical signs, symptoms, and laboratory examinations are notperceived as sensitive or specific for diagnosis of sepsis.Objective The purpose of this study was to evaluate the accuracyof the septic markers for diagnosis of neonatal sepsis.Methods Blood culture was used as gold standard to compareseptic markers to diagnose neonatal sepsis. Sensitivity, specificity,positive predictive value (PPV), negative predictive value (NPV),positive and negative likelihood ratio (LR), and accuracy werecalculated.Results We identified 130 cases suspected of neonatal sepsis duringSeptember 2005 until March 2006. Four patients were excludedbecause of major congenital anomalies. The mean age was 2.2 daysand 51.6% were boys. We found fifty six (44.4%) neonates havepositive blood culture. All of septic markers had sensitivity morethan 80%. Immature to Total Neutrophil ratio (Iff) ratio had thehighest sensitivity (96.4%) and C-Reactive Protein (CRP) had thelowest sensitivity (80.4o/o). Combination among leukocyte count,thrombocyte, and Iff ratio had the highest sensitivity (sensitivitywas 85. 7%, specificity was 97.1 o/o, positive predictive value was95.9%, negative predictive value was 89.5%, accuracy was 94.4%,and positive likelihood ratio was 30.0).Conclusion Septic markers can be used in the diagnosticevaluation of neonates with suspected sepsis.

scholarly journals Role of Hematological Score in Early Diagnosis of Neonatal Sepsis

2020 ◽  
Vol 18 (2) ◽  
pp. 45-48
Author(s):  
Dipika Dey ◽  
Razia Sulltana ◽  
Wazir Ahmed ◽  
Mahmood Ahmed Chowdhury ◽  
Farhana Akter ◽  
...  
Keyword(s):  
Blood Culture ◽  
Early Diagnosis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
High Sensitivity ◽  
High Specificity ◽  
Hematological Parameter ◽  
Total Leukocyte Count

Background: Neonatal sepsis is one of the major causes of morbidity & mortality in the newborn, more so in the developing countries. Objective: The objective of this study was to evaluate the applicability of Haematological Scoring System (HSS) in early diagnosis of sepsis and its compatibility with C-reactive protein (CRP) and blood culture. Materials and methods: This prospective study consisted of 205 neonates admitted at neonatal intensive care unit of Chattogram Maa-shishu-o General Hospital with clinical suspicion of neonatal sepsis, from July 2017 to December 2017. The neonatal hematological parameter was measured in all cases. Blood culture and CRP estimation were also performed. Blood culture is considered as gold standard for diagnosis of sepsis. Score 3 and more was considered as positive Results: Out of 205 neonates of our study population, forty one (20%) had proven sepsis according to culture. Total leukocyte count showed high sensitivity & least specificity, immature to mature neutrophil ratio showed high sensitivity and high specificity. Platelet count showed high negative predictive value and least positive predictive value. The HSS was found to have a sensitivity of 82.9%, specificity of 79.8%, positive predictive value was 50.74% and negative predictive value was 94.92%. Considering the high sensitivity and negative predictive value, this study implies that score ³3 were more reliable as a screening tool for sepsis than any of the individual hematological parameter. Conclusion: HSS is a simple, easy and rapid adjunct for the diagnosis of clinically suspected cases of neonatal sepsis. It also provides an effective guideline to make decisions regarding judicious use of antibiotic therapy. Chatt Maa Shi Hosp Med Coll J; Vol.18 (2); July 2019; Page 45-48

scholarly journals Role of annexin A2 and osteopontin for early diagnosis of hepatocellular carcinoma in hepatitis C virus patients

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Abd El-Fattah F. Hanno ◽  
Fatma M. Abd El-Aziz ◽  
Akram A. Deghady ◽  
Ehab H. El-Kholy ◽  
Aborawy I. Aborawy
Keyword(s):  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Early Diagnosis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Chronic Hepatitis C ◽  
Predictive Value ◽  
Annexin A2 ◽  
Alpha Fetoprotein

Abstract Background Liver cancer is the fifth most common cancer and the second most frequent cause of cancer-related death globally. Early stages of hepatocellular carcinoma (0&A) can be treated with curative procedures. The aim of this work was to evaluate the role of annexin A2 and osteopontin for early diagnosis of hepatocellular carcinoma in hepatitis C virus patients. Methods The study was carried out on 80 patients classified into two groups. Group A had 40 chronic hepatitis C patients without hepatocellular carcinoma, while group B had 40 chronic hepatitis C patients with early hepatocellular carcinoma (stages; 0&A). All patients were subjected to thorough history taking, clinical examination, liver function tests, renal function tests, serum alpha-fetoprotein, serum osteopontin, and serum annexin A2. Results Serum alpha-fetoprotein was found to be statistically significantly higher in patients with the hepatocellular carcinoma group than the chronic hepatitis C group. The ROC curve for alpha-fetoprotein for detection of HCC was significant, its diagnostic performance was 0.818* (p < 0.001*), and the cutoff point for predicting the probability for HCC was 6.0 (ng/ml) with sensitivity of 77.50%, specificity of 82.50%, positive predictive value of 81.60%, negative predictive value of 78.6%, and accuracy of 80%. Serum osteopontin was found to be statistically significantly higher in patients from the hepatocellular carcinoma group than the chronic hepatitis C group. The ROC curve for osteopontin was significant, its diagnostic performance was 0.739* (p < 0.001*), the cutoff point was 13.2 (ng/ml) with sensitivity of 65.0%, specificity of 90.0%, positive predictive value of 86.70%, negative predictive value of 72.0%, and accuracy of 77.0%. Serum annexin A2 was found to be statistically significantly higher in patients from the hepatocellular carcinoma group than the chronic hepatitis C group. The ROC curve for annexin A2 was significant, its diagnostic performance was 0.927* (p < 0.001*), the cutoff point was 10.1(ng/ml) with sensitivity of 85.0%, specificity of 85.0%, positive predictive value of 85.0%, negative predictive value of 85.0%, and accuracy of 85.0%. Conclusions Osteopontin had better specificity but lower sensitivity than serum alpha-fetoprotein for early diagnosis of hepatocellular carcinoma. Annexin A2 had better diagnostic sensitivity and specificity than alpha-fetoprotein for early diagnosis of hepatocellular carcinoma.

RISK STRATIFICATION UTILIZING THE MILAN SYSTEM OF CLASSIFICATION FOR SALIVARY GLAND CYTOLOGY : A CYTOHISTOLOGICAL CORRELATION STUDY IN TERTIARY CARE HOSPITAL IN HIMACHAL PRADESH

2021 ◽  
pp. 22-24
Author(s):  
Monica Sarohi ◽  
Kavita Mardi
Keyword(s):  
Salivary Gland ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Clinical Management ◽  
Care Hospital ◽  
Conventional System ◽  
Diagnostic Categories ◽  
Risk Of Malignancy

Introduction- Milan system is an evidence based system derived from the literature which correlates diagnostic categories with risk of malignancy and clinical management strategies. The goals of this system were to standardize salivary gland cytology reporting across institutions and provide a framework for guiding clinical management. It is a tier based classication having six diagnostic categories. The conventional system was used for diagnosis before the advent of Milan system. In this study, FNAC done for all sa Material and methods- livary gland lesions over a period of two years from 2018 - 2020 in department of pathology, IGMC Shimla are included. All cases are categorized according to MSRSGC and correlated with histopathological follow up wherever available. We calculated the sensitivity, specicity, positive predictive value, negative predictive value and diagnostic accuracy of FNA using the Milan system. We also calculated the ROM was for each category. All the cases were Results: categorized as per MSRSGC and were 14%, 45.4%, 0%, 31.4%, 0.6%, 0.6% and 8% in category I, II, III, IVA, IVB, V and VI respectively. ROM for category I, II, IVA, IVB, V and VI was 0%, 0%, 2.6%, 0%, 100% and 87.5% respectively. The sensitivity, specicity, positive predictive value, negative predictive value and diagnostic accuracy was 98.51%, 66.67%, 98.51%, 66.67% and 97.14% respectively. Milan system is an Discussion: effective tool for diagnosing salivary gland lesions. It offers advantages over the conventional system such as risk of malignancy, management options for each category and a better communication both institute wise and between clinicians and cytopathologists.

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 Diagnostic performance of the extended focused assessment with sonography for trauma (EFAST) patients in a tertiary care hospital of Nepal

2020 ◽  
Vol 5 (1) ◽  
pp. e000438
Author(s):  
Samjhana Basnet ◽  
Sanu Krishna Shrestha ◽  
Alok Pradhan ◽  
Roshana Shrestha ◽  
Anmol Purna Shrestha ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Injury Severity ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
University Hospital ◽  
Care Hospital ◽  
Abdominal Injuries ◽  
Contrast Enhanced Ct

BackgroundThoracoabdominal trauma presents a diagnostic challenge for the emergency physician. The introduction of bedside ultrasonography (USG) provides a screening tool to detect hemoperitoneum, hemothorax, pneumothorax and pericardial effusion in torso injuries.AimTo evaluate the accuracy of extended focused assessment with sonography for trauma (EFAST) for chest and abdominal injuries performed by first responders in a tertiary care hospital of Nepal.MethodsThis was a prospective study including all trauma patients who obtained either an Injury Severity Score ≥15 or direct trauma to the trunk in 1 year period in the emergency department (ED) of Dhulikhel Hospital-Kathmandu University Hospital. The results of the EFAST were then compared with contrast-enhanced CT (CECT), radiology ultrasound (USG)/chest X-ray, or intraoperative findings when the EFAST was positive. The negative EFAST cases were observed for a minimum of 4 hours in the ED. Descriptive statistics and sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated.ResultsOut of 267 cases, 261 patients underwent an EFAST examination. The sensitivity and specificity were 94.8% and 99.5%, respectively. The negative predictive value was 98.53% whereas the positive predictive value was 98.21%. The overall accuracy was 99.4%.ConclusionThe results of this study suggest that EFAST examination performed by first-line healthcare providers is a useful method for assessment of thoracic and abdominal injuries. EFAST was found to have a high specificity (99.5%) and positive predictive value (98.21%) which indicates that it is an effective technique for detecting intra-abdominal or thoracic injuries. However, the effectiveness of EFAST is limited by its being operator dependent, and thereby human error. For negative EFAST cases, we recommend a monitoring period of at least 4 hours, serial fast scan, or further investigation through other methods such as a CECT.Level of evidenceLevel I

scholarly journals Comparative study of Amsel’s criteria and Nugent scoring for diagnosis of bacterial vaginosis in a tertiary care hospital, Nepal

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rajshree Bhujel ◽  
Shyam Kumar Mishra ◽  
Santosh Kumar Yadav ◽  
Kesang Diki Bista ◽  
Keshab Parajuli
Keyword(s):  
Positive Predictive Value ◽  
Bacterial Vaginosis ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Scoring System ◽  
Vaginal Discharge ◽  
Care Hospital ◽  
Gold Standard Method ◽  
Abnormal Vaginal Discharge ◽  
Sensitivity Specificity

Abstract Background The most common pathological cause of abnormal vaginal discharge in reproductive-aged women is bacterial vaginosis (BV). Amsel’s criteria and Nugent scoring systems are commonly employed approaches for the diagnosis of BV. Despite the Nugent scoring system being the gold standard method for diagnosing BV, Amsel’s criteria are generally preferred in clinical setup owing to the fact Nugent scoring requires considerable time and expert microscopist. This study was conducted to determine the diagnostic value of Amsel’s criteria by comparing it with the Nugent scoring system. Methods This was a descriptive cross-sectional study conducted at Tribhuvan University Teaching Hospital, Nepal from October 2016 to September 2017. Vaginal specimens were collected from a total of 141 women presenting with abnormal vaginal discharge. The sensitivity, specificity, positive predictive value, and negative predictive value of Amsel’s criteria were calculated, and each component of Amsel’s criteria was compared to the Nugent scoring system. Results The sensitivity, specificity, positive predictive value, and negative predictive value of Amsel’s criteria were 50%, 98.2%, 87.5%, and 88.8% respectively. The clue cells showed 100% specificity and vaginal discharge with pH > 4.5 had 89.3% sensitivity while compared with Nugent’s scoring system. Conclusions Amsel’s criteria can be used as an adjunct method to Nugent scoring for the diagnosis of BV in the hands of skilled manpower in resources limited countries. The presence of clue cell and positive whiff test of Amsel’s criteria shows good match with Nugent’s score.

scholarly journals Mitral Annular Plane Systolic Excursion (MAPSE) as a Simple Index for Assessing Left Ventricular Function: An Observational Study

2021 ◽  
pp. 163-170
Author(s):  
Jayanti Venkata Balasubramaniyan ◽  
Ashutosh Prasad Tripathi ◽  
J. S. Satyanarayana Murthy
Keyword(s):  
Positive Predictive Value ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Lv Function ◽  
Care Hospital ◽  
Ventricular Ejection Fraction

Background: Mitral annular plane systolic excursion (MAPSE) has been proposed as a parameter for assessing left ventricular function. The assessment of LVF has major diagnostic and prognostic implications in patients with cardiovascular diseases. LVF is measured by Left Ventricular Ejection Fraction, however the accuracy of LVEF estimation by two dimensional echocardiography is limited especially in patients with poor image quality. Mitral annular plane systolic excursion (MAPSE) measurement predicts left ventricular function even in conditions with suboptimal echo window. Objective: To assess the correlation of MAPSE derived LVEF with LVEF measured by Modified Simpson’s method. Methods: This is a cross sectional study which included 279 patients admitted at our tertiary care hospital from December 2019 to March 2020 and the patients were divided in two groups. Group A – Patients with LVEF>= 50% and Group B – Patients with LVEF<50%. All patients underwent 2D echocardiographic examination using Modified Simpsons’ method and MAPSE measurement. The VIVID E9, VIVID T8, VIVID E95 and PHILIPS echocardiography machine was used for the non-invasive measurements. MAPSE was recorded at medial and lateral mitral annuli in the apical four-chamber approach. Results: On analysis, a cut off value for average MAPSE-S (medial mitral annuli) was 8.5 was obtained, denoting preserved LV function with sensitivity of 81.7%, specificity of 84.9%, positive predictive value of 91.6% and negative predictive value of 84.9%. The AUC for MAPSE-S was 0.822. Similarly, the cut off value of average MAPSE-L (lateral mitral annuli) was 7.5 denoting impaired LV functions with an AUC of 0.826, sensitivity of 82.8%, specificity of 72.0%, positive predictive value of 85.6% and negative predictive value of 72.0%. The AUC of 82.6% was observed for MAPSE-L. Conclusion: MAPSE reflects longitudinal myocardial shortening. MAPSE is a rapid and sensitive echocardiographic parameter for assessing normal LV function and global LV systolic dysfunction.

Comparison of the performance of Tubex® TF, widalimmunodiagnostic assay and blood culture in diagnosis of enteric fever in a private tertiary care hospital Peshawar, Pakistan

2020 ◽  
pp. 1-8
Author(s):  
Kamran Amir Khan ◽  
Sameed Ullah Qureshi ◽  
Shumaila Ehtisham ◽  
Admin
Keyword(s):  
Blood Culture ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Enteric Fever ◽  
Tertiary Care ◽  
Research Centre ◽  
Care Hospital ◽  
Widal Test ◽  
Culture Positive

Abstract Objective: To determine and compare the performance of TUBEX® TF, widal test & blood culture in the diagnosis of enteric fever. Methods: After approving with the ethical committee, we retrospectively identified patients presented with fever at Northwest General Hospital and Research Centre. Typhidot, Widal test and blood culture was performed as part of their evaluation from January 2018 to December 2018. SPSS 16 was used for data analysis. Results: Of the 241 patients, blood culture was positive for salmonella in 68(28.21%) and negative in 173(71.79%). In the culture positive group, TUBEX® TF was positive in 29(42.64%) and negative in 39(57.36%). Of these culture positive patients, Widal was positive in 25(36.76%) and negative in 43(63.24%). In patients with negative culture, TUBEX® TF was positive in 58(37.66%) and negative in 96(62.34%), Widal was positive in 77(44.5%) and negative in 96(55.5%). The positive predictive value of TUBEX® TF was 33.33% and the negative predictive value was 71.77%. The sensitivity of TUBEX® TF was 42.65% while specificity was 62.34%. The positive predictive value of Widal was 24.51% and the negative predictive value was 69.06%. The sensitivity of Widal was 36.76% while specificity was 55.49%. Conclusion: Sensitivity, specificity, positive predictive value and negative predictive value of TUBEX® TF and Widal test is very low as compared to blood culture. Keywords: Enteric Fever, TUBEX® TF, Widal, Continuous...

scholarly journals The Role of Pancreatic Stone Protein in Diagnosis of Early Onset Neonatal Sepsis

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Anwar A. Rass ◽  
Mohamed A. Talat ◽  
Mohamed A. Arafa ◽  
Hosam F. El-Saadany ◽  
Ezzat K. Amin ◽  
...  
Keyword(s):  
Negative Predictive Value ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Early Onset ◽  
Infected Group ◽  
Pancreatic Stone Protein ◽  
University Hospitals ◽  
Suspected Sepsis ◽  
Pancreatic Stone

Introduction. Early diagnosis and treatment of neonatal sepsis may help decrease neonatal mortality.Aim of the Study. To evaluate the role of pancreatic stone protein as a marker for early onset neonatal sepsis.Methods. A hospital-based prospective study was conducted on 104 (52 uninfected and 52 infected neonates) admitted to the Neonatal Intensive Care Unit (NICU) of Zagazig University hospitals during the period from April 2014 to April 2015. All newborns were subjected to full history taking, careful neonatal assessment, blood, C-reactive protein (CRP), and serum pancreatic stone protein.Results. Serum PSP levels were significantly higher in the infected group than in the uninfected group. At a cutoff level of PSP 12.96 ng/mL, the sensitivity was 96.2%, the specificity was 88.5%, positive predictive value was 95.8%, negative predictive value was 89.3%, and area under the curve was 0.87. A significant positive correlation between CRP and PSP was found in infected group.Conclusion. The high negative predictive value of PSP (89.3%) indicates that the serum PSP level is a good marker for diagnosis of early onset neonatal sepsis and can be used to limit hospital stay and antibiotic use in neonates treated for suspected sepsis.

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