Diagnostic Accuracy of Nasopharyngeal Swab Cultures in Children Less Than Five Years with Chronic Wet Cough

Background: It is necessary to find a non-invasive and accurate procedure to predict persistent bacterial bronchitis (PBB) causative organisms and guide antibiotic therapy. The study objective was to compare the diagnostic accuracy of nasopharyngeal swab cultures with bronchoalveolar lavage (BAL) cultures in children with PBB. Methods: Nasopharyngeal swab and BAL fluid specimens were collected and cultured for bacterial pathogens prospectively from less than five-year-old children undergoing flexible bronchoscopy for chronic wet cough. Results: Of the 59 children included in the study, 26 (44.1%) patients had a positive BAL bacterial culture with neutrophilic inflammation. Prevalence of positive cultures for any of the four common respiratory pathogens implicated in PBB (Moraxella catarrhalis, Streptococcus pneumoniae, Staphylococcus aureus, and Haemophilus influenzae) was significantly higher (p = 0.001) in NP swabs compared to BAL fluids (86.4% and 44.1% of PBB cases, respectively). NP swab cultures for any of the four main bacterial pathogens had 85% (95% CI: 65–96%) and 48% (95% CI: 31–66%) sensitivity and specificity of detecting PBB, respectively. Positive and negative predictive values were 56% (95% CI: 47–65%) and 80% (95% CI: 60–91%), respectively. In conclusion, in children less than 5 years of age with chronic wet cough (PBB-clinical), a negative NP swab result reduces the likelihood of lower airway infection; however, a positive NP swab does not accurately predict the presence of lower airway pathogens. Flexible bronchoscopy should be considered in those with recurrent PBB-clinical or with clinical pointers of central airway anomalies.

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PO 8565 PREVALENCE AND CLINICAL SIGNIFICANCE OF RESPIRATORY VIRUSES AND BACTERIA DETECTED IN TUBERCULOSIS PATIENTS COMPARED TO HOUSEHOLD CONTACT CONTROLS IN TANZANIA

BMJ Global Health ◽

10.1136/bmjgh-2019-edc.142 ◽

2019 ◽

Vol 4 (Suppl 3) ◽

pp. A54.2-A54

Author(s):

Francis Mhimbira ◽

Jerry Hella ◽

Hellen Hiza ◽

Emmanuel Mbuba ◽

Magreth Chiryamkubi ◽

...

Keyword(s):

Clinical Significance ◽

Bacterial Pathogens ◽

Severe Disease ◽

Respiratory Viruses ◽

Household Contact ◽

Nasopharyngeal Swab ◽

Respiratory Pathogens ◽

Viral Pathogens ◽

Tuberculosis Patients ◽

Study Participants

BackgroundThe study aim is to describe the prevalence of respiratory pathogens in tuberculosis (TB) patients and in their household contact controls, and to determine the clinical significance of respiratory pathogens in TB patients.MethodsWe studied 489 smear-positive adult TB patients and 305 household contact controls without TB with nasopharyngeal swab samples within an ongoing prospective cohort study in Dar es Salaam, Tanzania, between 2013 and 2015. We used multiplex real-time PCR to detect 16 respiratory viruses and seven bacterial pathogens from nasopharyngeal swabs.ResultsThe median age of the study participants was 33 years; 61% (484/794) were men, and 21% (168/794) were HIV-positive. TB patients had a higher prevalence of HIV (28.6%; 140/489) than controls (9.2%; 28/305). Overall prevalence of respiratory viral pathogens was 20.4% (160/794; 95% CI 17.7%–23.3%) and of bacterial pathogens 38.2% (303/794; 95% CI 34.9%–41.6%). TB patients and controls did not differ in the prevalence of respiratory viruses (Odds Ratio [OR] 1.00, 95% CI 0.71–1.44), but respiratory bacteria were less frequently detected in TB patients (OR 0.70, 95% CI 0.53–0.94). TB patients with both respiratory viruses and respiratory bacteria were likely to have more severe disease (adjusted OR [aOR] 1.6, 95% CI 1.1–2.4; p 0.011). TB patients with respiratory viruses tended to have more frequent lung cavitations (aOR 1.6, 95% CI 0.93–2.7; p 0.089).ConclusionRespiratory viruses are common for both TB patients and household controls. TB patients may present with more severe TB disease, particularly when they are co-infected with both bacteria and viruses.

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Pre-Procedural COVID-19 Nasopharyngeal Swab Has Good Concordance with Bronchoalveolar Lavage in Patients at Low Risk for Viral Infection

Respiration ◽

10.1159/000514928 ◽

2021 ◽

pp. 1-5

Author(s):

Catherine L. Oberg ◽

Reza Ronaghi ◽

Erik E. Folch ◽

Colleen L. Channick ◽

Tao He ◽

...

Keyword(s):

Bronchoalveolar Lavage ◽

Low Risk ◽

Lower Airway ◽

Nasopharyngeal Swab ◽

Symptom Screening ◽

The World ◽

Good Concordance ◽

Sensitivity Specificity ◽

Overall Reliability ◽

Rule Out

Background: The coronavirus disease 2019 (COVID-19) pandemic has drastically affected hospital and operating room (OR) workflow around the world as well as trainee education. Many institutions have instituted mandatory preoperative SARS-CoV-2 PCR nasopharyngeal swab (NS) testing in patients who are low risk for COVID-19 prior to elective cases. This method, however, is challenging as the sensitivity, specificity, and overall reliability of testing remains unclear. Objectives: The objective of this study was to assess the concordance of a negative NS in low risk preoperative patients with lower airway bronchoalveolar lavage (BAL) specimens obtained from the same patients. Methods: We prospectively sent intraoperative lower airway BAL samples collected within 48 h of a negative mandatory preoperative NS for SARS-CoV-2 PCR testing. All adult patients undergoing a scheduled bronchoscopic procedure for any reason were enrolled, including elective and nonelective cases. Results: One-hundred eighty-nine patients were included. All BAL specimens were negative for SARS-CoV-2 indicative of 100% concordance between testing modalities. Conclusions: These results are promising and suggest that preoperative nasopharyngeal SARS-CoV-2 testing provides adequate screening to rule out active COVID-19 infection prior to OR cases in a population characterized as low risk by negative symptom screening. This information can be used for both pre-procedural screening and when reintroducing trainees into the workforce.

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Comparison of saliva with healthcare workers- and patient-collected swabs in the diagnosis of COVID-19 in a large cohort

BMC Infectious Diseases ◽

10.1186/s12879-021-06343-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mitnala Sasikala ◽

Yelamanchili Sadhana ◽

Ketavarapu Vijayasarathy ◽

Anand Gupta ◽

Sarala Kumari Daram ◽

...

Keyword(s):

Healthcare Workers ◽

Early Stage ◽

Cost Effective ◽

Hospitalized Patients ◽

Detection Sensitivity ◽

Nasopharyngeal Swab ◽

Predictive Values ◽

Qrt Pcr ◽

Asymptomatic Patients ◽

Sensitivity Specificity

Abstract Background A considerable amount of evidence demonstrates the potential of saliva in the diagnosis of COVID-19. Our aim was to determine the sensitivity of saliva versus swabs collected by healthcare workers (HCWs) and patients themselves to assess whether saliva detection can be offered as a cost-effective, risk-free method of SARS-CoV-2 detection. Methods This study was conducted in a hospital involving outpatients and hospitalized patients. A total of 3018 outpatients were tested. Of these, 200 qRT-PCR-confirmed SARS-CoV-2-positive patients were recruited for further study. In addition, 101 SARS-CoV-2-positive hospitalized patients with symptoms were also enrolled in the study. From outpatients, HCWs collected nasopharyngeal swabs (NPS), saliva were obtained. From inpatients, HCWs collected swabs, patient-collected swabs, and saliva were obtained. qRT-PCR was performed to detect SARS-CoV-2 by TAQPATH assay to determine the sensitivity of saliva detection. Sensitivity, specificity and positive/negative predictive values (PPV, NPV) of detecting SARS-CoV-2 were calculated using MedCalc. Results Of 3018 outpatients (asymptomatic: 2683, symptomatic: 335) tested by qRT-PCR, 200 were positive (males: 140, females: 60; aged 37.9 ± 12.8 years; (81 asymptomatic, 119 symptomatic). Of these, saliva was positive in 128 (64%); 39 of 81 asymptomatic (47%),89 of 119 symptomatic patients (74.8%). Sensitivity of detection was 60.9% (55.4–66.3%, CI 95%), with a negative predictive value of 36%(32.9–39.2%, CI 95%).Among 101 hospitalized patients (males:65, females: 36; aged 53.48 ± 15.6 years), with HCW collected NPS as comparator, sensitivity of saliva was 56.1% (47.5–64.5, CI 95%), specificity 63.5%(50.4–75.3, CI95%) with PPV of 77.2% and NPV of 39.6% and that of self-swab was 52.3%(44–60.5%, CI95%), specificity 56.6% (42.3–70.2%, CI95%) with PPV 77.2% and NPV29.7%. Comparison of positivity with the onset of symptoms revealed highest detection in saliva on day 3 after onset of symptoms. Additionally, only saliva was positive in 13 (12.8%) hospitalized patients. Conclusion Saliva which is easier to collect than nasopharyngeal swab is a viable alternate to detect SARS-COV-2 in symptomatic patients in the early stage of onset of symptoms. Although saliva is currently not recommended for screening asymptomatic patients, optimization of collection and uniform timing of sampling might improve the sensitivity enabling its use as a screening tool at community level.

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Insulin-like growth factor-1 level is a poor diagnostic indicator of growth hormone deficiency

Scientific Reports ◽

10.1038/s41598-021-95632-0 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Hideyuki Iwayama ◽

Sachiko Kitagawa ◽

Jyun Sada ◽

Ryosuke Miyamoto ◽

Tomohito Hayakawa ◽

...

Keyword(s):

Growth Hormone ◽

Growth Factor ◽

Diagnostic Accuracy ◽

Growth Hormone Deficiency ◽

Screening Test ◽

Characteristic Curve ◽

Hormone Deficiency ◽

Height Velocity ◽

Insulin Like Growth Factor ◽

Predictive Values

AbstractWe evaluated the diagnostic accuracy of insulin-like growth factor-1 (IGF-1) for screening growth hormone deficiency (GHD) to determine the usefulness of IGF-1 as a screening test. Among 298 consecutive children who had short stature or decreased height velocity, we measured IGF-1 levels and performed growth hormone (GH) secretion test using clonidine, arginine, and, in cases with different results of the two tests, L-dopa. Patients with congenital abnormalities were excluded. GHD was defined as peak GH ≤ 6.0 ng/mL in the two tests. We identified 60 and 238 patients with and without GHD, respectively. The mean IGF-1 standard deviation (SD) was not significantly different between the GHD and non-GHD groups (p = 0.23). Receiver operating characteristic curve analysis demonstrated the best diagnostic accuracy at an IGF-1 cutoff of − 1.493 SD, with 0.685 sensitivity, 0.417 specificity, 0.25 positive and 0.823 negative predictive values, and 0.517 area under the curve. Correlation analysis revealed that none of the items of patients’ characteristics increased the diagnostic power of IGF-1. IGF-1 level had poor diagnostic accuracy as a screening test for GHD. Therefore, IGF-1 should not be used alone for GHD screening. A predictive biomarker for GHD should be developed in the future.

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An Artificial Intelligence System for the Detection of Bladder Cancer via Cystoscopy: A Multicenter Diagnostic Study

JNCI Journal of the National Cancer Institute ◽

10.1093/jnci/djab179 ◽

2021 ◽

Author(s):

Shaoxu Wu ◽

Xiong Chen ◽

Jiexin Pan ◽

Wen Dong ◽

Xiayao Diao ◽

...

Keyword(s):

Artificial Intelligence ◽

Bladder Cancer ◽

Diagnostic Accuracy ◽

External Validation ◽

Operation Time ◽

Short Latency ◽

Lesion Detection ◽

Diagnostic Study ◽

Internal Validation ◽

Predictive Values

Abstract Background Cystoscopy plays an important role in bladder cancer (BCa) diagnosis and treatment, but its sensitivity needs improvement. Artificial intelligence has shown promise in endoscopy, but few cystoscopic applications have been reported. We report a Cystoscopy Artificial Intelligence Diagnostic System (CAIDS) for BCa diagnosis. Methods In total, 69,204 images from 10,729 consecutive patients from six hospitals were collected and divided into training, internal validation, and external validation sets. The CAIDS was built using a pyramid scene parsing network and transfer learning. A subset (n = 260) of the validation sets was used for a performance comparison between the CAIDS and urologists for complex lesion detection. The diagnostic accuracy, sensitivity, specificity, and positive and negative predictive values and 95% confidence intervals (CIs) were calculated using the Clopper-Pearson method. Results The diagnostic accuracies of the CAIDS were 0.977 (95% CI = 0.974–0.979) in the internal validation set and 0.990 (95% CI = 0.979–0.996), 0.982 (95% CI = 0.974–0.988), 0.978 (95% CI = 0.959–0.989), and 0.991 (95% CI = 0.987–0.994) in different external validation sets. In the CAIDS versus urologists’ comparisons, the CAIDS showed high accuracy and sensitivity (accuracy = 0.939, 95% CI = 0.902–0.964; and sensitivity = 0.954, 95% CI = 0.902–0.983) with a short latency of 12 s, much more accurate and quicker than the expert urologists. Conclusions The CAIDS achieved accurate BCa detection with a short latency. The CAIDS may provide many clinical benefits, from increasing the diagnostic accuracy for BCa, even for commonly misdiagnosed cases such as flat cancerous tissue (carcinoma in situ), to reducing the operation time for cystoscopy.

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Accuracy of MRI in the Differential Diagnosis of Wilms Tumor

10.53350/pjmhs211582057 ◽

2021 ◽

Vol 15 (8) ◽

pp. 2057-2059

Author(s):

Maham Ashraf ◽

Aysha Anjum ◽

Eisha Tahir ◽

Amber Goraya ◽

Rabia Aqeel

Keyword(s):

Differential Diagnosis ◽

Diagnostic Accuracy ◽

Gold Standard ◽

Wilms Tumor ◽

Correct Diagnosis ◽

Renal Tumors ◽

Common Finding ◽

Predictive Values ◽

Female Ratio ◽

Male Predominance

Background & Objective: Renal tumors are a common finding in diagnostic imaging; these lesions usually are solid or cystic, benign or malignant, and the correct diagnosis may be difficult. The current study aims at to determine the diagnostic accuracy of magnetic resonance imaging for the diagnosis of Wilms tumor taking histopathology as gold standard. Methodology: This cross-sectional study was carried at the Department of Radiology, The Children’s Hospital & Institute of Child Health Lahore over 6 months from March 2019 to September 2019. The study involved 125 children of both genders aged between 2 years to 14 years presenting with a neoplastic mass in the retroperitoneum on ultrasound abdomen during initial workup. These children were assessed on MRI for the diagnosis of Wilms tumor. Later the diagnosis was confirmed on histopathology which was taken as gold standard and the diagnosis of MRI was judged accordingly as true/false and positive/negative. A written informed consent was obtained from every patient. Results: The mean age of the children was 5.8±3.9 years having a male predominance with male to female ratio of 1.8:1. Wilms tumor was suspected in 13 (10.4%) children on MRI. The diagnosis of Wilms tumor was confirmed in 13 (10.4%) children on histopathology. MRI was found to be 76.9% sensitive, 97.3% specific and 95.2% accurate with positive and negative predictive values of 76.9% and 97.3% respectively. Conclusion: In the present study, MRI was found to be 95.2% accurate in the differential diagnosis of Wilms tumor in children presenting with retroperitoneal mass which along with its non-invasive and radiation free nature advocates the preferred use of MRI in the diagnostic evaluation of such children in future oncologic practice. Keywords: Retroperitoneal Tumor, Wilms Tumor, MRI, Diagnostic Accuracy

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“A COMPARATIVE STUDY OF RIPASA SCORE AND ALVARADO SCORE IN THE DIAGNOSIS OF ACUTE APPENDICITIS”

10.36106/ijar/3200856 ◽

2021 ◽

pp. 25-28

Author(s):

M. Vijaya Kumar ◽

Manasa Manasa

Keyword(s):

Acute Appendicitis ◽

Diagnostic Accuracy ◽

Predictive Value ◽

Scoring System ◽

Local Population ◽

Scoring Systems ◽

Signs And Symptoms ◽

Alvarado Score ◽

Predictive Values ◽

Ripasa Score

Acute appendicitis is the most common condition encountered in the Emergency department .Alvarado and Modied Alvarado scores are the most commonly used scoring system used for diagnosing acute appendicitis.,but its performance has been found to be poor in certain population . Hence our aim was to compare the diagnostic accuracy of RIPASA and ALVARADO Scoring system and study and compare sensitivity, specicity and predictive values of these scoring systems. The study was conducted in Government district hospital Nandyal . We enrolled 176 patients who presented with RIF pain . Both RIPASA and ALVARADO were applied to them. Final diagnosis was conrmed either by CT scan, intra operative nding or post operative HPE report. Sensitivity,specicity, positive predictive value, negative predictive value, diagnostic accuracy was calculated both for RIPASA and ALVARADO. It was found that sensitivity and specicity of the RIPASA score in our study are 98.7% and 83.3%, respectively. PPV and NPV were 98.1% and 88.2% and sensitivity and specicity of the Alvardo score in our study are 94.3% and 83.3%, respectively. PPV and NPV were 98% and 62.5%.Diagnostic accuracy of RIPASA score and Alvarado score are 97% and 93% respectively. RIPASA is a more specic and accurate scoring system in our local population when compared to ALVARADO . It reduces the number of missed appendicitis cases and also convincingly lters out the group of patients that would need a CT scan for diagnosis (score 5-7.5 ) BACKGROUND: Acute appendicitis is one of the most commonly dealt surgical emergencies, with a lifetime prevalence rate of approximately 1 one in seven. The incidence is 1.5–1.9 per 1,000 in the male and female population, and is approximately 1.4 times greater in men than in women. Despite being a common problem, it remains a difcult diagnosis to establish, particularly among the young, the elderly and females of reproductive age, where a host of other genitourinary and gynaecological inammatory conditions can present with signs and symptoms that are 2 similar to those of acute appendicitis. A delay in performing an appendectomy in order to improve its diagnostic accuracy increases the risk of appendicular perforation and peritonitis, which in turn increases morbidity and mortality. A variable combination of clinical signs and symptoms has been used together with laboratory ndings in several scoring systems proposed for suggesting the probability of Acute Appendicitis and the possible subsequent management pathway. The Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) and ALVARADO score are new diagnostic scoring systems developed for the diagnosis of Acute Appendicitis and has been shown to have signicantly higher sensitivity, specicity and diagnostic accuracy. AIMS AND OBJECTIVES PRIMARY OBJECT 1. To compare RIPASA Scoring system and ALVARADO Scoring system in terms of diagnostic accuracy in Acute Appendicitis. 2. To study and compare sensitivity, specicity and predictive values of above scoring systems. SECONDARY OBJECT 1. To study the rate of negative appendicectomy based on above scoring systems. CONCLUSION: The RIPASA score is a simple scoring system with high sensitivity and specicity for the diagnosis of acute appendicitis. The 14 clinical parameters are all present in a good clinical history and examination and can be easily and quickly applied. Therefore, a decision on the management can be made early. Although the RIPASA score was developed for the local population of Brunei, we believe that it should be applicable to other regions. The RIPASA score presents greater Diagnostic accuracy and Sensitivity and equal specicity as a diagnostic test compared to the Alvarado score and is helpful in making appropriate therapeutic decisions. In hospitals like ours, the diagnosis of AA relies greatly on the clinical evaluation performed by surgeons. An adequate clinical scoring system would avoid diagnostic errors, maintaining a satisfactory low rate of negative appendectomies by adequate patient stratication, while limiting patient exposure to ionizing radiation, since 21 there is an increased risk of developing cancer with computed tomography, particularly for the paediatric age group.

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Diffusion Weighted MR Imaging of Primary and Recurrent Middle Ear Cholesteatoma: An Assessment by Readers with Different Expertise

BioMed Research International ◽

10.1155/2015/597896 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 16

Author(s):

A. Elefante ◽

M. Cavaliere ◽

C. Russo ◽

G. Caliendo ◽

M. Marseglia ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Middle Ear ◽

Spin Echo ◽

Interrater Agreement ◽

Lower Probability ◽

Kappa Statistics ◽

Single Shot ◽

Predictive Values ◽

Diffusion Weighted ◽

Middle Ear Cholesteatoma

Introduction and Purpose. Diffusion weighted imaging (DWI) has been proven to be valuable in the diagnosis of middle ear cholesteatoma. The aims of our study were to evaluate the advantage of multi-shot turbo spin echo (MSh TSE) DWI compared to single-shot echo-planar (SSh EPI) DWI for the diagnosis of cholesteatoma.Material and Methods. Thirty-two patients with clinical suspicion of unilateral cholesteatoma underwent preoperative MRI (1.5T) with SSh EPI and MSh TSE. Images were separately analyzed by 4 readers with different expertise to confirm the presence of cholesteatoma. Sensitivity, specificity, diagnostic accuracy, and positive (PPV) and negative predictive values (NPV) were assessed for each observer and interrater agreement was assessed using kappa statistics. Diagnosis was obtained at surgery.Results. Overall MSh TSE showed higher diagnostic accuracy and lower negative predictive value (NPV) compared to conventional SSh EPI. Interreader agreement between the observers revealed the superiority of MSh TSE compared to SSh EPI. Interrater agreement among all the four observers was higher by using MSh TSE compared to SSh EPI.Conclusion. Our findings suggest that MSh TSE DWI has higher sensitivity for detection of cholesteatoma and lower probability of misdiagnosis. MSh TSE DWI is useful in guiding less experienced observers to the diagnosis.

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Evaluation of Hookworm Diagnosis Techniques from Patients in Debre Elias and Sanja Districts of the Amhara Region, Ethiopia

Journal of Parasitology Research ◽

10.1155/2021/6682330 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Ayalew Jejaw Zeleke ◽

Ayenew Addisu ◽

Adane Derso ◽

Yalewayker Tegegne ◽

Meseret Birhanie ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Infection Intensity ◽

Public Health Problem ◽

Test Tube ◽

Test Accuracy ◽

Amhara Region ◽

Perfect Agreement ◽

Gold Standard Method ◽

Predictive Values ◽

Flotation Technique

Background. Inappropriate diagnosis could intimidate the prevention and control of hookworm infection. Thus, this study was aimed at evaluating the performance of hookworm diagnosis methods. Methods. An institution-based cross-sectional study was conducted from patients in Debre Elias and Sanja districts of the Amhara region, Ethiopia, from November 2019 to January 2020. The study subjects were selected conveniently. After the data was entered into Statistical Package for the Social Sciences (SPSS), sensitivity, specificity, predictive values, test accuracy, and agreement of the different hookworm diagnosis methods, namely, test tube flotation technique (TFT), McMaster (MM), formol-ether concentration (FEC), Kato-Katz (KK), and direct wet mount microscopy (DWMM), were calculated by using SPSS software. The composite reference standard (CRS) was used as the gold standard method. The kappa ( κ ) test was used to measure the level of agreement between diagnosis tests. Result. A total of 389 stool samples were collected from patients in the study. The overall prevalence of hookworm was 63.24%. The test tube flotation technique (TFT) was found to be the highest both in terms of sensitivity and diagnostic accuracy (100%). McMaster (MM) was the second most sensitive test (68.7%), followed by FEC (44.3%) and KK (38.2%). On the other hand, DWMM had the lowest sensitivity (37.4%), and its diagnostic accuracy was also the least (60%). Only TFT had a perfect agreement ( agreement = 100 % , kappa = 1 ) with the CRS. The sensitivity of DWMM, KK, and FEC showed a kind of linear function with the intensity of infection, but TFT and MM methods were not affected by the infection intensity. Conclusion. Hookworm is still a public health problem in the study area. TFT is by far more sensitive than MM, FEC, KK, and DWMM techniques.

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Evaluation of the diagnostic accuracy of transvaginal sonography versus hysteroscopy in detection of submucous myomas in peri and postmenopausal women with abnormal uterine bleeding

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20213856 ◽

2021 ◽

Vol 10 (10) ◽

pp. 3885

Author(s):

Kushla Pathania ◽

Surbhi Sharma

Keyword(s):

Diagnostic Accuracy ◽

Postmenopausal Women ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Transvaginal Sonography ◽

Cross Sectional ◽

Predictive Values ◽

Menopausal Women ◽

Submucous Fibroid ◽

Post Menopausal

Background: Abnormal uterine bleeding is a very common gynaecological condition that affects all age groups. This study was aimed at assessing the usefulness of TVS in comparison with hysteroscopy in AUB evaluation. Aim was to evaluate the diagnostic accuracy of transvaginal sonography versus hysteroscopy in detection of submucous myomas in peri and postmenopausal women with abnormal uterine bleeding.Methods: The present study was prospective cross sectional study conducted in the Department of Obstetrics and Gynaecology, Kamla Nehru State Hospital for Mother and Child Indira Gandhi Medical College Shimla for period of one year w.e.f. 1st May 2018 to 30th April 2019. The study was started after hospital ethical committee approval. 76 patients peri and post-menopausal women were enrolled in the study after taking written consent.Results: On TVS- all the study subjects underwent TVS examination, submucous fibroid was detected in 10 subjects (n= 76) i.e. 13.1% (all perimenopausal). On hysteroscopy submucous fibroid was detected in 11 (14.4%) subjects, on histopathology it was confirmed in 11 subjects (14.4%). Out of 11, 8 patients underwent hysterectomy, 1 myomectomy, 2 patients had hysteroscopic removal of fibroid. 1 subject with AUB-LSM was wrongly diagnosed as AUB-P. Sensitivity, specificity, positive and negative predictive values of transvaginal sonography versus hysteroscopy was 90.09%, 100%, 100%, 98.5% respectively.Conclusions: TVS is an important initial modality for evaluating the patient of AUB. It is quick, simple, painless, least invasive, less expensive and readily available procedure and does not need full bladder like TAS. On the other hand, hysteroscopy has a better diagnostic accuracy as it provides the option of see and treat which is recommended for peri and post-menopausal women with AUB.

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