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.

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 The Optimum Cut-off Value of the Nelwan Score to Diagnose Typhoid Fever in Adults

2021 ◽  
Author(s):  
Erni Juwita Nelwan ◽  
Luh Putu Listya Paramita ◽  
Robert Sinto ◽  
Fransiscus Nikodemus Hosea ◽  
Pringgodigdo Nugroho ◽  
...  
Keyword(s):  
Typhoid Fever ◽  
Clinical Presentation ◽  
Clinical Signs ◽  
Gastrointestinal Symptoms ◽  
Signs And Symptoms ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Clinical Signs And Symptoms ◽  
Sensitivity Specificity

AbstractIntroductionTyphoid fever can be challenging to diagnose since clinicians often depend merely on clinical presentation. Clinical scores are useful to provide more accurate diagnosis. Variables in Nelwan Score are derived from clinical signs and symptoms of suspected cases for typhoid. Diagnostic value of Nelwan Score based on a cut-off value has never been evaluated.MethodsA cross sectional study was conducted between July 2017 and January 2018 in five hospitals and two Primary Health Centers in Jakarta and Tangerang. The inclusion criteria were patients with 3-14 days of fever and gastrointestinal symptoms between July 2017 and January 2018. Diagnosis are confirmed by blood culture, rectal swab culture, or PCR. Cut-off analysis was performed by using Receiver Operating Characteristic (ROC) curve and diagnostic value was analyzed to generate sensitivity, specificity, predictive value and likelihood ratio.ResultFrom 233 subjects involved, 4.72% of them were confirmed to have typhoid fever. The optimal cut-off value of Nelwan Score is 10 with AUC 71.3%. This cut-off value has sensitivity 81.8%, specificity 60.8%, PPV 9.3%, NPV 98.5%, LR + 2.086, and LR – 0.299.ConclusionNelwan Score with cut-off value of 10 provides a good diagnostic performance as a screening tool for patients with suspected typhoid fever clinical presentation.

scholarly journals The Diagnostic Value of Neutrophil-Lymphocyte Ratio in Diagnosis of Autism Spectrum Disorders

2020 ◽  
Vol 26 (3) ◽  
Author(s):  
Nurmalia Purnama Sari ◽  
Yudianita K. ◽  
M. Rafli Haiqal ◽  
M. Fadill Akbar
Keyword(s):  
Predictive Value ◽  
Developmental Disorders ◽  
Neurodevelopmental Disorder ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Autism Spectrum ◽  
Cross Sectional ◽  
Neutrophil Lymphocyte Ratio ◽  
Markers Of Inflammation ◽  
Sensitivity Specificity

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder, progressive disruption of brain development and synaptic connections, which causes impaired communication and behavioral disorders. However, the etiology is unknown. A damaged perinatal environment causes chronic nerve inflammation in genetically susceptible children of ASD, dysregulation of the immune system, which leads to ASD. The ratio of Neutrophil to Lymphocyte (NLR) as one of the markers of inflammation is frequently associated with inflammation-related psychiatric diseases and is potentially used as a diagnostic instrument. A cross-sectional study was carried out from June to November 2019 by using medical records of Outpatients with growth and development disorders and ASD and involving 69 children. The diagnosis of ASD was confirmed by the fifth edition Diagnostic and Manual of Mental Disorders criteria (DSM-V). A routine hematology test was carried out with a flow cytometry method. Diagnostic tests were performed in 43 children with developmental disorders (mean NLR 1.01±0.07) and 26 ASD children (mean NLR 1.02±0.06), with a cut-off value of 0.68. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of NLR were 84.62%; 27.9%; 41.51%; 25%; and 50.2%, respectively. Neutrophil to lymphocyte is sensitive to diagnose ASD but its accuracy is low. Immune dysfunction and complex neurodevelopmental disorders that are affected by chronic inflammation play a role in the occurrence of ASD. Other inflammatory markers are needed to improve the accuracy of laboratory tests to diagnose ASD.

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

scholarly journals An Evaluation of the Arcus Corneae For Age Estimation

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.

scholarly journals Surgeon Performed Ultrasound in Assessing Thyroid Nodule Using American College of Radiology Tirads and Total Malignancy Score (TMS): A Validation Cross Sectional Study

2021 ◽  
Vol 20 (3) ◽  
Author(s):  
Adi Syazni Muhammed ◽  
Randeep Singh ◽  
Shahrun Niza Abdullah Suhaimi ◽  
Nani Harlina Muhammad Latar
Keyword(s):  
Diagnostic Accuracy ◽  
Thyroid Nodule ◽  
Predictive Value ◽  
Scoring System ◽  
Thyroid Nodules ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Diagnostic Reliability ◽  
Sensitivity Specificity

INTRODUCTION: This study aims to evaluate the diagnostic reliability of the American College of Radiology Thyroid Imaging Report and Data System (ACR-TIRADS) and Total Malignancy Score (TMS) scoring system, in differentiating benign and malignant thyroid nodules. MATERIALS AND METHODS: This is a cross-sectional study involving patients with thyroid nodules treated at Hospital Canselor Tuanku Muhriz from October 2017 until October 2019. Ultrasound findings were scored according to the ACR[1]TIRADS and TMS scoring system. They were then correlated with the FNAC or histopathology report. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of both scoring system were calculated for analysis. RESULTS: A total of 150 patients with 223 thyroid nodules were included. 17% or 38 nodules were found to be malignant. The sensitivity, specificity, PPV, NPV and accuracy of ACR-TIRADS and TMS were 97.37% vs. 84.21 % , 52.97% vs. 62.70%, 29.84% vs. 31.68%, 98.99% vs. 95.08% and 61% vs. 66% respectively. According to the ACR-TIRADS, only hypoechoic nodules was a strong predictor of malignancy. Comparatively, in the TMS, strong predictors of malignancy include single nodule, hypoechogenicity, irregular margin, and nodules with peri and intranodular vascularity. CONCLUSION: Both ACR-TIRADS and TMS score had good diagnostic accuracy in predicting malignant thyroid nodule. TMS is comparable and not inferior to ACR[1]TIRADS however, the latter is more practical for use as growth and Doppler characteristic are not included in the assessment.

scholarly journals Reliability of visual assessment of neonatal jaundice among neonates of black descent: a cross-sectional study from Tanzania

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ikunda Dionis ◽  
Omary Chillo ◽  
George M. Bwire ◽  
Calvin Ulomi ◽  
Manase Kilonzi ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Neonatal Jaundice ◽  
Visual Assessment ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Independent Variables ◽  
Sensitivity Specificity

Abstract Background Jaundice is common among neonates and if untreated can lead to kernicterus. Diagnosing neonatal jaundice (NJ) using Kramer’s method (visual assessment) is considered user-friendly in resource-limited areas. However, there are conflicting findings on reliability of the Kramer’s method in the diagnosis of NJ, particularly of black descent. Therefore, study aimed to determine the accuracy of Kramer’s method in comparison to the total serum bilirubin (TSB) test in the diagnosis of NJ among neonates of black descent in Tanzania. Methods A cross-sectional study was conducted between June and July 2020 at Muhimbili National Hospital (MNH) in Dar es Salaam Tanzania. A total of 315 neonates were recruited consecutively. In each neonate, jaundice was assessed using Kramer’s method and TSB test. NJ A total of 315 neonates were recruited i. A 2 X 2 table was created for the determination of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive and negative likelihood ratios (+LR/−LR), and diagnostic accuracy (effectiveness) of Kramer’s method. Cohen kappa (κ) was used to analyze the agreement between Kramer’s method and TSB. Association between independent variables and presence of jaundice were assessed using the chi-square test and the p < 0.05 was considered to be statistically significant. Results The prevalence of NJ was 49.8% by Kramer’s method and 63.5% by TSB. The Sensitivity, Specificity, PPV, and NPV of Kramer’s method were 70.5, 86.1, 89.8, and 62.6%, respectively. The +LR and –LR were 5.07 and 0.34, respectively. The diagnostic accuracy of Kramer’s method was 76.1%. There was a moderate agreement between Kramer’s method and TSB results (κ = 0.524, P<0.001). No significant relationship was observed between the independent variables and the presence of NJ. Conclusion Kramer has a good positive predictive value. However, due to low sensitivity and NPV one cannot say that overall predictive ability is good. Also, clinical assessment by Kramer’s method should not be used for screening of NJ. Further studies are needed to investigate the utility of other non-invasive techniques in detecting NJ among neonates of black descent.

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