scholarly journals ROLE OF HYSTEROSALPINGOGRAPHY IN MANAGEMENT OF FEMALE INFERTILITY AND ITS LAPAROSCOPIC CORRELATION

2019 ◽  
pp. 1-2
Author(s):  
(prof.) Alka Agrawal
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Uterine Cavity ◽  
Fallopian Tubes ◽  
Radiographic Technique ◽  
Invasive Techniques ◽  
Work Up ◽  
Tubal Pathology

BACKGROUND : Infertility nowadays has become a medical as well as social problem.Laboratory findings alone is inconclusive in diagnosing infertility.HSG is the radiographic technique for evaluation of uterine cavity & fallopian tubes..Direct visualization of abdominal and pelvic organs in laparoscopy allows a definite diagnosis where clinical examination & less invasive techniques such as ultrasound & HSG fail to identify the abnormality. AIMS & OBJECTIVES :To determine the role of HSG in the evaluation of infertility & to correlate its findings with laparoscopy. METHODS : 75 infertile females aged between 20-40 years were included. HSG & laparoscopy was performed in all patients & findings were analysed. RESULTS : Sensitivity of HSG was 80 %,specificity was 76 % with positive predictive value 63%, negative predictive value 88 % in detecting tubal pathology. Sensitivity of HSG in detecting uterine pathology was 67%, specificity 73%, positive predictive value 39% and negative predictive value 89%. CONCLUSION : HSG has reasonably good sensitivity & specificity in diagnosing tubal & uerine pathology while laparoscopy has diagnostic as well as therapeutic approach.Hence they are complimentary to each other in infertility work up.

A STUDY ON THE ROLE OF SALINE SONOSALPINGOGRAPHY AS A TEST FOR TUBAL PATENCY IN THE ASSESSMENT OF INFERTILITY

2021 ◽  
pp. 80-82
Author(s):  
Bishnu Prasad Das ◽  
Manoj Kumar Majumdar ◽  
Chumi Deka
Keyword(s):  
Predictive Value ◽  
High Sensitivity ◽  
Fallopian Tubes ◽  
Perfect Agreement ◽  
Tubal Patency ◽  
Primary Health ◽  
Infertility Patients ◽  
Work Up ◽  
Tubal Pathology

Background: Tubal pathology is one of the major causes of infertility and evaluation of fallopian tubes forms an essential part of work up of infertility patients. The aim of the study was to evaluate tubal patency by Saline Sonosalpingography and compare the results with that of hysterosalpingography. Methods: A total of 22 patients with primary infertility and 13 patients with secondary infertility attending our Obstetrics and Gynecology department were recruited for the study from July 2019 to June 2020. All the study subjects underwent Saline Sonosalpingography on day 7 to day 9 and Hysterosalpingography on 7th to 11th day of the menstrual cycle. Data was collected and compared to assess the sensitivity and specicity of Sonosalpingography with Hysterosalpingography as reference standard. Results: Sonosalpingography (SSG) has 98.18% sensitivity and 66.67% specicity in comparison to hysterosalpingography (HSG). Analysis of the raw data gave positive predictive value of 91.52% and negative predictive value of 90.9%. Near perfect agreement (Cohen's Kappa coefcient =0.9) was seen between the results of the two methods (SSG and HSG). Conclusions: Sonosalpingogrpahy has a high sensitivity for tubal patency and is less invasive. It is found to be a reliable and relatively less expensive diagnostic procedure in the management of infertility in females. Easy availability and accessibility of ultrasound in all primary health care centres denitely can prove superior to conventional method of diagnosis of tubal patency in such patient.

scholarly journals Role of diffusion-weighted magnetic resonance imaging in assessment of mammographically detected asymmetric densities

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Mohamed Zidan ◽  
Shimaa Ali Saad ◽  
Eman Abo Elhamd ◽  
Hosam Eldin Galal ◽  
Reem Elkady
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Benign Lesions ◽  
Adc Value ◽  
Dce Mri ◽  
Diffusion Weighted ◽  
Breast Asymmetries ◽  
Malignant Lesions

Abstract Background Asymmetric breast density is a potentially perplexing finding; it may be due to normal hormonal variation of the parenchymal pattern and summation artifact or it may indicate an underlying true pathology. The current study aimed to identify the role of diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) values in the assessment of breast asymmetries. Results Fifty breast lesions were detected corresponding to the mammographic asymmetry. There were 35 (70%) benign lesions and 15 (30%) malignant lesions. The mean ADC value was 1.59 ± 0.4 × 10–3 mm2/s for benign lesions and 0.82 ± 0.3 × 10–3 mm2/s for malignant lesions. The ADC cutoff value to differentiate between benign and malignant lesions was 1.10 × 10–3 mm2/s with sensitivity 80%, specificity 88.6%, positive predictive value 75%, negative predictive value 91%, and accuracy 86%. Best results were achieved by implementation of the combined DCE-MRI and DWI protocol, with sensitivity 93.3%, specificity 94.3%, positive predictive value 87.5%, negative predictive value 97.1%, and accuracy 94%. Conclusion Dynamic contrast-enhanced MRI (DCE-MRI) was the most sensitive method for the detection of the underlying malignant pathology of breast asymmetries. However, it provided a limited specificity that may cause improper final BIRADS classification and may increase the unnecessary invasive procedures. DWI was used as an adjunctive method to DCE-MRI that maintained high sensitivity and increased specificity and the overall diagnostic accuracy of breast MRI examination. Best results can be achieved by the combined protocol of DCE-MRI and DWI.

scholarly journals Role of laparoscopy in the Etiologic Diagnosis of Ascites of Unknown Origin

2017 ◽  
Vol 13 (1) ◽  
pp. 13-16
Author(s):  
Anup Sharma ◽  
P. Thapa ◽  
S. N. Gupta
Keyword(s):  
Positive Predictive Value ◽  
Peritoneal Carcinomatosis ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
College Teaching ◽  
Unknown Origin ◽  
Peritoneal Tuberculosis ◽  
Medical College ◽  
Etiologic Diagnosis

Introduction: Ascites is a consequence of many different etiologies, such as liver cirrhosis, neoplasm, tuberculous peritonitis, pyogenic peritonitis, congestive heart failure, renal and pancreatic diseases but, in some situations, ascites is of unknown cause in spite of comprehensive study. The aim of this study was to identify the role of laparoscopy in the etiological diagnosis of ascites of unknown origin.Methods: This was a prospective study of the patients who underwent diagnostic laparoscopy to determine the causes of ascites of unknown origin in the Department of Surgery, Nepalgunj Medical College Teaching Hospital from April 2012 to May 2014. All the patients underwent laparoscopy for the evaluation of ascites after appropriate clinical and laboratory examinations, which failed to reveal the cause.Results: Peritoneal tuberculosis and carcinomatosis peritonei were the two most common causes found in 37.14% and 57.14% of cases respectively. The average age of the patients was 52 years. Distension of abdomen, abdominal pain and weight loss were the most frequently observed symptoms in 33 patients (100%), 26 patients (74.28%) and 18 patients (51.42%) respectively. The CT scan findings, were a omental thickening in 28 cases (80%), peritoneal nodules in 7(20%) patients and the intraabdominal lymph nodes in 13 patients (39.39%). Ovarian mass was found in 4 patients (11.42%). The histological diagnosis was a peritoneal carcinomatosis in 13 (37.14%) patients and peritoneal tuberculosis in 20 (57.1%) patients and in two patients nonspecific inflammation. The sensitivity and specificity of laparoscopic diagnosis in the diagnosis of peritoneal tuberculosis were 78.67% and 98.6% respectively and in the diagnosis of peritoneal carcinomatosis were 94.78% and 72.2% respectively. The positive predictive value was 97.3% and the negative predictive value was 73.7% for peritoneal tuberculosis and for peritoneal carcinomatosis the positive predictive value was 83.7% and negative predictive value was 94.87%.Conclusion: The etiologic diagnosis of ascites of unknown origin is difficult despite the availability of several tests. Laparoscopy with peritoneal biopsy has still got a role in diagnosing these types of ascites where the other laboratory and imaging studies fail to reveal the cause.Journal of Nepalgunj Medical College Vol.13(1) 2015: 13-16

scholarly journals Role of ascitic fluid adenosine deaminase (ADA) and serum CA-125 in the diagnosis of tuberculous peritonitis

2015 ◽  
Vol 40 (3) ◽  
pp. 89-91 ◽  
Author(s):  
N Ali ◽  
NC Nath ◽  
R Parvin ◽  
A Rahman ◽  
TM Bhuiyan ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Diagnostic Test ◽  
Ascitic Fluid ◽  
Predictive Value ◽  
Ca 125 ◽  
Histopathological Diagnosis ◽  
Diagnostic Modality ◽  
Cross Sectional

This cross sectional study was carried out in the department of gastroenterology, BIRDEM, Dhaka from January 2010 to May 2011 to determine the role of ascitic fluid ADA and serum CA-125 in the diagnosis of clinically suspected tubercular peritonitis. Total 30 patients (age 39.69±21.26, 18M/12F) with clinical suspicion of tuberculosis peritonitis were included in this study after analyzing selection criteria. Laparoscopic peritoneal biopsy with ‘histopathological diagnosis’ was considered gold standard against which accuracics of two biomarkers (ADA & CA-125) were compared. Cut off value of ADA and CA-125 are 24 u/l, 35 U/ml respectively. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of ADA as a diagnostic modality in tuberculos peritonitis were 87.5%, 83.33%, 95.45%, 62.5% and 86.67% respectively where as CA-125 was found to have 83.33% sensitivity, 50% specificity, 86.9% positive predictive value, 42.85% negative predictive value and 76.6% accuracy. Both biomarkers are simple, non-invasive, rapid and relatively cheap diagnostic test where as laparoscopy is an invasive procedure, costly & requires trained staff and not without risk and also not feasible in all the centre in our country. So ascitic fluid ADA and serum CA-125 are important diagnostic test for peritoneal tuberculosis.Bangladesh Med Res Counc Bull 2014; 40 (3): 89-91

scholarly journals Role of Hysterosalpingography for Evaluation of Infertility

1970 ◽  
Vol 39 (1) ◽  
pp. 16-23 ◽  
Author(s):  
Shahara Haque
Keyword(s):  
Medical Journal ◽  
Diagnostic Tool ◽  
False Positive ◽  
False Negative ◽  
Uterine Cavity ◽  
Age Group ◽  
Fallopian Tubes ◽  
Potential Accuracy ◽  
Tubal Pathology

The patients investigated under this study have complaints of inability to conception and they were not responding to treatment. Patients with infertility were studied, the peak incidence of infertility was found in between 26-29 years of age group. Hysterosalpingography examination detected tubal and uterine pathology correctly in 26 cases (81.25%) out of 29 cases of complaining of infertility. Of 18 negative cases, 12 cases (80%) are diagnosed correctly as normal by Hysterosalpingography. After laparoscopic examination it was established that three (20%) were false positive and 6 cases were false negative. If a longer series are analyzed, these findings may vary slightly but still it is very useful diagnostic tool for detection of infertility. Hysterosalpingography will give utmost benefit to the patients of our country. In our study we found that Hysterosalpingography is still the best technique for intrauterine and tubal pathology. This study has established the fact that Hysterosalpingography should be the first approach in the diagnosis of infertility which gives valuable information about both uterine cavity and fallopian tubes at low risk and minimal hazards. As a result of our findings, it is our investigation of female infertility due to its potential accuracy and easy performance Keywords: Hysterosalpingography; Infertility. DOI: 10.3329/bmj.v39i1.6228 Bangladesh Medical Journal 2010; 39(1): 16-23

scholarly journals EVALUATION OF ACUTE APPENDICITIS USING ULTRASOUND

2021 ◽  
Vol 9 (02) ◽  
pp. 315-321
Author(s):  
Abdullah Hamdan ◽  
◽  
Nasraldeen Alnaeem M. Alkhidir ◽  
Abdelmoneim Saeed ◽  
◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Clinical Diagnosis ◽  
Predictive Value ◽  
Sensitivity Specificity ◽  
Histopathological Report

The diagnosis of acute appendicitis is mainly clinical and to confirm the clinical diagnosis ultrasonography (USG) of the abdomen is being used to help in diagnosis of the disease. To find out the role of USG in the diagnosis of acute appendicitis in clinically equivocal cases and to correlate USG findings with histopathological reports (HPR) of removed appendix.Total numbers of 100 patients were included in the study from 12March 2019 to 5 December 2019. Findings on ultrasound were finally compared with histopathological report of appendices removed on surgery. Those cases with alternate diagnosis were followed up and proved with other means of investigation. The sensitivity, specificity, positive predictive value, negative predictive value and overall accuracy of ultrasound in diagnosis of acute appendicitis in our study were found to be 79 %, 84.20 %, 95.50%, 48.40% and 80% respectively.

scholarly journals Clinicopathological evaluation of acute appendicitis and the role of ultrasound in diagnosis: a prospective study

2019 ◽  
Vol 6 (5) ◽  
pp. 1471
Author(s):  
Tony Mathew ◽  
Amit Shivshankar Ammanagi
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Prospective Study ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Scoring System ◽  
Lower Abdominal Pain ◽  
Negative Appendicectomy ◽  
A Prospective Study

Background: Acute appendicitis is the most common acute surgical condition of the abdomen. Delay in treatment of acute appendicitis causes lot of complication. Study was done with the objective to study the clinical and pathological presentations of acute appendicitis, to evaluate the role of ultrasound in early diagnosis of acute appendicitis and to reduce negative appendicectomy in patients.Methods: This is a prospective study done on 100 patients with acute right lower abdominal pain clinically presumed to be of appendicular origin. A thorough history, clinical examination and ultrasound scan, was done for all cases. All ultrasound positive cases were subjected to surgery and some negative cases were also taken for surgery based on clinical suspicion. The ultrasound diagnosis was compared with clinical findings, operative findings and histopathological examination reports.Results: The overall accuracy of clinical diagnosis (Alvarado scoring system) with histopathology findings was 72%. The overall sensitivity and specificity was 70.3% and 81.3% respectively and positive predictive value of was 95.2% whereas the negative predictive value was 34.2%. The overall accuracy of ultrasound with histopathology report was 93%, with a sensitivity of 96.4%, specificity of 75%, and a positive predictive value of 95% and a negative predictive value of 80%. Negative appendicectomy rate was 8.82% in females and 3.63% in males.Conclusions: The Alvarado scoring system combined with ultrasound can therefore be used as a cheap and inexpensive way of confirming acute appendicitis thus reducing negative appendicectomy rate.

Prognostic Role of PET-FDG Before Autologous Stem Cell Transplantation in Advanced Hodgkin's Lymphoma.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1548-1548
Author(s):  
Alessandro Pulsoni ◽  
Elena Cavalieri ◽  
Saveria Capria ◽  
Fabio Torelli ◽  
Giorgia Annechini ◽  
...  
Keyword(s):  
Stem Cell ◽  
Positive Predictive Value ◽  
Stem Cell Transplantation ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Prognostic Role ◽  
Resistant Disease ◽  
Extranodal Disease

Abstract Abstract 1548 Poster Board I-571 PET-FDG (PET) has assumed in recent years a relevant role in the management of patients with Hodgkin Lymphoma (HL). In advanced stage HL, PET performed after two courses of ABVD chemotherapy has demonstrated a very high negative predictive value (NPV) and positive predictive value (PPV), and is presently considered the most relevant available prognostic factor in correlation with outcome. The aim of our study was to investigate the prognostic role of PET performed before autologous stem cell transplantation (ASCT) in resistant or relapsed HL. From June 2002 to December 2008, 32 patients with resistant or relapsed HL underwent a salvage chemotherapy program consisting of 3 or 4 courses of IEV or IGEV chemotherapy with peripheral blood stem cell collection followed by BEAM conditioned ASCT. Eight patients were consolidated with the BEACOPP regimen (2 to 4 courses) before transplantation. Median age was 30.4 years (range 21.6 – 61.4); 19 were males. At the time of enrolment, B symptoms were present in 4 patients and bulky and/or extranodal disease was recorded in 7 patients; the International Prognostic Score (IPS) was ≥2 in 15 patients. Sixteen patients were resistant to first-line chemotherapy, 13 were in first relapse (in 6 cases occurred earlier than 12 months), 3 were in second or subsequent relapse. Pre-transplant PET evaluation was negative in 21 cases: of these, 16 are currently in continuous complete remission (CCR) after a median follow-up of 30 months (range 7.0 – 59.0), while 5 have relapsed after a median of 10 months from transplant (range 3.0 – 11.0). Among the 11 patients autografted after a positive PET, 9 have relapsed after a median of 8.3 months (range 3.3 – 18.6). In the figure is shown the progression free survival of the patients stratified by pre-transplant PET. On the entire population the negative predictive value (NPV) of pre-transplant PET was 76.2%, while the positive predictive value (PPV) was 81.8%. Analyzing separately patients enrolled with a primary resistant disease, the NPV was 62.5% and the PPV was 75.0%. In the group of patients enrolled in relapse NPV was 84.6% and PPV was 100%. The prognostic value of the following parameters at the time of enrolment was evaluated: presence of bulky and/or extranodal disease, number of previous chemotherapy lines, chemoresistance/chemosensitivity to pre-transplant therapy evaluated by CT scan: no statistically significant correlation with the outcome was recorded. In conclusion, our preliminary results show a relevant prognostic role of pre-transplant PET in patients with advanced phase HL: 76% of patients with a negative pre-transplant PET obtained a CCR compared to only 18% of those with a positive pre-transplant PET (p = 0.003). The predictive role of pre-transplant PET is superior in patients undergoing the transplant program for a relapsed disease with respect to those with a primary resistant disease. Other prognostic factors need to be considered, although none of those so far examined showed a statistically significant role. These data need to be conclusively confirmed on a larger number of patients and a longer follow-up. Disclosures No relevant conflicts of interest to declare.

scholarly journals Role of Resistance Index in Differentiation of Benign and Malignant Breast Masses Compared with Histopathological Diagnosis

2019 ◽  
Vol 9 (2) ◽  
pp. 97-103
Author(s):  
Mashah Binte Amin ◽  
Tarana Yasmin ◽  
Samar C Sarkar ◽  
Khaleda Parvin Rekha ◽  
Rushaida Haque Leeba ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Vascular Resistance ◽  
Predictive Value ◽  
Resistance Index ◽  
Diagnostic Methods ◽  
Breast Masses ◽  
Malignant Breast ◽  
Breast Lumps

Background: Breast tumor remains a worldwide public health problem for women. Linear array sonography is currently one of the main diagnostic methods for detecting breast lumps. Duplex color Doppler sonography has been helpful to distinguish malignant from benign breast disease and also to predict the disease prognosis. Objectives: The purpose of this study was to evaluate the role of spectral Doppler as a method to measure the vascular resistance index in differential diagnosis between the benign and malignant breast neoplasm. Materials and Methods: This cross-sectional study was carried out in department of Radiology & Imaging of Enam Medical College & Hospital during January 2015 to December 2017. Sonography was done in 153 women having breast lumps. Among them histopathology was done in 105 cases. Ultrasonographic findings and histopathological report analyses were done using SPSS 13.0. Results: The study was done in 105 women with mean age 31.6 ± 4.5 years. On ultrasonogram, lesions were diagnosed as benign in 65 (62%) cases and malignant in 40 (38%) cases. Out of sonographically diagnosed 65 benign lesions having peripheral vascularity and decreased RI, 63 (97%) were proved benign histopathologically. With these criteria for diagnosis of benign lesion, sensitivity was 94%, specificity 92%, positive predictive value 95%, negative predictive value 89% and accuracy 93%. Sonographically 40 lesions were diagnosed as malignant. Among them 37 (92.5%) cases were proven malignant histopathologically and showed central vascularity and increased RI having sensitivity of 92%, specificity 94%, positive predictive value 89%, negative predictive value 95% and accuracy 93%. Conclusion: The analysis of vascular resistance index combined with findings on grayscale sonographic images correlates well with histopathological reports and can be of great assistance in the assessment of breast masses with high sensitivity and specificity. J Enam Med Col 2019; 9(2): 97-103

scholarly journals The Role of Laparoscopic Ultrasonography in the Evaluation of Suspected Choledocholithiasis. A Single-Center Experience

Medicina ◽  
2020 ◽  
Vol 56 (5) ◽  
pp. 246
Author(s):  
Kristaps Atstupens ◽  
Maksims Mukans ◽  
Haralds Plaudis ◽  
Guntars Pupelis
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
False Negative ◽  
Diagnostic Methods ◽  
Laparoscopic Ultrasonography ◽  
Biliary Stones ◽  
Single Center Experience

Background and objectives: Opinions differ regarding the optimal diagnostic methods for patients with suspected choledocholithiasis. The aim of this study was to assess the diagnostic accuracy of laparoscopic ultrasonography (LUS) and compare it to pre-operative magnetic resonance cholangio-pancreatography (MRCP); Materials and Methods: In all patients with suspected choledocholithiasis LUS was performed during laparoscopic cholecystectomy to evaluate biliary stones. According to availability, part of the patients had pre-operative MRCP. Data for diagnostic accuracy and main outcomes were collected prospectively and analyzed retrospectively; Results: Choledocholithiasis was detected in 178 of 297 patients by LUS (59.93%) and in 39 of 87 patients by MRCP (44.8%), p = 0.041. LUS yielded a sensitivity of 99.4%, a specificity of 94.3%, a positive predictive value of 96.1% and a negative predictive value of 99.1%. However, pre-operative MRCP had a sensitivity of 61.7%, a specificity of 92.3%, a positive predictive value of 94.9% and a negative predictive value of 51.1%. Moreover, of the 47 patients with no choledocholithiasis by MRCP, in 23 cases it was later detected by LUS (a false negative MRCP finding—38.3%), p < 0.001. Median duration of hospitalization was significantly shorter in patients evaluated without pre-operative MRCP—8 days (interquartile range – IQR 11–6) vs. 11 days (IQR 14–9), p = 0.001; Conclusions: LUS may reduce the role of pre-operative MRCP and can become a rational alternative to MRCP as a primary imaging technique for the detection of choledocholithiasis.

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