scholarly journals Comparative Diagnostic Accuracy of Mean and Lowest Cycle Threshold Levels in Xpert MTB/RIF Assay and Molecular Epidemiology of Missing Probes In Rifampicin Resistant Tubercular Cases From A Tertiary Care Hospital

2022 ◽  
Vol 9 (3) ◽  
pp. 58-63
Author(s):  
Nisha Goyal ◽  
Bineeta kashyap ◽  
Hyanki Puneeta ◽  
Singh NP ◽  
A Khanna
Keyword(s):  
Diagnostic Accuracy ◽  
Molecular Epidemiology ◽  
Tertiary Care ◽  
Rpob Gene ◽  
Drug Regimen ◽  
Care Hospital ◽  
Ct Value ◽  
Source Of Infection ◽  
Selection Of

Abstract Background: The comparative diagnostic accuracy of mean and lowest Ct values needs to be evaluated for the assessment of mycobacterial burden in tubercular cases. Mutation in any codon of 81 base-pair core regions prevents the hybridization of one or more of five overlapping Probes A-Ein Xpert MTB/RIF assay indicated by “missing probe. Molecular epidemiology of missing probes may prove useful in tracing the source of infection and selection of a more suitable drug regimen for treatment. Methods: This study included 65 rifampicin resistant cases and an equal number of rifampicin sensitive cases detected by Xpert MTB/RIF assay. Only samples tested positive for tubercular bacilli were included. The information regarding the tubercular load, Ct values of five probes targeting the rpoB gene, lowest Ct value among the five probes, missing probe in rifampicin resistant cases and time taken for the entire cycle were recorded in each case. Results: Lowest Ct is a stronger indicator of tubercular load than the mean Ct value. E probe was found to be missing in majority (64.6%) of the cases, followed by A (6.2%), B and D (4.6%), C (1.5%) probes. In 7.6% cases, more than one probe was missing. None of the probe was missing in 10.6% of rifampicin resistant cases. Conclusions:  Lowest Ct value was found to be a better tool than mean Ct value for the determination of mycobacterium burden. Molecular epidemiology of missing probes could be useful in the development of new probes for the detection of rifampicin resistance.

scholarly journals Molecular Epidemiology ofClostridium difficileover the Course of 10 Years in a Tertiary Care Hospital

2009 ◽  
Vol 49 (8) ◽  
pp. 1141-1147 ◽  
Author(s):  
Jaime Belmares ◽  
Stuart Johnson ◽  
Jorge P. Parada ◽  
Mary M. Olson ◽  
Connie R. Clabots ◽  
...  
Keyword(s):  
Molecular Epidemiology ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital

Diagnostic accuracy of Multiparametric MRI in detection of prostate cancer compared with histopathology obtained by MRI directed TRUS guided cognitive fusion biopsy are T2WI, DWI and DCE enough for Indian scenario

2021 ◽  
Vol 20 (1) ◽  
pp. 10-12
Author(s):  
Mallinath Biradar ◽  
Keyword(s):  
Prostate Cancer ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Prostatic Cancer ◽  
Tertiary Care ◽  
Multiparametric Mri ◽  
Care Hospital ◽  
Cognitive Fusion ◽  
Fusion Biopsy ◽  
Indian Scenario

Background: The incidence of prostatic carcinoma is increasing worldwide. With its high resolution, ability to provide excellent tissue characterization and multiplanar imaging capabilities, multi-parametric magnetic resonance imaging (mpMRI) plays a crucial role in detection, local staging and follow-up of carcinoma prostate. It also helps guide targeted biopsies in initial biopsy negative patient. Objectives: Study diagnostic accuracy of mp-MRI and primarily that of the three MR sequences T2, DWI and DCE in detection of prostatic cancer by correlating them with histopathology and thus whether it is feasible for a short MRI of 3 sequences to be used on a large scale in Indian scenario. Materials and Methods: A prospective study was done at a tertiary care hospital between April 2017 to November 2018 in which 50 patients who presented with suspicion of prostate cancer were referred to radiology department for evaluation using MRI. MRIexamination was done using 3T Siemens Magnetom Verio. Followed by this MRI directed TRUS guided cognitive fusion biopsy was done from the prostate. Samples were sent for histopathology. Results: Out of 50 cases studied, 24 cases (48%) were found to be malignant and 26 cases (52 %) were benign on histopathology. In our study, combined T2 + DWI + DCE gave sensitivity of 95.83 %, specificity of 57.69%, positive predictive value of 68.21 % and negative predictive value of 93.75%. Conclusion: Multiparametric MRI using T2, DWI and DCE has a high diagnostic accuracy for evaluation of prostatic cancer.

scholarly journals Diagnostic Accuracy of Sonographic Septations in Tuberculous and Malignant Pleural Effusions

2020 ◽  
Vol 9 (2) ◽  
pp. 95-102
Author(s):  
Abdul Rasheed Qureshi ◽  
Muhammad Irfan ◽  
Zeeshan Ashraf
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Tertiary Care ◽  
Positive Likelihood Ratio ◽  
Fisher Exact Test ◽  
Care Hospital ◽  
Pleural Effusions ◽  
Malignant Pleural Effusions ◽  
Malignant Group

Background: Discrimination between tuberculous (TB) and malignant pleural effusions is a real practical challenge because both exist as exudative lymphocytic type. Transthoracic ultrasonography not only identifies and quantifies pleural effusion but also displays sonographic septations, which are frequently seen in TB pleural effusions and can help in differentiation between tuberculosis and malignancy successfully, without any invasive procedure. We designed this study to determine the diagnostic usefulness of these septations for tuberculous and malignant pleural effusions. Material and Methods: This prospective study was conducted in the OPD of Gulab Devi Chest Hospital Lahore, Pakistan, a 1500 bedded tertiary care hospital, from November 2016 to February 2018. Total of 339 consecutive cases, aged 14-83 years with radiological evidence of pleural effusion were included in the study. After detailed history, thorough physical examination, radiological, haematological and biochemical findings were recorded. Pleural fluid macroscopic, cytological, microbiologic and biochemical analysis results were also recorded. Ultrasonography was done, septated and non-septated pleural effusions identified and findings were noted. SPSS-16 was used for statistical evaluation. Fisher Exact test was utilized for comparison between TB and malignant cases with P-value < 0.05 taken as significant. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy and positive likelihood ratio were calculated. Results: Out of total 339 cases, 49 (14.45%) were malignant and 290 (85.55%) were non-malignant. In the malignant group, only 03 cases (6.12%) showed sonographic septations. In the non-malignant group, 259/290 (89.31%) cases showed tuberculous etiology and 187/259 (72.20%) of these cases displayed sonographic septations. By considering septations as predictor of TB, statistical analysis revealed a sensitivity of 79.23%, specificity of 92.85%, PPV of 98.42%, NPV of 44.31% and diagnostic accuracy of 81.29%, respectively. Conclusions: Sonographic septations can be a valuable predictor of tuberculosis, in a population with high prevalence of the disease. We found it to be a useful feature in differentiating between a malignant and tuberculous etiology, in exudative lymphocytic pleural effusions. It can be used with confidence in patients who are unfit for interventional procedures.

scholarly journals A Case of Congenital Tuberculosis in a Tertiary Care Hospital

2012 ◽  
Vol 1 (2) ◽  
pp. 85-87
Author(s):  
Ishrat Jahan ◽  
Mehedi Parvez ◽  
Laisha Yeasmin
Keyword(s):  
Clinical Presentation ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Male Infant ◽  
Abdominal Distension ◽  
Drug Regimen ◽  
Care Hospital ◽  
Gastric Aspirate ◽  
Congenital Tuberculosis ◽  
Low Weight

Congenital tuberculosis is an unusual and severe clinical presentation of Mycobacterium tuberculosis (MTB) infection. It is usually difficult to diagnose and treat. We report a tenweek-old male infant who had presented with fever, difficulty in breathing, abdominal distension, convulsion, low weight gain since one month of his age. The diagnosis was made by demonstration of MTB bacilli in the gastric aspirate of baby and chest radiography. Treatment with the four drug regimen including streptomycin was initiated, but the baby died   on the third day of ATT. This case gives an account of difficulties in diagnosis and therapeutic   management of congenital tuberculosis and alerts for development of protocols that foresee   these difficulties. DOI: http://dx.doi.org/10.3329/jemc.v1i2.11469   J Enam Med Col 2011; 1(2): 85-87  

scholarly journals Analysis of spontaneously reported adverse drug reactions to pharmacovigilance cell of a tertiary care hospital

2018 ◽  
Vol 7 (8) ◽  
pp. 1551
Author(s):  
Kaksha J. Patel ◽  
Ashwin K. Panchasara ◽  
Manish J. Barvaliya ◽  
C. B. Tripathi
Keyword(s):  
Health Care ◽  
Adverse Drug Reactions ◽  
Health Care Professionals ◽  
Geriatric Patients ◽  
Tertiary Care ◽  
Care Hospital ◽  
Drug Reactions ◽  
Adr Reporting ◽  
Common Group ◽  
Selection Of

Background: The objective of the study was to study the clinical patterns, causality and severity of adverse drug reactions in a tertiary care hospital.Methods: Total 131 ADR forms were collected from January 2012 to December 2012 and evaluated. Patient’s characteristics, ADR and drug characteristics, causality, severity and preventability of collected ADR were analyzed.Results: Total 131 ADR forms were evaluated. Male patient experiencing ADR were more (73, 55.7%) than female (58, 44.2%). Adult patients (12-60 years) experienced 110 (84%) ADR followed by pediatric patients (< 12 years) 11 (8.4%) and geriatric patients (>60 years) 10 (7.63%). Antimicrobial were the most common group of drugs responsible for ADR followed by NSAIDs and antipsychotic group.Conclusions: Present study shows lack of awareness among health care professionals for reporting of an ADR. Training and collaboration of health care professionals are needed for improvement in ADR reporting. Appropriate feedback from ADR reporting will help in selection of drug and promotes safer use of drugs.

Sign in / Sign up

Export Citation Format

Share Document