The Role of Musculoskeletal USG as Diagonostic Tool of CTS

Abstract Introduction Over the years NCS has been used to diagnose and monitor the patients with CTS though USG has several advantages as diagnostic tool. This study has been done to find out the diagnostic accuracy of USG in CTS and to compare the efficacy of USG with standard NCS in CTS. Prospective cross-sectional analytical study was conducted at Dept. of PM&R, IPGME&R, Kolkata from 1st March, 2012 to 31st August 2012 (6 months). Patient with clinical diagnosis of CTS of age >18 year of both sexes were included in this study and on the other hand patient with previous wrist surgery /injury, wrist deformity, diabetes mellitus, anatomical variants of median nerve on ultrasound were excluded from the study. Methodology After getting institutional ethical committee clearance, all patients who fulfil the above criteria were included in the study and further diagnostic conformation done by the standard diagnostic criteria of NCS. The same group of patients have been also screened by ultrasonography (USG). Results At the end of the study, data analysis showed that sensitivity and specificity were 92.3 and 70.0% respectively. Predictive value of +test, predictive value of -test were 88.9 and 77.8% respectively. Kappa value was 0.64 (between 0.5 and 0.7). It signifies that there is good correlation between NCS and USG as diagnostic tool of CTS. The comparison of the numerical values of median latency, amplitude and CSA USG within the groups with the help of ANOVA followed by Tukey's test showed that there was good correlation between latency and amplitude in mild, moderate, severe and profound CTS but unfortunately it was not correlated with the CSA measured by USG. Conclusion USG can be used for screening large population of patients as it is simple, easily available, non-invasive test and has relatively low cost and useful in evaluating and excluding local causes of nerve compression.

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Validity of Self-reported Diabetes Among Kurdish Population; a Large Population-based Study From Iran

10.21203/rs.3.rs-1005210/v1 ◽

2021 ◽

Author(s):

Yousef Moradi ◽

Negar Piri ◽

Hojat Dehghanbanadaki ◽

Ghobad Moradi ◽

Mahdiyeh Fotouk-Kiai ◽

...

Keyword(s):

Predictive Value ◽

Large Population ◽

Insulin Injection ◽

Epidemiological Studies ◽

Population Based ◽

Self Report ◽

Diabetes Prevalence ◽

Cross Sectional ◽

Diabetes Status ◽

Kappa Value

Abstract Background: The aim was to assess the validity of diabetes self-reporting based on oral anti-diabetic drugs, insulin injection, or high fasting blood sugar (FBS) in a large Kurdish population of Iran.Methods: We performed a cross-sectional analytical study on 4400 subjects aged 35-70 years of the Dehgolan Prospective Cohort Study (DehPCS). The reference for having diabetes was oral hypoglycemic drug consumption, insulin injection, or high FBS representing diabetes. Self-reported diabetes status was investigated by well-trained interviewers before the identification of diabetes status based on reference criteria. The accuracy and agreement of self-reported diabetes with reference were assessed in the overall population as well as in different sociodemographic and habitual conditions. Results: Out of 4400 adults, 3996 agreed to participate in this study (participation=90.8%). The diabetes prevalence among the study population was 13.1% based on self-report and 9.7% based on reference. Of the 523 people who reported diabetes, 213 (41.28%) did not have diabetes. We found a good agreement of 92.3% concordance with a kappa value of 65.1% between self-reported diabetes and reference. Self-reported diabetes also guaranteed sensitivity of 78.5%, specificity of 93.9%, positive predictive value of 58.7%, and negative predictive value of 98.0% to identify diabetic participants. Conclusion: Self-reported diabetes is identified as a valid tool that could accurately determine the diabetes prevalence in epidemiological studies on the Kurdish population of Iran.

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Association between Hippocampal Volume and Working Memory in 10,000+ 9–10-Year-Old Children: Sex Differences

Children ◽

10.3390/children8050411 ◽

2021 ◽

Vol 8 (5) ◽

pp. 411

Author(s):

Shervin Assari ◽

Shanika Boyce ◽

Tanja Jovanovic

Keyword(s):

Working Memory ◽

Sex Differences ◽

Parental Education ◽

Predictor Variable ◽

National Sample ◽

Hippocampal Volume ◽

Study Data ◽

Cross Sectional ◽

The Right

Aim: This study tested sex differences in the association between hippocampal volume and working memory of a national sample of 9–10-year-old children in the US. As the hippocampus is functionally lateralized (especially in task-related activities), we explored the results for the right and the left hippocampus. Methods: This is a cross-sectional study using the Adolescent Brain Cognitive Development (ABCD) Study data. This analysis included baseline ABCD data (n = 10,093) of children between ages 9 and 10 years. The predictor variable was right and left hippocampal volume measured by structural magnetic resonance imaging (sMRI). The primary outcome, list sorting working memory, was measured using the NIH toolbox measure. Sex was the moderator. Age, race, ethnicity, household income, parental education, and family structure were the covariates. Results: In the overall sample, larger right (b = 0.0013; p < 0.001) and left (b = 0.0013; p < 0.001) hippocampal volumes were associated with higher children’s working memory. Sex had statistically significant interactions with the right (b = −0.0018; p = 0.001) and left (b = −0.0012; p = 0.022) hippocampal volumes on children’s working memory. These interactions indicated stronger positive associations between right and left hippocampal volume and working memory for females compared to males. Conclusion: While right and left hippocampal volumes are determinants of children’s list sorting working memory, these effects seem to be more salient for female than male children. Research is needed on the role of socialization, sex hormones, and brain functional connectivity as potential mechanisms that may explain the observed sex differences in the role of hippocampal volume as a correlate of working memory.

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Role of CT (Computed Tomography) in the Evaluation of Fungal Diseases in Paranasal Sinus

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v31i4.21002 ◽

2014 ◽

Vol 31 (4) ◽

pp. 189-193

Author(s):

T Islam ◽

SA Azad ◽

ME Karim ◽

L Khondker ◽

K Rahman

Keyword(s):

Fungal Infection ◽

Ct Scan ◽

Paranasal Sinus ◽

Predictive Value ◽

Cross Sectional Study ◽

Fungal Diseases ◽

Cross Sectional ◽

Computed Tomographic ◽

Histopathological Result

A cross sectional study carried out with patients having suspected paranasal sinus (PNS) mass during January 2009 to October 2010 to evaluate the fungal diseases in PNS by computed tomographic(CT) image and comparison of the findings of this modality with histopathological result. Among the total 76 patients, the mean age of the patients was 35.95 ± 18.24 and common complaints of the patients were nasal obstruction (73.7%) and maximum 53.9% patients had PNS mass in maxillary sinuses. Out of all cases 10 were diagnosed as having fungal infection/mass by CT scan and confirmed by histopathological evaluation. Two cases were diagnosed as having fungal infection/mass by CT scan but not confirmed by histopathological findings. Of 64 cases of other than fungal infection/mass, which were diagnosed by CT scan, six were confirmed as having fungal infection/mass and 58 were other than having fungal infection/mass by histopathology. Sensitivity of CT scan to diagnose fungal infection/mass was 62.5%, specificity 96.7%, positive predictive value 83.3%, negative predictive value 90.6% and accuracy 89.5%. CT scan of the fungal diseases in paranasal sinus provides more information and better image quality and CT diagnosis correlate well with the findings of histopathology. DOI: http://dx.doi.org/10.3329/jbcps.v31i4.21002 J Bangladesh Coll Phys Surg 2013; 31: 189-193

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St. George’s Respiratory Questionnaire (SGRQ) sebagai Alat Bantu Diagnostik serta Prediktor Terjadinya Chronic Pulmonary Aspergillosis (CPA) pada Pasien Tuberkulosis Paru Pasca Terapi

Medical Scope Journal ◽

10.35790/msj.3.1.2021.32890 ◽

2021 ◽

Vol 3 (1) ◽

pp. 1

Author(s):

William S. Wangko ◽

Indra Kurniawan ◽

Maarthen C. P. Wongkar ◽

Agung Nugroho ◽

Efata B Polii

Keyword(s):

Diagnostic Tool ◽

Predictive Value ◽

Clinical Signs ◽

Clinical Score ◽

Pulmonary Aspergillosis ◽

Cross Sectional ◽

Lung Tuberculosis ◽

St George's Respiratory Questionnaire ◽

Chronic Pulmonary Aspergillosis ◽

Post Therapy

Abstract: Patients of post therapy lung tuberculosis (TB) that still have permanent or worsened clinical signs might be caused by chronic pulmonary aspergillosis (CPA). Diagnosis of CPA is difficult to confirmed without complete supporting tests. This study was aimed to establish whether Saint George’s Respiratory Questionnaire (SGRQ) could be used as diagnostic tool and predictor of the occurence of CPA in post therapy lung TB patients. This was an analytical observational study with a cross sectional design. There were 72 patients who had negative Gene Xpert sputum; 34.7% with positive Aspergillus-specific IgG. Their clinical signs were evaluated with SGRQ. The results showed that there was a very significant relationship between clinical score and CPA (p<0.0001). The lower the clinical score the less the probability of CPA. In this analysis we determined the diagnosis value of clinical score with a probability cut-off point = 0.5 which led to clinical score cut-off point of 45.6 with further results, as follows: sensitivity 68.0%; specificity 95.7%; positive predictive value 89.5%; negative predictive value 84.9%; OR 47.8, and CI 95% (9,2-248,2). In conclusion, SGRQ could be used as diagnostic tool and predictor of the occurence of CPA in post therapy lung TB patients.Keywords: post therapy lung TB; chronic pulmonary aspergillosis; Saint George’s Respiratory Questionnaire (SGRQ) Abstrak: Pasien TB paru pasca terapi yang masih memperlihatkan gejala klinis menetap atau bahkan memberat dapat disebabkkan oleh adanya chronic pulmonary aspergillosis (CPA). Diagnosis CPA sulit ditegakkan tanpa adanya pemeriksaan penunjang yang lengkap. Penelitian ini bertujuan untuk menentukan apakah Saint George’s Respiratory Questionnaire (SGRQ) dapat menjadi alat bantu diagnostik serta prediktor terjadinya CPA pada pasien TB paru pasca terapi. Jenis penelitian ialah analitik observasional dengan desain potong lintang. Hasil penelitian mendapatkan 72 pasien dengan sputum Gene Xpert negatif (34,7% dengan positif IgG Aspergillus) dilakukan penilaian skor klinis menggunakan SGRQ. Hasil uji menunjukkan terdapat hubungan sangat bermakna antara skor klinis dengan terjadinya CPA (p<0,0001). Makin rendah skor klinis makin kecil peluang terjadinya CPA. Melalui analisis ini dapat ditentukan nilai diagnosis skor klinis SGRQ dengan mengambil titik potong peluang = 0,5. Nilai peluang = 0,5 memberikan titik potong skor klinis = 45,6. Dengan titik potong skor klinis SGRQ = 45,6 diperoleh nilai-nilai diagnosis sebagai berikut: Sensitivitas = 68,0%; Spesifisitas = 95,7%; Nilai Prediksi Positif = 89,5%; Nilai Prediksi Negatif = 84,9%; OR = 47,8 dengan CI 95% (9,2-248,2). Simpulan penelitian ini ialah SGRQ dapat menjadi alat bantu diagnostik serta prediktor terjadinya CPA pada pasien TB paru pasca terapi.Kata kunci: tuberkulosis paru pasca terapi; chronic pulmonary aspergillosis; Saint George’s Respiratory Questionnaire (SGRQ)

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1173Anti-heart and anti-intercalated disk autoantibodies: possible novel biomarkers of cardiac sarcoidosis

European Heart Journal ◽

10.1093/eurheartj/ehz748.0015 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

A Caforio ◽

S Gianstefani ◽

A Baritussio ◽

R Marcolongo ◽

M Seguso ◽

...

Keyword(s):

Potential Role ◽

Cardiac Involvement ◽

Cardiac Sarcoidosis ◽

Cross Sectional Study ◽

Cross Sectional ◽

Non Invasive ◽

Immune Mediated ◽

Novel Biomarkers ◽

Intercalated Disk

Abstract Background Sarcoidosis is an immune-mediated disease; cardiac involvement, a granulomatous form of myocarditis, is under-recognised and prognostically relevant, as it can present with significant morbidity and mortality. Anti-heart autoantibodies (AHA) and anti-intercalated disk autoantibodies (AIDA) are reliable autoimmune markers in non-sarcoidosis myocarditis forms. Purpose The aim of this study was to assess the potential role of serum AHA and AIDA in cardiac sarcoidosis. Methods This is a cross-sectional study on a series of 29 patients with biopsy proven extra-cardiac sarcoidosis and with biopsy-proven or clinically suspected cardiac involvement, who were tested for AHA and AIDA. Patients were recruited in two recruiting tertiary centres, in USA and Italy. AHA and AIDA were detected by indirect immunofluorescence on human myocardium and skeletal muscle. Controls included sera from patients with non-inflammatory cardiac disease (NICD) (n=160), with ischemic heart failure (IHF) (n=141) and normal blood donors (NBD) (n=270). Results The frequencies of AHA and of AIDA were higher in sarcoidosis (86%; 62%) than in NICD (8%; 4%), IHF (7%; 2%), NBD (9%; 0%) (p=0.0001; p=0.0001 respectively). Sensitivity and specificity were: 86% and 92% for positive AHA and 62% and 98% for positive AIDA, respectively (see figure). Figure 1 Conclusions The detection of serum AHA and AIDA in biopsy-proven or clinically suspected cardiac sarcoidosis supports the involvement of heart-specific autoimmunity in the majority of our cases and may provide a novel non invasive diagnostic marker.

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Role of Multidetector Computerised Tomography in Evaluation of Proptosis

Nepalese Journal of Radiology ◽

10.3126/njr.v9i2.27421 ◽

2019 ◽

Vol 9 (2) ◽

pp. 24-31

Author(s):

Elina Shrestha ◽

Narayan Bikram Thapa ◽

Shankar Bahadur Singh Rajbhandari

Keyword(s):

Predictive Value ◽

Clinical Information ◽

Cross Sectional Study ◽

Computerised Tomography ◽

Cross Sectional ◽

Female Ratio ◽

Male Female Ratio ◽

One Year ◽

Female Male Female

Introduction: Proptosis is defined as bulging of eye anteriorly out of the orbit. Our main objective was to analyze the pattern of computerised tomographic findings in evaluation of proptosis. Computerised tomography (CT) is noninvasive, easily accessible, affordable and reliable imaging which helps in early diagnosis and prompt treatment. Methods: A descriptive cross sectional study of total 58 patients presenting with proptosis referred to our department of radiology for computerised tomography evaluation during one year period were undertaken into study. The clinical information provided by ophthalmologist also helped our study to derive into conclusion. SPSS version 20 software was used for statistical data analysis. Results: Out of 58 patients, the most common cause of proptosis was neoplasm constituting of 25 cases (43.1%). Retinoblastoma was the commonest orbital tumor. Out of remaining cases, 15 (25.8%) were infective, 14 (24.1%) were inflammatory, two (3.44%) were traumatic and remaining two cases (3.44%) had no definitive cause for proptosis. Bilateral proptosis was commonly associated with thyroid ophthalmopathy. Among the subjects 32 were male, 26 were female. Male: Female ratio was 1:1.23. Age group was ranging from 1 month to 73 years.Mean age was 26.4 ± 22 years. Conclusions: Computerised tomography has an important role in distinguishing the different types of lesions based on their characteristics, location and extension prior to undertaking definitive surgical and medical treatment. Overall accuracy of CT in our study was 81%, sensitivity of 82.6%, specificity of 80.6%, positive predictive value of 76% and negative predictive value of 86.2%.

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A multiplex immunoassay for the non-invasive detection of bladder cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.2_suppl.471 ◽

2016 ◽

Vol 34 (2_suppl) ◽

pp. 471-471

Author(s):

Charles Joel Rosser ◽

Yoshiko Shimizu ◽

Hideki Furuya ◽

Peter Bryant-Greenwood ◽

Owen Chan ◽

...

Keyword(s):

Bladder Cancer ◽

Predictive Value ◽

Clinical Status ◽

Multiplex Assay ◽

Detection Methods ◽

Protein Biomarkers ◽

Roc Curve Analysis ◽

Multiplex Immunoassay ◽

Non Invasive ◽

Invasive Test

471 Background: Urine based assays that can non-invasively detect bladder cancer (BCa) have the potential to reduce unnecessary and invasive procedures. The purpose of this study was to develop a multiplex immunoassay that can accurately and simultaneously monitor 10 diagnostic urinary protein biomarkers for application as a non-invasive test for BCa detection Methods: A custom electrochemiluminescent (ECL) multiplex assay was constructed (Meso Scale Diagnostics, LLC, Rockville, MD) to detect the following urinary proteins; IL8, MMP9, MMP10, ANG, APOE, SDC1, A1AT, PAI1, CA9 and VEGFA. Voided urine samples from two cohorts (cohort #1 n = 62 and cohort #2 n = 200) were collected prior to cystoscopy and samples were analyzed blinded to the clinical status of the participants. Means (±SD) and receiver operating characteristic (ROC) curve analysis were used to compare assay performance and to assess the diagnostic accuracy of the diagnostic signature. Results: Comparative diagnostic performance analyses revealed an AUROC value of 0.9258 for the multiplex assay and 0.9467 for the combination of the single-target ELISA assays (p = 0.625), so there was no loss of diagnostic utility for the MSD multiplex assay. Analysis of the independent 200-sample cohort using the multiplex assay achieved an overall diagnostic sensitivity of 0.85, specificity of 0.81, positive predictive value 0.82 and negative predictive value 0.84. Conclusions: It is technically feasible to simultaneously monitor complex urinary diagnostic signatures in a single assay without loss of performance. The described protein-based assay has the potential to be developed for the non-invasive detection of BCa.

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Clinical and paraclinical predictive factors for in-hospital mortality in adult patients with COVID-19

10.21203/rs.3.rs-819065/v1 ◽

2021 ◽

Author(s):

Seyed Alireza Mousavi ◽

Reyhaneh Sadat Mousavi-Roknabadi ◽

Fateme Nemati ◽

Somaye Pourteimoori ◽

Arefeh Ghorbani ◽

...

Keyword(s):

Mechanical Ventilation ◽

Hospital Mortality ◽

Ct Scan ◽

Predictive Factors ◽

Invasive Mechanical Ventilation ◽

Cross Sectional Study ◽

Study Data ◽

Cross Sectional ◽

Factors Affecting ◽

Non Invasive

Abstract Background Since December 2019, a type of coronavirus has emerged in Wuhan, China, which has become the focus of global attention due to an epidemic of pneumonia of unknown cause, called COVID-19. This study aimed to investigate the factors affecting in-hospital mortality of patients with COVID-19 hospitalized in one of the main hospital in central Iran. Methods This retrospective cross-sectional study (February 2019-May 2020) was conducted on patients with confirmed diagnosis COVID-19, who were admitted in Yazd Shahid Sadoughi Hospital, in middle of Iran. The patients with uncompleted or missed medical files were excluded from the study. Data were extracted from the patients' medical files and then analyzed. The patients were categorized as survivors and non-survivors groups, and they were compared. Results Totally, 573 patients were enrolled, that 356 (62.2%) were male. The mean ± SD of age was 56.29 ± 17.53 years, and 93 (16.23%) were died. All the complications were more in non-survivors. Intensive care unit (ICU) admission was in 20.5% of the patients which was more in non-survivors (P < 0.001). The results of multivariate logistic regression test showed that plural effusion in lung computed tomography (CT) scan (OR = 0.055, P = 0.009), white blood cell (WBC) (OR = 1.417, P = 0.022), serum albumin (OR = 0.009, P < 0.001), non-invasive mechanical ventilation (OR = 34.315, P < 0.001), and acute respiratory distress syndrome (ARDS) (OR = 66.039, P = 0.001) were achieved as the predictive factors for in-hospital mortality were the predictive factors for in-hospital mortality. Conclusion In-hospital mortality in patients with COVID-19 was about 16%. Plural effusion in lung CT scan, WBC, albumin, non-invasive mechanical ventilation, and ARDS were obtained as the predictive factors for in-hospital mortality.

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The role of animals as a source of antimicrobial resistant nontyphoidal Salmonella causing invasive and non-invasive human disease in Vietnam

10.21203/rs.2.23704/v1 ◽

2020 ◽

Author(s):

Andrea Parisi ◽

Tu Phuong ◽

Alison E Mather ◽

Thibaut Jombart ◽

Ha Thanh Tuyen ◽

...

Keyword(s):

Human Blood ◽

Population Based ◽

Human Pathogens ◽

Cross Sectional ◽

Middle Income ◽

Middle Income Countries ◽

Non Invasive ◽

Low Middle Income Countries ◽

Human Stool

Abstract BackgroundNontyphoidal Salmonella (NTS) are associated with both diarrhea and bacteremia. Antimicrobial resistance (AMR) is common in NTS in low-middle income countries, but the major source(s) of AMR NTS in humans are not known. Here, we aimed to assess the role of animals as a source of AMR in human NTS infections in Vietnam. We retrospectively combined and analyzed 672 NTS human and animal isolates from four studies in southern Vietnam and compared serovars, sequence types (ST), and AMR profiles. We generated a population structure of circulating organisms and aimed to attribute sources of AMR in NTS causing invasive and noninvasive disease in humans using Bayesian multinomial mixture models.ResultsAmong 672 NTS isolates, 148 (41%) originated from human blood, 211 (59%) from human stool, and 136 (43%) from animal stool. The distribution of serovars, STs, and AMR profiles differed among sources; serovars Enteritidis, Typhimurium, and Weltevreden were the most common in human blood, human stool, and animals, respectively. We identified an association between the source of NTS and AMR profile; the majority of AMR isolates were isolated from human blood (p<0.001). Modelling by ST-AMR profile found chickens and pigs were likely the major sources of AMR NTS in human blood and stool, respectively; but unsampled sources were found to be a major contributor.ConclusionsAntimicrobial use in food animals is hypothesized to play role in the emergence of AMR in human pathogens. Our cross-sectional population-based approach suggests a significant overlap between AMR in NTS in animals and humans, but animal NTS does explain the full extent of AMR in human NTS infections in Vietnam.

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Urine Phenylacetylglutamine Determination in Patients with Hyperphenylalaninemia

Journal of Clinical Medicine ◽

10.3390/jcm10163674 ◽

2021 ◽

Vol 10 (16) ◽

pp. 3674

Author(s):

Fernando Andrade ◽

Ainara Cano ◽

María Unceta Suarez ◽

Arantza Arza ◽

Ana Vinuesa ◽

...

Keyword(s):

Potential Role ◽

Venous Blood ◽

Phenyl Group ◽

Cross Sectional Study ◽

Cross Sectional ◽

Non Invasive ◽

Frequent Monitoring ◽

Healthy Control

Phenylketonuria (PKU), an autosomal-recessive inborn error of phenylalanine (Phe) metabolism is the most prevalent disorder of amino acid metabolism. Currently, clinical follow-up relies on frequent monitoring of Phe levels in blood. We hypothesize that the urine level of phenylacetylglutamine (PAG), a phenyl-group marker, could be used as a non-invasive biomarker. In this cross-sectional study, a validated liquid chromatography coupled to tandem mass spectrometry (LC-MS) method was used for urinary PAG quantification in 35 participants with hyperphenylalaninemia (HPA) and 33 age- and sex-matched healthy controls. We have found that (a) PKU patients present higher urine PAG levels than healthy control subjects, and that (b) there is a significant correlation between urine PAG and circulating Phe levels in patients with HPA. In addition, we show a significant strong correlation between Phe levels from venous blood samples and from capillary finger-prick dried blood spot (DBS) samples collected at the same time in patients with HPA. Further research in order to assess the potential role of urine PAG as a non-invasive biomarker in PKU is warranted.

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