Sequential Screening with Cytology and Colposcopy in Detection of Cervical Neoplasia

2009 ◽  
Vol 1 (3) ◽  
pp. 45-48 ◽  
Author(s):  
BR Desai ◽  
PR Malur ◽  
Dalal Anita ◽  
Durdi Geeta ◽  
Sherigar Bhavana ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Pap Smear ◽  
Cross Sectional Study ◽  
Diagnostic Efficacy ◽  
Cross Sectional ◽  
Sequential Screening ◽  
Sensitivity Specificity

ABSTRACT Background Pap smear is the most commonly used screening test for cervical cancer, however it has disadvantage of having low sensitivity. Colposcopy has higher sensitivity as compared to Pap smear but low specificity. Sequential screening with both Pap smear and colposcopy can overcome these problems. Aim The study was aimed to find out the diagnostic efficacy of both Pap smear and colposcopy. It was also intended to find out the advantages of sequential use of Pap smear and colposcopy in screening for cervical cancer. Design It was a cross-sectional study conducted in colposcopy clinic of KLE's Dr. Prabhakar Kore Hospital and MRC, Belgaum from November 2006 to September 2008. Material and methods A total of 190 patients with complaints of postcoital bleeding, intermenstrual bleeding, postmenopausal bleeding, persistent vaginal discharge or those found to have an unhealthy cervix on per speculum examination were included in the study. In all the 190 cases Pap smear, colposcopic evaluation and colposcopic directed biopsy were performed. Statistical analysis Sensitivity, specificity, positive predictive value, negative predictive value of both Pap smear and colposcopy were calculated with histopathology as a gold standard, keeping LSIL as a disease threshold for test positivity. Results Pap smear was positive in 14.21% (27/190) cases, colposcopy was positive in 37.89% (72/190) cases. Biopsy confirmed LSIL and higher lesions in 31.57% cases. The sensitivity, specificity, positive predictive value and negative predictive value of Pap smear were 41.66%, 96.92%, 86.21% and 78.26% respectively and 80%, 81.54%, 66.66% and 89.83% respectively for colposcopy. Combined colposcopy and Pap smear could accurately diagnose 53/60 biopsy confirmed cases of LSIL and higher lesions with an accuracy of 88.33%. Conclusion Sequential use of Pap smear and colposcopy in screening for cervical cancer increases the accuracy of the test.

scholarly journals Interleukin 21 as a diagnostic marker of rheumatoid arthritis.

2019 ◽  
Vol 26 (08) ◽  
pp. 1229-1232
Author(s):  
Khadija Kiran ◽  
Amtul Huda ◽  
Zuhair Bhatti
Keyword(s):  
Rheumatoid Arthritis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Diagnostic Marker ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Medical College ◽  
Sensitivity Specificity

To investigate the role of IL-21 as diagnostic marker in diagnosis of rheumatoid arthritis. Study Design: Cross sectional study. Setting: Department of Physiology and Orthopedic Gujranwala Medical College, Gujranwala. Period: October 2017 to October 2018 in one year duration. Materials and Methods: A total of 150 patients were included in the study, main variables assessed in this study were positive predictive value negative predictive value, sensitivity, specificity and accuracy of IL-21 in diagnosis of rheumatoid arthritis. SPSS version 23 was used to analyze the data. P value less than or equal to 0.05 was taken as significant. Study was started after permission from hospital ethical committee and patients were informed in detail about disease and procedure to be done. Non probability consecutive sampling was used. Results: The estimated sensitivity was 93.6%. The estimated specificity was 50%. Positive predictive value was 96.3% and negative predictive value was 35.7%. The overall accuracy was 90.6% for diagnosing rheumatoid arthritis. Conclusion: IL-21 induces MMP3 in rheumatoid arthritis patients, identification of IL-21 from synovium of patients indicates the presence of rheumatoid arthritis. We observed 90.6% diagnostic accuracy of IL-21 for rheumatoid patients taking RA factor as gold standard of diagnostic tool.

Diagnostic Efficacy of HbA1c in Diagnosis of Diabetes Mellitus in a Bangladesh Population

2014 ◽  
Vol 41 (1) ◽  
pp. 53-54 ◽  
Author(s):  
MR Rahman ◽  
M Saiedullah ◽  
S Shermin ◽  
S Begum ◽  
S Hayat
Keyword(s):  
Diabetes Mellitus ◽  
Negative Predictive Value ◽  
Plasma Glucose ◽  
Predictive Value ◽  
Cross Sectional Study ◽  
World Health ◽  
Diagnostic Efficacy ◽  
Cross Sectional ◽  
Sensitivity Specificity ◽  
Diagnosis Of Diabetes Mellitus

American Diabetic Association (ADA) affirms HbA1c with cut off value of 6.5% as a diagnostic criteria of diabetes mellitus. World Health Organization (WHO) also supports but recommended that a value <6.5% does not exclude diabetes which is diagnosed by glucose test. The aim of this study was to evaluate the diagnostic efficacy of HbA1c in terms of sensitivity, specificity, positive and negative predictive value and accuracy in a selected group of Bangladeshi subjects. This cross-sectional study included 761 adult Bangladeshi subjects of both sex attending the outdoor in a tertiary healthcare center during the period of September 2009 to September 2010. Fasting, postprandial (2 hours after glucose load) plasma glucose and HbA1c were measured. Diabetes is defined according to HbA1c and plasma glucose. Sensitivity, specificity, positive and negative predictive value of HbA1c were 90.00% (CI 86.48-92.86%), 76.21% (CI 71.68-80.35%), 78.17% (CI 73.94-82.00%) and 88.96% (CI 85.10-92.10%) respectively. Accuracy was 82.92% with odds ratio (OR) 28.84 (CI 19.10-43.54%); p < 0.001. Though HbA1c revealed remarkable diagnostic efficacy and ease of performance, still it can not over rule the role of plasma glucose in diagnosis of diabetes mellitus. DOI: http://dx.doi.org/10.3329/bmj.v41i1.18785 Bangladesh Medical Journal 2012 Vol. 41 No. 1; 53-54

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.

Comparison between qualitative and quantitative measurement of strength deficit in shoulder flexors of young females: a cross- sectional study

2021 ◽  
Vol 71 (11) ◽  
pp. 2559-2562
Author(s):  
Saadia Perwaiz ◽  
Muhammad Waqar Afzal ◽  
Ghulam Fatima
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Sampling Technique ◽  
Cross Sectional Study ◽  
Manual Muscle Testing ◽  
Primary Analysis ◽  
Cross Sectional ◽  
Young Females ◽  
Muscle Testing

Objective: To compare accuracy of manual muscle testing in detection of strength differences across grade 4 and 5 at different percentage deficits of dynamometric mean in shoulder flexors of young females.  Methods: Cross sectional research design, conducting primary analysis of strength of shoulder flexors measured through manual muscle testing and hand-held dynamometer. Three hundred young healthy females without any ailment of upper extremity or generalized health problem were selected from University of South Asia and Association of Fatima Jinnah Old Graduates, Lahore. Non-probability convenient sampling technique was used. The age group selected was 18-39 years. The strength of shoulder flexors measured through manual muscle testing and hand-held dynamometer was main outcome measure. Results: The overall diagnostic accuracy of manual muscle testing showed better results at 10% dynamometric measures. It was 63.33%(95% CI: 57.74%, 68.59%) in non-dominant shoulder flexors and 61.67% (95% CI: 56.05%, 66.99%) in dominant shoulder flexors. The positive predictive value (PPV) and specificity of manual muscle testing was better at 10% strength deficit in comparison with dynamometric measures, whereas negative predictive value (NPV) and sensitivity was better at 20% strength deficit. Contrasting association was found between positive predictive value (PPV) and sensitivity, negative predictive value and specificity.  Conclusion: The subjective area of grade 4 and 5 showed better, although not ideal, diagnostic worth at 10% deficit of dynamometric measures in shoulder flexors. Further exploration through study of contrasting trends between PPV and sensitivity by subgroup analysis is required. Continuous...

scholarly journals A Control Study on the Value of the Ultrasound Grayscale Ratio for the Differential Diagnosis of Thyroid Micropapillary Carcinoma and Micronodular Goiter in Two Medical Centers

2021 ◽  
Vol 10 ◽  
Author(s):  
Zhijiang Han ◽  
Na Feng ◽  
Yidan Lu ◽  
Mingkui Li ◽  
Peiying Wei ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Medical Center ◽  
Threshold Sensitivity ◽  
Ultrasound Images ◽  
Diagnostic Efficacy ◽  
Medical Centers ◽  
Sensitivity Specificity

ObjectiveTo investigate the value of ultrasound gray-scale ratio (UGSR) for the differential diagnosis of papillary thyroid microcarcinoma (PTMC) and micronodular goiter (MNG) in two medical centers.MethodsUltrasound images of 881 PTMCs from 785 patients and 744 MNGs from 687 patients in center A were retrospectively analyzed and compared with 243 PTMCs from 203 patients and 251 MNGs from 198 patients in center B. All cases were confirmed by surgery and histology. The grayscale values of thyroid lesions and surrounding normal tissues were measured, and the UGSR was calculated. The optimal UGSR threshold for identifying PTMCs and MNGs in two medical centers was determined by receiver operating characteristic (ROC) curve, and the area under the curve (AUC), optimal UGSR threshold, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were compared between the two medical centers.ResultsThe UGSR values of PTMCs and MNGs in medical center A were 0.5537 (0.4699, 0.6515) and 0.8708 (0.7616, 1.0123) (Z = -27.691, P = 0), respectively, whereas those in medical center B were 0.5517 (0.4698, 0.6377) and 0.8539 (0.7366, 0.9929) (Z = -16.057, P = 0), respectively. The UGSR of PTMCs and MNGs did not differ significantly between the two medical centers (Z = -0.609, P = 0.543 and Z = -1.394, P = 0.163, respectively). The AUC, optimal UGSR threshold, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the two medical centers were 0.898 vs. 0.918, 0.7214 vs. 0.6911, 0.881 vs. 0.868, 0.817 vs. 0.833, 0.851 vs. 0.834, 0.853 vs. 0.867, and 0.852 vs. 0.850, respectively.ConclusionsUGSR can quantify the echo intensity of PTMCs and MNGs and is therefore valuable for the differential diagnosis of the two diseases. The diagnostic efficacy was consistent between the two medical centers. This method should be widely promoted and applied.

scholarly journals Diagnostic Value of VIA Comparing with Conventional Pap Smear in the Detection of Colposcopic Biopsy Proved CIN

1970 ◽  
Vol 6 (1) ◽  
pp. 7-12 ◽  
Author(s):  
Divya Hegde ◽  
Harish Shetty ◽  
Prasanna K Shetty ◽  
Supriya Rai ◽  
Lakshmi Manjeera ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Visual Inspection ◽  
Pap Smear ◽  
High Grade ◽  
Low Resource Settings ◽  
Low Resource

Aim: A study to assess the role of visual inspection with acetic acid VIA as an alternative to Pap smear in screening program for cervical cancer in low resource settings. Method: Two hundred and twenty five women in reproductive age group attending the Gynecology department at K.S Hegde Charitable Hospital were enrolled in the study. A Papanicolaou smear and visual inspection of the cervix with acetic acid was done. All women then underwent colposcopy using the video colposcope. All patients who tested positive on screening then underwent colposcopy guided biopsy. Pap smear of Low grade squamous intraepithelial lesion (LSIL) and above was taken as abnormal. The statistical test used was chi square test and results were computed using Statistical Package for the Social Sciences (SPSS) version 12.0. Results: Out of 225 patients, VIA was positive in 27(12%) patients and Pap smear was abnormal in 26(11.7%). There were 15 LSIL, 6 high Grade Squamous intraepithelial lesions (HSIL) and 5 were squamous cell carcinoma. On biopsy, there were 15 mild dysplasia, 2 moderate dysplasia, 4 severe dysplasia and 3 squamous cancers. Pap smear had a sensitivity of 83%, specificity of 98%, and positive predictive value of 80 % and negative predictive value of 97.9%. VIA had a sensitivity of 70.8%, specificity of 95%, and positive predictive value of 62.9 % and negative predictive value of 96.5%. Conclusion: Since diagnostic values of VIA is comparable to Pap smear, and it performs well in detecting high grade lesion we conclude that VIA can be used as a screening modality for cervical cancer in low resource settings. Keywords: Cervical cancer in low resource settings, Pap smear- colposcopy, visual inspection with acetic acid   DOI: http://dx.doi.org/10.3126/njog.v6i1.5245 NJOG 2011; 6(1): 7-12

scholarly journals Evaluation of the Accuracy of Human Kallikrein6, Cancer Antigen125, and Human Epididymis 4 in Predicting Ovarian Cancer

2017 ◽  
pp. 110
Author(s):  
Yongki Wenas ◽  
Ketut Suwiyoga ◽  
I Nyoman H Sanjaya
Keyword(s):  
Ovarian Cancer ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Cancer Antigen 125 ◽  
Chi Square ◽  
Cross Sectional ◽  
Human Epididymis ◽  
Sensitivity Specificity ◽  
Histopathology Examination

Objective: To evaluate the accuracy of hK6, HE4, and CA125 in predicting the malignancy of ovarian mass. Methods: The design of this study was cross-sectional. This study was conducted in the Obstetrics and Gynecology Clinic, Sanglah Hospital, Denpasar, between the period of September 2014 and August 2016. Samples were all patients with ovarian tumors who underwent surgery at Sanglah Hospital, Denpasar. Data analysis was performed using McNemar and chi square test in SPSS for windows version 17.0. Results: 22 samples were obtained. P > 0.05 value of age and parity variables indicated no differences between the two groups. There is no accuracy differences (sensitivity, specificity, positive predictive value, negative predictive value) of hK6 compared to histopathology examination in diagnosing ovarian cancer (p = 1). There is no accuracy differences (sensitivity, specificity, positive predictive value, negative predictive value) of HE4 compared to histopathology examination in diagnosing ovarian cancer (p = 1). There is no accuracy difference (sensitivity, specificity, positive predictive value, negative predictive value) of CA125 compared to histopathology examination in diagnosing ovarian cancer (p = 0.687). Conclusion: There was no accuracy differences (sensitivity, specificity, positive predictive value, negative predictive value) found between hK6, CA125, HE4 compared to histopathology examination in predicting ovarian cancer. [Indones J Obstet Gynecol 2017; 5-2: 110-113] Keywords: cancer antigen 125, human epididymis-4, human kallikrein 6, ovarian cancer

scholarly journals Downes score as a clinical assessment for hypoxemia in neonates with respiratory distress

2016 ◽  
Vol 48 (6) ◽  
pp. 342 ◽  
Author(s):  
Anita Rusmawati ◽  
Ekawati L. Haksari ◽  
Roni Naning
Keyword(s):  
Positive Predictive Value ◽  
Respiratory Distress ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Negative Likelihood Ratio ◽  
Cross Sectional Study ◽  
Preterm Neonates ◽  
Term Infants ◽  
Cross Sectional ◽  
Service Training

Background Hypoxemia in neonates with clinical respiratorydistress has a high mortality. Downes score is used as an alternativeto evaluate clinical respiratory distress if blood gas analysisinstrument or pulse oxymetry is not available.Objective To evaluate the validity of Downes score for assessinghypoxemia in neonates with clinical respiratory distress.Methods A cross sectional study was carried out on neonates withclinical respiratory distress hospitalized at level 2 and 3 NeonatalCare Unit and in Emergency Room of Dr. Sardjito GeneralHospital, Yogyakarta. Downes score and oxygen saturationmeasured by a pulse oximetry were compared. Hypoxemia wasdefined as oxygen saturation less than 90% in term and post-term infants, less than 88% in preterm neonates, or Downesscore 2:5 according to Basic Emergency Service Training forObstetry and Neonatology (PONED) in 2007. The accuracy ofDownes score in predicting hypoxemia was assessed by sensitivity,specificity, positive-predictive value, negative-predictive value,and likelihood ratio.Results Eighty nine neonates were evaluated. Downes score hadsensitivity of 88%, specificity of 81 o/o, positive-predictive value of72%, negative- predictive value of 92%, positive likelihood ratio4.53, negative likelihood ratio 0.15, prevalence of 36%, and posttest probability of 72%.Conclusion Downes score can be used as a clinical diagnosticmeans for assessing hypoxemia in clinical respiratory distressedneonates with 88% sensitivity (95% CI 79 to 99), and specificity81% sensitivity (95% CI 70 to 91).

scholarly journals VIA (Visual inspection with acetic acid) and VILI (Visual inspection with lugol’s iodine) as an initial approach with colposcopy as a next screening tool with its positive predictive value in low socioeconomic patients

2017 ◽  
Vol 7 (1) ◽  
pp. 210
Author(s):  
Anita Paswan ◽  
Anil Kumar ◽  
Kumudini Jha ◽  
Shail Kumari Sinha
Keyword(s):  
Cervical Cancer ◽  
Acetic Acid ◽  
Positive Predictive Value ◽  
Cervical Carcinoma ◽  
Predictive Value ◽  
Visual Inspection ◽  
Pap Smear ◽  
Lugol’S Iodine ◽  
Resource Setting ◽  
Sensitivity Specificity

Background: Cervical Cancer is the second most common cancer in women worldwide and India alone contribute the 1/4th of the world’s cases of cervical cancer. In view to this huge burden there was need to establish a feasible screening programme to detect cervical carcinoma at earliest in developing country.Methods: This is a prospective study of 500 women who fulfil the selection criteria. 50 pregnant patients for VIA (Visual inspection with acetic acid), 50 pregnant patients for VILI (Visual inspection with lugol’s iodine) and 400 non-pregnant women for VIA, VILI and colposcopy were enrolled. In positive cases, cervical biopsy with histopathological examination was done. The sensitivity, specificity and positive predictive value of each test were obtained and compared. Chi-square (X2) test was used to test the significance of difference between two proportions of a quantitative data.Results: The sensitivity, specificity, positive predictive value and negative predictive value for VIA (85.1%, 84.1%, 41.7%, 97%), VILI (95.7%, 92.4%, 62.5%, 93.4%) and Colposcopy (83%, 86%, 51.3%, 96.6%) were statistically significant with its histopathological report.Conclusions: In a poor developing country like India where pap smear and colposcopy is not available in low resource setting VIA and VILI can prove a very helpful tool in picking up abnormal looking cervix which can then be confirmed by pap or colposcopy. It will go a long way in reducing the incidence of cervical carcinoma.

scholarly journals Correlation between ultrasonographic and histopathological findings of hysterectomy specimen in patients with abnormal uterine bleeding

2020 ◽  
Vol 9 (10) ◽  
pp. 4123
Author(s):  
Kaushik Mahajan ◽  
R. K. Praneshwari Devi ◽  
Ajitkumar Singh ◽  
Dipenty Lairenjam ◽  
Leimapokpam Roshan Singh ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Abnormal Uterine Bleeding ◽  
Clinical History ◽  
Uterine Bleeding ◽  
Kappa Statistics ◽  
Cross Sectional ◽  
Common Diagnosis ◽  
Sensitivity Specificity

Background: AUB is a common and debilitating condition and it is one of the main gynaecological reasons for hysterectomy. Ultrasonography can be as good as histopathology (HPE) in the diagnosis of abnormal uterine bleeding. Hence, our study was conducted to validate the ultrasonographic findings with HPE findings in diagnosis of AUB.Methods: A hospital based cross-sectional analytical study was conducted among 86 patients with abnormal uterine bleeding in the department of Obstetrics and Gynaecology in collaboration with department of Pathology, RIMS, Imphal from September 2017 to March 2019. The clinical history and socio demographic profile were collected using a pre-designed proforma. General physical examination, pelvic examination and ultrasonagraphy was carried out and the hysterectomy specimens were subjected to histopathological examination.Results: Fibromyoma was diagnosed by ultrasound in 62.8% of the patients and it was the common diagnosis in this study. The sensitivity, specificity, positive predictive value, negative predictive value and kappa statistics of USG for diagnosing leiomyoma was 92.9%, 93.3%, 96.3%, 87.5% and 84.9% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and kappa statistics of USG for diagnosing adenomyosis was 53.8%, 98.6%, 87.5%, 92.3% and 62.3% respectively.Conclusions: The study provides an evidence that ultrasonography has good diagnostic accuracy as histopathology in the diagnosis of fibroid in patients with abnormal uterine bleeding. However, as with all the diagnostic procedures, the utility of ultrasound in the diagnosis of adenomyosis is questionable, since it has a low sensitivity amidst good specificity.

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