scholarly journals ROLE OF DOPPLER INDICES IN THE PREDICTION OF ADVERSE PERINATAL OUTCOME IN PREECLAMPSIA

2021 ◽  
Vol 71 (4) ◽  
pp. 1209-1213
Author(s):  
Shakra Tabasam ◽  
Zaib Malik ◽  
Asifa Siraj ◽  
Sadaf Afroz
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Perinatal Outcome ◽  
Military Hospital ◽  
Reference Standard ◽  
Adverse Perinatal Outcome ◽  
Doppler Study ◽  
Sensitivity Specificity

Objective: To determine diagnostic accuracy of systolic/diastolic ratio and cerebro-placental index in predicting adverse perinatal outcome among patients in preeclampsia. Study Design: Cross-sectional validation study. Place and Duration of Study: Department of Obstetrics and Gynaecology, Pak Emirates Military Hospital, Rawalpindi, from Jun to Dec 2017. Methodology: A total of 191 patients with preeclampsia were included. Doppler ultrasound (including doppler wave forms obtained from free floating portion of umbilical artery and doppler waveform from middle cerebral artery at the level of circle of Willis) examination was done after gestational age 30 weeks and Doppler study repeated at 2-4 weeks interval depending on severity of preeclampsia and abnormalities of waveform. Cases were followed and results of last Doppler examination within 10 days of delivery were considered and perinatal outcome noted. Results: The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of systolic/diastolic ratio in predicting adverse perinatal outcome among patients in preeclampsia, keeping actual adverse perinatal outcome as reference standard was 82.35%, 86.52%, 87.50%, 81.05% and 84.29% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of cerebro-placental index in predicting adverse perinatal outcome among patients in preeclampsia, keeping actual adverse perinatal outcome as reference standard was 78.67%, 92.24%, 86.76%, 86.99% and 86.91% respectively. Conclusion: The diagnostic accuracy of systolic/diastolic ratio, cerebro-placental index in predicting adverse perinatal outcome among patients in preeclampsia is quite high.

Diagnostic accuracy of monofilament test to detect diabetic neuropathy

2021 ◽  
Vol 10 (1) ◽  
pp. 20-25
Author(s):  
Sujan Shrestha ◽  
Mamen Prasad Gorhaly ◽  
Manil Ratna Bajracharya
Keyword(s):  
Peripheral Neuropathy ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Diabetic Peripheral Neuropathy ◽  
Perception Threshold ◽  
Sensitivity Specificity ◽  
Vibration Perception ◽  
Monofilament Test

Background Diabetic peripheral neuropathy (DPN) is a significant independent risk factor for diabetic foot, and an effective screening instrument is required to diagnose DPN early to prevent future ulceration and amputation. This study aims to determine the diagnostic accuracy of monofilament test to detect diabetic peripheral neuropathy. Methods This cross-sectional study was conducted in National Academy of Medical Sciences, Bir hospital, Mahabouddha, Kathmandu from February 2016 to January 2017. A total of 96 diabetic patients attending inpatient and outpatient Department were selected. Diabetic peripheral neuropathy was assessed by measurement of loss of protective sensation (LOPS) by monofilament test and compared with vibration perception threshold by standard biothesiometer. The sensitivity, specificity, positive predictive value and negative predictive value of monofilament test were calculated. Results The prevalence of diabetic peripheral neuropathy was 26%. The sensitivity, specificity, positive predictive value and negative predictive value of monofilament test were found to be 92.0%, 95.8%, 88.5% and 97.1% respectively. There was strong association between LOPS by monofilament and vibration perception threshold by biothesiometer. Conclusion This study showed a strong diagnostic accuracy of monofilament test to detect DPN when compared with biothesiometer. As monofilament test is a cheap, easily available, and portable, it can be used in the periphery where biothesiometer is not available.  

DIAGNOSTIC ACCURACY OF GRAY SCALE ULTRASONOGRAPHY VERSUS COLOR DOPPLER IN SUSPECTED CASES OF ACUTE APPENDICITIS

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Tahir Iqbal ◽  
Muhammad Usman Shahid ◽  
Ishfaq Ahmad Shad ◽  
Shahzad Karim Bhatti ◽  
Syed Amir Gilani ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Color Doppler ◽  
Diagnostic Tools ◽  
Gray Scale ◽  
Versus Color ◽  
Sensitivity Specificity

ABSTRACT: BACKGROUND: A common surgical emergency is acute appendicitis. Various diagnostic tools are available to diagnosis acute appendicitis. Radiological investigations play an important role in making accurate and early diagnosis and thus preventing morbidity associated with the disease. OBJECTIVE: To determine the diagnostic accuracy of gray scale ultrasonography versus color Doppler in suspected cases of acute appendicitis. MATERIALS AND METHODS: The study was carried in the department of Radiology of Mayo Hospital, Lahore. A total of 75 patients were enrolled of age 18-40 years, both genders who were suspected cases of acute appendicitis. All patients underwent baseline investigations along with gray scale ultrasonography and color Doppler. All patients were subjected to surgery to confirm the diagnosis and findings were subjected to statistical analysis. RESULTS: The mean age of the patients was 23.25 ±10.55 and mean transverse diameter of appendix was 8.37 ±3.39. There were 62.7% males and 37.3%females. Findings of gray scale ultrasonography and color Doppler were then correlated with surgical findings to calculate the diagnostic accuracy of these modalities. The results revealed that gray scale ultrasonography sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 92.7%, 94.32%, 95%, 91.4% and 93.3% respectively, whereas color Doppler had sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 97.7%, 93.9%, 95.3%, 97% and 96% respectively. Diagnostic accuracy of both modalities together was 98.6%. CONCLUSION: Color Doppler has better diagnostic accuracy than gray scale ultrasonography for diagnosis of acute appendicitis and the combination of both modalities yields diagnostic accuracy that is similar to gold standard.

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 Validation of the Dutch leakage score as a predictor of anastomotic leakage in intestinal surgery in a third level hospital

2021 ◽  
Vol 9 (11) ◽  
pp. 3251
Author(s):  
Alan Barker-Antonio ◽  
Arturo Jarquin-Arremilla ◽  
Elias Hernandez Cruz ◽  
Roberto Armando Garcia-Manzano ◽  
Ediel Osvaldo Davila-Ruiz
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Anastomotic Leakage ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Intestinal Anastomosis ◽  
Intestinal Surgery ◽  
Patient Death ◽  
Versatile Tool ◽  
Sensitivity Specificity

Background: Intestinal surgery can present multiple complications that can lead to patient death; therefore, it is important to design early detection strategies to reduce complications in patients with intestinal anastomosis and thus avoid patient death. The aim of this work is to evaluate the diagnostic performance of the Dutch leakage score in 125 patients with intestinal anastomosis as a predictor of anastomotic leakage.Methods: In a sample of 125 patients undergoing intestinal anastomosis, demographic variables were identified and the Dutch leakage score was applied. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were obtained using a 2×2 table.Results: The Dutch leakage score was positive in 23.2% (29 patients) of whom 24 had anastomotic leakage and 5 had no anastomotic leakage. It presents a sensitivity in the test of 100%, a specificity of 95%, a positive predictive value of 82.7%, a negative predictive value of 100%. The diagnostic accuracy is 96%.Conclusions: The Dutch leakage score is a versatile tool, inexpensive, easy to apply and available in any hospital center. It is capable of early diagnosis of anastomotic leakage. It favors early re-intervention, improves prognosis and survival, decreases hospital stay and health care costs.

scholarly journals A Comparative Analysis Between RIPASA and Alvarado Scoring Systems for the Diagnosis of Acute Appendicitis- A Nepalese Perspective

2018 ◽  
Vol 6 (2) ◽  
Author(s):  
Suman Baral ◽  
Neeraj Thapa ◽  
Raj Kumar Chhetri ◽  
Rupesh Sharma
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Scoring System ◽  
Scoring Systems ◽  
Negative Appendectomy ◽  
Alvarado Score ◽  
Sensitivity Specificity

Introduction: Various diagnostic criteria have been described for acute appendicitis. For decades the most commonly used one has been Alvarado score. RIPASA scoring system has also been developed for Asian population which has shown highest sensitivity and diagnostic accuracy. This study aimed to compare these two diagnostic criteria in Nepalese population attending a tertiary center. Methods: Patients with clinically suspected acute appendicitis were classified according to both Alvarado and RIPASA scoring systems before undergoing surgery. Histopathological examination was taken as the gold standard for diagnosis. Statistical analysis was done using McNemar's test as applicable. Results: Ninety nine (90 %) patients had histologically confirmed appendicitis. With the cut-off value greater than 7.5 for RIPASA score; sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy and negative appendectomy rates were 94.5%, 27.27 %, 92.16 %, 37.5 %, 88.18% and 7.84% respectively. With the cut-off value greater than 7 for Alvarado score, sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy and negative appendectomy rates were 71.72%, 72.73 %, 95.95 %, 22.22%, 71.82 %, and 4.05 % respectively. 94.5% of patients were correctly stratified by RIPASA under higher probability group while only 71.8 % were classified by Alvarado (p value= 0.0001). Conclusion: RIPASA scoring system showed high sensitivity and diagnostic accuracy in comparison to Alvarado scoring system. So, this method can be applied in Nepalese setting for the diagnosis of acute appendicitis.

Diagnostic Accuracy of Ultrasound in Palpable Breast Lesions

2020 ◽  
Vol 5 (3) ◽  
pp. 1196-1200
Author(s):  
Manish Raj Pathak ◽  
Mahesh Gautam ◽  
Rashmita Bhandari
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Diagnostic Tool ◽  
Predictive Value ◽  
Breast Lesions ◽  
Non Invasive ◽  
Malignant Lesions ◽  
Palpable Breast ◽  
Sensitivity Specificity

Introduction: Breast carcinoma is the second leading cause of cancer related mortality in females around the world. Ultrasound plays a key role in differentiating cystic and solid lesions and is a convenient and non-invasive diagnostic tool to differentiate between benign and malignant lesions. Objectives: The aim of this study is to evaluate the diagnostic accuracy of ultrasound in palpable breast lesions. Methodology: A prospective cross-sectional study was carried out in patients with palpable breast lesions who presented in Department of radio diagnosis and imaging of Nobel Medical collegefor a period of one-year from February 2019- January 2020 using ultrasound. A total of 60 patientswereevaluated in the study. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated. Results: Out of 60 patients evaluated, ultrasound showed 46 (76.7%) cases to be benign and 14 (23.3%) cases to be malignant. FNAC revealed benign disease in 47 (78.3%) patients and malignant disease in 13 (21.7%) patients. The most common benign lesion was fibroadenoma. We found nearly 91.7% of the malignant lesions had spiculated margins and microcalcification. The sensitivity of ultrasound was 95.74% and specificity 92.3% with diagnostic accuracy 95%. Conclusion: Ultrasound is a convenient and non-invasive diagnostic tool with good sensitivity, specificity, positive predictive value, negative predictive value and accuracy in palpable breast lesions.

scholarly journals Obstetric Doppler studies in prediction of perinatal outcome in intrauterine growth restriction

2018 ◽  
Vol 7 (10) ◽  
pp. 4177
Author(s):  
Pradip R. Gaikwad ◽  
Sarah Zaidi ◽  
Meenakshi Rana ◽  
Vidyadhar Suryakar
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Intrauterine Growth Restriction ◽  
Perinatal Outcome ◽  
Umbilical Artery ◽  
Doppler Studies ◽  
Colour Doppler ◽  
Intrauterine Growth ◽  
Adverse Perinatal Outcome

Background: Fetal surveillance of the pregnancies that are complicated by IUGR is essential to improve fetal outcome. Colour Doppler studies of uteroplacental and fetoplacental circulation are useful in identification of hypoxemic status of the fetus and allows timely intervention in at risk fetuses. The present study was aimed to know the significance of colour Doppler studies in intrauterine growth restriction cases and to correlate with the perinatal outcome thus to offer better strategies for early diagnosis of compromised fetus and timely intervention.Methods: This was a prospective study of 125 singleton pregnancies in the third trimester with IUGR. The results of last Doppler ultrasound within one week of delivery were used for analysis. Adverse perinatal outcome was studied in the form of emergency cesarean section for fetal distress, meconium stained amniotic fluid, Apgar at 5 min <7, NICU admission and perinatal mortality (stillbirths and neonatal death). Sensitivity, Specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and Diagnostic accuracy of various Doppler parameters were calculated after comparing with standard.Results: In the present study 63 patients had one or more adverse perinatal outcome parameter. The diagnostic accuracy of umbilical artery was more (71.20%) than other parameters in predicting adverse perinatal outcome. Middle cerebral artery RI was having highest specificity and positive predictive value of 100% than any other parameter in predicting adverse perinatal outcome. Patients with AEDF and REDF had 33.3% and 50% perinatal deaths respectively.Conclusions: Middle cerebral artery Doppler studies shown more specificity and positive predictive value than umbilical artery Doppler in prediction of adverse perinatal outcome.

scholarly journals Unenhanced breast MRI: could it replace dynamic breast MRI in detecting and characterizing breast lesions?

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Reham Khalil ◽  
Noha Mohamed Osman ◽  
Nivine Chalabi ◽  
Enas Abdel Ghany
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Breast Mri ◽  
Breast Lesions ◽  
Dce Mri ◽  
Contrast Enhanced ◽  
Mri Protocol ◽  
Sensitivity Specificity

Abstract Background We aimed to evaluate the unenhanced MRI of the breast (UE-MRI) as an effective substitute for dynamic contrast-enhanced breast MRI (DCE-MRI) in both detecting and characterizing breast lesions. We enrolled in our retrospective study 125 females (232 breasts, as 18 patients had unilateral mastectomy) with breast mass at MRI of variable pathologies. Routine DCE-MRI protocol of the breast was conducted. We compared the conventional unenhanced images including STIR, T2, and DWIs to the DCE-MRI by two blinded radiologists, to detect and characterize breast lesions, and then we compared their results with the final reference diagnoses supplied by the histopathology or serial negative follow-ups. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy for UE-MRI and DCE-MRI were calculated. UE-MRI results of each observer were also compared with DCE- MRI. Results The calculated UE-MRI sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy for the first observer were 95%, 80%, 83%, 94%, and 89% respectively, and for the second observer, they were 94%, 79%, 81%, 93%, and 86%. On the other hand, those for the DCE-MRI by the first observer were 98%, 82%, 84%, 98%, and 90% and were 97%, 81%, 84%, 97%, and 89% by the second observer. The intraobserver agreement between the UE-MRI and DCE-MRI results of each observer was 94% and 95%, while the interobserver agreement for each section was 97.4% for UE-MRI and 98.3% for DCE-MRI. Conclusion UE-MRI of the breast can be a reliable and effective substitute for breast DCE-MRI. It can be used with comparable accuracy to DCE-MRI whenever contrast administration is not feasible or contraindicated.

scholarly journals Diagnosis of Congenital Anomalies of Kidney and Ureter by Ultrasonography

2015 ◽  
Vol 5 (1) ◽  
pp. 8-11
Author(s):  
Fathima Nusrath Halim ◽  
Mohammad Ali Sarker ◽  
Farah Nazlee ◽  
Md Nazrul Islam
Keyword(s):  
Kidney Disease ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Congenital Anomalies ◽  
Transabdominal Ultrasonography ◽  
Imaging Tool ◽  
Congenital Kidney Anomalies ◽  
Sensitivity Specificity

Present study was conducted to investigate the diagnostic accuracy of transabdominal ultrasonography in correlation with IVU in suspected patients of Congenital anomalies of kidney and Ureter. In study, ultrasonography and IVU was done in 50 clinically suspected patients of congenital anomalies of kidney that was admitted in BSMMU, BIRDEM & DMCH during the period of July 2008 to May 2009. Patients of all ages and both sexes were included. Findings of USG and IVU were correlated. Sonographically abnormalities were diagnosed in 46 (92%) cases, out of which 45 (95.7%) also diagnosed by IVU and 1 (33.3) was normal in IVU. Out of 4 (8%) Sonographically demonstrated normal cases, 2 (4.3%) were proved normal by IVU and 2 (66.7%) cases which missed by sonography were diagnosed by IVU. Sensitivity of ultrasonography in diagnosing congenital kidney disease was 95.7% and specificity was 66.7%, positive predictive value was 97.8%, negative predictive value was 50.0% and accuracy was 94.0%. So, we conclude that ultrasonography has significant sensitivity, specificity, positive predictive value, and accuracy in diagnosis of congenital kidney anomalies correlating with IVU. As such, USG can be considered as an appropriate imaging tool for diagnosis of congenital anomalies of kidney.J. Paediatr. Surg. Bangladesh 5(1): 8-11, 2014 (January)

scholarly journals Cerebroumbilical doppler ratio in pregnancy induced hypertension and its prediction for adverse perinatal outcome

2019 ◽  
Vol 8 (12) ◽  
pp. 4995
Author(s):  
Meena Bhati Salvi
Keyword(s):  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Doppler Ultrasound ◽  
Predictive Value ◽  
Perinatal Outcome ◽  
Control Group ◽  
Study Group ◽  
Pregnancy Induced Hypertension ◽  
Adverse Perinatal Outcome ◽  
Induced Hypertension

Background: To compare the changes in pulsatility index (PI) values of fetal middle cerebral artery (MCA), umbilical artery (UA) and ratio of PI of MCA and UA (cerebroumbilical ratio, C/U ratio) in normal pregnancies with pregnancy induced hypertension (PIH) and to evaluate their usefulness for predicting adverse perinatal outcome.Methods: This was a prospective comparative study carried out over a period of 1 year on total 140 patients between 30-40 weeks of gestation. Study group comprised of 70 patients with PIH. The control group comprised of 70 patients with normal BP. Both the groups were followed by doppler ultrasound and the UA PI, the MCA PI and the C/U ratio were measured. The results of the last doppler ultrasound before delivery were considered in the correlation with various adverse perinatal outcome. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of MCA PI and UA PI and C/U ratio were calculated and compared for predicting adverse perinatal outcome.Results: Abnormal C/U ratio was more common in PIH group (42.85%) than control group (5.71%). In the study group, 83.33% patients of abnormal C/U ratio showed adverse perinatal outcome. C/U ratio had highest sensitivity (75.75%), negative predictive value (80%) and diagnostic accuracy (81.42%) compared to MCA PI and UA PI for predicting adverse perinatal outcome in PIH women.Conclusions: Incidence of adverse perinatal outcome was more common with abnormal C/U ratio. C/U ratio is better predictor for adverse perinatal outcome in PIH women than individual MCA PI and UA PI.

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