Diagnostic accuracy of LDH/AST ratio in the detection of necrosis in ABP by taking CT scan as a Gold standard

2021 ◽  
Vol 15 (11) ◽  
pp. 3020-3021
Author(s):  
Shabbar Hussain Changazi ◽  
Usman Ali Rahman ◽  
Javaid ur Rehman ◽  
Barza Afzal ◽  
S. Bhatti ◽  
...  

Aim: To determine the diagnostic accuracy of LDH/AST ratio in the detection of necrosis in acute biliary pancreatitis by taking a CT scan as a gold standard. Methods: This cross-sectional study was conducted from October 2015 to September 2020. Patients of both sexes and ages ranging from 20 to 70 years with acute biliary pancreatitis were included in the study. Diabetic patients, smokers, and patients who had causes of elevated serum transaminases were excluded from the study. LDH/AST ratio was measured on the 5th post-admission day. A contrast-enhanced CT scan was performed on the 7th post-admission day to validate pancreatic necrosis (PNec). The sensitivity, specificity, and diagnostic accuracy of the LDH/AST ratio were then calculated. Results: A total of 270 pts with acute biliary pancreatitis were included in the study. The mean age was found to be 34.57±5.527 years. Ninety-three (34.4%) patients were male while 177(65.6%) patients were female. Total 43 (15.92%) patients were predicted to develop pancreatic necrosis on LDH/AST Ratio and among them, 42 (15.55%) were confirmed to have necrosis. The sensitivity of detecting PNec on basis of the LDH/AST ratio was 97.8%, specificity of LDH/AST ratio was 99.5%, positive predictive value was 97% and diagnostic accuracy of LDH/AST ratio was 98.9%. Conclusion: It was concluded that the LDH/AST Ratio is a strong biochemical marker to detect pancreatic necrosis. Furthermore, age and gender do not have any significant association with pancreatic necrosis. Keywords: CT Scan, pancreatitis, necrosis

2021 ◽  
Vol 15 (6) ◽  
pp. 1679-1681
Author(s):  
Afaque Ali ◽  
Majid Shaikh ◽  
Ahsanullah . ◽  
Adeel Ahmed ◽  
Abid Ali Sahito ◽  
...  

Objective: To determine the diagnostic accuracy of High-resolution computed tomography (HRCT) chest in detection of covid-19 infection taking PCR as gold standard. Study Design: Cross-sectional study Setting: Radiology department of Tabba Hospital, Karachi. Duration: From March 2019 to September 2020 Material and Methods: All the clinically suspected patients of covid-19, of any age, both genders and those referred to radiology for High-resolution computed tomography (HRCT) chest to detect the covid-19 infection were included. After two days, patients’ PCR reports were collected from the ward, after taking informed consent and permission from head of department. The diagnostic accuracy of HRCT was established with respect to sensitivity, PPV, NPV, and specificity by taking PCR as gold standard. All the information was collected via study proforma. Results: Total 70 patients suspected for COVID-19 were studied, and the patients’ mean age was 58.23±9.52 years. Males were in majority 54(77.1%). As per HRCT findings, COVID-19 infection was positive in 46 patients, however, 48 patients were detected positive for COVID-19 infection as per PCR findings. In the detection of COVID-19 infection, HRCT chest showed sensitivity of 91%, specificity of 90%, PPV of 83%, NPV of 84% and diagnostic accuracy of 94%; by taking PCR as gold standard. Conclusion: High-resolution computed tomography (HRCT) is a reliable diagnostic approach in promptly detecting the COVID-19; with 91% sensitivity, 90% specificity, 83% positive predictive value, 84% negative predictive value and 94% diagnostic accuracy. Keywords: Accuracy, HRCT, COVID-19


2021 ◽  
Vol 15 (10) ◽  
pp. 2682-2684
Author(s):  
Fiza Asif ◽  
Sobia Zafar ◽  
Tehmina Zafar ◽  
Tayyaba Majeed ◽  
Zahid Mahmood

Background: Cesarean section uterine scar dehiscence (CSD) is a rare but notable complication of Lower segment cesarean section (LSCS) surgery. The cause for a uterine scar dehiscence is based on the etiology behind the uterine scar defect or any event that would predispose the cesarean scar to dehisce. Globally accepted option for assessing the CS scar is transvaginal ultrasonography of the non-pregnant uterus. Objective: To determine the diagnostic accuracy of lower uterine segment scar thickness≤1.6mm in the prediction of scar dehiscence in patients with previous one LSCS who are undergoing repeat LSCS after trial of labour taking intraoperative findings as gold standard. Material and methods: This cross sectional study was conducted in Services Hospital, Lahore for 6 months. The Non probability consecutive sampling technique was used to include women with previous one LSCS at 36-38 weeks were asked to get their TVS done for scar thickness. Women with scar thickness≤1.6mm and scar thickness>1.6mm were identified. Their intraoperative findings of scar dehiscence were confirmed. All the data was entered and analyzed on SPSS version 20. Results: The mean age of patients was 29.87±6.07 years. The emergency LSCS was done in 599(49.1%) patients and elective LSCS was done in 621(50.9%) patients. The sensitivity, specificity & diagnostic accuracy of TVS was 98.31%, 99.05% & 98.69% respectively. Conclusion: According to our study results the TVS for uterine scar is a very useful and effective tool in the prediction of scar dehiscence in patients with previous one LSCS taking intraoperative findings as gold standard. Keywords: Transvaginal sonography, TVS, Uterine, Scar, dehiscence, LSCS, Intraoperative


2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Sohbia Munir ◽  
Sohail Ahmed Khan ◽  
Hina Hanif ◽  
Maria Khan

Objective: To evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) in detection of intra-axial gliomas in suspected cases keeping histopathology as gold standard. Methods: This cross-sectional study was conducted at Dow Institute of Radiology, DUHS from October 2017 - April 2018. Patients of either gender aged 30-70 years presenting with headache were included. Patients already diagnosed and referred for follow up were excluded. MRI was performed on 1.5T scanner by a trained MRI technician. T1, T2, FLAIR, diffusion weighted and T1 post contrast images were acquired and reviewed by two radiologists having more than five years post fellowship experience. Sensitivity, specificity, PPV, NPV and diagnostic accuracy of MRI for intraaxial gliomas was calculated taking histopathology findings as gold standard. Results: Mean age of the patient`s was 51.71 ±10.85 years. Positive intraaxial gliomas on MRI were observed in 123 (79.90%) patients while on histopathology, positive intraaxial gliomas were observed in 131 (85.10%) patients. Diagnostic accuracy of MRI in detection of intra-axial gliomas taking histopathology findings as gold standard showed sensitivity, specificity, positive predicted value (PPV), negative predicted value (NPV) and overall diagnostic accuracy as 89.31%, 73.91%, 95.12%, 54.84% and 87.01%. Conclusions: MRI has high sensitivity, moderate specificity and high diagnostic accuracy in detection of intraaxial gliomas. doi: https://doi.org/10.12669/pjms.37.1.2489 How to cite this:Munir S, Khan SA, Hanif H, Khan M. Diagnostic accuracy of magnetic resonance imaging in detection of intra-axial gliomas. Pak J Med Sci. 2021;37(1):125-130. doi: https://doi.org/10.12669/pjms.37.1.2489 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Author(s):  
Orhan Alimoğlu ◽  
Nuray Colapkulu ◽  
Tunç Eren

Acute biliary pancreatitis (ABP) is one of the most common gastrointestinal events that requires acute admission to the hospital with considerable risks of mortality & morbidity. Laparoscopic cholecystectomy has become the gold standard for the treatment of ABP. Our aim was to determine the safety of cholecystectomy during the first admission by performing a review of the current literature. Waiting for 6 - 8 weeks to perform cholecystectomy may result with an increased incidence of recurrent ABP attacks, which may increase morbidity and the length of the hospital stay. On the contrary, cholecystectomy during the index admission for mild ABP appears to be a preferable and safe approach with better surgical outcomes providing a definitive treatment.


2016 ◽  
Vol 23 (09) ◽  
pp. 1045-1051
Author(s):  
Adnan Ahmed ◽  
Mushtaque Ali Memon ◽  
Muhammad Iqbal

Objectives: The objective of this study was to determine the diagnosticaccuracy of CT scan in detecting thyroid cartilage invasion by carcinoma of larynx keepinghistopathological findings as a gold standard. Study Design: Cross sectional and descriptivestudy. Setting: Department of Radiology of LUMHS, And Karachi Institute of Radiotherapy &Nuclear Medicine. Period: February 2013 to August 2015. Subjects and Methods: Overall 86patients were incorporated in this study. All these patients subsequently had their histopathology.The CT outcomes were then contrasted with histopathological results & measures of variablescalculated, were based on the results. Results: Fifty patients were men & 36 patients werewomen. The ages varied from 31 to 65yrs with mean age of 50yrs. The specificity & sensitivityof CT in diagnosing thyroid cartilage invasion was 84.5% and 93.3% respectively. Accuratenessof CT in diagnosing thyroid cartilage invasion was 86.05%. Conclusion: The study establishedthe specificity, sensitivity, negative as well as positive predictive value and accuracy of CTscan for the detection of thyroid cartilage invasion as 84.5%, 93.3%, 98.4%, 56% and 86.05%respectively. Very low negative predictive value was found in patients of age more than 50 years.


2018 ◽  
Vol 12 (2) ◽  
pp. 513-518 ◽  
Author(s):  
Veit Phillip ◽  
Rickmer Braren ◽  
Nikolaus Lukas ◽  
Roland M. Schmid ◽  
Fabian Geisler

The formation of pancreatic pseudocysts and (pseudo-)aneurysms of intestinal vessels are rare but life-threatening complications in acute and chronic pancreatitis. Here we report the rare case of a patient suffering from chronic pancreatitis with an arterial pseudoaneurysm within a pancreatic pseudocyst and present its successful therapeutic management by angioembolization to prevent critical bleeding. A 67-year-old male with a history of chronic pancreatitis presented with severe acute abdominal pain and vomiting to the emergency department. Seven weeks prior to the present admission, a CT scan had displayed a pancreatic pseudocyst with a maximum diameter of 53 mm. A laboratory examination revealed an elevated white blood cell count (15.40 × 103/μL), as well as elevated serum lipase (191 U/L), bilirubin (1.48 mg/dL), and blood glucose (353 mg/dL) levels. Sonographically, the previously described pancreatic pseudocyst revealed a slightly increased maximum diameter of 65 mm and an inhomogeneous echo of the cystic content. A contrast-enhanced CT scan showed a further increase in maximum diameter to 70 mm of the known pseudocyst. Inside the pseudocyst, a pseudoaneurysm originating from the splenic artery with a maximum diameter of 41 mm was visualized. After interdisciplinary consultation, prophylactic coil embolization of the splenic artery was immediately performed. The pseudoaneurysm was shut off from blood supply by back-door/front-door occlusion employing 27 coils, resulting in complete exclusion of the pseudoaneurysm from the circulation. Pseudoaneurysms are a rare complication of acute and chronic pancreatitis which has been shown to be efficiently treated by coil embolization.


2021 ◽  
Vol 71 (3) ◽  
pp. 1015-19
Author(s):  
Muhammad Atif ◽  
Fida Hussain ◽  
Zaigham Salim Dar ◽  
Jameela Khatoon ◽  
Saadia Ajmal ◽  
...  

Objective: To determine diagnostic accuracy of 99mTc labelled Ubiquicidin (29-41) SPECT/CT for detection of osteomyelitis in diabetic foot patients by taking bone biopsy as gold standard. Study Design: Cross-sectional validation study. Place and Duration of Study: Nuclear Medical Centre, Armed Forces Institute of Pathology, from Apr 2017 to Mar 2018. Methodology: Study assessed 122 patients of both genders, aged between 30-80 years (mean age=55.3 years), presenting with diabetic foot ulcers having suspicion of osteomyelitis, by 99mTc-Ubiquicidin (29-41) SPECT/CT followed by bone biopsy (histopathology and culture) taken as gold standard. Results: Among 122 patients [94 male (77%) and 28 female (23%)], osteomyelitis was histopathologically confirmed in 113 patients. 107 out of these patients were positive for osteomyelitis on 99mTc-UBI (29-41) SPECT/CT (true positives) while 6 were false negative. Out of 9 patients declared negative for osteomyelitis on histopathology and culture, 8 were negative on 99mTc-UBI (29-41) SPECT/CT as well (true negative) while only 1 case came out to be positive (false positive). Thus, the 99mTc-UBI (29-41) scan showed 94.6% sensitivity, 88.89% specificity, 99% positive predictive value, 57% negative predictive value with overall 94.2% diagnostic accuracy. Conclusion: 99mTc labelled Ubiquicidin (29-41) SPECT/CT scan can precisely localize infective focus, in diabetic foot osteomyelitis, with simultaneous discrimination between bone and soft tissues.


2021 ◽  
Vol 15 (7) ◽  
pp. 1902-1905
Author(s):  
Farah Naz ◽  
Adnan Ahmed ◽  
Samina Shaikh ◽  
Hafeez ur Rehman ◽  
Tahir Baig ◽  
...  

Background and Aim: Evaluation of uterine abnormalities is infertility core partto be assessed in impaired reproduction cases. Uterine abnormalities can be assessed by various radiological imaging modalities such as transvaginal sonography, hysterosalpingography and hysterosonography. The current study aims to evaluate the diagnostic accuracy of hysterosonography in diagnosis of uterine lesions by taking hysteroscopy as gold standard. Materials and Methods: This observation-based cross-sectional study was carried out on 108 reproductive-age women at the Department of Obstetrics and Gynecology of Liaquat University of Medical and Health Sciences, Jamshoro during the period from January 2020 to June 2020.These women had uterine abnormalities such as recurrent pregnancy loss, abnormal uterine bleeding, infertility, and clinically diagnosed lesions of intrauterine. All individuals underwent hysteroscopy evaluation.Global sensitivity analysis technique was used to calculate the bias-adjusted specificity and sensitivity of hysterosonography. Uterine abnormalities were assessed by hysteroscopy taking it as a gold standard. SPSS version 20 was used for data analysis. Results:The mean age of the women was 27.3 ± 5.63 with age range 20 to 34 years and parity ranged from 0 to 5. Out of 108 patients, 49 (45.4%) had positive findings of abnormal uterine lesions including myomas in 13 (12.3%), polyps 17 (15.7%), uterine septum 7 (6.4%) and intrauterine adhesions 12 (11.1%). Among all, forty-nine (45.4%) women had infertility, previous cesarean section 20 (19.1%), recurrent pregnancy loss 18 (16.6%), and menstrual disorders 21 (19.4%).Diagnostic accuracy of hysterosonography in terms of specificity, sensitivity, and Positive prediction value (PPV) was 94%, 77%, and 74% for uterine lesions respectively while taking hysteroscopy as a gold standard. Conclusion: The present study concluded that uterine lesions among reproductive-age women could be easily assessed with higher accuracy of hysterosonography. Based on the specificity and sensitivity of hysteroscopy as a gold standard for hysterosonography is the most reliable, safe and accurate diagnostic technique for uterine lesions. Keywords:Hysterosonography, Uterine lesions


Author(s):  
Rabia Akram ◽  
Amna Khalid ◽  
Wasif Farman ◽  
Fazal Hussain Shah ◽  
Hina Baig ◽  
...  

Background: CT and MRI modalities are considered a gold standard for the diagnosis of hydrocephalus. The more readily available and cheap options like sonography are being sought out for the diagnosis of this entity. Objectives: To determine the accuracy of cranial ultrasonography in the diagnosis of hydrocephalus keeping CT scan as a gold standard. Study design: Cross-sectional study Place and duration of study: Department of Pediatrics, Combined Military Hospital, Rawalpindi, from 01-01-2017 to 30-06-2017 Materials and Methods: A total of 121 children with a clinical diagnosis of hydrocephalus were selected and subjected to ultrasound of the head. Subsequently, a CT scan of the head was done and both modalities were compared. The diagnostic accuracy of the ultrasound was determined to keep CT findings as to the gold standard. Results: The mean age was 51.36 ± 34.01 days. The male gender was dominant as 81 (66.9%) patients were males. Ultrasonography of the head detected 93 (76.9%) patients with hydrocephalus while CT scan detected 90 (74.4%). Sensitivity, specificity, PPV, NPV and accuracy of USG to diagnosed hydrocephalus were 88.9%, 58.1%, 86.0%, 64.3% and 80.99% respectively Conclusion: Ultrasonography of head is a valuable screening tool for the diagnosis of hydrocephalus. Keywords: Hydrocephalus, Tomography, X-Ray Computed, Ultrasonography


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