Does Static Intra Access Pressure Monitoring of Arteriovenous Fistulas Predicts Intra Access Stenosis?

The initiation of hemodialysis in patients with chronic kidney disease (CKD) requires vascular access formation. The choice of vascular access for individual patient depends on various factors however arteriovenous fistula (AVF) is conventionally considered to be the vascular access of choice. Once hemodialysis is initiated through a mature AVF, there is an ongoing need for surveillance of the AVF to ensure adequate function and prevent vascular access issues among which flow obstruction (both inflow and outflow) remains the most important. AVF stenosis can potentially lead to inadequate dialysis delivery and thrombosis thus leading to access loss. Physical examination and AVF Doppler ultrasonography (DUS) are useful for evaluation of stenosis in the arteriovenous connection and the outflow tract. Periodic assessment of the AVF with Static Intra access Pressure (SIAPR) determination may be a reliable means of predicting vascular access stenosis. Material & Methods A cross sectional study carried out at Department of Nephrology, Fatima Memorial Hospital, Lahore from July 2018 to December 2018. In total 113 patients were included, and all patients underwent SIAPR assessment and Doppler Ultrasound of AVF. Results Mean age of the patients was 56.81±9.38 years, male to female ratio of the patients was 1.8:1. In this study the SIAPR was suggestive of stenosis in 87(76.99%) patients. The sensitivity, specificity and diagnostic accuracy of SIAPR against Doppler US of the AVF for detection of stenosis was 75.86%, 22.62% & 36.28% respectively Conclusion SIAPR has low specificity and diagnostic accuracy compared to Doppler US for detection of AVF stenosis.

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Frequency of High MELD Score in Cirrhotic Patients undergoing Liver Resection due to Hepatocellular Carcinoma

10.53350/pjmhs211592841 ◽

2021 ◽

Vol 15 (9) ◽

pp. 2841-2843

Author(s):

Muhammad Omer Farooq ◽

Niaz Ahmed ◽

Hassan Nadeem ◽

Kashif Rafi ◽

Sadia Jabbar ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Resection ◽

Cross Sectional Study ◽

Meld Score ◽

Cross Sectional ◽

Female Ratio ◽

Score Study ◽

Insignificant Difference ◽

Cirrhotic Patients ◽

Male To Female

Objective: To determine the frequency of high MELD score in cirrhotic patients undergoing liver resection due to hepatocellular carcinoma also compare the frequency of mortality in patients with high or low MELD score. Study Design: Cross sectional study Place and Duration: Department of Gastroenterology, Shaikh Zayed Hospital, Lahore. Duration: 6months i.e. 23 12-2017 to 22-06-2018. Methodology: 75 patients were enrolled. Then blood sample was obtained. Reports assessed and MELD score calculated. Scores were labeled as high or low. Patients underwent liver resection according to BCLC. The mortality was noted. All the collected data was entered and analyzed on SPSS version 22. Results: In this study out of total 75 cases 60 were males and 15 females. The mean age of patients was 39.44±9.76 years, male to female ratio was 4:1. Low MELD class was noted in 45 (60%) cases and high MELD class noted in 30(40%) cases. Mortality occurred in 27(36%) cases. Insignificant difference found between the MELD class with mortality. Conclusion: High MELD score was seen in 40% cirrhotic patients undergoing liver resection due to HCC. Post HCC resection, mortality occurred in 36% patients within three months of surgery. No significant association was found between the mortality and MELD score. Keywords: MELD, Hepatocellular Carcinoma, Mortality, Cirrhosis

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HIV Prevalence and Frequency of Risk Behavior in Injecting Drug Users Entering Treatment and Out of Treatment: A Cross-Sectional Study in Five Italian Cities

Journal of Drug Issues ◽

10.1177/002204269402400312 ◽

1994 ◽

Vol 24 (3) ◽

pp. 527-535 ◽

Cited By ~ 6

Author(s):

Giovanni Rezza ◽

Stefania Salmaso ◽

Damiano Abeni ◽

Giovanna Brancato ◽

Alessandra Anemona ◽

...

Keyword(s):

Risk Behavior ◽

Drug Users ◽

Injecting Drug Users ◽

Cross Sectional Study ◽

Hiv Prevalence ◽

Sectional Study ◽

Cross Sectional ◽

Female Ratio ◽

Outreach Programs ◽

Male To Female

We conducted a study to describe current patterns of drug-related behaviors, and to identify characteristics that may distinguish injecting drug users entering treatment from those out of treatment, in five Italian cities. Overall, 1,180 subjects were recruited — 568 entering treatment and 612 out of treatment. Male to female ratio was 6.6:1. The median age was similar in the two groups. A high proportion of injecting drug users recruited out of treatment had been in treatment at least once. HIV prevalence among injecting drug users entering treatment was not higher than that of those who were out of treatment. Furthermore, a large proportion of injecting drug users who still were out of treatment reported having adopted safe behaviors. The results of the study emphasize the need to implement outreach programs aimed at harm reduction.

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ACCURACY OF THE UPPER LIP BITE TEST;

The Professional Medical Journal ◽

10.29309/tpmj/2013.20.01.589 ◽

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.

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Diagnostic Accuracy of Rapid Diagnostic Kits Test for Diagnosis of Malaria

10.53350/pjmhs2115102826 ◽

2021 ◽

Vol 15 (10) ◽

pp. 2826-2828

Author(s):

Muhammad Ahsan Zafar ◽

Sidra Khalid ◽

Talha Munir

Keyword(s):

Diagnostic Accuracy ◽

Gold Standard ◽

Female Ratio ◽

Diagnostic Kits ◽

Negative Results ◽

Malaria Antigen ◽

The Mean ◽

Sensitivity Specificity ◽

Age Range ◽

Male To Female

Objective: To assess the diagnostic accuracy of rapid diagnostic kits test for diagnosis of malaria taking microscopy as gold standard Methodology: A total of 375 cases with age range 18-65 years of either gender as suspected for malaria were included in the study. We excluded all those cases already taking anti-malarial drugs. The study was conducted at Chughtais Lahore Lab, Lahore. Required blood sample were obtained following aseptic measures. Malaria RDT SD Bioline Malaria Antigen Pf/Pan (Catalogue No. 05FK60, Standard Diagnostics Inc, Hagal-Dong, Korea, from now on referred as “SD RDT”) was used. Patients were labeled as positive or negative on the basis of reports from hematology department assessed by microscopy and patients were labeled as positive or negative Results: The mean age of the patients was 41.84±13.44 years, male to female ratio of the patients was 1.01:1. The sensitivity, specificity, and diagnostic accuracy of the RDT for diagnosing malaria was 96.79%, 96.28% and 96.53% respectively taking microscopy as gold standard Conclusion: Rapid diagnostic kits is very useful reliable test with high diagnostic accuracy for diagnosis of malaria taking microscopy as gold standard Keywords: Microscopy, Rapid Diagnostic kits, Malaria,

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Comparison of Led Fluorescent Microscopy and the Gene Xpert MTB/RIF Assay in Diagnosis of Pulmonary and Extrapulmonary Tuberculosis

Tribhuvan University Journal of Microbiology ◽

10.3126/tujm.v6i0.26596 ◽

2019 ◽

Vol 6 ◽

pp. 127-132

Author(s):

Sanam Thapa Magar ◽

Gokarna Ghimire ◽

Pradeep Kumar Shah

Keyword(s):

Pulmonary Tuberculosis ◽

Extrapulmonary Tuberculosis ◽

Fluorescent Microscopy ◽

Cross Sectional Study ◽

Smear Microscopy ◽

Cross Sectional ◽

Female Ratio ◽

Standard Guideline ◽

National Tuberculosis ◽

Male To Female

Objectives: The objective of this study was to evaluate Gene Xpert MTB/RIF Assay and anid fast staining (AFB) for rapid detection of Mycobacterium tuberculosis in specimen of patients suspected of pulmonary tuberculosis (PTB) and extra pulmonary tuberculosis (EPTB). Methods: A comparative cross-sectional study of 400 samples (PTB-365 and EPTB-35) of patients visiting National Tuberculosis Centre (NTC) was conducted from July 2018 to December 2018. Gene Xpert MTB/ RIF Assay, smear microscopy were performed under standard guideline inside biosafety cabinet class II. The result obtained from both the tests were analyzed using SPSS 20.0 software and Excel 2019. Results: Of the total samples, 18% (72/400) and 39% (156/400) were positive by AFB smear microscopy and Xpert MTB/RIF assay respectively. Prevalence of MTB positive was highest in the age group 35-44 years, 33 cases (17.74%) were detected in total, with a male to female ratio of 2.3:1. Pleural fluid, pus, and CSF fluid also yielded positive results with the Gene Xpert MTB/RIF assay accounting 1.28%, 0.64% and 1.28% of MTB positive case respectively. Rifampicin resistance was observed in 1.28% of the cases. Conclusion: The key findings of this study suggest that Gene Xpert test should be implemented as primary diagnostic test for PTB and EPTB.

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Pattern of Skin Diseases: Experience from a Rural Community of Bangladesh

Bangladesh Medical Journal ◽

10.3329/bmj.v41i1.18784 ◽

2014 ◽

Vol 41 (1) ◽

pp. 50-52

Author(s):

N Ahmed ◽

MZ Islam ◽

S Farjana

Keyword(s):

Rural Community ◽

Skin Diseases ◽

Ecological Factors ◽

Cross Sectional Study ◽

Cross Sectional ◽

Female Ratio ◽

Cutaneous Infections ◽

The People ◽

Disease Pattern ◽

Male To Female

Disease pattern in a given population is generally determined by different ecological factors. Thus the objective of this cross-sectional study was to determine the pattern of skin diseases in a selected rural community of Dhamrai Upazila under Dhaka district. Out of 2645 patients attending a medical camp showed 410(15.5%) patients with dermatological problems. Among all, 260(63.4%) patients were males and 150(36.6%) were females with a male to female ratio of 1.7:1. Of these patients, 178(43.4%) had cutaneous infections and 234(56.6%) had non-infectious dermatoses. Few patients (2.7%) had more than one dermatoses. Fungal infection was the commonest infection seen (22.9%) and eczemas took an upper hand in non-infectious group (32.2%). Improvement in the standard of living, health education, improvement in the environmental sanitation and good nutritious food may help the people to bring down the skin disease in the rural part of country. DOI: http://dx.doi.org/10.3329/bmj.v41i1.18784 Bangladesh Medical Journal 2012 Vol. 41 No. 1; 50-52

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Additional cytogenetic abnormalities in chronic myeloid leukemia; an experience from Pakistan

Journal of the Pakistan Medical Association ◽

10.47391/jpma.794 ◽

2020 ◽

pp. 1-8

Author(s):

Nida Anwar ◽

Muhammad Nadeem ◽

Sana Khurram ◽

Naveena Fatima ◽

Tahir Shamsi ◽

...

Keyword(s):

Bone Marrow ◽

International System ◽

Marrow Transplant ◽

Cross Sectional Study ◽

Cross Sectional ◽

Female Ratio ◽

Cytogenetic Abnormalities ◽

Human Cytogenetic ◽

Bone Marrow Cultures ◽

Male To Female

Abstract Objectives: To evaluate the presence and characteristics of additional karyotype abnormalities in chronic myeloid leukaemia cases. Method: The cross-sectional study was conducted at the Department of Cytogenetics and Molecular Pathology, National Institute of Blood Diseases and Bone Marrow Transplant, Karachi, from May 2010 to September 2016 and comprised diagnosed chronic myeloid leukaemiapatients regardless of age and gender.Baseline cytogenetic evaluation was done on overnight, 24-hrs un-stimulated and 72-hrs stimulated bone marrow cultures, and karyotypes were defined according to the International System for Human Cytogenetic Nomenclature2013. Data was analysed using SPSS 23. Results: There were 222 cases with a median age of 38 years (range: 12-84 years). The male-to-female ratio was 1.8:1. Chronic myeloid leukaemiawas detected in 18(8.1%) patients havingadditional cytogenetic abnormalities. Among the patients found positive, cytogenetic type was minor in 10(55.55%), major 3(16.66%), complex 3(16.66%), and variant 2(11.11%). . Conclusion: Additional cytogenetic abnormalitieswere found in 8% of the sample. Key Words: Additional cytogenetic abnormalities, Chronic myelogenous leukaemia, Bone marrow, Cytogenetics.

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Diagnostic accuracy of magnetic resonance imaging in detection of intra-axial gliomas

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.37.1.2489 ◽

2020 ◽

Vol 37 (1) ◽

Author(s):

Sohbia Munir ◽

Sohail Ahmed Khan ◽

Hina Hanif ◽

Maria Khan

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Diagnostic Accuracy ◽

Gold Standard ◽

High Sensitivity ◽

Cross Sectional Study ◽

Resonance Imaging ◽

Cross Sectional ◽

Post Contrast ◽

Sensitivity Specificity

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.

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NORMAL PLANTAR FASCIA THICKNESS IN ADULT

MNJ (Malang Neurology Journal) ◽

10.21776/ub.mnj.2022.008.01.4 ◽

2022 ◽

Vol 8 (1) ◽

pp. 16-20

Author(s):

Yusak Mangara Tua Siahaan ◽

Pricilla Yani Gunawan ◽

Jeffry Foraldy Haryanto ◽

Veli Sungono

Keyword(s):

Plantar Fasciitis ◽

Plantar Fascia ◽

Cross Sectional Study ◽

Heel Pain ◽

Sectional Study ◽

Normal Range ◽

Cross Sectional ◽

Female Ratio ◽

History Of ◽

Male To Female

Background: Plantar fasciitis is a common problem caused by thickening of the plantar fascia. The normal plantar fascia thickness ranged between 2-3 mm and it was generally accepted that value more than 4mm was considered pathologic. Objective: to identify normal plantar fascia thickness in adults using ultrasonography. Methods: This is a cross sectional study measuring the thickness of plantar fascia in 145 subjects with no history of heel pain. Plantar fascia thickness was measured in both feet using an ultrasound. Age, height and weight were recorded and analysed. Results: As much as 145 subjects were included in this study. Male to female ratio was 0.7. Mean age was 44 and body mass index (BMI) was mostly within normal range. Plantar fascia thickness in male was 2.71 ± 0.48 mm in right foot, and 2.74 ± 0.47 mm in left foot. Fascia thickness in female was 2.55 ± 0.50 mm in right foot, and 2.57 ± 0.45 mm in left foot. There was a significant plantar fascia thickness difference between male and female (p = 0.035 in right foot, and p=0.04 in left foot). Age, weight and BMI had a significant correlation towards plantar fascia thickness. In multivariate analysis, age and BMI revealed to have a linear correlation to plantar fascia thickness Conclusion: Age and BMI were found to be the best predictive factor of plantar fascia thickness.

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