scholarly journals Assessment of Different Technique of Eliciting the Planter Reflex in Term Neonates

2021 ◽  
pp. 26-31
Author(s):  
Amar Taksande ◽  
Rupesh Rao ◽  
Sachin Yedve ◽  
Patel Zeeshan Jameel ◽  
Revat Meshram
Keyword(s):  
Likelihood Ratio ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Term Neonates ◽  
Pediatric Residents ◽  
Before And After ◽  
Plantar Reflex ◽  
Dorsal Flexion

Background: Planter reflex is still an essential part of the neurological examination. The usual plantar reflex involved bending of the big toe or no response. There is a positive Babinski signal with corticospinal dysfunction, which involves big toe dorsal flexion and the accompanying fanning of the other toes. It’s one of the infant reflexes that disappers as the infant nervous system grows. The plantar reaction is primarily extensive in stable, term neonates. Many have researched this reflex's accuracy but very few studies have analyzed the various techniques of the planting reflex. Objective: To assess the five different technique of eliciting the plantar reflex in newborn babies. Materials and Methods: In this cross-sectional study, the eligible healthy newborn will be given the different methods for the elicitation of the plantar reflex i.e. Oppenheim sign, Gordon sign, Gonda’s sign, Chaddock sign, and Schaefer sign. During this procedure, we will record  the baseline RR, HR, and SpO2 before, and after the procedure. Three pediatric residents of the different years will be selected for examining the newborn reflexes throughout the study period. Results: After completion of the study, we will come to know the negative likelihood ratio, negative predictive value, positive predictive, specificity, positive likelihood ratio, and sensitivity of the Oppenheim sign, Gordon sign, Gonda’s sign, Chaddock sign, and Schaefer sign. Conclusion: The study will probably give us information about the sensitivity and specificity of the Oppenheim sign, Gordon sign, Gonda’s sign, Chaddock sign, and Schaefer sign for the elicitation of the plantar reflex in the neonates.

Validity and Diagnostic Accuracy of Clarke's Angle in Determining Paediatric Flexible Flatfoot Using Radiographic Findings as a Criterion Standard Measure: A Cross-Sectional Study

2021 ◽  
Author(s):  
Fatma Hegazy ◽  
Emad Aboelnasr ◽  
Amr A. Abdel-Aziem ◽  
In-Ju Kim
Keyword(s):  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Radiographic Findings ◽  
Flexible Flatfoot ◽  
Foot Posture ◽  
Posttest Probability

Background: Clinical diagnosis of Paediatric flexible flatfoot is still a challenging issue for the healthcare professionals. Clarke's Angle (CA) is frequently used clinically for assessing foot posture; however there is still a debate about its validity and diagnostic accuracy in evaluation of static foot posture especially in Paediatric population with some previous studies supporting, while the others are refuting its validity. The current study aimed to investigate validity and diagnostic accuracy of CA using radiographic findings as a criterion standard measure to determine flexible flatfoot between ages of 6-18 years. Methods: A cross-sectional study conducted on 612 participants (1224 feet) with flexible flatfoot aged 6-18 years (12.36 {plus minus}3.39) was recruited. The clinical measures results were compared to the criterion standard radiographic measures and displayed on the receiver operating characteristic curve (ROC) and the area under ROC curve (AUC) was computed. Intra-rater reliability, sensitivity, specificity, predictive values, and likelihood ratios were calculated for CA. Fagan nomogram was used to detect the posttest probability. Results: Clarke's angle (CA) demonstrated higher intra-rater reliability (ICC=0.99). CA showed higher sensitivity (98.4%), specificity (98.8), positive predictive value (97.3), negative predictive value (99.3), positive likelihood ratio (84) and negative likelihood ratio (0.02). AUC was 0.98[95%CI= 0095-1.00]. The positive likelihood ratio (LR+) yielded a posttest probability of 97%, while the negative likelihood ratio (LR−) yielded a posttest probability of 0.02. Conclusions: CA is a valid with high diagnostic accuracy in diagnosis of flexible flatfoot between the ages of 6-18 years.

Spanish Validation of the GEPARD Questionnaire for the Detection of Psoriatic Arthritis in Argentinian Patients with Psoriasis

Dermatology ◽  
2019 ◽  
Vol 235 (2) ◽  
pp. 101-106
Author(s):  
María Victoria Martire ◽  
María Paula Girard Bosch ◽  
Santiago Scarafia ◽  
Vanesa Cosentino ◽  
Maria Janina Tapia Moreira ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Likelihood Ratio ◽  
Diagnostic Tool ◽  
Area Under The Curve ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Spanish Validation ◽  
Previous Diagnosis

Background/Objective: Psoriatic arthritis (PsA) is preceded by psoriasis in approximately 80% of cases. Dermatologists are pivotal for early detection. It is important to have simple tools that allow the detection of PsA in patients with skin psoriasis. The aim of our study was to evaluate the performance of an adapted version of the GEPARD Questionnaire in Spanish in Argentinian patients with psoriasis. Methods: This is a cross-sectional study. A new Spanish (Argentinian) (GEPARDa) translated version of the original questionnaire (German) was developed and then tested as a diagnostic tool in patients with psoriasis, PsA, osteoarthritis associated to psoriasis, and osteoarthritis, all evaluated by rheumatologists who used the CASPAR criteria. Results: Eighty-three patients were included (55 [66.3%] women with a mean age of 50.7 years [SD 6.3]). Forty-four patients had PsA (29 [34.9%] patients had previous diagnosis of PsA, and 15 [18%] were newly diagnosed after referral by their dermatologists), and 39 patients were without PsA (18 [21.6%] patients had psoriasis without articular involvement, 6 [7.22%] had psoriasis associated with osteoarthritis, and 15 [18%] had osteoarthritis). An area under the curve of 0.9554 (SD 0.01; 95% CI 0.91–0.99) was calculated considering the CASPAR criteria as the gold standard. With a cutoff of ≥6 the questionnaire showed a sensitivity of 88.64%, a specificity of 89.74%, a positive likelihood ratio of 8.6, and a negative likelihood ratio of 0.12. Conclusions: The GEPARDa version has proven to be a diagnostic tool with excellent performance so that it can be considered a valid tool for the detection of PsA in Argentinian patients.

scholarly journals Evaluation of the diagnostic accuracy of a hemoglobin S and C screening test: Sickle Scan

2021 ◽  
Vol 15 (1) ◽  
pp. 234-240
Author(s):  
L. Adjé ◽  
V. Yapo ◽  
M. Yayo-Ayé ◽  
S. Bognini ◽  
M. Meledje ◽  
...  
Keyword(s):  
Likelihood Ratio ◽  
Screening Tool ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Reference Method ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Hemoglobin S ◽  
Hemoglobin C ◽  
Sensitivity Specificity

New tools for the rapid diagnosis of hemoglobinosis could encourage the extension of their screening in Africa. Our goal was to assess the analytical performances of a rapid hemoglobin S and C detection test, the Sickle Scan. This was a cross-sectional study carried out in March 2019 at the Yopougon Teaching Hospital. The subjects followed for hemoglobinosis as well as the subjects seeking out an electrophoresis of their hemoglobin were included. We carried out the hemogram, the electrophoresis of hemoglobin at alkaline pH (reference method) coupled with the metabisulfite sickling test (Emmel test) and the rapid detection test to be evaluated. This immunochromatographic test is capable of detecting hemoglobins A, S, and C, and to infer the hemoglobin phenotype from there. The study recruited 191 individuals. The test detected hemoglobins S and C with a sensitivity of 99.4% and 97.7% respectively; a specificity of 93.3% and 99.3%. The positive likelihood ratio for hemoglobins S and C was 15 and 144 respectively. The negative likelihood ratio was 0.01 for hemoglobin S, and 0.02 for hemoglobin C. The intrinsic characteristics obtained make this test an interesting screening tool for hemoglobinosis S and C. Keywords: Diagnostic test, hemoglobinosis, Abidjan, sensitivity, specificity.

scholarly journals The Diagnostic Accuracy of Combined Enolase/Cr, CA125, and CA19-9 in the Detection of Endometriosis

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Samaneh Rokhgireh ◽  
Abolfazl Mehdizadeh Kashi ◽  
Shahla Chaichian ◽  
Ali-Akbar Delbandi ◽  
Leila Allahqoli ◽  
...  
Keyword(s):  
Likelihood Ratio ◽  
Predictive Value ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Pelvic Mass ◽  
Abnormal Uterine Bleeding ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Noninvasive Test

Background. The present study was designed to verify the accuracy of the noninvasive biomarkers enolase/Cr, CA125, and CA19-9 as a clinical diagnostic tool for the detection of endometriosis. Methods. A cross-sectional study was performed at Rasool-e-Akram Hospital affiliated to Iran University of Medical Sciences, Tehran, Iran, from April 2015 to April 2018. Eighty-six women were scheduled to undergo laparoscopy due to chronic pelvic pain, infertility, pelvic mass, and abnormal uterine bleeding. Serum and urine samples of all patients were collected preoperatively. Serum levels of CA125 and CA19-9, and urine levels of enolase-1 were measured. Serum levels of CA125 and CA19-9 were determined by the electrochemiluminescence method (ECL). Urinary enolase-1 was measured by the ELISA method. Result. Serum levels of CA125 and CA19-9 were significantly higher in the endometriosis group than in controls (p<0.001, p=0.004, respectively). Levels of enolase I and enolase/Cr were higher in patients with endometriosis, but the differences were not statistically significant. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of combined enolase/Cr, CA125, and CA19-9 were 65%, 66.6%, 71%, and 60.1%, respectively. The positive likelihood ratio (PLR) and negative likelihood ratio (NLR) of combined enolase/Cr, CA125, and CA19-9 was 1.94 and 0.52, respectively. The area under the ROC curve for enolase/Cr+CA125+CA19−9 was 0.675 (95% confidence interval 0.573-0.710). Conclusion. The present study revealed that concurrent measurement of enolase-1, CA125, and CA19-9 might be a valuable noninvasive test for the identification of endometriosis.

Diagnostic Test Validity of CT-Scan for Detection of Hepatocellular Carcinoma

2018 ◽  
Vol 4 (2) ◽  
pp. 133-136
Author(s):  
Md Akter Hossain ◽  
Md Saiful Haque ◽  
Mostaque Ahmed Bhuiya ◽  
Abu Bakar Siddique
Keyword(s):  
Hepatocellular Carcinoma ◽  
Ct Scan ◽  
Likelihood Ratio ◽  
Tertiary Care ◽  
Test Validity ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Care Hospital ◽  
Hepatocelluar Carcinoma ◽  
Cross Sectional

Background: CT-scan can detect hepatocelluar carcinoma among the patients.Objective: The purpose of the present study was to see the pattern of hepatocelluar carcinoma among the patients attended at a tertiary care hospital in Dhaka city.Methodology: This cross-sectional study was carried out in the Department of Radiology and Imaging at Dhaka Medical College, Dhaka and Banghabandhu Sheikh Mujib Medical University, Dhaka from January 2007 to May 2008 for a period of around one and half year. All the patients presented with hepatocellular carcinoma at the age group of more than 20 years with both sexes were selected as study population. The patients were undergone CT-scan examination and the confirmation of tumor was performed by histopathological examination.Result: A total number of 50 patients were recruited in this study after fulfilling the inclusion and exclusion criteria. The sensitivity, specificity and accuracy of CT-scan in detecting hepatocellular carcinoma was seen to be 66%, 92% and 72% respectively. The PPV and NPV were 96.15% (95% CI 79.06% to 99.40%) and 45.83% (95% CI 34.53% to 57.58%) respectively. However, the Positive Likelihood Ratio and Negative Likelihood Ratio were 7.89 (95% CI 1.19 to 52.28) and 0.37(95% CI 0.23 to 0.60).Conclusion: In conclusion CT-scan is a good diagnostic tool for the detection of hepatocellular carcinoma.Journal of National Institute of Neurosciences Bangladesh, 2018;4(2): 133-136

Diagnostic Accuracy of Laser Doppler Imaging for the Assessment of Burn Depth: A Meta-analysis and Systematic Review

2019 ◽  
Vol 41 (3) ◽  
pp. 619-625 ◽  
Author(s):  
Ru Wang ◽  
Juan Zhao ◽  
Zhenyu Zhang ◽  
Chang Cao ◽  
Yange Zhang ◽  
...  
Keyword(s):  
Likelihood Ratio ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Laser Doppler ◽  
Doppler Imaging ◽  
Laser Doppler Imaging ◽  
Summary Receiver Operating Characteristic ◽  
Cross Sectional ◽  
Burn Depth

Abstract An overall assessment of the diagnostic value of laser Doppler imaging (LDI) to assess burn depth in patients is presented based on relevant studies. Both eligible research and relevant articles were identified through specific index searches of Embase, Cochrane, and PubMed databases. The latest study included was published in March 2019 and all eligible publications reported on cohort or cross-sectional research. All articles were tested for heterogeneity by using a suitable effect model to calculate amalgamative values of sensitivity, specificity, and the diagnostic odds ratio (DOR). Analyses of summary receiver operating characteristic (SROC) are given for burn depth values. After rigorous screening, 14 studies with a total cohort of 1,818 patients were chosen for the meta-analysis to explore the validity of LDI diagnosis to assess the depth of burns. The burn depth overall sensitivity for LDI was 91% (95% CI: 86–95%) and global specificity was 96% (95% CI: 92–98%). The overall positive likelihood ratio of LDI was 20.35 (95% CI: 10.71–38.69) and the overall negative likelihood ratio was 0.09 (95% CI: 0.05–0.15). The overall DOR was 152.93 (95% CI: 69.44–336.81) of LDI. The acreage under the SROC was not low for LDI (AUC = 0.98; 95% CI: 0.96–0.99). In conclusion, the present analysis reviewed the literature and meta-analysis of studies to validate LDI for the diagnosis of burn depth. The results indicated that LDI has a high accuracy for this diagnostic function.

scholarly journals Diagnostic Validity of Serum Cystatin C for Detection of Acute Kidney Injury in Children

2021 ◽  
Vol 7 (2) ◽  
pp. 44-48
Author(s):  
Sharmin Akter Luna ◽  
Jakia Sultana ◽  
Md Abdullah Yusuf ◽  
Golam Muin Uddin ◽  
Md Habibur Rahman ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Likelihood Ratio ◽  
Cystatin C ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Kidney Injury ◽  
Diagnostic Validity ◽  
Serum Cystatin C ◽  
Cross Sectional ◽  
Serum Cystatin

Background: Detection of acute kidney injury is very essential among the children. Objective: The purpose of the present study was to validate the serum cystatin C for the detection of acute kidney injury in children. Methodology: This cross-sectional study was conducted in the Department of Paediatric Nephrology with the collaboration of Paediatric Gastroenterology, Paediatric Neurology, Paediatric Neonatology and Microbiology and Immunology at Bangabandhu Sheikh Mujib University, Dhaka, Bangladesh from May 2018 to July 2019 for a period of one year. Patients with the age group of 1 month to 17 years, who were at risk of AKI, and admitted in the inpatient department of Pediatrics and allied at Bangabandhu Sheikh Mujib University, Dhaka, Bangladesh during this study period in both sexes were selected as study population. To detect AKI, serum creatinine was measured at 0 h (baseline), 48 h and 5th day respectively. Serum cystatin C were measured at 0 (baseline) and 48 h respectively for all patients. Result: A total number of 52 patients were enrolled in this study. Here the AUC was 0.93 with 95% CI (0.864 - 0.995). Serum cystatin C had sensitivity of 95% (95% CI 77.9%-099.7%) with specificity 84% (95% CI 73.7%-87.3%), PPV 79% (95% CI 64.9%-83.1%), NPV 96% (95% CI 84.2%-99.8%), accuracy 88.7% (95% CI 75.3%-92.1%), positive likelihood ratio 6.08 and negative likelihood ratio 0.06 (95% CI 2.96-7.87 and 0.003-0.300 respectively). Conclusion: In conclusion the diagnostic validity of serum cystatin C for the detection of AKI is very high among the children. Bangladesh Journal of Infectious Diseases 2020;7(2):44-48

scholarly journals EVALUATION OF A RAPID ANTIGEN TEST FOR SARS-COV-2 IN SYMPTOMATIC PATIENTS AND THEIR CONTACTS: A MULTICENTER STUDY

2021 ◽  
Author(s):  
IRERI THIRION-ROMERO ◽  
SELENE GUERRERO-ZUNIGA ◽  
ALEXANDRA ARIAS-MENDOZA ◽  
DORA PATRICIA CORNEJO-JUAREZ ◽  
PATRICIA MEZA-MENESES ◽  
...  
Keyword(s):  
Likelihood Ratio ◽  
Real Life ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Rapid Test ◽  
Antigen Test ◽  
Operating Characteristics ◽  
Rt Pcr ◽  
Cross Sectional ◽  
Diagnostic Characteristics

BACKGROUND Point-of-care rapid tests to identify SARS-CoV-2 can be of great help because, in principle, they allow decisions to be made at the site of care for treatment, or for the separation of cohorts avoiding cross-infection, especially in emergency situations. METHODS A cross sectional study in adults requesting care in Emergency Rooms (ER), or the outpatient clinics of referral hospitals for COVID-19, to define the diagnostic characteristics of a rapid antigen test for SARS-CoV-2 (the Abbott PanbioTM) having as a gold standard the RT-PCR for SARS-CoV-2. Health personnel in a routine situation within an active pandemic in several cities of Mexico performed the tests. RESULTS A total of 1,069 participants with a mean age of 47 years (SD 16 years), 47% with a self-reported comorbidity, and an overall prevalence of a positive RT-PCR test of 45%, were recruited from eight hospitals in Mexico. Overall sensitivity of the Panbio test was 54.4% (95%CI 51-57) with a positive likelihood ratio of 35.7, a negative likelihood ratio of 0.46 and a Receiver-Operating Characteristics curve area of 0.77. Positivity for the rapid test depended strongly on an estimate of the viral load (Cycle threshold of RT-PCR, Ct), and the days of symptoms. With a Ct 25, sensitivity of the rapid test was 0.82 (95%CI, 0.76-0.87). For patients during the first week of symptoms sensitivity was 69.6% (95%CI 66-73). On the other hand, specificity of the rapid test was above 97.8% in all groups. CONCLUSIONS The PanbioTM rapid antigen test for SARS-CoV-2 has a good specificity, but due to low and heterogeneous sensitivity in real life, a negative test in a person with suggestive symptoms at a time of community transmission of SARS-CoV-2 requires confirmation with RT-PCR, and after the first week of symptoms, sensitivity decreases considerably.

scholarly journals The relative incidence of cardiogenic and septic shock in neonates

2019 ◽  
Vol 25 (6) ◽  
pp. 372-377
Author(s):  
Ka Hong Chan ◽  
Shubhayan Sanatani ◽  
James E Potts ◽  
Kevin C Harris
Keyword(s):  
Septic Shock ◽  
Cardiogenic Shock ◽  
Likelihood Ratio ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Term Neonates ◽  
X Ray ◽  
Relative Incidence ◽  
History Of ◽  
Chest X Ray

Abstract Objective To evaluate the relative incidence of cardiogenic and septic shock in term neonates and identify findings that help differentiate the two entities. Study Design We conducted a retrospective chart review of term neonates presenting to British Columbia Children’s Hospital (BCCH) with decompensated shock of an undiagnosed etiology between January 1, 2008 and January 1, 2013. Charts were reviewed to determine the underlying diagnoses of all neonates meeting our inclusion criteria. Patients were categorized as having septic, cardiogenic, or other etiologies of shock. We then evaluated potential demographic, clinical, and biochemical parameters that could help differentiate between septic and cardiogenic shock. Results Cardiogenic shock was more common than septic shock (relative risk=1.53). A history of cyanosis was suggestive of cardiogenic shock (positive likelihood ratio, LR+=3.2 and negative likelihood ratio, LR−=0.4). Presence of a murmur or gallop (LR+=5.4, LR−=0.3), or decreased femoral pulses (LR+=5.1, LR−=0.5) on physical exam were also suggestive of cardiogenic shock as was cardiomegaly on chest x-ray (LR+=4.9, LR−=0.5). Notably, temperature instability (LR+=0.7, LR−=1.8) and white blood cell count elevation or depression (LR+=0.8, LR−=1.1) were all poor predictors of septic shock. Conclusion Cardiogenic shock is a more common cause of decompensated shock than septic shock. A history of cyanosis, murmur or gallop, or decreased femoral pulses on exam and cardiomegaly on chest x-ray are useful indicators of cardiogenic shock. In evaluating the neonate with decompensated shock, early consideration for Cardiology consultation and interventions to treat the underlying condition is warranted.

HEEADSSS up: pediatric residents’ confidence and practice in adolescent health care before and after mandatory adolescent medicine rotations in Thailand

2017 ◽  
Vol 0 (0) ◽  
Author(s):  
Rosawan S. Areemit ◽  
Boonying Manaboriboon ◽  
Supinya In-iw ◽  
Jiraporn Arunakul ◽  
Wirote Areekul
Keyword(s):  
Cross Sectional Study ◽  
Psychosocial Assessment ◽  
Adolescent Medicine ◽  
Cross Sectional ◽  
Pediatric Residents ◽  
Pediatric Residency ◽  
Before And After ◽  
The Difference ◽  
Mandatory Rotation ◽  
Growth Assessment

Abstract Background The field of adolescent medicine is an emerging area of specialization in Thailand. Adolescent medicine was made a mandatory rotation in general pediatric residency training programs for the class of 2013. Objective This study aims to explore the difference in pediatric residents’ confidence and the frequency in providing aspects of care to adolescents. Subjects Participants included two groups of pediatric residents; the former curriculum group (FCG) in 2012 and the mandatory curriculum group (MCG) in 2015. Methods Participants in this cross-sectional study answered a 41-item self-administered questionnaire and results were analyzed by descriptive statistics. Results There were 91 participants, 50.05% were in the MCG. The FCG reported a higher percentage of feeling “more confident” on physical examination (p = 0.031, V = 0.23) and growth assessment (p = 0.040, V = 0.22). The MCG reported a higher percentage of “more frequently” carrying out the psychosocial assessment (p = 0.035, V = 0.22). Conclusion The FCG reported higher levels of confidence than the MCG in most of the items, while the MCG reported higher levels of frequency in providing care. The psychosocial (HEEADSSS) assessment, a key aspect of the adolescent clinical visit, was the item that the MCG reported doing more frequently than the FCG which remained significant when only the postgraduate year of training (PGY) 4s were compared.

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