Diagnostic Evaluation of 99mTc-TRODAT-1 SPECT in Parkinsonism

Background Parkinsonism as a group of movement disorders, exhibit similar clinical presentation. Therefore, clinically differentiating these diseases is difficult. We investigated the diagnostic value of 99m Tc-TRODAT-1 SPECT in this setting. Due to the fact that this modality has some limitations in imaging small organs like the sub-regions of basal ganglia, we also evaluated the use of anatomical MR imaging along with functional SPECT imaging in parkinsonism. Methods This follow-up diagnostic test evaluation study was performed with 40 patients with the clinical presentation of parkinsonism, and 10 healthy subjects as controls. After administration of the radiopharmaceutical, SPECT images were acquired, then co-registered on MRI. Uptake values were evaluated in basal ganglia semi-quantitatively. Results In this study, 99mTc-TRODAT-1 SPECT was able to differentiate essential tremor and healthy subjects from progressive supranuclear palsy (PSP) and Parkinson’s disease (PD) with a sensitivity of 76.47% and specificity of 100% at a cut-off of 0.53; however, findings were not significant in differentiation of PD from PSP (p ˃0.05), and the results were similar in SPECT and co-registered MRI/SPECT images. In evaluation of the uptake pattern in basal ganglia, the lateralization of decreased uptake was only seen in PD; and in PSP, the dysfunction was bilateral in all patients. Conclusion 99mTc-TRODAT-1 SPECT is sensitive and specific in diagnosing basal ganglia dysfunction; however, 99mTc-TRODAT-1 SPECT alone or co-registration on MRI are not adequate in differentiation of the etiologies of basal ganglia dysfunction.

Pengembangan Alat Evaluasi Fisika Untuk Mengidentifikasi Miskonsepsi Siswa Kelas VIII SMP Negeri Oenino

The objective of study was developing diagnostic test evaluation instrument in multiple choice form with predetermined reason to identify Grade VIII student’s misconceptions on force topic in SMPN Oenino. Population of the study covered all students whereas the samples were Grade VIII students SMPN Oenino. The research method was Research and Development (R&D) with potential and problem, gathering information, product design, product validation, product revision, and product trial. Validation phase included experts and content validation. On expert’s validation, test instrument was validated by 3 validators with 87,7% worthiness average and was recommended applicable without revision. On content validation, 45 test items were tried out to students and 17 items were declared valid ranging from C1 to C4 cognitive domain which were used later to identify student’s misconceptions. Their misconceptions on force material were 23%, 38%, 13% and 26% from C1 to C4 cognitive domains. The result indicated that this instrument was applicable to identify student’s misconception on force materials.

Specificity of Lipase & Amylase Separately, in Alcoholic & Non-Alcoholic Pancreatitis

BACKGROUND Clinically, the course of all causes of acute pancreatitis is similar; however, inpatients with severe biliary pancreatitis, we can prevent complications with the help of ERCP. Serum L / A ratio of > 2 could help diagnose alcohol as the causative agent1 . Hence, our study aims at assessing the validity in Government Medical College, Thiruvananthapuram, after assessing the specificity and sensitivity of amylase and lipase in alcoholic and non-alcoholic patients separately and lipase amylase ratio as an indicator to distinguish acute alcoholic from non-alcoholic pancreatitis. We also wanted to study the prevalence of pancreatitis in age group of 20 - 40. METHODS This is a diagnostic test evaluation conducted among 92 inpatients of Department of General Surgery selected through consecutive sampling. After randomly selecting patients admitted with a provisional diagnosis of acute pancreatitis, the first investigator administered the consent form, if accepted, examined the patient, evaluated the laboratory parameters. Then these patients were prospectively followed and evaluated. Data are then analysed using Excel spread sheet version 2019 and SPSS software and sensitivity, specificity, prevalence and diagnostic accuracy were determined. RESULTS Among 92 patients, 80 (87 %), 55 (58.8%) and 25 (27.2%) were found to have pancreatitis, alcoholic and non-alcoholic causes respectively. 35 (38 %) patients were in the age group of 31 – 35 years. It was found that lipase has 94.55 % & 91.6 % sensitivity and specificity in alcoholic and 84 % & 91.6 % sensitivity and specificity in non-alcoholic pancreatitis patients, respectively, and amylase has 69 % & 91.67 % sensitivity and specificity in alcoholic and 72 % & 91.67 % sensitivity and specificity in non-alcoholic pancreatitis respectively. CONCLUSIONS Serum amylase and lipase are inevitable investigations with good sensitivity and specificity in the diagnosis of acute pancreatitis. Lipase amylase ratio >2 is diagnostic of alcoholic pancreatitis. KEYWORDS Acute Pancreatitis, Acute Alcoholic Pancreatitis, Acute Non-Alcoholic Pancreatitis, Specificity of Lipase and Amylase, Lipase Amylase Ratio

Concordance of “rapid” serological tests and IgG and IgM chemiluminescence for SARS-COV-2

AbstarctBackgroundThe COVID-19 serological tests for IgG and IgM have been developed with several methodologies: Immunoenzymatic Assay (ELISA), Chemiluminescence, Electro Chemiluminescence, Fluorescent Lateral Flow Immunoassays and Immunochromatography. None of these tests should be used for the diagnosis or population screening of the disease, considering that the antibodies appear only on the 8th – 14th day of the disease onset. The present study evaluates a sample of immunofluorescent and immunochromatographic rapid tests to show their agreement in relation to Chemiluminescence.MethodsA diagnostic test evaluation assay was performed to establish the performance of five “rapid” tests (4 immunochromatographic and 1 immunofluorescent tests) for IgG and IgM serology for SARS-CoV-2 using a panel of 30 serum samples from patients received in the laboratory analysis routine. For the evaluation of clinical performance, the qualitative results of the “rapid” tests were compared against those obtained by chemiluminescence, dichotomized as positives (≥ 10 AU / mL) or negative (<10 UA / mL).FindingsThe best agreement is seen in the immunofluorescent assay, for the IgG contrast, with a particularly good kappa index (0.85), without positive disagreements and a negative disagreement of about 15%. In the immunochromatographic methods Kappa index was 0.61 at best, with disagreements in negative findings of ≈35% and in positive cases of up to ≈70%.The IgM concordance behavior, on the other hand, reflects a weak to moderate Kappa concordance value (Kappa 0.2 to 0.6), with negative disagreements reaching up to 55% and positives of up to 84%, without any evaluated test reaching Kappa performance equal to or greater than 0.8.InterpretationSerological studies should be used in the clinical and epidemiological context and of other diagnostic tests. Given the high demand and supply in the market of “rapid serological tests”, its evaluation against panels of serologically positive or negative samples established by Chemiluminescence or Electro chemiluminescence is essential to authorize its extensive use in populationsFundingNone

Indirect quantification of IgG using a digital refractometer, and factors associated with colostrum quality in Norwegian Red Cattle

Background There is an increased interest in using digital refractometers to indirectly assess colostrum quality of dairy cattle, but knowledge on diagnostic accuracy for Norwegian Red dairy cows is lacking. Recent research has indicated a profound variability in the colostrum quality among dairy cows and herds in Norway. The aim of this study was to evaluate the diagnostic test sensitivity and specificity of a digital refractometer (Brix refractometer) at different cut-offs in Brix% for detection of colostrum of high quality (> 50 g/L) defined by the gold standard single radial immunodiffusion (IgG g/L). Furthermore, we aimed to identify possible associations between selected herd and cow-level management factors and colostrum IgG-levels in Norwegian Red dairy cows. Results Median colostrum IgG level across 167 cows from 19 herds was 35.0 g/L, ranging from 5 to 129 g/L. Mean Brix% (± SD) was 19.7 ± 4.12%, ranging from 10.1 to 30.5. Most samples (72.5%) had inferior quality as compared to the international standard of 50 g/L. Brix% and IgG in colostrum were strongly correlated (r = 0.71, P < 0.001). A Brix cut-off of 22%, which is currently recommended, yielded a sensitivity of (95% CI) 69.4% (54.6–81.7) and a specificity of 83.1% (75.0–89.3) for identifying colostrum with high quality (> 50 g/L). The only factor found to be associated with low colostrum quality was parity. Specifically, cows in the second parity were found to produce colostrum with low quality compared to cows in parities four and later. Conclusions The agreement between colostrum IgG and Brix% is good. However, the diagnostic test evaluation indicates suboptimal performance in identifying high vs. low colostrum quality in this population, possibly related to a high proportion of the samples with < 50 g/L IgG. The only factor found to be associated with low colostrum quality was parity. Specifically, cows in the second parity were found to produce colostrum with lower quality. Future research should investigate colostrum and serum IgG levels which best prevent calf illness under Norwegian conditions.