Comparison of High Resolution Computed Tomography with Intraoperative Findings in Patient with Chronic Suppurative Otitis Media, NAMS, Bir Hospital, Kathmandu, Nepal

Introduction: Chronic suppurative otitis media (CSOM) is an important cause of middle ear disease and its complications challenge both otologist and radiologist. The major benefit of HRCT is an excellent visualization of the osseous structure by means of special algorithms. This study compares the HRCT with intraoperative findings in patients with CSOM. Methods: This is an observational descriptive study conducted at NAMS Bir Hospital. Total of 30 patients, referred for HRCT from the department of ENT were studied. Comparison of HRCT findings was done with intraoperative findings regarding the status of EAC, ossicular chain, bony plate, inner ear structure and facing nerve canal was done, considering intraoperative findings as the gold standard. Results: Out of 30 patients, 16 patients had CSOM with cholesteatoma and 14 patients had CSOM without cholesteatoma. HRCT presented sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 87.5%, 85.7%, 87.5%, 85.7% and 86.7% respectively in diagnosing CSOM with cholesteatoma. HRCT presented sensitivity and specificity of 85.7% and 87.5% in identification of malleus erosion, sensitivity and specificity of 86.7% and 80%, in the identification of incus erosion. HRCT showed the specificity of 85% with relatively low sensitivity of 70% in identification of erosion of stapes. HRCT showed a sensitivity of 100% and specificity of 85.7%. HRCT presented sensitivity and specificity of 83.3% and 95.8% in diagnosing tegmen tympanum erosion. HRCT showed the highest sensitivity (100%) and specificity (100%) in diagnosing erosion of sigmoid sinus plate and mastoid cortex. HRCT showed relatively low sensitivity of 66.7% and 75% in diagnosing erosion of LSCC and facial canal respectively. HRCT detected soft tissue mass in the middle ear/mastoid in all 30 patients of CSOM. Hence, the sensitivity, specificity, positive predictive value and negative predictive value of HRCT for soft tissue mass in the middle ear and mastoid, all were 100%. Conclusion: The HRCT has a valuable role in preoperative evaluation of a case of CSOM. It has high sensitivity in diagnosing CSOM with cholesteatoma. However, HRCT has relatively low sensitivity for LSCC and facial nerve canal erosion.

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Drawing the line in the Edinburgh Postnatal Depression Scale (EPDS): a vital decision

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh.2011.005 ◽

2011 ◽

Vol 23 (1) ◽

Cited By ~ 8

Author(s):

Dagmar Lagerberg ◽

Margaretha Magnusson ◽

Claes Sundelin

Keyword(s):

Positive Predictive Value ◽

Predictive Value ◽

Postnatal Depression ◽

Edinburgh Postnatal Depression Scale ◽

Depression Scale ◽

Child Interaction ◽

Mother Child Interaction ◽

Problem Behaviours ◽

Low Sensitivity ◽

Sensitivity Specificity

Abstract Background: The Edinburgh Postnatal Depression Scale (EPDS) is widely used in early child health care. This study examined the appropriateness of the recommended EPDS cut-off score 11/12. Methods: Two main analyses were performed: 1. Associations between EPDS scores and maternal health behaviour, stress, life events, perceived mother-child interaction quality and child behaviour. 2. Screening parameters of the EPDS, i.e., sensitivity, specificity and positive predictive value. EPDS scores were available for 438 mothers and maternal questionnaires for 361 mothers. Results: Already in the EPDS score intervals 6–8 and 9–11, there were notable adversities, according to maternal questionnaires, in stress, perceived quality of mother-child interaction, perceived child difficultness and child problem behaviours. Using maternal questionnaire reports about sadness/distress postpartum as standard, the recommended EPDS cut-off score 11/12 resulted in a very low sensitivity (24%). The cut-off score 6/7 yielded a sensitivity of 61%, a specificity of 82% and a positive predictive value of 61%. Conclusions: In terms of both clinical relevance and screening qualities, an EPDS cut-off score lower than 11/12 seems recommendable.

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Correlation of Ultrasound and RIPASA Scoring System in the Diagnosis of Acute Appendicitis

International Journal of Medicine and Surgery ◽

10.15342/ijms.v5ir.193 ◽

2018 ◽

Vol 5 ◽

Author(s):

Anand Rai Bansal ◽

Suvendu Sekhar Jena ◽

Sanjeev Kumar

Keyword(s):

Acute Appendicitis ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Study Design ◽

Predictive Value ◽

Scoring System ◽

Negative Appendicectomy ◽

Low Sensitivity ◽

Sensitivity Specificity

Objective: Correlation of Ultrasound and RIPASA scoring system in the diagnosis of acute appendicitis. Study Design: 50 patients presenting to emergency underwent ultrasound and evaluation as per RIPASA scoring system followed by emergency appendicectomy. The sensitivity, specificity, positive and negative predictive value calculated for each goups. Results: The sensitivity, specificity, Positive Predictive Value and Negative Predictive Value for ultrasound were 75.51%, 100%, 100% and 7.69% respectively and that for RIPASA scoring system were 93.9%, 100% 100% and 25% respectively. The negative appendicectomy rate was 2%. Conclusion: RIPASA scoring system may be used for correctly diagnosing acute appendicitis but low sensitivity of ultrasound precludes its routine use and may be used as a complementary tool in diagnosing acute appendicitis. Keywards: Acute Appendictis, RIPASA, Ultrasound.

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Monofrequency electrical impedance mammography (EIM) diagnostic system in breast cancer screening

BMC Cancer ◽

10.1186/s12885-020-07283-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Blanca Murillo-Ortiz ◽

Abraham Hernández-Ramírez ◽

Talia Rivera-Villanueva ◽

David Suárez-García ◽

Mario Murguía-Pérez ◽

...

Keyword(s):

Breast Cancer ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Sensitivity And Specificity ◽

Predictive Value ◽

Electrical Impedance ◽

Screening Method ◽

Future Research ◽

Predictive Values ◽

Sensitivity Specificity

Abstract Background Some evidence has shown that malignant breast tumours have lower electrical impedance than surrounding normal tissues. Electrical impedance could be used as an indicator for breast cancer detection. The purpose of our study was to analyse the sensitivity and specificity of electrical impedance mammography (EIM) and its implementation for the differential diagnosis of pathological lesions of the breast, either alone or in combination with mammography/ultrasound, in 1200 women between 25 and 70 years old. Methods This study is a prospective, cross-sectional epidemiological observational study of serial screening. The women were invited to participate and signed a consent letter. Impedance imaging of the mammary gland was evaluated with the computerized mammography equipment of MEIK electroimpedance v.5.6. (0.5 mA, 50 kHz), developed and manufactured by PKF SIM-Technika®. The successful identification of breast cancer along with the sensitivity, specificity, and positive and negative predictive values of EIM were determined as follows: % sensitivity; % specificity; % positive predictive value (PPV); and % negative predictive value (NPV). Results EIM had a sensitivity of 85% and a specificity of 96%; the positive predictive value was 12%, and the negative predictive value was 99%. Seven cases were biopsy confirmed cancers. Significant correlations between the electrical conductivity index and body mass index (BMI) (p = 0.04) and patient age were observed (p = 0.01). We also observed that the average conductivity distribution increased according to age group (p = 0.001). We used the chi-squared test to assess the interactions between percent density and BMI (normal < 25 kg/m2 (n = 310), overweight 25–29.9 kg/m2 (n = 418) and obese ≥30 (n = 437)) (p < 0.05). The patients with a diagnosis of mammary carcinoma had a BMI of 35.51 kg/m2. Conclusions Our results demonstrate that the use of monofrequency electrical impedance mammography (EIM) in the detection of breast cancer had a sensitivity and specificity of 85 and 96%, respectively. These findings may support future research in the early detection of breast cancer. EIM is a non-radiation method that may also be used as a screening method for young women with dense breasts and a high risk of developing breast cancer.

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Isolated Incudostapedial Cholesteatomas: Unique Radiologic and Surgical Features

Ear Nose & Throat Journal ◽

10.1177/0145561320973785 ◽

2020 ◽

pp. 014556132097378

Author(s):

Bridget MacDonald ◽

Krishna Bommakanti ◽

Moises Mallo ◽

Daniela Carvalho

Keyword(s):

Hearing Loss ◽

Soft Tissue ◽

Ct Scan ◽

Middle Ear ◽

Conductive Hearing Loss ◽

Soft Tissue Mass ◽

Ossicular Chain ◽

Ct Scans ◽

Tissue Mass ◽

Conductive Hearing

Objectives: Congenital cholesteatomas originate from epithelial tissue present within the middle ear in patients with an intact tympanic membrane, no history of otologic surgery, otorrhea, or tympanic membrane perforation. They are diagnosed by a pearl-like lesion on otoscopy and computed tomography (CT) scan showing an expansile soft-tissue mass. We describe a series of patients with no prior otologic history presenting with progressive unilateral conductive hearing loss and normal otoscopy. The CT scans showed ossicular erosion without obvious soft-tissue mass. Surgery confirmed incudostapedial erosion found to be cholesteatoma. In this study, we characterize the clinical course of patients diagnosed with isolated incudostapedial cholesteatoma (IIC) and review possible pathologic mechanisms. Methods: Retrospective review of IIC cases treated by the Department of Pediatric Otolaryngology, Rady Children’s Hospital, San Diego, 2014 to 2020. Data included patient demographics, clinical features, imaging, surgical findings, and audiologic data. Results: Five patients were diagnosed with IIC (3 [60%] female; mean age at presentation 10.7 years [range 5.5-16.0]). All patients presented with postlingual unilateral conductive hearing loss and normal otoscopy without any past otologic history; delay in diagnosis ranged from 4 months to several years. The CT scans showed ossicular chain erosion with an absent long process of the incus and/or stapes superstructure. All patients underwent middle ear exploration, revealing a thin layer of cholesteatoma in the incudostapedial region, confirmed by histopathology. Mean preoperative speech reception threshold was 55 dB and improved to a mean of 31 dB in the 4 patients who underwent ossicular chain reconstruction. Conclusion: Isolated incudostapedial cholesteatoma should be included as a possible etiology in pediatric patients with insidious onset of unilateral conductive hearing loss with normal otoscopy, unremarkable otologic history, and a CT scan showing ossicular abnormality/disruption without notable middle ear mass. These patients should be counseled preoperatively regarding the possibility of cholesteatoma and should undergo middle ear exploration with possible ossiculoplasty.

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Evaluation of Wondfo Chlamydia Trachomatis Rapid Diagnostic Cassette Based on Nano-Gold Immunochromatography Gssay（GICA）

Advanced Materials Research ◽

10.4028/www.scientific.net/amr.236-238.2436 ◽

2011 ◽

Vol 236-238 ◽

pp. 2436-2440

Author(s):

Yun Ping Peng ◽

Ji Hua Wang ◽

Wen Mei Li ◽

Jun Lin Wu ◽

Shu Juan Yu

Keyword(s):

Chlamydia Trachomatis ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Sensitivity And Specificity ◽

Predictive Value ◽

Surveillance Data ◽

Blind Detection ◽

Test Results ◽

Nano Gold ◽

Sensitivity Specificity

This paper explains and demonstrates how to evaluate the sensitivity and specificity of wondfo chlamydia trachomatis rapid diagnostic cassette with GICA for detection of chlamydia trachomatis. 1026 genital specimens were collected from 630 females and 396 males.Two cassettes of wondfo and ClearView were used for the detection of Chlamydia trachomatis samples with blind detection simultaneously, inconsistent results by DFA. Sensitivity, specificity, positive predictive value and negative predictive value of wondfo cassette were analyzed. Out of 1026 samples detected, 83 were positive by both of wondfo and ClearView and 13 showed different results by wondfo and ClearView. Out of the 13 samples, the DFA confirmed 9 were positive. Therefore, 92 samples were truly positive and 934 were truly negative. The sensitivity, specificity, positive predictive value and negative predictive value of wondfo were 96.74% ,99.6% , 95.7% , 99.68%, respectively. The consistent rates of test results of the chlamydia trachomatis rapid diagnostic cassette , wondfo and ClearView, both were the same 98.64%. Of the three standard strains and two clinical strains of dilution test results showed that the sensitivity of wondfo slightly ClearView.The sensitivity and specificity of wondfo for the detection of Chlamydia trachomatis have the accept tability for clinical diagnostic and surveillance data.

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Correlation of Ultrasound and RIPASA Scoring System in the Diagnosis of Acute Appendicitis

International Journal of Medicine and Surgery ◽

10.15342/ijms.v5ri.193 ◽

2018 ◽

Vol 5 (r) ◽

Author(s):

Anand Rai BANSAL ◽

Suvendu Sekhar JENA ◽

Sanjeev KUMAR

Keyword(s):

Acute Appendicitis ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Study Design ◽

Predictive Value ◽

Scoring System ◽

Negative Appendicectomy ◽

Low Sensitivity ◽

Sensitivity Specificity

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OR07-05 Is Urinary Calcium the Only Predictor of Nephrolithiasis in Patients with Asymptomatic Primary Hyperparathyroidism?

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.1457 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Federica Saponaro ◽

Filomena Cetani ◽

Laura Mazoni ◽

Matteo Apicella ◽

Marco Scalese ◽

...

Keyword(s):

Positive Predictive Value ◽

Predictive Value ◽

Multivariate Analyses ◽

International Workshop ◽

High Specificity ◽

Risk Profile ◽

Urinary Calcium ◽

Youden Index ◽

Low Sensitivity ◽

Sensitivity Specificity

Abstract The 4th International Workshop for the management of asymptomatic PHPT included, among the criteria for parathyroidectomy, the presence of hypercalciuria (dUCa> 400 mg/day) and increased biochemical stone risk profile. The aim of the present study was to evaluate the biochemical stone risk profile in 176 consecutive patients (143 females and 33 males) with asymptomatic PHPT. We recorded clinical and biochemical data, including 24 hours urinary measurements of the following parameters: volume and pH, creatinine, calcium, magnesium, sodium, potassium, ammonium, uric acid, oxalate, citrate, phosphate, inorganic sulphate and chloride and kidney ultrasound. In our cohort dUCa> 400mg/day showed a low sensitivity and positive predictive value (PPV) for nephrolithiasis with high specificity (46.2, 32.7, 73.0% respectively), while hypercalciuria by 4 mg/kg/bw (d-UCa>4mg/kg) had a high sensibility, with low PPV and specificity (79.5, 27.7, 40.1%) Daily hypomagnesuria (d-HypoMg), but not any other urinary parameter, was an independent predictor of nephrolithiasis in the univariate (OR 2.97 CI 1.27-7.09 P=0.014) and multivariate analyses adjusting for age, sex, BMI, and eGFR (OR 3.13 CI 1.17-8.42 P=0.02). d-HypoMg was relatively lower in the regression analysis with urinary calcium in patients with nephrolithiasis compared with those without. The mean ratio between (dUCa) and (dUMg) was higher in patients with nephrolithiasis compared with those without (4.6±2.0 vs 3.3±4.1; P<0.001). In the univariate and multivariate analyses the dUCa/dUMg ratio was a significant predictor of nephrolithiasis [OR 4.9 (2.3-10.5); P<0.001; OR 5.3 (2.4-11.6), P<0.001, respectively]. The AUC using the dUCa/dUMg ratio as variables was 0.69 (CI 0.60-0.79; P<0.0001). The best cut-off value, set at the highest Youden index, was equal to 4.0, with a sensitivity of 59.0% and a specificity of 77.4%. In patients with hypercalciuria (>400 mg/24-hour) dUMg was positively correlated with dUCa in those without nephrolithiasis (r=0.50, β=0.2, P=0.002) but not in those with nephrolithiasis (r=0.05, β= 0.014; P=0.8). In patients without hypercalciuria we found that hypomagnesuria remained a predictor of nephrolithiasis using either 400 mg/die (P=0.002, OR 5.12 (1.84-14.24) or 4 mg/kg bw (P=0.014, OR 6.24 (1.45-26.8). Moreover, the OR for nephrolithiasis improved using the combination of d-HypoMg with d-UCa>4mg/kg (OR 8.12, CI 1.92-34.18, P=0.004), but not with dUCa> 400mg/day. The current urinary calcium threshold of >400 mg/24-hour has a low sensitivity in detecting nephrolithiasis; our data suggest that sensitivity, specificity and positive predictive value could be improved including dUMg, dUCa/dUMg ratio and the combination of d-HypoMg with d-UCa>4mg/kg in the stone risk evaluation.

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An investigation of new toxicity test method performance in validation studies: 3. sensitivity and specificity are not independent of prevalence or distribution of toxicity

Human & Experimental Toxicology ◽

10.1191/0960327102ht254oa ◽

2002 ◽

Vol 21 (6) ◽

pp. 325-334 ◽

Cited By ~ 8

Author(s):

L H Bruner ◽

G J Carr ◽

J W Harbell ◽

R D Curren

Keyword(s):

Positive Predictive Value ◽

Sensitivity And Specificity ◽

Test Performance ◽

Predictive Value ◽

Validation Studies ◽

Toxicity Test ◽

Test Method ◽

Toxic Substances ◽

Method Performance ◽

Sensitivity Specificity

Often, the only measures of toxicity test performance provided in validation studies are the contingent probability statistics (CPS) sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Sensitivity and specificity are generally used in preference to NPV and PPV since NPV and PPV are assumed to vary with changes in prevalence while sensitivity and specificity are assumed to be independent of changes in prevalence. The purpose of the studies reported here was to test whether or not sensitivity and specificity are actually independent of changes in prevalence. Results derived from these studies indicate that sensitivity and specificity vary significantly depending on the prevalence of toxic substances in the set of chemicals being tested. This means sensitivity and specificity should not always be considered constant indicators of toxicity test performance.

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SAMe-TT₂R₂ Score for Prediction of Anticoagulation Control in Thai Patients with Non-Valvular Atrial Fibrillation

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.06.12415 ◽

2021 ◽

Vol 104 (6) ◽

pp. 959-963

Keyword(s):

Atrial Fibrillation ◽

Positive Predictive Value ◽

Sensitivity And Specificity ◽

Predictive Value ◽

International Normalized Ratio ◽

Control Objective ◽

Anticoagulation Control ◽

Sensitivity Specificity

Background: The quality of anticoagulation control is an important determination of thromboembolism and bleeding in patients with non-valvular atrial fibrillation. Previous trials have shown that SAMe-TT₂R₂ score could be used for prediction of anticoagulation control. Objective: To predict labile international normalized ratio (INR) by SAMe-TT₂R₂ score in Thai patients with non-valvular atrial fibrillation. Materials and Methods: The author retrospectively studied patients with non-valvularatrial fibrillation at Pranangklao Hospital between January 2019 and October 2020. Results: One hundred thirty patients were enrolled. The average ages of the patients were 67.5±10.2 years. The average SAMe-TT₂R₂ scores were 3.2±0.8 and the average CHA₂DS₂-VASc score was 3.3±1.4. Most patients had hypertension and dyslipidemia. Most patients were prescribed betablockers. Most patients had time in therapeutic range (TTR) lower than 65. The present study has shown that patients with SAMe-TT₂R₂ score of 3 or more has also had high proportion of labile INR with statical significance. The sensitivity, specificity, positive predictive value, and negative predictive value of different cut-offs of SAMe-TT₂R₂ score greater than 2 and SAMe-TT₂R₂ score when excluding race showed improvement of the sensitivity and specificity for prediction of labile INR. Conclusion: Labile INR was predicted by SAMe-TT₂R₂ score and the sensitivity and specificity increased in SAMe-TT₂R₂ score when excluding race. Keywords: SAMe-TT₂R₂ score; Non-valvular atrial fibrillation; Anticoagulation control

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Comparison between AIR score and Alvarado score in cases of non-perforated and perforated acute appendicitis

International Surgery Journal ◽

10.18203/2349-2902.isj20191028 ◽

2019 ◽

Vol 6 (4) ◽

pp. 1108

Author(s):

Debabrata Gope ◽

Anuradha Santosh Dnayanmote ◽

Saurav Mahesh Thakkar ◽

Akriti Rajkumar Tulsian ◽

Shweta Achuthan Kutty ◽

...

Keyword(s):

Abdominal Pain ◽

Acute Appendicitis ◽

Positive Predictive Value ◽

Sensitivity And Specificity ◽

Predictive Value ◽

Acute Abdominal Pain ◽

Pathological Examination ◽

Alvarado Score ◽

Sensitivity Specificity ◽

Higher Sensitivity

Background: Acute abdominal pain is a common complaint in the emergency department. Diagnostics of one of the most common pathologies behind acute abdominal pain, acute appendicitis, has radically changed over the last decades. There are several different diagnostic scores for suspected acute appendicitis. The Alvarado score being most widely known. Appendicitis Inflammatory Response (AIR) score was designed to overcome drawbacks of previous scores. This score incorporated the C-reactive protein value in its design and was developed and validated on a prospective cohort of patients with suspicion of acute appendicitis.Methods: Patients with pain in RIF were admitted. Scores were assessed, patients whose score was significant by either of the system were subjected for appendicectomy. The specimens of appendix were sent for histo-pathological examination (HPE). Post-operative histopathology report was correlated with the scores. Sensitivity, specificity, positive predictive value and negative predictive for AIR and Alvarado score were calculated.Results: For scores >4, AIR score has higher sensitivity and specificity. The negative predictive value (NPV) of AIR score was higher and the positive predictive value (PPV) of AIR score was also high. For scores >8, Alvarado score has higher sensitivity as compared to AIR score whereas AIR score has higher specificity as compared to Alvarado score. NPV of Alvarado score was higher while PPV of AIR score was higher.Conclusions: In this study AIR score had Alvarado score displaying higher sensitivity and specificity.

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