Utility of Squash Cytology in Spinal Lesions with Special Reference to Ki67 Immunostain

2019 ◽  
Vol 63 (5) ◽  
pp. 424-430
Author(s):  
Debashis Chakrabarty ◽  
Shubhamitra Chaudhuri ◽  
Priyanka Maity ◽  
Uttara Chatterjee ◽  
Subhasis Ghosh
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
High Specificity ◽  
Histopathological Diagnosis ◽  
Spinal Tumours ◽  
Who Grade ◽  
Spinal Lesions ◽  
Sensitivity Specificity ◽  
A Prospective Study

Background: Squash cytology is of significant importance in intraoperative consultation of central nervous system (CNS) pathology. There are several studies on squash cytology of CNS lesions, and only a few of them deal with spinal lesions alone. Aims: (1) To evaluate intraoperative squash cytology of spinal lesions. (2) To correlate cytological diagnosis with histopathological diagnosis and assess the diagnostic accuracy. (3) To study Ki67 expression on squash smears and determine whether it can assist in grading spinal tumours on cytology. Materials and Methods: A prospective study was conducted on 68 patients with clinico-radiologically diagnosed lesions of the spine. Intraoperative squash smears were stained with haematoxylin-eosin (H&E) stain, Papanicolaou (Pap) stain, and May-Grünwald-Giemsa (MGG) stain. Subsequently, histological diagnosis was made. Ki67 immunostaining was performed on squash smears and histology sections. Results: The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of squash cytology in spinal lesions were 84.6, 100, 100, 23.1, and 80.88%, respectively. On immunocytochemistry, the mean Ki67 labelling indices for grade I, II, and III tumours were 0, 0.33 and 9%, respectively. Conclusion: Squash smear cytology is a rapid intraoperative technique for diagnosing spinal lesions, with high specificity and high positive predictive value. It is more effective in diagnosing neoplasms than non-neoplastic lesions. Ki67 immunostaining can be done on cytology smears to effectively differentiate between WHO grade I and grade II spinal tumours.

Diagnostic accuracy of monofilament test to detect diabetic neuropathy

2021 ◽  
Vol 10 (1) ◽  
pp. 20-25
Author(s):  
Sujan Shrestha ◽  
Mamen Prasad Gorhaly ◽  
Manil Ratna Bajracharya
Keyword(s):  
Peripheral Neuropathy ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Diabetic Peripheral Neuropathy ◽  
Perception Threshold ◽  
Sensitivity Specificity ◽  
Vibration Perception ◽  
Monofilament Test

Background Diabetic peripheral neuropathy (DPN) is a significant independent risk factor for diabetic foot, and an effective screening instrument is required to diagnose DPN early to prevent future ulceration and amputation. This study aims to determine the diagnostic accuracy of monofilament test to detect diabetic peripheral neuropathy. Methods This cross-sectional study was conducted in National Academy of Medical Sciences, Bir hospital, Mahabouddha, Kathmandu from February 2016 to January 2017. A total of 96 diabetic patients attending inpatient and outpatient Department were selected. Diabetic peripheral neuropathy was assessed by measurement of loss of protective sensation (LOPS) by monofilament test and compared with vibration perception threshold by standard biothesiometer. The sensitivity, specificity, positive predictive value and negative predictive value of monofilament test were calculated. Results The prevalence of diabetic peripheral neuropathy was 26%. The sensitivity, specificity, positive predictive value and negative predictive value of monofilament test were found to be 92.0%, 95.8%, 88.5% and 97.1% respectively. There was strong association between LOPS by monofilament and vibration perception threshold by biothesiometer. Conclusion This study showed a strong diagnostic accuracy of monofilament test to detect DPN when compared with biothesiometer. As monofilament test is a cheap, easily available, and portable, it can be used in the periphery where biothesiometer is not available.  

DIAGNOSTIC ACCURACY OF GRAY SCALE ULTRASONOGRAPHY VERSUS COLOR DOPPLER IN SUSPECTED CASES OF ACUTE APPENDICITIS

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Tahir Iqbal ◽  
Muhammad Usman Shahid ◽  
Ishfaq Ahmad Shad ◽  
Shahzad Karim Bhatti ◽  
Syed Amir Gilani ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Color Doppler ◽  
Diagnostic Tools ◽  
Gray Scale ◽  
Versus Color ◽  
Sensitivity Specificity

ABSTRACT: BACKGROUND: A common surgical emergency is acute appendicitis. Various diagnostic tools are available to diagnosis acute appendicitis. Radiological investigations play an important role in making accurate and early diagnosis and thus preventing morbidity associated with the disease. OBJECTIVE: To determine the diagnostic accuracy of gray scale ultrasonography versus color Doppler in suspected cases of acute appendicitis. MATERIALS AND METHODS: The study was carried in the department of Radiology of Mayo Hospital, Lahore. A total of 75 patients were enrolled of age 18-40 years, both genders who were suspected cases of acute appendicitis. All patients underwent baseline investigations along with gray scale ultrasonography and color Doppler. All patients were subjected to surgery to confirm the diagnosis and findings were subjected to statistical analysis. RESULTS: The mean age of the patients was 23.25 ±10.55 and mean transverse diameter of appendix was 8.37 ±3.39. There were 62.7% males and 37.3%females. Findings of gray scale ultrasonography and color Doppler were then correlated with surgical findings to calculate the diagnostic accuracy of these modalities. The results revealed that gray scale ultrasonography sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 92.7%, 94.32%, 95%, 91.4% and 93.3% respectively, whereas color Doppler had sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 97.7%, 93.9%, 95.3%, 97% and 96% respectively. Diagnostic accuracy of both modalities together was 98.6%. CONCLUSION: Color Doppler has better diagnostic accuracy than gray scale ultrasonography for diagnosis of acute appendicitis and the combination of both modalities yields diagnostic accuracy that is similar to gold standard.

scholarly journals The slipping slipper sign: a simple test with high specificity and positive predictive value for peripheral neuropathy among diabetic patients

2012 ◽  
Vol 2 (2) ◽  
pp. 51 ◽  
Author(s):  
Krystal A.T. Gayle ◽  
Marshall K. Tulloch-Reid ◽  
Rainford J. Wilks ◽  
Trevor S. Ferguson
Keyword(s):  
Peripheral Neuropathy ◽  
Positive Predictive Value ◽  
Diabetic Neuropathy ◽  
Predictive Value ◽  
High Specificity ◽  
Diabetic Patients ◽  
Simple Test ◽  
Diabetes Clinic ◽  
Sensitivity Specificity ◽  
Single Question

This study evaluated the ability of the slipping slipper sign (defined as unknowingly losing a slipper while walking) to identify diabetic neuropathy in Jamaican patients. A single question was used to ascertain the presence of the slipping slipper sign (SSS) among 69 patients attending a diabetes clinic. Nurses assessed pain, vibration and pressure perception among the same patients in order to detect diabetic neuropathy. The sensitivity, specificity and positive predictive value for the SSS were calculated. Eight participants (men=5, women=3) reported positive SSS. The SSS had a sensitivity of 28.6%, specificity of 100% and positive predictive value (PPV) 100% for neuropathy on at least one of the three tests. These findings indicate that the SSS has high specificity and PPV for diabetic neuropathy but the sensitivity is low. The sign may be a useful adjuvant to conventional methods of screening for severe neuropathy

scholarly journals ACCURACY OF THE UPPER LIP BITE TEST;

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.

scholarly journals Clinical Performance of the Spot Vision Photo Screener before and after Induction of Cycloplegia in Children

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Konuralp Yakar
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Clinical Performance ◽  
High Specificity ◽  
Screening Criteria ◽  
Predictive Values ◽  
Before And After ◽  
Sensitivity Specificity ◽  
Vision Screener

Aim. To compare the clinical performance of the Spot Vision Screener used to detect amblyopia risk factors (ARFs) in children before and after induction of cycloplegia; the children were referred because they met the screening criteria of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS). Methods. The Spot Vision Screener and a standard autorefractometer were used to examine 200 eyes of 100 children aged 3–10 years, before and after cycloplegia induction, in terms of ARFs. Sensitivity, specificity, and positive and negative predictive values for the detection of significant refractive errors were measured using the AAPOS referral criteria. It was explored that Spot Screener data were affected by cycloplegia. The extent of agreement between cycloplegic/noncycloplegic photoscreening data and cycloplegic autorefraction measurements was assessed using Wilcoxon and Spearman correlation analyses. Results. The Spot’s sensitivity was improved from 60.9% to 85.3% and specificity from 94.9% to 87.4% with cycloplegia compared to cycloplegic standard autorefractometer results. The positive predictive value of Spot was 75.7%, and the negative predictive value was 90.4% without cycloplegia. With cycloplegia, the positive predictive value of Spot was 63.6% and the negative predictive value was 95.8%. Conclusions. The Spot Screener afforded moderate sensitivity and high specificity prior to cycloplegia. The sensitivity and negative predictive value improved after induction of cycloplegia. Examiners should be aware of the effects of cycloplegia on their findings.

scholarly journals Accuracy of High Resolution Sonography in Diagnosis of Fibroadenosis Compared with Histopathological Diagnosis

2018 ◽  
Vol 8 (3) ◽  
pp. 139-142
Author(s):  
Mashah Binte Amin ◽  
Tarana Yasmin ◽  
Khaleda Parvin Rekha ◽  
Rushaida Haque Leeba ◽  
Nasima Akhter ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Linear Array ◽  
Histopathological Diagnosis ◽  
Fibrocystic Disease ◽  
Medical College ◽  
Breast Condition ◽  
Sensitivity Specificity ◽  
Test Result

Background: Fibrocystic breast condition is a common, non-cancerous condition that affects premenopausal woman between 20 and 50 years of age. Because of non-specific nature of clinical presentation, diagnosis is not that easy. Linear array sonography has been helpful for detection of mammary dysplasia.Objective: The purpose of this study was to determine the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of superficial sonography in the diagnosis of chronic cystic mastitis.Materials and Methods: This study was carried out in department of Radiology & Imaging of Enam Medical College and Hospital during June 2013 to October 2017. Sonography was done in 1350 women suspected of having fibrocystic disease. Among them FNAC was done only in 1020 cases. Ultrasonographic findings and histopathological reports were analyzed using SPSS 13.0.Results: According to our study the sensitivity of superficial sonography was 92.4%, specificity 88.8%, positive predictive value 93.8%, negative predictive value 86.4% and accuracy 91% in the diagnosis of fibrocystic changes.Conclusion: With the validity test result, it can be concluded that high frequency sonography provides an accurate diagnosis of fibroadenosis.J Enam Med Col 2018; 8(3): 139-143

scholarly journals Comparative Study of Imprint Cytology and Frozen Section in the Intraoperative Diagnosis of Thyroid Lesions

1970 ◽  
Vol 24 (1) ◽  
pp. 12-15 ◽  
Author(s):  
Sukumar Shaha ◽  
AJE Nahar Rahman
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Frozen Section ◽  
Cost Effective ◽  
Imprint Cytology ◽  
Intraoperative Diagnosis ◽  
Fresh Specimen ◽  
Sensitivity Specificity ◽  
Thyroid Lesions

 Imprint cytology can provide a useful adjunct to the frozen section diagnosis and may be used safely in the intraoperative diagnosis of thyroid nodules, especially in the centres where frozen section facilities are not available. This study was conducted to compare imprint cytology and frozen section in terms of diagnostic accuracy, sensitivity, specificity, positive predictive value and to assess the value of imprint cytology in the intraoperative diagnosis of thyroid lesions. A total of 57 consecutive patients were enrolled in the study. All of the patients underwent frozen section in the department of pathology, BSMMU, Dhaka. Imprints were taken from the fresh specimen sent for frozen section from departments of otolaryngology and surgery of BSMMU. Imprint slides were stained with rapid H & E staining method. Then the tissues were submitted for frozen section by standard method. In this study, diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive value of imprint cytology were 81.25%, 66.66%, 82.59%, 87.12% respectively. Frozen section revealed the diagnostic accuracy, sensitivity, specificity, positive predictive value and negative predictive as 88.46%, 72.72%, 100%, 100%, 83.33% respectively. Imprint cytology was found to be comparable with frozen section in diagnostic accuracy and sensitivity. Since imprint cytology is a simple and cost-effective procedure it can be used as an alternative to frozen section in hospitals where frozen section facilities are not available. Key Words: Imprint cytology, frozen section, intraoperative diagnosis of thyroid lesions  doi: 10.3329/bjpath.v24i1.2876 Bangladesh J Pathol 24 (1) : 12-15   

scholarly journals A comparative study of RIPASA score and ALVARADO score in diagnosis of acute appendicitis

2018 ◽  
Vol 5 (3) ◽  
pp. 796
Author(s):  
Vamsavardhan Pasumarthi ◽  
C. P. Madhu
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Roc Curve ◽  
Predictive Value ◽  
Scoring System ◽  
Alvarado Score ◽  
Predictive Values ◽  
Sensitivity Specificity ◽  
Ripasa Score

Background: The RIPASA Score is a new diagnostic scoring system developed for the diagnosis of Acute Appendicitis which showed higher sensitivity, specificity and diagnostic accuracy compared to ALVARADO Score, particularly when applied to Asian population. Not many studies have been conducted to compare RIPASA and ALVARADO scoring systems. Hence, author want to compare prospectively Alvarado and RIPASA score by applying them to the patients attending the hospital with right iliac fossa pain that could probably be acute appendicitis.Methods: A prospective analysis of 116 cases admitted with RIF pain during a 2 years period was performed. Patients between 15-60 years were scored as per Alvarado and RIPASA scoring system. Histopathological reports of the cases were collected and compared with the scores. ROC curve area analysis was performed to examine diagnostic accuracy of RIPASA and ALVARADO scores.Results: The sensitivity of ALVARADO score is estimated to be 52.08 for a cut off of 6. The specificity is 80%, positive predictive value is 92.59, negative predictive value is 25.81. The Diagnostic accuracy of ALVARADO scoring is found to be 56.9. The sensitivity, specificity, positive predictive value and negative predictive values of RIPASA scoring system are 75%, 65%, 91.14%, 35.14%. The diagnostic accuracy of RIPASA score is 73.28.Conclusions: The difference in the diagnostic accuracy between ALVARADO and RIPASA scoring system is significant indicating that the RIPASA score is a much better diagnostic tool for the diagnosis of acute appendicitis. When the ROC curve was observed the area under the curve is high for RIPASA scoring system.

Usefulness of Grey Scale and Doppler transvaginal sonography in diagnosis of ovarian torsion

2020 ◽  
Vol 14 (2) ◽  
pp. 97-102
Author(s):  
Khalid Rehman `Yousaf ◽  
Shahzad Saeed ◽  
Saman Chaudhry ◽  
Rabia Bashrat ◽  
Abadullah Khalid ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Ovarian Function ◽  
Imaging Modality ◽  
Ovarian Torsion ◽  
Transvaginal Sonography ◽  
Predictive Values ◽  
Grey Scale ◽  
Sensitivity Specificity

Background: Ovarian torsion diagnosis is a great challenge as delay in diagnosis can cause severe morbidity. Early accurate diagnosis is crucial to preserve ovarian function. Ultrasonography being the primary imaging modality plays a vital role in the evaluation of suspected ovarian torsion by helping surgeons reach the correct diagnosis, thus avoiding unnecessary intervention. This study aims to determine the diagnostic accuracy of isolated and combined sonographic features of ovarian torsion on grey scale and Doppler transvaginal ultrasonography. Patients and methods: From radiology database, from January 2016 till December 2019, sonographic signs of ovarian torsion in 113 women with suspected ovarian torsion on ultrasonography and subsequent surgical diagnosis were evaluated. Ultrasound findings were compared with surgical findings to determine the accuracy, sensitivity, specificity, and positive and negative predictive values of individual and combined ultrasound signs. Results: Diagnostic accuracy of ultrasound for ovarian torsion was 85.8%. Abnormal ovarian Doppler flow was the most accurate individual sonographic sign with accuracy, sensitivity, specificity and positive predictive value of 85.8%, 83.5%, 100% and 100% respectively followed by ovarian enlargement and ovarian edema. Combined ultrasound signs resulted in higher sensitivity and positive predictive values, and lower specificity and negative predictive values for ovarian torsion. Increasing the number of sonographic parameters increased the specificity but decreased sensitivity. High accuracy, sensitivity, positive predictive value, specificity and negative predictive value was seen when combination of three or two sonographic parameters was used as diagnostic criteria. Conclusion: Transvaginal sonography is a convenient, reliable and extremely useful imaging modality for preoperative diagnosis of ovarian torsion with high specificity, sensitivity, positive predictive value and diagnostic accuracy helping treating physicians to take prompt decisions regarding timely surgical intervention. However, due to low negative predictive values, absence of sonographic signs does not rule out ovarian torsion and high index of clinical suspicion remains of utmost importance.

scholarly journals A prospective study of trauma patients at Gandhi Medical College and associated hospital emergency department, Bhopal, analysing anatomical and physiological scoring systems to predict mortality

2017 ◽  
Vol 5 (3) ◽  
pp. 871
Author(s):  
Moorat Singh Yadav ◽  
Vibhore Agarwal ◽  
Surabhi Garg
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Scoring Systems ◽  
Trauma Patients ◽  
Adult Age ◽  
Medical College ◽  
Life Years ◽  
Gandhi Medical College ◽  
Sensitivity Specificity ◽  
A Prospective Study

Background: Trauma, in a developing country like India, is a leader together with non-communicable diseases, when measured in terms of disability adjusted life years (DALYs) lost. Trauma scoring systems have been shown to decrease the number of preventable deaths caused by trauma. The aim of this study is to compare the various physiological and anatomical scoring systems.Methods: Two hundred and sixty two cases of trauma of adult age group admitted in Gandhi Medical College and Hamidia Hospital, Bhopal, Madhya Pradesh, India from 1 July 2014 to 1 December 2014.Results: Out of the 262 patients included in the study, 242 were discharged alive while 20 (7.6%) died. In our study, in of the patients who died it was observed that RTS was significantly low (<7) and ISS and TRISS were significantly high (>/=25 for ISS and >/=50 for TRISS).Conclusions: Of all the scoring system TRISS has got the best sensitivity, specificity and positive predictive value of 83.3% and also miscalculation rate of 1.5 as per the MOTS norms as compared to RTS, which has sensitivity of 90% but low specificity, and ISS which has sensitivity and specificity comparable to TRISS but low positive predictive value.

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