Comparison of the performance of Tubex® TF, widalimmunodiagnostic assay and blood culture in diagnosis of enteric fever in a private tertiary care hospital Peshawar, Pakistan

2020 ◽  
pp. 1-8
Author(s):  
Kamran Amir Khan ◽  
Sameed Ullah Qureshi ◽  
Shumaila Ehtisham ◽  
Admin
Keyword(s):  
Blood Culture ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Enteric Fever ◽  
Tertiary Care ◽  
Research Centre ◽  
Care Hospital ◽  
Widal Test ◽  
Culture Positive

Abstract Objective: To determine and compare the performance of TUBEX® TF, widal test & blood culture in the diagnosis of enteric fever. Methods: After approving with the ethical committee, we retrospectively identified patients presented with fever at Northwest General Hospital and Research Centre. Typhidot, Widal test and blood culture was performed as part of their evaluation from January 2018 to December 2018. SPSS 16 was used for data analysis. Results: Of the 241 patients, blood culture was positive for salmonella in 68(28.21%) and negative in 173(71.79%). In the culture positive group, TUBEX® TF was positive in 29(42.64%) and negative in 39(57.36%). Of these culture positive patients, Widal was positive in 25(36.76%) and negative in 43(63.24%). In patients with negative culture, TUBEX® TF was positive in 58(37.66%) and negative in 96(62.34%), Widal was positive in 77(44.5%) and negative in 96(55.5%). The positive predictive value of TUBEX® TF was 33.33% and the negative predictive value was 71.77%. The sensitivity of TUBEX® TF was 42.65% while specificity was 62.34%. The positive predictive value of Widal was 24.51% and the negative predictive value was 69.06%. The sensitivity of Widal was 36.76% while specificity was 55.49%. Conclusion: Sensitivity, specificity, positive predictive value and negative predictive value of TUBEX® TF and Widal test is very low as compared to blood culture. Keywords: Enteric Fever, TUBEX® TF, Widal, Continuous...

scholarly journals Diagnostic performance of the extended focused assessment with sonography for trauma (EFAST) patients in a tertiary care hospital of Nepal

2020 ◽  
Vol 5 (1) ◽  
pp. e000438
Author(s):  
Samjhana Basnet ◽  
Sanu Krishna Shrestha ◽  
Alok Pradhan ◽  
Roshana Shrestha ◽  
Anmol Purna Shrestha ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Injury Severity ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
University Hospital ◽  
Care Hospital ◽  
Abdominal Injuries ◽  
Contrast Enhanced Ct

BackgroundThoracoabdominal trauma presents a diagnostic challenge for the emergency physician. The introduction of bedside ultrasonography (USG) provides a screening tool to detect hemoperitoneum, hemothorax, pneumothorax and pericardial effusion in torso injuries.AimTo evaluate the accuracy of extended focused assessment with sonography for trauma (EFAST) for chest and abdominal injuries performed by first responders in a tertiary care hospital of Nepal.MethodsThis was a prospective study including all trauma patients who obtained either an Injury Severity Score ≥15 or direct trauma to the trunk in 1 year period in the emergency department (ED) of Dhulikhel Hospital-Kathmandu University Hospital. The results of the EFAST were then compared with contrast-enhanced CT (CECT), radiology ultrasound (USG)/chest X-ray, or intraoperative findings when the EFAST was positive. The negative EFAST cases were observed for a minimum of 4 hours in the ED. Descriptive statistics and sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated.ResultsOut of 267 cases, 261 patients underwent an EFAST examination. The sensitivity and specificity were 94.8% and 99.5%, respectively. The negative predictive value was 98.53% whereas the positive predictive value was 98.21%. The overall accuracy was 99.4%.ConclusionThe results of this study suggest that EFAST examination performed by first-line healthcare providers is a useful method for assessment of thoracic and abdominal injuries. EFAST was found to have a high specificity (99.5%) and positive predictive value (98.21%) which indicates that it is an effective technique for detecting intra-abdominal or thoracic injuries. However, the effectiveness of EFAST is limited by its being operator dependent, and thereby human error. For negative EFAST cases, we recommend a monitoring period of at least 4 hours, serial fast scan, or further investigation through other methods such as a CECT.Level of evidenceLevel I

scholarly journals Estimating the burden of enteric fever in Chhattisgarh: A single-center study on culture-positive cases from a newly built tertiary care hospital

2019 ◽  
Vol 11 (03) ◽  
pp. 234-239 ◽  
Author(s):  
Debabrata Dash ◽  
Padma Das ◽  
Anudita Bhargava ◽  
Ujjwala Nitin Gaikwad ◽  
Sanjay Singh Negi ◽  
...  
Keyword(s):  
Blood Culture ◽  
Enteric Fever ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Central India ◽  
Empiric Therapy ◽  
Blood Stream ◽  
Salmonella Typhi ◽  
Care Hospital ◽  
Culture Positive

Abstract BACKGROUND: Enteric fever is the most common cause of community acquired blood stream infections in under developed and developing countries. The enteric fever is exclusive to humans and transmitted through the faeco-oral route. Though India is an endemic zone for enteric fever, the data is very scarce from Central India. The present study was undertaken to determine the prevalence of enteric fever in this region and to know the antimicrobial susceptibility pattern of the isolated typhoidal Salmonellae. MATERIAL AND METHOD: We conducted a retrospective analysis of blood culture positive cases of enteric fever over a period of two years (December 2015 to December 2017). All blood cultures submitted for suspected enteric fever and associated symptoms were included in the study. Relevant demographic, clinical and laboratory data were analyzed. RESULT: A total of 51 cases (3.56%) were of typhoidal Salmonella from a total of 1430 blood culture submission. Salmonella Typhi were 70.5% while Salmonella Paratyphi A were 29.5% of the total isolated Salmonellae. The most vulnerable age group was 10-19years (41.2%). The mean minimum inhibitory concentration of ciprofloxacin for Salmonella Typhi and Salmonella Paratyphi A are 1.20 and 1.97 μg/ml respectively. All the isolates were susceptible to ceftriaxone. Highest isolation was in the July – September quarter (35.3%). CONCLUSION: There is a high prevalence of the disease which needs urgent focus on safe water, sanitation services and also to establish guidelines for empiric therapy for enteric fever.

scholarly journals Procalcitonin – A Reliable Marker for Diagnosis of Neonatal Sepsis in Compare to CRP

2018 ◽  
Vol 42 (1) ◽  
pp. 19-25
Author(s):  
Jesmin Akter ◽  
Forrukh Ahammad ◽  
Tahmina Begum
Keyword(s):  
Early Diagnosis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Neonatal Sepsis ◽  
Predictive Value ◽  
Early Recognition ◽  
Care Hospital ◽  
Suspected Sepsis ◽  
Reliable Marker ◽  
Serum Crp

Background: Early recognition and diagnosis of neonatal sepsis are difficult because of the variable and non-specific clinical presentation of this condition. It is extremely important to make an early diagnosis of neonatal sepsis for prompt institution of antimicrobial therapy. So the objective of the study was to evaluate the efficacy of serum procalcitonin as a reliable marker in diagnosis of neonatal sepsis.Methodology: This cross sectional analytical study was carried out in the Special Care Baby Unit of a tertiary level care hospital in Bangladesh from September 2012 to May 2013. Total 75 newborn with suspected sepsis were included in the study. Specimens of blood were obtained from each neonate prior to commencement of antibiotic for sepsis work up. Serum CRP and procalcitoninlevels were measured. The data from blood cultures were used as the gold standard to evaluate the optimum sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and area under the Receiver Operative Characteristic (ROC) curves.Results:Among total 75 newborns included in this study, 49.3% (37) newborn were diagnosed as proven sepsis and 50.7% (38) newborn as clinical sepsis.The procalcitonin (PCT) was high in 58.7% (500-<2000 pg/ml) newborn and remarkably high (2000-<10000) in 36% newborn with sepsis. At a cut-off value > 500pg/ml, the sensitivity of PCT in detecting sepsis was 48.6%, its specificity 76.3%, positive predictive value was 66.7%, and negative predictive value was 60.4% whereas the sensitivity of CRP for predicting sepsis was 35.1%, specificity 78.9%, positive predictive value 61.9% and negative predictive value was 55.6%. The area under the ROC curve for procalcitonin(0.653) was significantly higher than CRP (0.571).Conclusion:Serum PCT was superior to serum CRP level in terms of early diagnosis of neonatal sepsis, in detecting the severity of sepsis. PCT is a reliable marker than CRP in the diagnosis of neonatal sepsis.Bangladesh J Child Health 2018; VOL 42 (1) :19-25

scholarly journals Clinical spectrum of enteric fever in children admitted to a tertiary care hospital

2020 ◽  
Vol 7 (7) ◽  
pp. 1530
Author(s):  
Jawad Nazir Wani ◽  
Abdus Sami Bhat ◽  
Saleem Yusuf ◽  
Umer Amin Qureshi
Keyword(s):  
Public Health ◽  
Blood Culture ◽  
Health Problem ◽  
Enteric Fever ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Clinical Spectrum ◽  
Care Hospital ◽  
Presenting Symptoms ◽  
Normal White Blood Cell

Background: Enteric fever is a common public health problem with variable clinical presentation. The aim of study was to study the clinical spectrum of enteric fever in children.Methods: This was a prospective study conducted over period of one year from January 2019 to January 2020 in the Department of Paediatrics at Govt Medical College Srinagar. It included all patients in the age group of 1-18 years who were clinically suspected to have enteric fever and had either a positive blood culture for Salmonella or a positive Widal test.Results: This study included total of 76 patients out of which 36 were males and 40 were females. The most common presenting symptoms were fever anorexia, vomiting, diarrohea, abdominal pain, headache and constipation. The most common signs were coated tongue, toxic look, hepatomegaly, splenomeagly, pallor, jaundice and abdominal distension. Complications were seen in in 8 (10.5%) patients. Myocarditis was seen in 3 patients. Encephalopathy and hepatitis was seen in 2 patients each. Pneumonia was seen in 1 patient. Majority of patients had normal white blood cell count (4000-11000/cumm). Leukopenia (<4000/cumm) was seen in 10% patients and leukocytosis (>11000/cumm) was seen in 15% patients. Thrombocytopenia was seen in 9% patients. Blood culture was positive in 36 (47.36%) patients. Salmonella typhi was seen in 33 patients whereas Salmonella paratyphi A was seen in 3 patients. All culture positive cases were sensitive to ceftriaxone, cefixime and azithromycin. Ciprofloxacin resistance was seen in 11 (14.4%) patients.Conclusions: Enteric fever is a common public health problem with fever as most common presenting symptom. Culture yield can be increased in enteric fever by drawing blood culture prior to administration of antibiotics. Ceftriaxone is highly efficacious as monotherapy in enteric fever.

scholarly journals CLINICAL PROFILE AND ANTIBIOTIC SENSITIVITY PATTERN OF ENTERIC FEVER AMONG CHILDREN ADMITTED IN PEDIATRICS DEPARTMENT OF JLNMCH, BHAGALPUR, BIHAR

2021 ◽  
pp. 1-3
Author(s):  
Mithilesh Kumar ◽  
R. K. Sinha ◽  
Debarshi Jana
Keyword(s):  
Enteric Fever ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Urban Slum ◽  
Case Definition ◽  
Clinical Profile ◽  
Suspected Case ◽  
Care Hospital ◽  
Widal Test ◽  
Sensitivity Pattern

Objective: In this study our main aims to know the clinical profile of pediatric enteric fever and the sensitivity pattern of the disease to drugs in this region. Methodology: This prospective observational study conducted in a tertiary care hospital at Dhaka from March to December 2019 among suspected case of Enteric fever as per case definition. Among 212 suspected enteric fever 117 children were diagnosed as enteric fever by blood culture and/or Widal test. Results: During the study, Male: female were 1.3: 1. Maximum (70%) children were in age group 5 years or more. Most of the children were from urban slum area (53.6%) of Dhaka city. Cases were admitted throughout the year. Common presentation were fever (100%), anorexia (100%), pain abdomen (74.4%) and loose motions (46.1%). The common signs were hepatomegaly (41.9%), hepatosplenomegaly (5.1%) coated tongue (64.9%), pallor (74.4%). The complications rate was 35.9% and commonest being UTI and pneumonia. The overall positivity of Widal test was 89.7% and the culture positivity was 32.5%. Among isolates, 94.7%were Salmonella typhi and 5.3% Salmonella paratyphi A. Among them18.1% isolates were multi drug resistant. Conclusion: Enteric fever is most prevalent during summer & rainy session. WASA supplied water may play a role. Hepatomegaly is common. UTI and pneumonia are the commonest complication. Multidrug resistant cases are not so as high as other countries. Cefixime, Ceftriaxone. Meropenam and Ofloxacine are the drugs of choice. Ciprofloxacin is still could be chosen for the treatment of enteric fever. Higher rate of resistant to Azithromycin is alarming.

scholarly journals Typhidot IgM as a reliable and rapid diagnostic test for typhoid fever among children in a tertiary care hospital

2020 ◽  
Vol 7 (8) ◽  
pp. 1677
Author(s):  
Mohammad Ashfaque Ansari ◽  
Amit Kumar Thakur ◽  
Atindra Mishra ◽  
Md Jaffer Rain
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Diagnostic Test ◽  
Rapid Diagnostic Test ◽  
Predictive Value ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Antibiotics Resistance ◽  
Major Public Health Problem ◽  
Care Hospital

Background: Typhoid fever still continues to be a major public health problem in Nepal. A clinical spectrum of typhoid varies widely. It causes significant complication as well as mortality. A simple, reliable, affordable and rapid diagnostic test has been a long felt need of the clinicians to prescribe specific medication, adopt prevention of the emergence of antibiotics resistance and overall reduce the disease burden in the community.Methods: The prospective descriptive study was performed in 125 children between 2 years to 15 years of age admitted to the Pediatrics Department from September 2017 to September 2018. Blood culture, Typhidot rapid IgM were performed. MEDCALC software was used to calculate 95% confidence interval for sensitivity, specificity, predictive value positive, predictive value negative and accuracy. Kappa test was used to determine the agreement between Typhidot IgM and blood culture methods.Results: The study consisted of 125 children with acute febrile illness for more than 3 days with clinical symptomatology, consistent with typhoid fever. The reliability of Typhidot IgM in relation with blood culture and the study lighten that sensitivity 92.3% (95% CI: 63.9, 99.8), specificity 49.1% (95% CI: 39.5, 58.7), PPV 17.4% (95% CI: 14.2, 21.1), NPV 98.2% (95% CI: 89.2, 99.7) and accuracy 53.6% (95% CI: 44.5, 62.6). The two methods i.e. Typhoid IgM and blood culture shows significant agreement with p value 0.004.Conclusions: The present study demonstrates that Typhidot IgM has all the attributes of an ideal screening test.

scholarly journals Validity of Immunochromatographic Test for Antibody in Diagnosis of Typhoid Fever in Children Admitted in A Tertiary Care Hospital

2018 ◽  
Vol 16 (2) ◽  
pp. 20-24
Author(s):  
Zabeen Choudhury ◽  
Mohammed Rezaul Karim ◽  
Rasheda Samad ◽  
Shanjana Islam
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Predictive Value ◽  
Tertiary Care ◽  
False Negative ◽  
Care Hospital ◽  
Immunochromatographic Test ◽  
True Negative ◽  
College Hospital ◽  
Cross Sectional

Background: To determine the Validity of Immunochromatographic Test (ICT) in diagnosis of typhoid fever in children admitted in a tertiary care hospital.Methods: This cross sectional study was carried out the in Pediatric & Medicine wards of Chittagong Medical College Hospital (CMCH), Chittagong during the period July 2012 to June 2013. A total number of 150 clinically suspected cases of typhoid fever (Age >6 months to18 years) were enrolled in this study. After taking informed written consent, detailed history & clinical examination were completed. A blood culture sample was taken on the day of admission before starting antibiotic. On the 5th day onwards of appearance of fever, blood sample was taken to perform ICT. Patients received standard medical treatment of the admitting wards.Results: Blood C/S for Salmonella typhi was found positive in 16(10.7%) cases. Positive ICT for typhoid fever was found in 37(24.7%) cases. Among then, IgM was 18(12.0%) IgM+IgG were 8(5.3%) and IgG was 11(7.3%). ICT found true positive in 14, false positive in 23, false negative in 2 and true negative in 111 cases, where blood culture considered as gold standard. The difference was statistically significant (p<0.05) between two groups. Immunochromatographic Test (ICT) showed sensitivity 87.5%, specificity 82.8%, accuracy 83.3%, positive predictive value 37.8% and negative predictive value 98.2% for identification of typhoid fever.Conclusion: The present study has shown high sensitivity & specificity of ICT, it can be used as a useful & prospectful diagnostic tool.Chatt Maa Shi Hosp Med Coll J; Vol.16 (2); July 2017; Page 20-24

RISK STRATIFICATION UTILIZING THE MILAN SYSTEM OF CLASSIFICATION FOR SALIVARY GLAND CYTOLOGY : A CYTOHISTOLOGICAL CORRELATION STUDY IN TERTIARY CARE HOSPITAL IN HIMACHAL PRADESH

2021 ◽  
pp. 22-24
Author(s):  
Monica Sarohi ◽  
Kavita Mardi
Keyword(s):  
Salivary Gland ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Clinical Management ◽  
Care Hospital ◽  
Conventional System ◽  
Diagnostic Categories ◽  
Risk Of Malignancy

Introduction- Milan system is an evidence based system derived from the literature which correlates diagnostic categories with risk of malignancy and clinical management strategies. The goals of this system were to standardize salivary gland cytology reporting across institutions and provide a framework for guiding clinical management. It is a tier based classication having six diagnostic categories. The conventional system was used for diagnosis before the advent of Milan system. In this study, FNAC done for all sa Material and methods- livary gland lesions over a period of two years from 2018 - 2020 in department of pathology, IGMC Shimla are included. All cases are categorized according to MSRSGC and correlated with histopathological follow up wherever available. We calculated the sensitivity, specicity, positive predictive value, negative predictive value and diagnostic accuracy of FNA using the Milan system. We also calculated the ROM was for each category. All the cases were Results: categorized as per MSRSGC and were 14%, 45.4%, 0%, 31.4%, 0.6%, 0.6% and 8% in category I, II, III, IVA, IVB, V and VI respectively. ROM for category I, II, IVA, IVB, V and VI was 0%, 0%, 2.6%, 0%, 100% and 87.5% respectively. The sensitivity, specicity, positive predictive value, negative predictive value and diagnostic accuracy was 98.51%, 66.67%, 98.51%, 66.67% and 97.14% respectively. Milan system is an Discussion: effective tool for diagnosing salivary gland lesions. It offers advantages over the conventional system such as risk of malignancy, management options for each category and a better communication both institute wise and between clinicians and cytopathologists.

scholarly journals Pattern of Antibiotic Sensitivity in Enteric Fever: A Tertiary Care Hospital Experience

2014 ◽  
Vol 15 (2) ◽  
pp. 122-124 ◽  
Author(s):  
Samira Rahat Afroze ◽  
Muhammad Abdur Rahim ◽  
Md. Mehedi Hasan ◽  
Farhana Afroz ◽  
Hasna Fahmima Haque ◽  
...  
Keyword(s):  
Blood Culture ◽  
Nalidixic Acid ◽  
Enteric Fever ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Sensitivity Pattern ◽  
Drug Resistant Strains

Objectives: To describe the antibiotic sensitivity pattern ofSalmonella typhi and Salmonella paratyphi from blood culture specimens. Methods: This cross-sectional study was done in the Department of Medicine, BIRDEM from July 2009 to June 2012. Standard laboratory and microbiological procedures were followed for blood culture and antibiotic sensitivity tests. Results: Among the 97 blood culture positive samples, S. typhi was 71 (73.2%) and S. paratyphi was 26 (26.8%). Multi-drug resistant strains of S. typhi and S. paratyphi were 23 (32.4%) and 3 (11.5%) cases respectively. Azithromycin, nalidixic acid, ciprofloxacin, levofloxacin and amoxicillin resistance was also found in a good number of cases (S. typhi and S. paratyphi: 71.8% and 57.7%, 42.3% and 30.8%, 38% and 34.6%, 38% and 26.9% and 38% and 26.9% cases respectively). Nineteen (31.1%) of the 61ciprofloxacin sensitive organisms were resistant to nalidixic acid. Ceftriaxone was sensitive in 100% of S. typhi and S. paratyphi. Cefixim, ciprofloxacin, levofloxacin, imipenem were among the most common sensitive antibiotics (S. typhi and S. paratyphi: 83.1% and 73.1%, 62% and 65.4%, 53.5% and 65.4%, 76.1% and 65.4% cases respectively). Conclusion: Ceftriaxone was the most sensitive antibiotic for treating enteric fever followed by cefixim, imipenem and ciprofloxacin. However, in suspected cases of enteric fever, blood culture should be requested before prescribing antibiotic.DOI: http://dx.doi.org/10.3329/jom.v15i2.20684 J MEDICINE 2014; 15 : 122-124

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