ABSTRACT
Objects: to evaluate the accuracy of liver fibrosis stage by utilizing the techniques of advanced ultrasound performance in patients with chronic liver disease with Hepatitis C
Material and Method: this cross-sectional study was prospectively designed by including 101 consecutive patients with a diagnosis of chronic liver disease including liver cirrhosis between January and December 2010. The ultrasound score was determined from both hepatic lobes and the average scoring was calculated for liver edge, liver surface and liver parenchymal texture. A score of O was given when no abnormality was observed; score 1 for mild abnormality; score of 2 for moderate abnormality; and a score of 3 for severe abnormality. Scoring was given for a blunted edge and severe irregular surface or a highly coarse texture only when these characteristics were clearly confirmed by the low frequency probe
Results: out of 101 subjects, 63.4 % were male and 36.6 % were female with age range of.23-70 years [mean age 50.73 years SD+/- 10]. 17.8 % subjects were between age group 20-40 years, 67 .3 % between age group 41- 60 years and 14.9 % between 61 years and above. Mean duration of illness was 2.86 years [minimum 1 year and maximum 15 years]. Mean liver size was 12.261 with SD+ 2.7145. Mean portal vein size was 1.662 SD+ 2.3247. Mean spleen size was 71.71 SD+ 32.226. 62.4 % had splenomegaly, 66.3 % had ascites, 56.4 % had bruising and bleeding, 62.4% had varices. 20.8 % had sharp edge 48.5 % had mildly blunted edge and 30.7 % had blunt edge, '11.9% had smooth edge. 33.7% had mildly irregular edge, 39.6 % had irregular edge and 14.9 % had highly irregular edge. Regarding liver parenchymal structure 13.9 % had fine, 22.8 % had mildly coarse, 48.5 had coarse and 14.9 % had highly coarse liver parenchymal. structure.15.8 % of subjects had mild fibrosis [score 0-2], 55.4 % had moderate fibrosis [score 3-5], 28.7 % had severe fibrosis [score 6-8]
Conclusion: US scoring system is clinically useful for differentiating patients with minimal or no fibrosis from those with mild to severe fibrosis. This is also useful for prognostic information and determining the optimal therapeutic options during the follow-up of chronic liver disease
ABSTRACT
Background: sputum smear examination: for acid-fast bacilli [AFB] can diagnose up to 50-60% of cases of pulmonary tuberculosis .in well-equipped laboratories. In low-income countries, poor access to high, quality microscopy services contributes to, even lower rates of AFB detection
Objective: to assess diagnostic accuracy of three consecutive sputum smear for tuberculosis taking sputum culture as gold standard
Study Design: cross Sectional retrospective study. Study Setting: Study conducted in tertiary care, teaching hospitals outpatient department of Tuberculosis and Chest. Study Duration: Three months from June - August 2008
Material and Methods: data was collected retrospectively after fulfilling the inclusion criteria in a structured questionnaire of 88 patients who presented to outdoor department for diagnosis of pulmonary tuberculosis and was investigated for presence of pulmonary tuberculosis. Reports of three consecutive sputum examinations were taken along with sputum culture for and diagnostic accuracy of sputum for Acid Fast Bacilli was calculated taking sputum culture as Gold standard. Demographic information and symptoms were also taken into account
Results: 88 patient's reports were recruited for the study. 55.6% of the respondents were between age group of 15-44 years. 51.1% were male in our study groups and 48.9% were females. Diagnostic accuracy of three consecutive sputum for AFB was calculated. Sensitivity turned out to be 93.2%. Specificity was 80.0%. Positive predictive value of sputum turned out to be 95.8% and negative predictive value was 70.6%
Conclusions: sputum smear examination for AFB has appreciable sensitivity, specificity and predictive values and three sputum smears is sufficient for the early detection of AFB in outpatient setting
ABSTRACT
Background: the role of radiologists is to differentiate between conditions using imaging modalities such as, ultrasound, Computerized Tomography and Magnetic Resonance Imaging. Where appropriate the radiologist will stage lesions for management purposes and aid in guiding aspiration and biopsy, Proper evaluation of the adult neck masses is important and ultrasonography plays a very important role in neck mass differential diagnosis
Objectives: to asses the predictive value of ultrasonography in differential diagnostics of adult neck masses and to find out the frequency of the different types of neck masses among adult patients presenting in a tertiary teaching hospital
Study Design: cross sectional study
Study Setting: study was conducted in radiology department of a tertiary care, teaching hospitals Jinnah hospital Lahore
Sample Selection: 73 subjects with defined neck masses not undergone diagnostic biopsy were recruited for the study
Results: 73 subjects were recruited for the study. The Sonographic consistency of neck masses shows 65.8% solid masses 15.1% cystic masses and 19.2% are mixed consistency. Comparison of diagnostic accuracy of ultrasonography with FNAC [Gold standard] revealed that the infective neck masses diagnostic accuracy is 27.4% on sonography as compared to 24.7% on FNAC. Cystic neck mass diagnostic accuracy was 19.2% on both FNAC as well as sonography. The diagnostic accuracy in benign neck masses showed 26.0% on FNAC and 37.0% on sonography. The diagnostic accuracy in neoplastic neck mass was 17.8% on FNAC and 9.6% on sonography. The metastatic neck mass 12.3% FNAC and 6.8% is sonography. The screening value of ultrasonography for infective neck mass the sensitivity is 90.0% , specificity is 96.2% , for cystic mass showed a 100% sensitivity, specificity, for benign neck masses showed a sensitivity 100% , for neoplastic neck mass depicted a sensitivity 53.8% , specificity
Conclusions: the study results suggest that Modem ultrasound is highly valuable, useful, and reliable in the differential diagnosis of tumors in the preauricular area, submandibular area, and cheek. It enables precise localization, measurements, and assessment of the structure of lesions. It may be the first and last imaging method needed to formulate the final diagnosis, or it may guide fine-needle aspiration biopsy. In many cases, ultrasound may also suggest the nature of the tumor. The accuracy of ultrasound in detecting neoplastic lesion, and metastatic lesions turned out quite lower than expected