Diagnostic accuracy of Ultrasound B scan using 10 MHz linear probe in ocular trauma; Results from a high burden country

Objective: To study the diagnostic accuracy of Ultrasound B scan using 10 MHz linear probe in ocular trauma

Methods: A total of 61 patients with 63 ocular injuries were assessed during July 2013 to January 2014. All patients were referred to the department of Radiology from Emergency Room since adequate clinical assessment of the fundus was impossible because of the presence of opaque ocular media. Based on radiological diagnosis, the patients were provided treatment [surgical or medical]. Clinical diagnosis was confirmed during surgical procedures or clinical follow-up

Results: A total of 63 ocular injuries were examined in 61 patients. The overall sensitivity was 91.5%, Specificity was 98.87%, Positive predictive value was 87.62 and Negative predictive value was 99%

Conclusion: Ultrasound B-scan is a sensitive, non invasive and rapid way of assessing intraocular damage caused by blunt or penetrating eye injuries

Accuracy of computed topography in characterizing the Paranasal Fungal Infection

Background: To determine the diagnostic accuracy of CT in characterizing the Paranasal fungal Infection

Methods: All patients suspected of having Paranasal fungal infection underwent CT scan examination on 4 slice Toshiba Asteion multislice CT scanner. Final diagnosis was based on smear analysis for fungal culture which was done subsequently. Statistical analysis was performed by SPSS version-17

Results: Out of 65 patients, 48 were confirmed having fungal sinusitis and remaining 17 were negative on the gold standard culture analysis. While on CT, 44 patients were positive for fungal sinusitis and four patients had a normal scan [false negative]. Out of 17 patients, 14 patients were also negative on CT and three were positive for fungal infection [false positive]. Sensitivity of CT was 93.6% and accuracy was 89.2%

Conclusion: CT scan is highly accurate in diagnosing and characterizing paranasal fungal infection. CT scan also guides in defining disease extent as well as aids in deciding the surgical approach to be used

Diagnostic cut-off levels of plasma brain natriuretic peptide to distinguish left ventricular failure in emergency setting

To determine the diagnostic cut-off values of brain natriuretic [BMP] peptide to establish left ventricular failure in patients presenting with dyspnoea in emergency department. Descriptive study. Ziauddin University Hospital, Karachi, from July to December 2011. BMP estimation was done on Axysm analyzer with kit provided by Abbott diagnostics, while the Doppler echocardiography was done on Toshiba istyle [UICW-660A] using 2.5 MHz and 5.0 MHz probes. Log transformation was done to normalize the original BNP values. A receiver operating curve was plotted to determine the diagnostic cut-off value of BNP which can be used to distinguish CHF from other causes of dyspnoea. Statistical analysis was performed by SPSS version 17. A total of 92 patients presenting with dyspnoea in the emergency department were studied. There were 38/92 [41.3%] males and 54/92 [58.7%] females, and the average age of the study population was 64 +/- 14.1 years. These patients had BNP levels and Doppler echocardiography done. The average BNP was found to be 1117.78 +/- 1445.74 pg/ml. In log transformation, the average was found to be 2.72 +/- 0.58. BNP value of 531 pg/ml was found to be the cut off to distinguish between cardiogenic and non-cardiogenic causes of dyspnoea. BNP value of 531 pg/ml can distinguish CHF from other conditions as a cause of dyspnoea in emergency