Amirhosein Meisami
Volume 9, Issue 1 , January 2021, , Pages 15-20
Abstract
Objective: To determine the sensitivity, specificity and accuracy of ultrasound to diagnose the patients with tendon rupture of upper extremity referred to Taleghani Hospital’s center of Kermanshah in 2019. Methods: This was a diagnostic value study which performed on 113 patients with non-fracture ...
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Objective: To determine the sensitivity, specificity and accuracy of ultrasound to diagnose the patients with tendon rupture of upper extremity referred to Taleghani Hospital’s center of Kermanshah in 2019. Methods: This was a diagnostic value study which performed on 113 patients with non-fracture penetrating hand trauma. In the first stage, all patients have been diagnosed with tendon injury by a first-year resident and then ultrasound was performed by a trained 2nd year resident in emergency medicine ward and the results were recorded in a checklist. Further examination of the tendon was performed as well as exploring the site for the patients after the patient was transferred to the orthopaedic service. Final result was recorded in the checklist. Data were analysed by SPSS software and sensitivity and specificity of ultrasound have been calculated. Results: Results showed that ultrasound was able to identify 73 patients of 77 individuals with tendon injury. Of the patients with complete rupture, 45 individuals were correctly diagnosed based on the results of surgery in ultrasound test. Ultrasound and surgical findings were significantly different. Of the 36 individuals without confirmed rupture in surgery, 10 cases were diagnosed with tendon rupture by ultrasound. Of 52 cases of complete rupture based on surgical findings, 45 individuals were correctly diagnosed based on the results of surgery. Twenty-one patients were correctly diagnosed based on ultrasound out of 25 cases of partial rupture based on surgical findings. Conclusion: Overall, the results of the present study show that ultrasound is not very sensitive and specific in diagnosing of upper extremity tendon rupture and cannot be used as a reliable alternative in diagnosing of upper exteremity rupture; however, further studies is essential according to the limitations of this research. The limitations were low sample size in subgroups analysis based on the presence of complete or partial rupture and performing the ultrasound by an emergency medicine resident who is less experienced rather than radiologists.
Navid Kalani; Seyed Reza Habibzade; Roya Ghahremaninezhad; Ayoub Tavakolian; Naser Hatami; Saeed Barazandeh pour; Samaneh Abiri
Volume 8, Issue 2 , April 2020, , Pages 111-114
Abstract
Objective: To evaluate the diagnostic accuracy of history taking and physical examination in the patients with traumatic rib fractures. Methods: In a cross-sectional study, all patients with multiple traumas who referred to the emergency department were evaluated for the mechanism of injury, chief complaints, ...
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Objective: To evaluate the diagnostic accuracy of history taking and physical examination in the patients with traumatic rib fractures. Methods: In a cross-sectional study, all patients with multiple traumas who referred to the emergency department were evaluated for the mechanism of injury, chief complaints, vital signs and oxygen saturation. History taking and physical examination were performed according to Barbara Bates reference. Fracture was diagnosed based on chest x-ray results and CT scan, if needed. The results were analyzed by receiver operating characteristic (ROC) curves and area under the curve (AUC) analysis. Results: Isolated rib fractures of thoracic bones were found in 8 out of 99 subjects with mean age of 33.4±19.43 years. In the sensitivity analysis of history taking and physical exam tests, the highest sensitivity was chest tenderness and deformity with 100% sensitivity for each one and the lowest was for the dyspnea with 28.10%; however, the highest sensitivity was for dyspnea with 62.50% sensitivity; and pulmonary hearing aid and chest deformity were not specific (0%). For heart rate, AUC analysis was significant. Heart rate above 80/min was associated with 87.5% sensitivity and 62.5% specificity for rib fractures. Conclusion: Proper and physical examination and history taking can help to detect rib fractures with high sensitivity and specificity denoting to the importance of the issue; while, radiographic or surgical approval is required to diagnose rib fractures.
Alireza Pedram; Fatemeh Asadian; Naghmeh Roshan
Volume 7, Issue 3 , July 2019, , Pages 278-283
Abstract
Objective: To evaluate the diagnostic accuracy of ultrasonography in pediatric acute appendicitis.Methods: In this cross-sectional study, 230 children aged 5-15 years with the diagnosis of acute appendicitis were studied. This study included the evaluation of demographic indices, ultrasound findings ...
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Objective: To evaluate the diagnostic accuracy of ultrasonography in pediatric acute appendicitis.Methods: In this cross-sectional study, 230 children aged 5-15 years with the diagnosis of acute appendicitis were studied. This study included the evaluation of demographic indices, ultrasound findings at diagnosis, and then comparing the results with the description of the patient's procedure and the pathology report of these patients. Patients who did not undergo ultrasound before surgery or their ultrasound did not include the evaluation of appendicitis or their pathologic report was not available were excluded.Results: Overall, we have included a total number of 230 children with clinical diagnosis of acute appendicitis among whom there were 121 (52.6%) girls and 109 (47.4%) boys with mean age of 11.44 ± 2.90 years. Preoperative ultrasound report showed that 51.3% were normal and 48.7% had acute appendicitis. 34.8% had normal appendix and 65.2% had a pathological diagnosis of acute appendicitis. The sensitivity and specificity of ultrasound in these children were 58% and 68%, respectively. Positive and negative predictive values were 77% and 46%, respectively. The area under curve (AUC) was 0.853 (CI 95% 0.788-0.917) indicating a test with moderate accuracy. Conclusion: According to the obtained results, abdominal ultrasonography is of acceptable diagnostic accuracy in pediatric patients with acute appendicitis. The use of auxiliary techniques in ultrasound would increase the sensitivity and specificity in the diagnosis of acute appendicitis in children.
Shahram Paydar; Behnam Dalfardi; Bardia Zangbar-Sabegh; Hossein Heidaripour; Leila Pourandi; Alireza Shakibafard; Mehdi Tahmtan; Leila Shayan; Mohammad Hadi Niakan
Volume 6, Issue 1 , January 2018, , Pages 26-30
Abstract
Objective: To determine the predictive value of repeated abdominal ultrasonography in patients with multiple trauma and decreased level of consciousness (LOC).Methods: This prospective cross-sectional study was conducted over a six-month period at Shahid Rajaee Trauma Hospital, Shiraz, Iran. We included ...
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Objective: To determine the predictive value of repeated abdominal ultrasonography in patients with multiple trauma and decreased level of consciousness (LOC).Methods: This prospective cross-sectional study was conducted over a six-month period at Shahid Rajaee Trauma Hospital, Shiraz, Iran. We included hemodynamically stable blunt abdominal trauma patients with a decreased LOC (Glasgow Coma Scale ≤ 13) who were referred to the neurosurgery ICU ward. Included cases underwent 1 contrast-enhanced CT scan and two-time ultrasonographic study of the abdomen with an interval of 48 hours. The diagnostic accuracy of the ultrasonography was determined according to the CT-scan results.Results: Overall 80 patients with mean age of 37.75 ± 18.67 years were included. There were 17 (21.3%) women and 63 (78.8%) men among the patients. Compared with the CT-Scan, the first ultrasonography showed a sensitivity of 60%, specificity of 80%, PPV of 16.60%, NPV of 96.80%, and a diagnostic accuracy of 70%. The same values for the second ultrasonographic study were 80%, 79%, 20%, 98%, and 79%, respectively. In 4 (5%) patients whose first ultrasonography and CT scan results were negative, the second ultrasonography was positive for injury.Conclusion: In patients with blunt trauma to the abdomen, when the only indication of abdominal CT scan is a decreased LOC, two ultrasonographic studies can replace a CT imaging.
Hosseinali Khalili; Golnaz Yadollahikhales; Mohammad Isaee
Volume 3, Issue 2 , April 2015, , Pages 53-58
Abstract
Objective: To determine the diagnostic value of serum white blood cell (WBC) count, fever (>38˚C) and WBC rise (>10%) for bacterial meningitis in patients with severe traumatic brain injury (TBI).Method: This cross-sectional study was conducted in Shahid Rajaei hospital affiliated with Shiraz ...
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Objective: To determine the diagnostic value of serum white blood cell (WBC) count, fever (>38˚C) and WBC rise (>10%) for bacterial meningitis in patients with severe traumatic brain injury (TBI).Method: This cross-sectional study was conducted in Shahid Rajaei hospital affiliated with Shiraz University of Medical Sciences during a 1-year period from 2013 to 2014. We included consecutively all the patients with severe TBI admitted to our center during the study period who were febrile (>38˚C orally) and underwent lumbar puncture (LP) and analysis and culture of cerebrospinal fluid (CSF). Laboratory analysis of CSF and blood were performed within 2 hours of LP. CSF culture was considered the gold standard for diagnosis of bacterial meningitis. The sensitivity, specificity, positive and negative predictive value (PPV, NPV) of peripheral blood WBC count, fever (>38˚C) and WBC rise (>10%) was determined according to the CSF culture.Results: Overall we included242 consecutive patients with severe TBI. The mean age of the participants was 32.8 ± 17.4 years. Acinetobacter was the most common organism found in the CSF cultures. The sensitivity and specificity of peripheral WBC count (>10,000)was 48.4% (95% CI: 0.42-0.56) and 47% (95% CI: 0.37-0.58) respectively. The PPV and NPV was 13.1% (95% CI: 0.33-0.52) and 84.8% (95% CI: 0.42-0.61), respectively. The AUC for WBC count was 0.478 (95% CI: 0.37-0.58) indicating low accuracy for the diagnosis of bacterial meningitis. The AUC for WBC rise (>10%) and temperature >38˚C was0.460 (95% CI: 0.351-0.569) and 0.517 (95% CI: 0.410-0.624) respectively, both indicating low accuracy for diagnosis of bacterial meningitis. Conclusion: The results of the current study indicates that peripheral blood leukocyte count, fever (>38˚C) and WBC rise (>10%) is a non-reliable marker for diagnosis of bacterial meningitis in patients with severe TBI.
