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Register a new userDiagnostic Value of Cytology in the Evaluation of the Biliary Tree Strictures
القيمة التشخيصية للدراسة الخلوية (Cytology) في دراسة تضيقات الشجرة الصفراوية
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أُجري هذا البحث لدراسة دور الدراسة الخلوية (cytology) بالفرشاة في تحديد سبب التضيق ضمن الشجرة الصفراوية . حيث أنّ الفرشاة تُعتبر تقنيةً ذاتَ قيمةٍ كبيرةٍ لتوفير العينات الخلوية أثناء إجراء تصوير الطرق الصفراوية و المعثكلية التنظيري بالطريق الراجع (ERCP) لمرضى التضيق الصفراوي . شملت الدراسة 34 مريضاً مع تضيق صفراوي , و تم إجراء ERCP لجميع المرضى و أخذت عينات للدراسة الخلوية باستخدام الفرشاة . و خلال مدة الدراسة التي بلغت عاماً , تم وضع التشخيص النهائي لجميع هؤلاء المرضى بمقاربة منهجية (سريرية , شعاعية , مخبرية , نسيجية بخزعات جراحية ) . و دُرست حساسية و نوعية الفرشاة لتشخيص التضيق الخبيث و بلغت حساسيتها 57.1% , نوعية 100% , قيمة تنبؤية إيجابية 100% , قيمة تنبؤية سلبية 76.9 % , و دقة تشخيصية 82%. النتيجة : إن الدراسة الخلوية بالفرشاة تملك نوعيةً عاليةً جداً و لكن حساسيةً متوسطة لتشخيص التضيق الخبيث و مع ذلك فيهي ذات فائدةٍ تشخيصيةٍ عاليةٍ للتمييز بين الأسباب الخبيثة و الحميدة للتضيق الصفراوي .
This research is designed to study the diagnostic yield of brush cytology for biliary strictures. Brush cytology technique is of a great value to provide cytological samples during ERCP for patients with biliary strictures . The study included 34 patients with biliary stricture, ERCP was performed to all patients and cellular samples were taken using a brush for cytology . During the study period (one year) , the final diagnosis was made using a systematic approach based on clinical, radiological, laboratory or histopathological diagnosis . Sensitivity and specificity of brush cytology were studied . The sensitivity of biliary brushing was 57.1% , specificity was 100%, positive predictive value was 100% , negative predictive value was 76.9% and accuracy was 82% . Conclusions: Brush cytology has a very high specificity but an intermediate sensitivity for the diagnosis of malignant biliary strictures . Despite that , brush cytology is of a high diagnostic utility to distinguish between malignant and benign causes of biliary strictures .
References used
VECCHIO R, FERRARA M, PUCCI L, MELI G, LATTERI S. [Treatment of iatrogenic lesions of the common bile duct] [Italian]. Minerva Chir. 1995 Jan-Feb. 50(1-2):29-38
HANAU LH, STEIGBIGEL NH. Acute (ascending) cholangitis. Infect Dis Clin North Am. 2000 Sep. 14(3):521-46
HASTIER P, BUCKLEY JM, PETEN EP, DUMAS R, DELMONT J. Long term treatment of biliary stricture due to chronic pancreatitis with a metallic stent. Am J Gastroenterol. 1999 Jul. 94(7):1947-8
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differentiating between a malignant and benign thyroid nodule. It greatly influences the
treatment decision.
Aim : This study aimed to evaluate the accuracy of fine
needle aspiration cytology
(FNAC) in the diagnosis of thyroid nodules by evaluating the cytology–histopathology
correlation .
Materials and Methods : This is a prospective study of 49 diagnosed cases of thyroid
nodules who underwent FNAC and histological study of surgical biopsies for diagnosis at
Tishreen University Hospital , during the period between march 2017 – march 2018 .The
results were categorized according to Betheseda classification into:
insufficient for diagnosis, benign, follicular lesion of undetermined significance, follicular
neoplasm, suspicious for malignancy, and malignant sampling. The final histologic
diagnosis was considered the gold standard.
Results : The study included 49 cases presented with thyroid nodules who underwent
diagnostic thyroid FNAC. Female to male ratio was 7.2:1, and the mean age was 43.6
years.
Thirty –nine cases (79.6%) were diagnosed as benign, 3 cases (6.1%) as unsatisfactory , 2
cases (4.1%) as follicular neoplasm, 2 cases (4.1%) as suspicious for malignancy, 2 cases
(4.1%) as malignant, and 1 case (2%) as follicular lesion of undetermined significance.
Nodular goitre represented the majority of benign cases (62.8%), while papillary
carcinoma was the most frequent malignant lesion (83.3%).
Cytologic diagnoses were compared with their corresponding final histologic ones. FNAC
achieved a sensitivity of 83.3%, a specificity of 97.4%, a positive predictive value of
83.3%, a negative predictive value of 97.4%, a false positive rate of 2.5% , a false negative
rate of 16.6% , and a total accuracy of 95.5%.
Conclusion : FNA cytology is a sensitive, specific, and accurate initial diagnostic test for
the evaluation of patients with thyroid nodules.
Background and objectives: The advent of high-resolution MRI with a dedicated epilepsy protocol improves the ability to identify possible structural abnormalities that underlie seizure disorders. The aims of this study were to evaluate the diagnostic
efficacy of standard MRI, identify whether there is an increase in the diagnostic yield with the addition of dedicated seizure protocol, and compare the diagnostic yields of MRI and electroencephalogram (EEG) individually and in combination. Subjects and Methods: This was a cross-sectional analytic study, included 100 cases who presented with seizure over 18 months. Patients underwent complete neurological examination, EEG, and MRI with a standard and dedicated epilepsy protocol. Results: We found epileptogenic lesions in MRI in 55.5. Mesial temporal lobe sclerosis was the most common epileptogenic lesion (45.5%). The diagnostic efficacy of MRI had increased with dedicated epilepsy protocol compared to standard protocol. Abnormal MRI and EEG were compatible in 21%. Conclusion and implications: Dedicated epilepsy protocol increased the diagnostic efficacy of brain MRI in detecting a structural epileptogenic lesion, with 100% of mesial temporal sclerosis, the most common lesion in our study, was detected only in dedicated epilepsy protocol and missed in standard protocol.
Introduction: Urinary tract infections are very common in childhood (especially under the age of 5 years) and because of the large number of complications resulting from it (renal failure – hypertension- kidney scarring) had to be diagnosed and early
treatment, although that urine culture is the standard Golden diagnosis, but its results are late to appear, Many studies have indicated an accompanying increase in platelet counts in urinary tract infections, so that platelet counts may be a vital indicator directed to it without asylum to the costly analyzes in its diagnosis. Objective: the objective of the following study is to assess the sensitivity and specificity of the plate count (PLT) in UTI. Methods: The study included 65 Patients (14 males, 51females) They were between (3-6) year with upper urine tract infections were diagnosed through symptoms, urological test, Serum tests, and radiology, who were admitted to the pediatric department at Tishreen University Hospital in Lattakia City. PLT was obtained through a complete CBC blood count (sensitivity and sensitization), and comparison of the ratio Percentage of Thrombocytosis between urine culture with Gram-positive germs and Gram-negative germs. Results: The study showed a good sensitivity=80.39% [75–84] to platelet counts compared to urine culture. it also showed statistically significant paper p-value=0.003 between platelet count and type of pathogen (positive or negative Gram) and the increase was more favorable to positive urine culture. Also showed that the average value of platelets is higher in culture a positive gram 521.9±90.9 x103 platelet/mcl than in gram negative 432.3±73.5 x103 platelet/mcl. Conclusion: higher Platelet numbers are a good analysis or sensitivity for the diagnosis of upper urinary tract infection in children with reliable urinary symptoms to start treatment. So that we get the results of culture urine .and the higher platelet count must be taken gram positive bacteria into account.
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The objective of this research is to insist on the most important symptoms and signs
of appendicitis and diagnosis in a timely manner to avoid complications and deaths. The
aim of the study was to establish diagnostic criteria for acute appendiciti
s in children in the
light of the data obtained from the study of a large number of patients with appendicitis
and to determine the surgical indication to reduce complications and negative abdominal
opening and to include the studied criteria in a spec
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this scale. The study included 104 children who visited the Pediatric emergency
department at Al-Assad University and University Hospital and Tishreen university
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patients was 76 patients and 28 females, abdominal pain was present in all patients, The
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acute appendicitis. In comparison with international standards, we observed that the scale
studied in our study is more objective and eliminates the subjective factor in the diagnosis
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