Diagnostic Profile Research Articles

Diagnostic Accuracy of the Standing Test in Adults Suspected for Congenital Long-QT Syndrome.

Background An elegant bedside provocation test has been shown to aid the diagnosis of long-QT syndrome (LQTS) in a retrospective cohort by evaluation of QT intervals and T-wave morphology changes resulting from the brief tachycardia provoked by standing. We aimed to prospectively determine the potential diagnostic value of the standing test for LQTS. Methods and Results In adults suspected for LQTS who had a standing test, the QT interval was assessed manually and automated. In addition, T-wave morphology changes were determined. A total of 167 controls and 131 genetically confirmed patients with LQTS were included. A prolonged heart rate-corrected QT interval (QTc) (men ≥430 ms, women ≥450 ms) at baseline before standing yielded a sensitivity of 61% (95% CI, 47-74) in men and 54% (95% CI, 42-66) in women, with a specificity of 90% (95% CI, 80-96) and 89% (95% CI, 81-95), respectively. In both men and women, QTc≥460 ms after standing increased sensitivity (89% [95% CI, 83-94]) but decreased specificity (49% [95% CI, 41-57]). Sensitivity further increased (P<0.01) when a prolonged baseline QTc was accompanied by a QTc≥460 ms after standing in both men (93% [95% CI, 84-98]) and women (90% [95% CI, 81-96]). However, the area under the curve did not improve. T-wave abnormalities after standing did not further increase the sensitivity or the area under the curve significantly. Conclusions Despite earlier retrospective studies, a baseline ECG and the standing test in a prospective evaluation displayed a different diagnostic profile for congenital LQTS but no unequivocal synergism or advantage. This suggests that there is markedly reduced penetrance and incomplete expression in genetically confirmed LQTS with retention of repolarization reserve in response to the brief tachycardia provoked by standing.

Distinguishing between ICD-11 complex post-traumatic stress disorder and borderline personality disorder: clinical guide and recommendations for future research.

Although complex post-traumatic stress disorder and borderline personality disorder are distinct disorders, there is confusion in clinical practice regarding the similarities between the diagnostic profiles of these conditions. We summarise the differences in the diagnostic criteria that are clinically informative and we illustrate these with case studies to enable diagnostic accuracy in clinical practice.

THE PROFILE OF DIAGNOSTIC OF UNCATEGORIZED SYNDROME TREATED BY ISLAMIC SPECIFIC PRAYER IN NUR HIDAYAH HOSPITAL

In daily practice, there are many patients that medically are not sick but suffer from illness. Those syndrome categories to be psychosomatic disorder (ICD 10). Islam believes about the power of an evil spirit. It can invade and attack a person caused illness. Physical exam and laboratory finding can be normal. They need islamic specific praying to relieve their suffering. The research design is a cross sectional study. Subjects in this study are patients at Nur Hidayah Hospital in 2014 - 2019 to whom receiving Islamic specific praying (ruqyah syar’iyyah). There are 369 patients treated by Islamic specific praying, but in the beginning, there is no standardized recording. The complete data of 22 patient are collected and statistically analyzed. The medical diagnosis of the subjects is: gastrointestinal disorders (10; 45%); cephalgia-epilepsy (5; 22%) anxiety disorders (4; 18%), sexual disorders (3; 13%). The reaction of treatment is vomiting, headache, heat sensation, and delirium. After those kinds of reaction, the patient relief from suffering and cure their illness. It is studied the diagnostic profile of Islamic specific praying in Nur Hidayah Hospital. Ruqyah Syar’iyyah can be used as complementary treatment

Natural course of IgE-mediated food allergy in children.

The prevalence of food allergy and food-induced anaphylaxis in children is increasing worldwide. Cow's milk, hen's eggs, and wheat allergies in young children have a more favorable prognosis with a relatively early outgrow, while allergies to peanuts, tree nuts, and seafood are more likely to be persistent. Although our understanding of the mechanism underlying the resolution of food allergy is incomplete, the roles of dendritic cells, regulatory T cells, and regulatory B cells are important. Many past studies on the natural course of food allergy were retrospective analyses of specific study groups, but large-scale population-based prospective studies are now being published. This review summarizes recent studies of the natural course of cow's milk, hen's eggs, wheat, peanuts, tree nuts, soy, sesame, and seafood allergies. The potential factors affecting the natural course of food allergy include symptom severity on ingestion, age at diagnosis, allergic comorbidities, skin prick test reaction size or serum food-specific immunoglobulin (Ig) E levels, changes in sensitization degree, IgE epitope specificity, ratio of food-specific IgE to IgG4, food-specific IgA levels, component-resolved diagnostic profile, diet, gut microbiome, and interventions such as immunotherapy. Since food allergy places a significant burden on patients and their caregivers in daily life, clinicians should be able to provide relevant knowledge on the natural course of food allergy, appropriately evaluate its resolution, and offer therapeutic options whenever possible.

The Contribution of Society of Social Psychiatry P. Sakellaropoulos to the Psychiatric Reform in Rural Greece

The present paper aims to describe the structure, function, and goals of two of the oldest Mobile Mental Health Units in Greece, namely, the Mobile Mental Health Unit in Fokida (MMHU-F) and the Mobile Mental Health Unit in Thrace (Alexandroupolis, MMHU-T). Information about their historical background, catchment areas, and current staffing, as well as the services provided by each MMHU is discussed. The focus of the paper is slightly biased towards the MMHU-F because it is the only available mental health service in the whole Fokida prefecture. The major goals of the MMHUs are the diagnosis, treatment, and prevention of relapse of severe mental illness within the community. Other important goals of the MMHUs are psychoeducation, psychological support for the family/caregivers, as well as vocational training and support for patients with severe mental illness. Statistical data depicting the demographic characteristics and diagnostic profiles of patients in each MMHU is also provided, and the differences between the two MMHUs are briefly discussed.

Evaluating diaphragmatic dysfunction and predicting non-invasive ventilation failure in acute exacerbation of chronic obstructive pulmonary disease in India.

Baseline diaphragmatic dysfunction (DD) at the initiation of non-invasive ventilation (NIV) correlates positively with subsequent intubation. We investigated the utility of DD detected 2 hours after NIV initiation in estimating NIV failure in acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients. In a prospective-cohort design, we enrolled 60 consecutive patients with AECOPD initiated on NIV at intensive care unit admission, and NIV failure events were noted. The DD was assessed at baseline (T1 timepoint) and 2 hours after initiating NIV (T2 timepoint). We defined DD as ultrasound-assessed change in diaphragmatic thickness (ΔTDI) <20% (predefined criteria [PC]) or its cut-off that predicts NIV failure (calculated criteria [CC]) at both timepoints. A predictive-regression analysis was reported. In total, 32 patients developed NIV failure, nine within 2 hours of NIV and remaining in next 6 days. The ∆TDI cut-off that predicted NIV failure (DD-CC) at T1 was ≤19.04% (area under the curve [AUC], 0.73; sensitivity, 50%; specificity, 85.71%; accuracy; 66.67%), while that at T2 was ≤35.3% (AUC, 0.75; sensitivity, 95.65%; specificity, 57.14%; accuracy, 74.51%; hazard ratio, 19.55). The NIV failure rate was 35.1% in those with normal diaphragmatic function by PC (T2) versus 5.9% by CC (T2). The odds ratio for NIV failure with DD criteria ≤35.3 and <20 at T2 was 29.33 and 4.61, while that for ≤19.04 and <20 at T1 was 6, respectively. The DD criterion of ≤35.3 (T2) had a better diagnostic profile compared to baseline and PC in prediction of NIV failure.

Accuracy of Narrow-Band Imaging Bronchoscopy for Early Diagnosis of Airway Cancer Lesions: A Systematic Review and Meta-analysis

Context: The accuracy of narrow-band imaging (NBI) is a technology imaging for the assessment of lung cancer. Objectives: We aimed at summarizing the diagnostic profile of NBI for the early diagnosis of airway cancer lesions. Methods: We used PubMed, Scopus, and EMBASE databases to search for eligible studies published up to October 2022. Eligible studies have investigated the diagnostic profile of bronchoscopy NBI for the early diagnosis of lung cancer. The index test was NBI bronchoscopy, and the reference test was the histopathological results of lung cancer based on the World Health Organization (WHO) classification. In eligible studies, the detected lesions were confirmed by histopathology. We extracted true positive (TP), true negative (TN), false positive (FP), and false negative (FN) from the eligible studies to calculate the diagnostic profile of NBI. the quality assessment of diagnostic accuracy studies-2 (QUADAS-2) assessment was used as a tool to assess the risk of bias. A random-effects model was used to pool the summary receiver operating characteristic curve, specificity, and sensitivity. Results: Five studies were included, involving 1267 subjects with 1850 biopsy specimens. The overall pooled sensitivity and specificity for NBI bronchoscopy for the early detection of airway cancer lesions were 98% (95% confidence interval [CI]: 89% - 100%) and 77% (95% CI: 62% - 88%), respectively. All I2 values for sensitivity and specificity were 35.93% and 85%, respectively, with a P-value of 0.001. The positive LR was 4.35 (95% CI: 2.51 - 7.54, P &lt; 0.001), and the negative LR was 0.03 (95% CI: 0.01 - 0.14, P = 0.006). The area under the receiver operating characteristic curve was 0.95 (95% CI: 0.92 - 0.96). Conclusions: Narrow-band imaging bronchoscopy can be used as a diagnostic modality for the early diagnosis of airway cancer lesions with good diagnostic accuracy.

Predictive role of radiomics features extracted from preoperative cross-sectional imaging of pancreatic ductal adenocarcinoma in detecting lymph node metastasis: a systemic review and meta-analysis.

Lymph node metastases are associated with poor clinical outcomes in pancreatic ductal adenocarcinoma (PDAC). In preoperative imaging, conventional diagnostic modalities do not provide the desired accuracy in diagnosing lymph node metastasis. The current review aims to determine the pooled diagnostic profile of studies examining the role of radiomics features in detecting lymph node metastasis in PDAC. PubMed, Google Scholar, and Embase databases were searched for relevant articles. The quality of the studies was examined using the Radiomics Quality Score and Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tools. Pooled results for sensitivity, specificity, likelihood, and odds ratios with the corresponding 95% confidence intervals (CIs) were calculated using a random-effect model (DerSimonian-Liard method). No significant publication bias was detected among the studies included in this meta-analysis. The pooled sensitivity of the validation datasets included in the study was 77.4% (72.7%, 81.5%) and pooled specificity was 72.4% (63.8, 79.6%). The diagnostic odds ratio of the validation datasets was 9.6 (6.0, 15.2). No statistically significant heterogeneity was detected for sensitivity and odds ratio (P values of 0.3 and 0.08, respectively). However, there was significant heterogeneity concerning specificity (P = 0.003). The pretest probability of having lymph node metastasis in the pooled databases was 52% and a positive post-test probability was 76% after the radiomics features were used, showing a net benefit of 24%. Classifiers trained on radiomics features extracted from preoperative images can improve the sensitivity and specificity of conventional cross-sectional imaging in detecting lymph node metastasis in PDAC.

Molecular profile of patients with inborn errors of immunity from Nepal

Background and AimsInborn errors of immunity (IEIs) are increasingly being diagnosed in various regions of the world. There are significant challenges in the diagnosis and treatment of IEIs in resource-limited countries. With the availability of one immunologist and increasing awareness, IEIs are diagnosed with increasing frequency and accuracy in Nepal. IEIs are also being evaluated in children presenting with autoimmune manifestations. We describe the profile of patients diagnosed with IEIs in Nepal during 2020–2022. MethodsRecords of all patients with IEIs who were diagnosed and treated at our tertiary care center in Nepal from August 2020 to April 2022 were analysed. Lead author (DB) has examined and diagnosed all cases. IEIs were diagnosed based on the European Society for Immunodeficiencies (ESID) diagnostic criteria and genetic analysis. ResultsThirty-two patients with IEI (19 boys; 13 girls) and 801 children with autoimmune disorders were diagnosed during the study period. Genetic analysis was done on 18 patients. The diagnostic profile of the patients includes patients with chronic granulomatous disease, X-linked agammaglobulinemia, severe combined immunodeficiency, Job syndrome, selective IgA deficiency, specific antibody deficiency, Wiskott-Aldrich Syndrome, CTLA4 deficiency, IPEX syndrome, IFN-IL12 axis defect, hereditary angioedema, MonoMac syndrome, ARPC1B deficiency, leukocyte adhesion defect, PAPA syndrome, autoimmune lymphoproliferative syndrome, ADA2 deficiency, early-complement deficiency lupus, familial cold auto-inflammatory syndrome, A20 haploinsufficiency, and Blau syndrome. Some patients succumbed before the scope of diagnosis. HSCT is planned for 3 patients. ConclusionsOur is the first report of genetically proven IEIs in Nepal. Logistic constraints coupled with a lack of awareness of IEIs among laity and pediatrician accounted for a missed diagnosis, late diagnosis, and poor outcomes in resource-limited settings. Antimicrobial prophylaxis reduced the incidence of breakthrough infections. The lack of HSCT facilities precludes definitive treatment of many IEIs.

Uncommon Medical Diagnostic Profiles in Psychiatric Settings Across South-South Nigeria

Background: Some medical disorders occurring in psychiatric settings cause diagnostic delays and missed diagnoses which may lead to poor prognosis and outcomes.

Circulation of Pestiviruses in Small Ruminants from Greece: First Molecular Identification of Border Disease Virus.

The incidence of small ruminant pestivirus infections in Greece remains unknown as they have not been diagnosed in the country since 1974 when the most recent Border Disease Virus (BDV) outbreak was reported. The objective of our study was to explore the possible occurrence of pestiviral infections among sheep and goat farms in Greece and to further determine the variants of major concern. Thus, serum samples were collected from 470 randomly selected animals belonging to 28 different flocks/herds. ELISA on p80 antibody revealed the existence of seropositive animals in four out of the 24 studied sheep flocks, whereas all the goats in the four studied herds were seronegative. Viral RNA and antigens were detected in two sheep out of the four seropositive flocks by RT-PCR and ELISA, respectively. Sequencing and phylogenetic analysis showed that the newly identified Greek variants were closely related to the strains of the BDV-4 genotype. One of the BDV-positive sheep demonstrated the diagnostic profile of a persistently infected (PI) animal, providing additional information regarding the source of the infection. This is the first molecular identification of BDV isolates in Greece. Our findings indicate that BDV infections are likely to remain undiagnosed, highlighting the need for further epidemiological studies and active surveillance programs to determine the prevalence and impact of BDV infections on a countrywide level.

Scrofula: a descriptive study on the clinical and diagnostic profile of patients with tuberculous lymphadenitis

Background: Tuberculosis remains to be the major health burden primarily affecting the developing countries. The commonest is pulmonary tuberculosis. The aim of the study was to study about the clinical presentation of tuberculous cervical lymphadenopathy and to correlate clinical diagnosis with the histopathological findings, management, outcome, follow up and improvement. Methods: A retrospective descriptive study involving 75 patients with cervical lymph node tuberculosis were followed up from the time of diagnosis till the completion of treatment. Results: It is more common in young females (21-30 years). Constitutional symptoms absent in most of the patients. Mantoux and erythrocyte sedimentation rate (ESR) raised in most cases. Fine needle aspiration cytology (FNAC) showed granuloma in 90.6% cases. GeneXpert results showed Mycobacterium tuberculosis (MTB) detected rifampicin (Rif) resistance not detected in 65.3% and MTB detected Rif resistance detected in 6.1%. Most of the patients recovered daily chemotherapy regimen. Surgery was rarely needed. Conclusions: TB is still the commonest cause of cervical lymph node enlargement in developing countries. FNAC is a rapid, cheap, simple, and effective method of diagnosis for cervical lymphadenopathy. Anti-tubercular drugs should be started in patients with FNAC/biopsy showing granuloma even if GeneXpert negative and all the patients must be followed up regularly.

Современные аспекты этиопатогенеза и диагностики синдрома сухого глаза у пациентов рефракционного профиля

Modern literature materials on the main aspects of etiopathogenesis and diagnosis of dry eye syndrome in patients who plan to undergo keratorefractive surgery are presented. There are etiopathogenetic aspects of the development of induced dry eye syndrome after keratorefractive surgery. This requires examination of the ocular surface before and after surgery. There is a phasing in performing diagnostic screening of the xerosis of the ocular surface. A comprehensive diagnostic approach to the examination’s state of the ocular surface, which consists of subjective and objective data, the results of laboratory research methods, creates a holistic view of the homeostasis of the ocular surface in refractive profile patients. This diagnostic profile will determine the choice of optimal refractive surgery technology, patient management tactics and features of the course of the postoperative period. Key words: tear film, ocular surface, dry eye syndrome, refractive surgery

Nocardioides okcheonensis sp. nov., isolated from riverside soil.

An actinobacterial strain designated MMS20-HV4-12T, displaying a high hydrolytic potential for various substrates, was isolated from a riverside soil sample and characterized by polyphasic taxonomic analysis. Growth occurred at 10-37 °C (optimum, 30°C), with NaCl concentrations of 0-4 % (optimum, 0 %) and at pH 7-9 (optimum, pH 8). MMS20-HV4-12T was catalase-positive, oxidase-negative, rod-shaped and formed creamy white-coloured colonies. Based on the results of 16S rRNA gene sequence analysis, MMS20-HV4-12T was found to be mostly related to the type strains of Nocardioides alpinus (98.3 % sequence similarity), Nocardioides furvisabuli (98.1 %) and Nocardioides zeicaulis (98.0 %). MMS20-HV4-12T showed optimal growth on Reaoner's 2A agar, forming white-coloured colonies. The diagnostic polar lipid profile consisted of diphosphatidylglycerol, phosphatidylglycerol and phosphatidylinositol, the major fatty acids were iso-C16 : 0, C17 : 1 ω8c and 10-methyl-C17 : 0, the major isoprenoid quinone was MK-8(H4), the diagnostic cell-wall sugar was galactose, and the cell-wall diamino acid was ll-diaminopimelic acid. The genome of MMS20-HV4-12T was 4.47 Mbp in size with a G+C content of 72.9 mol%. The genome based analysis indicated low relatedness between MMS20-HV4-12T and all compared species of Nocardioides, as the highest digital DNA-DNA hybridization and the orthologous average nucleotide identity values were 26.8 and 83.8% respectively. Based on genotypic, phenotypic and phylogenomic characterization, MMS20-HV4-12T evidently represents a novel species of genus Nocardioides, for which the name Nocardioides okcheonensis sp. nov. (type strain=MMS20-HV4-12T=KCTC 49651T=LMG 32360T) is proposed.

Multiple Myeloma of the Young Subject Revealed In Chronic Hemodialysis: About an Observation and Review of the Literature

Introduction: Multiple myeloma (MM) is a monoclonal proliferation of mature plasma cells. It usually occurs in people over 50 years of age with a peak in frequency at 65 years of age and less than 2% of patients are under 40 years of age. Case presentation: This case report is of a 38 year old black African woman with chronic kidney disease stage 5D. The IR was of glomerular origin (hypertension for 2 years, proteinuria at 4 g/24 hours, oedematous syndrome). Serum protein electrophoresis showed a beta peak at 29.7 g/l and urine protein immunoelectrophoresis showed a kappa/lambda ratio of 8.4. The myelogram showed a rich marrow with 51% plasma cells. Radiography showed multiple cystic images at the upper 1/3 of the left humeral shaft. Renal histology showed minimal glomerular damage. The diagnostic profile of IgG kappa light chain MM with CRAB criteria complicated by chronic glomerulonephritis with unorganised monoclonal immunoglobulin deposits was suggested. Management consisted of chemotherapy with bortezomib and dexamethasone for 4 cycles. The evolution under chronic dialysis was favourable after 1 year. Conclusion: MM in young adults (defined as 19-40 years of age) is rare, but it does exist. In young patients, this condition is initially not considered in the differential diagnosis and the occurrence of IR has a strong prognostic impact. Survival seems to be better in young adults than in elderly patients, which needs to be proven by a longer follow-up.

A clinical impact study of dermatologists’ use of the 23- or 35-gene expression profile tests to guide surgical excision and enhance management plan confidence

Purpose: To understand how dermatologists utilize the results from ancillary diagnostic gene expression profile (dGEP) testing with the 23- or 35-GEP tests to determine optimal patient management strategies. Study: Dermatologists who regularly treat patients with difficult-to-diagnose melanocytic lesions who had previously initiated dGEP testing at least 3 times were eligible to complete the questionnaire in this Institutional Review Board-approved study. There were 24 randomized vignettes presented covering a spectrum of cases with diagnostic/clinical uncertainty such as atypical melanocytic proliferation, dysplastic nevus with regression, deep penetrating melanocytic neoplasm, and atypical intraepidermal melanocytic proliferation. Respondents were provided with a clinical impression and diagnosis in the context of a narrative pathology report with/without a re-excision recommendation; cases were also described without (baseline) and with a dGEP test result (likely benign or likely malignant). Anonymous responses concerning the patient management plan including excision and follow-up recommendations and confidence were captured. Statistical significance was calculated by nonparametric Wilcoxon signed-rank test with continuity correction. Results: In total, 32 dermatologists (84% in a private practice setting) completed the survey, with 50% indicating additional dermatopathology specialization. Approximately 44% of respondents indicated they performed 10-50 biopsies of melanocytic lesions per month, and 31%, greater than 100 per month. When dGEP results were provided, there was an overall increase in management plan confidence, regardless of which dGEP result was provided (benign dGEP 26.2%, malignant dGEP 24.7%). Also, when dGEP results were provided, changes in surgical excision recommendations were statistically significant in 75% of scenarios tested (p &lt; 0.02). Clinical impact was assessed by quantifying the directional shift in treatment in relation to the dGEP result. With regard to excision recommendations across vignettes, benign dGEP results prompted 29.7% of clinicians to decrease their margins or forgo excision altogether. Malignant dGEP results prompted 63.5% of clinicians to increase their surgical excision recommendations. Appropriate alterations in patient follow-up frequency were observed, with 18.8% of clinicians reducing and 43.2% increasing follow-up frequency for patients receiving benign or malignant dGEP results, respectively. Conclusion: The addition of dGEP testing to diagnostic scenarios with confounding clinical features and uncertainty in optimal management prompted important changes in recommendations regarding the need for excision, appropriate margins, and follow-up-frequency. Overall, dGEP tests help to guide clinical decision-making for dermatologists in a variety of otherwise diagnostically ambiguous or clinicopathologically discordant scenarios.

Mixed-phenotype acute leukemia, T/megakaryoblastic: does it really exist?

Mixed-phenotype acute leukemias (MPAL) account for < 4% of all cases of acute leukemias. These are a heterogeneous group of leukemias grouped together by the WHO classification as "rare subtypes." The diagnosis and treatment of MPAL is extremely challenging particularly for low middle income countries. Of these, B/myeloid and T/myeloid combinations are relatively common subtypes. However, megakaryoblastic and erythroid lineages in combination with other lineages are still rare enough to not even be addressed in the WHO classification. To date, there have been only a few reports of mixed B or T cell and megakaryocytic or mixed B or T cell and erythroid leukemias. We report the clinical presentation, diagnostic profile, and disease course of MPAL cases with a biphenotypic pattern consistent with T/megakaryoblastic lineage which is not yet defined in WHO classification. These cases were phenotyped using 8-color flow cytometry (BD FACS CANTO-II) using an extensive panel of markers. Interphase fluorescence in situ hybridization (FISH) was done using dual color dual fusion probes for BCR::ABL1, RUNX1::RUNX1T1, and ETV6::RUNX1, while MLL and CBFB gene rearrangement was tested by break-apart probes. Karyotyping was performed using the conventional GTG-banding technique. Both FISH and karyotyping were analyzed by the automated cell imaging system Leica Biosystems, using Cytovision MB8. The cases presented here satisfy the criteria for both T-lineage assignment (cyCD3 intensity reaches that of normal T-lymphocytes) and acute megakaryoblastic leukemia (≥ 1 megakaryocytic marker in > 50% blasts) and thus represent the first documented examples of this unusual entity from Pakistan. It is crucial to report these cases to gather more data about clinical presentation, diagnostic profile, and disease course. Additionally, the reported cases highlight the limitations of existing classifications which do not address rare subtypes. More importantly, T/megakaryoblastic MPAL needs to be included in the WHO classification as a separate entity.

Evaluation of fetal lung maturity by ultrasound

Background: Monitoring lung development is important for both birth preparation and counselling parents. Clinical procedures such as menstrual history, LMP, pelvic abdomen inspection, and date of quickening can be used to estimate when a foetus' lungs are fully developed. Extra diagnostic procedures include amniocentesis, x-rays, and ultrasounds.Objective: to assess the non-invasive parameters to determine the fetal lung maturity by ultrasound.Patients and Methods: it was is a cross-sectional study was conducted on Department of Obstetrics and Gynecology, Faculty of Medicine, Tanta University Hospitals on 75 pregnant cases. Study duration was from August 2020 till 30th May 2022.Results: Correlation foetal biometry and Shake scores significantly differed among groups. Test, Relation between Placental grading and postnatal lung maturity, Relation between Shake test and postnatal lung maturity and the Diagnostic profile. Conclusion: Based on the previous findings, ultrasound might be a useful method of evaluation of fetal lung maturity. Either of placental grading, free floating particles and shake test are good predictive tools for detecting lung maturity, with the superior hand for the floating particles.

A phenomenological cartography of misophonia and other forms of sound intolerance

People with misophonia have strong aversive reactions to specific "trigger" sounds. Here we challenge this key idea of specificity. Machine learning was used to identify a misophonic profile from a multivariate sound-response pattern. Misophonia could be classified from most sounds (traditional triggers and non-triggers) and, moreover, cross-classification showed that the profile was largely transferable across sounds (rather than idiosyncratic for each sound). By splitting our participants in other ways, we were able to show-using the same approach-a differential diagnostic profile factoring in potential co-morbidities (autism, hyperacusis, ASMR). The broad autism phenotype was classified via aversions to repetitive sounds rather than the eating sounds most easily classified in misophonia. Within misophonia, the presence of hyperacusis and sound-induced pain had widespread effects across all sounds. Overall, we show that misophonia is characterized by a distinctive reaction to most sounds that ultimately becomes most noticeable for a sub-set of those sounds.

A STUDY OF VARIATIONS IN COAGULATION PROFILE AND HEMATOLOGICAL PROFILE OF COVID-19 PATIENTS- IS IT USEFUL IN DECIDING SEVERITY OF DISEASE ?

Background: Since covid has emerged as the most dreadful global health crisis and data on diagnostic profile and morbidity mortality indicators in it is still limited, we propose to study the correlation of morbidity and mortality with values of Inflammatory markers in these patients. To STUDY variations in COAGULATION AND HEMATOLOGI Aim: CAL PROFLE IN COVID-19 PATIENTS and correlating it with severity of disease. using STA Satellite Materials and Methods: automated coagulation analyzer we study PT, INR, APTT. With the help of Snibe maglumi 800 we studied D-dimer. For hematological analysis we use Hemax 330 hematological analyzer for HB, TLC, Neutrophil and Lymphocytes count, Neutrophil lymphocyte ratio, Platelets count. In hematological profile leucocytosis was associated w Results: ith severity and mortality. In coagulation profile D-dimer was associated with severity and mortality. Overall only leukocytosis and raised D-dimer values were associated with death. On the basis of findings in this Conclusion: study coagulation profile and hematological profile Leucocytosis and D-dimer concluded as important predictors of disease severity and outcome.These parameters can be used to identify high-risk patients at resource-limited settings