Predictive Signs Research Articles

Evaluation of clinical and radiographic warning signs for prediction of oroantral communication following tooth extractions

ObjectivesOroantral communication (OAC) is a relatively common and mild complication of maxillary tooth extractions. Preoperative prediction of OAC can reduce treatment duration and prepare both operators and patients for the procedure. This study aims to identify alarming radiographic and clinical indicators that can predict OAC therefore assisting clinical decision making to practicing general dentists.MethodsIn this retrospective case–control study the OAC group consisting of 97 cases and a control group twice the size was established. Clinical data were collected, and measurements were conducted separately by two blinded observers on digital panoramic radiographs. Inter-rater reliability was assessed. In case of disagreement a third observer’s results were utilized. The correlation between OAC and demographic data (age, sex), as well as various factors assessed on panoramic radiographs (including, but not limited to, the length of the root, root projection into the sinus, bone width, presence of mesial and distal adjacent teeth), was statistically evaluated.ResultsInter-rater reliability was found to be excellent. Several factors were identified as potential predictors of OAC. According to our model, the strongest predictors were the distance between the cemento-enamel junction and marginal bone, extent of root projection into the sinus, presence of sinus recess around the roots, angulation, and absence of the mesial adjacent tooth.ConclusionsWell-defined measurements on panoramic radiographs may aid in predicting OAC. Further prospective investigations are necessary to confirm these indicators and address factors related to clinical examination and operation.Clinical relevanceWe present several clinical and radiographic warning signs of OAC that can facilitate pre-extraction decision-making.

Comparison of the Patient Demographics, High-Resolution Computed Tomography Features of the Pulmonary Ground-Glass Opacity and Its Diagnostic Value Analysis

Introduction Pulmonary ground-glass opacity (GGO) observed on computed tomography (CT) is widely regarded as a diagnostic feature of lung adenocarcinoma; however, a significant radiological predictive sign remains controversial. In this retrospective study, we conducted a comprehensive analysis of 206 patients with GGO to establish a correlation analysis model between CT images and diagnosis of GGO nodules. Methods Histopathologic specimens were obtained from 206 patients (130 women, 76 men; age range 24–77). The clinical data, pathologic findings, and thin-section CT features of solid, pure GGO (pGGO), and mixed GGO (mGGO) nodules were compared using rigorous statistical methods, such as t-test, Fisher’s exact test, or univariate logistic regression analysis. Results Significant differences were observed among the 3 groups in terms of patient demographics, including gender (P = 0.016), smoking history (P = 0.002), and nodule size (P = 0.002). Morphologic CT characteristics, such as the presence of spiculated sign, lobulated sign, vascular sign, bubble-lucency sign, or pleural retraction, exhibited significant differences among the solid nodule, pGGO, and mGGO groups. However, no significant differences were observed in terms of air-bronchogram sign. Notably, the incidence of malignancy was significantly higher in pGGO nodules (76.52%) than in solid (48.48%) and mGGO (73.86%) nodules. Patients with mGGO had up to 2.988 times higher hazard of malignant lesions than those with solid nodules [P = 0.036, hazard ratio (HR) = 2.988]. Similarly, the hazard of malignant lesions was 2.941 times higher in patients with pGGO than in those with solid nodules (P = 0.007, HR = 2.941). Conclusion Clinical, pathological, and thin-section CT features of solid, pGGO and mGGO nodules were found to be significantly different. Based on our comprehensive analysis, patients presenting with a mGGO or pGGO on CT scans were more likely to be diagnosed with lung cancer.

“Don’t miss the globe” – Study of diagnostic accuracy of computed tomography in detecting open globe injury

Abstract: PURPOSE: The purpose is to determine the computed tomography (CT) characteristics of open globe injury and establish the relative accuracy and reliability of various features on CT. Second, to assess the significance of a difference in the anterior chamber depths (ACDs) on CT in cases of open globe injury. METHODS: The diagnostic database of our radiology department was retrospectively reviewed to obtain details of patients with a history of blunt or penetrating injury to the orbit between September 2018 and March 2021. A total of 190 patients (144 males and 46 females) were included. A radiologist analyzed the CT scans without prior knowledge of ophthalmologic findings or surgical outcomes. Operative and ophthalmic examination findings were considered the gold standard for comparison. RESULTS: Out of 190 injured globes, the final clinical diagnosis confirmed 54 (28.4%) open globe injuries and 136 (71.5%) closed globe injuries. Between the two groups, intraocular hemorrhage, lens dislocation, lens injury or absence, intraocular foreign body, intraocular air, wall/contour defect, and ACD change were considered statistically significant (P < 0.05). The average sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CT in diagnosing open globe injury were 71.3%, 98.5%, 83.6%, 95.75%, and 94.9%, respectively. CONCLUSION: Globe contour deformity or defect, intraocular hemorrhage, and a change in ACD were the three most predictive signs of open globe injury. CT is of valuable help in a multi-trauma setting and in an uncooperative patient for ophthalmological examination to draw attention to globe injury. However, CT examination alone is insufficient in detecting all cases of open globe injury. There is a need for a more collaborative approach among emergency physicians, ophthalmologists, and radiologists.

Predictive Value of the Nomogram Model Based on Multimodal Ultrasound Features for Benign and Malignant Thyroid Nodules of C-TIRADS Category 4.

To explore the predictive value of the nomogram model based on multimodal ultrasound features for benign and malignant thyroid nodules of C-TIRADS category 4. A retrospective analysis was conducted on the general conditions and ultrasound features of patients who underwent thyroid ultrasound examination and fine needle aspiration biopsy (FNA) or thyroidectomy at the Affiliated Hospital of Zunyi Medical University from April 2020 to April 2023. Predictive signs for benign and malignant nodules of thyroid C-TIRADS category 4 were screened through LASSO regression and multivariate logistic regression analysis to construct a nomogram prediction model. The predictive efficiency and accuracy of the model were assessed through ROC curves and calibration curves. Seven independent risk factors in the predictive model for benign and malignant thyroid nodules of C-TIRADS category 4 were growth pattern, morphology, microcalcifications, SR, arterial phase enhancement intensity, initial perfusion time, and PE [%]. Based on these features, the area under the curve (AUC) of the constructed prediction model was 0.971 (p ＜ .001, 95% CI: 0.952-0.989), with a prediction accuracy of 93.1%. Internal validation showed that the nomogram calibration curve was consistent with reality, and the decision curve analysis indicated that the model has high clinical application value. The nomogram prediction model constructed based on the multimodal ultrasound features of thyroid nodules of C-TIRADS category 4 has high clinical application value.

Proportion of confluent B-Lines predicts respiratory support in term infants shortly after birth

ObjectiveTo develop and evaluate the predictive value of a simplified lung ultrasound (LUS) method for forecasting respiratory support in term infants.MethodsThis observational, prospective, diagnostic accuracy study was conducted in a tertiary academic hospital between June and December 2023. A total of 361 neonates underwent LUS examination within 1 h of birth. The proportion of each LUS sign was utilized to predict their respiratory outcomes and compared with the LUS score model. After identifying the best predictive LUS sign, simplified models were created based on different scan regions. The optimal simplified model was selected by comparing its accuracy with both the full model and the LUS score model.ResultsAfter three days of follow-up, 91 infants required respiratory support, while 270 remained healthy. The proportion of confluent B-lines demonstrated high predictive accuracy for respiratory support, with an area under the curve (AUC) of 89.1% (95% confidence interval [CI]: 84.5-93.7%). The optimal simplified model involved scanning the R/L 1–4 region, yielding an AUC of 87.5% (95% CI: 82.6-92.3%). Both the full model and the optimal simplified model exhibited higher predictive accuracy compared to the LUS score model. The optimal cut-off value for the simplified model was determined to be 15.9%, with a sensitivity of 76.9% and specificity of 91.9%.ConclusionsThe proportion of confluent B-lines in LUS can effectively predict the need for respiratory support in term infants shortly after birth and offers greater reliability than the LUS score model.

Longitudinal Study of Oral Precancerous Lesions: Transformation Rate and Predictive Markers for Malignancy.

One of the main risk factors for the occurrence of oral cancer is oral precancerous lesions (OPLs). Early management and preventive efforts depend on knowing the transformation rate and detecting predictive signs of malignancy. For 6 months, a group of 200 individuals with clinically diagnosed OPLs was followed up on in this longitudinal research. To examine biomarker expression levels and describe the lesions, examinations using immunohistochemistry, histopathology, and clinical methods were carried out. Over the course of 2 years, 200 patients with OPLs were monitored in this study. Most lesions had mild dysplasia, according to histopathological examination. The expression of many biomarkers that were correlated with the dysplasia grade were p53 (60.0%), Ki-67 (40.0%), CDKN2A (30.0%), and epidermal growth factor receptor (EGFR) (25.0%). In summary, this study emphasizes how crucial it is to provide patients with OPLs with individualized care plans and routine surveillance. Certain biomarkers, such EGFR, Ki-67, and p53, can be useful prognostic markers for identifying malignant transformation. To confirm these results and create tailored therapies for high-risk patients, more study is necessary.

Analysis of the significance of echocardiographic signs of right ventricular dysfunction for predicting the outcome of heart failure with reduced left ventricular ejection fraction

Objective: to determine the ultrasound signs of right heart dysfunction, which increase the prognostic value of the recommended parameters of left ventricular (LV) dysfunction in patients with heart failure with reduced ejection fraction (HFrEF).Materials and methods. The prospective study included 79 patients with HFrEF LV with clinical manifestations of chronic heart failure functional class III according to the New York Heart Association (HF NYHA Class III) in 52 patients (65.8%) and HF NYHA Class IV in 27 (34.1%). The primary end point was death during a follow-up period of up to 3 years while waiting for heart transplantation.Results. Overall mortality was 33 patients (41.7%), 17 (21.5%) during the 1st year of follow-up. Regression analysis revealed the following independent ultrasound predictors of poor prognosis: LV ejection fraction on 3D-echocardiography (3DE LVEF), p = 0.014; global longitudinal strain of the LV (GLS LV), p = 0.010, and of the interventricular septum basal segment (IVSLS BS), p = 0.012; mean longitudinal strain of the basal segment of the right ventricle free wall (FWLS BS RV), p = 0.003. Changes in the configuration and dilatation of the LV cavity, an increase in LV end-diastolic pressure, impaired contractility, and strain of the LV myocardium can affect the function of the right ventricle (RV) through the common interventricular septum (IVS). Dilatation of the RV due to an increase in the end diastolic area (RV EDA) of more than 30 cm2 (p = 0.012) and end systolic area (RV ESA) of more than 25 cm2 (p = 0.001), an increase in the volume of the right atrium (3DE AKI) of more than 100 ml (p = 0.036), and a decrease in the % inspiratory collapse of the inferior vena cava (% IVC) less than 30% (p = 0.005) demonstrated a prognostic significance in the observed patients. A decrease in the deformation properties of the pancreas due to the longitudinal component and impaired strain of the basal segment makes a greater contribution to RV dysfunction (FWLS BS, % < -15% (p < 0.001)).Conclusions. RV dysfunction in patients with HFrEF is an unfavorable prognostic factor, independently associated with existing LV dysfunction. The most significant ultrasound sign for surveillance prediction of patients with LV HFrEF and RV dysfunction are indicators of ventricular myocardial deformation. Remodeling of the right chambers and dysfunction of the RV is a trigger for the separation of the RV and pulmonary artery, which ultimately leads to adverse outcomes.

International Multi-Specialty Expert Physician Preoperative Identification of Extranodal Extension n Oropharyngeal Cancer Patients using Computed Tomography: Prospective Blinded Human Inter-Observer Performance Evaluation.

Extranodal extension (pENE) is a critical prognostic factor in oropharyngeal cancer (OPC) that drives therapeutic disposition. Determination of pENE from radiological imaging has been associated with high inter-observer variability. However, the impact of clinician specialty on human observer performance of imaging-detected extranodal extension (iENE) remains poorly understood. To characterize the impact of clinician specialty on the accuracy of pre-operative iENE in human papillomavirus-positive (HPV+) OPC using computed tomography (CT) images. This prospective observational human performance study analyzed pre-therapy CT images from 24 HPV+ OPC patients, with duplication of 6 scans (n=30) of which 21 were pathologically confirmed pENE. Thirty-four expert observers, including 11 radiologists, 12 surgeons, and 11 radiation oncologists, independently assessed these scans for iENE and reported human-detected radiologic criteria and observer confidence. The primary outcomes included accuracy, sensitivity, specificity, area under the receiver operating characteristic curve (AUC), and Brier score for each physician, compared to ground-truth pENE. The significance of radiographic signs for prediction of pENE were determined through logistic regression analysis. Fleiss' kappa measured interobserver agreement, and Hanley-MacNeil AUC discrimination testing. Median accuracy across all specialties was 0.57 (95%CI 0.39 to 0.73), with no specialty showing discriminate performance greater than random estimation (median AUC 0.64, 95%CI 0.44 to 0.83). Significant differences between radiologists and surgeons in Brier scores (0.33 vs. 0.26, p < 0.01), radiation oncologists and surgeons in sensitivity (0.48 vs. 0.69, p > 0.1), and radiation oncologists and radiologists/surgeons in specificity (0.89 vs. 0.56, p > 0.1). Indistinct capsular contour and nodal necrosis were significant predictors of correct pENE status among all specialties. Interobserver agreement was weak for all the radiographic criteria, regardless of specialty (κ<0.6). Multiobserver testing shows physician discrimination of HPV+OPC pENE on pre-operative CT remains non-different than blind guessing, with high interrater variability and low diagnostic accuracy, regardless of clinician specialty. While minor differences in diagnostic performance among specialties are noted, they do not significantly affect the overall poor agreement and discrimination rates observed. The findings underscore the need for further research into automated detection systems or enhanced imaging techniques to improve the accuracy and reliability of iENE assessments in clinical practice.

A cuproptosis-related gene DLAT as a novel prognostic marker and its relevance to immune infiltration in low-grade gliomas

DLAT has been recognized as a cuproptosis-related gene that is crucial for cuproptosis in earlier research. The study is to look at how DLAT affects individuals with low-grade glioma's prognosis and immune infiltration. The Genotype-Tissue Expression (GTEx) database and the TCGA database were used in this work to download RNAseq data in TPM format. DLAT was found to be overexpressed in LGG by comparing DLAT expression levels between LGG and normal brain tissue, and the expression of DLAT was verified by immunohistochemistry and semi-quantitative analysis. Then, the functional enrichment analysis revealed that the biological functional pathways and possible signal transduction pathways involved were primarily focused on extracellular matrix organization, transmembrane transporter complex, ion channel complex, channel activity, neuroactive ligand-receptor interaction, complement and coagulation cascades, and channel activity. The level of immune cell infiltration by plasmacytoid dendritic cells and CD8 T cells was subsequently evaluated using single-sample gene set enrichment analysis, which showed that high DLAT expression was inversely connected with that level of infiltration. The link between the methylation and mRNA transcription of DLAT was then further investigated via the MethSurv database, and the results showed that DLAT's hypomethylation status was linked to a poor outcome. Finally, by evaluating the prognostic value of DLAT using the Cox regression analysis and Kaplan-Meier technique, a column line graph was created to forecast the overall survival (OS) rate at 1, 3, and 5 years after LGG identification. The aforementioned results demonstrated that high DLAT expression significantly decreased OS and DSS, and that overexpression of DLAT in LGG was significantly linked with WHO grade, IDH status, primary therapy outcome, overall survival (OS), disease-specific survival (DSS), and progression-free interval (PFI) events. DLAT was discovered as a separate predictive sign of OS in the end. DLAT might thus represent a brand-new predictive biomarker.

Prediction of substantial closed-globe injuries in orbital wall fractures.

To determine risk factors for substantial closed-globe injuries in orbital fractures (SCGI) and to develop the best multivariate model for the prediction of SCGI. A retrospective study was performed on patients diagnosed with orbital fractures at Farabi Hospital between 2016 and 2022. Patients with a comprehensive ophthalmologic examination and orbital CT scan were included. Predictive signs or imaging findings for SCGI were identified by logistic regression (LR) analysis. Support vector machine (SVM), random forest regression (RFR), and extreme gradient boosting (XGBoost) were also trained using a fivefold cross-validation method. A total of 415 eyes from 403 patients were included. Factors associated with an increased risk of SCGI were reduced uncorrected visual acuity (UCVA), increased difference between UCVA of the traumatic eye from the contralateral eye, older age, male sex, grade of periorbital soft tissue trauma, trauma in the occupational setting, conjunctival hemorrhage, extraocular movement restriction, number of fractured walls, presence of medial wall fracture, size of fracture, intraorbital emphysema and retrobulbar hemorrhage. The area under the curve of the receiver operating characteristic for LR, SVM, RFR, and XGBoost for the prediction of SCGI was 57.2%, 68.8%, 63.7%, and 73.1%, respectively. Clinical and radiographic findings could be utilized to efficiently predict SCGI. XGBoost outperforms the logistic regression model in the prediction of SCGI and could be incorporated into clinical practice.

Coxa pedis: can calcaneal pronation angle be considered a predictive sign of medial plantar arch overload?

PurposeTo assess whether a correlation between the calcaneal pronation angle and the presence of internal plantar arch overload signs (such as upper-medial spring ligament lesion, posterior tibial tendon tenosynovitis, etc.) could lead to a better understanding of coxa pedis pathology.Material and methodsOne hundred ankle MRIs of consecutive patients were retrospectively reviewed measuring the calcaneal pronation angle and either the presence or absence of internal plantar arch overload signs. Next, the association of overload signs with increasing pronation angle was evaluated to establish a cut-off point beyond which coxa pedis pathology could be defined.ResultsThe tibial-calcaneal angle values in patients with and without effusion proved to be significantly different (p < 0.0001). The tibial-calcaneal angle values in patients with and without oedema also demonstrated a significant difference (p < 0.0056). Regarding posterior tibial tendon, a significant difference was found between the two groups (p < 0.0001). For plantar fascia enthesopathy, the result was borderline significant (p < 0.054). A linear correlation was found between the value of pronation angle and the extent of spring ligament injury (p < 0.0001). In contrast, no correlation with age was found.ConclusionIn conclusion, the literature associates medial longitudinal plantar arch overload with posterior tibial tendinopathy and spring ligament complex injuries. Our data show that both injuries are highly correlated with increased calcaneal pronation angle, which could be considered a predictive sign of internal plantar arch overload, prior to the development of the associated signs.

Sulfuric Acid Ingestion: May the Severity of the Metabolic Acidosis be Considered as a Predictive Sign of Late Damage to the Gastrointestinal Tract?

Caustic substances ingestion results in a complex syndrome. The patient characteristics and severity of injury are important prognostic predictors. The monitoring of clinical changes and the multidisciplinary approach are necessary to prevent death in the early stages of the poisoning. The case report describes the suicide of a woman by ingestion of a large amount of 15% sulfuric acid for suicidal purposes (15-20 ml). The initial conditions were stable, and no changes were found on a CT scan. However, the main sign was a severe metabolic acidosis. After 7 hours, haematemesis and oedema of the larynx appeared, and oro-tracheal intubation and ICU admission were necessary. Consequent progressive haemodynamic deterioration with persistent severe metabolic acidosis, increasing lactates and septic shock appeared. A new CT scan with contrast was performed 22 hours later detecting diffuse perforations and liquid in pleurae and abdomen. A pleural sample showed necrotic liquid. The death was 24 hours after ingestion and no surgical treatment was performed because of the diffuse lesions to the thoracoabdominal districts. Early detection of gastroenteric lesions and the monitoring of clinical changes are mandatory to avoid the death of the patient. Gastroenteric perforations require an immediate radiological evaluation and surgical treatment. The clinical case report states the severity of prognosis was related to high doses of sulfuric acid ingestion. The immediate metabolic acidosis is related to quick subsequent severe systemic pathological lesions of the gastrointestinal tract. The severity of absorption metabolic acidosis, consequently, may be an early and prognostic sign of the late chest and abdominal lesions. Severity of metabolic acidosis after sulfuric acid ingestion may anticipate late damage to the gastrointestinal tract.

Determination of predictive factors in families of girls with menstrual disorders comorbid with endocrine system pathology

Objective — to determine predictive factors in the families of girls with menstrual disorders comorbid with endocrine system pathology. Materials and methods. The genealogical analysis was carried out in the families of 47 girls with oligomenorrhea (OM) and 44 girls with abnormal uterine bleeding (AUB) comorbid with endocrine system pathology. The comparison group consisted of the pedigrees of 30 families of healthy girls living in Kharkiv and Kharkiv Region. During the genealogical study, we observed the principles of the Declaration of Helsinki, the Council of Europe Convention for the Protection of Human Rights and Dignity of the Human Being, and the relevant laws of Ukraine. The Student’s t­test was used to determine the significance of the differences between the signs. The predictive implications of the studied signs were determined by the Wald method with informativity estimation using the Kullback criterion. Results and discussion. Hereditary burden of reproductive, gynecological non­inflammatory, endocrine diseases and environmental factors was identified in the families of girls with OM and AUB comorbid with endocrine pathology: pernicious habits and stress in the mothers of sick girls before and during pregnancy, threatened miscarriage. Risk factors for the sick girls included artificial feeding of a girl, stress, traumatizing of a girl, and prolonged use of the Internet and gadgets. Among non­communicable diseases in relatives of sick girls, the most common were gynecological non­inflam­matory diseases when compared with the relatives of girls with AUB and healthy girls (p &lt; 0.001), while relatives of healthy girls mostly suffered from nervous system disorders (p &lt; 0.05). Common and distinct predictive signs in the families of girls with OM and AUB and comorbid endocrine pathology have been identified. Conclusions. The predictive factors in the families of girls with OM and AUB have been identified, the use of which will allow forming high-risk groups as regards the high risk of menstrual disorders based on the genealogical analysis.

Dental Attrition and its Association With the Signs and Symptoms of TMJ Dysfunction and Radiographic Condylar Changes – An Observational Study

ABSTRACT To determine the level of dental attrition and its relation to signs of TMJ dysfunction adding to condylar alterations analyzed by conventional TMJ Tomography and to propose the correlation between dental attrition and signs of TMJ dysfunction and condylar changes. Patients for the study were selected from the regular outpatient Department of Oral Medicine, Diagnosis and Radiology, Rajah Muthiah Dental College and Hospital, Annamalai University, Chidambaram, with performed criteria. The radiographic examination of TMJ is performed by the PLANMECA OPG machine using the tomographic program. Statistical analysis was performed using a Chi-square test to determine the relation between attrition and temporomandidular disorders [TMD] signs and symptoms. The study group comprises 60 subjects who are having dental attrition, and they are divided into three groups according to their age: Group I, 20-40 age; Group II, 41-60 age; Group III, more than 60 age 80% of the samples had one or more tooth with significant attrition with grades of two or more on a 0-4 scale The prevalence of changes in condylar morphology was more in individuals above 40 yrs (33.33%) as compared to those below the age of 40 with a total prevalence of 41.67%. The most common symptom reported is tooth sensitivity, joint sounds, and muscle tenderness. The last reported are scalloped tongue, buccal mucosa ridging, referred pain, and limitation of mouth opening. Out of the 25 subjects who showed condylar changes, 10 subjects had symptoms of TMD. The symptoms reported are strain in the mouth opening, tenderness in jaw movements, and TMJ clicking sounds. Attrition is not a predictable sign of TMJ dysfunction, yet a finite association was defined between attrition and signs and symptoms of TMJ dysfunction. Studies involving larger samples compared with additional radiographic modalities are recommended.

Prognostic significance of alterations in fibrinogen level and fibrinogen-to-lymphocyte ratio after radiotherapy on survival outcomes in glioblastoma.

Fibrinogen (FIB) plays an important role in tumor initiation, progression, and metastasis, but its clinical significance in glioblastoma has not been studied. We intend to explore the prognostic value by retrospectively analyzing the changes in FIB and fibrinogen-to-lymphocyte ratio (FLR) in glioblastoma patients before and after radiotherapy, and study the impact of radiotherapy on them. This study retrospectively included 104 patients who were newly diagnosed with glioblastoma between February 2017 and February 2022 and analysed their clinical data from before to after radiotherapy. The cut-off values for FLR and FIB were calculated using a receiver operating characteristic curve. For inter-group comparisons, the Mann-Whitney U or t-test was applied. The prognostic importance of FIB and FLR was evaluated using the Kaplan-Meier curve and the Cox regression model. Spearman correlation coefficients were calculated to evaluate the association of FIB and FLR with radiotherapy-related dose-volume parameters. The mean progression-free survival (PFS) and overall survival (OS) of the high FIB and high FLR groups were significantly lower than those of the low FIB and low FLR groups (P<0.05). Larger planning target volume (PTV), mean brain dose, and mean brainstem dose were independent prognostic factors for poor PFS and OS in patients with glioblastoma. FLR was a unique and very accurate predictor for the prognosis of glioblastoma, and FIB rise after radiation was a predictive sign of poor survival. Both PTV volume and dose volume for involved organs could significantly affect the FIB and FLR values in patients with glioblastoma.

UNLOCKING THE FUTURE OF MATERNAL HEALTH: PLATELET INDICES AS PREDICTORS OF PREECLAMPSIA

Objective: Preeclampsia is a dangerous pregnancy condition that puts the health of the mother and fetus at great risk. Early diagnosis and treatment of this illness depend on predictive signs. Because of their correlation with coagulation problems, platelet indices, such as platelet count (PC), platelet distribution width (PDW), mean platelet volume (MPV), and platelet crit (PCT), may be useful as biomarkers for preeclampsia. The purpose of this study is to find out how well platelet indices can predict preeclampsia.&#x0D; Methods: From Mar 1, 2021, to Feb 28, 2022, the study was carried out at the Kamla Nehru State Hospital for Mother and Child in Shimla, Himachal Pradesh. Pregnant women without pre-existing illnesses were removed, and those with normotension who had singleton pregnancies after 20 w of gestation were included. Patients were classified according to the degree and course of preeclampsia, and platelet indices were monitored during pregnancy. To ascertain the significance of fluctuations in the platelet index, statistical tests were conducted and data were analyzed using SPSS-PC-25.&#x0D; Results: According to the study, patients with preeclampsia (PE) and normotensive individuals had significantly different platelet indices. Compared to people with normotension, PE patients showed higher platelet distribution width (PDW), a lower platelet count, and an elevated mean platelet volume (MPV). Interestingly, MPV increased noticeably in PE before blood pressure rose. In severe PE patients, the platelet count drastically reduced. The potential of MPV and platelet count as predictors of PE was shown by Receiver Operating Characteristic (ROC) curve analysis. These results demonstrate the importance of platelet indices in the diagnosis of PE and the potential use of these indices as early indicators of this hypertensive condition in pregnancy.&#x0D; Conclusion: Platelet indices show potential as early indicators for identifying and tracking preeclampsia, especially platelet count, MPV, and PDW. Monitoring platelet indices in addition to blood pressure may help determine the extent and course of the illness, which might lead to better results for both the mother and the fetus. To improve clinical usefulness and improve prediction models, more research in this area is necessary.

Comparison of Egg and Banana Sign, Carina Crossover Sign in Prediction of Pulmonary Embolism: A Cross-sectional Study

Introduction: Acute pulmonary embolism is a life-threatening condition that can lead to sudden death. Pulmonary Artery Hypertension (PAH) can be found in the setting of acute pulmonary embolism. The Egg and Banana sign and Carina Crossover (CCO) sign are seen in PAH, which are present on Computed Tomographic scans (CT scans). Aim: To determine the accuracy of CT scans, the Egg and Banana sign, and CCO sign seen in PAH in the evaluation of pulmonary embolism. Materials and Methods: This retrospective, cross-sectional study was conducted from May 2019 to May 2021 in the Department of Radiodiagnosis at Father Muller Medical College Hospital in Mangalore, Karnataka, India. The CT scans of 102 consecutive patients who underwent CT Pulmonary Angiography (CTPA) for suspected pulmonary embolism were evaluated for the presence of the CCO sign and Egg and Banana sign. The CCO sign was considered positive when the right pulmonary artery (PA) was seen crossing anterior to the carina at its bifurcation. The Egg and Banana sign was considered present when the PA was found lateral to the aortic arch, with the PA described as the Egg and the arch as the Banana. The results were statistically analysed using Statistical Package for Social Sciences version 3.0. Results: Pulmonary embolism was seen in 26 out of 102 cases, with a mean age of 60.2±16.27 years. Pulmonary embolism was absent in 76 cases with a mean age of 55.8±17.11. An equal gender distribution was seen in 26 cases of pulmonary embolism. The Egg and Banana sign was found in 8 out of 26 patients with pulmonary embolism and had a specificity of 78.9%, negative predictive value of 76.92%, and diagnostic accuracy of 66%. The CCO sign was seen in 14 out of 26 cases of pulmonary embolism and had a higher specificity of 81.58% and diagnostic accuracy of 74.51%. The CCO sign had a statistically significant value in detecting pulmonary embolism. Conclusion: According to the study, the CCO sign had a higher accuracy in detecting pulmonary embolism compared to the Egg and Banana sign. The accuracy was further improved when combined with other signs of pulmonary embolism.

Application of shock index-based classification in hypovolemic shock due to obstetric hemorrhage and its comparison with conventional vital sign for prediction of adverse maternal outcome

Background: At least, 358,000 women worldwide die annually from pregnancy and childbirth-related problems. Obstetric hemorrhage is the single most significant cause of maternal mortality worldwide accounting for 25–30% of all maternal deaths. Aims and Objectives: The objective of the study is to see the usefulness/importance of shock index (SI) in obstetric hemorrhage (antepartum and post-partum hemorrhage) and to compare the performance of SI with conventional vital signs for prediction of maternal outcome. Materials and Methods: The descriptive study was conducted in 100 cases of hemorrhagic shock patients admitted in obstetrics and gynecology at Baba Raghav Das Medical College, Gorakhpur, between June 2020 and May 2021, on 100 subjects. Results: In our study, there were 100 patients. Patients with SI 0.6 to &lt;1 were included in Group I which comprises 26% patients in which 57.69% patients required only intravenous (IV) fluid, while 30.77% patients needed blood transfusion. Patients with SI&gt;1 were included in Group II which comprises 74% patients in which all patients required initial resuscitation with IV fluid and then blood transfusion, 21.62% patients require inotropic support, and 9.46% patients needed fresh frozen plasma transfusion. Maternal outcome in Group I patients is that only 15.38% patients required emergency lower segment cesarean section (LSCS). While in Group II, 28.95% patients required emergency LSCS, 5.26% patients required intensive care unit (ICU) admission for ventilator support, 3.95% went for cesarean hysterectomy, while 2.63% patients landed in end organ failure and expired. Conclusion: All patients with obstetric hemorrhage with SI&gt;1 should receive immediate intervention such as blood transfusion need of ICU or surgical intervention. This is higher than the upper limit of normality in non-pregnant population. In low-resource settings, this simple parameter could improve outcomes because it has a significant ability to predict adverse maternal outcomes of hemorrhage.

A study to identify novel biomarkers associated with multiple myeloma

Background. multiple myeloma (mm) is a plasma cell cancer that affects white blood cells. plasma cells from the bone marrow grow abnormally, as a consequence of which patients have high amounts of monoclonal immunoglobulin in their blood and urine, poor renal function, and recurring infections due to this condition. osteolytic bone lesions and immunodeficiency also impact multiple myeloma patients’ longevity and quality of life. The disease accounts for 13 % of all hematological malignancies worldwide, making it the second most common blood cancer.Material and Methods. The studies investigating mm biomarkers from 2000 to 2021 are collected from various databases. “multiple myeloma”, “biomarkers”, “genetic markers”, “prognostic markers”, “epidemiology of multiple myeloma”, and “risk factors for multiple myeloma” are the key phrases utilized to gather the articles.Results. The scientific and medical research progressed into mm, and the number of cases increased over time and continues to rise, prompting researchers and clinicians to discover new consequences of the disease and new markers for prognosis, diagnosis, detection, and treatment of cancer in the earliest stages. Prognostic and predictive signs for illness recurrence and response to medication may be detected adequately by innovative potential biomarkers, which are more accurate than current approaches.Conclusion. treatment for multiple myeloma includes a variety of chemotherapeutic medicines, including immune modulators and proteasome inhibitors; however, most patients still experience recurrence after completing treatment. There have been numerous novel techniques for managing multiple myeloma, and this review summarises the most commonly used and the new ones that have appeared in the previously published articles.

EP33.04: The accuracy of sliding sign in prediction of pelvic adhesions during ultrasound for any gynecologic indication in a tertiary training hospital

EP33.04: The accuracy of sliding sign in prediction of pelvic adhesions during ultrasound for any gynecologic indication in a tertiary training hospital