1.Chest Radiograph Findings In Novel Swine-Origin InfluenzaA (H1N1) Virus (S-OIV) Infection: A UKMMC Experience
Norzailin Abu Bakar ; Norhafizah Ehsan
The Medical Journal of Malaysia 2015;70(2):93-97
OBJECTIVE: 1.To evaluates and recognizes findings in chest
radiograph in patients with laboratory-confirmed S-OIV
(H1N1) infection treated at UKMMC. 2. To evaluate whether
the findings on initial chest radiographs of influenza A
(H1N1) patients can help to predict the prognosis.
MATERIAL AND METHODS: Total of 109 adult patients
presenting to the Universiti Kebangsaan Malaysia Medical
Centre (UKMMC) with flu-like symptoms who were positive
for influenza A and these patients had underwent chest
radiographs (CXR). The initial CXRs were evaluated for the
pattern (consolidation, ground-glass, and reticulation),
distribution, and extend of abnormality. The disease is
classifies by the clinical severity (mild, moderate or severe
illness) and adverse outcome (ventilated, death or recovered
well).
RESULTS: The initial CXRs were normal in 56% of cases.
The predominant radiographic finding was consolidation,
most commonly involving the middle and lower zones (35%
of cases). There is no significant association between initial
CXR findings with the patient clinical outcome either fully
recovered or death/ ventilated.
CONCLUSION: Normal chest radiographs is the most
common radiographic finding in S-OIV (H1N1) infection and
the most common abnormal lung finding is consolidation.
Initial chest radiographs did not determine the patient
clinical outcome and a normal initial radiograph could not
exclude adverse outcome.
Influenza A Virus, H1N1 Subtype
2.Multiple oesophago-respiratory fistulae: sequelae of pulmonary tuberculosis in retroviral infection.
Soo Fin LOW ; Chai Soon NGIU ; Erica Yee HING ; Norzailin Abu BAKAR
Singapore medical journal 2014;55(7):e104-6
Pulmonary tuberculosis (PTB) is a common infectious disease worldwide. However, mediastinal tuberculous lymphadenitis complicated by oesophageal involvement and oesophago-respiratory fistula is now uncommon due to improved anti-tuberculous regimes and better general awareness. The overall incidence of acquired oesophago-respiratory fistula due to infection is low, and therefore, the lesion is not often a frontrunner in differential diagnosis. Still, tuberculous oesophago-respiratory fistulae can potentially occur in patients with retroviral disease, as they tend to have atypical and more virulent manifestations. In this study, we report the case of multiple oesophago-respiratory fistulae in a patient with PTB and retroviral disease, and highlight the computed tomography features of these lesions as an atypical presentation of PTB in retroviral disease. Clinicians should suspect oesophago-respiratory fistulae if patients present with Ono’s sign, and remain particularly vigilant for patients with underlying PTB and retroviral disease, as early diagnosis and treatment could help to reduce mortality.
Adult
;
Diagnosis, Differential
;
Esophagus
;
physiopathology
;
Fistula
;
diagnosis
;
Humans
;
Lung
;
pathology
;
Male
;
Radiography, Thoracic
;
Retroviridae
;
metabolism
;
Tomography, X-Ray Computed
;
Trachea
;
physiopathology
;
Treatment Outcome
;
Tuberculosis, Lymph Node
;
Tuberculosis, Pulmonary
;
complications
;
diagnosis
3.The sensitivity, specificity and predictive values of post mortem computed tomography in detecting liver and splenic injury due to road traffic accident
Norzailin Abu Bakar ; Noor Azman Shairi ; Mohammad Helmi Mohammad Nor ; Khairul Anuar Zainon
The Medical Journal of Malaysia 2016;71(1):1-7
Objective: The purpose of the study was to determine the
sensitivity, specificity, positive predictive value (PPV) and
negative predictive value (NPV) of post mortem computed
tomography (PMCT) in detecting liver and splenic injuries
due to road traffic accidents.
Material & Method: 61 road traffic accidental death cases
underwent both PMCT and conventional autopsy. The
imaging findings were compared to the conventional
autopsy findings.
Result: The sensitivity, specificity, PPV and NPV for liver
injuries in PMCT was 71%, 82%, 68% and 85% while that of
splenic injuries was 73%, 80%, 55% and 90% respectively.
The accuracy of PMCT scan was 79% for both liver and
splenic injuries. There is strong association between lower
left ribs fracture and splenic injury (p=0.005) and significant
association between positive liver and splenic PMCT finding
and intraabdominal fatal injury (p=0.037).
Conclusion: In conclusion PMCT has high specificity and
NPV for liver and splenic injuries; however the sensitivity
and PPV are low. The overall accuracy is not high enough to
enable PMCT to be used as a replacement for conventional
autopsy; however it is a useful complementary examination
and has potential to be used as decision making tool for
selective internal autopsy.
Autopsy
4.Positive Predictive Value of Sonographic BI-RADS Final Assessment Categories for Breast Lesions
Nursyahirah @Sheila Salinah Md Bohari ; Norzailin Abu Bakar ; Sharifah Majedah Idrus Alhabshi ; Nur Yazmin Yaacob
Malaysian Journal of Medicine and Health Sciences 2021;17(No.2):91-97
Introduction: We want to evaluate the sensitivity, specificity, positive (PPV) and negative predictive values (NPV)
of BI-RADS ultrasound, as well as PPV and NPV of BI-RADS ultrasound lexicon. Methods: A total of 517 ultrasound-guided breast biopsy cases were performed within three years. A total of 324 cases remained after 193 cases
were excluded from this study. The sensitivity, specificity, accuracy, PPV and NPV of overall BI-RADS and PPV for
each BI-RADS categories were calculated from the data when compared with histopathological examination (HPE)
finding. One observer evaluated four criteria of BI-RADS ultrasound lexicon; margin, echogenicity, posterior artefact
and internal echo from static sonographic images to determine the PPV and NPV of sonographic BI-RADS lexicon
based on HPE correlation. Results: There were 236 (72.8%) benign and 88 (27.1%) malignant lesions. The overall
BI-RADS has a sensitivity of 93.18%, specificity of 66.95%, accuracy of 74.07% with PPV and NPV of 51.25% and
96.34% respectively. The PPV of each BI-RADS categories were; BI-RADS 2 (9.09%), BI-RADS 3 (3.27%), BI-RADS 4
(39.02%) and BI-RADS 5 (91.89%). The highest predictive value for malignancy was irregular margin (52.3%) and for
benign was well-defined margin (89.7%). Criteria for margin and posterior artefact had a significant association with
HPE (p<0.0001) in differentiating between malignant and benign breast lesions in breast ultrasound. Conclusion:
Overlapping benign and malignant sonographic breast lesion descriptors tend to influence radiologist’s decision to
overcall final BI-RADS categories. The margin and posterior artefact are the important criteria in BI-RADS lexicon in
differentiating benign and malignant breast lesion.
5.Image Quality of Coronary CT Angiography (CCTA) using 640-slice Scanner: Qualitative and Quantitative Assessments of Coronary Arteries Visibility (Kualiti Imej Tomografi Berkomputer Angiografi Koronari Menggunakan Mesin Pengimbas 640 Hirisan: Penilaian Kualitatif dan Kuantitatif ke atas Keterlihatan Arteri Koronari)
SHAHRIL SHAMSUL ; AKMAL SABARUDIN ; HAMZAINI ABDUL HAMID ; NORZAILIN ABU BAKAR ; OTEH MASKON ; MUHAMMAD KHALIS ABDUL KARIM
Malaysian Journal of Health Sciences 2020;18(No.2):49-57
The purpose of this study was to evaluate the image quality and diagnostic accuracy of coronary computed tomography angiography (CCTA) using 640-slice scanner. Advancement of multidetector computed tomography (MDCT) technology with higher spatial, temporal resolution, and increasing detector array have improved the image quality and diagnostic accuracy of CCTA. A total of 25 patients (12 men and 13 women) underwent CCTA examination was chosen and data was acquired by 640-slice scanner. All 16 segments of coronary arteries were evaluated by two reviewers using a 4-likert scale for qualitative assessment. In quantitative assessment, the evaluation of 4 main coronary arteries were analysed in terms of signal intensity (SI), image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). All 25 patients with a mean age of 52.88 ± 14.75 years old and body mass index (BMI) of 24.24 ± 3.28 kg/m2 were analysed. In qualitative assessment, from the total of 400 segments, 379 segments (95%) had diagnostic value while 21 segments did not have diagnostic value, which means 5% artefact was detected. In quantitative assessment, there was no statistical differences in gender, race, and BMI (p>0.05). Overall evaluation showed that higher SI at the left main artery (LM) at 393.7 ± 47.19. Image noise was higher at right coronary artery (RCA) at 39.01 ± 13.97. SNR and CNR showed higher at left anterior descending (LAD) with 12.73 ± 5.17 and LM 9.14 ± 4.2, respectively. In conclusion, this study indicates that 640-slice MDCT has higher diagnostic value in CCTA examination with 95% vessel visibility with 5% artefact detection.