This study was conducted to see the sensitivity, specificity, and accuracy of fine needle aspiration cytology (FNAC) for solitary thyroid nodules and to compare our experience with that of other regions of the world. It was a prospective cross sectional study conducted on 76 thyroid samples submitted and reported at the Department of Pathology, King Edward Medical University, Lahore. There were 65 (85.5%) females and 11 (14.5%) males. Male to female ratio was 1:5.9. Ages of the patients ranged from 10 to 60 year with mean age 35.37 +/- 12.17. Thirty-three (43.42%) samples were indeterminate. There were 30 cases (39.47%) of benign lesions, comprising of colloid goiter, follicular adenoma, and diffuse hyperplasia. The final reports of these cases were almost the same. On FNAC, 13 cases were declared as malignant (6 cases) or suggestive of malignancy (3 cases) or suspicious for malignancy [4 cases (5.26%)]. Only 9 cases (11.84%) were clearly committed as malignant lesions, comprising of papillary carcinoma, anaplastic carcinoma and suggestive of follicular carcinoma. Comparison of malignant cases on histopathology (14 cases) was close to that of FNAC (13 cases). After comparison of FNAC results with histopathology, overall sensitivity of FNAC was found to be 90%, specificity 87.5%, and accuracy 87%, while positive predictive value (PPV) was 93% and negative predictive value (NPV) was 79.5%. In conclusion, we recommend this procedure in the light of views of other experts as a primary investigation of thyroid lesions. We strongly recommend the suggestion that in a patient with one or more thyroid nodule, FNAC should be advised for every patient for exclusion of cancer. We will also encourage the clinicians to embrace this procedure in the initial management of patients. As FNAC is inexpensive, sensitive, specific, and an accurate procedure it should be adapted as an initial investigation of thyroid diseases in all tertiary hospitals in developing countries like Pakistan.
Abstract. Fecal excretion of Cryptosporidium parvum oocysts was determined in 625 children less than five years old who presented at the pediatric clinic of a teaching hospital in Rawalpindi, Pakistan. Single stool specimens were collected from 475 children with acute diarrhea and from 150 children without diarrhea. The Cryptosporidium infection rate was significantly higher in children with diarrhea than in children without diarrhea (10.3% versus 3.3%). The C. parvum infection rate was highest in children 19-24 months of age (21.8%). There was no significant difference in the Cryptosporidium infection rate among male and female children of any age group studied. Sociodemographic information, drinking water supply, and contact with domestic animals had no significant role in the acquisition of C. parvum infection in our study population. The data suggest that C. parvum is relatively endemic in young children in the Rawalpindi area and that C. parvum may be an important pathogen associated with diarrhea.Enteric cryptosporidiosis is prevalent worldwide and causes a variety of problems ranging from acute severe diarrhea to self-limiting diarrhea, mainly in infants and young children, to nosocomial infection leading to fatal cases in immunocompromised persons. [1][2][3] In well-nourished, immunocompetent children, the disease is often short and selflimited. 2 However, this enteric agent is associated with persistent diarrhea in malnourished pediatric 4,5 and with prolonged severe or fatal watery diarrhea in patients with acquired immunodeficiency syndrome. 6 Children may be most susceptible, 4,7 and those less than two years old may have the greatest prevalence. 8 Epidemiologic studies have demonstrated that Cryptosporidium is more prevalent in developing countries (5% to Ͼ 10%) than in developed countries (Ͻ 1% to 3%). 2,3,[9][10][11] In most studies, the isolation rates from healthy persons have been low; however, several recent reports have identified high percentages of asymptomatic infections in children from South Africa 10 and India. 11 In Pakistan, no study has been conducted to determine the C. parvum infection rate in children. In this study, we report the prevalence and importance of C. parvum infection as a causal agent of acute diarrhea among children in Rawalpindi, Pakistan. MATERIALS AND METHODSStudy population. The study was conducted during the period March 1996 to September 1996 in 475 children (250 boys and 225 girls) less than three years of age with acute diarrheal disease presenting at the pediatric clinic of Rawalpindi General Teaching Hospital (RGH). The control group included 150 comparable children presenting at the same clinic with complaints other than gastrointestinal symptoms. This hospital covers a large area of population living in urban as well as in the rural areas. Four hundred twenty-two of the children were severely dehydrated and required admission to the hospital for rehydration. This extremely high rate of dehydration seen in the children is primarily due to the lack of health...
Deficiencies of essential vitamins, iron (Fe), and zinc (Zn) affect over one-half of the world's population. A significant progress has been made to control micronutrient deficiencies through supplementation, but new approaches are needed, especially to reach the rural poor. Agronomic biofortification of pulses with Zn, Fe, and boron (B) offers a pragmatic solution to combat hidden hunger instead of food fortification and supplementation. Moreover, it also has positive effects on crop production as well. Therefore, we conducted three separate field experiments for two consecutive years to evaluate the impact of soil and foliar application of the aforementioned nutrients on the yield and seed biofortification of mungbean. Soil application of Zn at 0, 4.125, 8.25, Fe at 0, 2.5, 5.0 and B at 0, 0.55, 1.1 kg ha −1 was done in the first, second and third experiment, respectively. Foliar application in these experiments was done at 0.3% Zn, 0.2% Fe and 0.1% B respectively one week after flowering initiation. Data revealed that soil-applied Zn, Fe and B at 8.25, 5.0 and 1.1 kg ha −1 , respectively, enhanced the grain yield of mungbean; however, this increase in yield was statistically similar to that recorded with Zn, Fe and B at 4.125, 2.5 and 0.55 kg ha −1 , respectively. Foliar application of these nutrients at flower initiation significantly enhanced the Zn contents by 28% and 31%, Fe contents by 80% and 78%, while B contents by 98% and 116% over control during 2019 and 2020, respectively. It was concluded from the results that soil application of Zn, Fe, and B enhanced the yield performance of mungbean; while significant improvements in seed Zn, Fe, and B contents were recorded with foliar application of these nutrients.
The main purpose of this paper is to introduce the concept of generalized sensitivity matrices extending the usual concept of generalized sensitivity functions. We consider systems with finitely many measurable outputs, because this case occurs frequently. It is demonstrated that the generalized sensitivity matrix can be interpreted as the Jacobian of the estimated parameters with respect to the nominal parameter vector. This interpretation is supported by numerical results for two examples, the Verhulst–Pearl logistic growth model, which as been used frequently in the context of generalized sensitivity functions, and the so-called minimal model for the intravenous glucose tolerance test, which represents a system with two measurable outputs. Furthermore, we discuss the implications of linear behavior of the generalized sensitivity matrix at large sampling times for identifiability of system parameters.
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