The Evaluation of the Role of Ultrasonography and Ultrasound-Guided Aspiration as an Initial Screening Test in Blunt Abdominal Trauma

Hd, El Abdullah; Ma, Daifu; Shukla, AK

doi:10.5144/0256-4947.1996.300

Ann Saudi Med

1996

DOI: 10.5144/0256-4947.1996.300

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The Evaluation of the Role of Ultrasonography and Ultrasound-Guided Aspiration as an Initial Screening Test in Blunt Abdominal Trauma

El Abdullah Hd

Daifu Ma

AK Shukla

Abstract: The role of ultrasonography (US) as an initial screening test was evaluated in 3000 consecutive cases of blunt abdominal trauma (BAT). Seventy-three were positive for free fluid collection or organ injury. US-guided aspiration was used to rule out the hollow visceral injury in those referred to nonsurgical therapy. Sixty patients underwent laparotomy. These included 53 clinically unstable patients, three stable patients with positive US-guided aspiration for bile or intestinal contents and four who deteriorate… Show more

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Abdullah et al, 1 and felt obliged to make the following comments. First, it was not clear whether the article was a prospective or a retrospective study.

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confidence: 99%

The Role of Ultrasonography and Ultrasound-guided Aspiration in Blunt Abdominal Trauma

Abu‐Zidan

1997

Ann Saudi Med

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Abdullah et al., 1 and felt obliged to make the following comments. First, it was not clear whether the article was a prospective or a retrospective study. Although the authors mention that there were 3000 consecutive patients examined in a period of five years, giving the impression that this was a prospective study, the protocol of the study is similar to that of Goletti et al., 2 including the algorithm. Actually they had similar results by performing ultrasound within 30 minutes of patients' arrival, with an average of four minutes to perform it. Was this a retrospective or prospective analysis?Second, when evaluating any test, a gold standard is needed to compare the results. Although laparotomy was used as the gold standard for the operated patients, the authors did not define the false-positive findings for the nonoperated patients, who also need a gold standard (CT scan, for example). This is important when studying the specificity. Specificity is defined as the true-negative results divided by the summation of true-negative and falsepositive. The authors mentioned that ultrasound has a specificity of 97% in detecting splenic injury. Since there were 2927 true-negative results, a simple calculation shows that there were 91 false-positive splenic injuries. How were these defined, and what was their clinical course?Third, the authors cited only four references relating to the use of ultrasound in blunt abdominal trauma, which is a controversial topic. One of these was wrongly cited, 2 as the authors mentioned that sensitivity, specificity and accuracy in ultrasound in detecting hemoperitoneum approach 86.6%, 100% and 97% respectively. The original reference shows that "the overall sensitivity of US in detecting free fluid collection in that study was 98%, with a specificity of 99% and a positive predictive value of 100%." Extensive literature has been published over the last four years regarding the role of ultrasound in blunt abdominal trauma which could have been evaluated. I notice that the time between finishing the study (April 1995), and its submission (May 1995), was less than two months. This is a very short period compared to this extensive experience (3000 patients). It is actually the largest series in the literature reported to date. The second largest series was reported by Glaser et al., 3 and was a retrospective analysis of 10 years' duration, involving 1151 patients. Writing a clinical study should take a lot of consideration, including critical evaluation of the information available.The fourth point is that the inclusion criteria of the study were not mentioned. This is essential in defining the study population. The reported injury percentage of this study (true-positive and false-negative findings) is the lowest in the literature at 2% (73/3000), compared to other studies which varied between 6% to 54%.3-7 Was ultrasound actually indicated in all these patients?My last point is that it seemed that some of the statistical principles are not clear to the authors. The mean (average) is a s...

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“…

Abdullah et al, 1 and felt obliged to make the following comments. First, it was not clear whether the article was a prospective or a retrospective study.

…”

mentioning

confidence: 99%

The Role of Ultrasonography and Ultrasound-guided Aspiration in Blunt Abdominal Trauma

Abu‐Zidan

1997

Ann Saudi Med

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The Legislative Value of Excellency Prophet’s Actions -Bedruddin al-Maqdisī Example-

Kalaç

2020

Kafkas Üniversitesi İlahiyat Fakültesi Dergisi

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Both prophet's (pbuh) words and actions have been quite important since he was described as the personality who should be dependant to by all human kind in the book of Allah. The term "Sunnah" has been used for everything related to the Prophet of Allah such as his words, actions and all the things narrated as verdicts. From this perspective, Prophet's actions constitute a kind of sunnah accepted as the secondary basic source of Islam. Therefore, Prophet's actions forming a part of sunnah are one of the fundamentals of legislation. However, in terms of legislative values, all of Prophet's actions have not been evaluated in the same category. As a result of this, the legislative values of actions, in other words whether they are binding or not; or, which ones are binding, have always been the subject of controversy among the Islamic scholars. Not only hadith scholars but also fıqh scholars have been interested in this issue. One of the fıqh scholars is Bedruddîn al-Maqdisî (d. 773/1371). Bedruddîn, is the grandson of Abdulğanî al-Maqdisî (d. 600/1203), known as al-Cemmâlî, and who was a famous hadith scholar. Bedruddîn, who had the prominent names of his era as his teachers, directed his scholarly work to hadith and fiqh and wrote works especially on fiqh method. In this manuscript, after Prophet's approaches related with his actions are presented, how Bedruddîn al-Maqdisî, a Hambeli sect scholar, and who is not much famous, tackled with the issue will be investigated within the context of his work, et-Tezkire fi Usûlî'l-Fıkh, which has reached today.

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The Evaluation of the Role of Ultrasonography and Ultrasound-Guided Aspiration as an Initial Screening Test in Blunt Abdominal Trauma

Cited by 2 publications

References 4 publications

The Role of Ultrasonography and Ultrasound-guided Aspiration in Blunt Abdominal Trauma

The Role of Ultrasonography and Ultrasound-guided Aspiration in Blunt Abdominal Trauma

The Legislative Value of Excellency Prophet’s Actions -Bedruddin al-Maqdisī Example-

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