Displaying publications 841 - 860 of 3037 in total

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  1. Yap PY, Hwang JS, Bong JJ
    Asian J Surg, 2017 Mar 10.
    PMID: 28286020 DOI: 10.1016/j.asjsur.2017.01.003
    BACKGROUND/OBJECTIVE: Postoperative pancreatic fistula (POPF) remains an important cause of morbidity and mortality after pancreaticoduodenectomy. Pancreaticogastrostomy (PG) as a reconstruction method after pancreaticoduodenectomy is a safe and optional surgical technique in decreasing the risk of POPF. In this study, a retrospective analysis was carried out to evaluate a new modification of PG technique that uses a two-layer anastomoses with an internal stent.

    METHODS: Forty-seven patients underwent this newly modified PG technique between February 2012 and August 2016. Demographics, histopathological findings, type of surgery performed, perioperative parameters, postoperative length of stay, postoperative complications and interventional procedures, follow-up, and mortality data were collected and analyzed. Clavien-Dindo classification was used to grade the complications' severity.

    RESULTS: Postoperative mortality was 4.25%, unrelated to POPF, and postoperative morbidity was 44.68%. Thirteen patients had severe (>Grade IIIa) complications, according to Clavien-Dindo classification. As classified in accordance to the International Study Group of Pancreatic Fistula, 24 (51.06%) patients developed Grade A POPF, and no occurrence of Grade B/C POPF was noted. All patients recovered uneventfully with successful treatment interventions.

    CONCLUSION: The reported PG anastomotic technique is a safe and dependable reconstruction procedure with acceptable morbidity and mortality.

    Matched MeSH terms: Retrospective Studies
  2. Teoh SK, Wong WP
    Med J Malaysia, 1977 Sep;32(1):90-5.
    PMID: 609353
    Matched MeSH terms: Retrospective Studies
  3. Bastion, M.L.C., Siti Aishah, S., Aida Zairani, M.Z., Barkeh, H.J.
    Medicine & Health, 2010;5(2):93-102.
    MyJurnal
    A retrospective case series review was conducted to determine the pre-operative role and safety of pre-operative adjunctive anti-vascular endothelial growth factor (anti- VEGF) agent ranibizumab “LUCENTISTM” in patients with diabetic retinopathy requiring vitrectomy. The study involved twenty consecutive eyes of sixteen patients (age range: 46-72 years; mean 57.5 years) which received intravitreal injection of 0.5 - 1 mg of ranibizumab 3 to 8 days (mean 4.4 days) prior to vitrectomy for diabetic retinopathy. There were no local or systemic post-injection complications. Indications for vitrectomy were retinal detachment (RD) [n=11; 3 combined tractional (TRD) - rhegmatogenous RD (RRD), 8 TRD], TRD with vitreous haemorrhage (VH) (n=3) ,VH (n=8) and vitreomacular traction syndrome (n=1). Inclusion criteria include all consecutive eyes of diabetic patients requiring vitrectomy receiving a first pre-operative injection of anti- VEGF. Pre-operative visual acuity (VA) ranged from 6/36 to light perception. All eyes had minimal to moderate intraoperative bleeding. Post-operative VH in eyes without tamponade or gas tamponade was nil (n=1), mild (n=13) or moderate (n=1). Silicone filled eyes had nil (n=1), moderate (n=3) or severe haemorrhages (n=1). Post-operative VA was unchanged (n=2) (10%), improved (n = 14) (70%) or worsened (n=4). VA was 2/60 or better (n=15) to no light perception (n=1). Two eyes achieved 6/12 or better vision (10%). Ten eyes (50%) had 6/36 or better vision. In conclusion, pre-operative intravitreal ranibizumab is safe and useful in diabetic vitrectomy and appears to help with perioperative bleeding leading to improvement in vision.
    Matched MeSH terms: Retrospective Studies
  4. Lam AWC, Zaim MR, Helmy HH, Ramdhan IMA
    Malays Orthop J, 2014;8(1):46-49.
    MyJurnal
    Diabetic foot disease is the leading cause of non-traumatic amputations of the lower limb, hence a major health care and socioeconomic burden. It has been found that most of the costs occur in the inpatient setting; therefore this study is to quantify the costs of managing inpatient diabetic foot infections (DFI). We treated 182 inpatients from May 2012 till April 2013 and analysed the cost of antibiotic usage, wound dressing, surgical procedure, admission and basic investigation costs. The total cost was ~ USD 11,000 (2013). This number, however, only reflects the cost for managing an acute infection. The price for follow-up care as an outpatient, rehabilitation and indirect costs (emotional suffering, reduced productivity) is estimated to be much more.
    Study site: Diabetic Inpatient Registry, Hospital Sultanah Nur Zahirah, Kuala Terengganu, Terengganu, Malaysia
    Matched MeSH terms: Retrospective Studies
  5. Nazimah, I., Noor Sham, Y.L., Khairun Niza, C.N., Mohd Ikhsan, S., Nadzratulaiman, N., Juliana, Y.
    MyJurnal
    Objective: To evaluate the factors that contributes to the decision for termination of pregnancy in prenatally diagnosed fetal anomaly cases.
    Methods: A retrospective analysis of all cases of prenatally diagnosed fetal anomaly who delivered between 1 January 2007 and 30 June 2009 in two tertiary hospitals in Malaysia.
    Results: A total of seventy-two (72) prenatally diagnosed pregnancies with fetal anomalies were identified. Mean maternal age was 29.8 ± 5.5 years and mean parity 1.47 ± 1.8. 70.8% of patients were ethnic Malay, 15.3% Chinese and 12.5% ethnic Indian. 22 (30.6%) fetuses were lethally abnormal. The overall pregnancy termination rate was 29.2%. 50% of pregnancies with lethally abnormal fetuses were terminated compared to 20% of pregnancies with non-lethal abnormality (p
    Matched MeSH terms: Retrospective Studies
  6. Abdul Wahab Jantan, Zabidi Azhar Mohd Husin
    MyJurnal
    Objective: The clinical characteristics and out-come offebrile convulsions in children admitted to the University Hospital in Kubang Kerian were analysed in this retrospective study.

    Method: The medical records of 244 children aged between 6 months to 5 years who presented with their first convulsions between January 1989 to December 1990 were reviewed. Patients were followed till one year after their first febrile convulsions.

    Results: The mean age of presentation was 18.26 (s.d. 11.83) months. One hundred and thirty (54.5%) were males. Complex febrile convulsions were noted in 47.5% and simple febrile convulsions in 52.5%. Seventy-two children (29.5%) were less than one year old at the time offirst febrile convulsions. A family history offebrile convulsions was significantly higher in the complexfebrile convulsions group. Ten children (4.1%) presented with prolonged first febrile convulsions. Data on 117 children on follow-up were available for analysis. Recurrence of febrile convulsions occurred in fifty children (46.7%) with mean interval of 6.53 (s.d. 5.25) months. There was significant difference in children who presented with febrile convulsions at age of less than one year old and having family history offebrile convulsions with regard to recurrence. Three children developed epilepsy at a mean age of 31.56 months. Identifiable causes of febrile convulsions were upper respiratory infection, presumed viral infection (fever with rashes) and acute gastro-enteritis. Laboratory investiga-tions that were done were not helpful.

    Conclusions: Children with a family history of febrile convulsions were more likely to develop complex febrile convulsions. Routine investi-gations were rarely helpful. The recurrence rate is significantly influenced by the age of presentation and family history of febrile convulsions in siblings or either parent. The types offebrile convulsions did not significantly influence the recurrent rate.
    Matched MeSH terms: Retrospective Studies
  7. Hilwati, Hashim, Radhiana Hassan, Syazarina Sharis, Shahrul Azmin, Rabani Remli, Shahizon Azura Mukari, et al.
    Neurology Asia, 2013;18(4):355-360.
    MyJurnal
    Background and Objective: Intravenous thrombolysis service for stroke was introduced at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC) in 2009, based on the recommendations of a multidisciplinary team of clinicians. We report the experience at our center in establishing a stroke protocol incorporating computed tomography perfusion (CTP) of the brain, to assess the feasibility of incorporating CTP in the stroke protocol.
    Methods: A retrospective review of all patients who had a CTP between January 2010 and December 2011 was performed. Results: Of 272 patients who were admitted with acute ischemic stroke, 44 (16.2%) arrived within 4.5 hours from symptom onset and had a CTP performed with the intention to treat. The median time for symptom-to-door, symptom-to-scan and door-to-scan was 90.0 minutes (62.5 – 146.3), 211.0 minutes (165.5 – 273.5) and 85.0 minutes (48.0 – 144.8) respectively. Eight patients (2.9%) were thrombolysed of whom five received IV thrombolysis and three underwent mechanical thrombolysis. The median symptom-to-needle and door-to-needle times were 290.5 minutes (261.3 – 405.0) and 225.0 minutes (172.5 – 316.8) respectively. Four patients were thrombolysed despite being outside the window of treatment based on the CTP findings. Six of the thrombolysed patients had a Modified Rankin Score (MRS) of 1-2 at 5 months post procedure.
    Conclusions: CTP provides a benefit to management decisions and subsequent patient outcome. It is feasible to incorporate CTP as a standard imaging modality in a stroke protocol. The delays in the time-dependent pathways are due to our work flow and organisational process rather than performing the CTP per se.
    Matched MeSH terms: Retrospective Studies
  8. Liang Ann Lim, Michelle Sze Hui Chin, Denish Kwasso Devan, Jun Hoe Hui, Thamron Keowmani
    MyJurnal
    This study aims to examine the vancomycin initial dosing and the resultant trough level in paediatric patients. In this retrospective observational study, all therapeutic drug monitoring (TDM) records of paediatric patients admitted to Sabah Women and Children Hospital (SWACH) from January 2011 to September 2013 were reviewed and 116 patients without renal disease were included in the study. Of the total, 38.8% were neonates, 32.8% were infants and 28.4% were children. The majority of the patients were intensive care patients (69.0%) and the most common clinical indication for vancomycin was sepsis (44.8%). The four initial dosing regimens identified were 40 mg/kg/day (38.8%), 30 mg/kg/day (31.0%), 60 mg/kg/day (25.0%) and 45 mg/kg/day (5.2%). The distribution of initial dosing regimen was significantly different between the three age groups (p40 mg/kg/day (p=0.007). The proportions of those who achieved the target therapeutic range (10–20 mg/L) in the 2 dosing groups were 30.9% and 60.0% respectively. In conclusion, the study showed that the initial dosing of >40 mg/kg/day is more likely to achieve the target therapeutic range (10–20 mg/L) compared to the initial dosing of ≤40 mg/kg/day.
    Matched MeSH terms: Retrospective Studies
  9. Hasnah Ibrahim, Fatah Ab Rahman
    MyJurnal
    Individualising a drug dosage regimen is more appropriate if it is based on pharmacokinetics data derived from local populations. In this study, we estimated valproic acid (VPA) and carbamazepine (CBZ) clearances in the Malaysian population from routinely collected therapeutic drug monitoring (TDM) data. We also evaluated the effects of gender, age, weight and concurrent antiepileptic drug (AED) therapy on VPA and CBZ clearance. Data was collected retrospectively from TDM forms of adult patients. Apparent drug clearance was estimated based on the standard steady state clearance equation. Mann-Whitney and KruskalWallis tests were used to evaluate gender and therapy differences, while Spearman’s Rank correlation was used to determine the associations of age and weight with clearance. One hundred thirty-two samples for VPA and 67 for CBZ were included in the analysis. Patients’ ages ranged from 15 to 72 years old. Mean VPA and CBZ clearances were found to be 0.36 l/kg/d and 1.60 l/kg/d, respectively. VPA clearance correlated positively but poorly with weight. Our results showed significant differences in (i) VPA clearance among male and female patients and (ii) VPA clearance between monotherapy and combination therapy. These findings provide a guide to initiate maintenance doses of VPA and CBZ in our local patients. Awareness of factors influencing drug clearance should help to optimise patients’ dosing regimens.
    Matched MeSH terms: Retrospective Studies
  10. Rozita, A.M., Marniza, S., Mastura, M.Y., Wan Zamaniah, W.I., Yip, C.H., Taib, N.A.
    JUMMEC, 2010;13(1):24-32.
    MyJurnal
    Despite being the major cause of cancer-related death in Malaysian women,local data on patterns of breast cancer relapse and their long term outcomes are still scarce. We conducted a retrospective study on all patients treated for non-metastatic invasive breast cancer in 1999-2000 at the University of Malaya Medical Centre (UMMC), who subsequently developed relapse. We sought to analyse the patterns of relapse, their associated clinicopathological features and the overall survival ratefollowing the relapses. Univariate and multivariate analyses were used to analyse demographics and clinicopathological factors. Survival was analysed using the Kaplan and Meier method and compared by the log rank test. A total of 268 patients with a mean age of 50, were identified for the study. At a median follow-up of 50 months, 73 patients (27.2%) had relapsed. Local, regional and distant relapse rates were 5.5%, 1.9% and 19.8% respectively, whereas, the 5-year survival rates were 61%, 40% and 21% respectively (p < 0.01). Most relapses occurred within the first five years of diagnosis. Patients with long disease-free interval had better survival. The most common distant relapse site was the lungs while bone was the distant relapse site with the best prognosis. Disease stage, nodal status and oestrogen receptor status were found to have correlation with the risk of relapse. We concluded that the survival of patients with relapsed breast cancer was associated with the site(s) of first relapse and the disease free interval and clinicopathological factors can be used to predict the risk of relapse.
    Matched MeSH terms: Retrospective Studies
  11. Anuar R, Mohd-Hisyamudin HP, Ahmad MH, Zulkiflee O
    Malays Orthop J, 2015 Nov;9(3):40-43.
    PMID: 28611908 MyJurnal DOI: 10.5704/MOJ.1511.006
    Delayed presentation of Developmental Dysplasia of Hip (DDH) comes with challenges in treatment as well as high surgical cost. Therefore the objective of this study is to quantify the economic impact of management of late presentation of DDH during a last 3-year period. We conducted a retrospective study with analysis of DDH cases managed between years 2012 to 2014. Early and late presentations of DDH were identified and cost management for both was estimated. Out of twenty-four DDH cases, thirteen cases fulfilled the inclusion criteria. All were female with majority of them presenting with unilateral DDH predominantly of the left hip. Most patients presented after age of six months and the principal complaint was abnormal or limping gait. The grand total cost for managing DDH during the three years period was USD 12,385.51, with 86% of the amount having been used to manage late presentation of DDH that was mostly contributed by the cost of surgery. We concluded that delayed presentation of DDH contributes heavily to high national expenditure. Early detection of DDH cases with systematic neonatal screening may help to minimize the incidence of the late presenting DDH and subsequently reduce the economic burden to the government.
    Matched MeSH terms: Retrospective Studies
  12. MyJurnal
    Introduction: Pneumonia is the most common diagnosis made in hospitalised children. The Malaysian Clinical Practice Guidelines on pneumonia and respiratory tract infections provides a comprehensive guidance in the local context. We evaluated the documented assessment and management of children diagnosed with pneumonia admitted to the children’s ward, Hospital Batu Pahat against this guideline.
    Methods: We performed a retrospective analysis of hospital case notes for children admitted from January to May 2004.
    Results: Ninety six case notes were analysed. Most patients (84%) had at least four positive clinical features leading to the diagnosis of pneumonia. 92% met the guideline criteria for admission. Sp02 was performed for 58% on admission, and 58% with reading below 95% received supplemental oxygen. Throughout hospital stay, each patient had an average of four investigations (range: 1 – 12). Among 23 patients who had further investigations, justifications were only recorded in seven patients (30.4%), and changes in management resulted in 23%. The most common antibiotic prescribed was intravenous Penicillin (97 %). In 17 patients who met the guideline classification for severe pneumonia, none received the recommended antibiotic combination. The median time to fever resolution was 22 hours (range 2 – 268), and median hospital stay was 3 days (range 1 – 12).
    Conclusions: Although the quality of clinical assessment and antibiotic choices were acceptable, there was a failure to critically evaluate patients according to disease severity and initiate corresponding investigations and managements. Future efforts need to be directed at promoting further guideline adherence and the exercise of critical judgment in patient evaluation.
    Matched MeSH terms: Retrospective Studies
  13. Ong, C.K., Tan, W.C., Leong, K.N., Muttalif, A.R.
    MyJurnal
    The incidence of tuberculosis (TB) is currently increasing. HIV induced immuno-suppression modifies the clinical presentation of TB. Our aim is to determine the differences in clinical presentation of HIV-TB co-infection based on their CD4 counts. This retrospective study looked at cases of adult active TB and HIV-1 co-infection treated in Penang Hospital from January 2004 to December 2005. Of the 820 patients treated for active TB, HIV-1 seropositivity rate was 12.6% (103 patients). Majority of HIV-1 co-infected patients presented with prolonged insidious and non-specific symptoms like weight loss, fever and night sweats. The clinical presentation of TB depended on the stage of HIV-1 infection and associated degree of immunodeficiency. Compared to the less immuno-compromised HIV-1 and TB co-infected population (CD4 > 200/mm3 ), patients with CD4 counts ≤ 200 are more likely to have atypical chest radiographs (P = 0.009). During active TB, the Mantoux test was positive in 12 (14.5%) HIV-1 infected patients with a CD4 counts ≤ 200/mm3 and in 16 (80%) of those with CD4 counts > 200/mm3 (P = 0.0001). In our series, the AFB smear / AFB culture and type of TB did not show obvious correlation with CD4 counts. Therefore to diagnose TB in severely immuno-compromised HIV patients, we need to have a high index of suspicion.
    Matched MeSH terms: Retrospective Studies
  14. Rahman, Z.A.A., Hamimah, H., Bunyarit, S.S.
    Ann Dent, 2005;12(1):-.
    MyJurnal
    The aim of this retrospective study was to study the clinical patterns of oro-facial infections presented and their management (or trends of management) at the Department of Oral and Maxillofacial Surgery, Dental Faculty, University of Malaya. These included the predisposing factors, presentations and management. This study reviewed the oro-facial infection cases over 15 years. The data was obtained from case note reviews of patients using specially designed proforma. A total number of 409 samples were included in this study. Majority of the patients were generally healthy with about 6.6% having diabetes mellitus. The common presentations were pain (47.4%), pus discharges (16.9%) and limitation of mouth opening (12.5%). The major site was in the submandibular region (18.9%) followed by cheek (13.2%). Most of the infections were from odontogenic source (63.2%). Other sources includes cysts (15.4%) and tumours (6.7%). Incision and drainage were the treatment of choice performed on 57.55% of patients. Monoantimicrobial therapy was the treatment instituted in 20.8% of cases.
    Matched MeSH terms: Retrospective Studies
  15. Norshamsiah, M.D., Wan Haslina Wah, Kok, H.S., Sharifa Ezat, W.P., Fuad, I.
    Medicine & Health, 2015;10(1):23-31.
    MyJurnal
    Radiation retinopathy (RR) is a known complication after radiotherapy for Nasopharyngeal Carcinoma (NPC). This study aims to relate the relationship of RR and radiation dose in patients with NPC through assessment with clinical
    funduscopy and fundus fluorescein angiogram (FFA). A cross sectional study was conducted on patients with NPC who had completed radiotherapy treatment in the Oncology Clinic, Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Eighty two eyes of 42 patients were examined and the prevalence of RR was found to be 35.4%. The severity of RR is strongly associated with the dose of radiation to the retina (Spearman correlation value=0.48; p<0.001). The common features of RR assessed by FFA were telangiectatic vessels (26.2%) and capillary non-perfusion (14.3%). Retinal neovasularization occurred in 10.7% of eyes. The level of visual deterioration correlated with the severity of RR with 26% of eyes experiencing a visual acuity of 6/18 or worse. More than one third of patients developed RR, with radiation maculopathy being the commonest cause for significant visual loss. FFA is a useful tool in detecting early signs of radiation retinopathy and maculopathy.
    Keywords: nasopharyngeal carcinoma, fluorescein fundus angiography, retinopathy, radiotherapy
    Study site: Oncology Clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
    Matched MeSH terms: Retrospective Studies
  16. Rashid, A.K., Anwar, N., Azizah, A.M., Narayan, K.A.
    MyJurnal
    A mucous cyst is a benign, self limiting mucous containing cyst of the salivary glands commonly occuring in the oral cavity. Mucocele may develop following the obstruction of the salivary flow from secretory apparatus of the salivary gland. Mucoceles commonly occur on the lower lip but may occur in other locations too. The objective of the study was to determine the factors associated with mucocele in patients attending the dental clinic of Penang Hospital from January 2000 to December 2005. This is a retrospective record review analysis of all the total 35 cases treated during this period, comprising of 20 males (57.1%) and 15 females (42.9%) with Malays as the largest group of patients treated and, mainly students had seek treatment. Mucocele was frequently treated in patients aged 21 to 24 year old. The site of the mucocele was the lower lip and all of the cases were treated surgically. The size of the mucocele ranged from 0.5 to 5 centimetres with 1.0 cm as the most common size. Most of the patients gave a history of spontaneous development (71.4%), followed by lip biting (25.7%) and trauma (2.9%). Lip biting was more common among students (55.6%) as compared to others. There were only two recorded cases of recurrence.
    Matched MeSH terms: Retrospective Studies
  17. Lim DS, Sambamoorthy VR, Ling DSY, Syed Aznal SS
    ASEAN Journal of Psychiatry, 2009;10(1):8-18.
    MyJurnal
    Objective: In Malaysia, opioid abuse is an acknowledged problem with severe health and economic repercussions. Until recently, drug addicts were mainly criminalised and forcefully rehabilitated in correctional facilities. However, the high relapse rates of this approach, coupled with the high rates of blood borne infections among drug users, led to increasing acceptance of a healthcare-based approach in the rehabilitation of drug addicts. Methadone was among the medications introduced as substitution maintenance therapy in 2005 and Universiti Malaya Medical Centre (UMMC) is a centre for MMT. This study aimed to determine the effects of MMT on quality of life in patients here. Methods: The sample was 46 patients who attended the Psychiatric outpatient clinic in fill in UMMC. The instrument used to assess quality of life was the WHOQOL-BREF. Results: The study design was cross-sectional with retrospective elements. Baseline QOL scores were obtained from case records and follow-up scores from the month of September 2007. Statistically significant improvements in all four domains of WHOQOL-BREF were found. Physical: p

    Study site: Psychiatric outpatient clinic, Universiti Malaya Medical Centre (UMMC
    Matched MeSH terms: Retrospective Studies
  18. MyJurnal
    In a retrospective analysis of paediatric referrals to a Neurology outpatients clinic, the largest single category of 47 patients (32%) presented with acute recurrent headache. There were 30 girls and 17 boys. Using conventional criteria 43 of the children could be classified as classical migraine ( 10 ), common migraine (20), basilar migraine (3), opthalmoplegic migraine (1) and tension headache (9). The 9 children with tension headache, all girls, had pain char-acteristics distinct from the rest, but in terms of severity and duration of headache attacks ,were similar to those with classical migraine, which is against the theory that tension headache and migraine are at different ends of the spectrum of the same process. These findings are consis-tent with recent adult data, but have not been noted in paediatric work. (Copied from article).
    Matched MeSH terms: Retrospective Studies
  19. Loh, C.C., Mohd Amin, S., Kasmini, K.
    MyJurnal
    This is a retrospective and descriptive study of 30 children and adolescents with conduct disorders diagnosed for the first time this year (1993) at the Child and Family Consultation Unit, UKM. Eleven of them were diagnosed to have a Socialized Conduct Disorder, 8 had symptoms of Unsocialized Conduct Disorder, whilst 4 had Conduct Disorder confined to the family context. Another 5 had Depressive Conduct Disorders while 2 had features of other mixed disorders of conduct and emotions. Most them were boys and were ten years old and above. The majority presented with at least one year history of illness and school authorities played an important role in being the main referral agency. Prominent abnormal psychosocial situations were inadequate or inconsistent parental control and discordant intro familial relationships. Socio-economic status and geographical differences were associated with the prevalence of the disorder. The main symptomatology found were disobedience and frequent lying, stealing, truancy and fighting or bullying.

    Study site: outpatient clinic, Hospital Kuala Lumpur
    Matched MeSH terms: Retrospective Studies
  20. Hanita, O., Azura, N.R., Faizal, M.M.Z.
    Medicine & Health, 2012;7(1):24-31.
    MyJurnal
    The most common cause of hyperthyroidism is Graves disease (GD) which is characterised by the presence of autoantibodies which binds to the TSH receptor (TRAb). Recently, a rapid, fully automated electrochemiluminescent immunoassay ElecsysAnti-TSHR for detection of autoantibodies to TSH receptor was made available for routine clinical use. The objective of this study is to evaluate this assay and to determine the sensitivity, specificity and cut-off value. Interassay and total imprecision (CV) were determined at 3.78-7.02 IU/L and 13.5-21.2 IU/L respectively. A total of 124 samples which comprised of 46 GD, seven Hashimoto thyroiditis (HD), 11 non autoimmune nodular goitre (NAG), 2 thyroid cancers (Ca) and 58 normal controls were retrospectively analysed to determine the sensitivity, specificity and cut-off value. Inter-assay CV’s were 2.4% at a concentration of 3.90 IU/L (range: 3.78-7.02 IU/l) and 0.8% at 20.80 IU/L (range:13.5-21.2 IU/l). Total imprecision was 3.8% at a concentration of 3.80 IU/L (range:13.5-21.2 IU/l) and 1.0% at 20.8 IU/L (range:13.5-21.2 IU/l). The ROC analysis of patients with GD, other thyroid disorders and normal controls revealed that the highest sensitivity (94%) and specificity (98%) were seen at cut-off value of 1.69 IU/L. Positive predictive value (PPV) and negative predictive value (NPV) was 95% and 94% respectively. At this derived cut-off value of 1.69 IU/L, we found that the sensitivity of TRAb positivity within the group of 29 newly diagnosed GD patients was 94%. Our results demonstrate that this fully automated assay with testing time of 27 minutes has high sensitivity in detecting GD and high specificity for discriminating other thyroid disease and represent major improvement in the diagnosis and management of patients with thyroid diseases.
    Matched MeSH terms: Retrospective Studies
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