Objective: The objective of this study is to evaluate the diagnostic accuracy of H. pylori Stool Antigen (HpSA) test keeping histopathology as gold standard. Study Design: This is a cross sectional observational study. Place and Duration: This study was performed from Jan 2015 to Mar 2020 at Najran Armed Forces Hospital, kingdom of Saudi Arabia. Methodology: Total 151 patients in whom HpSA was done were included in the study. They were followed for their results of histopathology on gastric biopsies. Results: Among 151 patients 85(56.3%) were females and 66 (43.7%) were males. Mean age was 40 years. Forty three (28.5%) patients were positive for both HpSA and on histology, Fifteen (9.9%) patients were positive on HpSA test but negative on histology. Twenty two (14.6%) patients were negative on HpSA but they were positive on histology. Seventy one (47%) patients were negative both on HpSA and histology. The sensitivity and specificity were 66.1% and 82.5% respectively. Positive predictive value (PPV) was 74.1% and negative predictive value (NPV) was 76.3% for HpSA. Diagnostic accuracy for this test was 75.5%. Conclusion: Keeping in view the low sensitivity and diagnostic accuracy HpSA test cannot be used as screening tool in all patients, however it can be used for clinical correlation in setups where other diagnostic tests are not available due to the simplicity of its use, low cost and easy repeatability
Objective: To analyse histopathological findings in gastric biopsies of patients with dyspepsia using an updated Sydney System. Study Design: Retrospective longitudinal study. Place and Duration of Study: Histopathology Department, Najran Armed Forces Hospital (NAFH), Saudi Arabia, from Jan 2013 to Mar 2020. Methodology: A total of 408 cases whose gastric biopsies were included in the study, and their histological features were studied. Results: Among 408 patients included in the study, 191(46.8%) were males, and 217(53.2%) were females. The mean age was 37.0±15.0 years. A total of 343 patients showed gastritis, which was mild 152(44.3%), moderate 158(46.1%) and severe 33(9.6%), respectively. The activity was observed in 200(49.0%) patients. H.pylori infection was observed in 196(48.0%) patients and intestinal metaplasia in 9(2.2%) patients. Conclusion: Most of the cases with dyspepsia showed histological evidence of gastritis. However, a significant number of patients had no gastric mucosal abnormality. Therefore, adequate and timely treatment of H.pylori infection can significantly reduce related morbidity.
Objective: To reduce unnecessary requests for Serum Thyroid stimulating hormone (TSH) levels in a hospital setting using targeted interventions. Study Design: Interventional study. Setting: Najran Armed Forces Hospital (NAFH), Saudi Arabia. Period: January 2019 to June 2020. Material & Methods: Sampling technique was non probability convenient sampling and included all the TSH requests received in the laboratory. The tests were categorized into three categories e.g., repeated requests within one month, requests as routine investigation and requests not related to diagnosis. The interventions made included the initiation of hospital guidelines, resolving the limitations of Laboratory information system (LIS) and increasing awareness of physicians. The effectiveness of interventions was calculated by measuring the number of unnecessary requests out of total number of TSH requests. The comparison was made between problem identification phase and post implementation phase. Results: The analysis of data showed a reduction in the routine unnecessary TSH requests by almost 11%. During the first half of 2019(Jan -July) total number of TSH tests were 5713 with 3427 (60%) unnecessary requests. After initiation and implementation of interventions the unnecessary requests reduced by 11% during Jan-July 2020. There were only 1857(49%) unnecessary requests out of total 3827 TSH tests. These results were statistically significant with p-value of less than 0.05. Conclusion: The application of appropriate interventions decreased the unnecessary requests of TSH. This reduction in turn reduced the wastage of the cost spent and the workload implied on staff for processing these unnecessary requests.
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