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Home > Comparison of Multi-Detector Ct Venography and Venous Sonography for Detecting Lower Limb Deep Venous Thrombosis in Patients With Suspected Pulmonary Embolism

Comparison of Multi-Detector Ct Venography and Venous Sonography for Detecting Lower Limb Deep Venous Thrombosis in Patients With Suspected Pulmonary Embolism

Thesis Info

Author

Wanjohi, Ruth

Department

Imaging and Diagnostic Radiology (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2010

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728040718

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Objective: This was a prospective analytic study that aimed to compare the agreement between CT pulmonary angiography (CTPA/CTV) and ultrasonography (US) for diagnosis of thromboembolic disease and determine the sensitivity, specificity, positive and negative predictive values of the 2 tests using the presence of thromboembolic disease as a reference standard. Methods: 76 consecutive patients who were referred for CTPA at the Radiology department of Aga Khan University Hospital over an 8 month period between December 2008 and July 2009 were included in the study. All the patients underwent combined CTPA/CTV according to the usual departmental protocol. They subsequently had bilateral lower limb duplex US within 24 hours of the CTPA/CTV study. Results for the presence or absence of DVT were analyzed for both CTV and US. Presence of thromboembolic disease was defined by a composite reference standard and this was used to determine the sensitivity, specificity, positive and negative predictive values for both tests. Results: 73 patients were included in the final analysis. The 2 imaging tests had similar results in 62 (84.93%) patients; CTV was positive and US was negative in 7 (9.6%) patients, while CTV was negative and US was positive in 4 (5.5%) patients. There was a moderate level of agreement (k= 0.528) between CTV and US for detection of DVT. CTV had a much higher sensitivity (94.1%), specificity (100%), PPV (100%), NPV (98.2%) compared to US (58.9%, 94.6%, 76.9%, 88.3% respectively) when the presence of thromboembolic disease was used as a reference standard. Conclusion: CTV has higher sensitivity, specificity, positive and negative predictive values for detection of asymptomatic DVT compared to US when the presence of venous thromboembolic disease is used as a reference standard. Therefore, in patients suspected to have PE, CTV can be used to detect DVT without an additional duplex US examination.
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سوکھا کم نئیں ہوندا۔۔۔

سوکھا کم نہیں ہوندا اے عشق اندر، آس یار دے بوہے دی لا رکھنی
چیہہ وٹ کے درد نوں سہہ جانا، پنڈ دکھاں دی سر تے چا رکھنی
غم ہجر فراق نوں جھل کے تے، رو رو کے تے راتیں یاد کرنا
اگوں سوہنیاں دی مرضی اپنی اے، کیہدے نال سلام دعا رکھنی
خون جگر دا تلی تے رکھ کے تے، ہتھ یار نوں جا وکھا دینے
اگوں سودے نے بے نیازیاں دے، نہ کوئی ہمدردی نہ وفا رکھنی
چادر کھیس موہڈے اتے رکھ لینا، بکل مار کے کندھاں دے نال بہنا
ویکھو عشق دے کیسے قانون وکھرے، جرم ہور تے ہور سزا رکھنی
درد دکھ فراق دے لکھ سہنے، ہوکے بھرنے یار دے ہجر اندر
آس رکھ لینی، آس توڑ دینی، اینویں جندڑی گھول گھما رکھنی
اکھاں نال بہار حنیف دی اے، اکھاں نال پریت دا لطف ہوندا
اکھاں والڑے قدر ہی جاندے نیں، اکھاں نال ہے کیویں وفا رکھنی

قضية مساواة المرأة بالرجل وقوامته عليها في ضوء القرآن الكريم

It is well fact that before the advent ofthe Prophet Mu hammad (PBUH) the whole world was in totally darkness. Oppression was the order of the day. Womenfolkwas the most depressed segment ofthe society but when Islam cameit notonlyenjoined it followers to strive for theestablishmentofa just society in all walks of life. The issues of oppression of women folk was particularly addressed. Many verses ofthe Holy Quran and Sunnah clearly elaborated the duties as well rights of women. Islam considers woman as equal to man in respect ofduties and rights keeping her physical difference in view. In this article six points have been chosen for discussion which are as under equality of woman with man in humanity, equality in rights and obligation, equality in ownership and employment, equality in responsibility and equality in punishments Equality in liaan process.

A Situational Agile Framework to Support Team Coordination in Global Software Engineering

Context: Modern computer systems are prone to a continuous evolution under varying situations such as Application and Organization. The increasing and complex project situations need to employ resources on a global scale that has resulted in Global Software Engineering (GSE), commonly known as Global Software Development (GSD). In addition, GSD teams work round the clock to fulfill the complex and competitive market situation to optimize and decrease costs by utilizing time zones effectively. However, apart from the advantages in GSD, it also entails certain challenges due to distance and time difference such as information sharing, communication delays and lack of control over team coordination that lead to project failure. With the passage of time, the complexity of software has increased greatly. It is for these reasons that organizations are moving from traditional development approaches to Agile based approach as it has the ability to deliver products closer to customer’s expectations. In this study there are two main problems that have been addressed, first and foremost is problem with the integration of two popular trends in Agile practices with GSD and second is formulating a situational method in order to handle the Agile GSD situations. However, literature review suggests the Situational Method Engineering (SME) as a solution for the integration of more than one methods and formulation of situational method. It also arises as a solution when we want to combine two approaches for the formulation of a new paradigm. Hence SME aims at providing method construction techniques by reusing existing methods, practices, techniques and approaches. Objective: The objective of this research is to design the structure of the 3C-SAME (3C _Situational Agile Methods for Global Software Engineering Environment) Framework in order to formulate situational methods to help Agile GSD practitioners to provide a productive solution. Method: In order to design 3C-SAME Framework, we use multi method research methodology. In addition, we use grounded theory to formulate the situational taxonomy. Action Research is also used in order to formulate the Situational Agile framework. In designing the Framework we perform a Literature Review to identify the impacts, challenges and existing issues from published articles, reports, case studies in a structured manner. In the context of the non-structured ad hoc research review, the systematic review is beneficial for the evidence based impact of existing theories, frameworks and challenges. We use the Multi method to design the 3C-SAME Framework. We evaluate our proposed framework through ISO/IEC 9126-1 quality model, case study and experimental study. Result: The results of the proposed 3C-SAME Framework help Agile GSD practitioners in order to improve their performance for Agile GSD managers and practitioners. It is a viable framework which can provide solutions to the well-known problems by applying SME principles. Hence the framework brings improvements in functionality and usability of the software development processes. However, the study is limited to only two agile methods, Scrum and XP, which have been used to formulate the proposed situational framework. The proposed framework is handle specific situations not for general purpose. Keywords: Agile Software Development, Global Software Engineering (GSE), Global Software Development (GSD), Situational Method Engineering (SME), Team Coordination.