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Home > Comparison of Quantitative Analysis to Qualitative Analysis for Interpretation of Lower Limb Lymphoscintigraphy

Comparison of Quantitative Analysis to Qualitative Analysis for Interpretation of Lower Limb Lymphoscintigraphy

Thesis Info

Author

Nganga, Edward Chege

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

2015

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728041070

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Background: Lymphoscintigraphy is now the primary imaging modality used in determining a diagnosis in patients with suspected extremity lymphedema. However, analysis is mainly by visual qualitative analysis which is subjective and has a wide inter-observer variability. Subtle differences in ilioinguinal uptake between normal and abnormal limbs may be missed with visual qualitative analysis. This study seeks to compare quantitative analysis to qualitative analysis by computing percentage ilioinguinal nodes uptake at 1.5 hours. Objectives: To compare quantitative analysis to qualitative analysis of lower limb lymphoscintigraphy in the diagnosis of lymphedema. To determine the diagnostic accuracy of quantitative lymphoscintigraphy analysis. Methodology: 52 lymphoscintigrams of consecutive patients meeting the study criteria were analyzed quantitatively. 53 normal and 51 abnormal limbs were analyzed. For both the normal and abnormal limbs, a region of interest was drawn around the injection site (B) and ilioinguinal nodes (A) at 1.5 hr. static images and the counts in these ROIs recorded. Percentage ilioinguinal nodes uptake was computed as: Analysis of variance was done to determine whether there is significant difference in ilioinguinal uptake between normal and abnormal limbs. Using different cut-offs, and qualitative analysis as a reference standard, specificity and sensitivity was calculated and the figures used to plot a receiver operator characteristics (ROC) curve. Area under the curve was estimated. Findings: 52 patients; 36 females and 16 males (104 limbs) were analyzed. Proportion of male limbs with a lymphoscintigraphy proven lymphedema was significantly higher (78% vs 36%, p<0.001). ANOVA revealed a statistically significant difference between the mean uptake of normal (19.7%) and abnormal limbs (5.5%) (F=81, p Discussion: The statistically significant difference in the means of ilioinguinal uptake between normal limbs and limbs with lymphedema is indicative of reduced lymphatic function as seen in previous studies. More female subjects were enrolled in the study suggesting that edema of whatever etiology is more common in females. The higher proportion of male limbs with lymphedema indicates that edema in our male subjects was more likely to be due to lymphedema.
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مرشد دا پیار

مُرشد دا پیار
(آنحضور قبلہ صوفی محمد اصغر سائیں آف جہلم والوں کی یاد میں جب آپ نے ہیڈ جالوالہ پر مور پالے ہوئے تھے )

موراں والیا سائیاں وے
تیتھوں جند کراں قربان
ہر دم تیریاں لوڑاں وے
توں ایں میرا مان تران

تیرے باہجھوں چین نہ آئوندا
ہر ویلے پیا دل گھبرائوندا
ویکھ لواں جے تینوں آئوندا
آوے میرے جثے جان

تیریاں راہواں پئی تکاواں
یاد کراں تے دل بہلاواں
بھلدیاں نہیں سجناں اوہ تھانواں
جتھے دلبر ملدے ہان

جس دم یار نے جھاتی پائی
میل دلے وچ رہی ناں کائی
بھاندے دل نوں بُوٹے کائی
جتھے وسدا بھٹی خان

تیرے موراں چال نیاری
ویکھو چلدے بنھ قطاری
جاندے نیں دل میرا ٹھاری
نالے دل میرا پرچان

موراں نوں میں چوگاں پاواں
نالے کر دی رہواں دعاواں
قادریؔ دی کرو معاف خطاواں
لکھ واری جاواں قربان

قرآن مجید میں دعوی تضاد کا علمی محاسبہ

One of the main arguments that Allah has made in the Quran about the authenticity of this last book is that the Quran is free from all kinds of contradictions and differences. Whoever interprets the Quran, the authenticity of the Quran has become clearer on it. Different forms of language and literature are adopted in the Quran. If one is not familiar with the Quranic verses or does not have access to the truth of the words or is unfamiliar with the reality of the ayah, it may be possible to feel the contradiction in some places, when in reality it is not.

Tracing Spaces of Knowers Autonomy for Knowledge Construction in International Baccalaureate Ib Curriculum

Autonomy is readiness, which entails both capacity and willingness, to take charge of one’s learning through critical thinking and reflection. The research focuses on envisaged, perceived and enacted roles and meaning of autonomy of the knower in context of Theory of Knowledge course of IB Diploma Programme. It also explores the ways in which the autonomy of the knower reflects in the process of knowledge construction via interplay between curricular spaces such as course content, pedagogy and assessments. Qualitative case study approach was employed to gain the perception and experiences of knowers. Document analysis, observations, semi-structured interviews and personal portrayals were used as data collection methods. The findings of the research suggest that the learner holds central position as a ‘knower’ in the learning processes. The data gathered in the study gives indications that the meaning and scope of autonomy is defined by its context. The findings reveal that students are developing autonomy as they are becoming more competent in the art of critical thinking and reflection. Students are also demonstrating the key attributes such as inquisitiveness, resourcefulness, positive constructs of self and sustained interest for learning. Curriculum content, pedagogy and assessments foster autonomy of knowers by providing them necessary knowledge and skills. Consequently, each proposes some challenges to knower such societal and academic pressure related to questioning, less-directive instructions and limited spaces for creative expression. The results also indicate that knowers do not prefer development of autonomy as an independent sport because interdependency is highly valued in their cultural/social context. Such nature of autonomy also creates implications on the interplay between freedom and control in the teaching and learning processes. Therefore, the research recommends that autonomy should be supported by scaffolding through a guided inquiry, communication of role changes and discussions following the independent task to facilitate learning.