Diagnostic accuracy of fibrosis-4 index in assessment of hepatic fibrosis in metabolic dysfunction associated steatotic liver disease (Record no. 3480)
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| 000 -LEADER | |
|---|---|
| fixed length control field | 03098nam a22002417a 4500 |
| 005 - DATE AND TIME OF LATEST TRANSACTION | |
| control field | 20251007134010.0 |
| 008 - FIXED-LENGTH DATA ELEMENTS--GENERAL INFORMATION | |
| fixed length control field | 251007b |||||||| |||| 00| 0 eng d |
| 040 ## - CATALOGING SOURCE | |
| Description conventions | NLM |
| 060 ## - NATIONAL LIBRARY OF MEDICINE CALL NUMBER | |
| Classification number | WI 141.5.F4 |
| Item number | 00768 |
| 100 ## - MAIN ENTRY--PERSONAL NAME | |
| Personal name | Joshi, Bishal Raj Dr. |
| 245 ## - TITLE STATEMENT | |
| Title | Diagnostic accuracy of fibrosis-4 index in assessment of hepatic fibrosis in metabolic dysfunction associated steatotic liver disease |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. | |
| Place of publication, distribution, etc. | Kathmandu, Nepal ; |
| Name of publisher, distributor, etc. | Kathmandu University & Nepal Health Research Council (NHRC) ; |
| Date of publication, distribution, etc. | 2025. |
| 300 ## - PHYSICAL DESCRIPTION | |
| Extent | 60p. |
| 500 ## - GENERAL NOTE | |
| General note | In partial fulfilment of the requirements for the degree of Master in Medical Research. |
| 520 ## - SUMMARY, ETC. | |
| Summary, etc. | Background: Tuberculosis (TB) remains a leading cause of morbidity in developing nations, with cervical lymphadenopathy being the most common extrapulmonary manifestation. In resource-limited settings like Nepal, rapid and accurate diagnosis is critical for effective treatment. This study evaluates the diagnostic performance of two key modalities - ultrasound-guided fine-needle aspiration cytology (FNAC) and GeneXpert MTB/RIF assay - in patients with suspected tuberculous lymphadenitis.<br/>Methods<br/>We conducted a hospital-based comparative cross-sectional study at Bir Hospital, Nepal from February to June 2025. Sixty-two consecutive patients presenting with cervical lymphadenopathy underwent simultaneous ultrasound-guided FNAC and GeneXpert testing. FNAC smears were evaluated for cytomorphological features of TB, while GeneXpert detected Mycobacterium tuberculosis DNA and rifampicin resistance. A composite reference standard combining both tests was used for analysis. Diagnostic accuracy parameters including sensitivity, specificity, positive and negative predictive values were calculated. Agreement between tests was assessed using Cohen's kappa statistic.<br/>Results: FNAC demonstrated superior sensitivity (93.1% vs 89.6%) while both tests showed perfect specificity (100%). The combined approach increased diagnostic yield by 7.4%, identifying additional cases that would have been missed by either test alone. Excellent agreement was observed between methods (?=0.902, p<0.001). Among 27 GeneXpert- positive cases, no confirmed rifampicin resistance was detected, though 14.8% showed indeterminate results. The majority of patients (58.1%) were aged 25-50 years, with a female predominance (59.7%).<br/>Conclusions<br/>Both ultrasound-guided FNAC and GeneXpert are highly accurate for diagnosing tuberculous lymphadenitis. Their complementary use enhances detection rates and should be adopted in high-burden settings. These findings support the integration of these diagnostic tools in the Nepalese TB control program to improve case detection and<br/>treatment outcomes.<br/>Keywords: extrapulmonary tuberculosis, lymphadenitis, Nepal, sensitivity and specificity, tuberculosis.<br/> |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM | |
| Topical term or geographic name entry element | Extrapulmonary tuberculosis. |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM | |
| Topical term or geographic name entry element | Lymphadenitis. |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM | |
| Topical term or geographic name entry element | Sensitivity and specificity. |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM | |
| Topical term or geographic name entry element | Tuberculosis. |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM | |
| Topical term or geographic name entry element | Nepal. |
| 856 ## - ELECTRONIC LOCATION AND ACCESS | |
| Link text | https://nhrc.gov.np/contact |
| Public note | Visit NHRC Library |
| 942 ## - ADDED ENTRY ELEMENTS (KOHA) | |
| Source of classification or shelving scheme | National Library of Medicine |
| Koha item type | Thesis Report |
| Call number prefix | THS00768-JOS-2025. |
| Suppress in OPAC | Yes |
| Withdrawn status | Lost status | Source of classification or shelving scheme | Damaged status | Not for loan | Home library | Current library | Shelving location | Date acquired | Source of acquisition | Total Checkouts | Full call number | Date last seen | Price effective from | Koha item type |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| National Library of Medicine | Nepal Health Research Council | Nepal Health Research Council | Thesis Cart | 10/07/2025 | Self Collection | WI 141.5.F4/THS00768/JOS/2025 | 10/07/2025 | 10/07/2025 | Thesis Report |