High diagnostic accuracy of automated rapid Strep A test reduces antibiotic prescriptions for children in the United Arab Emirates.

BACKGROUND: Diagnosis of Group A Streptococcus (GAS) pharyngitis in children is hindered by variable sensitivity of clinical criteria and rapid Strep A tests (SAT), resulting in reliance on throat cultures as the gold standard for diagnosis. Delays while awaiting culture reports result in unnecessary antibiotic prescriptions among children, contributing to the spread of antimicrobial resistance (AMR). METHODS: Diagnostic accuracy study of an automated SAT (A-SAT) in children up to 16 years of age presenting to an emergency room with signs and symptoms of pharyngitis between March and June 2019. Paired throat swabs for A-SAT and culture were collected. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for A-SAT were calculated. RESULTS: Two hundred and ninety-one children were included in this study. 168 (57.7%) were boys and the mean age was 4.2 years. A-SAT was positive in 94 (32.3%) and throat culture was positive in 90 (30.9%) children. A-SAT and throat culture results showed a high level of consistency in our cohort. Only 6 (2%) children had inconsistent results, demonstrating that the A-SAT has a high sensitivity (98.9%), specificity (97.5%), PPV (94.7%) and NPV (99.5%) for the diagnosis of GAS pharyngitis in children. Only 92 (32%) children were prescribed antibiotics while the vast majority (68%) were not. CONCLUSIONS: A-SAT is a quick and reliable test with diagnostic accuracy comparable to throat culture. Its widespread clinical use can help limit antibiotic prescriptions to children presenting with pharyngitis, thus limiting the spread of AMR.

Diagnostic accuracy of QuickVue® Dipstick Strep A test and its effect on antibiotic prescribing in children in the United Arab Emirates.

BACKGROUND: Unnecessary antibiotic prescription to patients with upper respiratory tract infections (URTIs) has led to the increase in antibiotics resistant bacteria rates. In this study, we evaluated the diagnostic accuracy of QuickVue® Dipstick Strep A test (QV-SAT) in children presenting with acute pharyngotonsillitis and its effect on antibiotic prescribing. METHODS: A single-gated diagnostic accuracy study of children with fever, runny nose, and tonsillitis presenting to a paediatric clinic between March 2016 and September 2018. Paired throat swabs for QV-SAT and culture were collected. None of the children received antibiotics prior to sample collection. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the test were calculated. RESULTS: Two hundred four children were included in this study. 111 (54.4%) were boys and 146 (71.6%) were under the age of 5 years. QV-SAT was positive in 44 (21.6%) and throat culture was positive for Group A ß- haemolytic Streptococcus (GAS) in 42 (20.6%) of the children. The results of QV-SAT were highly consistent with culture results: only 2 (0.9%) children with negative results had a positive throat culture. The sensitivity of the QV-SAT in the identification of GAS infection was 100% (95% CI 91.6%, 100%) and the NPV was 100% (95% CI 99.9%, 100%). Only 42 children ( 20.6%) were given antibiotics, while 162 (79.4%) were not. CONCLUSION: The QV-SAT is a quick and reliable test that can help dramatically reduce antibiotic prescriptions to children presenting with fever and acute pharyngotonsillitis.

Retrocaval ureter: A case report and review of the literature.

Retrocaval ureter is a rare malformation. We report a case of right retrocaval ureter of type 1. The usual clinical manifestation being lumbar pain due to obstruction of the upper urinary tract, asymptomatic forms can also be encountered. Since the diagnosis was based on the CT-scan, the treatment was uncrossing with uretero-ureteral anastomosis by lumbotomy, with a satisfactory long-term result.

Post-traumatic adrenal hematoma: A case report and revue of literature.

Post-traumatic adrenal hematoma, which has rare but severe complications, is a difficult to diagnose condition. Only computed tomography, which is often performed systematically during lesional assessments of violent thoraco-abdominal trauma, can confirm the diagnosis. Symptoms are often masked by associated visceral or parietal lesions. Standard biological examinations are generally not very helpful. We will describe the case of a 47-year-old man who presented with a right adrenal hemorrhage following a road accident, for only associated lesion, a fracture of the middle arch of the first and 8th ribs, and the transverse process L1.

The correlation between the gleason score of the biopsy and that of the prostatectomy patch.

Since the advent of massive dosage of prostate specific antigen (PSA), prostate cancer has become a major public health problem. It is currently the most common cancer and the second leading cause of cancer death in men (after lung cancer). More than 670,000 new cases are diagnosed annually worldwide. This is a retrospective study including all patients treated for prostate cancer by radical prostatectomy at the Ibn Rochde University Hospital in Casablanca between January 2017 and December 2020, i.e. a period of 4 years. At the end of our study, we identified 18 cases of radical prostatectomy.

Correlation between CT and anatomopathological staging of kidney cancer.

Our Moroccan context is experiencing an increase in the frequency of renal tumors. This trend can be explained by the generalization of the use of imaging, in particular abdominal ultrasound, which has become almost systematic among general practitioners (Godley and Ataga, 2000 [1]). The specificity of kidney cancer is anatomopathological heterogenicity: histological type, nuclear grade, tumor stage, these elements constitute the most important prognostic factors. Renal biopsy appears to be a safe and reliable solution with a low risk of tumor seeding and complications, however it cannot provide all the detailed histological information needed. Hence the interest in the abdominal scanner. The abdominal scanner is the reference examination for the evaluation of renal tumors, it diagnoses the tumor, specifies these characteristics, it assesses the loco regional, venous extension. The objective of our study is to correlate pathological and CT findings of 70 kidney cancer in order to determine the reliability of CT in kidney cancer and its extension.

Clinical utility of a new rapid test for the detection of group A Streptococcus and discriminate use of antibiotics for bacterial pharyngitis in an outpatient setting.

OBJECTIVE: To evaluate the clinical usefulness of the Diaquick Strep. A Test (SAT) as a rapid streptococcal antigen test, and its effect on antibiotic use in children. METHODS: This was a prospective study of children with acute catarrh, fever, and acutely inflamed throat/tonsils. Paired throat swabs for SAT and culture were collected. None of the children received antibiotics prior to testing. RESULTS: Five hundred and five children were included in the study: 278 were boys (55%) and 409 (81%) were aged under 5 years. The SAT was negative in 434 cases (86%) and positive in 71 (14%); culture was negative in 425 cases (84%) and positive in 80 (16%), including nine cultures that grew bacteria other than group A beta-hemolytic streptococci (GAS). Both the SAT and culture were negative in 422 cases (84%) and positive in 68 (13%), but were inconsistent in 15 cases (3%). For GAS infection, the SAT positive predictive value was 95.8% (68/71). The negative predictive value for the whole group as well as for children under five years of age was over 99% (422/425 and 355/358, respectively). SAT sensitivity was almost 96%. Finally, only 74 children (15%) were given antibiotics, while a staggering 431 (85%) were not. CONCLUSION: The Diaquick Strep. A Test (SAT) is a quick, reliable, and clinically useful test, which could help to dramatically reduce the usage of antibiotics in children with fever, catarrh, and acute pharyngotonsillitis.