Background: Ascitic fluid infection is presumptively diagnosed when the fluid polymorph nuclear (PMN) concentration equals or exceeds 250 cells /mic,l. The leukocyte esterase (lE) test has been shown to be a good predictor of the presence of PMNs in urine and other body fluids. This study examines of value of multistix 8SG DIPSTICK test for rapid diagnosis of infected ascitic fluid.Materials and Methods: Seventy three ascitic fluid samples were evaluated by PMN count and LE DIPSTICK testing. LE DIPSTICK values of small or greater were considered positive. For each samples the LE test result was compared to the corresponding PMN count.Results: From 73 total patient (mean age: 55.1) they were 38 female (mean age: 46.4) & 35 male (mean age: 64.4). The causes of cirrhosis were HBV infection (39.7%), HCV infection (12.3%), Autoimmune hepatitis (9.6%), Cryptogenic (15%), other (4%) and Under evaluation (13%).The most finding in SBP negative group was asymptomatic (79%) but abdominal pain (77%) in SBP positive group.Eight of ten LE positive samples has PMN>=250 cells/mic,l while eight of nine samples with PMN>=250 cells/mic,l were also LE positive.Of 63 LE negative samples, 62 were also negative by PMN count. Sixty two of 64 samples with PMN<250 cells/mic,l had negative LE test.The sensitivity and specificity of the LE test for detecting ascitic fluid PMN>=250 cells/mic,l were 88.8% (95% CI: 52-100%) and 97% (95% CI: 89-100%) respectively with a positive predictive value of 80%, a negative predictive value of 98.5%, and an accuracy of 95%.Conclusion: The multistix leukocyte esterase test is useful for prompt detection of an elevated ascitic fluid PMN count, and recommended as a conveniant new method for the rapid diagnosis of infected ascitic fluid.

Background: Microalbuminuria is a marker for nephropathy in diabetic patients and recognition of albuminuria is an important step for early detection and evaluation of diabetes complications.Objective: To assess the reliability of urine DIPSTICK tests for detection of albuminuria.Methods: The first morning urine samples from candidates for urinanalysis were collected and the results of DIPSTICK tests for protein on 200 selected samples recorded. Urine albumin concentration was determined by electroimmunoassay and the level of urine creatinine determined by Jaffe method. The albumin/creatinine ratio was further calculated as an index of urine albumin excretion rate. Comparing with reference method, the sensitivity, specificity, positive predictive value (PV+), and negative predictive value (PV-) of DIPSTICK test for detection of microalbuminuria were calculated.Findings: Based on results obtained by DIPSTICK test, 69 urine samples were negative for presence of protein, 51 trace (±), 22 (1+), 27 (2+), and 31 (3+). Detection limit of DIPSTICK for urine albumin concentration ranged from 58 to 585 mg/L with a mean of 280 mg/L. When the reference method for detection of protein in urine samples was used, 35 urine specimens were negative for albuminuria, 85 with microalbuminuria, and 80 with macroalbuminuria. DIPSTICK test was found to produce false positive and negative results of 3 and 25%, respectively. The sensitivity, specificity, PV+, PV- of DIPSTICK test for detection of microalbuminuria were calculated at 70, 86, 96, and 37.5%, respectively. Conclusion: Chemical DIPSTICK test is of poor sensitivity for detection of microalbuminuria. However, the severity of albuminuria among considerable numbers of diabetic patients is high enough to be detectable by urine DIPSTICKs. While the positive predictive value of chemical urine DIPSTICK tests are more or less at acceptable limit, the negative predictive values are controversial and need to be reevaluated by more sensitive and specific methods.

Background: This study aimed to evaluate the sensitivity and specificity of the leukocyte esterase (LE) band in two groups of patients receiving and not receiving antibiotics and compare the results. Methods: This prospective cross-sectional study was conducted on 105 joints with clinical suspicion of infectious arthritis (based on Kocher criteria) admitted in Shohada Hospital, Tabriz, Iran, within 2017-2018. Patients were divided into two groups, including receiving antibiotics (n=29; group 1) and not receiving antibiotics (n=76; group 2). Articular fluid aspiration was performed under sterile conditions with an 18-gauge angiocath with at least 1 ml volume of the hip, knee, ankle, elbow, and shoulder joints. Polymorphonuclear cell percentage count, cell count, Gram staining (GS), culture, and leukocyte esterase test were performed immediately after the aspiration of the specimens. Results: Levels of synovial fluid white blood cell count, serum white blood cell count, PMN, serum glucose, erythrocyte sedimentation rate, C-reactive protein, and time of aspiration (TOA) were significantly higher in the group receiving antibiotics (P<0. 05). Synovial glucose levels were significantly lower in the group receiving antibiotics. Furthermore, the positive frequency of glucose esterase, blood culture, GS, serum culture, and ultimate diagnosis of septic arthritis tests were significantly lower in the antibiotic receiving group (P<0. 05). The sensitivity, and positive predictive value of the leukocyte esterase test were obtained at 100%, and 96. 55% in the antibiotic receiving group, respectively. Moreover, in the group not receiving antibiotics, the sensitivity, specificity, positive predictive value, and negative predictive value of the leukocyte esterase test were estimated at 72. 22%, 92. 50%, 89. 66%, 78. 72%, respectively. Conclusion: Antibiotic use and the prolongation of TOA lead to increased inflammatory products, which is interfering with lab variables. As a result, they increase the sensitivity of the test. The sensitivity and specificity of the leukocyte esterase test in patients who did not receive antibiotics showed that this was a suitable and reliable laboratory method for the rapid detection of infectious arthritis that required an emergency rescue procedure.

In order to determine the value of DIPSTICK analysis of urinary protein in pregnancy induced hypertension, a prospective study analyzing pregnant patients with a diagnosis of hypertensive disorder was conducted to compare the result of urinary protein DIPSTICK analysis with 24hr. urine protein collection in obstetrical clinics affiliated to Shiraz University of Medical Sciences.All patients fulfilling the criteria of the American College of Obstetricians and Gynecologists' definitions for establishing a diagnosis of hypertensive disorder on the basis of urinary DIPSTICK measurements were included in the study.During the study, 102 hypertensive pregnant patients aged from 16-42 years were included in the study. Obtained results showed that the presence of negative value on urinary DIPSTICK with a sensitivity of 100% is a useful method for ruling out significant proteinuria (> 300 mg/24hr). But values of >2+ are not adequate to confirm a diagnosis of severe hypertensive disorder because its positive predictive value is only 22% and values of> trace-although highly suggestive of significant proteinuria (positive predictive value: 78%)-have a false positive rate of 23%; a timed collection of urine for determination of 24-hr protein excretion becomes mandatory in such cases.The urinary DIPSTICK determination of protein excretion therefore has significant limitations for determination of the presence or severity of proteinuria.

Urine DIPSTICK is a useful and commonly used test because of its rapidity and low cost; however its diagnostic accuracy is debatable.This research were carried out To determine sensitivity, specificity and positive and negative predictive values of Nitrite (NIT) and Leukocyte Esterase (LE) testing in relation to urine culture. This research was conducted on 100 hospitalized patients with clinical signs and symptoms compatible with urinary tract infections (UTI). Urine culture and DIPSTICK tests were carried out on urine samples of all patients. Urinalysis LE and NIT studies were performed in fresh and uncentrifuged urine by using a manual urine analyzer (rapignost, Co. Marburg, Germany). The urine culture was considered as gold standard. Urine cultures were positive in 75 (75%) patients. DIPSTICK tests of urine were positive in 79(79%) patients. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of DIPSTICK test were 76%, 12%, 72% and 14% respectively. Although DIPSTICK test of LE and NIT can avoid a large part of the cost incurred by urine culture, any method of urine screen (LE and NIT) shouldn't be substituted for a urine culture in the symptomatic patients in childhood.

Background: Urinary tract infection (UTI) is a common reason for referral to the emergency department (ED) especially in unwell infants. Upper UTIs are particularly at risk of significant complications later in life. Rapid DIPSTICK urinalysis and microscopy are often used in unwell children as a screening tool to guide early diagnosis and treatment. This study aims to evaluate the sensitivity of DIPSTICK urinalysis and microscopy in the diagnosis of UTI. Methods: A retrospective review of children aged 16 years and below with positive urine culture (UC) over a 3‑ year period was done. The results of urine DIPSTICK and microscopy were compared with the positive UC and sensitivities calculated. Results: DIPSTICK urinalysis and microscopy of 262 children were studied. Female-to-male ratio of 1. 8: 1. Median age was 0. 79 (range: 0. 02– 15. 95) years. The sensitivity of nitrite, blood, and leukocyte esterase (LE) were 0. 54, 0. 74, and 0. 86 (95% confidence interval [CI] = 0. 46– 0. 62, 0. 68– 0. 80, and 0. 82– 0. 91), respectively. The sensitivity of pyuria of ≥ 100 cells/mm3 was 0. 92 (95% CI = 0. 89– 0. 95). The presence of any of the 3 DIPSTICK parameters increased the sensitivity to 0. 97 (95% CI = 0. 95– 0. 99). The lowest sensitivity 0. 49 (95% CI = 0. 40– 0. 58) was found with combined positive LE and nitrite. There was a significant comparison between positive LE DIPSTICK test and pyuria (P = 0. 000004). Conclusions: DIPSTICK urinalysis may not be reliable in ruling out UTI in children. However, considering both positive DIPSTICK and pyuria will be more useful in making the diagnosis.

Background and Aim: Diagnosing urinary tract infection (UTI) in children is difficult due to its non-specific clinical manifestations, difficulty obtaining a clean urine sample, and risk of renal scarring complications in the future. Urine culture is the gold standard for diagnosing UTI, but it requires 48-72 hours to report, causing delays in treatment. This study aims to evaluate the effectiveness of urine DIPSTICK nitrite and leukocyte esterase tests in detecting UTIs in children. Methods: This cross-sectional, observational study was conducted on 79 children clinically suspected of UTI. The test results, urine DIPSTICK test (nitrite and leukocyte esterase tests), pyuria in urine microscopy, and urine culture were checked for their sensitivity, specificity, positive predictive value, and negative predictive value. Results: Among 79 children, fever was the most common clinical manifestation, and Escherichia coli was the most common uropathogen. Compared to urine culture, the sensitivity and specificity of leukocyte esterase and nitrite tests were 83. 87%, 45. 83%, 9. 68%, and 91. 67%, respectively. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the combined test were 9. 68%, 93. 75%, 50. 00%, and 61. 64%, respectively. Similar sensitivities and specificities were calculated, considering pyuria in urine microscopy as the gold standard in rural areas. Conclusion: The leukocyte esterase test is reliable for diagnosing UTIs in children, showing good sensitivity. Higher leukocyte esterase grades indicate a higher likelihood of infection. Due to its feasibility and effectiveness, this test can replace urine microscopy for pyuria in rural areas. Nitrite tests, or their combinations, have poor sensitivity but high specificity, making them suitable for proving urinary infections in children.