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.

Objective: To evaluate the capability of ascitic fluid DIPSTICK results for pH, glucose, and protein in order to predict a low serum-ascites albumin gradient (SAAG) at the bedside of the patient in the emergency department (ED).Methods: This prospective cross-sectional study was conducted during one year in the ED of Afzalipour hospital in Kerman, Iran. All patients with diagnostic or therapeutic paracentesis of ascitic fluid were considered as eligible patients. Exclusion criteria included clinical suspicion for spontaneous bacterial peritonitis (SBP), any contraindications to paracentesis, and patients’ refusal to participate in the study. DIPSTICK values were obtained at the bedside, and SAAG was calculated after the determination of serum and ascitic fluid albumin by laboratory. A low SAAG ascitic fluid was defined as the study outcome. We also used our study population as a test group to evaluate an equation proposed in one previous study: K=0.012 Protein−0.012 Glucose−3.329 pH+23.498 Results: A total of 50 patients were enrolled in the study. Based on multivariate regression analysis, DIPSTICK values for protein and glucose were independently predictive of a low SAAG ascitic fluid (P=0.23, OR=1.04; and P=0.001, OR=0.81, respectively). The formula proposed in one of the previous studies was tested by our data set, with sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) at 84%, 83%, 84%, and 80%, respectively.Conclusion: DIPSTICK test of ascitic fluid for pH, glucose, and protein has an acceptable sensitivity and specificity as a point of care test, but it cannot be recommended as a substitute for SAAG determination based on the current findings.