Kashif Nawaz, Bilal Aziz, Tazeen Nazar, Bilquis Shabbir.
Diagnostic Accuracy of AST/ALT for Diagnosis of Esophageal Variceal Bleeding Taking Endoscopy as Gold Standard.
Pak J Med Health Sci Jan ;12(2):485-8.

Aim: To determine the diagnostic accuracy of AST / ALT at >= 1 for the diagnosis of esophageal varices taking endoscopy as gold standard. Study design: Cross- sectional study Place and duration of study: Department of Medicine, Mayo Hospital, Lahore from 22nd August, 2014 to 21st February, 2015. Methodology: 220 patients of either sex between 20-60 years of age with the diagnosis of liver cirrhosis were selected using non- probability purposive sampling. AST/ALT Ratio was measured and esophageal varices were confirmed on endoscopy. Results: Out of a total of 220 patients, 133 (60.5%) were males and 87 (39.5%) were females. Mean age of sampled population was 9.23+-7.7 years. Duration of CLD ranged from2 to 9 years with mean 5.38+-2.034 years. For AST/ALT Ratio >1, sensitivity of 97.05%, Specificity 57.1%, Positive predictive value 78.5%, Negative predictive value 92.3%, false positive rate 42 .8% and false negative rate of 7.6% were recorded taking endoscopy as gold standard. Conclusion: AST/ALT Ratio > 1 is sensitive (97.05%) but not specific (57.1%) for the diagnosis of esophageal variceal bleeding

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