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Journal of Paediatric Surgeons of Bangladesh
Original Articles · Vol. 14 No. 1-2 (2023)

Operational Diagnostic Criteria in Conjunction with the Triangular Cord Sign Enhance the Screening for Biliary Atresia

Vol. 14 No. 1-2 (2023) — cover
Cover
JPSB
Journal of
Paediatric Surgeons of Bangladesh
Published : July 2023
CONTENTSVolume 14Number 1 & 2January - July 2023
Editorial
Gender Diversity and Disorders of Sex Development: Time for Greater Medical Awareness in Bangladesh
Md Nazrul Islam
01
Original Articles
Impact of Prematurity and Low Birth Weight on Postoperative Mortality in Neonatal Intestinal Obstruction
Manash Talukdar, Md Tawhidul Islam, Shabnam Rashedi, Dibendu Kumar Das, Md Tayef Rahman, Must Tamanna Ruksana, Towkir Ahmed, Anshua Das Trisha
04
Early intervention in NTDs in children leads to better surgical outcome
Anupam Das, Mohammad Mahabubul Alam
11
Use of Pavlik Harness in the Treatment of Infantile Femur Fracture: Clinical and Radiological Outcome
Tafhim Ehsan Kabir, Touhidul Islam, Rahma Binte Anwar, Nafeesa Mubashshira
17
Assessing the Role of Mid-day Meal (MDM) on the Nutritional Profile of School Going Children: Snapshot of a Suburban School
Arpita Biswangree, Md Fahadul Islam, Mustari Nailah Tabassum, Rahatil Asyekin Raha, Sakibul Alam, Mohammad Ismail, Md Sharif Imam, Tahmina Banu
24
Operational Diagnostic Criteria in Conjunction with the Triangular Cord Sign Enhance the Screening for Biliary Atresia
Md Jahidur Rahman, Manash Talukdar Talukdar, Md Mahbub Hossain, Shabnam Rashedi, Sabrina Rahman Mahi
31
Penile Agenesis: Demographic Characteristics and Management Experience in a Tertiary Care Teaching Hospital in Bangladesh
Md Nazrul Islam, Shoheli Alam, Mohammad Mahbubul Alam, Taslima Akter, Asma Ul Husna, Sabrina Khan Mou, Pravin Chowdhury, Mohammad Idrish Ali
36
Evaluation of Chronic Gingivitis in Response to Nickel Chromium and Gold Alloy Crown
Mohammadullah, Md Nazrul Islam, Mohammed Mahbub Zaki, Tawfiqur Rahman, Md Immamur Rashid, Mohammad Idrish Ali
39
Congenital choanal atresia - Endonasal endoscopic surgery - Bangabandhu Sheikh Mujib Medical University
Mohammad Idrish Ali, Kamrul Hasan Tarafder, Sheikh Hasanur Rahman, Rokeya Begum, Md Nazrul Islam, Asma Ul Husna, Sabrina Khan Mou
45
Case Reports
Adult Presentation of Untreated Exstrophy–Epispadias Complex with Squamous Cell Carcinoma: A Rare Case Report
Md Ruhul Amin, Md Nazrul Islam, Pravin Chowdhury
49
The Official Journal of the
ASSOCIATION OF PAEDIATRIC SURGEONS OF BANGLADESH (APSB)
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Authors

  • Md Jahidur RahmanLecturer, Department of Forensic Medicine & Toxicology, Sir Salimullah Medical College, Dhaka, Bangladesh.
  • Manash Talukdar TalukdarAssistant Registrar, Department of Paediatric Surgery, MAG Osmani Medical College Hospital, Sylhet.
  • Md Mahbub HossainAssistant Professor, Department of Radiology & Imaging, National Institute of Ophthalmology and Hospital, Dhaka.
  • Shabnam RashediAssistant Professor, Department of Paediatric Surgery, Sylhet MAG Osmani Medical College.
  • Sabrina Rahman MahiIntern, Community Based Medical College, Bangladesh, Mymensingh.

Keywords

Biliary atresia Diagnostic accuracy Infantile cholestasis Operational criteria Screening Triangular cord sign Ultrasonography

Abstract

Background: The early and accurate diagnosis of biliary atresia (BA) is critical for timely intervention. The triangular cord sign (TCS) on ultrasonography is a valuable tool, but its diagnostic performance can be variable. Objective: To evaluate whether the use of operational diagnostic criteria (ODC) in conjunction with TCS enhances the screening accuracy for BA. Methods: A prospective cohort study was conducted at MAG Osmani Medical College Hospital, Sylhet in Bangladesh from July 2021 to December 2022. A total of 60 infants with persistent jaundice underwent evaluation for biliary atresia via triangular cord sign, operational diagnostic criteria, and confirmation by intraoperative cholangiography. Data were analyzed with SPSS 23.0. Results: Among 60 infants, biliary atresia was confirmed in 38 (63.3%). The triangular cord sign (TCS) showed 76.3% sensitivity and 86.4% specificity. Operational diagnostic criteria (ODC) alone demonstrated 89.5% sensitivity. Crucially, combining TCS and ODC (positive if either was positive) significantly enhanced sensitivity to 97.4% (p<0.001) with a specificity of 77.3%. The negative predictive value for the combined model was 94.4%, and its AUC of 0.94 was superior to either tool alone. Conclusion: The combination of operational diagnostic criteria with the triangular cord sign creates a highly sensitive and effective screening algorithm for biliary atresia. This integrated approach outperforms either method in isolation and can significantly enhance early detection, timely referral, and ultimately, improve outcomes for infants with this serious condition.

Journal of Paediatric Surgeons of Bangladesh (2023) Vol. 14 (1 & 2): 31–35

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