KHALID’S MANEUVER; A NEW APPROACH TO GROCCO’S SIGN IN PATIENTS WITH PLEURAL EFFUSION
Objective: To compare the usefulness of Grocco’s sign with an alternative method, Khalid’s maneuver, which does not require any change in patient’s position to elicit Grocco’s sign. Study Design: A comparative prospective study. Place and Duration of Study: Combined Military Hospital Lahore, f...
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| Format: | Article |
| Language: | English |
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Army Medical College Rawalpindi
2020-10-01
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| Series: | Pakistan Armed Forces Medical Journal |
| Subjects: | |
| Online Access: | https://pafmj.org/index.php/PAFMJ/article/view/5544 |
| _version_ | 1818431294042800128 |
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| author | Muhammad Khalid Azam Abdul Latif Khattak Shazia Naz Muhammad Tahir Ibrahim Karamat Hussain Shah Bukhari Riaz Ahmed |
| author_facet | Muhammad Khalid Azam Abdul Latif Khattak Shazia Naz Muhammad Tahir Ibrahim Karamat Hussain Shah Bukhari Riaz Ahmed |
| author_sort | Muhammad Khalid Azam |
| collection | DOAJ |
| description | Objective: To compare the usefulness of Grocco’s sign with an alternative method, Khalid’s maneuver, which does not require any change in patient’s position to elicit Grocco’s sign.
Study Design: A comparative prospective study.
Place and Duration of Study: Combined Military Hospital Lahore, from Jan 2019 to Jul 2019.
Methodology: A total of 200 patients who were divided into two groups (group A and group B) with 100 patients in each group. Group A was a control group. Group B was subdivided into group B1 containing patients with serous pleural effusion and group B2 containing patients with empyema. Two independent operators were asked to do chest percussion in all patients to elicit Grocco’s sign. Furthermore Positional method and Inspiratory
method (Khalid’s maneuver) to elicit disappearance of dullness in Grocco’s triangle were compared in patients with positive Grocco’s sign Statistical significance & 95% confidence interval was calculated using nonparametric unpaired t test (Mann-Whitney U-Test).
Results: Grocco’s sign was negative in all patients in group A while it was positive in all patients in group B. In group B1 patients, the percussion dullness disappeared in Grocco’s triangle in 48 (96%) (95% CI 93.2-98.1) patients by the positional method and 46 (92%) (95% CI 90.1-95.6) patients by Khalid’s maneuver with statistically insignificant p-value i.e. 0.44. In group B2 patients, the percussion dullness failed to disappear by both methods.
Conclusion: Grocco’s sign helps in assessment of the patients with simple and complex pleural effusion and thus guiding further management decisions early in time. Khalid’s maneuver which has the ability to elicit Grocco’s sign with near similar accuracy provides handy alternative for such patients with comparable p-value to the standard procedure. |
| first_indexed | 2024-12-14T15:47:01Z |
| format | Article |
| id | doaj.art-e9f823f3b56f4913863a4c74b407f7e5 |
| institution | Directory Open Access Journal |
| issn | 0030-9648 2411-8842 |
| language | English |
| last_indexed | 2024-12-14T15:47:01Z |
| publishDate | 2020-10-01 |
| publisher | Army Medical College Rawalpindi |
| record_format | Article |
| series | Pakistan Armed Forces Medical Journal |
| spelling | doaj.art-e9f823f3b56f4913863a4c74b407f7e52022-12-21T22:55:28ZengArmy Medical College RawalpindiPakistan Armed Forces Medical Journal0030-96482411-88422020-10-0170512511255KHALID’S MANEUVER; A NEW APPROACH TO GROCCO’S SIGN IN PATIENTS WITH PLEURAL EFFUSIONMuhammad Khalid Azam0Abdul Latif Khattak1Shazia Naz2Muhammad Tahir Ibrahim3Karamat Hussain Shah Bukhari4Riaz Ahmed5Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) PakistanCombined Military Hospital Lahore/National University of Medical Sciences (NUMS) PakistanPak Rangers Teaching Hospital, Lahore PakistanCombined Military Hospital Lahore/National University of Medical Sciences (NUMS) PakistanCombined Military Hospital Lahore/National University of Medical Sciences (NUMS) PakistanCombined Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi PakistanObjective: To compare the usefulness of Grocco’s sign with an alternative method, Khalid’s maneuver, which does not require any change in patient’s position to elicit Grocco’s sign. Study Design: A comparative prospective study. Place and Duration of Study: Combined Military Hospital Lahore, from Jan 2019 to Jul 2019. Methodology: A total of 200 patients who were divided into two groups (group A and group B) with 100 patients in each group. Group A was a control group. Group B was subdivided into group B1 containing patients with serous pleural effusion and group B2 containing patients with empyema. Two independent operators were asked to do chest percussion in all patients to elicit Grocco’s sign. Furthermore Positional method and Inspiratory method (Khalid’s maneuver) to elicit disappearance of dullness in Grocco’s triangle were compared in patients with positive Grocco’s sign Statistical significance & 95% confidence interval was calculated using nonparametric unpaired t test (Mann-Whitney U-Test). Results: Grocco’s sign was negative in all patients in group A while it was positive in all patients in group B. In group B1 patients, the percussion dullness disappeared in Grocco’s triangle in 48 (96%) (95% CI 93.2-98.1) patients by the positional method and 46 (92%) (95% CI 90.1-95.6) patients by Khalid’s maneuver with statistically insignificant p-value i.e. 0.44. In group B2 patients, the percussion dullness failed to disappear by both methods. Conclusion: Grocco’s sign helps in assessment of the patients with simple and complex pleural effusion and thus guiding further management decisions early in time. Khalid’s maneuver which has the ability to elicit Grocco’s sign with near similar accuracy provides handy alternative for such patients with comparable p-value to the standard procedure.https://pafmj.org/index.php/PAFMJ/article/view/5544empyema thoraxgrocco’s signkhalid’s maneuverparavertebral triangle pleural effusion |
| spellingShingle | Muhammad Khalid Azam Abdul Latif Khattak Shazia Naz Muhammad Tahir Ibrahim Karamat Hussain Shah Bukhari Riaz Ahmed KHALID’S MANEUVER; A NEW APPROACH TO GROCCO’S SIGN IN PATIENTS WITH PLEURAL EFFUSION Pakistan Armed Forces Medical Journal empyema thorax grocco’s sign khalid’s maneuver paravertebral triangle pleural effusion |
| title | KHALID’S MANEUVER; A NEW APPROACH TO GROCCO’S SIGN IN PATIENTS WITH PLEURAL EFFUSION |
| title_full | KHALID’S MANEUVER; A NEW APPROACH TO GROCCO’S SIGN IN PATIENTS WITH PLEURAL EFFUSION |
| title_fullStr | KHALID’S MANEUVER; A NEW APPROACH TO GROCCO’S SIGN IN PATIENTS WITH PLEURAL EFFUSION |
| title_full_unstemmed | KHALID’S MANEUVER; A NEW APPROACH TO GROCCO’S SIGN IN PATIENTS WITH PLEURAL EFFUSION |
| title_short | KHALID’S MANEUVER; A NEW APPROACH TO GROCCO’S SIGN IN PATIENTS WITH PLEURAL EFFUSION |
| title_sort | khalid s maneuver a new approach to grocco s sign in patients with pleural effusion |
| topic | empyema thorax grocco’s sign khalid’s maneuver paravertebral triangle pleural effusion |
| url | https://pafmj.org/index.php/PAFMJ/article/view/5544 |
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