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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Autores principales:	Muhammad Khalid Azam, Abdul Latif Khattak, Shazia Naz, Muhammad Tahir Ibrahim, Karamat Hussain Shah Bukhari, Riaz Ahmed
Formato:	article
Lenguaje:	EN
Publicado:	Army Medical College Rawalpindi 2020
Materias:	empyema thorax grocco’s sign khalid’s maneuver paravertebral triangle pleural effusion Medicine R Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/e9f823f3b56f4913863a4c74b407f7e5
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spelling	oai:doaj.org-article:e9f823f3b56f4913863a4c74b407f7e52021-12-02T17:38:55ZKHALID’S MANEUVER; A NEW APPROACH TO GROCCO’S SIGN IN PATIENTS WITH PLEURAL EFFUSION0030-96482411-8842https://doaj.org/article/e9f823f3b56f4913863a4c74b407f7e52020-10-01T00:00:00Zhttps://pafmj.org/index.php/PAFMJ/article/view/5544https://doaj.org/toc/0030-9648https://doaj.org/toc/2411-8842Objective: 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.Muhammad Khalid AzamAbdul Latif KhattakShazia NazMuhammad Tahir IbrahimKaramat Hussain Shah BukhariRiaz AhmedArmy Medical College Rawalpindiarticleempyema thoraxgrocco’s signkhalid’s maneuverparavertebral triangle pleural effusionMedicineRMedicine (General)R5-920ENPakistan Armed Forces Medical Journal, Vol 70, Iss 5, Pp 1251-1255 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	empyema thorax grocco’s sign khalid’s maneuver paravertebral triangle pleural effusion Medicine R Medicine (General) R5-920
spellingShingle	empyema thorax grocco’s sign khalid’s maneuver paravertebral triangle pleural effusion Medicine R Medicine (General) R5-920 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
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.
format	article
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
title	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_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_sort	khalid’s maneuver; a new approach to grocco’s sign in patients with pleural effusion
publisher	Army Medical College Rawalpindi
publishDate	2020
url	https://doaj.org/article/e9f823f3b56f4913863a4c74b407f7e5
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KHALID’S MANEUVER; A NEW APPROACH TO GROCCO’S SIGN IN PATIENTS WITH PLEURAL EFFUSION

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