The SLAPPA (Significance of Lower Abdominal/Periumbilical Piercing as a predictor of acute Appendicitis) audit

Sexual Health ◽  
2006 ◽  
Vol 3 (3) ◽  
pp. 195 ◽  
Author(s):  
Irfan Ahmed ◽  
Matthew K. Boulter ◽  
Dileep N. Lobo
Keyword(s):  
Acute Appendicitis ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Clinical Judgment ◽  
Health Care Professionals ◽  
Iliac Fossa ◽  
Final Diagnosis ◽  
Female Patients ◽  
Group A ◽  
Group B

Background: Anecdotal observations among medical staff suggest that young women with periumbilical piercing presenting with right iliac fossa pain are more likely to have pelvic inflammatory disease than acute appendicitis because of an unconventional lifestyle. This audit was performed to test the validity of this prejudice. Methods: The clinical data of all female patients aged 16–45 years admitted to a teaching hospital with suspected acute appendicitis were collected prospectively over six months. Patients who had undergone previous appendicectomy or gynaecological surgery, those with known Crohn’s disease, or those on antibiotics at the time of admission were excluded. Results: 107 patients with a median age of 29.7 years (range 15–45 years) were studied. Thirty-two patients had periumbilical piercing (Group A) and 75 patients did not (Group B). Fifty-nine out of 107 (55.14%) were operated upon. Ten (31.2%) patients in Group A had histologically confirmed acute appendicitis compared with 25 (33.3%) in Group B. Other diagnoses in Group A included non-specific abdominal pain (n = 13, 40.6%), urinary tract infection (4, 12.5%), pelvic inflammatory disease (4, 12.5%) and ovarian cyst (1, 3.1%). Corresponding figures for patients in Group B were 30 (40.0%), 8 (10.7%), 7 (9.3%) and 4 (5.3%) respectively. None of the differences between the two groups were statistically significant. Conclusions: There was no difference in the frequency of a final diagnosis of acute appendicitis or pelvic inflammatory disease in female patients with and without periumbilical piercing. Health care professionals should not allow their clinical judgment to be prejudiced by the presence of body piercing.

scholarly journals ANTIBIOTIC PROPHYLACTICS ON CURETTAGE FOR PREVENTING PELVIC INFLAMMATORY DISEASE EVENTS: IS IT NECESSARY?

2018 ◽  
Vol 11 (11) ◽  
pp. 267
Author(s):  
Fauna Herawati ◽  
Abdul Rahem ◽  
Dwi Handayani ◽  
Rika Yulia
Keyword(s):  
Antibiotic Prophylaxis ◽  
Pelvic Inflammatory Disease ◽  
Sedimentation Rate ◽  
Inflammatory Disease ◽  
Vaginal Discharge ◽  
Pain Scale ◽  
Prophylactic Antibiotics ◽  
Erythrocyte Sedimentation ◽  
Group A ◽  
Group B

Objective: This study aimed to compare pelvic inflammatory disease (PID) symptoms in curettage procedure with three antibiotic prophylaxis strategies.Methods: The patients were allocated to three Groups (A, B, and C). Group A was patients receiving prophylactic antibiotics and post-curettage antibiotics, Group B received prophylactic antibiotics without post-curettage antibiotics, and Group C did not receive prophylactic antibiotics but received post-curettage antibiotics. The outcomes measured to identify the occurrence of PID symptoms included leukocytes, erythrocyte sedimentation rate, temperature, pain, vaginal discharge, and bleeding.Results: This study shows that there were no significant differences in any PID symptoms between antibiotic strategies except for pain scale (p=0.03).Conclusion: The PID symptoms between the three strategies of antibiotic prophylaxis were similar.

scholarly journals Diagnostic accuracy of acute appendicitis by comparing clinical judgment of surgeons and Alvarado scoring in suspected acute appendicitis

2021 ◽  
Vol 8 (9) ◽  
pp. 2725
Author(s):  
Ishory Bhusal ◽  
Chandra Shekhar Agarwal ◽  
Rakesh Kumar Gupta ◽  
Suresh Prasad Sah
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Clinical Judgment ◽  
Scoring System ◽  
Randomized Study ◽  
Tertiary Hospital ◽  
Alvarado Score ◽  
Suspected Appendicitis ◽  
Group A ◽  
Group B

Background: The Alvarado score is a clinical scoring system used in the diagnosis of acute appendicitis. The aim of the study was to compare the clinical judgment of surgeons and Alvarado score in diagnosing acute appendicitis within Nepalese people and to refine the score and suggest a new score to make a more accurate diagnosis of acute appendicitis.Methods: In this prospective, parallel-group, quasi-randomized study of patients presenting at a tertiary hospital in eastern Nepal with suspected appendicitis during 1 year were assigned in weekly alternation to either group A or group B. The group A patients were treated on the basis of their Alvarado score, and the group B patients based on the clinical judgment. The correctness of the methods was assessed by the final histology.Results: In this study, the mean age of patients in Alvarado group was 26.45 years and in clinical judgment was 28.68 years. The sensitivity, the specificity, the diagnostic accuracy, the positive predictive value and negative appendectomies in Alvarado group were 95.5%, 68.9%, 90.91%, 93.4% and 6.56% respectively whereas in clinical judgment group were 98.51%, 85.71%,496.4%, 97.04% and 3.59% respectively.Conclusions: This study showed clinical judgment to be more reliable in the diagnosis of acute appendicitis than the Alvarado score, but the score is a useful diagnostic aid, especially for young colleagues. The use of the new scoring system has become easier. It includes fewer criteria as well as an important and sensitive predictor: the ultrasound investigation.

scholarly journals What are the responsible risk factors for delay in diagnosis of acute appendicitis in children? Eleven-year research from a single institution

Folia Medica ◽  
2019 ◽  
Vol 61 (3) ◽  
pp. 389-396
Author(s):  
Katerina Kambouri ◽  
Maria Aggelidou ◽  
Savvas Deftereos ◽  
Aggelos Tsalkidis ◽  
George Vaos ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Imaging Techniques ◽  
Diagnostic Delay ◽  
Initial Examination ◽  
Delay In Diagnosis ◽  
Paediatric Surgeon ◽  
Main Effect ◽  
Logistic Regression Method ◽  
Group A ◽  
Group B

Introduction: We conducted a retrospective analysis of 602 children operated on for acute appendicitis (AA) in our department between 1/2007 and 12/2017. Aim: The aim of this study was to identify factors that are related to a delay in diagnosing AA in children. Furthermore, we’d like to strengthen our previous preliminary results by a) adding gender as a new factor and b) studying a much larger population. Materials and methods: The time that elapsed from the onset of symptoms to the surgical intervention was associated with gender, age, obesity, use of antibiotics prior to diagnosis, and the initial examination by a paediatric surgeon or another physician. Univariate and multivariate logistic regression method (backward method) was applied. Results: The diagnosis of AA was delayed by at least 48 hours in 287 patients (group A, 47.7%) and was made within 48 hours in 315 patients (group B, 52.3%). In multivariate model we noticed that boys who were examined by a paediatric surgeon and didn’t take antibiotics had decreased odds of having length of diagnostic period >48 hours, girls who received antibiotics compared to girls who do not use antibiotics are almost 12 times more likely to have length of diagnostic period >48 hours, the very young age has а main effect оn the diagnostic delay and girls who have been examined by other physician compared to females who have been examined by paediatric surgeon have decreased odds of having length of diagnostic period >48 hours. Conclusions: Therefore, physicians examining children with abdominal pain must keep in mind the multiple causes of diagnostic delay that may exist alone or in combination, and which can lead to serious complications and lengthen the hospital stay. Performing repeated examinations and asking for advice from a specialist specifically for children who are a special category of patients, in areas where it is rather impossible to use imaging techniques, could be the key to correctly diagnosing and treating AA.

scholarly journals Comparison of Early and Delayed Laparoscopic Cholecystectomy in Acute Cholecystitis

2021 ◽  
Vol 15 (1) ◽  
pp. 91-94
Author(s):  
Muhammad Nasir ◽  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Acute Cholecystitis ◽  
Open Cholecystectomy ◽  
Early Laparoscopic Cholecystectomy ◽  
Female Patients ◽  
Delayed Laparoscopic Cholecystectomy ◽  
Conversion To Open Cholecystectomy ◽  
Group A ◽  
Male Patients ◽  
Group B

Background: Laparoscopic Cholecystectomy is now accepted as being safe for acute cholecystitis. However, it has not become routine, because the exact timing and approach to the surgical management remains ill define. Careful selection of patients, the knowledge of typical procedure-related complications, and their best treatment are the key points for a safe Laparoscopic Cholecystectomy. Objective: To compare the early and delayed Laparoscopic Cholecystectomy in the acute phase in terms of frequency of conversion to open cholecystectomy. Study Design: Randomized clinical trial. Settings: Department of Surgery, Divisional Headquarter Hospital, Faisalabad. Punjab Medical College, Faisalabad Pakistan. Duration: Study was carried out over a period of six months from June 2018 to May 2019. Methodology: A total of 152 cases (76 cases in each group) were included in this study. All patients were randomly allocated to either group i.e., group -A early Laparoscopic Cholecystectomy and group-B delayed Laparoscopic Cholecystectomy. Results: Mean age was 39.09 + 8.8 and 37.05+ 8.5 years in group- A and B, respectively. In group-A, male patients were 48 (63.2%) and female patients were 28 (36.8%). Similarly, in group-B, male patients were 41 (53.9%) and female patients were 35 (46.1%). Conversion to open cholecystectomy was required in 6 patients (7.9%) of group-A and 16 patients (21.0%) of group – B. Significant difference between two groups was observed (P= 0.021). Conclusion: Early laparoscopic cholecystectomy for acute cholecystitis is safe and feasible in terms of less frequency of conversion to open cholecystectomy.

Posterior Tibial Tendon Dysfunction: Its Association with Seronegative Inflammatory Disease

Foot & Ankle ◽  
1989 ◽  
Vol 9 (5) ◽  
pp. 219-225 ◽  
Author(s):  
Mark Myerson ◽  
Gary Solomon ◽  
Michael Shereff
Keyword(s):  
Inflammatory Disease ◽  
Demographic Data ◽  
Mechanical Trauma ◽  
Posterior Tibial Tendon ◽  
Inflammatory Disorder ◽  
Posterior Tibial Tendon Dysfunction ◽  
Posterior Tibial ◽  
Systemic Inflammatory Disease ◽  
Group A ◽  
Group B

Idiopathic inflammation and rupture of the posterior tibial tendon (PTT) has received much attention in the recent literature. In this report of the presentation of PTT dysfunction as a manifestation of seronegative inflammatory disease, we describe the clinical and laboratory features of 76 patients with inflammation and/or rupture of the PTT. Analysis of all patients identified two discrete groups. Group A patients were younger (mean age 39 years) and had multiple manifestations of inflammation at other sites of ligament and tendon attachments (enthesopathy). Other features of a systemic inflammatory disorder such as oral ulcers, conjunctivitis, colitis, and especially psoriasis were common in the latter patients and their families. Group B consisted predominantly of elderly patients (mean age 64 years) with isolated dysfunction of the PTT. These two groups differed widely in the manner of clinical presentation, demographic data, family history, HLA data, and surgical pathology. These distinctions suggest different pathogeneses for posterior tibial tendinitis. Group A demonstrated local manifestations of a systemic inflammatory disease, whereas group B exhibited the effects of mechanical trauma and degeneration.

Cervical malalignment after laminoplasty: relationship to deep extensor musculature of the cervical spine and neurological outcome

2007 ◽  
Vol 7 (6) ◽  
pp. 610-614 ◽  
Author(s):  
Haku Iizuka ◽  
Takashi Nakajima ◽  
Yoichi Iizuka ◽  
Yasunori Sorimachi ◽  
Tsuyoshi Ara ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Neurological Outcome ◽  
Neurological Recovery ◽  
Cervical Lordosis ◽  
Cervical Alignment ◽  
Female Patients ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
The Relationship

Object The goal of this study was to investigate the relationship between preservation of the insertion of the deep extensor musculature of the cervical spine at C-2 and postoperative cervical alignment, especially differences between cases involving male and female patients, as well as the relationship between the loss of cervical lordosis and neurological outcome after laminoplasty. Methods The authors reviewed the records of 50 patients who underwent laminoplasty to elevate the C-3 lamina with repair of the deep extensor musculature (Group A) and 31 patients who underwent laminoplasty by C-3 dome laminotomy or laminectomy (Group B). They compared the degree of cervical lordosis after laminoplasty with preoperative measurements. Neurological function at last follow-up was also compared with preoperative assessments. Results In Group A, the mean values for pre- and postoperative cervical lordosis were 14.5 and 10.9°, respectively (p > 0.18). In female patients, however, the pre- and postoperative means were 14.4 and 3.7°, respectively (p < 0.004). In Group B, the overall means for pre- and postoperative cervical lordosis were 17.3 and 19.1°, respectively (p > 0.48); the corresponding means for female patients were 15.0 and 14.1° (p > 0.83). The mean percentages of neurological recovery were 54.1% in Group A and 54.8% in Group B. Conclusions Preservation of the insertion of the deep extensor musculature to the C-2 spinous process prevented significant changes in cervical alignment after laminoplasty, even among female patients. Neurological recovery was not affected by the loss of cervical lordosis.

How to differentiate acute pelvic inflammatory disease from acute appendicitis ? A decision tree based on CT findings

2017 ◽  
Vol 28 (2) ◽  
pp. 673-682 ◽  
Author(s):  
Kim El Hentour ◽  
Ingrid Millet ◽  
Emmanuelle Pages-Bouic ◽  
Fernanda Curros-Doyon ◽  
Nicolas Molinari ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Decision Tree ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Ct Findings ◽  
Acute Pelvic Inflammatory Disease

scholarly journals FVC, FEV1 and FEV1 / FVC % in Hypothyroid Female and their Relationships with Thyroid Hormones

1970 ◽  
Vol 6 (1) ◽  
pp. 45-51
Author(s):  
Pervin Akter ◽  
Shelina Begum ◽  
Taskina Ali ◽  
Noorzahan Begum
Keyword(s):  
Lung Function ◽  
Thyroid Hormones ◽  
Female Patients ◽  
Normal Ranges ◽  
Significant Difference ◽  
Microparticle Enzyme Immunoassay ◽  
Group A ◽  
Predicted Values ◽  
Group B ◽  
Serum Tsh

Background: Hypothyroidism is a common hormonal disorder affecting various organs including lungs. It may be associated with respiratory symptoms and can decrease lung function. Objective: To observe FVC, FEV1 and FEV1/ FVC % in hypothyroid female patients. Methods: This crosssectional study was carried out in the Department of Physiology, BSMMU, Dhaka, from 1st July 2008 to 30th June 2009 on 60 hypothyroid female patients of 30-50 years age (Group B). For comparison, 30 age and BMI matched apparently healthy subjects (Group A) were also studied. Based on receiving treatment, hypothyroid patients were divided into B1 (untreated patients on their 1st day of diagnosis) and B2 (patients treated for at least 12-18 months). They were selected from the Out Patient Department of Endocrinology wing of department of Medicine, BSMMU, Dhaka. Serum TSH and FT4 levels were measured by Microparticle Enzyme Immunoassay (MEIA) principle in AxSYM system. The FVC, FEV1, FEV1/FVC%, of all the subjects were measured by a digital MicroDL spirometer. Data were analyzed by One way ANOVA test, Independent sample t- test and Pearson’s correlation coefficient test. Results: The mean percentage of predicted values of all the lung function variables in healthy female subjects and treated hypothyroids were within normal ranges. However, all of them were lower in untreated hypothyroids in comparison to those of control and treated hypothyroids.FVC and FEV1 showed statistically significant (p<0.001) difference and FEV1/FVC% showed non significant difference . In addition, all the ventilatory variables had negative correlation with serum TSH level and positive correlation with serum FT4 level and these relationships were statistically significant in control (p<0.001) and treated hypothyroids (p<0.01). Conclusion: This study reveals that lung function may be lower in untreated hypothyrod patients and correlated with thyroid hormones. Treatment of hypothyroids may reverse this changes. Key words: FVC, FEV1 , FEV1/FVC%, Hypothyroidism    DOI: http://dx.doi.org/10.3329/jbsp.v6i1.8084 J Bangladesh Soc Physiol. 2011 June; 6(1): 45-51

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