95 Evaluating The Rate, The Predictors And The Outcomes Of Patients With Negative Appendectomy(NAR)

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
K Noureldin ◽  
A Ayantunde ◽  
M Elkholy ◽  
H S Shah Heer Shah ◽  
A Hatim
Keyword(s):  
Serum Bilirubin ◽  
Lower Abdominal Pain ◽  
Inflammatory Cells ◽  
Female Gender ◽  
P Value ◽  
Negative Appendectomy ◽  
Duration Of Symptoms ◽  
The Mean ◽  
Negative Appendicectomy ◽  
Definition Of

Abstract Introduction Appendectomy is associated with complications and negative appendicectomy. We evaluated the rate and predictors of NAR in a cohort. Method Patients' data who underwent emergency appendicectomies over a year was analysed. A definition of NA; absence of inflammatory cells in the appendix. The NAR was calculated using (NAR-SDC) and (NAR-STC). Leucocytosis was a total WBC >11000/mm3, elevated CPR >5 mg/L. Results 372 patients were included. Median durations of symptoms 2 days. The mean admission WBC, CRP and serum bilirubin levels were 12,600 (3000-38000)/mm3, 66.9 (1-323) mg/L and 12.7 (4-38) µmol/L respectively. Laparoscopic appendectomy was performed in 93.5% with a conversion rate of 4.6%.NAR-SDC was 10.2% and NAR-STC was 25.8%. NAR was higher in females than males (39.4% versus 11.1%; p-value 0.0001). Patients with NA were younger (p-value 0.0001), had lower WBC (p-value 0.014), CRP (p-value 0.0001) levels on admission. Female gender, duration of symptoms more than 3 days, lower WBC were found to be predictors of NAR. Conclusions NA is a problem in management of patients with acute right lower abdominal pain. Our NAR compared favourably with reported rates. Female gender, symptoms more than 3 days, lower WBC were predictors of NA.

scholarly journals TP9.2.1Evaluating the incidence, the predictors and the outcomes of patients with negative appendicectomy

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Khaled Noureldin ◽  
Mohamed Elkhouly ◽  
Heer Shah ◽  
AliAsgar HatimAli ◽  
Bolu Ayantunde ◽  
...  
Keyword(s):  
Lower Abdominal Pain ◽  
Inflammatory Cells ◽  
Female Gender ◽  
P Value ◽  
Duration Of Symptoms ◽  
Standard Definition ◽  
Significant Pathology ◽  
The Mean ◽  
Negative Appendicectomy ◽  
Definition Of

Abstract Introduction Negative appendicectomy (NA) is still a major issue following appendicectomy. We evaluated the rate and predictors of negative appendicectomy in a cohort. Patients and Methods Data of patients who underwent emergency appendicectomies over a year was collected and analysed. The absence of inflammation and/or other significant pathology in the appendix was considered negative by standard definition. A stricter definition of NA was the absence of inflammatory cells in the appendix. Negative appendicectomy rate (NAR) was calculated using the standard criteria (NAR-SDC) and the strict criteria (NAR-STC). Results 372 patients were included, 179 males and 193 females with a median age of 27 (5-94) years. Median duration of symptoms and waiting time to surgery were 2 days and 1 day respectively. The mean admission WBC and CRP were 12,600 (3000-38000)/mm3 and 66.9 (1-323) mg/L respectively. Laparoscopic appendicectomy was performed in 93.5% of patients with a conversion rate of 4.6%. NAR-SDC was 10.2% and NAR-STC was 25.8%. NAR was significantly higher in females than males (39.4% versus 11.1%; p-value 0.0001). Patients with NA were younger (p-value 0.0001), had lower mean total WBC (p-value 0.014) and CRP (p-value 0.0001) on admission. Independent predictors of negative appendicectomy are female gender, duration of symptoms more than 3 days, and lower total WBC. Conclusion NA is still a major problem in the management of patients with acute right lower abdominal pain. Our NAR compared favourably with reported rates. Female gender, symptoms duration more than 3 days, lower WBC are independent predictors of NA.

Outcome of Corticosteroid Injection in De Quervain's Tenosynovitis

2021 ◽  
Vol 15 (11) ◽  
pp. 3288-3292
Author(s):  
Wahid Bakhsh ◽  
Asad Ullah Jan ◽  
Muhammad Shafiq ◽  
Naveed Iqbal ◽  
Muzafar Hussain Buriro ◽  
...  
Keyword(s):  
Pain Score ◽  
Triamcinolone Acetonide ◽  
Corticosteroid Injection ◽  
Mean Value ◽  
Injection Pain ◽  
P Value ◽  
Duration Of Symptoms ◽  
De Quervain’S Tenosynovitis ◽  
Minimum Age ◽  
The Mean

Background: De Quervain's tenosynovitis is a painful and swollen stenosing tenosynovitis of the first dorsal compartment of the wrist. After analysing the patient's medical history and doing a physical examination, a diagnosis is made. Finkelstein's test is almost always positive. Objective: The goal of this study was to investigate the effectiveness of local corticosteroid injections in the treatment of de Quervain's tenosynovitis. Material & Methods: The study enrolled fifty patients with De Querven's Tenosynovitis. NSAIDs were provided orally and topically to all patients for an average of six weeks with no obvious improvement. Using a visual analogue scale, it was determined how much soreness would be felt in the first dorsal compartment and how much pain would be felt during the Finkelstein test. The edoema was removed by injecting a mixture of 1 mL (10 mg) triamcinolone-acetonide and 1 mL of 1% lidocain hydrochloride into the affected wrist's first dorsal compartment. They were subsequently examined every two weeks for twenty-four weeks. After a local triamcinolone acetonide injection, pain and discomfort on the radial side of the wrist were alleviated, and a negative Finkelstein test was done. Results: The mean age among the patients was 36.6 years with 12.4 SD. The maximum age was 60 years and the minimum age was 25 years old. The duration of symptoms in 4-8 weeks was observed, the mean value was 6 weeks with 1.4 as SD the minimum duration recorded was 4 weeks with 8 weeks as maximum duration. At the start of the week of appearance of symptoms the pain score was 6.44 with 1.6 as SD. The minimum pain score was 4 and maximum pain score was 8. Pain score at 4 weeks was 0.66 with 1.6 as SD. As per the independent t-test the p value was less than 0.05 so the test was significant statistically. Conclusion: One or two local steroid injections in the first dorsal compartment can give considerable pain and inflammation alleviation in people with de Quervain's tenosynovitis.

Factors predicting the occurrence of syringomyelia in patients with Chiari I malformations

2019 ◽  
Vol 7 (8) ◽  
pp. 2967
Author(s):  
Vijayan Peettakkandy ◽  
Bijukrishnan Rajagopalawarrier ◽  
Sreenath Kuniyil ◽  
Jithin Veliyath Thankaraj
Keyword(s):  
Foramen Magnum ◽  
P Value ◽  
Tonsillar Herniation ◽  
Duration Of Symptoms ◽  
Medical College ◽  
Chiari I ◽  
The Mean ◽  
Time Of Presentation ◽  
Common Association ◽  
Cerebellar Tonsils

Background: Chiari I malformations are defined as the downward herniation of cerebellar tonsils more than 5 mm through the foramen magnum. Syringomyelia is a common association of Chiari I malformation.Methods: This purpose of this study was to determine the various factors predicting the occurrence of syringomyelia in patients with Chiari I malformations. This retrospective study was conducted in Government medical college, Thrissur, Kerala, India. 27 patients admitted with diagnosis of symptomatic Chiari I malformations during the period of January 2015 to January 2019 were selected for the study.Results: The mean age was 22.8 years and syringomyelia was more common in patients older than 10 years (p value0.005). Females were 17(63%) and males were 10(37%) but there no difference in occurrence of syringomyelia among both sexes(p value is 0.16). Syringomyelia was present in 17(63%) cases. Association between various factors and syringomyelia measured by calculating P value which was 0.005 for age >10 years, 0.16 for sex, 0.093 for duration of symptoms >12 months, 0.05 for tonsillar descend >10mm and 0.097 for hypertension. The p value for the association of duration of symptoms >12months and extend of tonsillar descend is 0.001 Mean duration of symptoms (onset of first symptom to the time of presentation) was 16.3 months and syringomyelia was more common in patients with duration of symptoms more than 12 months but this difference was statistically not significant (p value 0.093). Mean tonsillar descend from the level of foramen magnum was 11.3 mms and syringomyelia was more common in patients with tonsillar herniation more than 10mm (p value 0.05). There is a statistically significant relationship between duration of symptoms more than 12 months and tonsillar descend more than 10mm(p value 0.001).There is no significant association between hypertension and occurrence of syringomyelia in patients with Chiari I malformation.Conclusions: Incidence of Chiari I Malformations is more among adults and it is slightly higher in females. Syringomyelia is a common association of Chiari I Malformations. The occurrence of syringomyelia in patients with Chiari I Malformations associated with increasing age of patients and extend of tonsillar herniation. There is no statistically significant association between syringomyelia and duration of symptoms or hypertension.

scholarly journals Severe Perinatal Asphyxia and Risk of Neonatal Jaundice at a Tertiary Hospital in Northern Nigeria

2021 ◽  
pp. 17-22
Author(s):  
I. A. Imoudu ◽  
M. O. Yusuf ◽  
A. T. Aro ◽  
P. E. Akpabio ◽  
Z. M. Waziri
Keyword(s):  
Medical Records ◽  
Neonatal Jaundice ◽  
Serum Bilirubin ◽  
Perinatal Asphyxia ◽  
Tertiary Hospital ◽  
P Value ◽  
Community Based ◽  
Special Care Baby Unit ◽  
The Mean ◽  
The Relationship

Background: The risk factors of neonatal jaundice are largely known, yet there is little agreement on the association between it and perinatal asphyxia. Aim: To investigate the association between severe perinatal asphyxia (SPA) and the risk of clinical jaundice (NNJ) among neonates managed at the Federal Medical Centre, Azare, Nigeria. Methodology: Case control design was employed. Medical records of 315 babies managed at the special care baby unit from 1st January, 2011 to 31st December, 2018 were analysed. The exposure of interest was SPA and the outcome was jaundice. Logistic regression was applied to demonstrate the relationship between neonatal jaundice and SPA. Relative risk was provided as odds ratio and 95% confidence interval. Results: Sixty-three cases and 252 controls were enrolled in the study. The mean age of the cases (4.39) and that of the controls (4.95 ) did not differ significantly (t= -0.52, P= 0.30). One hundred and fifty-six (61.9%) of the controls were males while 34 (54.0%) of the cases were females. For 59 (93.7%) of the cases treatment for jaundice was done with phototherapy and 1.6% required exchange blood transfusion. SPA significantly reduced the risk of developing NNJ (adjusted OR = 0.27, P-value ˂ 0.01).                                                                           Conclusion: We demonstrated a significantly reduced risk of developing neonatal jaundice with prior exposure to severe perinatal asphyxia. Prospective multicenter and community based studies correlated with serum bilirubin levels are recommended.   

scholarly journals Portal vein thrombosis post-splenectomy in thalassemia major patients

2019 ◽  
Vol 10 (4) ◽  
pp. 3356-3368
Author(s):  
Kussay M. Abbas Zwain ◽  
Samer M. Mohamed Al-Hakkak ◽  
Alaa A. Al-Wadees ◽  
Zainab Mahdi Majeed
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Female Gender ◽  
Thalassemia Major ◽  
Spleen Weight ◽  
P Value ◽  
Vein Thrombosis ◽  
Significant Difference ◽  
The Mean ◽  
Wbc Count

β-thalassemia major is a chronic, inherited hematological disease that leads to chronic anemia in the affected children. One of the options of treatment in such patients was splenectomy; however, it is not without risk of many complications; one of them is the thrombotic events. A prospective study of 55 patients with β-thalassemia inscribes in this study. 14 patients (25.5%) had a normal thrombocyte count and 41 patients (74.5%) have an abnormally high thrombocytes count which was significantly associated with PVT (P. Value <0.001), Regarding the WBC count, it extended between 4000 to more than 30,000, in both genders with non-statistically significant differences between both genders, (P>0.05). Regarding the serum ferritin, the mean level was 2908.5 ± 1024.3 ng/ml. In males, the mean S. Ferritin was relatively higher than that of females, 3167.6 ± 1841.3 mg/dl, and 2573.8 ± 1150.6 ng/ml. The weight of the spleen was up to 1500 grams in 25 (80.6%) of males and 20 (83.3 %) of females while it was more than 1500 grams in the remaining and females and males, without a significant difference statistically in the spleen weight of, (P>0.05). The most frequent presenting symptom was abdominal pain. It was founded in 46 patients (83.6%), followed by fever in 76.4%, diarrhea in 58.2%, and Nausea and vomiting in 31 (56.4%). 3 patients out of the 55 (5.5%) developed portal vein thrombosis in their follow up period. Post splenectomy PVT in thalassemia the patient is relatively frequent (5.5%) complication that require a high degree of doubt for diagnosis early, especially in patients with postoperative pain of the abdomen within 2 months after surgery, Female gender, Large spleen and postoperative increase number of platelets are risk factors for PVT so one can initiate surveillance by Doppler ultrasound postoperatively and start antiplatelet prophylactic therapy immediately for such patients. 

scholarly journals Evaluation of variation of D-dimer levels in COVID-19 patients to predict the disease outcome in a hospital based study

2020 ◽  
Vol 24 (5) ◽  
Author(s):  
Shahtaj Khan ◽  
Hamzullah Khan ◽  
Saba Khan ◽  
Mansoor Akhtar
Keyword(s):  
Relative Risk ◽  
Survival Rate ◽  
Standard Deviation ◽  
Age Groups ◽  
Female Gender ◽  
P Value ◽  
The Mean ◽  
And Gender ◽  
Age Range ◽  
D Dimer

Objectives: To determine the variation of d-dimers in COVID-19. To determine the contribution of demographic factors (age and gender) toward an elevated d-dimers values. To determine the probability of surviving in different age groups in COVID-19, with d-dimer > 0.5 µg/ml. Methodology:  A total of 193 patients were enrolled from COVID-19 isolation units, Hayatabad medical complex Peshawar, whose d-dimer levels were performed as per instructions of the treating physician and were followed. Relevant information’s were recorded on a pre-designed performa prepared in accordance with the objectives of the study. Results: Out of total 193 patients 152(78.8%) were males and 41(21.2%) females. 94(48.7%) patients were in the age range 35-55 y while 76(39.4%) patients had age more than 55 y. Regarding d-dimer readings, 162(83.9%) had d-dimer levels more than 0.5 µg/ml. The mean with standard deviation of age of the patients was 52 ± 13 y. The mean with standard deviation of d-dimer values of the patients was 4.9 ± 13.3 µg/ml. It was observed that, the relative risk of deranged values of d-dimers was 1.18 (rr = 1.18) in patients with age > 55 y. Similarly in female gender the relative risk of higher values of d-dimers above normal was 1.26 (rr = 1.26) without reaching a statistically significant p-value (p = 0.48). The probability of worse outcome in term of death was 2.06 times more in patients with d dimers > 0.5 µg/ml (OR = 2.06). Furthermore the probability of surviving was 90-100% by age < 50 y, 80% in age range 51-60 y, 45% in age range 61-70 y and 30% at age  > 80 y. Conclusion: The deranged d-dimer levels were noted in 84% of the COVID-19 patients. Age > 55 y and female gender are at higher risk of deranged d-dimers and further consequences. Survival rate of patients with deranged d-dimers drops to 30% in patients with age > 80 y, 45% at age < 70 y. Key word: COVID-19, D-dimers, survival rate, prognostic values Anaesth. pain intensive care 2020;24(5): Received: 20 June 2020, Reviewed: 24, 28 June 2020, Accepted: 1 July 2020

Atrophic changes in the trigeminal nerves of patients with trigeminal neuralgia due to neurovascular compression and their association with the severity of compression and clinical outcomes

2014 ◽  
Vol 120 (6) ◽  
pp. 1484-1495 ◽  
Author(s):  
Paulo Roberto Lacerda Leal ◽  
Charlotte Barbier ◽  
Marc Hermier ◽  
Miguel Angelo Souza ◽  
Gerardo Cristino-Filho ◽  
...  
Keyword(s):  
High Resolution ◽  
Trigeminal Neuralgia ◽  
Clinical Outcomes ◽  
Pearson Correlation ◽  
P Value ◽  
Neurovascular Compression ◽  
Duration Of Symptoms ◽  
The Mean ◽  
Trigeminal Nerves ◽  
Grade Iii

Object The aim of this study was to prospectively evaluate atrophic changes in trigeminal nerves (TGNs) using measurements of volume (V) and cross-sectional area (CSA) from high-resolution 3-T MR images obtained in patients with unilateral trigeminal neuralgia (TN), and to correlate these data with patient and neurovascular compression (NVC) characteristics and with clinical outcomes. Methods Anatomical TGN parameters (V and CSA) were obtained in 50 patients (30 women and 20 men; mean age 56.42 years, range 22–79 years) with classic TN before treatment with microvascular decompression (MVD). Parameters were compared between the symptomatic (ipsilateralTN) and asymptomatic (contralateralTN) sides of the face. Twenty normal control subjects were also included. Two independent observers blinded to the side of pain separately analyzed the images. Measurements of V (from the pons to the entrance of the nerve into Meckel's cave) and CSA (at 5 mm from the entry of the TGN into the pons) for each TGN were performed using imaging software and axial and coronal projections, respectively. These data were correlated with patient characteristics (age, duration of symptoms before MVD, side of pain, sex, and area of pain distribution), NVC characteristics (type of vessel involved in NVC, location of compression along the nerve, site of compression around the circumference of the root, and degree of compression), and clinical outcomes at the 2-year follow-up after surgery. Comparisons were made using Bonferroni's test. Interobserver variability was assessed using the Pearson correlation coefficient. Results The mean V of the TGN on the ipsilateralTN (60.35 ± 21.74 mm3) was significantly smaller (p < 0.05) than those for the contralateralTN and controls (78.62 ± 24.62 mm3 and 89.09 ± 14.72 mm3, respectively). The mean CSA of the TGN on the ipsilateralTN (4.17 ± 1.74 mm2) was significantly smaller than those for the contralateralTN and controls (5.41 ± 1.89 mm2 and 5.64 ± 0.85 mm2, respectively). The ipsilateralTN with NVC Grade III (marked indentation) had a significantly smaller mean V than the ipsilateralTN with NVC Grade I (mere contact), although it was not significantly smaller than that of the ipsilateralTN with NVC Grade II (displacement or distortion of root). The ipsilateralTN with NVC Grade III had a significantly smaller mean CSA than the ipsilateralTN with NVC Grades I and II (p < 0.05). The TGN on the ipsilateralTN in cured patients had a smaller mean CSA than that on the ipsilateralTN of patients with partial pain relief or treatment failure (p < 0.05). The same finding was almost found in relation to measurements of V, but the p value was slightly higher at 0.05. Conclusions Results showed that TGN atrophy in patients with TN can be demonstrated by high-resolution imaging. These data suggest that atrophic changes in TGNs, which significantly correlated with the severity of compression and clinical outcomes, may help to predict long-term prognosis after vascular decompression.

scholarly journals Correlation between serum bilirubin and serum ferritin Level in thalassaemia patients

2013 ◽  
Vol 4 (2) ◽  
pp. 6-12 ◽  
Author(s):  
N Sultana ◽  
S Sadiya ◽  
MH Rahman
Keyword(s):  
Liver Function ◽  
Serum Ferritin ◽  
Serum Bilirubin ◽  
Common Finding ◽  
P Value ◽  
Thalassaemia Major ◽  
Minimum Level ◽  
Group A ◽  
The Mean ◽  
Group B

Thalassaemia is the most common hereditary disorder in the world including Bangladesh. Beta thalassaemia major and Hb-E thalassaemia both are common in our country. Iron overload causes most of the mortality and morbidity associate with thalassaemia. To assess the iron over load and liver function a cross sectional comparative study was carried out in the Department of Biochemistry, Dhaka Medical College, Dhaka in collaboration with Thalassaemia Center and Department of Pathology, Dhaka Shishu Hospital, Dhaka during the period of July 2006 to June 2007. The study was carried out with the patients who visited regularly in Dhaka Shishu Hospital Thalassaemia Centre (DSHTC) and had multiple transfusions (more than five) and age more than 2 years. To compare the state of liver function with normal healthy individuals' normal healthy persons were also included. Total 70 subjects were included in this study. The study subjects were distributed into two groups, the group - A (cases, n=40) and group - B (healthy controls, n=30). According to the major types of thalassaemia present in our country, group -A again divided into two, group - AI ?-thalassaemia major (n=12) and group - AII of Hemoglobin E ?-thalassaemia (n=28). The mean of serum Bilirubin in group - A and group - B were (2.04 ±0.70) mg/dl and (0.67±0.15) mg/dl respectively. Group - A had higher serum bilirubin than group -B in p value <0.001.The mean level of serum bilirubin in group - AI was (1.70±0.70)mg/dl and the mean of bilirubin in group AII was (2.18±0.66) mg/dl. Group -AI had lower serum bilirubin than group AII in p value <0.05. Pearson's correlation between serum bilirubin and serum ferritin had r value -0.26 was statistically not significant. Mean level of serum ferritin in the total was (2729.40 ± 1935.87) ng/ml, minimum level was 304 ng/ml and maximum was 7256ng/ml. Mean level of serum ferritin in the patients of ? - thalassaemia major was (4098.67 ± 1598.63) ng/ml, minimum level was 1212ng/ml and maximum was 7560ng/ml. Mean level of serum ferritin in the patients of HbE ? - thalassaemia was (2232.57± 1598.63) ng/ml, minimum level was 304ng/ml and maximum was 630ng/ml. Group AI had higher level of serum ferritin than group AII in p value <0.05.In conclusion, iron over load and jaundice are common finding of thalassaemia. In this present study serum ferritin and serum bilirubin parameter of iron over load and jaundice are correlated. But no statistical correlation was found between these two parameters. DOI: http://dx.doi.org/10.3329/bjmb.v4i2.13769 Bangladesh J Med Biochem 2011; 4(2): 6-12

scholarly journals Dominantly Inherited Ataxias in Portugal

1988 ◽  
Vol 15 (4) ◽  
pp. 397-401 ◽  
Author(s):  
L. Cunha ◽  
A. Gonçalves ◽  
M. Dinis ◽  
C. Oliveira ◽  
M. Ferro ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Cross Section ◽  
Age Of Onset ◽  
Duration Of Symptoms ◽  
Follow Up Study ◽  
Duration Of Disease ◽  
The Mean ◽  
Inherited Ataxias ◽  
Definition Of

ABSTRACT:We analysed the clinical features of 82 patients with dominantly inherited ataxia in a cohort survey. All patients fulfilled the diagnostic criteria for Machado-Joseph disease. The mean age of onset of symptoms was 39.8 (± 12.5) years and the duration of the disease was 9.2 (± 6.7) years. Ataxia, peripheral neuropathy, and fasciculation scores correlated with age of onset and duration of disease. Upper motor neuron scores failed to correlate with age of onset. In a follow-up study we analysed the clinical data of 46 patients two years after the first examination. A paired ttest was used to compare differences between observations. The results are in agreement with those of the cross-section in time, suggesting a deterioration of the symptoms with the evolution of the disease. We conclude that dynamic definition of the disease according to age of onset and duration of symptoms is preferable to subdivision into classical types.

scholarly journals Diagnostic value of serum bilirubin in appendicular perforation

2017 ◽  
Vol 4 (10) ◽  
pp. 3445
Author(s):  
Mallikarjuna M. N. ◽  
Utpala Uday
Keyword(s):  
Acute Appendicitis ◽  
Analytical Study ◽  
Serum Bilirubin ◽  
Histopathological Examination ◽  
Perforated Appendicitis ◽  
Liver Function Tests ◽  
Diagnostic Value ◽  
Total Serum ◽  
P Value ◽  
The Mean

Background: Hyperbilirubinemia has been well documented in relation to acute appendicitis. This study tries to establish the diagnostic value of this parameter in determining the severity of acute appendicitis.Methods: This is a prospective analytical study conducted on 100 patients with acute appendicitis. All patients were subjected to clinical evaluation and investigations; including liver function tests. The diagnosis was confirmed peri-operatively and postoperatively by histopathological examination. The data was compiled and analysed.Results: The incidence of complicated appendicitis was found to be 18%, defined as evidence of gangrene, or microscopic or gross perforation on histopathological examination. Among these total serum bilirubin (TSB) was raised in 17 cases (17%) and statistically significant correlation was established by p-value <0.001. The mean of TSB level was higher in perforated appendicitis than in cases of acute appendicitis (0.57±0.26 mg/dL; range 0.1-1.2 versus 1.68±1.09 mg/dL; range 0.8-4.8 mg/dL). TSB was shown to have specificity of 96.4%, sensitivity 88.2%, PPV 83.3% and NPV was 97.6%. The diagnostic accuracy of raised bilirubin for diagnosis of appendicular perforation was calculated to be 95.0%. The rise in bilirubin was mixed in type (both indirect and direct). There could not be established any correlation between the liver enzymes and appendicitis or its complications.Conclusions: This study ascertains the predictive value of serum bilirubin in acute appendicitis patients as an indicator of severity. Raised bilirubin in the setting of acute appendicitis identifies higher probability of appendicular perforation. 

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