EP.FRI.479 Clinical accuracy of u/sound combined with inflammatory markers in Acute Appendicitis

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Nadia Gulnaz ◽  
Sadia Tasleem ◽  
Farooq Abdullah
Keyword(s):  
Acute Appendicitis ◽  
Clinical Diagnosis ◽  
Inflammatory Markers ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Negative Appendectomy ◽  
Care Hospital ◽  
Clinical Accuracy ◽  
Negative Appendicectomy ◽  
Sensitivity Specificity

Abstract Traditionally acute appendicitis has been a clinical diagnosis based on patients' history and physical examination, but the accuracy of clinical diagnosis ranges from 70-95%. Pre-operative diagnosis of acute appendicitis still remains an enigmatic challenge, because no single test alone can reduce the rate of negative appendectomy. Hence some authors have recommended a combination of two or more investigations to increase accuracy and therefore the use of imaging is gaining support. The objective of the study was to determine the clinical accuracy of ultrasound, combined with inflammatory markers such as CRP, WBC, and neutrophilia keeping histopathology as the gold standard. Methods The study was conducted in a Tertiary care hospital in Peshawar from September 2014 to March 2015 on 250 patients who were clinically diagnosed with acute appendicitis. All these patients underwent u/sound scanning in addition to blood tests. Findings In this study, WBC had the highest sensitivity (77.68%) followed by neutrophil% (69.96%), CRP(67.10%), and U/Sound (62.96%) respectively. While U/Sound had the highest specificity (70.59%) followed by CRP and TLC (64.71% each) and neutrophil% (58.82%) respectively. When all the four tests were combined the sensitivity, specificity, (99.17% and 98.45%) increased significantly. When all four tests were negative, appendicitis could be safely ruled out. Conclusion Acute appendicitis is very unlikely and surgery can be safely deferred in these patients when all tests are negative thereby reducing the negative appendicectomy rates. 

TO DETERMINE THE ROLE OF CA125 IN THE DIAGNOSIS OF ACUTE APPENDICITIS

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Vinod Kumar ◽  
Bhupen Songra ◽  
Richa Jain ◽  
Deeksha Mehta
Keyword(s):  
Acute Appendicitis ◽  
Clinical Diagnosis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Ca 125 ◽  
Care Hospital ◽  
Serum Samples ◽  
Roc Curve Analysis ◽  
Surgery Department

Background: the present study was under taken to determine the role of CA-125 in the diagnosis of acute appendicitis (AA), to prevent its complications and also in preventing negative appendicectomies in tertiary care hospital. Methods: The study was conducted at a tertiary care and research center between 01/03/2018 to 30/06/2019. Patients admitted to the surgery department with diagnosis of AA were considered for the study. After informed consent, a, standardized history was obtained as a case Performa. Serum samples from all the cases with clinical diagnosis of AA were obtained and stored. Only the cases with histopathologically approved AA were included in the study. Cases operated for clinical diagnosis of AA, but not histopathologically proven AA was not included in the study. CA125 levels in cases with definitive diagnosis of AA were measured. Results: In present study, ROC curve analysis revealed the sensitivity of 87.27 % and specificity of 90.91 % when the CA 125 cut-off value of > 16.8 was taken to diagnose acute appendicitis. AUC was 0.911 with a standard error of 0.0292. Conclusion: In this study we have observed that CA125 showed a positive correlation with acute appendicitis, that was statistically not significant (P>0.05). We didn’t evaluate the correlation with the disease severity. We consider that CA125 can be used as a marker in acute appendicitis cases although further research is still needed. Keywords: CA125, Acute Appendicitis, Surgery.

scholarly journals APPENDICITIS;

2019 ◽  
Vol 26 (01) ◽  
Author(s):  
Gulshan Ali Memon ◽  
Syed Kashif Ali Shah ◽  
-ur-Rehman Khan Toor
Keyword(s):  
Diagnostic Accuracy ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Scoring Systems ◽  
Negative Appendectomy ◽  
Care Hospital ◽  
Predictive Values ◽  
Suspected Appendicitis ◽  
Clinical Accuracy ◽  
Prospective Comparative Study

ABSTRACT… Background: Acute appendicitis continues to be the most common surgical problem till date and its diagnosis in this era of advance innovation still remains to be on lock horns, resulting in the high rates of negative appendectomy. In this perplexed dilemma the designed scoring systems have been forwarded to aid the clinical accuracy in patients for suspicious appendicitis.The appendicitis Inflammatory Response (AIR) score has outperformed the more widespread Alvarado scoring (ALS) in many documented studies. So, the aim of this study was to evaluate and compare the AIR score with ALS system for diagnostic accuracy in patients with suspicious appendicitis. Study Design: Prospective comparative study to evaluate the AIR and ALS at score of (5 – 8) in 150 patients with suspected appendicitis. Setting: Tertiary care hospital. Period: March 2016 to January 2018. Methods: The score were measured and compared for diagnostic accuracy through statistical analysis. Results: This prospective study has drawn an inference that AIR scoring system for suspicious appendicitis has slightly higher percentage (91.07%) of sensitivity compared to ALS system (86.36%). This study enunciates the positive, negative predictive values for profound accuracy of diagnosis with 91.07%, 73.68% and 86.67% by AIRs and 86.36%, 62.50% and 80% by ALS systems (ALs) respectively. Among 150 patients, 30 (20%) were with negative appendectomies. Conclusion: The data of present study appreciate that:AIRs system having variable of CRP and WBC has high diagnostic accuracy in comparison to ALS system of patients with suspected appendicitis.AIRs can safely protect the health care resource by avoiding un-necessary hospitalization, Investigations and interventions.

scholarly journals Clinical and Demographic Characteristics of COVID-19 Patients Admitted in a Tertiary Care Hospital in the Dominican Republic

2020 ◽  
Author(s):  
David De Luna ◽  
Yori Roque ◽  
Nicolás Batlle ◽  
Katherine Gómez ◽  
Miguelina Jáquez ◽  
...  
Keyword(s):  
Dominican Republic ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Inflammatory Markers ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Demographic Characteristics ◽  
Care Hospital ◽  
Presenting Symptoms ◽  
Overall Mortality

AbstractTo present clinical and demographic characteristics of COVID-19 patients admitted to Hospital Metropolitano de Santiago in Dominican Republic, we analyzed electronic medical records of all hospitalized patients clinically admitted as viral pneumonia through March - April, 2020. Of 374 patients, 150 (40.1%) laboratory confirmed, were included in this study. Most of the patients were men (104 / 69.3%) with a median (IQR 44 - 66) age of 54. Hypertension (83 / 55.3%) and diabetes mellitus (49 / 32.7%) were the most common comorbidities, whereas fever (120 / 80%), cough (79 / 52.7%) and fatigue (60 / 40%) were the most common presenting symptoms. 28 (18.7%) patients required admission to the intensive care unit, of them, 26 patients (17.3%) required mechanical ventilation. The overall mortality rate was 10.7% Higher levels of inflammatory markers were associated with longer length of stay (LOS). This findings indulge information that could contribute to stratify patients at higher risk of complications.

scholarly journals A prospective study of clinical and diagnostic methods of ovarian tumors admitted in a tertiary care hospital and its correlation with histopathology

2021 ◽  
Author(s):  
Silika Madria ◽  
Vineeta Ghanghoriya ◽  
Kavita N. Singh ◽  
Manisha Lokwani ◽  
Ranu Tiwari
Keyword(s):  
Clinical Diagnosis ◽  
Sensitivity And Specificity ◽  
Tertiary Care ◽  
Ovarian Tumors ◽  
Diagnostic Methods ◽  
Care Hospital ◽  
Ultrasound Score ◽  
Benign Ovarian Tumors ◽  
Sensitivity Specificity ◽  
Ovarian Masses

Background: Aim of the study was to study demographic profile and diagnostic modalities of ovarian tumors and their correlation with histopathological report (HPR).Methods: Prospective observational study conducted in NSCB medical college, Jabalpur from February 2019 to July 2020 on subjects with ultrasonographically diagnosed ovarian tumors. Relevant history obtained, gynecologic examination, investigations recorded. Subjects followed up to collection of HPR and correlation with histopathology done.Results: Out of 120 cases of ovarian tumors, 39.16% were malignant and 60.83% were benign ovarian tumors. Out of 80 premenopausal females, majority (78.75%) had benign ovarian masses. Amongst 40 postmenopausal females, 75% of ovarian masses were malignant. CA125 had sensitivity 76.59%, specificity 76.71% and accuracy 76.66% in diagnosing ovarian malignancy. Amongst 4 RMI scores, RMI 1 has the highest sensitivity and specificity 85.10%, 86.30% respectively. Sensitivity, specificity, and accuracy of ultrasound score was 65.21%, 86.30% and 77.5% respectively. Sensitivity and specificity of clinical diagnosis was 83% and 95.89% respectively and ROC analysis showed clinical diagnosis can accurately predict benign and malignant ovarian tumors in 89% cases.Conclusions: RMI 1 score has the highest sensitivity and specificity in our study. When all 4 methods of diagnosis i.e., RMI Score, ultrasound score, CA125 and clinical diagnosis were compared, clinical diagnosis has highest prediction of malignancy.

Clinical profile of acute appendicitis at tertiary care hospital

2019 ◽  
Vol 11 (1) ◽  
pp. 72-74
Author(s):  
Sanjay Anarase ◽  
◽  
Yogita Sanjay Anarase ◽  
Keyword(s):  
Acute Appendicitis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Profile ◽  
Care Hospital

EVALUATION OF MODIFIED ALVARADO SCORE IN DIAGNOSIS OF ACUTE APPENDICITIS AT TERTIARY CARE HOSPITAL IN WESTERN RAJASTHAN

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Anil Kumar Dadhich ◽  
Atul Kumar Sharma
Keyword(s):  
Acute Appendicitis ◽  
Acute Abdominal Pain ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Alvarado Score ◽  
Common Complaint ◽  
Emergency Department Patients ◽  
Modified Alvarado Score ◽  
High Degree

Background: Acute abdominal pain is a common complaint among emergency department patients. Methods:  A 100 consecutive patients suspected of acute appendicitis who were admitted in department of surgery. They were prospectively evaluated using the modified Alvarado scoring (MAS) to determine whether or not they had acute appendicitis. Result: In present study, out of total 100 patients 78(78%) were have MAS score 7-9, 20% were have 5-6 and 2% have MAS score 1-4. Conclusion: The study shows that use of MASS in patients suspected to have acute appendicitis provides a high degree of diagnostic accuracy. Keywords: Modified Alvarado Score (MAS), acute appendicitis, Patients.

scholarly journals Patterns of Lesions in Hysterectomy Specimens in a Tertiary Care Hospital

2015 ◽  
Vol 53 (197) ◽  
pp. 18-23 ◽  
Author(s):  
Sujan Vaidya ◽  
Sapana Amatya Vaidya
Keyword(s):  
Clinical Diagnosis ◽  
Tertiary Care Hospital ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Abnormal Uterine Bleeding ◽  
Operative Management ◽  
Uterovaginal Prolapse ◽  
Care Hospital ◽  
Ovarian Tumours ◽  
Operative Indications

Introduction: Hysterectomy is one of the most common gynaecological procedures performed all over the world. The most frequent indications for hysterectomy are fibroids, abnormal uterine bleeding uterovaginal prolapse and endometriosis. The objective of this study was to present the histopathological patterns of various uterine and adnexal pathologies in the hysterectomy specimens and also to correlate its pre-operative clinical diagnosis with histopathology. Methods: This is a two-year descriptive study of hysterectomy specimens carried out in the Department of Pathology, Patan Academy of Health Sciences (PAHS), Lalitpur, Nepal. Data of all the hysterectomy specimens collected during this period was analyzed.   Results: Out of the 533 cases, fibroid was the most common indication for hysterectomy that was seen in 229 (42.94%) cases followed by uterovaginal prolapse in 101 (18.93%) cases. Leiomyoma was the most common pathology reported in 250 (46.90%) hysterectomy specimens, followed by ovarian tumours in 95 (17.82%) cases. In 17.82% (95/533) cases, no pathology was seen. Overall, the pre-operative indications in 533 cases of hysterectomy were histopathologically verifiable in 487 (91.37%) cases. Conclusions: Though the histopathological examination correlates well with the pre-operative clinical diagnosis, a number of lesions were also encountered as pure incidental findings. Hence, it is mandatory that every hysterectomy specimen should be subjected to histopathological examination so as to ensure better post-operative management. Keywords: adenomyosis; hysterectomy; leiomyoma; tumour; uterovaginal prolapse.  

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