scholarly journals A comparative study between abdominal plain radiography and ultrasonography in non-traumatic acute abdominal emergencies in tertiary care hospital

2016 ◽  
Vol 5 (1) ◽  
pp. 113 ◽  
Author(s):  
Chiranjeev Kumar Gathwal ◽  
Monika B. Gathwal ◽  
Shreya Garg ◽  
Yogita Kumari ◽  
Kulvinder Singh
Keyword(s):  
Comparative Study ◽  
Acute Abdomen ◽  
Tertiary Care ◽  
False Negative ◽  
False Negative Rate ◽  
Plain Radiography ◽  
Radiographic Evaluation ◽  
Care Hospital ◽  
X Rays ◽  
Abdominal Emergencies

Background: Acute abdomen is a loose term frequently used to describe the acute abdominal pain in a subgroup of patients who are seriously ill developing suddenly, over a period of several hours or few days.Methods: It was a prospective comparative study between abdominal plain radiography and ultrasonography in non-traumatic acute abdominal emergencies in Tertiary Care Hospital.Results: All the included patients (140) were imaged with abdominal X-rays series (AAS) and Ultrasonography (US) by different blinded radiologists without conveying results to either. Final diagnosis was made on the basis of clinical findings / laboratory or biochemical findings /radiological evaluation /therapeutic response / operative findings / histopathological examination. The entire data was collected, recorded and statistically analyzed as per objectives. GIT system was most commonly involved, in 75/140 cases (53.57%). Most common diagnoses were acute appendicitis, KUB calculus disease and acute cholecystitis seen in 32/140 (22.86%), 24/140 (17.14%) and 21 (15%) cases respectively. US supersedes Provisional clinical diagnosis and Radiographic evaluation in diagnosing acute abdominal conditions with Sensitivity, Positive Predictive Value, False positive rate, False Negative rate and Diagnostic Accuracy as 90.71, 100, 0 ,9.28 and 90.71 percent respectively.Conclusions: We concluded that Plain X rays can be used as screening modality in the diagnosis of acute abdominal emergencies; however ultrasound examination is cheaper, non-invasive, quick, reliable and highly accurate modality in diagnosing the exact cause of pain and its origin in a patient presenting with an acute abdomen and thus helps the physician or surgeon to plan the timely management.

scholarly journals Evaluation of a step-by-step approach to frozen section diagnosis in ovarian masses

2021 ◽  
Vol 12 (12) ◽  
pp. 133-139
Author(s):  
Ashumi Gupta ◽  
Neelam Jain
Keyword(s):  
Sensitivity And Specificity ◽  
Malignant Tumors ◽  
Frozen Section ◽  
Tertiary Care ◽  
False Negative ◽  
Significant Proportion ◽  
False Negative Rate ◽  
Accurate Diagnosis ◽  
Care Hospital ◽  
Ovarian Masses

Background: Ovarian cancer forms a significant proportion of cancer-related mortality in females. It is often detected late due to non-specific clinical presentation. Radiology and tumor markers may indicate an ovarian mass. However, exact diagnosis requires pathological evaluation, which may not be possible before surgery. Intraoperative frozen section (FS) is, therefore, an important modality for the diagnosis of ovarian masses. Aims and Objectives: This study was conducted to study step-by-step approach along with diagnostic utility and accuracy of intraoperative FS in diagnosis of ovarian masses. Materials and Methods: Retrospective comparative analysis was done to determine the diagnostic accuracy of FS as compared to routine histopathology in the pathology department of a tertiary care hospital. Diagnostic categorization was done into benign, borderline, and malignant. Overall accuracy, sensitivity, and specificity of FS technique were calculated. Results: Out of 51 cases, FS analysis yielded accurate diagnosis in 94.1% of ovarian masses. Intraoperative FS had a sensitivity of 94.7%, specificity of 96.9%, 3.1% false-positive rate, and 5.3% false-negative rate in malignant tumors. In benign lesions, FS had 91.7% sensitivity and 100% specificity. FS had 75% sensitivity and 96.4% specificity in cases of borderline tumors. Conclusion: FS is a fairly accurate technique for intraoperative evaluation of ovarian masses. It can help in deciding the extent of surgery. It distinguishes benign and malignant tumors in most cases with high sensitivity and specificity. A methodical approach is useful in determining accurate diagnosis on FS diagnosis.

scholarly journals Role of early CT scan in diagnosis of occult scaphoid fractures- a prospective study

2017 ◽  
Vol 5 (9) ◽  
pp. 4072
Author(s):  
Omeshwar Singh ◽  
Anuradha Sen ◽  
Sumeet Singh Charak ◽  
Shakeel Ahmad
Keyword(s):  
Ct Scan ◽  
Tertiary Care ◽  
False Negative ◽  
False Negative Rate ◽  
Scaphoid Bone ◽  
X Rays ◽  
X Ray ◽  
Scaphoid Fractures ◽  
Number Of Patients

Background: Wrists injuries are one of the common presentations to emergency departments and orthopaedic clinics. The scaphoid bone is the most commonly injured of the carpal bones accounting for 50-80% of carpal injuries and predominantly occurs in young healthy individuals. Scaphoid fractures are the most problematic to diagnose in a clinical setting because it can take up to 6 weeks for scaphoid fractures to become conclusive on plain X-ray films. Aim of the study was to retrospective study was carried out to study the role of early CT scan in diagnosis of occult scaphoid fractures.Methods: A total of 123 patients presented with an acute wrist injury with subsequent signs of scaphoid injury in the absence of a diagnostic fracture on plain X-ray within the time period from June 2014 to May 2016 in a tertiary care centre.Results: This study shows that 31% of normal X-rays were pathological on CT scan and out of these; scaphoid fractures (74% of pathologies) represent a large number of patients with fractures that were missed by initial plain films.Conclusions: This study shows an extremely high false-negative rate for plain X-rays and advocate CT at the first attendance to fracture clinic if there is suspicion of scaphoid injury. An earlier diagnosis leads to appropriate management and reduces restrictions to the patient in terms of prolonged immobilization and repeated clinical reviews.

scholarly journals A prospective study of epidemiology and clinical presentation of non-traumatic acute abdomen cases in a tertiary care hospital of central India

2016 ◽  
Vol 4 (1) ◽  
pp. 242
Author(s):  
Rajiv Jain ◽  
Vikas Gupta
Keyword(s):  
Prospective Study ◽  
Acute Abdomen ◽  
Tertiary Care ◽  
Central India ◽  
Care Hospital ◽  
Medical College ◽  
Sri Aurobindo ◽  
Life Threatening ◽  
Abdominal Emergencies ◽  
A Prospective Study

Background:Acute Abdomen is a term used to encompass a spectrum of surgical, medical and gynecological conditions ranging from trivial to life threatening conditions, which require hospital admission, investigations and treatment. The purpose of this study was to identify the epidemiological pattern and to determine the spectrum of disease causing “non-traumatic acute abdomen in central India”.Methods: This is a prospective study of 98 patients of non-traumatic acute abdominal cases conducted in the Department of Surgery, Sri Aurobindo Medical College and PG Institute, Indore, Madhya Pradesh, India. In this study, preoperative detailed history and thorough physical examination was done for all acute abdominal emergencies, to arrive at pre-operative diagnosis.Results:Amongst the study of 98 patients, males have higher incidence of acute abdomen with the young age group (21-30 years) most commonly affected. Perforation peritonitis constituted the most common cause of acute abdomen (39.7%), followed by acute appendicitis (37.7%), followed by intestinal obstruction (14.2%).Conclusions: This study was conducted to evaluate the epidemiology, etiology and differential diagnosis of non-traumatic acute abdomen. At the end of the study, we had a better insight of the spectrum of the condition and we concluded that there is more scope for further work in the same field for better understanding of this topic.

scholarly journals A retrospective evaluation of Alvarado score in diagnosing acute appendicitis in a tertiary care hospital at Pondicherry

2021 ◽  
Vol 8 (4) ◽  
pp. 1089
Author(s):  
G. Ray ◽  
S. Selvakumaran
Keyword(s):  
Acute Appendicitis ◽  
Laboratory Finding ◽  
Tertiary Care ◽  
False Negative ◽  
Age Groups ◽  
False Negative Rate ◽  
Care Hospital ◽  
Alvarado Score ◽  
Diagnostic Skills ◽  
One Year

Background: Acute appendicitis is a common and sometimes confusing cause of acute abdomen in all age groups. Diagnosis of appendicitis can be difficult, occasionally taxing the diagnostic skills of even the most experienced surgeon. Despite the increased use of USG, CT, the rate of misdiagnosis of appendicitis has remained the same (15.3%). To evaluate the usefulness of the Alvarado score as a simple and reliable tool in preoperative diagnosis of acute appendicitis.Methods: This retrospective study conducted on 97 cases includes all patients who were admitted with a clinical diagnosis of acute appendicitis for a period of one year from February 2019 to January 2020 at IGMCRI Pondicherry with clinical suspicions of acute appendicitis were included in the study. The modified scoring system is based on 3 signs, 3 symptoms, and 1 laboratory finding. The patient was classified as males, females, and children (<12 years). These were further grouped based on the scores 7-9, 5-6, and <5.Results: A total of 80 patients with a score of 7-9 and 5-6 were operated on. Among males with a score of 7-9, 35 patients were operated and 34 were found to have an inflamed appendix. Females with scores 7-9, 16 were operated and 11 were found to have an inflamed appendix.Conclusions: Alvarado scores significantly reduce the number of negative laparotomies without increasing the overall rate of appendicular perforation. It is very effective in men and children but diagnostic laparoscopy or ultrasonography is advised to minimize the high false-negative rate in women.

scholarly journals External validation for sensitivity of the Ottawa subarachnoid hemorrhage rule in a Japanese tertiary teaching hospital

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tomoharu Suzuki ◽  
David Itokazu ◽  
Yasuharu Tokuda
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
External Validation ◽  
False Negative ◽  
False Negative Rate ◽  
Prediction Rule ◽  
Japanese Patients ◽  
Inclusion Criteria ◽  
Tertiary Teaching

AbstractThe Ottawa subarachnoid hemorrhage (OSAH) rule is a validated clinical prediction rule for ruling out subarachnoid hemorrhage (SAH). Another SAH rule (Ottawa-like rule) was developed in Japan but was not well validated. We aimed to validate both rules by examining the sensitivity for ruling out SAH in Japanese patients diagnosed with SAH. We conducted a retrospective cohort study by reviewing the medical records of consecutive adult patients hospitalized with SAH at a tertiary-care teaching hospital in Japan who visited our emergency department between July 2009 and June 2019. Sensitivity and its 95% confidence interval (CI) were estimated for each rule for the diagnosis of SAH. In a total of 280 patients with SAH, 56 (20.0%) patients met the inclusion criteria and were analyzed for the OSAH rule, and a sensitivity of the OSAH rule was 56/56 (100%; 95% CI 93.6–100%). While, 126 (45%) patients met the inclusion criteria of the Ottawa-like rule, and the rule showed a sensitivity of 125/126 (99.2%; 95%CI 95.7–100%). The OSAH rule showed 100% sensitivity among our Japanese patients diagnosed with SAH. The implementation of the Ottawa-like rule should be cautious because the false-negative rate is up to 4%.

A Comparative Study of Endoscopic Coblation Adenoidectomy and Regular Curettage Adenoidectomy in a Tertiary Care Hospital in Kerala

2021 ◽  
Vol 8 (41) ◽  
pp. 3559-3566
Author(s):  
Abdul Salam R. T. ◽  
Shahul Hameed A. ◽  
Meera Rajan
Keyword(s):  
Blood Loss ◽  
Comparative Study ◽  
Tertiary Care ◽  
Operation Time ◽  
Care Hospital ◽  
Adenoid Tissue ◽  
Significant Difference ◽  
Tube Function ◽  
Prospective Comparative Study ◽  
The Mean

BACKGROUND An ideal surgery to remove hypertrophied adenoid mass should be safe, with less bleeding and operation time along with post-operative improvement in the eustachian tubal ventilation and normal respiration. It should also have low morbidity and mortality. Among the various methods described for its removal, the two commonly used methods are conventional cold curettage method and coblation technique. The purpose of this study was to collate the safety and efficacy of endoscopic coblation adenoidectomy with the conventional curettage adenoidectomy. METHODS A prospective comparative study with fifty patients was studied who underwent adenoidectomy. Twenty five patients underwent endoscopy assisted coblation adenoidectomy and twenty five patients underwent regular adenoidectomy by curettage. RESULTS Patients who underwent coblation adenoidectomy showed better results during follow up in terms of completeness of removal. 80 % of children undergoing regular adenoidectomy by curettage method showed remnant adenoid tissue in the nasopharynx at the end of the procedure. But it was 6 % among the children undergoing endoscopic assisted coblation adenoidectomy. The mean duration of operation was higher for endoscopic assisted coblation adenoidectomy which was significant statistically. The mean blood loss was 30.36 ml in regular curettage adenoidectomy; 10.6 ml with endoscopic coblation adenoidectomy. The grading of pain was significantly lower in endoscopic assisted coblation adenoidectomy. There was no significant difference between two groups in terms of eustachian tube function after surgery. CONCLUSIONS Coblation adenoidectomy has significant advantages over conventional adenoidectomy in terms of completeness of removal, reduced blood loss, and lower post-operative pain grade. KEYWORDS Coblation, Adenoidectomy, Curettage, Haemorrhage and Complications

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