scholarly journals The role of ultrasonography in acute appendicitis

2017 ◽  
Vol 4 (5) ◽  
pp. 1769
Author(s):  
Yashwant R. Lamture ◽  
Varsha P. Gajbhiye ◽  
Vinay V. Shahapurkar
Keyword(s):  
Data Analysis ◽  
Acute Appendicitis ◽  
Crucial Role ◽  
Study Data ◽  
Normal Appendix ◽  
Chronic Appendicitis ◽  
Expert Radiologist ◽  
Negative Appendicectomy ◽  
Rule Out

Background:Acute appendicitis is the most common surgical emergency. Inspite of new investigations, mainstay of diagnosis depends on clinical sign and symptoms, laboratory and USG (ultrasonography) of abdomen. Out all these investigations USG is having a crucial role in a diagnosis of it. Hence this study was undertaken to prove its efficacy.Methods: This study was conducted in 418 patients with 186 females and 251 males. Patients were of acute appendicitis operated for appendicectomy were included in the study. Data analysis was done by Stata statistic software. Before surgery patients were subjected for necessary investigations including USG.Results:The mean age was 18.8 (range 8-83) years. Normal appendix found in 22 cases, hence negative appendicectomy rate was 6.6%.  Chronic appendicitis was found in 28 patients. Different pathology was found in 1 in the form of carcinoid of appendix (0.24%) but treated by appendicectomy. USG abdomen in present study showed sensitivity of 88.6% and specificity 92% with PPV and NPV was 98% and 52.3%, frequency reports were s/o acute appendicitis in 337 patients and normal in 82 subjects.Conclusions:It conclude that USG is very important tool to diagnose and rule out appendicitis and its complications like perforation or peritonitis. Its liberal use by expert radiologist can help to reduce negative appendicectomy rate.

scholarly journals The role of rebound tenderness in acute appendicitis and appendicular perforation

2017 ◽  
Vol 4 (2) ◽  
pp. 725
Author(s):  
Yashwant R. Lamture ◽  
Varsha P. Gajbhiye
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Study Data ◽  
Rebound Tenderness ◽  
Important Sign ◽  
Male Patients ◽  
Rule Out

Background: Acute appendicitis is the most common surgical emergency. Inspite of sophisticated new investigations mainstay of diagnosis depends on clinical sign and symptoms, rebound tenderness is very important sign with controversial views regarding it in available literature. Hence this study was undertaken to prove its efficacy of it related to rule out appendicular perforations.Methods: This study was conducted in 418 patients with 186 female and 251 male. Patients were of acute appendicitis operated for appendicectomy were included in the study. Data analysis was done by data statistic software.Results: The sensitivity and specificity of rebound tenderness to diagnose acute appendicitis is 65% and 73.6% respectively whereas the sensitivity and specificity of rebound tenderness to diagnose appendicular perforation was 94% and23.3% respectively with positive predictive value is 5 and negative predictive value is 99.Conclusions: Hence it indicates that rebound tenderness is very important to rule out complications like perforation or peritonitis and to support diagnosis of acute appendicitis. It has minimal significance to diagnose perforation of appendix as positive predictive value is less.

scholarly journals Sherren`s triangle hyperaesthesia a tool to rule out complicated appendicitis

2018 ◽  
Vol 5 (7) ◽  
pp. 2563
Author(s):  
Yashwant R. Lamture ◽  
Harshal Ramteke ◽  
Varsha Gajbhiye
Keyword(s):  
Data Analysis ◽  
Acute Appendicitis ◽  
Clinical Sign ◽  
Sensitivity And Specificity ◽  
Study Data ◽  
Complicated Appendicitis ◽  
Predictive Values ◽  
Surgical Emergency ◽  
Important Sign ◽  
Rule Out

Background: Acute appendicitis is the most common surgical emergency. In spite of sophisticated new investigations mainstay of diagnosis depends on clinical sign and symptoms, Sherren`s triangle hyperaesthesia is very important sign with controversial efficacy about it in available literature. Hence this study was undertaken to prove its efficacy of it.Methods: This study was conducted in 418 patients with 186 females and 251 males. Patients were of acute appendicitis operated for appendicectomy included in the study. Data analysis was done by data statistic software.Results: Sensitivity and specificity of hyperaesthesia in Sherren’s triangle were 47.7% and 42.9% respectively with positive and negative predictive values were 92.1% and 5.56%.Conclusions: Hence it indicates that hyperaesthesia in Sherren’s triangle is important sign to suspect to support diagnosis of acute appendicitis. It has minimal significance to rule out it.  This sign plays very important role in a diagnosis of complicated appendicitis like obstructive appendicitis.

scholarly journals EP.FRI.241 Negative appendicectomy rate and role of biomarkers in predicting the severity of acute appendicitis

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Cher Pin So ◽  
Nicholas Bradley ◽  
Andrew B C Crumley ◽  
Michael Samuel James Wilson
Keyword(s):  
Acute Appendicitis ◽  
Perforated Appendicitis ◽  
Grading System ◽  
Histopathological Analysis ◽  
Normal Appendix ◽  
Single Centre ◽  
Exact Test ◽  
Negative Appendicectomy ◽  
Appendiceal Perforation

Abstract Aim Acute appendicitis is the most common general surgical emergency. A recent consensus study has proposed a 10% negative appendicectomy rate. We aimed to determine the negative appendicectomy rate in our centre whilst evaluating the role of biomarkers in predicting the severity of appendicitis. Methods A single-centre retrospective analysis of consecutive laparoscopic appendicectomies from 2019-2020 was performed. Patients were categorised by severity using AAST grading system. Kruskal-Wallis test was used to compare biomarkers levels (WCC, CRP, bilirubin, neutrophil:lymphocyte ratio (NLR) and platelet:lymphocyte ratio (PLR)). T-test, ROC curve and Fisher’s exact test were used to differentiate between perforated and non-perforated appendicitis and negative appendicectomy rate. WCC ≥11, CRP ≥50, bilirubin ≥21, NLR ≥6.4 and PLR ≥153 were the cut-off values. Negative appendicitis was defined as normal appendix at histopathological analysis.   Results 224 patients were included; mean age 33.7 years, 57.1% were male. 17 patients (7.6%) had negative appendicectomy.  CRP, NLR, bilirubin and PLR increase with AAST score (P < 0.001).  WCC ≥11 (p < 0.001) and NLR ≥6.4 (p = 0.007) predicted acute appendicitis. WCC (p = 0.018), CRP (p < 0.001), bilirubin (p < 0.001), NLR (p < 0.001), PLR (p = 0.002) were predictive for appendiceal perforation. Conclusion 7.6% negative appendicectomy rate in our centre is below the recommended standard of 10% and lower than other centres. In our centre, raised WCC and NLR were predictive of acute appendicitis. WCC, CRP, bilirubin, NLR and PLR may be used to distinguish between perforated and non-perforated appendicitis. Our results add to the conflicting body of evidence relating to biomarkers and the severity of appendicitis.

The appearance of a normal appendix on barium enema examination does not rule out a diagnosis of chronic appendicitis: Report of a case and review of the literature

Surgery Today ◽  
1997 ◽  
Vol 27 (6) ◽  
pp. 550-553 ◽  
Author(s):  
Tatsuro Okamoto ◽  
Tohru Utsunomiya ◽  
Sadaaki Inutsuka ◽  
Tomoru Sakaguchi ◽  
Takayuki Notsuka ◽  
...  
Keyword(s):  
Barium Enema ◽  
Review Of The Literature ◽  
Normal Appendix ◽  
Barium Enema Examination ◽  
Chronic Appendicitis ◽  
Rule Out

scholarly journals A comparison of intra-operative diagnosis to histopathological diagnosis of acute appendicitis in paediatric and adult cohorts: an analysis of over 1000 patients

2021 ◽  
Author(s):  
Johnathon Harris ◽  
Christina A. Fleming ◽  
Paul N. Stassen ◽  
Daniel Mullen ◽  
Helen Mohan ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Histopathological Diagnosis ◽  
Open Appendicectomy ◽  
Normal Appendix ◽  
Macroscopic Appearance ◽  
Surgical Department ◽  
Suspected Appendicitis ◽  
Final Histological Diagnosis ◽  
Negative Appendicectomy ◽  
Operating Surgeon

Abstract Background Appendicitis is a common general surgical emergency. The role of removing a normal appendix is debated. However, this relies on accurate intra-operative diagnosis of a normal appendix by the operating surgeon. This study aimed to compare surgeon’s intra-operative assessment to final histological result acute appendicitis in paediatric and adult patients. Methods All patients who underwent appendicectomy over a 14-year period in a general surgical department were identified using the prospective Lothian Surgical Audit system and pathology reports retrieved to identify final histological diagnosis. Open appendicectomy was selected to examine, as the routine practise at our institution is to remove a normal appendix at open appendicectomy. Results A total of 1035 open appendicectomies were performed for clinically suspected appendicitis. Sensitivity of intra-operative diagnosis of appendicitis with operating surgeon was high at 95.13% with no difference between trainee and consultant surgeon or between adult and paediatric cases. Specificity of intra-operative diagnosis was lower in the paediatric group (32.58%) than in the adult group (40.58%). Women had a higher rate of negative appendicectomy than men. Conclusion The results of this study highlight some discordance between histological evidence of acute appendicitis and intra-operative impression. Therefore other clinical variables and not just macroscopic appearance alone should be used when deciding to perform appendicectomy.

Promoting Female Entrepreneurial Growth Intention in Thailand’s Tourism Industry: Role of Education Driven Ability, Opportunities and Advisory

2019 ◽  
Vol 16 (11) ◽  
pp. 4638-4645
Author(s):  
Paitoon Chetthamrongchai ◽  
Kittisak Jermsittiparsert
Keyword(s):  
Regression Analysis ◽  
Data Analysis ◽  
Study Data ◽  
Tourism Industry ◽  
Female Entrepreneurs ◽  
The Past ◽  
Study Results ◽  
Research Gap ◽  
Entrepreneurial Growth

This research proposes to find out the aspects that impact the growth intention (GI) of female entrepreneurs in the sector of tourism of Thailand. The purpose of the current paper is to examine why female industrialists attain growth goals whereas others don’t. This research uses quantitative approach and a self-administrated questionnaire was utilized with 200 female tourism entrepreneurs in Thailand. In this study, data analysis was performed through SPSS and regression analysis was run. This study results revealed that that all hypotheses of the study were accepted and are also consistent with the findings of the past studies. This study also showed that female entrepreneurs in Thailand can increase their entrepreneurial capabilities though, the growth of their business is limited by the deficiency of fiscal resources. This study fills the research gap in the domain of feminine tourism industrialists and their growth intention (GI) from the perception of an emerging nation like Thailand.

The Value of Scoring Systems for the Diagnosis of Acute Appendicitis

2015 ◽  
Vol 87 (2) ◽  
Author(s):  
Dominik A. Walczak ◽  
Dariusz Pawełczak ◽  
Agata Żółtaszek ◽  
Rajmund Jaguścik ◽  
Wojciech Fałek ◽  
...  
Keyword(s):  
Data Analysis ◽  
Acute Appendicitis ◽  
Hospital Admission ◽  
Diagnostic Accuracy ◽  
Scoring Systems ◽  
Diagnostic Value ◽  
Accurate Diagnosis ◽  
Normal Appendix ◽  
Detailed Medical History ◽  
Suspected Acute Appendicitis

AbstractAccurate diagnosis of acute appendicitis (AA) is still a problem and is not always easy, even for experienced surgeons. Studies have shown that 20 to 30% of the appendices removedwere normal. Therefore, various scoring systems have been developed to aid in the diagnosis of doubtful cases and reduce the number of unnecessary appendectomies.The aim of this study was to assess the diagnostic value of different scoring systems in acute appendicitis.Material and methods. The study involved 94 patients who underwent laparotomy due to suspected acute appendicitis. Medical examination at hospital admission was performed by a resident and a general surgery specialist. The probability of AA was evaluated using six different scoring systems: Alvarado, Fenyo, Eskelinen, Ohman, Tzankis, and RIPASA. The resident calculated the results in individual systems. The decision to perform the operation was taken by a specialist surgeon who did not know the results.Results. Normal appendix was removed in 26% of cases. Eskelinen, RIPASA and Alvarado systems showed highest sensitivity (99%, 88% and 85%, respectively). Tzankis and Fenyo systems showed highest specificity (62% and 50%, respectively).Conclusions. Our study has shown limited value of scoring systems for the diagnosis of acute appendicitis. The systems may improve diagnostic accuracy as they require obtaining a more detailed medical history, and making a more thorough and organized data analysis. However, the scoring systems should be treated only as an aid to diagnosis

scholarly journals Role of modified Alvarado scoring system and USG abdomen in acute appendicitis: an overview

2017 ◽  
Vol 4 (12) ◽  
pp. 4029
Author(s):  
Rajkishore Singh ◽  
Rajiv Singh ◽  
Kulwant Singh
Keyword(s):  
Acute Appendicitis ◽  
Scoring System ◽  
Clinical Teaching ◽  
Research Centre ◽  
Medical Sciences ◽  
Alvarado Score ◽  
Major Procedure ◽  
Negative Appendicectomy ◽  
Modified Alvarado Score

Background: Acute appendicitis is the most common cause of an ‘acute abdomen’ in young adults and, as such, the associated symptoms and signs have become a paradigm for clinical teaching. Appendicitis is sufficiently common that appendicectomy (termed appendectomy in North America) is the most frequently performed urgent abdominal operation and is often the first major procedure performed by a surgeon in training. In this study we correlate the usefulness of Modified Alvarado scoring system(MASS) and ultrasonography(USG) in management of acute appendicitis.Methods: The study was done on 60 patients of symptomatic appendicitis, requiring management accordingly, attending surgical OPD of People’s College of Medical Sciences(PCMS) and Research Centre, Bhopal, India from 1st October 2011 to 30th August 2013. The study includes 60 patients between 5-60 yrs of age. They were prospectively evaluated on admission using the modified Alvarado Score to determine whether or not they had acute appendicitis, all equivocal cases were subjected to ultrasonography examination. The score and ultrasonography were correlated with the operative and histological findings.Results: All 60 patients underwent surgery. The sensitivity of the modified Alvarado score was 89.65% and sensitivity of USG was 91.37%, out of 60 cases of acute appendicitis male were 36 and remaining 24 cases were female. So, it showed sex ratio of 36:24, 3:2 which correlate with literature and other studies. With use of both MASS and USG as diagnostic tool, out of 60 cases 57 cases were positive and with the help of histopathology, it was confirmed in 58 cases.Conclusions: The modified Alvarado scoring system is a good diagnostic indicator for acute appendicitis. It helps in minimizing the rates of negative appendicectomy. It can be used as an adjunct to surgical decision-making along with ultrasonography in doubtful cases. When combined, modified Alvarado score and ultrasonography can work very effectively in diagnosing acute appendicitis(AA) correctly and in reducing the number of negative appendicectomy.

scholarly journals The role of character education in learning during the COVID-19 pandemic

2020 ◽  
Vol 13 (2) ◽  
pp. 129-136
Author(s):  
Enika Vera Intania ◽  
Sutama Sutama
Keyword(s):  
Online Learning ◽  
Data Analysis ◽  
Character Education ◽  
Social Life ◽  
Study Data ◽  
Important Thing ◽  
Face To Face ◽  
Analysis Techniques ◽  
Data Validity

Abstract Coronavirus Disease-2019 (COVID-19) has an impact on all aspects of life, including education. Face-to-face education must be transferred to online learning. In learning, both face-to-face and online, character education must always be instilled in students. Character education is an important thing that students must have in order to grow their character, so they can have good personalities In a pandemic such as now, character education is very necessary for students to continue to develop their potential, even though learning is carried out online. The purposes of this study are 1) Analyzing the role of character education in learning; 2) Describing the role of character education in learning in the pandemic era of COVID-19. This type of research is a reference research. The object of this research is the role of character education in learning in the COVID-19 pandemic era. Data validity is done by Triangulation of Sources and Triangulation of Extension. In this study, data analysis techniques used constant comparison. The results of the study are twofold, 1) Character education in learning has a role for students to foster good character that can be realized in their social life; 2) In the pandemic era COVID-19 character education can play a role so that students independently want to learn material and develop an attitude of responsibility towards the tasks given by the teacher in online learning. Peran pendidikan karakter dalam pembelajaran selama pandemi COVID-19Pandemi COVID-19 menimbulkan dampak pada semua aspek kehidupan, termasuk pendidikan. Pendidikan tatap muka harus dialihkan ke pembelajaran online. Dalam belajar, baik tatap muka maupun online, pendidikan karakter harus selalu ditanamkan pada siswa. Pendidikan karakter merupakan hal penting yang harus dilakukan siswa agar dapat menumbuhkan karakternya, sehingga mereka dapat memiliki kepribadian yang baik Di masa pandemi seperti sekarang, pendidikan karakter sangat diperlukan bagi siswa untuk terus mengembangkan potensinya, meskipun pembelajaran dilakukan secara online. Tujuan penelitian ini adalah, 1) Menganalisa peran pendidikan karakter dalam pembelajaran; 2) Menggambarkan peran pendidikan karakter dalam pembelajaran di era pandemi COVID-19. Jenis penelitian ini adalah penelitian referensi. Objek penelitian ini adalah peran pendidikan karakter dalam pembelajaran di era pandemi COVID-19. Validitas data dilakukan dengan Triangulasi Sumber dan Triangulasi Ekstensi. Dalam penelitian ini, teknik analisis data menggunakan perbandingan konstan. Hasil penelitian menunjukkan bahwa 1) Pendidikan karakter dalam pembelajaran memiliki peran bagi siswa untuk menumbuhkan karakter baik yang dapat diwujudkan dalam kehidupan sosialnya; 2) Di era pandemic, pendidikan karakter COVID-19 dapat berperan penting sehingga siswa secara mandiri ingin belajar materi-materi dan mengembangkan sikap tanggung jawab terhadap tugas-tugas yang diberikan guru dalam pembelajaran daring.

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