scholarly journals MODIFIED ALVARADO SCORE

2010 ◽  
Vol 17 (04) ◽  
pp. 546-550
Author(s):  
SYED WARIS ALI SHAH ◽  
CHAUDHRY AHMED KHAN ◽  
SIKANDER ALI MALIK ◽  
AHMED WAQAS ◽  
AJMEL MUNIR TARRAR ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Histopathological Examination ◽  
Military Hospital ◽  
P Value ◽  
Alvarado Score ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Negative Appendicectomy ◽  
Modified Alvarado Score

objective: To compare the frequency of inflamed appendix in suspected patients of acute appendicitis having Modified Alvarado Score (MAS) of 7 or more with patients having MAS of 6 or below. Design: Comparative cross sectional study. Place and duration of study: The study was carried out at Surgical Departments of Combined Military Hospital (CMH) and Military Hospital (MH) Rawalpindi from April 2006 to April 2007. Material and Methods: This study involved 100 patients who were operated with provisional diagnosis of acute appendicitis. Preoperatively MAS of each patient was calculated and the patients were divided in two groups. Group-I had MAS of 7 or more while Group-II had MAS of 6 or below. Postoperatively appendices of all the patients were sent for histopathological examination and its result regarding presence or absence of acute appendicitis was then compared with MAS of respective group. Results: (a) Group-I:- A total of 72 patients with 64(88.9%) positive inflamed appendices on histology. Negative appendicectomy rate 8(11.1%), (b) Group-II:- A total of 28 patients with 8(28.6) positive inflamed appendices. Negative appendicectomy rate 20(71.4%). There is statistical significant difference of positive appendicectomy rate between two groups with (p-value<0.001). Conclusion: Frequency of inflamed appendix is more in patients having MAS of seven orabove. The number of negative appendicectomies can be reduced by using MAS in clinical practice.

scholarly journals ALVARADO SCORE;

2012 ◽  
Vol 20 (01) ◽  
pp. 001-005
Author(s):  
SHAFAQAT ALI ◽  
ZAKA ULLAH MALIK ◽  
M. MUTTAHHAR ASIM NIAZ ◽  
Naveed Ahmed
Keyword(s):  
Acute Appendicitis ◽  
Gold Standard ◽  
Alvarado Score ◽  
Cross Sectional ◽  
Female Ratio ◽  
Group I ◽  
Male Patients ◽  
Group Ii ◽  
Negative Appendicectomy ◽  
Hospital Group

Objective: To determine the validity of Alvarado score in diagnosing acute appendicitis keeping histopathology of appendixas gold standard. Study Design: Cross sectional (Validation) study. Place and Duration of Study: Department of Surgery CombinedMilitary Hospital Rawalpindi from April 2009 to October 2009. Materials and Methods: 90 patients with clinical suspicion/diagnosis ofacute appendicitis were included in study. All were divided into two groups on the basis of Alvarado score. Group I with score 7-10, whounderwent open appendicectomy. Group II(a) with 5-6, who were observed in hospital. Group II(b) with< 4 were discharged. In alloperated cases appendix was sent for histopathology. Alvarado score was compared with histopathology (gold standard). Results: Maleto female ratio was 3.5 :1. Mean age was 25.34. Alvarado score had overall 88.13% sensitivity, 70.96% specificity, 85.24% PPV,75.86%NPV and 16.90% negative appendicectomy rate. Whereas in male patients it had 90.74% sensitivity, 75% specificity, 92.45%PPV,70.58%NPV and 6.89% negative appendicectomy rate. In female it had 60% sensitivity, 66.66% specificity, 37.5% PPV, 83.33%NPV and38.46% negative appendicectomy rate. Conclusion: Alvarado score is very accurate for acute appendicitis in male patients. Patients withscore 4 can safely be discharged home. USG should be performed routinely in female patients to improve the diagnostic accuracy ofAlvarado score.

scholarly journals Comparison of Alvarado and RIPASA scoring systems in diagnosis of acute appendicitis and correlation with intraoperative and histopathological findings

2017 ◽  
Vol 4 (5) ◽  
pp. 1755 ◽  
Author(s):  
Mahendra Kumar Regar ◽  
Ganpat Singh Choudhary ◽  
Chandrakanta Nogia ◽  
Dharmendra Kumar Pipal ◽  
Anand Agrawal ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Histopathological Examination ◽  
Scoring Systems ◽  
Exclusion Criterion ◽  
P Value ◽  
Chi Square ◽  
Alvarado Score ◽  
Lower Quadrant ◽  
Histopathological Findings ◽  
Negative Appendicectomy

Background: Despite extraordinary advances in modern radiology and laboratory investigations an accurate diagnosis of acute appendicitis cannot be made in atypical cases. No single diagnostic aid can dramatically reduce the rate of negative appendicectomy.Methods: To reduce the rate of negative appendicectomies, application of RIPASA and Alvarado scoring done in every clinically diagnosed cases of appendicitis in a prospective study from January 2015 to January 2016 was done. 100 patients with right lower quadrant abdominal pain fulfilling the inclusion and exclusion criterion underwent appendicectomy in Mahatma Gandhi Hospital, Dr. S.N. Medical college, Jodhpur, Rajasthan, India.Results: The results of both scoring system were reported and were correlated with intraoperative and histopathological findings. Chi-square test was applied to calculate the p-value for the association between the variables of studied. The mean age was 24.86 years (10-80 years) and there were 61 males and 39 females in the study. Histopathological examination confirmed appendicitis in 95 patients with 5 negative appendicectomies. Negative appendicectomy rate for RIPASA and Alvarado score was 2.17% and 1.54% respectively. Accuracy for RIPASA and Alvarado score was 93% and 68% respectively.Conclusions: RIPASA score is a more valuable tool for diagnosing acute appendicitis with 93% accuracy, sensitivity 94.74% and specificity 60%; inspite of sophisticated investigations like CT, thus reducing the cost of treatment and minimize negative appendicectomy rate.

scholarly journals Application of Modified Alvarado scoring system in the diagnosis of acute appendicitis: a study in a tertiary care hospital

2018 ◽  
Vol 6 (10) ◽  
pp. 3192
Author(s):  
Anup Kumar Saha ◽  
Ankit Sandhu ◽  
Kumar Vikram
Keyword(s):  
Acute Appendicitis ◽  
Scoring System ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Scoring Systems ◽  
Care Hospital ◽  
Alvarado Score ◽  
Cross Sectional ◽  
Group I ◽  
Negative Appendicectomy

Background: Acute Appendicitis is one of the common surgical diseases which require early intervention; however, it may lead to higher negative appendicectomy rates, in uncertain Diagnosis. Negative appendicectomy rate is 20-40%. There are various scoring systems to assist in diagnosis. The aim of this study is to assess the effectiveness of Modified Alvarado Scoring System (MASS) in patients with acute appendicitis in AGMC and GBP Hospital.Methods: This was a cross sectional study to evaluate the effectiveness of MASS in patients presenting with acute appendicitis. The Principal Investigator scored all the patients according to the variables of MASS and divided them into three groups. Group I included patients with MASS of four and below, Group II were patients with MASS of 5-6 and Group III included patients with MASS of seven and above. The diagnosis of acute appendicitis was confirmed by histopathological examination. Data was collected using a coded, pre-tested questionnaire and analyzed using SPSS statistical software version 11.5.Results: In this study, 36 cases out of 42 cases had acute appendicitis. The sensitivity of Modified Alvarado Score of >7 was 85.7% (proportion of true positive). The sensitivity was highest among males i.e., 92% while in females, it was 76.4%. Negative appendicectomy rates were highest among females (23.6%), whereas in case of males it was 8%.Conclusions: The present study has shown that MASS provides high degree of sensitivity, specificity, PPV, NPV and accuracy in the diagnosis of acute appendicitis and has found to be more helpful in and high positive predictive value for male patients as compared to females.

scholarly journals To evaluate the diagnostic accuracy of alvarado score, C-reactive protein, ultrasonography and computed tomography in acute appendicitis and to correlate them with operative and histological findings

2016 ◽  
Vol 4 (1) ◽  
pp. 361
Author(s):  
Dharmendra Kumar Pipal ◽  
Saurabh Kothari ◽  
Harshit Shrivastava ◽  
Amit Soni ◽  
Vibha Pipal
Keyword(s):  
Acute Appendicitis ◽  
Histopathological Examination ◽  
Exclusion Criterion ◽  
P Value ◽  
Chi Square ◽  
Alvarado Score ◽  
Lower Quadrant ◽  
Negative Appendicectomy ◽  
Gandhi Medical College ◽  
A Prospective Study

Background:Despite extraordinary advances in modern radiology and laboratory investigations an accurate diagnosis of acute appendicitis cannot be made in atypical cases. No single diagnostic aid can dramatically reduce the rate of negative appendicectomy.Methods: To reduce the rate of negative appendicectomies by the combined use of diagnostic modalities in a prospective study from July 2011 to December 2012 was done. 100 patients with right lower quadrant abdominal pain fulfilling the inclusion and exclusion criterion underwent appendicectomy in Mahatma Gandhi Medical College and Hospital, Jaipur, India.Results:The results of the diagnostic aids were reported in combination using the ‟or” rule and were correlated with intraoperative and histopathological findings. Chi-square test was applied to calculate the p value for the association between the variables of studied. The mean age was 26±11.25 years (10-59 years) and there were 70 males and 30 females in the study. Histopathological examination confirmed appendicitis in 90 patients with 10 negative appendicectomies. A negative appendicectomy rate of 5.71% in men and 20% in women was observed.Conclusions:Alvarado score in combination with ultrasonography is a valuable tool for diagnosing acute appendicitis inspite of sophisticated investigations like CT, thus reducing the cost of treatment and preventing negative appendicectomy rate.

scholarly journals Results of modern tuboperitoneal infertility treatment

2009 ◽  
Vol 66 (1) ◽  
pp. 57-62 ◽  
Author(s):  
Drenka Turjacanin-Pantelic ◽  
Dragana Bojovic-Jovic ◽  
Biljana Arsic ◽  
Eliana Garalejic
Keyword(s):  
Statistical Analysis ◽  
Surgical Treatment ◽  
Infertility Treatment ◽  
P Value ◽  
Modern Approach ◽  
Vitro Fertilization ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Background/Aim. A modern approach to surgical treatment of tuboperitoneal infertility is based on laporascopic techniques. The aim of this study was to compare results of tuboperitoneal infertility treatment by the use of laparoscopy and classical laparotomy. Methods. A retrospectiveprospective study on 66 women treated operatively form tuboperitoneal infertility was performed. Data from patient's anamnesis and those related to the surgical treatment results, obtained by the use of an inquiry, were used in retrospective and prospective analysis, respectively. Chi-square test was used in statistical analysis. P value < 0.05 was considered significant. Results. Classical laparotomy was used on 34 women in a period from 1996 to 1997, while 32 women were operated laparoscopically in a period from 1999 to 2000. The results were as follows: a total number of conceived women was 16 (24%), seven in the group I (20.6%) and nine in the group II (28.1%); 13 women were with one pregnancy, six in the group I (17.6%) and seven in the group II (22%). Twice pregnant were three women, one in the group I (2.9%) and two in the group II (6.2%). The resulting pregnancies were: five women with abortion spontaneous, two in the group I (5.9%) and three in the group II (9.4%); two women with extrauterine pregnancy in the group I (5.9%); three with pretemporal birth, one in the group I (2.9%) and two in the group II (6.2%), while six women were with the temporal birth, two in the group I (5.9%) and four in the group II (12.5%). Statistical analysis showed that there was no significant difference in the results between these two groups. Conclusion. Surgical treatment of tubeperitoneal infertility, regardless of the used methods (classical laparotomy or laparoscopy) was successful in a great number of women. These methods have a great advantage over in vitro fertilization, and they should not be ignored.

scholarly journals Limb Salvage in Early Versus Delayed Revascularization of Acute Lower Limb Ischemia

2021 ◽  
Vol 15 (9) ◽  
pp. 2239-2241
Author(s):  
Salman Jamil Noor ◽  
Nauman Imtiaz ◽  
Wishal Shaukat ◽  
Athar Abbas Gilani ◽  
Palwasha Shahid ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Lower Limb ◽  
Limb Ischemia ◽  
P Value ◽  
Limb Salvage Rate ◽  
Lower Limb Ischemia ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Salvage Rate

Aim: To compare the limb salvage rate in early versus late presenting patients of Rutherford class IIB acute lower extremity ischemia undergoing revascularization. Study Design: Comparative/observational study Place and duration of study: Department of Surgery, CMH Peshawar from January 2019 to March 2021 Methodology: Twenty eight patients of both genders with ages 20 to 70 years presented with Rutherford class IIB acute lower limb ischemia were enrolled in this study. Patients were divided into two groups. Group I (presented after 6 hours of onset of symptoms) consisted of 20 patients and group II (presented within 6 hours of onset of symptoms) consisted of 8 patients. All the patients underwent femoral embolectomy. Limb salvage rate between both groups was examined at postoperative 3rd month. Data was analyzed by SPSS 24.0. P-value <0.05 was taken as significant. Results: There were 16(80%) male and 4(20%) females with mean age 50.52±11.74 years in group I, in group II 6(75%) were male and 2(25%) were females with mean age 50.08±10.94 years. No significant difference was observed between both groups regarding age and gender with p-value >0.05. In group I, limb salvage found in 19(95%) patients while in group II limb salvage found in 5(62.5%) patients, a significant difference was observed regarding limb salvage rate between both groups (p-value <0.05). Mortality rate was high in group II (delayed presentation) as compared to group I (12.5% Vs 0%) with p-value <0.05. Conclusion: The limb salvage rate was high in early presenting patients than late presenting patients with a significant difference. 30 days mortality rate and amputation rate were significantly high in delayed presentation as compared to early presented cases. Keywords: Acute lower limb ischemia, revascularization, limb salvage

scholarly journals Sildenafil Citrate Versus Nifedipine and Dydrogesreone in Prevention of Preterm Labor with Short Cervix

2018 ◽  
Vol 2 (1) ◽  
pp. 01-05
Author(s):  
Abd El-Naser Abd El-Gaber Ali ◽  
Khaled M Abdallah ◽  
Ahmed Abdelhamid
Keyword(s):  
Pregnant Women ◽  
Preterm Labor ◽  
Cervical Length ◽  
Sildenafil Citrate ◽  
Health Concern ◽  
P Value ◽  
Short Cervix ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Background: Prevention of the premature birth occurrence remains is considered one of the most tough challenges for obstetricians worldwide, mainly to avoid neonatal prematurity complications leading to short and long term morbidities additionally prematurity prevention will reduce premature neonatal mortality rates which is considered a major health concern of obstetricians, neonatologists and families. Objective: To compare and contrast the efficacy of Sildenafil citrate, Nifedipine and Dydrogesrone in prevention of premature labor in gestations with short cervix. Setting: Obstetrics & Gynecology Departments, Faculties of medicine, south Valley and Al-Azhar (Asyut) Universities, Egypt. Duration: from September 2014 to March 2018. Patients And Methds: the study was conducted on 300 pregnant women who randomly divided into three groups: Group I included 100 cases received Sildenafil citrate (Respatio tablet 20mg twice daily orally), Group II included 100 cases received Nifedipine (Epilat retard tablets 20mg twice daily orally) and Group III included 100 pregnant women received dydrogesreone 10 mg (Duphaston) twice daily orally. Results: incidence of preterm labor was (9.37, 8.51 and 14.28) in (Group I, Group II and Group II) respectively. Mean ± SD of cervical length at 32 weeks of gestation was mildly statistically significant among groups (p value <0.05) but no significance in neonatal outcome (p value >0.05) except birth weight which had a highly statistically significant difference (p value < 0.001). There was a highly statistically significant difference among studied groups as regard to drug side effects in (p value <0.001). Conclusion: Sildenafil citrate was as effective as Nifedipine and better than oral Dydrogesterone on myometrial relaxation and prevention of preterm birth in pregnant women who had short cervix.

scholarly journals Short and Long-Term Follow up Results of Daily 5 Mg Tadalafil as a Treatment for Erectile Dysfunction and Premature Ejaculation

2021 ◽  
Author(s):  
Tarek Gharib ◽  
Ibrahim Abdelal ◽  
Adel Elatreisy ◽  
Elsayed Salih ◽  
Ahmed Sebaey
Keyword(s):  
Erectile Dysfunction ◽  
Premature Ejaculation ◽  
P Value ◽  
Group I ◽  
Significant Difference ◽  
Long Term Follow Up ◽  
The Mean ◽  
Group Ii

Abstract Objective: To evaluate effectiveness and safety of a 5mg tadalafil daily treatment for men with erectile dysfunction (ED) and premature ejaculation (PE) and assessment of long-term follow up by persistence of improvement 2 years after stoppage of tadalafil.Materials and Methods: The study included 160 patients diagnosed with erectile dysfunction from April 2018 to June 2020. All were evaluated using the international index of erectile function questionnaire-5 (IIEF-5) to evaluate ED and intravaginal ejaculatory latency time (IELT) for PE. Patients subdivided into two equal groups. I included 80 patients treated with tadalafil 5 mg daily for 3 months, and group II included 80 patients treated with a placebo for same period. After 3 months treatment and 2 years later after stoppage of tadalafil, all patients were assessed for ED and PE using the same questionnaires. Results: The mean IELT and IIEF pretreatment were 37±11.24 s and 13.2±4.2 respectively for group I, while in group II was 35.98±10.8 s and 13.12±4.11, respectively. After 3 months of treatment, the mean value of IELT in group I showed a highly significant improvement from 37±11.24 sec to 120.5±47.37 sec (p-value < 0.001), but for group II, the mean values of IELT showed no significant improvement from baseline 35.98±10.8 to endpoint 39.43±13.6 ( p-value > 0.05). As regarding the IIEF, there was a highly significant improvement from baseline 13.2±4.2 to endpoint 20.45±4.5 in group I (p-value < 0.001) while there was no significant difference in group II from baseline 13.12±4.11 to endpoint 15±4.84 (p-value > 0.05) . 2 years later after stoppage of tadalafil , 75 patients from group I complete follow up and there was significant improvement in IELT and IIEF form base line (37±11.24) (13.2±4.2) to endpoint (98±18.3) (19.1±2.3) respectively but less than the results after 3 months treatment.ConclusionDaily Tadalafil 5 mg was effective, tolerable, and safe treatment for patients suffering from ED and PE. Long-term follow up after 2 years declared persistence of significant improvement.

scholarly journals Comparison of tolterodine and Solifancine in treatment of female with overactive bladder

2021 ◽  
Vol 10 (6) ◽  
pp. 2138
Author(s):  
Nermeen Mohamed Hefila ◽  
Tamer Mamdouh And el dayem ◽  
Hisham Adel Elfazari
Keyword(s):  
Overactive Bladder ◽  
Maternity Hospital ◽  
P Value ◽  
Detrusor Muscle ◽  
Urinary Urgency ◽  
Urinary Frequency ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Group 1

Background: OAB (overactive bladder) is primarily a neuromuscular problem in which the detrusor muscle contracts inappropriately during bladder filling (i.e., storage phase). These contractions often occur regardless of the amount of urine in the bladder. The aim of this work is to study the effect of Solifenacin in comparison to Tolterodine in treatment of females with idiopathic over active bladder.Methods: This study included 50 patients who presented between March 2020 and February2021 to the outpatients clinic at El-Shatby maternity Hospital, Alexandria university. The patients were complaining of urinary urgency usually with urinary frequency, nocturia with or without urge incontinence. All cases were divided in two groups one of them receive Solifenacin5mg twice daily and the otherreceiveTolterodine2mg twice daily.Results: Both groups showed significant decrease in frequency number per day with p value <0.001ingroup I with Solifenacin which mean statistically significant difference between two groups. When the percentage of symptoms severity were compared between both groups, group 1 showed 53% reduction in symptoms severity while group II showed 6.67% reduction which cleared significant difference statistically in group I (p=0.001). The percentage of reduction of severity of symptoms was compared between the two groups, it showed about 60%reduction in symptoms severity in group 1while in group II only 9.7% reduction. This was statistically significant with (p<0.001) in group I with Solifenacin.Conclusions: This study suggests that Solifenacin10mg/day is more effective than Tolterodine4mg/day in reducing OAB incontinence episodes.

scholarly journals COMPARISON OF ARTHROCENTESIS PLUS PLATELET RICH PLASMA WITH ARTHROCENTESIS ALONE IN THE TREATMENT OF TEMPOROMANDIBULAR JOINT DYSFUNCTION

2021 ◽  
Vol 71 (4) ◽  
pp. 1377-81
Author(s):  
Humaira Sarwar ◽  
Irfan Shah ◽  
Ali Akhtar Khan ◽  
Muhammad Afzal ◽  
Adnan Babar ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Temporomandibular Joint ◽  
Platelet Rich Plasma ◽  
Maxillofacial Surgery ◽  
Mouth Opening ◽  
Military Hospital ◽  
Control Group ◽  
Group I ◽  
Significant Difference ◽  
Group Ii

Objective: To evaluate the role of combination therapy of platelet rich plasma (PRP) with arthrocentesis and to compare it with arthrocentesis alone in the temporomandibular dysfuction (TMD) patients.Study Design: Quasi experimental study.Place and Duration of Study: Oral and Maxillofacial Surgery department, Armed Forces Institute of Dentistry, Combined Military Hospital Rawalpindi, from Jan 2017 to Jun 2019.Methodology: Forty-two patients diagnosed with refractory unilateral temporomandibular dysfuction, were included in the study. Patients were divided in two groups with 21 temporomandibular joints in each. Arthrocentesis alone was the control group (group I) and arthrocentesis with intra-articular injection of platelet rich plasma (group II) was the study group. Treatment outcomes were assessed and compared for all patients based on clinical parameters of pre and post treatment; for pain, maximal mouth opening and temporomandibular joint clicking sounds. Results: Out of 42 patients, 33 (79%) were females and 9 (21%) were males with mean age of 34.3 ± 8.4 years. There was statistically significant difference in both groups for all variables. The p-value of maximum mouth opening of both groups before and after treatment was 0.746 and 0.01, joint clicking sounds were present in 69% of our patients before the treament and it reduced to 14% after the treatment. There was marked gradual decrease in pain of both groups, group I (6.48 ± 1.470 to 1.81 ± 0.602) and group II (7.29 ± 1.007 to 1.19 ± 0.402). Conclusion: Combination therapy of platelet rich plasma with arthrocentesis is more effective treatment method than.......

Sign in / Sign up

Export Citation Format

Share Document