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 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 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 APPENDICULAR MASS

2010 ◽  
Vol 17 (02) ◽  
pp. 180-184
Author(s):  
SARDAR ALI ◽  
HAFIZ MUHAMMED RAFIQUE
Keyword(s):  
Conservative Treatment ◽  
Acute Appendicitis ◽  
Cost Effective ◽  
Female Ratio ◽  
Surgical Exploration ◽  
Group I ◽  
Variable Extent ◽  
Group Ii ◽  
Adhesive Intestinal Obstruction ◽  
Appendicular Mass

Introduction: Appendicular mass is a common complication of acute appendicitis. The traditional treatment of this is conservative followed by delayed appendectomy. But now with advancement in all the fields of medicine early surgical exploration of the appendicular mass can be done with satisfactory results. Aims and objectives: A comparison of conservative treatment versus early surgical exploration of appendicular mass. Study Design: Experimental study. Material and Method: Two years study from December 2003 to November 2005 at district headquarters hospital Khanewal. Total 60 patients, both males and females between 12 to 65 years of age with symptoms and signs consistent with appendicular mass were included. They were randomly divided into group I (Early exploration) and group II (Conservative treatment) each containing 30 patients. A comparison of outcome between two groups was done statistically by applying studentChi-square test. Results: There was a peak incidence of acute appendicitis in Second and third decades of life. Male to female ratio was 2:1. More than 90% of patients had history of shifting of abdominal pain. 100% of the patients had inflamed appendix to variable extent on exploration. The complications in the form of adhesive intestinal obstruction; failure of treatment; lost follow up; misdiagnosis and re admissionwere less in group I. There was a significant less duration of hospital stay in group I as compared to Group II. The observations and outcome in this study are almost comparable and correspond with other studies done in this regard. Conclusion: Early surgical exploration of appendicular mass is safe and cost effective.

scholarly journals Alpha Feto Protein in vaginal fluid as a diagnostic marker of Premature rupture of membrane

2018 ◽  
Vol 10 (1) ◽  
pp. 335-338
Author(s):  
Nasreen Sultana ◽  
Shamima Rahman ◽  
Fakhruddin Ahmed ◽  
SK Ashraf Ullah
Keyword(s):  
Gold Standard ◽  
Normal Pregnancy ◽  
Vaginal Fluid ◽  
Sensitive Test ◽  
Premature Rupture ◽  
Paper Test ◽  
Cross Sectional ◽  
Group I ◽  
Alpha Feto Protein ◽  
Group Ii

Background : Premature Rupture of Membrane (PROM) is a significant obstetric emergency where a normal pregnancy suddenly becomes a high risk one. It can cause serious complications of mother and fetus. Patient’s history, per speculum vaginal with Nitrazine paper test and Fern test considered as gold standard for diagnosis of PROM. But these multiple tests are hazardous and time consuming. Therefore Alpha-Feto Protein (AFP) test is a single sensitive test for proper diagnosis of PROM. Objective : To evaluate the accuracy of Alpha-Feto protein in vaginal fluid as a diagnostic tool of PROM. Method : It was a cross sectional study, carried out among 120 pregnant women who had the gestational age between 28th to 40th week of pregnancy. Sample was collected purposively and divided into two groups. In group-I-62 suspected PROM patients were selected who gave the history of per vaginal watery discharge and was found positive in per speculum examination (P/S). In group-II-58 non PROM pregnant patients were selected. Then in group-I, Nitrazine paper test and Fern test were done to confirme PROM patients. Both groups AFP test was done by AxSYM auto analyzer. Finally the accuracy of AFP was evaluated against the gold standard test. Result : It was found that AFP concentration was significantly higher in group-I of suspected PROM patients (30- 502ng/ml) than in group-II (0-40ng/ml). Among 62 suspected PROM patients 49 were found gold standard (Nitrogen paper test and Fern test) positive. Out of these 49 confirmed PROM patients 48 was found positive in Alpha-Feto protein test. The sensitivity of AFP test was found 98%, specificity was 84.6% and accuracy was 95.1%. Conclusion : As Alpha-Feto protein in vaginal fluid was found highly accurate (95.1%) for diagnosis of PROM. Therefore, AFP test can be used as a single sensitive test for diagnosis of PROM. Northern International Medical College Journal Vol.10(1) Jul 2018: 335-338

A Comparison between the Diagnostic Accuracy of Alvarado and Tzanaki Scoring Systems in Acute Appendicitis

2021 ◽  
Vol 15 (12) ◽  
pp. 3175-3177
Author(s):  
Anum Iftikhar ◽  
Muhammad Arsalan ◽  
Sheeza Azaz ◽  
S H Waqar ◽  
Sajid Ali Shah ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Gold Standard ◽  
Scoring Systems ◽  
Negative Appendectomy ◽  
Alvarado Score ◽  
Cross Sectional

Aim: To find out how accurate the Alvarado and Tzanaki scoring systems are in diagnosing acute appendicitis taking histopathology as gold standard. Methods: A cross-sectional prospective study was conducted from August 2019 to July 2020 at Department of General Surgery, Pakistan Institute of Medical Sciences Islamabad. Sixty patients were included, all of whom had appendectomies after a clinical diagnosis of acute appendicitis. Samples were submitted for histopathology, which was used as the gold standard for the definitive diagnosis of acute appendicitis. The specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy and negative appendectomy rate of Alvarado and Tzanaki scoring systems was calculated using SPSS version 23. Results: The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of Alvarado score at optimal cut-off threshold of ≥7.0, were calculated as 74%, 55%, 90%, 27% and 71.66% respectively. The cut-off threshold point of Tzanaki score was set at more than 8, which yielded a 94.11% sensitivity and an 88.88% specificity. The positive predictive value was 99.95% and the negative predictive value was 72.72%. The Alvarado and Tzanaki scoring systems had negative appendectomy rates of 9.5% and 2.04%, respectively. Conclusion: The Tzanaki scoring system has a better diagnostic accuracy for acute appendicitis as compared to the Alvarado score. Keywords: Acute appendicitis, Alvarado score, Tzanaki score

scholarly journals Diabetes Mellitus and the risk of Primary open angle glaucoma

2017 ◽  
Vol 9 (1) ◽  
pp. 17-23 ◽  
Author(s):  
P Lavaju ◽  
S Shah ◽  
S Sharma ◽  
R Maskey
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Primary Open Angle Glaucoma ◽  
Open Angle Glaucoma ◽  
Corneal Thickness ◽  
Open Angle ◽  
Cross Sectional ◽  
Female Ratio ◽  
Group I ◽  
Group Ii

Background: Diabetes mellitus (DM) is one of the risk factors for Primary open angle glaucoma (POAG). Inclusion of DM as a risk factor for POAG is controversial. The objectives of the study were to investigate whether Type II (T2) DM is a risk factor for POAG and to determine central corneal thickness (CCT) in the subjects with T2DM and to examine the relationship between T2DM and intraocular pressure (IOP).Materials and methods: A comparative cross sectional study was conducted including 189 subjects of age > 40 years. In Group I, 113 patients diagnosed with T2DM and Group II, age and sex matched 76 subjects with POAG without DM was included. Detailed ocular examination, IOP, CCT and funduscopy evaluation was done. Results: Most of the patients were more than 60 years of age with mean age 58 ± 11 years. Male: female ratio was 1:1. POAG was seen in 27.4% of patients with T2DM. Mean IOP in T2DM was 14.67± 2.63mmHg and in non diabetic, 17.25±4.47 mmHg (p <0.00). In group I, mean CCT was 538.83± 22.7μm and in group II, 531.26 ± 20.9μm (p-0.126). There was no association between CCT and glaucoma (p=0.072, 95% CI: -0.76 –17.46). The study could not elicit an association of T2DM with glaucoma. Duration of T2DM did not affect an association between T2DM and glaucoma (p-0.757). Random blood sugar (p<0.001) and oral hypoglycemic drugs (p=0.030) showed an association with glaucoma. Conclusion: The study failed to show an association between T2DM and primary open angle glaucoma and CCT though an association seen with IOP. A larger prospective comparative study may be help in understanding this association. 

scholarly journals APPENDICULAR MASS

2010 ◽  
Vol 17 (02) ◽  
pp. 180-184
Author(s):  
SARDAR ALI ◽  
HAFIZ MUHAMMED RAFIQUE
Keyword(s):  
Conservative Treatment ◽  
Acute Appendicitis ◽  
Cost Effective ◽  
Chi Square ◽  
Female Ratio ◽  
Surgical Exploration ◽  
Group I ◽  
Group Ii ◽  
Adhesive Intestinal Obstruction ◽  
Appendicular Mass

Introduction: Appendicular mass is a common complication of acute appendicitis. The traditional treatment of this is conservative followed by delayed appendectomy. But now with advancement in all the fields of medicine early surgical exploration of the appendicular mass can be done with satisfactory results. Aims and objectives: A comparison of conservative treatment versus early surgical exploration of appendicular mass. Study Design: Experimental study. Material and Method: Two years study from December 2003 toNovember 2005 at district headquarters hospital Khanewal. Total 60 patients, both males and females between 12 to 65 years of age with symptoms and signs consistent with appendicular mass were included. They were randomly divided into group I (Early exploration) and group II (Conservative treatment) each containing 30 patients. A comparison of outcome between two groups was done statistically by applying student Chi-square test. Results: There was a peak incidence of acute appendicitis in Second and third decades of life. Male to female ratio was 2:1. More than 90% of patients had history of shifting of abdominal pain. 100% of the patients had inflamed appendix to variable extent on exploration. The complications in the form of adhesive intestinal obstruction; failure of treatment; lost follow up; misdiagnosis and re admissionwere less in group I. There was a significant less duration of hospital stay in group I as compared to Group II. The observations and outcome in this study are almost comparable and correspond with other studies done in this regard. Conclusion: Early surgical exploration of appendicular mass is safe and cost effective.

scholarly journals Evaluation of Alvardo score in diagnosis of acute appendicitis

2017 ◽  
Vol 4 (7) ◽  
pp. 2276
Author(s):  
Uday Kiran Mokati ◽  
L. Hari Prasada Rao ◽  
N. Siva Durgesh ◽  
P. Avinash ◽  
K. Baby Lakshmi ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Iliac Fossa ◽  
Ultra Sound ◽  
Study Group ◽  
Age Group ◽  
Alvarado Score ◽  
Female Ratio ◽  
Group I ◽  
Study Results ◽  
Right Iliac Fossa Pain

Background: Acute appendicitis is a common cause of abdominal pain for which a prompt diagnosis is rewarded by a marked decrease in morbidity and mortality. Right Iliac fossa pain is the hallmark of acute appendicitis until proven otherwise. Decision making in a case of acute appendicitis may be difficult, especially for junior surgeons. Hence, we aimed at analysing the Alvarado Score in patients with right iliac fossa pain.Methods: A prospective study involving 120 patients with right iliac fossa pain attending KIMS casualty during May 2015- April 2016 were included in the study. Results: The least was in the age group of 56 to 65 years (2%). Out of 120 patients, 84 were males (70%) and 36 were female (30%). The male to female ratio was 1:0.4. Patients with Alvarado score 7-9 (Group I) includes 60 male and 26 females (71% of total study group). Alvarado score 5-6 (Group II) includes 17 males,19 female (22% of total study group). Alvarado score 1-4 (Group III) includes 7 males, and 1 female (7% of total study group). In patients of Group I, among 60 males, 51 were confirmed with acute appendicitis. Among 26 females, 19 were confirmed with acute appendicitis, with a positive appendicectomy rate of 81.3% and negative appendicectomy rate 19.7%. The numbers of patients were highest in the age group 15 to 25 years (38%) followed by 36 to 45 years (30%).Conclusions: The Modified Alvarado scoring system was found to be highly effective in the diagnosis of the acute appendicitis in men and can be widely used to avoid expensive time consuming and non-readily available additional investigations. However, this system was not very effective in women. Therefore, ultra sound examination of abdomen and pelvis and diagnostic laparoscopy are also advised to minimize the high false negative rate in women which excludes common pelvic pathology that mimic clinically acute appendicitis.

scholarly journals A comparison of HDL-c, VLDL-c among diabetics with and without dyslipidemia and healthy controls.

2020 ◽  
Vol 27 (11) ◽  
pp. 2427-2432
Author(s):  
Hajira Siddique ◽  
Sarah Sadiq ◽  
Asifa Majeed
Keyword(s):  
Mean Value ◽  
Healthy Controls ◽  
Cross Sectional ◽  
Female Ratio ◽  
Mean Values ◽  
Group Iii ◽  
Medical College ◽  
Group I ◽  
Group Ii ◽  
Disease Study

Objectives: To determine and compare the levels of HDL-c and VLDL-c between Diabetic with/without dyslipidemia with normal healthy controls and risk of Cardiovascular disease. Study Design: Cross Sectional Comparative study. Setting: Multidisciplinary Lab I, Department of Biochemistry and Molecular Biology Army Medical College, Rawalpindi. Period: 2 years January 2016 to January 2019. Material & Methods: Total 90 subjects were enrolled in three groups i.e., group I comprised of 30 patients of Diabetic dyslipidemia, group II consisted of 30 patients of Diabetes without dyslipidemia and group III consisted of 30 healthy normal controls. Demographic and clinical data were collected. Data collected was analyzed by SPSS version 22. Results: Male to female ratio included in group I was 1:1.73 and in group II and III was 1:1.5 each. Mean value of the HDL-c among group I was significantly lower as compared to controls. Mean values of the triglycerides (TG) among group I and group II were significantly elevated as compared to the controls. Most of the subjects of group III were doing exercise as part of everyday routine. Conclusion: The HDL-c and TG (VLDL-c) levels are perturbed significantly among Diabetic dyslipidemic patients as compared to Diabetic non-dyslipidemic patients and normal healthy controls. Exercise is an important factor missed by patients to manage their disease.

scholarly journals VALIDITY OF ALVARADO SCORING SYSTEM IN DIAGNOSIS OF ACUTE APPENDICITIS

1969 ◽  
Vol 5 (2) ◽  
pp. 663-666
Author(s):  
ASGHAR ALI ◽  
ABDUR RAHMAN ◽  
FAZAL RAHIM
Keyword(s):  
Acute Appendicitis ◽  
Scoring System ◽  
Iliac Fossa ◽  
Cross Sectional Study ◽  
Alvarado Score ◽  
Cross Sectional ◽  
Female Ratio ◽  
Suspected Appendicitis ◽  
Surgical Ward ◽  
Male To Female

BACKGROUND: The first appendectomy was performed by Claudius Amyand in 1736 when he wasoperating on a boy for hernia and found appendix lying in hernial sac. Reginald Fitz introduced the wordappendicitis in 1886 and before that it was called typhlitis or perityphlitis.Frederick Treves performedthe lstappendicle surgery in England for the new disease ‘appendicitis’ in 1887.OBJECTIVE: To study the accuracy of modified Alvarado scorning system in diagnosis of acuteappendicitis.MATERIAL & METHODS: This descriptive cross sectional study was conducted at DHQ HospitalTimergara Dir lower from January 2015 to July 2015 to find out the accuracy of Alvarado Scoringsystem in the diagnoses of acute appendicitis. A total of 50 patients admitted in surgical ward from OPDand Casualty with suspected appendicitis were included in the study. Patients less than 7 years andpatients with mass right iliac fossa were excluded. Every patient was evaluated with modified Alvaradoscoring system on a standard Proforma. Patients with Alvarado score of > 6 underwent appendectomy.The removed appendices were sent for histopathology to confirm or otherwise the provisional diagnosisof acute appendicitis and hence the accuracy of Alvarado scoring system.RESULTS: Out of 50 patients, 20 were male &30 were female with a male to female ratio of 1:1.5. Themean age of the patients was 19.7 ± 9.6years. The mean Alvarado score was 7.92 ± 1.383. TheHistopathology reports of the specimens of 37 patients were confirmative of acute appendicitis whereasthe rest of the (13 patients) removed appendices were reported normal by histopathalogist. So thesensitivity is 74%.CONCLUSION: Our study shows that Alvarado scoring system is a simple and quick tool in theevaluation and management of suspected cases of acute appendicitis. Its accuracy increases if used inpatients above 14 years of age.KEYWORD: Alvarado scoring system, Appendicitis, Accuracy.

Sign in / Sign up

Export Citation Format

Share Document