scholarly journals ACUTE APPENDICITIS

2015 ◽  
Vol 22 (12) ◽  
pp. 1601-1605
Author(s):  
Khawar Saeed Jamali ◽  
Humaid Ahmed ◽  
Muhammad Jawed ◽  
Ubedullah Shaikh

Objectives: The objective of this study was to compare the efficacy of ClinicalEvaluation and modified Alvarado scoring system in diagnosing acute appendicitis. StudyDesign: Cross sectional study. Place and Duration of Study: This study was conducted atSurgical Unit III of Civil Hospital Karachi from May 2010 to October 2010. Methodology: Thisstudy consisted of eighty patients. Patients were divided in two groups. Group A for completeclinical evaluation comprising of 40 patients and Group B for modified Alvarado scoring systemcomprising of 40 patients. Inclusion criteria were all patients presenting with RIF pain, nausea,vomiting, fever and/or anorexia, diagnosed as having acute appendicitis preoperatively andundergoing emergency appendectomy during this period, age >12 years and both gender.Exclusion criteria included not willing for surgery, General anesthesia problem, pregnant femalepatients and those who did not give written consent. Results: A total of 80 patients were includedin the study, placed alternatively into two groups of 40 patients each with majority being male(n = 61, 76.3%). The mean age was 22.46 years. The positive predictive value for patients ofGroup A was 92.5% while for Group B was 77.5%. When diagnostic accuracy was compared onthe basis of Gender for the two groups, the positive predictive value for male patients of GroupA and B was 90.09% and 89.28% respectively, but for females the positive predictive valueof Group A and B was 100% and 50% respectively. Conclusion: We conclude that modifiedAlvarado score can be used safely and effectively in diagnosing acute appendicitis in adultmales especially as the score increases from seven to nine.

2015 ◽  
Vol 22 (11) ◽  
pp. 1550-1524
Author(s):  
Khawar Saeed Jamali ◽  
Naveed Ali Khan ◽  
Muhammad Jawed ◽  
Ubedullah Shaikh

Objectives: The objective of this study was to compare the outcome of diathermyincisions v/s surgical scalpel incisions in general surgery. Study Design: Cross sectional study.Place and Duration of Study: This study was conducted at surgical unit 7, Sindh Govt. LyariGeneral Hospital and Dow University of Health Sciences between January to December 2009.Methodology: 100 consecutive patients for elective general surgery were randomly assignedto either group A incision with cutting diathermy (n=50) or group B cold steel scalpel (n=50).Data including demographic details, hospital stay, infection rate and non-infective complicationslike swelling, bleeding, dehiscence and seroma formation were recorded in both groups tocompare the final surgical outcome compared. Results: A total of 80 patients were included inthe study, placed alternatively into two groups of 40 patients each with majority being male (n =61, 76.3%). The mean age was 22.46 years. The positive predictive value for patients of Group Awas 92.5% while for Group B was 77.5%. When diagnostic accuracy was compared on the basisof Gender for the two groups, the positive predictive value for male patients of Group A and Bwas 90.09% and 89.28% respectively, but for females the positive predictive value of Group Aand B was 100% and 50% respectively. In Diathermy (Group A) total 20% patients developedcomplications and these were seroma formation (n=4, 8%), wound dehiscence (n=3, 6%) andwound infection (n=3, 6%). In Scalpel (Group B) total 26% patients developed complications(P-value=0.370) in which seromas was noted (n=5, 10%) then wound infection (n=4, 8%), thenwound bleeding (n=3, 6%) and lastly seroma formation (n=1, 2%). Hospital stays were alsoalmost similar with mean value 8.24 days in diathermy group and 10.54 days in scalpel group.No remarkable difference in demographics, characteristics and in other variables of patientswas noted. Conclusion: We conclude that no significant difference in surgical outcome ofboth groups (cutting diathermy Vs. steel scalpel). Therefore, use of either technique to createsurgical wound merely depends upon preference of surgeon.


1970 ◽  
Vol 9 (1) ◽  
pp. 44-48
Author(s):  
ASM Nurunnabi ◽  
A Alim ◽  
M Sabiha ◽  
B Manowara ◽  
K Monira ◽  
...  

Context: A cross-sectional study was designed to find out the difference in weight of the thyroid gland of Bangladeshi people in relation to age and sex and to compare with previous local and foreign studies. Materials & Methods: The present study was performed on 60 post mortem human thyroid gland (39 of male and 21 of female) collected from unclaimed dead bodies which were in the morgue under examination in the Department of Forensic Medicine, Dhaka Medical College, Dhaka. The samples were divided into three age-groups including Group A (10-20 years), Group B (21-50 years) & Group C (>50 years) and the weight of the thyroid glands were measured and recorded. Results: The mean weight of the thyroid gland in male was 15.14 gm, 19.20 gm and 14.64 gm and in female was 16.02 gm, 19.03 gm and 14.67 gm in group A, B and C respectively. The mean weight of the thyroid gland was 15.48 gm in group A, 19.15 gm in group B and 14.65 gm in group C. There was no difference in mean weight of the thyroid gland between male and female. The difference in mean weight of the thyroid gland between group A & group B and group B & group C were found statistically significant. The weight of the gland was found to increase from early childhood and puberty up to 50 years of age and then decrease. Key words: Thyroid gland; Weight of thyroid gland. DOI: 10.3329/bjms.v9i1.5230 Bangladesh Journal of Medical Science Vol.09 No.1 Jan 2010 44-48


2016 ◽  
Vol 30 (2) ◽  
pp. 80-85 ◽  
Author(s):  
Sankar Kumar Basak ◽  
Kohinoor Begum ◽  
Maliha Rashid ◽  
Nahid Yasmin ◽  
Hasina Begum

Objective(s): To assess the association between the haematocrit value and severity of preeclampsia.Materials & Methods: This cross sectional study was conducted in the department of Obstetrics & Gynaecology of Dhaka Medical College Hospital, Dhaka during the period of January 2012 to December 2013. Total of 100 patients were studied and they were divided into two groups – group-A and group-B. Fifty preeclamptic patients were included in the group-A and 50 normal pregnant women were included in the group-B.Results: Majority of preeclamptic women (68%) and normal pregnant women (76%) were in the age group of 20-30 years with the mean ages of group-A and group-B subjects were 26.50±5.71 and 26.26±4.91 years respectively. Eighty six percent of group-A and 70% of group-B women were of lower socioeconomic status. Majority of the study subjects (74% of group-A and 80% of group-B) were housewife. More than half (54%) of the preeclamptic women were primigravid and 60% of normal pregnant women were multigravid. Among the preeclamptic subjects 16 (32%) had mild hypertension (DBP<110mmHg) and 34 (68%) had severe hypertension (DBP ? 110 mmHg). Out of 50 preeclamptic subjects 45 (90%) had severe proteinuria (+++) and only 5 (10%) had moderate (++) proteinuria.The mean haematocrit value of preeclamptic patients was 34.881±3.03 and that of normal pregnant women was 31.94±1.2. It was statistically significant (P value 0.001). The mean haematocrit value of normal pregnant, mild and severe preeclamptic women were 31.94±1.2, 33.31±2.57 and 35.62±2.95 respectively. It was also statistically significant (P value 0.001).Conclusion: This study shows that haematocrit value of preeclamptic patients is significantly higher compared to that of the normal pregnant women (P<0.05). There is a strong association of increasead haematocrit and preeclampsia.Bangladesh J Obstet Gynaecol, 2015; Vol. 30(2) : 80-85


Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 716
Author(s):  
Wisam Sbeit ◽  
Anas Kadah ◽  
Amir Shahin ◽  
Tawfik Khoury

Background and Objectives: The diagnosis of pancreatic cysts is mostly based on a combination of morphological appearance and fluid analysis of amylase and carcinoembryonic antigen (CEA). We aimed to assess the capability of the string sign in differentiating mucinous from non-mucinous pancreatic cysts. Materials and Methods: All patients who were referred for endoscopic ultrasound (EUS) for pancreatic cysts assessment from 2015 to 2020 were retrospectively analyzed. Results: Our cohort consisted of 112 patients. Of them, 92 patients (82.1%) had mucinous cystic neoplasms (group A) and 20 patients (17.9%) had non-mucinous cystic neoplasms (group B). The average age in groups A and B was 71.3 and 60.4 years, respectively. String sign was positive in 47 patients (51.1%) and negative in 21 patients (22.8%) in group A, while in group B, string sign was negative in 19 patients (95%). String sign showed significant correlation with the diagnosis of mucinous cystic neoplasms (OR 64.2, 95% CI 8.1–508.6, p = 0.0001). Cytology confirmed mucinous cystic neoplasms that included 32 patients; the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of string sign for mucinous cystic neoplasms were high, reaching 93.8%, 85.7%, 96.8%, and 75%, respectively, with an excellent accuracy rate of 92.3%. Conclusions: The string sign is highly accurate for predicting pancreatic mucinous cystic neoplasms, and should be used as an important aid for improving diagnostic accuracy.


2013 ◽  
Vol 25 (1) ◽  
pp. 28-31
Author(s):  
N Habib ◽  
M Rashid ◽  
USN Begum ◽  
N Ahter ◽  
D Akhter

This cross-sectional study was carried out to assess blood pressure parameters among adult male smokers and smokeless tobacco users. For this purpose, 105 male respondents were selected. They were divided into two groups; Group A-consisting of 30 were smokeless tobacco users and group B consisting of 75 smoker patients The participants were selected from medicine outdoor of Dhaka Medical College Hospital. In this study, the mean (±SD) of systolic blood pressure were 154.50±26.793 mm of Hg in Group A and 151.67±19.248 mm of Hg in group B respectively. Statistical analysis was done by unpaired‘t’ test, there were no statistical significant differences (P>0.05) of systolic blood pressure between Group A and Group B. The mean (±SD) of diastolic blood pressure were 96.67±10.933 mm of Hg in Group A and 86.47±14.745 mm of Hg in group B respectively. The mean (± SD) of diastolic blood pressure were significantly higher (P<0.05) in Group A than Group B. DOI: http://dx.doi.org/10.3329/medtoday.v25i1.16066 Medicine Today 2013 Vol.25(1): 28-31


2018 ◽  
Vol 5 (11) ◽  
pp. 2827-2831
Author(s):  
Mohammad Kazem Shahmoradi ◽  
Hormoz Mahmoudvand ◽  
Sedigheh Nadri ◽  
Massumeh Niazi ◽  
Mahin Adeli ◽  
...  

Background: Acute appendicitis is the most common surgical emergencies; while unusual symptoms have a differential diagnosis. This study aimed to determine the diagnostic accuracy of CBC and abdominal X-ray in acute suppurative appendicitis. Methods: This cross-sectional study was performed on 198 patients. For all patients, complete blood count and abdominal X-ray were recorded. The pathological report after surgery was the gold standard for diagnosis. Then indicators of the validity of tests CBC, X-ray and neutrophil to lymphocyte ratio, consisted of positive predictive value (PPV) and negative predictive value (NPV), sensitivity, specificity, were analyzed. Results: Out of patients, 133 of patients were male (67.2%), and 65 (32.8%) were female with mean age of 29.13 years. Acute appendicitis confirmed in 77.8% of pathological study, and 17.7% was the normal appendix. Leukocytosis, NLR and abdominal X-ray tests, each have a sensitivity of 89.5%, 78.5% and 100%, specificity of 31.4%, 31.4% and 31.8%, PPV 85.8%, 84.2% and 53.9%, NPV 39.2%, 23.9% and 100%, respectively. There was a significant relationship between appendicitis and WBC> 10.000 and abdominal radiography findings. Conclusion: Due to the sensitivity of performing CBC and leukocytosis and NLR is at an acceptable level, especially with a relatively high positive predictive value, could be concluded that the positivity of these tests for confirming the diagnosis in suspected cases might be helpful and can help to strengthen the clinical diagnosis. Our results in relation to the x-ray of the abdomen suggest its usefulness in the diagnosis of appendicitis.  


2021 ◽  
Vol 71 (Suppl-1) ◽  
pp. S255-60
Author(s):  
Muhammad Tahsin Hashmi ◽  
Irum Taqi ◽  
Amberin Taqi ◽  
Hassan Junaid Sarwar

Objective: To evaluate the accuracy of ultrasound findings as compared to operative findings and positive predictive value of ultrasonography in the diagnosis of acute appendicitis. Study Design: Cross sectional study. Place and Duration of Study: Pak Field Hospital – 7 (Level III) United Nations African Union Mission in Darfur (UNAMID) Darfur, Sudan, from Mar 2015 to Mar 2016. Methodology: All patients presenting with clinically suspected acute appendicitis (Alvarado’s score >4) were referred for right lower quadrant sonography. Three point scale was used to grade sonographic findings ranging from grade 1 to grade 3. Fifty One patients with persistent symptoms and/or positive sonographic findings were operated. Operative findings were also graded on a 3 point scale. Subsequently, sonographic and operative findings were compared. Surgical findings were considered gold standard to assess diagnostic accuracy of sonography. Results: Out of 51 patients 46 (90.2%) were males and 5 (9.8%) were females. Mean age of the patients was 32.3 ± 7.3 years. Among the study subjects, 15 (29.4%) patients were from Nigeria followed by 12 (23.5%) from Pakistan, 7 (13.7%) from Egypt and 17 (33.5%) from other countries.The sonographic findings were detected positive for acute appendicitis in 40 (78.4%) and negative in 11 (21.6%) out of 51. All Fifty-one patients underwent surgery. The surgical findings were positive for appendicitis in 43 patients (84.3%). Four patients with negative sonographic findings did have acute appendicitis according to surgical findings. The positive predictive value was 90.9%. There was good agreement between sonographicfindings and surgical findings..........


2019 ◽  
Vol 26 (02) ◽  
Author(s):  
Ayesha Baqar

Introduction: To study and compare the changes in the height of dermal papillae in the skin of different age groups in a segment of Pakistani population. Study Design: Cross sectional study. Period: Five months, from July 2010 to November 2010. Setting: Anatomy Department, Army Medical College, Rawalpindi. Materials & Method: Sixty volunteers of both sexes, after fulfilling the inclusion criteria, participated in this cross sectional study. They all gave written informed consent. They were divided into three equal groups according to their ages, Group A ranged in age from 18 – 29 years, Group B from 30 – 49 years, and Group C > 50 years. Punch biopsies were taken from the sun protected upper arm skin, from all volunteers, after giving local anaesthesia. Samples were stained with Hematoxylin and Eosin. They were observed under light microscope. Height of dermal papillae was measured at three random sites in each sample and mean was taken.The mean of all three groups was compared with each other and data was analyzed. Results: The mean of each sample was taken and then final mean of each group was calculated. They were then compared with each other. The mean height of dermal papillae of group A was 98.667µm, that of group B was 83.333µm and the mean height of dermal papillae in group C was 47.33µm. There was significant difference between the three groups and ‘p’-value was less than 0.5. Conclusion: At the end of this study, it was concluded that, the height of dermal papillae reduces significantly with age.


2012 ◽  
Vol 19 (02) ◽  
pp. 150-154
Author(s):  
SOHAIL ASHRAF ◽  
ARSHALOOZ J. RAHMAN ◽  
KASHIF ABBAS

Background: Determination of anthropometric measurements, especially of birth weight of newborn in first few days after birthis important for the assessment of neonatal nutritional status, gestational maturity, and prediction of early neonatal death. Objectives: (1) Todetermine the mean birth weight, mean birth length and mean head-circumference. (2) To seek association between income of the family andmean birth weight. Study Design: Analytical cross-sectional study. Setting & Period: This study was done in the pediatric department of LiaquatNational Hospital from March 2003 to September 2003. Materials and methods: One hundred full terms, normal, singleton newborn babieswere included and birth weight, length and head circumference were taken within 72 hours of birth. Results: Overall mean birth weight was2.890 kg, mean birth length 48.245cm and mean head circumference was 34.232 cm.The % of LBW babies was 13. The mean birth weight ofbabies belonging to group A (born to families with income >5000 Rs/mth) was 3.044 Kg and that of group B (born to families with income <5000Rs/mth) was 2.736 Kg. Group A had 8 % LBW babies whereas group B had 18 %. Mean birth weight, length and head circumference of boys was2.961Kg, 48.776 cm and 34.316 cm respectively. Mean birth weight, length and head circumference of girls was 2.788 Kg, 47.480 cm and34.109 cm respectively. Conclusions: Community based studies should be conducted from time to time in order to develop our own populationdata.


2020 ◽  
Vol 23 (1) ◽  
pp. 14-18
Author(s):  
Manish Pokhrel

Introduction: Comparison of penile measurements between boys with and without hypospadias is important to determine whether there is any truth in the notion that the hypospadic penis is shorter than its age-matched normal counterpart. This study was designed to check whether there was any difference in penile sizes between Nepalese boys with and without hypospadias. Methods: A cross-sectional study was conducted among 72 Nepalese boys (36 with hypospadias and 36 without hypospadias) attending the paediatric surgical unit of Kathmandu Medical College Teaching Hospital between July 2019 and June 2020. The penile length was measured in both the flaccid state and the stretched state yielding the flaccid penile length (FPL) and the stretched penile length (SPL) for each subject utilizing standardized measuring conditions. The SPL/FPL ratio was calculated for each patient. Results: The mean FPL in the hypospadias group (A) was 3.42±0.80cms while that in the normal group (B) was 3.62±0.61cms. The mean SPL in group A was 4.58±0.94cms compared to 5.52±0.68cms in group B. The SPL/FPL ratio was 1.34±0.14 in group A compared to 1.54±0.17 in group B. The difference in FPL was not significant between groups but the difference in SPL and the SPL/FPL ratio was statistically significant between groups. Conclusion: The flaccid penile length (FPL) does not vary between the two groups. However, the stretched penile length (SPL) and the Stretched penile to Flaccid penile length ratio (SPL/FPL ratio) are significantly different between the two groups of boys.


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