scholarly journals Ultrasonography in acute appendicitis

2017 ◽  
Vol 13 (1) ◽  
pp. 203-206
Author(s):  
V Natraj Prasad ◽  
Pramod Kumar Chhetri
Keyword(s):  
Emergency Department ◽  
Acute Appendicitis ◽  
Clinical Diagnosis ◽  
Cross Section ◽  
Wall Thickness ◽  
Gold Standard ◽  
Histopathological Examination ◽  
Clinical Impression ◽  
Clinical Settings ◽  
Outer Diameter

Background & Objectives: This study was undertaken to establish the Ultrasonographic (USG) findings in acute appendicitis and to establish the accuracy of USG in the diagnosis of acute appendicitis.Materials & Methods: One hundred patients who presented to the emergency department with a clinical diagnosis of acute appendicitis were subjected to USG. USG findings of those patients suggestive of acute appendicitis were noted. The decision to operate for appendicitis was made on the surgeon's final clinical impression after correlating with USG findings. Histopathological examination of the appendicectomy specimen was taken as the gold standard for the diagnosis of acute appendicitis.Results: USG diagnosis of acute appendicitis is based on a combination of sonographic features. The findings of an aperistaltic tubular structure arising from the caecum with a target appearance on cross section, outer diameter of  > 6 mm, mural wall thickness > 3 mm, and probe tenderness over the visualized appendix should prompt the diagnosis in the appropriate clinical settings. The visualization of appendicolith is associated with higher rate of perforation and the visualization of fluid with internal echoes in acute appendicitis could suggest abscess formation.Conclusion: USG is a very useful and essential modality in the diagnosis of acute appendicitis with a sensitivity of 93.93%, specificity of 100%, PPV of 100%, NPV of 89.47% and an overall accuracy of 96% in the diagnosis of acute appendicitis.

scholarly journals Abdominal hysterectomy: analysis of clinico-histopathological correlation in Western Rajasthan, India

2017 ◽  
Vol 6 (3) ◽  
pp. 1012
Author(s):  
Dinesh Pal Yadav ◽  
Ramgopal Yadav ◽  
Indra Bhati
Keyword(s):  
Clinical Diagnosis ◽  
Histopathological Examination ◽  
Abdominal Hysterectomy ◽  
Major Surgery ◽  
Clinical Impression ◽  
Histopathological Analysis ◽  
Age Group ◽  
Histopathological Correlation ◽  
Wide Range ◽  
Gynecological Diseases

Background: Hysterectomy is the most common gynecological surgery done in the females worldwide as it provides definitive cure to a wide range of gynecological diseases, both benign and malignant. The indications to perform this major surgery should always be justified and the pathology should be proved histopathologically. Histopathological analysis and review is mandatory to evaluate the appropriateness of the hysterectomy.Methods: A retrospective, longitudinal study was conducted in the Department of Obstetrics and Gynecology, UMAID Hospital, Dr. S.N. M.C. Jodhpur (Raj.) during October 2014 to March 2015.Total 105 cases were studied during this period. The study included all women undergoing planned abdominal hysterectomy. Data was recorded on proformas, including demographic characteristics and clinical features. Hysterectomy specimens were saved in 10% formalin and sent to the Department of Pathology. Histopathology reports were analyzed and compared with the indications of surgery to draw various informative conclusions.Results: Of 105 cases, 55(52.38%) were in the age group of 41 – 50, which comprised the commonest age group undergoing the surgery. Maximum women (95%) those underwent hysterectomy were multiparous. Most common preoperatively clinical diagnosis was leiomyoma uterus which was diagnosed clinically and sonographically in 51(48.57%) cases. On Histopathological examination, the commonest pathology, similar to clinical impression, was found to be Leiomyoma at 50.48% (n = 53). Adenomyosis (21.90%) was detected as Second most common pathology. Histopathological confirmation of pre-operative diagnosis was 89% for malignancy, 96% for fibroids, 100% for adenomyosis, 100% for pelvic inflammatory disease.Conclusions: There was a high correlation when the clinical diagnosis was a fibroid, adenomyosis and ovarian mass. Every hysterectomy specimen should be subjected to histopathological examination because it is mandatory for conforming diagnosis and ensuring optimal management, in particular of malignant disease.

scholarly journals Acute appendicitis: a 2- year review of clinical presentation and histopathology

1970 ◽  
Vol 1 (2) ◽  
pp. 104-107 ◽  
Author(s):  
N Subedi ◽  
US Dangol ◽  
MB Adhikary ◽  
S Pudasaini ◽  
R Baral
Keyword(s):  
Acute Appendicitis ◽  
Clinical Diagnosis ◽  
Clinical Presentation ◽  
Histopathological Examination ◽  
Iliac Fossa ◽  
Operative Procedure ◽  
Lymphoid Hyperplasia ◽  
Negative Appendectomy ◽  
Histopathological Correlation ◽  
The Right

Background: Acute appendicitis is the most common surgical emergency. Obstruction of the lumen by fecolith is the usual cause of acute appendicitis.The aim of the study was to analyze clinical presentation of acute appendicitis and its histopathological correlation. Materials and Methods: A retrospective study of acute appendicitis was done in the Department of Surgery of Helping Hands Community Hospital from January 2009 to December 2010. Three hundred forty five patients out of 415 patients with clinical diagnosis of appendicitis underwent operative treatment. The histopathological reports were reviewed and correlated with clinical diagnosis. Results: Out of 345 patients who underwent operative procedure 98% (n= 338) came with chief complaint of pain in the periumbilical region migrating to the right iliac fossa. The mean age of presentation was 42 years. Increased leucocyte count was seen in only 65% cases. Acute appendicitis was more commonly seen in male patients (214 cases, 62%). The most common per operative finding was acutely inflammed appendix (84%) followed by perforated appendix (7.5%), gangrenous appendix (3.5%) and appendicular lump (1.5%). However, histopathological diagnoses were acute appendicitis (91.9%), resolving appendicitis (3.5%), lymphoid hyperplasia (2.6%), mucocele (0.3%) and carcinoid (0.3%). Normal histology was seen in 1.4% cases. Conclusion: Though there are other causes of acute abdomen, acute appendicitis still stands first amongst all the emergencies. Histopathological examination of appendectomy specimen should not be omitted in order to see the incidence negative appendectomy rate and to avoid complications relating to malignant conditions. Keywords: Acute appendicitis; Appendectomy; Appendicular perforation; Histopathology DOI: http://dx.doi.org/10.3126/jpn.v1i2.5402 JPN 2011; 1(2): 104-107

A STUDY OF CLINICAL CORRELATION WITH HISTOPATHOLOGICAL DIAGNOSIS OF ABNORMAL UTERINE BLEEDING AT JLNMCH, BHAGALPUR, BIHAR

2021 ◽  
pp. 73-74
Author(s):  
Archana Jha ◽  
Satyendra Kumar ◽  
[Prof.] Usha Kumari ◽  
Debarshi Jana
Keyword(s):  
Clinical Diagnosis ◽  
Histopathological Examination ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Clinical Impression ◽  
Histopathological Diagnosis ◽  
Endometrial Sampling ◽  
Carcinoma Of Cervix ◽  
Perimenopausal Women ◽  
Pathological Evaluation

Background: Abnormal uterine bleeding in perimenopausal women accounts for about 70% of gynaecologic Outpatient Department visits. Perimenoppause, also called the menopausal transition, is the interval in which a woman's body makes a natural shift from more or less regular cycles of ovulation and menstruation toward permanent infertility, or menopause. Polymenorrhagia, intermenstrrual bleeding and metrorrhagia are other common disorders at perimenopause. Endometrial sampling is a safe and effective diagnostic step in evaluation of abnormal uterine bleeding after ruling out medical causes. The present study was aimed to review the causes of abnormal uterine bleeding in perimenopausal women establishing the correlation with clinical diagnosis and histopathological examinations. A total of 150 perimenopausal Material and Methods: women with abnormal uterine bleeding in the age group of 37-51 years for a period of 6 months were included. These women were evaluated clinically and ultrasonographically for the cause of abnormal uterine bleeding. Clinical impression and USG reports were correlated. These women underwent dilatation and curettage for endometrial sampling and specimen sent for histopathological examination. Histopathological reports were correlated with clinical diagnosis. Most of the patients with AUB were Results: between 37-41 years of age (56%). The incidence was high in parity-3 (26%) annd grand multipara (49.33%). The majority of the women were presented with menorrhagia (54.66%). Clinically, majority of the cases were diagnosed as broids 66 (44%) followed by dysfunctional uterine bleeding (DUB) 56 (37.33%). However, histopathological reports conrmed broid in 52 cases, DUB in 49, adenomyosis in 36 and polyp in 11 cases. Fibroi Discussion: ds are common nding in women with menorrhagia. Clinical, radiological and pathological evaluation correlated very well to diagnose broids and DUB. However clinically as well USG proved of little help to diagnose adenomyosis and carcinoma of cervix and endometrium. Thus, histopathological evaluation of endometrium is recommended in perimenopausal women.

Theoretical, Numerical and Experimental Investigation of the Effects of Manufacturing Process Parameters on Thin-Walled Tube Bending Defects

2009 ◽  
Vol 83-86 ◽  
pp. 1107-1112
Author(s):  
J. Taheri Kahnamouei ◽  
Mohammad Sedighi
Keyword(s):  
Cross Section ◽  
Wall Thickness ◽  
Thickness Ratio ◽  
Outer Diameter ◽  
Tube Bending ◽  
Effective Parameters ◽  
Bending Process ◽  
Thin Walled Tube ◽  
Bending Radius ◽  
Thin Walled

The aim of this paper is to survey thin-walled tube bending process (without use of mandrel and booster). In tube bending process there are several effective parameters such as wall thickness, outer diameter-to-wall thickness ratio, and centerline bending radius-to-outer diameter ratio. Any mismatch in selecting these parameters would cause defects like wrinkling, variation in wall thickness, and cross section distortion. Firstly, the effects of these parameters on the initiation of the wrinkle, depth of wrinkling, change in wall thickness, and cross section distortion are studied. For this purpose, an FE commercial code has been used to simulate the process. Then, a series of experimental tests have been carried out to verify the results simulation. A comparison between analytical and experimental results shows a reasonable agreement with each other. Based on this comparison, it has been observed that there is a critical bending radius for any tube with a certain radius and thickness, in which the wrinkling begins to occur. For a certain bending angle and radius, it have been observed that the depth of wrinkling, change in wall thickness, and cross section distortion increase with reduction in wall thickness and outer diameter-to-wall thickness ratio

Experimental Study on Residual Cross-Sectional Flattening of Thin-Walled Pipes Under Pure Plastic Bending

2019 ◽  
Vol 141 (6) ◽  
Author(s):  
Ziqian Zhang
Keyword(s):  
Cross Section ◽  
Wall Thickness ◽  
Residual Deformation ◽  
Outer Diameter ◽  
Cross Sectional ◽  
Plastic Bending ◽  
Thin Walled Pipe ◽  
Bending Radius ◽  
Thin Walled ◽  
The Cross

Abstract Cross-sectional ovalization (ovalization) usually occurs when thin-walled pipe is subjected to large plastic bending. This paper is concerned with residual deformation of thin-walled pipe's cross section in a radial direction when external bending moment is removed. In order to clarify the fundamental ovalization characteristics, find out what factors influence the residual flattening (value of ovalization), the ovalization behavior is investigated experimentally. The experiments are carried out on 21 stainless steel specimens with different geometric parameters under different bending radii by means of a four-point pure bending device. The residual cross-sectional flattenings are monitored continuously by scanning the cross section periodically along the circumferential direction. From the experimental results, it is observed that the cross-sectional shape of the thin-walled pipe is not perfect standard ellipse, and the appearance of the maximum residual flattening is usually found in the direction normal to the neutral surface. It is also revealed the relationships between the residual flattening and the bending radius, the wall thickness, and the pipe outer diameter, i.e., the residual flattening increases as the bending radius and the wall thickness reduce, but it increases as the outer diameter increases. These results are expected to find their potential application in thin-walled pipe bending operation.

Morphological Pattern of Endometrial Biopsy in Women with Clinical Diagnosis of Abnormal Uterine Bleeding

Esculapio ◽  
2021 ◽  
Vol 16 (4 (oct 2020 - dec 2020)) ◽  
Author(s):  
Nosheen Khurram ◽  
Nasim Aslam Ghumman ◽  
Noshin Wasim Yusuf
Keyword(s):  
Clinical Diagnosis ◽  
Histopathological Examination ◽  
Age Groups ◽  
Abnormal Uterine Bleeding ◽  
Endometrial Biopsy ◽  
Uterine Bleeding ◽  
Clinical Impression ◽  
Morphological Pattern ◽  
Study Results ◽  
Routine Basis

Objectives: This study was carried out to determine the underlying gynecological pathology with help of morphological pattern of the endometrial histology in women of different age groups with clinical diagnosis of abnormal uterine bleeding. Methods: This is a retrospective study of a series of one hundred and twenty cases of women with presenting complaint of abnormal uterine bleeding. This study was done in the Department of Pathology, Rashid Latif Medical College, in collaboration with Gynecology departments of Arif Memorial Hospital and Hameed Latif Hospital over period of one year. (July 2018 to June 2019). One hundred and twenty cases of endometrial curettage, with clinical impression of abnormal uterine bleeding were analyzed and reported by two histopathologists. Patients with complications of pregnancy were excluded from present study. Results: Histopathological examination of endometrial curetting revealed spectrum of morphology from physiological changes to malignancy. Endometrium with normal cyclical changes were seen in 64 (53.33%) cases, followed by endometrial polyp 18 (15%) cases, endometrial hyperplasia 15 (12.5%), and disordered proliferative of endometrium 10 (8.33%) cases. Malignancy was noticed in 3 (2.5%) cases. Malignancy was diagnosed mostly in the postmenopausal age group. Conclusion: The present study proves that on routine basis endometrial histopathological evaluation is a useful diagnostic measure to determine the underlying cause of abnormal uterine bleeding which ultimately help in accurate treatment. Key Words: Abnormal uterine bleeding, polyp, hyperplasia, disordered proliferation, malignancy How to Cite: Khurram N, Aslam N, G. Wasim N.Y. Morphological pattern of endometrial biopsy in women with clinical diagnosis of abnormal uterine bleeding. Esculapio.2020;16(04):3-7.

scholarly journals Correlación diagnóstica de la escala RIPASA en pacientes intervenidos quirúrgicamente por apendicitis aguda

2020 ◽  
Vol 112 (2) ◽  
pp. 178-184
Author(s):  
Rodrigo A. Gasque ◽  
◽  
Walter A. Moreno ◽  
Gabriel E. Vigilante
Keyword(s):  
Acute Appendicitis ◽  
Likelihood Ratio ◽  
Clinical Diagnosis ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Histopathological Examination ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Cross Sectional ◽  
Ripasa Score

Background: Acute appendicitis (AA) is the most common surgical emergency worldwide. Its correct and early diagnosis is essential to avoid unnecessary surgeries and complications associated with its natural history. Objective: The aim of this study was to determine the diagnostic sensitivity and specificity of the RIPASA score in patients with suspected AA. Material and methods: This analytical, cross-sectional, observational and retrospective study included appendectomy specimens of patients of both sexes > 18 years operated on with clinical diagnosis of AA between January 1 and December 31, 2017. The histopathological examination of the appendectomy specimens was considered the gold standard diagnostic test. A score of 7.5 for the RIPASA score was chosen as cut-off value. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Results: A total of 68 appendectomies were included; 57 (83.82%) specimens were positive for acute appendicitis. Mean age was 43.32 years. The histological diagnosis of AA was present in 32 (84.21%) men and in 25 (83.33%) women. For the RIPASA score, 54 patients had a true positive result (cut-off point ≥ 7.5 and positive histology for AA) with a sensitivity of 93%, specificity of 40%, PPV of 90%, NPV of 50%, positive likelihood ratio of 1.55 and negative likelihood ratio of 0.175. Conclusion: The RIPASA score has demonstrated excellent sensitivity and specificity for the clinical diagnosis of AA in a fast, simple and non-invasive fashion.

scholarly journals Role of serum bilirubin in predicting the severity of acute appendicitis

2019 ◽  
Vol 6 (12) ◽  
pp. 4415
Author(s):  
Sandeep Y. Chinnapur ◽  
Naveen Kumar S. ◽  
Hanumanthaiah K. S.
Keyword(s):  
Acute Appendicitis ◽  
Clinical Diagnosis ◽  
Total Bilirubin ◽  
Serum Bilirubin ◽  
Histopathological Examination ◽  
Serum Total Bilirubin ◽  
Medical College ◽  
Gangrenous Appendicitis ◽  
Routine Investigations

Background: The aim of the study was to establish the role of hyperbilirubinemia as a new diagnostic tool to predict gangrenous/perforated appendicitis.Methods: A prospective study carried for 9 months (March 2018 to November 2018) at Rajarajeswari Medical College and Hospital. All patients admitted with clinical diagnosis of acute appendicitis and posted for surgery were included in the study. Serum total bilirubin results will be compared with Rajarajeswari Medical College and Hospitals laboratory reference values. These cases will be operated and clinical diagnosis will be confirmed per-operatively and post-operatively by histopathological examination. Final histopathological examination will be considered as a gold standard for diagnosing and categorizing patients as having normal appendix, acute appendicitis and acute appendicitis with perforation and/or gangrene. Based on histopathological examination patients will be categorized as positive (acute appendicitis with perforation and/or gangrene) and negative (acute appendicitis without perforation or gangrene).Results: Sensitivity of serum bilirubin in case of perforated/gangrenous appendicitis was found to be 90%. Specificity of serum bilirubin was found in case of perforated/gangrenous appendicitis was found to be 90.47%. Positive predictive value and negative predicting value of serum bilirubin in perforated/gangrenous appendicitis was found to be 81.8% and 95% respectively with p value of 0.003.Conclusions:Serum total bilirubin is an easily available and cheap and can be estimated from the same blood sample withdrawn for routine investigations, if added to routine investigations, then diagnosis of complicated appendicitis can be made with fair degree of accuracy.  

scholarly journals OPTIMIZATION OF BELLOWS AND TUBES CUTTING BY DISC KNIFE TO ACHIEVE THE MINIMUM BURR SIZE

2021 ◽  
Vol 2021 (6) ◽  
pp. 5373-5380
Author(s):  
RADEK CADA ◽  
◽  
PAVEL LOSAK ◽  
Keyword(s):  
Cross Section ◽  
Wall Thickness ◽  
Cutting Tool ◽  
Circular Cross Section ◽  
Minimum Size ◽  
Optimal Size ◽  
Outer Diameter ◽  
Burr Size ◽  
Metal Bellows

The paper solves the determination of the optimal size of the shear gap when dividing components with a circular cross section (hydroformed metal bellows and tubes) with a disc knife to achieve the smallest burr size on the divided surfaces. The analyzes were performed on bellows with an outer diameter of 15 mm and a wall thickness of 0.4 mm. During the experiments, the size of the shear gap between the inner disc knife and the outer knife was changed, and the pressing force of the inner disc knife was changed. The experiments were carried out using a cutting tool after 20,000 cuts and after 120,000 cuts. The optimal size of the cutting gap was determined, allowing the minimum size of the burr to be achieved, thus reducing the time to remove it by brushing or tumbling in the subsequent operation. The mentioned procedure can be applied to analogous cases of division.

scholarly journals Comparative evaluation of the role of Sonography in diagnosis of Acute Appendicitis versus Surgeon`s clinical impression

2016 ◽  
Vol 9 (1) ◽  
Author(s):  
Ahsen Nazir Ahmad ◽  
Noor Fatima ◽  
Rana Amjad Hussain ◽  
Qadir SNR
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Clinical Evaluation ◽  
Clinical Judgment ◽  
Ultrasound Examination ◽  
Lower Abdominal Pain ◽  
Clinical Impression ◽  
Abdominal Sonography

A randomly selected group of patients presented in Accidents & Emergency department of Jinnah hospital Lahore with complaint of acute lower abdominal pain were subjected to abdominal sonography and those positive for acute appendicitis on ultrasound examination were operated. Another group of randomly selected patients with acute lower abdominal pain in Emergency department were clinically evaluated for acute appendicitis and surgery was done based on clinical impression (history and classical signs for acute appendicitis). Ultrasound examination showed the following parameters. Sensitivity 71.8%, specificity 62.5%, PPV 88.4%, NPV 35.7%. Clinical evaluation showed the sensitivity of 95.2%, specificity 77.7%, PPV 90.9%, NPV 87.5%. It was concluded on the basis of the results that clinical evaluation of the patient is more sensitive in correctly categorizing those who need appendicectomy than the ultrasound examination. Although the latter can be used in suspected cases and to rule out other pathological conditions resulting in acute abdomen. Limitations: Clinical judgment to a large extent rest on the experience and expertise of the surgeon and so is the quality of sonographic results, which depend on experience of sonographer & quality of ultrasound machine.

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