scholarly journals The Diagnostic Role of Hyperbilirubinemia in Complicated and Non -complicated Appendicitis.

2018 ◽  
Vol 2 (2) ◽  
Author(s):  
Valon Zejnullahu ◽  
Rozalinda Isjanovska ◽  
Besnik Bicaj ◽  
Vjosa A. Zejnullahu ◽  
Astrit R. Hamza ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Clinical Signs ◽  
Cross Sectional Study ◽  
Complicated Appendicitis ◽  
Clinical Approach ◽  
Cross Sectional ◽  
Laboratory Marker ◽  
Diagnostic Role ◽  
Sensitivity Specificity

Background: Acute appendicitis is one of the most frequent causes of abdominal pain. Early diagnosis is the key to success for the surgeon, followed by the treatment with operation or conservative treatment as a new approach, before the stage of gangrenous appendicitis or perforation occurs.Aim: This study aims to establish he role of hyperbilirubinemia as a laboratory marker in prediction of acute appendicitis in the early diagnosis.Materials and methods: This is a cross-sectional study; it included 201 patients admitted in the emergency ward with suspicion for acute appendicitis. All patients that participated in this study have been subject to appendectomy. The blood samples were taken from all patients in order to analyze the level of total/direct bilirubin.Results: The study samples of 201 patients consisted of 67.7% with complicated appendicitis and 32.3% with non-complicated appendicitis. The sensitivity, specificity, PPV, NPV for laboratory marker, as predictor for complicated vs non-complicated cases of appendicitis was as follows: Total bilirubin; specificity (72.3%), sensitivity (54.4%), PPV (80.4%), NPV (43.1%),Conclusion: Elevation of total/direct bilirubin level in patients with clinical signs of acute appendicitis might predict the stage of acute appendicitis, such prediction may help surgeons to provide accurate treatment of the disease without delay in the diagnosis. This accuracy can be further supplemented by using Alvarado scoring model during the clinical approach.

scholarly journals The Diagnostic Role of Hyperbilirubinemia in Complicated and Non -complicated Appendicitis

2018 ◽  
Vol 2 (2) ◽  
pp. 151-162
Author(s):  
Valon Zejnullahu ◽  
Rozalinda Isjanovska ◽  
Besnik X. Bicaj ◽  
Vjosa A. Zejnullahu ◽  
Astrit R. Hamza ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Clinical Signs ◽  
Cross Sectional Study ◽  
Complicated Appendicitis ◽  
Clinical Approach ◽  
Cross Sectional ◽  
Laboratory Marker ◽  
Diagnostic Role ◽  
Sensitivity Specificity

Background: Acute appendicitis is one of the most frequent causes of abdominal pain. Early diagnosis is the key to success for the surgeon, followed by the treatment with operation or conservative treatment as a new approach, before the stage of gangrenous appendicitis or perforation occurs.Aim: This study aims to establish he role of hyperbilirubinemia as a laboratory marker in prediction of acute appendicitis in the early diagnosis.Materials and methods: This is a cross-sectional study; it included 201 patients admitted in the emergency ward with suspicion for acute appendicitis. All patients that participated in this study have been subject to appendectomy. The blood samples were taken from all patients in order to analyze the level of total/direct bilirubin.Results: The study samples of 201 patients consisted of 67.7% with complicated appendicitis and 32.3% with non-complicated appendicitis. The sensitivity, specificity, PPV, NPV for laboratory marker, as predictor for complicated vs non-complicated cases of appendicitis was as follows: Total bilirubin; specificity (72.3%), sensitivity (54.4%), PPV (80.4%), NPV (43.1%),Conclusion: Elevation of total/direct bilirubin level in patients with clinical signs of acute appendicitis might predict the stage of acute appendicitis, such prediction may help surgeons to provide accurate treatment of the disease without delay in the diagnosis. This accuracy can be further supplemented by using Alvarado scoring model during the clinical approach.

scholarly journals Clinical symptoms, paraclinical tests and histopathological results in children with acute appendicitis in Zabol southeast of Iran: a cross-sectional study

2017 ◽  
Vol 5 (7) ◽  
pp. 2836
Author(s):  
Mehran Hesaraki
Keyword(s):  
Acute Appendicitis ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Cross Sectional Study ◽  
Intestinal Loop ◽  
Negative Appendectomy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Clinical Signs And Symptoms ◽  
Histopathological Results

Background: This article aimed to assessment clinical signs and symptoms, paraclinical tests and histopathological results in children with acute appendicitis.Methods: A cross-sectional study conducted on 100 children with acute appendicitis in an urban hospital in southeast of Iran from January to December 2016. Participants were selected by simple random sampling method. Clinical signs and symptoms, paraclinical tests and histopathological results recorded in checklists. The data were analyzed using SPSS 22.Results: Mean age of the patients was 10.26±3.25, fourthly-eight of patients (58.5%) were males and 34 patients (41.5%) were females. The most frequent clinical signs and symptoms were acute suppurative appendicitis with peri appendicitis (45.83%) and acute suppurative appendicitis (39.58%). The most frequent results in ultrasound reports were Intestinal loop thickness greater than 6 mm without peristalsis (positive report) (46.34%) and Invisible appendix (nega Hesaraki tive report) (13.41%).Conclusions: The results of this study showed that abdominal pain and RLQ tenderness were the most common signs and symptoms and WBC left-shift was the most common laboratory finding. Since the rate of negative appendectomy in this study was consistent with surgical results and other articles, it is concluded that diagnostic accuracy of preoperative appendectomy was acceptable and most children with acute appendicitis underwent appendectomy.

scholarly journals The Optimum Cut-off Value of the Nelwan Score to Diagnose Typhoid Fever in Adults

2021 ◽  
Author(s):  
Erni Juwita Nelwan ◽  
Luh Putu Listya Paramita ◽  
Robert Sinto ◽  
Fransiscus Nikodemus Hosea ◽  
Pringgodigdo Nugroho ◽  
...  
Keyword(s):  
Typhoid Fever ◽  
Clinical Presentation ◽  
Clinical Signs ◽  
Gastrointestinal Symptoms ◽  
Signs And Symptoms ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Clinical Signs And Symptoms ◽  
Sensitivity Specificity

AbstractIntroductionTyphoid fever can be challenging to diagnose since clinicians often depend merely on clinical presentation. Clinical scores are useful to provide more accurate diagnosis. Variables in Nelwan Score are derived from clinical signs and symptoms of suspected cases for typhoid. Diagnostic value of Nelwan Score based on a cut-off value has never been evaluated.MethodsA cross sectional study was conducted between July 2017 and January 2018 in five hospitals and two Primary Health Centers in Jakarta and Tangerang. The inclusion criteria were patients with 3-14 days of fever and gastrointestinal symptoms between July 2017 and January 2018. Diagnosis are confirmed by blood culture, rectal swab culture, or PCR. Cut-off analysis was performed by using Receiver Operating Characteristic (ROC) curve and diagnostic value was analyzed to generate sensitivity, specificity, predictive value and likelihood ratio.ResultFrom 233 subjects involved, 4.72% of them were confirmed to have typhoid fever. The optimal cut-off value of Nelwan Score is 10 with AUC 71.3%. This cut-off value has sensitivity 81.8%, specificity 60.8%, PPV 9.3%, NPV 98.5%, LR + 2.086, and LR – 0.299.ConclusionNelwan Score with cut-off value of 10 provides a good diagnostic performance as a screening tool for patients with suspected typhoid fever clinical presentation.

scholarly journals Investigating cell blood counter and abdominal radiography accuracy in diagnosis of acute suppurative appendicitis among patients under surgery

2018 ◽  
Vol 5 (11) ◽  
pp. 2827-2831
Author(s):  
Mohammad Kazem Shahmoradi ◽  
Hormoz Mahmoudvand ◽  
Sedigheh Nadri ◽  
Massumeh Niazi ◽  
Mahin Adeli ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Complete Blood Count ◽  
Cross Sectional Study ◽  
Abdominal Radiography ◽  
Cross Sectional ◽  
X Ray ◽  
High Positive Predictive Value ◽  
Sensitivity Specificity

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.  

scholarly journals Gene Xpert MTB / RIF – Diagnostic Role in Tuberculous Pleurisy

2016 ◽  
Vol 22 (1) ◽  
pp. 78
Author(s):  
Muhammad Khalid Ch ◽  
Muhammad Saqib Saeed ◽  
Rizwan Iqbal ◽  
Akhtar Ali
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Tuberculous Lymphadenitis ◽  
Care Hospital ◽  
Cross Sectional ◽  
Diagnostic Role ◽  
Tuberculous Pleurisy ◽  
Medical University

<p><strong>Abstract</strong></p><p><strong>Background:  </strong>Tuberculous pleurisy is a common extrapulmonary manifestation and is second to tuberculous lymphadenitis. Due to its paucibacillary in origin, its diagnosis is a challenge. Furthermore, it is also complicated by the emergence of MDR. Gene Xpert MTB/RIF is a new rapid promising innovation for the detection of mycobacterium tuberculosis and its resistance to Rifampicin, giving result within two hours.</p><p><strong>Objective:  </strong>To evaluate the diagnostic role of Gene Xpert MTB/RIF in suspected cases of tuberculous pleurisy.</p><p><strong>Study Design:  </strong>Cross sectional study.</p><p><strong>Study Setting:  </strong>Institute of Chest Medicine Mayo Hospital – a Tertiary Care Hospital affiliated with King Edward Medical University, Lahore.</p><p><strong>Methodology:  </strong>The study group, one hundred (M-60 and F-40) cases having exudative, predominantly lymphocytic pleural effusion with strong suspicion of tuberculous in origin were enrolled randomly for Gene Xpert MTB / RIF.</p><p><strong>Results:  </strong>Among one hundred study cases, Gene Xpert detected mycobacterium tuberculosis in 12(12%) cases [M-8 (13.3%) and F-4 (10%)]. Resistance to Rifampacin was detected in 6 (6%) cases [M-2 (3.3%) and F-4 (10%)].</p><p><strong>Conclusion:  </strong>Gene Xpert MTB/RIF is a useful new rapid promising technique to diagnose tuberculous pleurisy. Although at present it has limited availability and utility.</p><p><strong>Key Words:  </strong>Gene Xpert. MTB – Mycobacterium tuberculosis. RIF – Rifampacin. TB – Tuberculosis. MDR – Multidrug resistance.</p>

scholarly journals Frequency and outcome of complicated appendicitis in toddlers and pre-schoolers

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Naseem Khan ◽  
Muhammad Ayub Khan ◽  
Jehangir Khan ◽  
Sajjad Ali ◽  
Imran Khattak ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Pediatric Population ◽  
Perforated Appendicitis ◽  
Cross Sectional Study ◽  
Complicated Appendicitis ◽  
Cross Sectional ◽  
Generalized Peritonitis ◽  
Operative Findings ◽  
Study Participants ◽  
Emergency Abdominal Surgery

Background: Acute appendicitis is a frequent indication of emergency abdominal surgery in the pediatric population. In younger children, especially toddlers, and preschoolers, the presentation is comparatively late resulting in complicated appendicitis. This study was done to determine the frequency and outcome of complicated appendicitis in toddlers and preschoolers. Methods: This is a cross-sectional study done at the Department of Pediatric Surgery, Lady Reading Hospital Peshawar, during August 2018 and February 2019. The medical records of 144 toddlers and preschoolers who presented with acute appendicitis were reviewed for demography, clinical presentation, operative findings, and outcome. Frequency and types of complicated appendicitis were recorded. Results: The mean age of study participants was 3 years (±2.84), including 46(32%) toddlers and 98(68%) preschoolers. Overall 62% of patients were male while 38% of patients were female. Complicated appendicitis was documented in 75% of patients. The common types of complicated appendicitis were perforation of the appendix with a localized abscess in 68 patients, gangrenous appendicitis in 4 patients, generalized peritonitis in 24 patients, and mass formation in 12 patients. All patients did well after surgery, except one who succumbed to complications of leukemia. Conclusion: In our study, a great deal (75%) of toddlers and preschoolers had complicated appendicitis especially perforated appendicitis with localized peritonitis.

scholarly journals Accuracy Score on Raja Isteri Pengiran Anak Saleha (RIPASA) and Pediatric Appendicitis (PAS) for Diagnosing Acute Appendicitis in Children

2020 ◽  
Vol 3 (2) ◽  
pp. 102-111
Author(s):  
Shalita Dastamuar ◽  
M. Roby ◽  
Sindu Saksono ◽  
Erial Bahar
Keyword(s):  
Acute Appendicitis ◽  
Pediatric Patients ◽  
Histopathological Examination ◽  
Pediatric Population ◽  
Cross Sectional Study ◽  
Accuracy Score ◽  
Cross Sectional ◽  
Clinical Scoring ◽  
Surgical Field ◽  
Sensitivity Specificity

Abstract Introduction. Acute appendicitis is the most common case of acute abdomen. Diagnosis of acute appendicitis is still difficult and is one of the problems in the surgical field. The Clinical Scoring System (CSS) has been developed to help doctors classify risk categories. PAS has been widely evaluated in the pediatric population. In another study it was found that RIPASA had better sensitivity, specificity, and accuracy than PAS in pediatric patients. Methods. This study is a cross sectional study to assess the level of concordance between RIPASA and PAS scores in diagnosing acute appendicitis, with the gold standard of Histopathological examination. Samples were taken by consecutive method, in 30 patients aged <18 years for 1 year. Results. This study had an average age of 10.10 ± 3.745 years. Histopathologically early acute appendicitis 3.3%, acute suppurative appendicitis as much as 20%, acute gangrenous appendicitis 73.3% and others 3.3%. Using a cut-off point value of 9.5 for RIPASA and 7 for PAS, the sensitivity, Specificity, Accuracy of 82.75%, 100%, 80% for RIPASA, and 75.8%, 100%, 73.3% for PAS. Conclusion. The RIPASA score on the cut-off treshold 9.5 has better sensitivity and accuracy than PAS in diagnosing acute appendicitis in pediatric patients and can be used as CSS to assist in making decisions regarding the diagnosis of acute appendicitis in children.

scholarly journals Diagnostic Role of C- Reactive protein in Acute Appendicitis

2020 ◽  
Vol 16 (4) ◽  
pp. 246-251
Author(s):  
Ashis Pun ◽  
Amit Dhungana ◽  
Ramjee Bastola
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
White Blood Count ◽  
Negative Appendectomy ◽  
C Reactive Protein ◽  
Accuracy Rate ◽  
Reactive Protein ◽  
Diagnostic Role ◽  
Sensitivity Specificity

 Introduction: Acute appendicitis is the common surgical disease however, accurate diagnosis and exclusion of acute appendicitis always remains challenge to the surgeons. Although diagnoses rely mostly on clinical examination but C- reactive protein (CRP) can be of valuable armamentarium. Hence, this study was conducted to find the diagnostic role of C-reactive protein in Acute Appendicitis Methods: A retrospective cross sectional study was conducted among 100 respondents in the Department of Surgery, Bharatpur Hospital from September 2019 to August 2020. Ethical approval was taken from the Institutional Review Committee (IRC) Bharatpur Hospital. Statistical analysis was done by using SPSS version 16 using descriptive statistics. Results: Total of 100 patients was included in study with mean age 31 years old.Out of which 60% were male and 40% were female. CRP value was raised (>6) in 87 (87%) cases and normal in 13(13%) cases. Among those with raised CRP, three patients had normal appendix histopathologically and 57 had uncomplicated appendicitis and 27 had complicated appendicitis histopathologically with sensitivity, specificity, positive predictive value and diagnostic accuracy rate of 95.45 %, 75 %, 96.55 % and 93% respectively. When white blood count (WBC) and CRP level were combined with HPE findings, its sensitivity, specificity and diagnostic accuracy rate were 100%, 80% and 93.83 % respectively. Conclusions: CRP improves the diagnostic accuracy of Acute appendicitis. The adjunct use of CRP and leucocyte count can effectively reduce the negative appendectomy rate.

scholarly journals Correlation of Surgical Site Infection (SSI) after appendicectomy with per-operative morphological appearance of appendix.

2020 ◽  
Vol 27 (02) ◽  
pp. 251-259
Author(s):  
Rehana Firdos ◽  
Irfan Haider Abdi ◽  
Qambar Ali Laghari ◽  
Mujeeb ur Rahman Sahito ◽  
Naimatullah Kalhoro
Keyword(s):  
Acute Appendicitis ◽  
Surgical Site Infection ◽  
Cross Sectional Study ◽  
Complicated Appendicitis ◽  
Pathological State ◽  
Site Infection ◽  
Cross Sectional ◽  
Economic Point ◽  
Delay In Diagnosis ◽  
Morphological Appearance

Acute appendicitis is the most common cause of emergency abdominal surgery worldwide. Postoperatively, surgical site infection (SSI) occurs in 3% to 60% of appendicectomized patients, depending on pathological state of appendix. SSI is a devastating complication from biologic and economic point of view and has enormous impact on patient’s quality of life. Objectives: To determine the frequency of surgical site infection after appendicectomy in patients presenting as acute appendicitis and correlate it with per-operative morphological appearance of appendix. Study Design: Cross-sectional study. Setting: Department of General Surgery, Liaquat University of Medical and Health Sciences Jamshoro. Period: One year from March 2015 to February 2016. Material & Methods: This study was carried out on 200 patients. All male and female patients above age of 12 years with clinical diagnosis of acute appendicitis or localized peritonitis due to perforated appendix undergoing appendectomy by grid iron incision and whose skin closed primarily by interrupted silk 2/0 stitches were included in the study. Operative findings were recorded and inflammation of appendix was graded into four categories. Postoperatively patients were followed for period of 30 days to check the development of SSI. Results: Out of 200 patients, 42 suffered from SSI (21%). On the basis of per-operative morphological appearance of appendix, uncomplicated appendicitis was significantly high 135(67.5%) than complicated appendicitis 65(32.5%). SSI developed in 12(28.5%) cased of uncomplicated and 30(71.5%) cases of complicated appendicitis. Conclusion: It was not possible to establish a relationship between SSI and per-operative morphological appearance of appendix. Frequency of SSI reported here (21%) is comparable with literature. We recommended that avoiding delay in diagnosis, use of peri-operative antibiotics, sound surgical technique to avoid wound contamination and continuing surveillance is necessary to further reduce SSI rates after open appendicectomy.

scholarly journals EOSINOPENIA DAN PROCALCITONIN DALAM SEPSIS

2018 ◽  
Vol 19 (2) ◽  
pp. 119
Author(s):  
Danny Luhulima ◽  
W. Hidayati ◽  
IGAAP. Sri Rejeki ◽  
R. Permatasari
Keyword(s):  
Diagnostic Marker ◽  
Clinical Signs ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Procalcitonin Level ◽  
Highly Sensitive ◽  
Common Causes ◽  
The Common

Sepsis is one of the common causes of morbidity and mortality in the ICU. Clinicians need to know and realize of good diagnosticmarkers to identify sepsis as early as possible. The role of eosinopenia as a marker of sepsis has recently been evaluated.The aim of thisstudy was to test the value of eosinopenia as a diagnostic marker of sepsis in comparison to Procalcitonin. A cross sectional study wasperformed in 61 adult patients with SIRS, and blood of all patients were cultured. Further examinations were done for comparing theeosinophil count with the Procalcitonin levels if the blood culture was positive or when there were clinical signs which supported for sepsis.In this study there were fourty two patients enrolled. Procalcitonin level yielded a sensitivity of 90.0%, specificity of 83.3%, a positivepredictive value (PPV) of 93.1% and a negative predictive value (NPV) of 76.9% at cut-off value of 2.75 ng/mL. The eosinophil (cut off ≤50 cells/μL) produced a sensitivity of 80.0%, specificity of 75.0%, PPV of 88.9%, and NPV of 60.0%. based on this study Procalcitoninappeared to be a more accurate diagnostic of sepsis than eosinopenia, but eosinopenia is still a helpful tool for clinicians, and may also beused as a diagnostic marker of sepsis, because it is highly sensitive, moderately specific, easy to measure, rapid and inexpensive as well.

Sign in / Sign up

Export Citation Format

Share Document