TO DETERMINE THE ROLE OF CA125 IN THE DIAGNOSIS OF ACUTE APPENDICITIS

Author(s):  
Vinod Kumar ◽  
Bhupen Songra ◽  
Richa Jain ◽  
Deeksha Mehta

Background: the present study was under taken to determine the role of CA-125 in the diagnosis of acute appendicitis (AA), to prevent its complications and also in preventing negative appendicectomies in tertiary care hospital. Methods: The study was conducted at a tertiary care and research center between 01/03/2018 to 30/06/2019. Patients admitted to the surgery department with diagnosis of AA were considered for the study. After informed consent, a, standardized history was obtained as a case Performa. Serum samples from all the cases with clinical diagnosis of AA were obtained and stored. Only the cases with histopathologically approved AA were included in the study. Cases operated for clinical diagnosis of AA, but not histopathologically proven AA was not included in the study. CA125 levels in cases with definitive diagnosis of AA were measured. Results: In present study, ROC curve analysis revealed the sensitivity of 87.27 % and specificity of 90.91 % when the CA 125 cut-off value of > 16.8 was taken to diagnose acute appendicitis. AUC was 0.911 with a standard error of 0.0292. Conclusion: In this study we have observed that CA125 showed a positive correlation with acute appendicitis, that was statistically not significant (P>0.05). We didn’t evaluate the correlation with the disease severity. We consider that CA125 can be used as a marker in acute appendicitis cases although further research is still needed. Keywords: CA125, Acute Appendicitis, Surgery.

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Nadia Gulnaz ◽  
Sadia Tasleem ◽  
Farooq Abdullah

Abstract Traditionally acute appendicitis has been a clinical diagnosis based on patients' history and physical examination, but the accuracy of clinical diagnosis ranges from 70-95%. Pre-operative diagnosis of acute appendicitis still remains an enigmatic challenge, because no single test alone can reduce the rate of negative appendectomy. Hence some authors have recommended a combination of two or more investigations to increase accuracy and therefore the use of imaging is gaining support. The objective of the study was to determine the clinical accuracy of ultrasound, combined with inflammatory markers such as CRP, WBC, and neutrophilia keeping histopathology as the gold standard. Methods The study was conducted in a Tertiary care hospital in Peshawar from September 2014 to March 2015 on 250 patients who were clinically diagnosed with acute appendicitis. All these patients underwent u/sound scanning in addition to blood tests. Findings In this study, WBC had the highest sensitivity (77.68%) followed by neutrophil% (69.96%), CRP(67.10%), and U/Sound (62.96%) respectively. While U/Sound had the highest specificity (70.59%) followed by CRP and TLC (64.71% each) and neutrophil% (58.82%) respectively. When all the four tests were combined the sensitivity, specificity, (99.17% and 98.45%) increased significantly. When all four tests were negative, appendicitis could be safely ruled out. Conclusion Acute appendicitis is very unlikely and surgery can be safely deferred in these patients when all tests are negative thereby reducing the negative appendicectomy rates. 


Author(s):  
SREEJA NYAYAKAR ◽  
MANDARA MS ◽  
HEMALATHA M ◽  
LALLAWMAWMI ◽  
MOHAMMED SALAHUDDIN ◽  
...  

Objective: Antibiotics are the only drug where use in one patient can impact the effectiveness in another, so antibiotic misuse adversely impacts the patients and society. Improving antibiotic use improves patient outcomes and saves money. Antibiotic resistance has been identified as a major threat by the WHO due to the lack of development of new antibiotics and the increasing infections caused by multidrug resistance pathogens became untreatable. Methods: A prospective observational study was conducted for a period of 6 months. Data were collected from prescriptions and inpatient record files at the surgery department of the tertiary care hospital. Patients above age of 18 years of either gender whose prescription containing the antibiotics and patients who are willing to participate in the study were included in the study. Microsoft Excel was used for recording and analyzing the data of recruited subjects. Results: During our study period, we have collected 100 cases as per inclusion criteria, in total collected 100 cases, 52% are male and 48% are female. The mean age and standard deviation of the study population were found to be 46.61±16.12. The most commonly prescribed classification before and after the surgery is cephalosporin’s that is 57%. Results show that in pre-surgery, almost 93% of prescriptions have chosen the drugs as per ASHP guidelines, whereas in post-surgery, 95% of drugs have selected the drug as per ASHP guidelines. Conclusion: Our study has observed that some of the prescriptions are irrationally prescribed so the pharmacist has to take the responsibility to improve the awareness regarding rational prescribing of antibiotics. The national wide monitoring of antibiotics use, national schemes to obtain rational use of antibiotics, reassessing the prescriptions, education to practitioners, and surveys on antibiotics should be implemented.


2017 ◽  
Vol 6 (94) ◽  
pp. 6858-6862
Author(s):  
Singhal R P ◽  
Pardaman Singh Setia ◽  
Kawal Preet Kaur ◽  
Virinder Mohan ◽  
Payal Bansal

2020 ◽  
Vol 8 (1) ◽  
pp. 4-6
Author(s):  
Ashu Dogra

Porphyria cutanea tarda is the most frequent type of Porphyria worldwide & presents with skin symptoms mainly. Porphyrias can affect peripheral, autonomic and central nervous system. In Porphyria conditions there is accumulation of heme precursors 5 Aminolevulinic acid, Porphobilinogen and porphyrins which are associated with characteristic clinical feature with acute neurovisceral attacks and skin lesions. This case report summarizes Case of PCT that was successfully managed with Therapeutic Phlebotomy.


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