COMPARING THE ACCURACY OF CT AND ULTRASONOGRAPHY IN THE DIAGNOSIS OF ACUTE APPENDICITIS IN TERTIARY MEDICAL CENTRE OF SOUTH BIHAR

2021 ◽  
pp. 16-19
Author(s):  
Kumar Brajbhanu Jha ◽  
Pushpkant Tiwari ◽  
Md Shamim Ahmad ◽  
Rahul Mohan
Keyword(s):  
Acute Appendicitis ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Prospective Observational Study ◽  
Signs And Symptoms ◽  
Preoperative Imaging ◽  
Medical College ◽  
Surgical Emergencies ◽  
The Difference ◽  
The One

Introduction: Acute appendicitis is the one of the most common surgical emergencies, the incidence rate is almost 10% . Making an accurate diagnosis is of utmost importance to surgeons providing care, so preoperative imaging is now widely accepted by most surgeons and emergency medicine physicians in the workup of acute appendicitis. To calculate the Aim And Objective: sensitivity, specicity, positive predictive value and negative predictive value for both CT and USG having the histopathology ndings as gold standard. This is a prospective observational study planned to conduct at Narayan Material And Methods: medical college and Hospital, Rohtas, Bihar on the 110 patients presented with signs and symptoms suggesting Acute Appendicitis. They will be selected from Emergency Department of Narayan medical college & Hospital. On the diagnosis of AA Result: , the sensitivity, specicity, positive and negative predictive value, and accuracy of US vs. CT were 85.5 percent vs. 87.8%, 66.7 percent vs. 75.0 percent, 98.5 percent vs. 97.7%, 15.4 percent vs. 33.3 percent, and 84.8 percent vs. 86.8%, respectively (Table 2). The researchers next included a subgroup of 24 patients who had both US and CT exams prior to surgery for ROC analysis to compare the diagnostic efcacy of the two imaging procedures. The area under the ROC (AUC) of US was 0.84, which was higher than that of CT (0.66), albeit the difference was not statistically signicant , Both ultrasonography and Conclusion: CT examinations were highly effective in diagnosing acute appendicitis.

scholarly journals Diagnostic Value of Ultrasonography in Patients Suspected Acute Appendicitis

2013 ◽  
Vol 2 (2) ◽  
pp. 13-19
Author(s):  
MA Elahifar ◽  
H Taheri ◽  
A Bighamian
Keyword(s):  
Acute Appendicitis ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Histopathological Examination ◽  
Imaging Modality ◽  
Diagnostic Value ◽  
Preoperative Imaging ◽  
Outpatient Basis ◽  
Abdominal Ultrasonography ◽  
Cell Counts

Introduction: Appendectomy is one of the most frequently performed abdominal operations in surgical practice. Preoperative imaging has been demonstrated to improve diagnostic accuracy in appendicitis. Abdominal ultrasonography (US) is the most commonly and first-line imaging modality used for diagnosing acute appendicitis (AA).The aim of this study was to demonstrate the diagnostic value of abdominal ultrasonography for diagnosing acute appendicitis. Methods: In a retrospective study, we analyzed 200 consecutive patients with abdominal pain that undergoing appendectomy, from June 2009 to April 2012. Patient characteristics, preoperative ultrasonography (US) and laboratory assessment including WBC were collected. Final diagnosis of appendicitis was confirmed by histopathological examination. Results were compared with US. Results: Two hundred patients were admitted to this study that undergoing appendectomy. Mean age was 24 years (range: 1 to 91 years), and 57% were females. Patient White blood cell counts were found to be high in 78% while it was 86% for AA group and 64% for NA group (p < 0.05). One hundred sixty-six of these patients (83%) were diagnosed as acute appendicitis on pathology, and 34 (17%) were diagnosed differently. 157 of patients underwent US, eighty two of this patients diagnosed as acute appendicitis on US examinations and in 78 of them were also reported as acute appendicitis on histopathological examination. The sensitivity and specificity of abdominal US for diagnosing appendicitis were 70% and 90.2% respectively. Positive predictive value (PPV) was 93% and negative predictive value (NPV) was reported 62%. Conclusion: Ultrasonography has a high PPV and specificity, so as a diagnostic tool, positive US strongly suggests the diagnosis of AA. A low negative predictive value recommends that negative US is not sufficient to exclude the diagnosis of AA and patients could not be managed on an outpatient basis following a negative scan. Nepalese Journal of Radiology; Vol. 2; Issue 2; July-Dec. 2012; 13-19 DOI: http://dx.doi.org/10.3126/njr.v2i2.7680

A CLINICOPATHOLOGICAL STUDY IN PATIENTS OF ACUTE APENDICITIS AND CORRELATION OF SYMPTOMS WITH DIFFERENT POSITIONS SEEN INTRAOPERATIVELY

2021 ◽  
pp. 25-29
Author(s):  
Sandip Kumar Ghosh ◽  
Ajay Halder ◽  
Arnab Mishra ◽  
Prabir Biswas
Keyword(s):  
Acute Appendicitis ◽  
Prospective Observational Study ◽  
Signs And Symptoms ◽  
Vermiform Appendix ◽  
Female Ratio ◽  
Medical College ◽  
Study Results ◽  
Male Female Ratio ◽  
Recurrent Appendicitis ◽  
Pelvic Position

INTRODUCTION: The appendix, another named vermiform appendix (from the Latin ward-appendix means “dangling” + “vermis”+ “form” i.e.-dangling worm-shaped thing) is a diverticulum of caecum and marks the beginning of the colon in the conuence of taenias. The appendix is posteromedially attached to the caecum, about 2cm below the ileocecal junction. Taking into account that often the appendix is a mobile structure, the medical 9 importance of its relative position has been questioned by some authors. In general, however some authors describe a signicant relationship between its location and sign and symptoms of acute appendicitis. OBJECTIVES:1.To study the commonest position of appendix seen intraoperatively among the patients with acute appendicitis present in Emergency and OPD of Burdwan Medical College. 2.To identify the commonest position responsible for of gangrenous appendix and appendicular perforation. 3.To identify various signs and symptoms according to their different anatomical position and correlation with intraoperative ndings MATERIALS AND METHODS: This is a Prospective Observational Study in Burdwan Medical college and hospital ,May 2019 to July 2020 on 100 patients. All willing patients in Emergency and OPD of BMCH with acute and recurrent appendicitis who underwent surgery are included in this study. RESULTS: rd th Appendicitis is commonest during 3 decade (43%) followed by 4 decade (36%).Appendicitis is slightly commoner in females with male: female ratio 1:2.4..The most common position of appendix in our study is pelvic position.

scholarly journals C-reactive protein, as a marker for predicting acute appendicitis and its severity in KVG medical college and hospital, Sullia

2021 ◽  
Vol 8 (10) ◽  
pp. 3002
Author(s):  
Abhirup H. Ramu ◽  
Priyanka Kenchetty ◽  
Aishwarya K. Chidananda
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
False Negative ◽  
Clinical Suspicion ◽  
C Reactive Protein ◽  
Common Procedure ◽  
Medical College ◽  
Reactive Protein

Background: Appendicectomy for suspected acute appendicitis is a common procedure. The rate of normal appendices unnecessarily removed remains high despite several techniques and investigations used to improve the diagnostic accuracy. This study emphasizes the value of C reactive protein (CRP) in three groups of patients operated for clinical suspicion of acute appendicitis with different finding at appendicectomy namely an un-inflamed appendix, uncomplicated acute appendicitis or complicated acute appendicitis.Methods: This prospective study was performed on 100 consecutive patients who were operated on for treatment of acute appendicitis in KVG medical college and hospital between 01 August 2019 to 01 February 2021. Clinically proven by a surgeon, patients underwent appendicectomy. Serum CRP results of all patients were determined. Sensitivity, specificity, positive predictive value and negative predictive value were calculated. Statistical analysis will be made using descriptive statistic and SPSS version 21 was used for analysis.Results: The percentage of negative laparotomies was 13% and surgeon ‘s clinical suspicion was true in 87%. Preoperative CRP values were false negative in 21 patients with appendicitis and false positive in 2 patients with normal appendix. The difference of true and false results between CRP tests and surgeon’s diagnosis was statistically significant (p=0.001). Present study revealed, sensitivity=76%, specificity=87.5%, positive predictive value=96% and negative predictive value=41%.Conclusions: Serum C reactive protein when elevated supports the surgeon’s clinical diagnosis of acute appendicitis. It can be used frequently to diagnosis the acute appendicitis, so that the complication rate and negative laparotomies can be avoided. 

scholarly journals Comparision of ultrasonographic diagnosis with ‘Tzanakis’ Score in acute appendicitis

2016 ◽  
Vol 19 (1) ◽  
pp. 9-12
Author(s):  
Ashish Prasad Rajbhandari ◽  
Nischal Dhakal ◽  
Robin Koirala ◽  
Manohar Lal Shrestha
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
College Teaching ◽  
Medical College ◽  
Ultrasonographic Diagnosis ◽  
Ultrasound Findings ◽  
Sensitivity Specificity ◽  
Better Than

Introduction: Acute appendicitis is one of the most common acute surgical abdominal conditions requiring surgery. Ever since the inflamed appendix was demonstrated in the 1980’s by Ultrasonography, it has been used as an aid to clinically diagnose acute appendicitis. Tzanakis scoring system is a combination of clinical examination, Ultrasonography and inflammatory markers. Methods: A retrospective non-randomized observational study was conducted from April 2014 to March 2015 on all cases of acute appendicitis, which underwent preoperative ultrasound before appendectomy (open/laparoscopic) at the Department of surgery, Nepal Medical College Teaching Hospital. Ultrasound findings and Tzanaki score were compared in the cases. No studies could be found in literature comparing ultrasound diagnosis with Tzanaki score in appendicitis. Results: The sensitivity, specificity, positive predictive value and negative predictive value of ultrasound were 73%, 50%, 95% and 12% respectively. The sensitivity, specificity, positive predictive value and negative predictive value of Tzanaki were 87%, 50%, 96% and 23% respectively. Tzanaki score is better than ultrasound alone as a diagnostic test for acute appendicitis. Conclusion: Tzanaki score is better than ultrasound in diagnosis of acute appendicitis.  

DIAGNOSTIC ACCURACY OF GRAY SCALE ULTRASONOGRAPHY VERSUS COLOR DOPPLER IN SUSPECTED CASES OF ACUTE APPENDICITIS

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Tahir Iqbal ◽  
Muhammad Usman Shahid ◽  
Ishfaq Ahmad Shad ◽  
Shahzad Karim Bhatti ◽  
Syed Amir Gilani ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Color Doppler ◽  
Diagnostic Tools ◽  
Gray Scale ◽  
Versus Color ◽  
Sensitivity Specificity

ABSTRACT: BACKGROUND: A common surgical emergency is acute appendicitis. Various diagnostic tools are available to diagnosis acute appendicitis. Radiological investigations play an important role in making accurate and early diagnosis and thus preventing morbidity associated with the disease. OBJECTIVE: To determine the diagnostic accuracy of gray scale ultrasonography versus color Doppler in suspected cases of acute appendicitis. MATERIALS AND METHODS: The study was carried in the department of Radiology of Mayo Hospital, Lahore. A total of 75 patients were enrolled of age 18-40 years, both genders who were suspected cases of acute appendicitis. All patients underwent baseline investigations along with gray scale ultrasonography and color Doppler. All patients were subjected to surgery to confirm the diagnosis and findings were subjected to statistical analysis. RESULTS: The mean age of the patients was 23.25 ±10.55 and mean transverse diameter of appendix was 8.37 ±3.39. There were 62.7% males and 37.3%females. Findings of gray scale ultrasonography and color Doppler were then correlated with surgical findings to calculate the diagnostic accuracy of these modalities. The results revealed that gray scale ultrasonography sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 92.7%, 94.32%, 95%, 91.4% and 93.3% respectively, whereas color Doppler had sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 97.7%, 93.9%, 95.3%, 97% and 96% respectively. Diagnostic accuracy of both modalities together was 98.6%. CONCLUSION: Color Doppler has better diagnostic accuracy than gray scale ultrasonography for diagnosis of acute appendicitis and the combination of both modalities yields diagnostic accuracy that is similar to gold standard.

“A COMPARATIVE STUDY OF RIPASA SCORE AND ALVARADO SCORE IN THE DIAGNOSIS OF ACUTE APPENDICITIS”

2021 ◽  
pp. 25-28
Author(s):  
M. Vijaya Kumar ◽  
Manasa Manasa
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Scoring System ◽  
Local Population ◽  
Scoring Systems ◽  
Signs And Symptoms ◽  
Alvarado Score ◽  
Predictive Values ◽  
Ripasa Score

Acute appendicitis is the most common condition encountered in the Emergency department .Alvarado and Modied Alvarado scores are the most commonly used scoring system used for diagnosing acute appendicitis.,but its performance has been found to be poor in certain population . Hence our aim was to compare the diagnostic accuracy of RIPASA and ALVARADO Scoring system and study and compare sensitivity, specicity and predictive values of these scoring systems. The study was conducted in Government district hospital Nandyal . We enrolled 176 patients who presented with RIF pain . Both RIPASA and ALVARADO were applied to them. Final diagnosis was conrmed either by CT scan, intra operative nding or post operative HPE report. Sensitivity,specicity, positive predictive value, negative predictive value, diagnostic accuracy was calculated both for RIPASA and ALVARADO. It was found that sensitivity and specicity of the RIPASA score in our study are 98.7% and 83.3%, respectively. PPV and NPV were 98.1% and 88.2% and sensitivity and specicity of the Alvardo score in our study are 94.3% and 83.3%, respectively. PPV and NPV were 98% and 62.5%.Diagnostic accuracy of RIPASA score and Alvarado score are 97% and 93% respectively. RIPASA is a more specic and accurate scoring system in our local population when compared to ALVARADO . It reduces the number of missed appendicitis cases and also convincingly lters out the group of patients that would need a CT scan for diagnosis (score 5-7.5 ) BACKGROUND: Acute appendicitis is one of the most commonly dealt surgical emergencies, with a lifetime prevalence rate of approximately 1 one in seven. The incidence is 1.5–1.9 per 1,000 in the male and female population, and is approximately 1.4 times greater in men than in women. Despite being a common problem, it remains a difcult diagnosis to establish, particularly among the young, the elderly and females of reproductive age, where a host of other genitourinary and gynaecological inammatory conditions can present with signs and symptoms that are 2 similar to those of acute appendicitis. A delay in performing an appendectomy in order to improve its diagnostic accuracy increases the risk of appendicular perforation and peritonitis, which in turn increases morbidity and mortality. A variable combination of clinical signs and symptoms has been used together with laboratory ndings in several scoring systems proposed for suggesting the probability of Acute Appendicitis and the possible subsequent management pathway. The Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) and ALVARADO score are new diagnostic scoring systems developed for the diagnosis of Acute Appendicitis and has been shown to have signicantly higher sensitivity, specicity and diagnostic accuracy. AIMS AND OBJECTIVES PRIMARY OBJECT 1. To compare RIPASA Scoring system and ALVARADO Scoring system in terms of diagnostic accuracy in Acute Appendicitis. 2. To study and compare sensitivity, specicity and predictive values of above scoring systems. SECONDARY OBJECT 1. To study the rate of negative appendicectomy based on above scoring systems. CONCLUSION: The RIPASA score is a simple scoring system with high sensitivity and specicity for the diagnosis of acute appendicitis. The 14 clinical parameters are all present in a good clinical history and examination and can be easily and quickly applied. Therefore, a decision on the management can be made early. Although the RIPASA score was developed for the local population of Brunei, we believe that it should be applicable to other regions. The RIPASA score presents greater Diagnostic accuracy and Sensitivity and equal specicity as a diagnostic test compared to the Alvarado score and is helpful in making appropriate therapeutic decisions. In hospitals like ours, the diagnosis of AA relies greatly on the clinical evaluation performed by surgeons. An adequate clinical scoring system would avoid diagnostic errors, maintaining a satisfactory low rate of negative appendectomies by adequate patient stratication, while limiting patient exposure to ionizing radiation, since 21 there is an increased risk of developing cancer with computed tomography, particularly for the paediatric age group.

scholarly journals Comparison of RMI 3 and RMI 4 in pre-operative evaluation of ovarian masses

2019 ◽  
Vol 8 (9) ◽  
pp. 3602
Author(s):  
Badugu Rao Bahadur ◽  
Gangadhara Rao Koneru ◽  
Prabha Devi Kodey ◽  
Jyothi Melam
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Malignant Tumors ◽  
Clinical Approach ◽  
Ovarian Mass ◽  
Medical College ◽  
Operative Evaluation ◽  
Sensitivity Specificity ◽  
Final Confirmation

Background: To differentiate ovarian mass as benign or malignant could change clinical approach. Finding a screening and diagnostic method for ovarian cancer is challenging due to high mortality and insidious symptoms. Risk malignancy index (RMI) has the advantage of rapid and exact triage of patients with ovarian mass.Methods: Prospective study carried for 2 years at NRI Medical College and General Hospital, Chinakakani, Mangalagiri, Andhra Pradesh, India. 79 patients with ovarian mass were investigated and risk malignancy index (RMI-3 and RMI-4) calculated. Final confirmation was done based on histopathological report. Sensitivity, specificity, positive predictive value and negative predictive value were calculated for RMI 3 and RMI 4 taking histopathology as control and comparison was done.Results: (n=79); 50 (63.29%) cases were benign and 29 (36.70%) were malignant based on histopathology. RMI 4 is more sensitive (68.96%) than RMI 3 (62.06%), but RMI 3 is more specific (94%) than RMI 4 (92%).The positive predictive value of RMI-3 and RMI-4 were 85.71%  and 83.33% respectively. The negative predictive value for RMI-4 and RMI-3 were 83.63% and 81.03% respectively.Conclusions: With increasing age, chance of malignancy increases. RMI 4 was more sensitive than RMI-3, however less specific than RMI 3 in differentiating benign and malignant tumors. The positive predictive value is slightly more for RMI 3, than RMI 4. Negative predictive value is slightly more for RMI 4, than RMI 3. 

scholarly journals A study of quantitative and qualitative analysis of standardized speech samples in persons suffering from dysarthria due to various neurological disorder

2020 ◽  
Vol 7 (10) ◽  
pp. 1527
Author(s):  
Somesh Maheshwari
Keyword(s):  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Normal Population ◽  
Software Tool ◽  
Cross Sectional ◽  
Medical College ◽  
Subject Variability ◽  
Ataxic Dysarthria ◽  
The Central Nervous System

Background: Dysarthria is manifested as a disorder of movement, it is important to recognize that sensori-motor integration (with tactile, proprioceptive, and auditory feed-back representing the crucial sensory components) is essential to speech motor control, from this standpoint, most or all dysarthria localized to the central nervous system should be thought of as sensori-motor rather than simply motor disturbances.Methods: This non-interventional, cross-sectional comparative, observational study, conducted in 100 study subjects (50 cases and 50 controls) from March 2016 to February 2017 at MGM medical college and MY hospital Indore, MP, India.Results: The mean age of normal population was 53 years and that of dysarthric population was 55 years. Among the dysarthric group, there were 10 cases of ataxic dysarthria, 23 cases of spastic dysarthria, and 9 cases of hypo kinetic dysarthria. There were 20 cases of mild dysarthria 19 cases of moderate dysarthria and 10 cases of severe dysarthria. In ataxic dysarthria, pitch break was found in 6 out of 10 subjects. It was found that there is negative predictive value 93.33%, and positive predictive value, 77.14% in spastic dysarthria and negative predictive value, 83.33% and positive predictive value, 90.90% in ataxic, whereas negative predictive value, 85.71% and positive predictive value, 95.34% in hypo kinetic dysarthria.  Conclusions: Different types of dysarthria when analyzed with software tool after extracting pitch and formants showed specific patterns. These patterns correlated with the clinical diagnosis. And Pattern recognition of different dysarthria will help to identify the types of dysarthria in scientific way and prevent inter-subject variability.

scholarly journals COMPARATIVE STUDY OF CLINICAL VERSUS USG IN DIAGNOSIS OF EARLY TRIMESTER BLEEDING PV

2020 ◽  
pp. 60-62
Author(s):  
Narendra Nath Hait ◽  
Brahmarshi Das ◽  
Ratan Chandra Mandal ◽  
Haricharan Roy ◽  
Debarshi Jana
Keyword(s):  
Statistical Analysis ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Common Cause ◽  
Clinical Method ◽  
Medical College ◽  
Threatened Miscarriage ◽  
Obstetrics And Gynaecology ◽  
Threatened Abortion ◽  
The Difference

Background: Threatened abortion is till most common cause of early trimester bleeding PV and can be diagnosed and managed by early USG diagnosis. Materials and methods: This was a prospective observational study. Place of the study was Department of Obstetrics and Gynaecology and Department of Radiodiagnosis, Midnapore Medical College and Hospital from January 2019 to June 2020. Eighteen months. Result: When the clinical method to diagnose threatened miscarriage was compared to the sonographic method, it was evident that sonographic method was reliable than the clinical method and the difference was statistically significant. Conclusion: In case of missed miscarriage and complete miscarriage, although the percentage of discrepancy was 100%, on further statistical analysis, the discrepancy was not statistically significant. And the cause behind this was probably inadequate sampling.

The negative predictive value of a negative repeat urinalysis in patients presenting with haematuria: A review of 1138 patients

2017 ◽  
Vol 10 (5) ◽  
pp. 471-475
Author(s):  
Benjamin Zak Starmer ◽  
Amal Singh ◽  
Stephen Bromage
Keyword(s):  
Negative Predictive Value ◽  
Predictive Value ◽  
Urothelial Cancer ◽  
Urine Culture ◽  
Bladder Tumour ◽  
High Grade ◽  
Microscopic Haematuria ◽  
Positive Urine Culture ◽  
Positive Urine ◽  
The One

Objective: Haematuria may be transient for a number of benign conditions, particularly a urinary-tract infection (UTI). We set out to determine if a negative repeat urinalysis at the time of urological assessment for patients with haematuria could predict negative investigations and whether investigations could be tailored by this test. Methods: This was a retrospective analysis of records for all patients attending a haematuria clinic between 16 September 2013 and 12 September 2014. This included patients with visible and non-visible (microscopic) haematuria. Results: There were 1138 patients, 599 with visible haematuria (VH) and 460 with non-visible haematuria (NVH). Seventy-two patients were excluded. A total of 546 patients had a positive repeat urinalysis for blood; 438 patients had a negative repeat urinalysis when tested at the haematuria clinic, 298/599 for VH and 140/460 NVH. For those who had negative repeat urinalysis, urothelial cancer was found in 15/298 VH and 1/140 NVH. The one patient with negative repeat urinalysis and NVH was found to have a grade 2 (high grade) bladder tumour. The negative predictive value for a negative repeat urinalysis in transient haematuria was 0.95 for VH and 0.99 for NVH. Twenty-nine patients with VH and repeat negative urinalysis on assessment had a positive urine culture suggesting a UTI as a cause. None of these patients was found to have urothelial cancer ( p = 0.0413). Conclusion: Patients who experience transient VH and subsequent repeat negative urinalysis in the absence of infection have a 5% chance of urothelial cancer and should still be investigated. For those with transient NVH, the probability of finding a urothelial cancer is <1%, although we did find a high-grade bladder tumour in this group. If patients have a positive urine culture and a negative repeat urinalysis following treatment, they could be spared haematuria investigations.

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