Online ISSN: 2515-8260

Keywords : appendicitis


A Clinical Study and Ultrasonography Diagnosis in Clinically Suspected Cases of Acute Appendicitis

Dr. Janardhan Jakkula, Dr. Ramesh Lingala, Dr. Shekhar Goud S, Dr. Sridhar Matta

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1-11

Background: Acute appendicitis is the most prevalent cause of acute abdomen and
subsequent surgery. Misdiagnosis is a common and critical problem in general surgery
because the diagnosis is primarily based on clinical grounds. Maximum incidence observed
in the second and third decades of life, with male preponderance. Graded compression
ultrasonography is one of the diagnostic procedures that has been shown to reduce the need
for unfavourable surgical treatments, particularly in females.Objectives: Objectives of the
study were to study the clinical features of acute appendicitis, Utility of USG in supporting
the clinical diagnosis of acute appendicitis. Methods: This study included one hundred and
Twenty Five patients with history of RLQ pain where clinical diagnosis of acute appendicitis
was made. The study period was of 18 months between November 2019 to May 2021.
Routine bloodinvestigations and abdominal USG were done in all cases. All ultrasound
positive cases were subjected to surgery. Some ultrasound negative cases were also taken to
surgery on the high clinical suspicion of acute appendicitis. The ultrasound findings were
compared with clinical findings and histopathological examination reports.

ASSESSING THE EFFICACY AND ROLE OF DIAGNOSTIC LAPAROSCOPY IN SUBJECTS WITH CHRONIC ABDOMINAL PAIN

Dr. SK. Khairul Enam, Dr. Shruti Yadu, Dr. Deepak Kumar Benia, Dr. Vaishali Bhagat

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 274-279

Background: Most demanding and challenging conditions to manage across the globe in
subjects of all ages are chronic idiopathic pain syndromes. Various diagnostic advancements
have been made, pain in these subjects still presents a challenge for all available diagnostic
and management methods.
Objectives: The present study was conducted to assess the efficacy and role of diagnostic
laparoscopy in the identification of the etiology of chronic abdominal pain which is not
diagnosed.
Materials and methods: In 30 subjects with chronic abdominal painwith unknown etiology
or who were refractory to the treatment for more than 3 months. Diagnostic laparoscopy was
done for all the subjects. The collected data were subjected to statistical evaluation and the
results were formulated.

A Comparative Study of Alvarado, Ripasa and Airs Scoring Systems in the Diagnosis of Acute Appendicitis

Darshanjit Singh Walia, Nikhil Dehankar, Anand Singla, Husain Najmi, Manpreet Kaur Walia

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 369-379

Background: Acute appendicitis is the most common cause of abdominal emergency in
both developed and developing countries, yet its diagnosis remains challenging. Several
scoring systems have been developed in order to aid the decision-making process to
reach diagnosis of acute appendicitis in the quickest way, which include the Alvarado
Score, the AIRS Score, and the RIPASA Score. The current study compares and
assesses the utility of the scoring systems in establishing a diagnosis of acute
appendicitis, as compared to a final histological report.
Materials and Methods: This was a prospective study conducted at the Department of
General Surgery, Rajindra Hospital, Patiala, including 60 patients presenting with right
iliac fossa pain for less than 72 hours and were planned to undergo appendectomy, from
2020 to 2021. A structured pre-prepared proforma was used to enter the complete
history, clinical examinations, hematological and biochemical investigations, the
calculated scores for the Alvarado, RIPASA, and AIRS scoring system, and the
histopathological report for each patient. Sensitivity, specificity, accuracy, PPV, and
NPV were calculated for Alvarado, RIPASA, and AIRS Scores for the diagnosis of
acute appendicitis with histopathologic diagnosis as the gold standard. Receiver
operator characteristics (ROC) curve was done, and criterion value was estimated
depending on the specificity and sensitivity.
Results: In our series, the RIPASA score had the highest statistical parameters amongst
all 3 scores. The sensitivity, specificity, PPV and NPV were 92.45%, 85.71%, 98%, and
60% respectively. It had the highest diagnostic accuracy (91.67%). It was followed by
the AIRS scoring system with a sensitivity, specificity, PPV, and NPV of 88.68%,
71.43%, 95.92%, and 45.45% respectively. Its diagnostic accuracy was 86.67%. The
Alvarado score had a sensitivity, specificity, PPV, and NPV were 81.13%, 71.43%,
95.56%, and 33.33% respectively. Its diagnostic accuracy was 80%.
Conclusion: It is concluded that the RIPASA Scoring system is a valid and better tool
with high discriminating power in the diagnosis of acute appendicitis, and for
minimizing unproductive admission and abdominal explorations, especially in Asian
ethnicity, as it outperforms the Alvarado and the AIRS Scores in all statistical
parameters, as per our study.

ANALYSING THE POTENCY AND ROLE OF DIAGNOSTIC LAPAROSCOPY IN SUBJECTS WITH CHRONIC ABDOMINAL PAIN

Dr. SK. Khairul Enam, Dr. Shruti Yadu, Dr. Deepak Kumar Benia, Dr. Vaishali Bhag

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 993-998

Background: Most demanding and challenging conditions to manage across the globe in
subjects of all ages are chronic idiopathic pain syndromes. Various diagnostic advancements
have been made, pain in these subjects still presents a challenge for all available diagnostic
and management methods.
Objectives: The present study was conducted to assess the efficacy and role of diagnostic
laparoscopy in the identification of the etiology of chronic abdominal pain which is not
diagnosed.
Materials and methods: In 30 subjects with chronic abdominal painwith unknown etiology
or who were refractory to the treatment for more than 3 months. Diagnostic laparoscopy was
done for all the subjects. The collected data were subjected to statistical evaluation and the
results were formulated.

ANALYSING THE POTENCY AND ROLE OF DIAGNOSTIC LAPAROSCOPY IN SUBJECTS WITH CHRONIC ABDOMINAL PAIN..

Dr. SK. Khairul Enam, Dr. Shruti Yadu, Dr. Deepak Kumar Benia, Dr. Vaishali Bhagat

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1852-1857

Background: Most demanding and challenging conditions to manage across the globe in
subjects of all ages are chronic idiopathic pain syndromes. Various diagnostic advancements
have been made, pain in these subjects still presents a challenge for all available diagnostic
and management methods.
Objectives: The present study was conducted to assess the efficacy and role of diagnostic
laparoscopy in the identification of the etiology of chronic abdominal pain which is not
diagnosed.
Materials and methods: In 30 subjects with chronic abdominal painwith unknown etiology
or who were refractory to the treatment for more than 3 months. Diagnostic laparoscopy was
done for all the subjects. The collected data were subjected to statistical evaluation and the
results were formulated.

Evaluation of Ohmann Score in the Diagnosis of Acute Appendicitis in Patients Admitted in a Tertiary Care Hospital

Nandula Sai Bharath, M. Anurag, Lavudya Srinivas, Ganesh Banothu

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 4729-4737

Background:To Diagnose Acute Appendicitis based on Ohmann score and correlating it
with postoperative histopathological report.
Materials and Methods: This study was undertaken in 80 patients with a provisional
diagnosis of acute appendicitis getting operated over a period of 18. months.Ohmann
score was applied in the preliminary diagnosis, which was confirmed by intra operative
and histopathological findings.
Results: Fifty-eight patients were males and 22 were females. There was no statistical
significance in the male to female ratio. The highest incidence was found in the age
group of 21-30 and the lowest was seen in the age group of >40. Ohmann score of 13.5
was found in 11 patients and score of 14 was also seen in 11 patients .1.5 was least
ohmann score seen who had a normal appendix on histopathology. As ohmann score
was categorised into 3 categories,3 patients had Ohmann score of less than 6 out of
which 2 had a normal appendix on histopathology and the other patient had
appendicitis on histopathology. Depending on the cut-off value taken, sensitivity ranges
from 100% to 4.54%, specificity ranges from 14.28% to 100%, positive predictive value
ranges from 84.61% to 100% and negative predictive value ranges from 100% to
18.18%.
Conclusion: Ohmann scoring system significantly reduces the number of negative
laparotomies without increasing overall rate of appendicular perforation. It can work
effectively in routine practice as an adjunct to surgical decision making in questionable
acute appendicitis. It is simple to use and easy to apply since it relies only on history,
clinical examination and basic lab investigations.

ANALYSING THE POTENCY AND ROLE OF DIAGNOSTIC LAPAROSCOPY IN SUBJECTS WITH CHRONIC ABDOMINAL PAIN.

Dr. SK. Khairul Enam,Dr.Shruti Yadu,Dr. Deepak Kumar Benia, Dr. Vaishali Bhagat

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1006-1011

Background: Most demanding and challenging conditions to manage across the globe in
subjects of all ages are chronic idiopathic pain syndromes. Various diagnostic advancements
have been made, pain in these subjects still presents a challenge for all available diagnostic
and management methods.
Objectives: The present study was conducted to assess the efficacy and role of diagnostic
laparoscopy in the identification of the etiology of chronic abdominal pain which is not
diagnosed.
Materials and methods: In 30 subjects with chronic abdominal painwith unknown etiology
or who were refractory to the treatment for more than 3 months. Diagnostic laparoscopy was
done for all the subjects. The collected data were subjected to statistical evaluation and the
results were formulated.

Efficacy of postoperative antibiotics after appendectomy in patients with non- perforated appendicitis- A clinical study

Dr Sanjay Kumar, Dr Sumesh Kumar Garg

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1151-1155

Background: Appendicitis is the most common cause of acute abdominal pain,
requiring surgical intervention. The present study was conducted to assess efficacy of
postoperative antibiotics after appendectomy in non- perforated appendicitis.
Materials & Methods: 76 patients undergoing appendectomy of both genders were
divided into 2 groups of 38 each. Group I patients were not given any postoperative
antibiotics and the group II patients received a single dose of cefuroxime sodium and
metronidazole, 8 hours postoperatively. Open appendectomy was performed by the
standard operating technique through right lower quadrant incision. Parameters such
as duration of symptoms, duration of surgery and hospital stay was recorded.
Results: There were 26 males and 12 females in group I and 20 males and18 females in
group II. Duration of symptoms was 1.9 days in group I and 1.4 days in group II,
duration of surgery was 52.3 minutes in group I and 54.8 minutes in group II. The mean
hospital stay was 2.31 days in group I and 2.42 days in group II and surgical site
infections was 10 days in group I and 5 days in group II. The difference was significant
(P< 0.05).
Conclusion: Both groups were comparable in terms of surgical site infection.

Using of calprotectin and lactoferrin levels in early detection of acute uncomplicated appendicitis in children

Athir Ahmed Kadium; Alaa Mohammed Ali Al Baazi; Mahmood Mosa Mahmood

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 1, Pages 4335-4341

This study was conducted in Kirkuk city for the period from December, 2019 to June 2020, and included 50 children with acute appendicitisand 50 children without any other disease, where the ages of children in both groups ranged from 3-12 years. The study included collecting information from children in both groups, including gender, age, living situation, number of family members, standard of living and social as well as the number of family members, number of rooms in the house. Amount of 5 ml of blood samples were collected from all the children included in this study, where the blood samples were separated by the centrifuge device and the serum samples were separated from them and kept in the refrigerator until the tests for determination of calprotectin and lactoferrin by ELISA and CRP by immunofluorescence. In this study, there were no significant difference between the 2 groups regarding age, sex and residence. The study found that, 95% of children with appendicitis was suffered from abdominal pain , 50% with fever and weight loss, 48% with nausea and 40% with vomiting. The study revealed a significant elevated level of calprotectin in children with appendicitis as compared with healthy children(18.54±4.25 vs 11.37±3.28 ng/ml) (P<0.001). The study also exposed a significant higher level of lactoferrin in children with appendicitis as compared with healthy children(10.51±1.52 vs 2.18±0.19 ng/ml) (P<0.001).The study showed that the maximum means of calprotectin and lactoferrin in children with appendicitis were observed in those with abdominal pain, followed by vomiting. The study revealed a significant positive correlation between calprotectin and lactoferrinlevel among children with acute appendicitis.The mean serum level of CRP was significantly elevated in children with acute appendicitiscompared to control group (27.57 ± 4.22 and 5.57 ± 3.9 mg/dl) respectively at a P value < 0.001. Conclusions:The study showed a significant relation of calprotectin and lactoferrin withappendicitis.