Evaluation of Ultrasound Accuracy in Acute Appendicitis Diagnosis

Acute appendicitis it a quite common abdominal disorder and considered as a difficult diagnosis. An accurate diagnosis is essential to prevent any complication from delayed surgical intervention. Aim: To evaluate the diagnostic accuracy of ultrasound in acute appendicitis cases in Saudi Arabia compared with histopathology. Moreover, to determine whether there is a correlation between the accuracy of ultrasound in acute appendicitis and the sonographers’ expertise. Methods: A retrospective study was conducted, including patients who admitted to the emergency room with clinical symptoms of suspected acute appendicitis and underwent ultrasound examinations. Diagnostic features, including diameter of the appendix ≥7 mm, free fluid, lack of compressibility, no appendix seen, normal appearance, and thick wall, were recorded for each patient. Results: Only 61 of the 132 patients in the study were accurately diagnosed with the use of ultrasound. Just 44 of them were diagnosed with appendicitis (true positives) and 17 without appendicitis (true negatives). However, 69 patients who had positive histopathologic results received a negative ultrasound diagnosis (false negatives), and 2 patients with negative histopathologic findings had a positive ultrasound diagnosis (false positives). There was no significant association between the accuracy of the ultrasound diagnosis and the years of experience of the sonographers. Conclusion: a low level of diagnostic accuracy was demonstrated when utilizing ultrasound to diagnose cases of acute appendicitis. In addition, no association was found between the years of experience of the sonographer conducting the examination and the diagnosis of acute appendicitis.

Traditional use, Phytochemicals and Pharmacological activity of Salvadora persica: A Review

Salvadora persica L. also known as ‘Miswak’, Peelu and Arak is use traditionally as a source of food, cosmetic, fuel and medicine. Most common traditional use of Salvadora persica sticks is tooth cleaning. Other traditional use of Salvadora persica are in diabetes, arthritis, constipation, fever, cold, malaria, viral infection, gonorrhea, worms, antidotes, stimulators, laxative and in various veterinary problems such as poor milk production, abdominal disorder, diarrhea etc. Now traditional uses of Salvadora persica have scientifically proved in modern research. Various pharmacological activities of Salvadora persica reported in modern research were anti-microbial, antifungal, anti-inflammatory, analgesic, antiulcer, anticonvulsant, antifertility, wound healing, anthelmintic, antidepressant, anticancer etc. these pharmacological activities are due to present of many phytochemicals in Salvadora persica. Phytochemicals present in Salvadora persica are alkaloids, glycosides, tannins, Flavonoids, proteins, terpenoids and sterols. Aim of this review to provide various traditional use of Salvadora persica proved by modern research and highlighting its pharmacological activity and phytochemicals. This review article may be used to set a new research hypothesis with reference of traditional use.

The Correlation Between Pediatric Intussusceptions and Celiac Disease

The most common acute abdominal disorder in the pediatric population appears as a telescoping of the bowel, resulting in either intermittent or complete obstruction. Intussusceptions transpire as the bowel prolapses into a more distal bowel segment and is propelled forward. A case is presented of multiple small bowel intussusceptions, pneumatosis, intraperitoneal fluid, and pericardial effusion. Sonography initially visualized the obstructions, along with multiple other indicators of an abdominal disorder. The use of computed tomography followed to provide a more comprehensive view of the child’s abdomen. Each imaging technique revealed new aspects of the abdominal disorder and concluded in the diagnosis of celiac disease. This case supports the idea that small bowel intussusceptions should not be disregarded as insignificant incidental findings but rather should alert sonographers to further investigate for evidence of celiac disease.

Management of patients with acute pancreatitis at Al-Karama teaching hospital

Background: Acute pancreatitis is an acute inflammatory condition. It's not an uncommon disease, in both the developed and developing countries, causes high morbidity and mortality, and inflicts a heavy economic burden. Severe acute pancreatitis is present in up to 25% of patients with acute pancreatitis, with considerable mortality. Changes in the management of acute pancreatitis in the last 2 decades contributed to reduce the mortality. The aim of this study was to review the diagnosis and management and outcomes of patients with acute pancreatitis of patients with acute pancreatitis in Al- Karama teaching hospital.Methods: This prospective study included 63 patients with acute pancreatitis in surgical and medical wards in Al- Karma teaching hospital from the 1st October 2014 to 30th September 2017.Results: 63 patients with acute pancreatitis were included 35 male and 28 female patients with upper abdominal pain in which the diagnosis was not confirmed by CT or serum amylase or by CRP are not included in this study. Age and gender had no significant relations to outcome. Medical therapy is the mainstay, with supportive therapy consisting of controlled volume resuscitation and enteral feeding. Minimally invasive drainage and debridement play a role in managing infective pancreatic necrosis but in general should not be used until at least 4weeks after the acute illness.Conclusions: Acute pancreatitis is a benign abdominal disorder in up to 85% of cases. In the remaining 10%-15% of cases the disorder is life threatening with management of the disorder requiring admission to an intensive care unit with cardiovascular, respiratory, and renal monitoring and support.

ACUTE ABDOMEN;

Introduction: The term “acute abdomen” denotes any sudden spontaneousnon-traumatic disorder whose chief manifestation is in the abdominal area. There is frequently a progressive underlyingintra-abdominal disorder, the correct early diagnosis and treatment of which is essential for a favorable outcome.Objectives: (I) To find out the most common causes of acute abdomen. (II) To compare the preoperative assessmentwith postoperative diagnosis. Design: A Non-interventional Analytical (Comparative) study. Setting: Emergencydepartment of Combined Military Hospital Kharian. Period: Oct 2001 to Mar 2002. Patients & Methods: Total of 220patients who presented with acute abdomen. Results: The most frequent cause was found to be Acute Appendicitis,followed by Nonspecific abdominal pain, acute cholecystitis, acute intestinal obstruction and perforated duodenal ulcer.Preoperative diagnosis was wrong in 9.5% (n=21) of cases. Conclusion: Acute appendicitis was found to be the mostcommon cause of acute abdomen and the single most important cause of acute abdominal pain causing greatdiagnostic difficulties. the preoperative diagnostic accuracy can be increased especially in female of child bearing ageby using modern diagnostic tools especially laparoscopy.