INTRODUCTION: Acute appendicitis is a common surgical emergency. Accurate diagnosis and timely intervention reduces mortality and morbidity. This study compared the efficacy of Tzanakis and Alvarado score in diagnosis of acute appendicitis. METHODS: A prospective, non randomized study was conducted in 100 consecutive patients who had undergone emergency appendectomy from May 2008 to October 2008. Tzanakis and Alvarado scores were obtained at the time of admission. Final diagnosis of acute appendicitis was based on histological findings. RESULTS: The sensitivity, specificity and overall diagnostic accuracy of Tzanakis score was 91.48% and 66.66% and 90% respectively. The sensitivity, specificity and overall diagnostic accuracy of Alvarado score was 81.91% and 66.66% and 81% respectively. Negative appendectomy rate was 6%. CONCLUSIONS: Tzanakis score is an effective modality to establish the accurate diagnosis of acute appendicitis. Keywords: acute appendicities, Tzanakis score, Alvarado Score.
INTRODUCTION: Intravesical prostatic protrusion is a morphological change due to excessive growth of the median and lateral lobes of the prostate into the bladder in benign prostatic hyperplasia. It causes a 'ball-valve' type of obstruction during voiding. It is a useful parameter to assess the severity of the disease process, selection of treatment modality and its possible outcome in benign prostatic hyperplasia.MATERIAL AND METHODS: A prospective, non-randomized, observational study was carried out from January 2014 to June 2014 in the Department of Urology, College of Medical Sciences, Nepal. Total of 50 patients with benign prostatic hyperplasia were evaluated to assess the correlation of intravesical prostatic protrusion with international prostate symptom score, prostate volume, maximum flow rate and post void residual urine. Correlation between parameters of interest was quantified with Pearson correlation test.RESULTS: A positive correlation was demonstrated between intravesical prostatic protrusion, international prostate symptom score, prostate volume and post void residual urine. There was a negative correlation between intravesical prostatic protrusion and maximum flow rate.CONCLUSION: Intravesical prostatic protrusion is correlated with international prostate symptom score, prostate volume, maximum flow rate, and post void residual urine volume and hence can be used to assess the severity of benign prostatic hyperplasia.Journal of Universal College of Medical Sciences Vol. 3, No. 1, 2015: 6-10
Introduction: The lesions of urinary bladder both non-neoplastic and neoplastic pose a common source of both morbidity and mortality. An accurate diagnosis of these lesions requires cystoscopy which allows a direct visualization of the bladder mucosa and biopsies of suspected lesions. Urinary bladder cancer is sixth most common cancer worldwide and represents a heterogeneous group of neoplasms. The current study aimed to study the different bladder lesions and its clinical features to detect it in early stage and as a mainstay option in the diagnosis and follow up. Materials and methods: This was a retrospective analysis of biopsies of urinary bladder submitted to the department of pathology over a period of 12 months. The study was approved by the institutional review board of the Universal College of Medical Sciences (UCMS-TH). All the urinary bladder biopsies received in the department were included in the study whereas autolysis of specimen and inadequate biopsies were excluded. Results: Among the 36 cases of urinary bladder lesions, the majority (35.36%) were in age group 61-70 years (22.33%). The patients had combination of lower urinary tract symptoms, the commonest being hematuria. 30.55% had non-neoplastic lesions and 69.55% had neoplastic lesion. Among non- neoplastic cases, 5.55% had chronic granulomatous inflammation. Most common neoplastic lesions was infiltrating urothelial carcinoma (n=6) followed by non- invasive urothelial neoplasia (n=5). Conclusion: A variety of lesions occur in urinary bladder and is commonly encountered by pathologist. Hematuria was commonest symptom and the clinicians investigated these patients further, which led to discovery of the urothelial tumors. Identification of these patients has an important impact on prognosis as well as on therapeutic approach.
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