Appendicitis being the commonest acute abdominal surgical condition, although diagnosis can be made clinically but possess diagnostic difficulty to junior surgeons. The need for appropriate tool/scoring system that can be easily applicable, accurate & reproducible in the diagnosis of appendicitis is essential to have a low negative Appendicectomy rate. This prospective study is designed to assess one such scoring system, i.e., Modified Alvarado Score. MATERIALS AND METHODS: SETTING AND DURATION: Department of Surgery, Hassan Institute of Medical Sciences/Teaching Hospital, Hassan. From August 2013 to September 2014. A total of 227 consecutive male and female patients with age above 14 years presenting with right lower abdominal pain were enrolled in this study, analysed according to eight variables of Modified Alvarado scoring system and were accordingly placed into 3 groups. Group-I patients having score 1-4 were discharged, Group-II patients having score 5-6 were observed, while Group-III patients having score 7-10 were operated and all the operated patients were followed up for 30 days. These groups were compared with intra-operative findings, histopathological results & early post -operative complications. RESULTS: Of the total 227 patients included in this study, 155 underwent Appendicectomy based on the Modified Alvarado scoring system. Out of 155 operated patients 142(91.6%) had acute appendicitis, thus yielding a positive predictive value of 91.6% while negative appendicectomy rate 9.3%. Frequency of negative appendicectomy was 5.3% (5/94) among males and 9.4% (08/61) in females. Post-operative complication rate including wound infection, pelvic abscess, chest and urinary tract infection was 10.3% (16/155). CONCLUSION: The present study showed that Alvarado clinical scoring system has a high diagnostic value of 90%. Alvarado scoring system is dynamic one & its proper application improves diagnostic accuracy. There by reduce the rate of negative appendicectomy, anticipate the post-operative stay & complications. In acute appendicitis, modified Alvarado scoring can be used as an objective criteria for selection of patient for appropriate Medical or Surgical treatment. This scoring system is easy, simple and cheap complementary aid for supporting the diagnosis of acute appendicitis especially for junior surgeons.

Urolithiasis is a common condition that affects approximately 5% to 10% of the population and the incidence of Urolithiasis is rising. Ureteric stones account for 20% of urinary tract stones and about 70% of them are found in the lower third of the ureter at presentation. Recent literatures show the efficacy of various drugs and minimally invasive procedures for the management of lower third ureteral stones. We performed a randomized, prospective study to assess and compare the efficacy of tamsulosin and silodosin as medical expulsive therapy for lower third ureteral stones.