Aim & Objective: To compare the accuracy of modified Alvarado score and ultrasonography in the diagnosis of acute appendicitis to reduce the morbity and mortality from appendicitis and also reduce the negative appendicectomy rates Methodology: This study was undertaken in 100 patients with a provisional diagnosis of acute appendicitis getting operated in Prathima Institute of Medical Sciences, Karimnagar from November 2016 to October 2018. Modified Alvarado score and USG findings were applied in the preliminary diagnosis, which was confirmed by intra operative and histopathological findings. Results: Fifty five patients were females and forty five were males. There was no statistical significance in the male to female ratio. The highest incidence (37%) was found in the age group of 21-30 and the lowest (4% each) was seen in the age group of 51-60 & 61 & above respectively. Ninety nine patients presented with anorexia and tender RIF. Ninety eight patients had migratory RIF pain. Nausea & vomiting, rebound tenderness, and leucocytosis were seen in 58, 53 and 39 patients respectively. Only 27 patients had elevated temperature. Forty three patients had a score of >7 out of which 42 had appendicitis and 1 was normal on histopathological examination which contributed to 97.7% and 2.3% of the patients respectively. Sensitivity, specificity and accuracy of MAS was 44.6%, 83.3%, 47% respectively. Sixty one patients were found to have appendicitis by USG out of which 60 had appendicitis and 1 was normal on histopathological examination, with a sensitivity of 63.8% and a specificity of 83.3% & accuracy 65%. Ninety four patients were diagnosed to have appendicitis by histopathological examination and 6 were reported to be normal. Accuracy of ultrasound to diagnose acute appendicitis was 65% and MAS was 47%.

Wound closure is as important as any other action performed by the surgeon. Apart from the need for producing a healthy and strong scar, it is the surgeon's responsibility to ensure its aesthetically pleasing physical appearance. Skin staples are an alternative to regular sutures in offering this advantage. The present study has helped to highlight the comparison between skin sutures and skin staplers. The skin stapling devices have revolutionized surgery for the purpose of rapid closure of abdominal wounds. However, staples have their own drawbacks. In view of this, this prospective study has been undertaken to highlight the outcomes of closure by staples and sutures with respect to speed of closure, cost effectiveness and post operative wound dehiscence, acceptance of scar and post operative pain. This is a prospective hospital based study conducted in our hospital from January 2017 to December 2018 at S.V.S Medical College. 200 patients who underwent various surgical procedures. Results were analyzed and compared with previous studies. It has been found that the use of staples in abdominal surgical wound closure gives faster speed of closure, less postoperative pain, and better cosmetic results. Staples, however, are costlier, and when used in emergency cases, associated with higher rates of wound dehiscence and a less acceptable scar.