AIM:To assess the reliability and practical applicability of the widely used Alvarado,Eskelinen,Ohhmann and Raja Isteri Pengiran Anak Saleha Appendicitis(RIPASA)scoring systems in patients with suspected acute appendi...AIM:To assess the reliability and practical applicability of the widely used Alvarado,Eskelinen,Ohhmann and Raja Isteri Pengiran Anak Saleha Appendicitis(RIPASA)scoring systems in patients with suspected acute appendicitis.METHODS:Patients admitted to our tertiary center due to suspected acute appendicitis constituted the study group.Patients were divided into two groups.appendicitis group(Group A)consisted of patients who underwent appendectomy and were histopathologically diagnosed with acute appendicitis,and non-appendicitis group(Group N-A)consisted of patients who underwent negative appendectomy and were diagnosed with pathologies other than appendicitis and patients that were followed non-operatively.The operative findings for the patients,the additional analyses from follow up of the patients and the results of those analyses were recorded using the follow-up forms.RESULTS:One hundred and thirteen patients with suspected acute appendicitis were included in the study.Of the 113 patients(62 males,51 females),the mean age was 30.2±10.1(range 18-67)years.Of the 113patients,94 patients underwent surgery,while the rest were followed non-operatively.Of the 94 patients,77patients were histopathologically diagnosed with acute appendicitis.Our study showed a sensitivity level of81%for the Alvarado system when a cut-off value of 6.5was used,a sensitivity level of 83.1%for the Ohmann system when a cut-off value of 13.75 was used,a sensitivity level of 80.5%for the Eskelinen system when a cut-off value of 63.72 was used,and a sensitivity level of 83.1%for the RIPASA system when a cut-off value of 10.25 was used.CONCLUSION:The Ohmann and RIPASA scoring systems had the highest specificity for the diagnosis of acute appendicitis.展开更多
Obesity and diabetes is a co-pandemic and amajor health concern that is expanding. It has many psychosocial and economic consequences due to morbidity and mortality of this disease combination. The pathophysiology of ...Obesity and diabetes is a co-pandemic and amajor health concern that is expanding. It has many psychosocial and economic consequences due to morbidity and mortality of this disease combination. The pathophysiology of obesity and related diabetes is complex and multifactorial. One arm of this disease process is the genetic susceptibility. Other arm is dependent on the intricate neuro-humoral factors that converge in the central nerve system. Gut hormones and the adipose tissue derived factors plays an important role in this delicate network. Bariatric surgery provides the only durable option for treatment of obesity and furthermore it provides a remission in the concomitant diseases that accompany obesity. This review provides a brief insight to all these mechanisms and tries to deduce the possible reasons of remission of type 2 diabetes after bariatric surgery.展开更多
文摘AIM:To assess the reliability and practical applicability of the widely used Alvarado,Eskelinen,Ohhmann and Raja Isteri Pengiran Anak Saleha Appendicitis(RIPASA)scoring systems in patients with suspected acute appendicitis.METHODS:Patients admitted to our tertiary center due to suspected acute appendicitis constituted the study group.Patients were divided into two groups.appendicitis group(Group A)consisted of patients who underwent appendectomy and were histopathologically diagnosed with acute appendicitis,and non-appendicitis group(Group N-A)consisted of patients who underwent negative appendectomy and were diagnosed with pathologies other than appendicitis and patients that were followed non-operatively.The operative findings for the patients,the additional analyses from follow up of the patients and the results of those analyses were recorded using the follow-up forms.RESULTS:One hundred and thirteen patients with suspected acute appendicitis were included in the study.Of the 113 patients(62 males,51 females),the mean age was 30.2±10.1(range 18-67)years.Of the 113patients,94 patients underwent surgery,while the rest were followed non-operatively.Of the 94 patients,77patients were histopathologically diagnosed with acute appendicitis.Our study showed a sensitivity level of81%for the Alvarado system when a cut-off value of 6.5was used,a sensitivity level of 83.1%for the Ohmann system when a cut-off value of 13.75 was used,a sensitivity level of 80.5%for the Eskelinen system when a cut-off value of 63.72 was used,and a sensitivity level of 83.1%for the RIPASA system when a cut-off value of 10.25 was used.CONCLUSION:The Ohmann and RIPASA scoring systems had the highest specificity for the diagnosis of acute appendicitis.
文摘Obesity and diabetes is a co-pandemic and amajor health concern that is expanding. It has many psychosocial and economic consequences due to morbidity and mortality of this disease combination. The pathophysiology of obesity and related diabetes is complex and multifactorial. One arm of this disease process is the genetic susceptibility. Other arm is dependent on the intricate neuro-humoral factors that converge in the central nerve system. Gut hormones and the adipose tissue derived factors plays an important role in this delicate network. Bariatric surgery provides the only durable option for treatment of obesity and furthermore it provides a remission in the concomitant diseases that accompany obesity. This review provides a brief insight to all these mechanisms and tries to deduce the possible reasons of remission of type 2 diabetes after bariatric surgery.
