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Effectiveness of conservative management of uncomplicated acute appendicitis: A single hospital based prospective study
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<bold>ABSTRACT</bold> <sec> <title>Background:

Acute appendicitis is one of the commonest causes of acute abdomen. There is a wide discussion and controversy on the surgical and nonsurgical treatment of acute uncomplicated appendicitis. The aim of this study was to evaluate the efficacy and outcomes of the conservative management of selected cases of acute appendicitis with an antibiotic first plan.

Patients and methods:

This was a single hospital-based prospective study with a duration of 25 months. Patients with clinical and radiological features of acute appendicitis presenting within 72 h of the beginning of abdominal pain with Alvarado score ≥5 were included. The patients received a therapeutic dose of broad-spectrum antibiotics and symptomatic treatment. The follow-up period was 6 months.

Results:

90 patients were evaluated, 54 (60%) patients were female and 36 (40%) patients were male with mean age 34.4 years. Conservative treatment was successful in 68 (75.6%) patients and failed in 22 (24.4%) patients. No mortality recorded in this study. The main complications which occurred in those patients who failed to respond to conservative treatment were perforated appendicitis (3 patients), appendicular abscess (3 patients) and appendicular mass (4 patients).

Conclusion:

Majority of cases of the first attack of uncomplicated acute appendicitis can be treated successfully by conservative treatment. However, conservative treatment demands precise communication, close monitoring and follow-up to recognize failure which needs to be treated immediately by surgery.

Highlights:
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Publication Date
Wed Dec 30 2015
Journal Name
Al-kindy College Medical Journal
Application of Alvarado scoring system in the diagnosis of acute appendicitis.
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Background: Acute appendicitis is the most common abdominal surgical emergency. The diagnosis of this condition is still essentially clinical and there is difficulty in the clinical diagnosis, especially among elderly, children and patients with a typical presentation, so early and accurate diagnosis of acute appendicitis is important to avoid its complications.Objectives: To evaluate the degree of accuracy of Alvarado scoring system in the diagnosis of acute appendicitis.Method: Two hundred patients were admitted to the Alkindy Teaching Hospital from January 2011 to april 2014- presented with symptoms and signs suggestive of acute appendicitis. After examination and investigations all patients were given a score according to Alvarado sc

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Publication Date
Mon Apr 01 2013
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Congenital lobar emphysema surgical versus conservative management
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Back ground: Congenital lobar Emphysema (CLE) is a rare yet serious condition which requires early detection and management, and usually present during infancy.

Patients and methods: This retrospective study aimed to review and evaluate methods adopted for the management of congenital lobar emphysema cases and it aimed to report and to document any observation which might need further research. The study retrospectively reviewed medical records of 53 cases whom were admitted to the department of thoracic surgery-medical city teaching complex over a period of 4 years (from June 2005 to June 2010). All of them had been diagnosed and managed as cases of congenital lobar emphysema based on their clin

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Publication Date
Wed Jul 01 2009
Journal Name
Journal Of The Faculty Of Medicine Baghdad
parastic infection associated with acute appendicitis in surgically removed appendices
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BACKGROUND-to explor the infections associated with acute appendicitis in surgically removed appendices in Diyala.

Materials and Methods: this study include 160 surgically removed appendices with acute appendicitis . the patients were 66 fenales and 94 males. the age range was 5-53years with mean age 22.9±7.2 years.the surgically removed appendicitis were submitted for gross inspection and microscopic examination including direct mount, sedimentation and flotation techniques. Additionally specimens from 25 appendices were processed and examined histopathologically.

Results: The rate of parasitic infection in surgically removed appendices was 26.2%. the rate of single parastic infection was 23.1%, while the rate of two pa

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Publication Date
Fri Sep 17 2021
Journal Name
Al-kindy College Medical Journal
Single Layer Extra-Mucosal Versus Double Layer Intestinal Anastomosis for Colostomy Closure: A Prospective Comparative Study
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Background: The main objective was to compare the outcome of single layer interrupted extra-mucosal sutures with that of double layer suturing in the closure of colostomies.

Subjects and Methods: Sixty-seven patients with closure colostomy were assigned in a prospective randomized fashion into either single layer extra-mucosal anastomosis (Group A) or double layer anastomosis (Group B). Primary outcome measures included mean time taken for anastomosis, immediate postoperative complications, and mean duration of hospital stay. Secondary outcome measures assessed the postoperative return of bowel function, and the overall mean cost. Chi-square test and student t-test did the statistical analysis..

Resu

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Publication Date
Wed Aug 30 2023
Journal Name
Al-kindy College Medical Journal
Comparative Study between RIPASA Scoring System and ALVARADO Scoring System in Diagnosing Acute Appendicitis in Adults
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Background: Acute appendicitis is regarded as one of the most common inflammation that needs surgical intervention. Different scoring systems have been used for diagnosing of acute appendicitis. ALVARADO score is one of the most widely used score in diagnosing of acute appendicitis, but the accuracy of the latter is insufficiently low in Middle-East patients. Thus a new scoring system called RIPASA score has been designed for diagnosing of acute appendicitis in those patients. The aim of this study is to use RIPASA score and compare its result with ALVARADO score in diagnosing of acute appendicitis.

Subjects and Methods: The study includes 200 patients with symptoms and signs of

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Publication Date
Sun Oct 01 2023
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Acute Kidney Injury in Neonates: A Single-Center Experience
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Background: Neonatal intensive care unit infants frequently experience acute kidney damage. Estimates of the prevalence of acute kidney vary depending on the definitions used. In Iraq, studies addressing the prevalence and risk factors of acute kidney injury in this age group are scarce, none of which has implicated the KDIGO diagnostic and staging criteria.

Objectives: To describe the prevalence, demographics, risk factors, etiology, and staging of acute kidney injury using KDIGO criteria in the Neonatal intensive care unit and correlate these findings with patient outcomes.

Methods: A retrospective study was conducted in the Neonatal Intensive Care Unit/ CWTH/ Medical Cit

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Publication Date
Wed Aug 31 2022
Journal Name
Al-kindy College Medical Journal
Acute Appendicitis and Multisystemic Inflammatory Syndrome due to COVID-19: a Case Report and Literature Review
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The prevalence of gastrointestinal symptoms of COVID-19 is variable with different types of presentations. Some of them many present with manifestations mimicking surgical emergencies. Yet, the pathophysiology of acute abdomen in the context of COVID-19 remains unclear. We present a case of a previously healthy child who presented with acute appendicitis with multisystemic inflammatory syndrome. We also highlight the necessity of considering the gastrointestinal symptoms of COVID-19 infection in pediatric patients in order to avoid misdiagnosis and further complications.

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Publication Date
Sun Apr 03 2011
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Cholestatic jaundice in a sample of Iraqi Infants (A hospital based study)
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Background: Cholestatic Jaundice is a dilemma facing not only the primary care provider but also the specialist pediatricians in our country.
Subjects & methods: Analysis of 50 cases of cholestatic jaundice aged 3 weeks- 18 months were carried out over 18 months in the Gastroenterology & Hepatology unit in the Children Welfare Teaching Hospital, Medical City, and Baghdad. Clinical, biochemical, radiological and histopathological results were recorded.
Results: Fifty patients with Cholestatic Jaundice, 28 males &22 females, were evaluated. The main causes of Cholestatic Jaundice were Biliary Atresia in 22 cases (44%)(the mean age of presentation was 4.1 months ), and Neonatal Hepatitis Syndr

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Publication Date
Sun Jan 02 2011
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Bilinorm administration combined with Phototherapy in the management of neonatal jaundice: a hospital based clinical trial
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Background: Neonatal jaundice (NJ) is a common problem worldwide and frequent in Iraq . Several reports were published on prevalence, distribution, causes and treatment of NJ.This clinical trial was carried out to demonstrate the effect of combinations of Castrol oil, riboflavin and magnesium in mechanical elimination of bilirubin after enhancing hepatic excretion by phototherapy.
Patients & methods: This clinical trial included a total of 61 significantly jaundiced neonates who were admitted to the special care baby unit of Children Welfare Teaching Hospital, medical city complex, Baghdad, Iraq, during the period June 1st to Dec.31st 2007. Phototherapy was applied alone in 30 neonates (group 1) and p

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Publication Date
Thu Apr 18 2019
Journal Name
Al-kindy College Medical Journal
Evaluation of Ultrasonography in the Diagnosis of Acute Appendicitis with Histopathology as Gold Standard
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Background: Acute appendicitis is the most common surgical abdominal emergency with a life time prevalence of 1 to 7 individuals. Because the clinical diagnosis of acute appendicitis remains a challenge to surgeons, so different aids were introduced like different scoring systems, computer aided programs, ultrasonography, computerized tomography, Magnetic resonance imaging, Gastrointestinal tract contrast studies and laparoscopy to improve the diagnostic accuracy.

Objective: To evaluate ultrasound in the diagnosis of acute appendicitis in those patients clinically diagnosed with histopathology as gold standard.

Methods: A cross sectional study carried in Al-kindy Teaching

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