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Predictive Value of Alvarado Score and Ultrasound in the Diagnosis of Acute Appendicitis (A prospective study

Background:  Acute appendicitis is the commonest non traumatic cause of acute abdominal pain that needs surgical management .Alvarado score and ultrasonographies are the most cost effective, easy and available aids for diagnosis. The aim of the study was determining   the reliability of Alvarado score and ultrasound in the diagnosis of acute appendicitis.


Results:
The study was applied with 100 cases with different types of abdominal pain at presentation with 51 males and 49 females .The sensitivity was97.3% ,specificity 90%, and accuracy  89 of combined usage of Alvarado score and U/S findings preoperatively.

Patients and method:  A prospective non-interventional study including patients admitted with suggestive history with signs and symptoms of acute appendicitis to the surgical emergency ward of Baghdad teaching hospital from July 1st 2017 to Feb 10th 2018, Alvarado score calculated and ultrasonography done for each patient enrolled in this study, then to be followed for intraoperative findings.

Conclusions: Combined application of Alvarado score and U/S has sensitivity 94.1% ,specificity 90% and accuracy 89% . In our medical facility and emergency ward, acute appendicitis remains as one of the top acute abdominal emergencies needing surgery in patients presenting with atypical clinical finding. So diagnosis becomes difficult. So Alvarado score along with ultrasound findings are useful for increasing the reliability in emergency department for  accurate diagnosis of acute appendicitis therefore there should be training for the use of U/S by emergency physician and general surgeon in the diagnosis of acute appendicitis in order to decrease the rate of negative appendectomies .  

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Publication Date
Sun Nov 08 2020
Journal Name
Journal Of The Faculty Of Medicine Baghdad
the The Role of Ultrasound in the Diagnosis of Malignant Thyroid Nodules

Background: Thyroid nodules are very common in clinical practice. Although most of thyroid nodules are benign, it is crucial to checkout which nodules are more likely to be malignant. Ultrasound is a major diagnostic tool for screening and evaluating thyroid diseases because it is safe, non-invasive, non-radioactive and effective.
Objective: The aim is to identify the role of ultrasound in assessing thyroid nodules and to review various ultrasound criteria predicting malignancy.
Patients and methods: A case series study conducted during the period from January 2015 to February 2016 at the First Surgical Unit, Department of Surgery, Baghdad Teaching Hospital by a team of surgeons. One hundred eighty Patients who underwent surgical i

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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.

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
Sun Oct 02 2016
Journal Name
Journal Of The Faculty Of Medicine Baghdad
The predictive value of selected ultrasound features in evaluating malignancy in thyroid nodules

Background: Thyroid ultrasound has been widely used to differentiate benign from malignant nodules; many investigators have tried to point out few ultrasonographic features in order to identify those lesions, which are at a higher risk of malignancy.
Objectives: To evaluate the efficacy of selected conventional ultrasound (US) features of thyroid focal lesions useful for predicting malignancy and establishing indications for fine-needle aspiration cytology (FNAC).
Patients and Methods:Two hundred and four consecutive patients with thyroid nodules who visited the outpatient clinic of the surgical department of Tikrit University teaching hospital for the period from January 2011 to April 2014, and who underwent surgery for clinical s

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Publication Date
Tue May 11 2021
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Pathological Nipple discharge: a comparison between breast ultrasound and mammography

Background:Nipple discharge is a relatively common complaint of females in reproductive age and after menopause.

Objectives: The aim of this stud was to compare the radiological findings of mammography and ultrasound in women with pathological nipple discharge of different pathology.

 Methods:  mammography and ultrasound was done for a total of 50 patients attending the National center of Early detection of Breast cancer with pathological nipple discharge. Ultrasound guided FNA was performed for all cases, and histopathology was available for eleven case.

Results: ultrasound was able to provide clue of possible underlying cause for all pathological nipple discharge whereas mammography was negative in 54%

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Publication Date
Thu Jan 02 2014
Journal Name
Journal Of The Faculty Of Medicine Baghdad
The value of ultrasound to differentiate between benign and malignant duct ectasia

Background: Mammary duct ectasia is defined as dilated duct larger than 2 mm in diameter seen in fibrocystic changes, ductal epithelial hyperplasia, papiloma, DCIS. US has a significant role in diagnostic breast imaging. It is most commonly used as an adjunctive test in characterizing lesions detected by other imaging modalities or by clinical examination

Objective: This study was designed to investigate differences in ultrasonographic findings between malignant and benign mammary duct ectasia.

Patients and Methods: From November 2010 to July 2011, 100 womem with mammary duct ectasia lesions depicted on sonograms were included in this study. We evaluated the ultrasonograp

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Publication Date
Tue Apr 01 2014
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Accuracy of ultrasound versus computed tomography in diagnosis of maxillary sinusitis

Background: ultrasound offers non-invasive, rapid and simple method for confirming the clinical diagnosis of maxillary sinus pathologies.
Objective: to evaluate the accuracy of real time ultrasound compared with the computed tomography in evaluation of maxillary sinusitis.
Patients and materials: This comparative cross-sectional study was done on 42 patients referred for computed tomography examination of paranasal sinuses in Al-Yarmook Teaching Hospital-Baghdad, from October 2012 to February 2013 with patients clinically suggesting an underlying maxillary sinusitis. Ultrasound and computed tomography examinations were carried out on the same day, the ultrasound being the first investigation. The sample of this study consisted of 2

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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

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
Mon Jul 29 2019
Journal Name
Journal Of The Faculty Of Medicine Baghdad
Ultrasound Findings of MammographicallyDense Breasts in a Sample of Iraqi Female PatientsDOI:https
Background: Breast problems including breast cancer have been increasing in Iraq during the recent years. Yet, early detection and screening programs using mammography mainly with complementary ultrasound had dramatically decreased the mortality rates from this emerging disease.
Objective: To assess the dense breast detected by mammography for the presence of any hidden
suspicious lesion by using ultrasound.
 Patients and methods:  this is a cross - sectional study on 53 female patients who came for breast cancer
screening or attended the Breast Clinic in the Oncology Teaching Hospital of the M
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Publication Date
Mon Jan 01 2018
Journal Name
International Journal Of Surgery Open
Effectiveness of conservative management of uncomplicated acute appendicitis: A single hospital based prospective study
<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 durat

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Publication Date
Sun Oct 02 2016
Journal Name
Journal Of The Faculty Of Medicine Baghdad
The effectiveness of irrigation method by normal saline compared to povidone iodine soaking in decreasing the rate of contamination in appendectomy wound

Background: The number of bacteria is important as much as the type of it in developing wound infection. Pressurized irrigation of the surgical wound leads to decrease bacterial number which led to decrease incidence of wound infection.
Objective: to evaluate effectiveness of normal saline irrigation and povidone iodine soaking in decreasing the number of bacteria.
Patient and method: This was a prospective study of 100 patients who were admitted to Al Kadhimyia Teaching Hospital during the period from May 2012 and April 2013 with diagnosis of acute appendicitis. After appendicectomy was done, patients were randomized into two groups, fifty patients (group one) the subcutaneous tissue was irrigated by

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