Role of modified Alvarado score in acute appendicitis

To evaluate the efficacy of Modified Alvarado Score in Acute Appendicitis, and to correlation it with the operative and histopathological findings. Observational, cross sectional study carried out in two phases, 2000-2001 at Nawahshah and 2002-2003 at Karachi. Nawabshah Medical College Hospital and Sindh Govt. Lyari General Hospital, Karachi. All patients admitted with the diagnosis of Acute Appendicitis during the study period. After collecting the basic and clinical data, the patients were divided into three groups according to the Alvarado Score. Group-7 [Score 1-4] patients were put on conservative treatment and sent home, while Group III [Score 8-10] patients were operated after necessary preparations. Group-II [Score 5-7] cases were admitted, put on conservative treatment and, re-assessed and re-scored after few hours. Those settling down were discharged, while those deteriorting with increase in their Alvarado Score were operated. Modified Alvarado Score was then correlated with the operative and histopathological findings. A total of 254 patients, 140 males and 114 females were included in the study. Majority [62.19%] of them were teenagers or in their twenties. Amongst them 174 patients, 110 of Group-Ill and 64 from Group-II, underwent appendicectomy. Out of these 20 [11.49%] cases had a normal appendix. Modified Alvarado Score is effective, cheap and easy to apply Hence it helps in improving the diagnosis in cases of Acme Appendicitis

Outcome of surgery for pilonidal sinus: karydakis versis open procedure

To compare and analyze the outcome of Karydaki's procedure with Open excision technique for Pilonidal sinus especially in term of recovery time, period off work, complications and recurrence. Prospective, randomized and comparative study from April 2004 to Sept. 2006. Dept. of Surgery [Unit-I], Sindh Government Lyari General Hospital, Karachi. Twenty six patients with Pilonidal sinus of the natal cleft were included in the study. Biodata, symptoms and signs of all the patients were recorded and appropriate investigations performed. They were randomized into two groups. Group-K underwent Karydaki's procedure in which a wedge of tissue including the simus and its ramifications were excised with primary asymmetrical closure of the wound. In Group-O patients, wide excision of the Pilonidal sinus tract was done and the wound was left open. Amongst the 26 patients included in the study, majority [25] were males in the third decade of life [52.85%]. Their mean duration of symptoms was 8.53 months. The mean operating time for K-Group [45 +/- 10 mins.] cases a bit longer than the O-Group patients [25 +/- 5 mins.] however the former group was associated with fewer postoperative complications, lesser recovery period [2.46 weeks], lesser period off-work [3.53 weeks] and low recurrence rate [7.69%]. In contradiction, amongst the O-Group patients the mean recovery period was 6.69 weeks, mean period off-work was 8.15 weeks and recurrence was seen in 15.38% patients. The Karydakis procedure is superior to Open excision in terms of post-operative morbidity, recurrence rate and recovery period, though it takes a big longer to perform