ABSTRACT
ABSTRACT BACKGROUND: Acute appendicitis is a common surgical emergency worldwide. Recent studies on hematological inflammatory markers concerning acute appendicitis have shown variable results. AIMS: The aim of this study was to evaluate pre-operative values of platelet indices such as mean platelet volume (MPV) and platelet distribution width (PDW), and red cell distribution width (RDW) in relation to the diagnosis of acute appendicitis and their efficacy as predictors of appendicular perforation. METHODS: A prospective observational study of 190 patients diagnosed with appendicitis and who underwent an appendectomy was undertaken and confirmed histopathologically. Preoperatively, blood samples of white blood cells (WBCs), platelet count, MPV, PDW, and RDW were analyzed using a Sysmex XN1000 analyzer machine. RESULTS: Of 190 patients, 169 had acute appendicitis, and 21 had perforated appendicitis. The mean age of patients was 28.04 ± 14.2 years. The male-to-female ratio was 1.5:1. The WBC (p<0.05), MPV (p<0.05), and PDW (p<0.05) were found to have higher statistically significant values in acute appendicitis and perforated appendicitis compared to the RDW (p>0.05). However, perforated appendicitis had a higher RDW value compared to acute appendicitis, which can be a predictive factor. CONCLUSIONS: The elevated value of MPV and PDW associated with leukocytosis can be used as supportive evidence for the clinical and radiological diagnosis of acute appendicitis and appendicular perforation. Thus, these values can be used as diagnostic cost-effective inflammatory biomarkers.
RESUMO RACIONAL: A apendicite aguda é uma emergência cirúrgica comum em todo o mundo. Estudos recentes sobre marcadores inflamatórios hematológicos relacionados à apendicite aguda mostraram resultados variáveis. OBJETIVOS: Avaliar valores pré-operatórios de índices plaquetários como volume médio de plaquetas (VPM) e largura de distribuição de plaquetas (PDW), largura de distribuição de hemácias (RDW) em relação ao diagnóstico de apendicite aguda e sua eficácia como preditores de apendicite perfuração. MÉTODOS: Estudo observacional prospectivo de 190 pacientes diagnosticados com apendicite e submetidos a apendicectomia confirmados histopatologicamente. Amostras de sangue pré-operatórias de glóbulos brancos (WBC), contagem de plaquetas, volume plaquetário médio (MPV), distribuição das plaquetas (PDW) e distribuição dos glóbulos vermelhos (RDW) foram analisadas usando uma máquina analisadora Sysmex XN1000. RESULTADOS: Foram incluídos 190 pacientes, sendo que 169 tiveram apendicite aguda e 21 tiveram apendicite perfurada. A média de idade dos pacientes foi de 28,04 ± 14,2. A proporção homem-mulher foi de 1,5:1. Verificou-se que WBC (p<0,05), MPV (p<0,05) e PDW (p<;0,05) têm valores estatisticamente significativos mais altos na apendicite aguda e na apendicite perfurada em comparação com o RDW (p> 0,05). No entanto, a apendicite perfurada apresentou um valor de RDW maior em comparação com a apendicite aguda, o que pode ser um fator preditivo. CONCLUSÕES: O valor elevado de MPV e PDW associado à leucocitose pode ser usado como evidência de suporte para o diagnóstico clínico e radiológico de apendicite aguda e perfuração apendicular. Assim, esses valors podem ser usado como biomarcadores inflamatórios diagnósticos de baixo custo.
ABSTRACT
Background: Patients who attend the hospital for any form of operative procedure frequently undergo physical or mental pain and agitation. These patients are extremely anxious. It is important to choose the most appropriate form of anesthesia for induction for the analgesia or sedation. This study examined the safety and effectiveness of the Ketamine and Propofol combination technique for short procedures like D and C, MTP, evacuation and marsupilisation of Bartholin’s abscess.Methods: The present observational study was carried out in association with the Gynecology and Obstetrics department and Department of Anesthesiology of PDMMC and hospital, Amravati, Maharashtra, India over a period of 3 months from 1st January to 31st March 2019.Results: In present study, 28 (56%) patients were of 25-40 years age, 14 (28%) patients were of 41-50 years age while 8 (16%) patients were of 51-60 years age. 7 (14%) patients were underweight, 26 (52%) patients had normal BMI, 10 (20%) patients were overweight while 7 (14%) patients were obese. MAP before surgery was 100 ± 12, which decreased to 92±9.2 during operation and increased to 97±19.4 in the postoperative period. Heart rate and arterial SPO2 were not significantly different before, during, and after the operation. Mean VAS score for pain was 5.2±5.1 and the mean Ramsay’s score of sedation was 5.8 ± 0.01. 1 (2%) patient had apnea, 1 (2%) patient had skin reaction, 1 (2%) patient had cough, 1 (2%) patient had agitation while 2 (4%) patient had nausea and vomiting.Conclusions: Ketamine and Propofol combination technique can be recommended for use in the short procedures safely and effectively.
ABSTRACT
Introduction: Acute appendicitis is the most common abdominal emergency encountered in general surgery.Purpose: In this study, diagnostic accuracy of Procalcitonin, C-Reactive Protein (CRP), Bilirubin as a biomarker in acuteappendicitis and its complications have been analyzed. 82 patients with clinical diagnosis of acute appendicitis or appendicealperforation were studied. Method: The serum Procalcitonin, C-Reactive Protein (CRP), and Bilirubin were carried out in allthe patients. The diagnosis was confirmed USG reports and intra-operative findings and those differing from the pre-operativediagnosis were excluded from the study.Results: 53 patients (64.6%) were males while the remaining 29 patients (35.4%) were females. The mean age in our studypopulation (82 patients) was 25.9 ± 11.5 years. The average age in females 27.8±12.6 years was slightly higher than males24.9±10.8 years. 65 patients (79.3%) were diagnosed as acute appendicitis pre-operatively while 17 patients (20.7%) werediagnosed with Appendiceal perforation. The mean level of procalcitonin, C-Reactive Protein (CRP), Bilirubin were found tohave increased in both acute appendicitis and appendiceal perforation. The mean procalcitonin levels in patients diagnosedwith acute appendicitis was 2.2 ±0.9 ng/mL (range, 0.8– 3.4 ng/mL) while in patients diagnosed with Appendiceal perforationwas 2.7±0.8 ng/mL (range, 1.5– 4.6 ng/mL). The mean bilirubin levels in patients diagnosed with acute appendicitis was0.7 ± 0.4 mg/dL (range, 0.09– 1.6 mg/dL) while in patients diagnosed with Appendiceal perforation was 0.8±0.2 mg/dL(range, 0.5– 1.2 mg/dL). The mean CRP levels in patients diagnosed with acute appendicitis was 1.4 ± 0.5 mg/dL (range, 0.5–2.2 mg/dL) while in patients diagnosed with Appendiceal perforation was 1.8±1.1 mg/dL (range, 0.9– 6.0 mg/dL). Sensitivity ofProcalcitonin, C-Reactive Protein (CRP) and bilirubin in predicting acute appendicitis and appendiceal perforation diagnosiswas 64.6%, 41.54% and 16.9% respectively.Conclusion: The findings indicate that procalcitonin is a useful marker of acute appendicitis with abscess and/or perforationthan CRP and Serum bilirubin.
Subject(s)
/physiology , Capnography/methods , Disinfectants , Equipment Design , Hot Temperature , Humans , Humidity , Positive-Pressure RespirationABSTRACT
The objective of this study was to evaluate α- amylase inhibitory activity of a marketed polyherbal formulation. The α-amylase is one of the major secretory products helps in digestion of starch and glycogen. The polyherbal extract were prepared with aqueous, hydroalcohol and ethanol. In addition, total phenolic content, total flavonoid content and in vitro antioxidant activity was evaluated. Total phenolic content was found to be 3.5725 ± 0.2336 mg of GAE/ 100 g (aqueous extract), 2.9616 ± 0.2563 mg of GAE/ 100 g (hydroalcohol extract), 4.6683 ± 0.4199 mg of GAE/ 100 g (ethanol extract). Total flavonoid content was found to be 96.1556 ± 4.2664 mg of quercetin equivalent/ 100 g (aqueous extract), 85.1881 ± 4.2135 mg of quercetin equivalent/ 100 g (hydroalcohol extract), 96.0122 ± 2.9972 mg of quercetin equivalent/ 100 g (ethanol extract). In vitro antioxidant activity was found to be 6.436 ± 0.3638 mg of ascorbic acid equivalent / 100 g (aqueous extract), 6.7242 ± 0.2461 mg of ascorbic acid equivalent / 100 g (hydroalcohol extract), 5.4616 ± 0.6696 mg of ascorbic acid equivalent / 100 g (ethanol extract). α-amylase inhibitory activity was found to maximum in water extract followed by ethanol extract and hydroalcohol extract.