Role of modified alvarado score in diagnosing acute appendicitis in emergency setup

The objective of the study was to evaluate the diagnostic accuracy of modified Alvarado score on patients presenting in surgical emergency with suspicion of acute appendicitis. We studied the Alvarado score of 200 patients in 11 months period who presented to the emergency department with right iliac fossa pain. We decided to design this study with the aim of investigating whether the Alvarado Score can be used by emergency doctors as a criteria for diagnosing acute appendicitis. We compared the Alvarado Score with the operative findings and grade of appendicitis. A total of two hundred patients were studied. We found that patients who had a score of less than 5 had a normal appendix, but at the same time 17% had acute appendicitis. While if, Alvarado Score >5, 59% had acute appendicitis and 1% have normal appendix. Thus the Alvarado Score is both specific and sensitive in diagnosis of acute appendicitis. It is concluded that Alvarado score is a free and easy to use tool and is very helpful in diagnosing acute appendicitis and decreasing the incidence of negative appendectomies

Mortality analysis of a surgical unit

The progress in surgery has largely been due the recent emphasis on audit and analysis. This has become the cornerstone of evidence - based medicine. We retrospectively analyzed data for the year 2002 with the view to determine the rate and causes of mortality in our general surgical unit. In a total of 2771 admissions, 173 patients expired. The most frequent group was trauma and the most frequent cause was burn i.e. 34.1%. The burnt patients were predominantly females. FAI and stabs also figured prominently. Among them 52.1% patients had septicaemia resulting in multi-organ system failure as the final common pathway. With our current analysis we were able to establish guidelines in the subsequent year, which helped us achieve a better patient care and a resulting lower mortality. Hence we conclude that recording and analyzing mortality is a way of testing the diagnostic and therapeutic efficacy in a quest for a high quality of care