Non-contrast spiral computed tomography in diagnosis of acute appendicitis

Approach to patients with acute right lower quadrant pain remains a clinical dilemma. Decreasing the risk of negative appendectomies is one of the major goals surgery units intend to achieve. This study has been conducted to determine the accuracy of non-contrast focused appendiceal computed tomography [CT] in preoperative diagnosis of acute appendicitis. During a period of three months, 50 consecutive adult and adolescent patients who were clinically diagnosed as acute appendicitis were included in this study. Focused non-enhanced appendiceal spiral computed tomography [CT] was performed for all patients, preoperatively. Two radiologists who were unaware of the surgical findings assessed the CT scans. After the operation and pathologic assessment, eight patients with negative appendectomy were found. The sensitivity of CT was 0.71 and 0.83 according to the interpretations of the first and second radiologists, respectively. Moreover, its specificity was 0.88 and 0.75 according to the first and second radiologists' reports, respectively. In patients with clinically diagnosed acute appendicitis, relying on abdominal CT is not helpful

[Evaluation of two surveillance methods for surgical site infection]

Surgical wound infection surveillance is an important facet of hospital infection control processes. There are several surveillance methods for surgical site infections. The objective of this study is to evaluate the accuracy of two different surgical site infection surveillance methods. In this prospective cross sectional study 3020 undergoing surgey in general surgical wards of Imam Khomeini hospital were included. Surveillance methods consisted of review of medical records for postoperative fever and review of nursing daily note for prescription of antibiotics postoperatively and during patient's discharge. Review of patient's history and daily records and interview with patient's surgeon and the head-nurse of the ward considered as a gold standard for surveillance. The postoperative antibiotic consumption especially when considering its duration is a proper method for surgical wound infection surveillance. Accomplishments of a prospective study with postdischarge follow up until 30 days after surgery is recommended. The result of this study showed that postoperative antibiotic surveillance method specially with consideration of the antibiotic usage duration is a proper method for surgical site infection surveillance in general surgery wards. Accomplishments of a prospective study with post discharge follow up until 30 days after surgery is recommended