A Comparison of the Modified Alvarado Score and the Raja Isteri Pengiran Anak Saleha Appendicitis (Ripasa) Score in a Southeast Asian Population With Histopathology as the Gold Standard.

Background The diagnosis of acute appendicitis has remained difficult despite it being one of the most common surgical emergencies in the world. One of the most frequently used scoring systems is the Modified Alvarado Score (MAS). However, the MAS has been known to be less efficient in Asian populations. To overcome this issue, the Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) score has been specifically developed to improve the diagnosis of acute appendicitis in Asian populations. This study aimed to evaluate the accuracy of the RIPASA score compared to the MAS for the diagnosis of acute appendicitis in a Southeast Asian population keeping histopathology as the gold standard. Methodology The study group comprised 150 patients. Data were collected from each patient using a simple proforma to ascertain both the MAS and the RIPASA score for each patient at the time of presentation. The patients then underwent open appendectomy and histopathology was used as the gold standard to determine the presence or absence of acute appendicitis in the excised specimens. Results The RIPASA score had a sensitivity and specificity of 89.83% and 59.38%, respectively, compared to 64.41% and 53.12%, respectively, for the MAS. Diagnostic accuracy was similarly higher for the RIPASA score at 83.33% versus 62.00% for the MAS. Conclusions The RIPASA score is superior to the MAS for the diagnosis of acute appendicitis. Using the RIPASA score instead of the MAS in Southeast Asian populations can lead to a more accurate and timely clinical diagnosis of patients with suspected acute appendicitis and help improve patient outcomes.

Ternary nanohybrid of reduced graphene oxide-nafion@silver nanoparticles for boosting the sensor performance in non-enzymatic amperometric detection of hydrogen peroxide.

A sensitive and novel electrochemical sensor was developed for the detection of hydrogen peroxide (H2O2) using a reduced graphene oxide-nafion@silver6 (rGO-Nf@Ag6) nanohybrid modified glassy carbon electrode (GC/rGO-Nf@Ag6). The GC/rGO-Nf@Ag6 electrode exhibited an excellent electrochemical sensing ability for determining H2O2 with high sensitivity and selectivity. The detection limit of the electrochemical sensor using the GC/rGO-Nf@Ag6 electrode for H2O2 determination was calculated to be 5.35×10-7M with sensitivity of 0.4508µAµM-1. The coupling between rGO-Nf with silver nanoparticles (AgNPs) significantly boosted the electroanalytical performance by providing more active area for analyte interaction, thereby allowing more rapid interfacial electron transfer process. The interfering effect on the current response of H2O2 was studied and the results revealed that the sensor electrode exhibited an excellent immunity from most common interferents. The proposed non-enzymatic electrochemical sensor was used for determining H2O2 in apple juice, and the sensor electrode provided satisfactory results with reliable recovery values. These studies revealed that the novel GC/rGO-Nf@Ag6 sensor electrode could be a potential candidate for the detection of H2O2.