APPRAISE DIRECTNESS

APPRAISE DIRECTNESS
• COMPARE AND CONTRAST HISTO-PATHOLOGY
FINDINGS AND USING PREVENTIVE TOOLS
SUCH AS TOTAL LYMPHOCYTE COUNT AND
NEUTROPHIL COUNT
• CHECK INCLUSION AND EXCLUSION CRITERIA
OF JOURNAL
 CLINICAL SCENARIO JOURNAL STUDY
POPULATION NEGATIVE APPENDECTOMY INCIDENCE IS 1.5 TO 1.9
USUALLY SIGNIFICANTLY PER 100.000 AND IS 1.4
SLIGHTLY MALE TO FEMALE TIMES MORE COMMON IN
PREDOMINANCE BUT MEN
HIGHER IN FEMALE
INTERVENTION
OUTCOME
METHOD RETROSPECTIVE STUDY
SAMPLE SELECTION
 SAMPLE SELECTION
INCLUSION CRITERIA EXCLUSION CRITERIA
• ALL CASES PRESENTED IN • PATIENTS WITH INTERVAL,
THE EMERGENCY WITH A ELECTIVE OR INCIDENTAL
DIAGNOSIS OF ACUTE APPENDECTOMIES ARE
APPENDICITIS DURING THE EXCLUDED
PERIOD OF STUDY WERE • ALL CASES WITH CO-
INCLUDED. MORBIDITIES SUCH AS
CROHN’S DISEASE, PELVIC
INFLAMMATORY DISEASE,
GASTROENTERITIS, SYSTEMIC
INFECTION, AND PREGNANCY
WERE EXCLUDED
 APPRAISE VALIDITY
• Were patient randomly assigned to participate in the
study?
• Was the two preventive tool confirms to be positive in
reducing negative appendectomies?
• Which gender are in risk of emergency
appendectomy?
• What is acute appendicitis in terms of clinical
diagnosis?
• What are the baseline investigations carried out?
• Comparison of True Appendectomy and Negative
Appendectomy
 Were patient randomly assigned to participate in the
study?

• All cases presented to the emergency with a

diagnosis of acute appendicitis, during this
period are all included.
• All two hundred ninety four of the total four
hundred eight patients had signs that are
consisted with acute appendicitis.
 Was the two preventive tool confirms to be
positive in reducing negative appendectomies?

• Mean TLC and NC were found to be normal in

patients with negative appendectomy which
are both components of ALVARADO score
• No significant differences between group
regarding three variables with p-values for all
three: TLC, NC and ALVARADO <0.001.
 Which gender are in risk of emergency appendectomy?

• Incidence is 1.5 to 1.9 per 100.000 and is 1.4

times more common in men.
What is acute appendicitis in terms of clinical diagnosis?

• Acute appendicitis is a clinical diagnosis

supported by various scoring method
(ALVARADO score), radiograph, and laboratory
(lab) test.
 What are the baseline investigations carried out?

• Base line investigations like total leukocyte

and neutrophil count are routinely carried out
in every center due to the ease of availability
and interpretation.
• Total leukocyte count and neutrophil count
are among the commonly performed base-line
investigations.
Comparison of True Appendectomy and Negative
Appendectomy