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  • Listino Prezzi Boiron 1 gennaio 2015medici.boiron.it/sites/default/files/23042015_QUARTINO...NUX VOMICA 9 CH granuli 4,20 10% OSCILLOCOCCINUM 6 DOSI 15,00 10% OSCILLOCOCCINUM 30 DOSI
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2019 Vol. 7 No. 1: 3 Short Communication DOI: 10.36648/2254-6758.7.1.108 Journal of Universal Surgery ISSN 2254-6758 1 iMedPub Journals ht tp://www.imedpub.com © Under License of Creative Commons Attribution 3.0 License | This Article is Available in: www.jusurgery.com Awayshih MMA*,Yousef AJ and Nofal MN Department of General Surgery and Anesthesia, College of Medicine, Mutah University, Jordan *Corresponding author: Awayshih MMA [email protected] Department of General Surgery and Anesthesia, College of Medicine, Mutah University, Jordan. Tel: +00962790662682 Citation: Awayshih MMA, Yousef AJ, Nofal MN (2019) Evaluation of Alvarado Score in Diagnosing Acute Appendicitis. J Univer Surg Vol.7 No.1:3 Evaluaon of Alvarado Score in Diagnosing Acute Appendicis Received: May 09, 2019; Accepted: May 27, 2019; Published: June 03, 2019 Abstract Background: Using a reliable scoring system to diagnose acute appendicis can help reduce the rate of unnecessary surgery and, henceforth, its complicaons. This cohort study aimed to evaluate Alvarado scoring system for diagnosing acute appendicis in our health facility. Methods: 100 paents of different age groups with clinical suspicion of acute appendicis admied in the General Surgical Ward, Karak Teaching Hospital in Karak, Jordan, from April, 2013 to December, 2014 were included in the study. All paents underwent surgery and were grouped according to the variables of Alvarado scoring system and then divided into two groups. Group I paents (score 7 or more), group II paents (scores 3-5, and 5-6). Diagnosis was confirmed by histopathologic examinaon. Reliability of scoring system was assessed by calculang negave appendectomy rate and posive predicve value. Results: Out of total 100 paents, appendicis was confirmed 80 paents, thus giving negave appendectomy rate of 20% (male 6%, female 16%). Perforaon rate was 4%, posive predicve value was 90%, negave predicve value of 29%, sensivity of 54%, specificity 75%, and diagnosc accuracy value of 58%. Conclusion: Alvarado score is not sensive tool for aiding diagnosis of acute appendicis. Keywords: Acute appendicis; Appendectomy; Scoring system; Alvarado Score Introducon Acute appendicis is the most common abdominal surgical emergency with a lifeme cumulave incidence of 7% [1]. In 1886; Fitz described the tradional signs and symptoms of acute apendicis [2]. The diagnosis of acute appendicis is basically clinical depending on history, clinical examinaon and somemes aided by laboratory invesgaons (such as white blood cells count or CRP level). Imaging modalies are not requested rounely because they have been shown to add very lile informaon unless there are complicaons. The definive diagnosis is achieved at surgery and aſter histopathologic examinaon of the resected appendix [3]. Delay in diagnosis and management may result in significant morbidity and, somemes, mortality. A number of scoring systems have been developed for aiding early diagnosis of acute appendicis. Previous reports menoned that scoring systems are a valuable and valid instrument of discriminaon between acute appendicis and nonspecific abdominal pain [4]. Alvarado scoring system, introduced in 1986, is one of these systems and is based on history, clinical examinaon and few laboratory findings (Table 1) [5]. Materials and Methods This study was carried out on 100 consecuve paents admied to the Surgical Ward of Karak Teaching Hospital, Karak-Jordan, with the clinical diagnosis of acute appendicis during the period from April 2013 to December 2014. Paents of any age group and both sexes presenng to the emergency department with pain in right iliac fossa pain and operated with appendectomy were included in the study. Paents with clear presentaon of other diagnoses such as urological, gynaecological or acute abdomen condions other than appendicis were excluded from the study. All included paents were admied aſter inial assessment in the emergency department and base-line invesgaons

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Page 1: Listino Prezzi Boiron 1 gennaio 2015medici.boiron.it/sites/default/files/23042015_QUARTINO...NUX VOMICA 9 CH granuli 4,20 10% OSCILLOCOCCINUM 6 DOSI 15,00 10% OSCILLOCOCCINUM 30 DOSI

Prezzo al pubblico consigliato

in Euro - IVA inclusaIVASpecialità

1 gennaio 2015

ARNIGEL 45 g 10,30 10%

ARNIGEL 120 g (disponibile da 1/5/2015) 14,40 10%

ARNICA MONTANA 9 CH granuli 4,20 10%

APIS MELLIFICA 15 CH granuli 4,20 10%

AVENOC unguento 11,00 10%

AVENOC supposte 11,00 10%

BI-OPTIMUM CU - Capelli e Unghie 22,00 10%

BI-OPTIMUM S - Stress 22,00 10%

CAMILIA 11,00 10%

CIDERMA 11,40 10%

COCCULINE 11,50 10%

CORYLIA 11,50 10%

CREMA alla CALENDULA 10,80 10%

CY.TA.FU. 14,50 10%

DAPIS Gel 8,50 22%

DATIF PC 10,90 10%

DOLISOBIOS 15 21,00 10%

DROSETUX 12,00 10%

ENDOTROL 11,30 10%

EUPHRALIA 10 collirio 9,30 10%

EUPHRALIA 30 collirio 19,90 10%

HOMEODENT dentifricio Anice/Clorofilla/Limone 6,80 22%

HOMEODENT dentifricio Gel Fragola-Lampone 5,10 22%

HOMEOGENE 9 11,50 10%

HOMEOGENE 46 11,00 10%

HOMEOPLASMINE 11,40 10%

HOMEOSTICK 6,80 22%

HOMEOX 11,50 10%

INFLUENZINUM (ex Para-F, ex INF) vedi TUBI/DOSI

LENICALM 12,90 10%

MAGNESIUM 300+ 22,50 10%

Listino Prezzi Boiron

Page 2: Listino Prezzi Boiron 1 gennaio 2015medici.boiron.it/sites/default/files/23042015_QUARTINO...NUX VOMICA 9 CH granuli 4,20 10% OSCILLOCOCCINUM 6 DOSI 15,00 10% OSCILLOCOCCINUM 30 DOSI

NUX VOMICA 9 CH granuli 4,20 10%

OSCILLOCOCCINUM 6 DOSI 15,00 10%

OSCILLOCOCCINUM 30 DOSI 34,00 10%

PARA G 11,00 10%

PATES (Baudry, Mandarine, Sambucus) 8,40 10%

POLLENSI’ 10,50 10%

QUIETALIA 11,90 10%

SINALIA 10,50 10%

STODAL granuli 6,50 10%

STODAL sciroppo 11,60 10%

VAL.BIA.PAS. 14,50 10%

Prezzo al pubblico consigliato

in Euro - IVA inclusaIVA

Specialità

Tubi granuli 6,90 10%

Liquidi flacone 30 ml 10,90 10%

Unguenti 11,00 10%

Composé

Oliboi scatola da 15 contenitori monodose Bottelpack® da 2 ml Oligoelementi unitari/complessi 16,50 10%

Scatola da 12 fiale orali in vetro da 1 ml Oligoelementi unitari 16,50 10%

Oligoelementi

Page 3: Listino Prezzi Boiron 1 gennaio 2015medici.boiron.it/sites/default/files/23042015_QUARTINO...NUX VOMICA 9 CH granuli 4,20 10% OSCILLOCOCCINUM 6 DOSI 15,00 10% OSCILLOCOCCINUM 30 DOSI

Prezzo al pubblico consigliato

in Euro - IVA inclusaIVA

Medicinali a Nome Comune

APIS MELLIFICAARNICA MONTANABELLADONNABRYONIAIGNATIA AMARAINFLUENZINUM

LEDUM PALUSTREMERCURIUS SOLUBILISNUX VOMICAPULSATILLARHUS TOXICODENDRON

TUBI CATEGORIA 2 I successivi 45 ceppi alle diluizioni: 5, 7, 9, 15, 30 CH

ACONITUM NAPELLUSACTAEA RACEMOSAALLIUM CEPAALUMINAANTIMONIUM CRUDUMANTIMONIUM TARTARICUMARGENTUM NITRICUMARSENICUM ALBUMBORAXCALCAREA CARBONICA OSTREARUMCALCAREA PHOSPHORICACANTHARISCARBO VEGETABILISCAUSTICUMCHAMOMILLA VULGARIS

CHINA RUBRACOLOCYNTHISCUPRUM METALLICUMDROSERAEUPHRASIA OFFICINALISFERRUM PHOSPHORICUMGELSEMIUM SEMPERVIRENSGRAPHITESHEPAR SULFURHISTAMINUMHYPERICUM PERFORATUMIPECAKALIUM BICHROMICUMKALIUM MURIATICUMLACHESIS MUTUS

LYCOPODIUM CLAVATUMNATRUM MURIATICUMNATRUM SULFURICUMPHOSPHORUSPHYTOLACCA DECANDRAPOUMON HISTAMINEPYROGENIUMRICINUS COMMUNISRUTA GRAVEOLENSSEPIA OFFICINALISSILICEASPONGIA TOSTASTAPHYSAGRIASULFURTHUYA OCCIDENTALIS

TUBI CATEGORIA 3 Tutti gli altri ceppi e diluizioni

TUBI granuli da 4 g (80 granuli ca) TUBI CATEGORIA 1 4,20 10%

TUBI CATEGORIA 2 5,80 10%

TUBI CATEGORIA 3 7,00 10%

TUBI 50/LM 7,00 10%

TUBI CATEGORIA 1 I primi 11 ceppi alle diluizioni: 5, 7, 9, 15, 30 CH

LIQUIDI flacone da 60 ml Tinture Madri 13,90 10%Macerati Glicerici 13,90 10%Sève de Bouleau 13,90 10%Diluizioni 13,90 10%

Page 4: Listino Prezzi Boiron 1 gennaio 2015medici.boiron.it/sites/default/files/23042015_QUARTINO...NUX VOMICA 9 CH granuli 4,20 10% OSCILLOCOCCINUM 6 DOSI 15,00 10% OSCILLOCOCCINUM 30 DOSI

Prezzo al pubblico consigliato

in Euro - IVA inclusaIVA

CEPPI DOSI CATEGORIA 1 I primi 11 ceppi alle diluizioni: 9, 15, 30, 200 CH; 200, 1.000, 10.000 K

ARNICA MONTANACALCAREA CARBONICA OSTREARUMIGNATIA AMARAINFLUENZINUMNATRUM MURIATICUMNUX VOMICA

PULSATILLASEPIA OFFICINALISSILICEASULFURTHUYA OCCIDENTALIS

DOSI CATEGORIA 2 I successivi 10 ceppi alle diluizioni: 9, 15, 30, 200 CH; 200, 1.000, 10.000 K

ARSENICUM ALBUMCALCAREA PHOSPHORICAGELSEMIUM SEMPERVIRENSLACHESIS MUTUSLYCOPODIUM CLAVATUM

MERCURIUS SOLUBILISPHOSPHORUSRHUS TOXICODENDRONSTAPHYSAGRIATUBERCULINUM

DOSI CATEGORIA 3 Tutti gli altri ceppi e diluizioni

Medicinali a Nome ComuneDOSI globuli da 1 g DOSI CATEGORIA 1 3,00 10%

DOSI CATEGORIA 2 4,30 10%

DOSI CATEGORIA 3 6,00 10%

DOSI 50/LM 6,00 10%

FIALE ORALI scatola da 12 fiale da 1 ml Fiale orali 16,50 10%

OVULI scatola da 12 Hydrastis-Calendula ovuli 13,50 10%

UNGUENTI tubo da 20 g Unguenti 11,00 10%

DOSI 200 CH

DOSI GLOBULI 200 CH CATEGORIA 1 5,00 10%

DOSI GLOBULI 200 CH CATEGORIA 2 7,00 10%

DOSI GLOBULI 200 CH CATEGORIA 3 8,50 10%

CEPPI DOSI 200 CH CATEGORIA 1

CEPPI DOSI 200 CH CATEGORIA 2

CEPPI DOSI 200 CH CATEGORIA 3

Via Cassanese, 100 - 20090 Segrate (MI)Servizio Informazioni Boiron 800-032203 - [email protected]

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