Acute appendicitis is one of the most common surgical emergencies in clinical practice, with an estimated lifetime prevalence of approximately 1 in 7. Different techniques have been devised to assist in equivocal cases in attempts to decrease negative appendicectomy rates. Except USG and CT as a principal imaging technique for appendicitis, several clinical systems have been developed to aid in the diagnosis of acute appendicitis. Several scoring systems exist specifically for appendicitis are the Alvarado score, the Modified Alvarado score, the Samuel score, Kharbanda's Low Risk score, the Lindberg score, the Ohmann score, the RIPASA score etc. here the present study has been attempted to assess the reliability and practical applicability of the widely used Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scoring system and comparison of the RIPASA and the modified Alvarado scoring system in the diagnosis of acute appendicitis among patients attending North Bengal Medical College and Hospital, West Bengal, India. Total 98 patients including males and females undergoing emergency appendicectomy in Department of General Surgey, North Bengal Medical College were considered for present study. Depending on the clinical details and investigation, RIPASA scoring system and Modified Alvarado Score System has been administered with corroboration of Histopathological report. Sensitivity, specificity, positive predictive value (PPV) and negative predictive (NPV) for RIPASA & Alvarado system was done. The RIPASA scoring system in the present study had sensitivity of 96.29, specificity 76.4, positive predictive value 95.1, negative predictive value 81.25% and diagnostic accuracy 92.85% whereas Modified Alvarado score had sensitivity of 76.82%, specificity of 88.23%, positive predictive value of 96.92%, negative predictive value of 45.45%, and diagnostic accuracy of 81.25%.The present study revealed that RIPASA scoring system is more convenient, accurate, and specific scoring system for Indian population than Alvarado scoring system.

Background: Several diagnostic aids have been developed to improve diagnosis in suspected acute appendicitis. Modified Alvarado Score includes signs and symptoms associated with ones degree of clinical suspicion. Graded Compression Ultrasonograpy is used in many institutions to aid the diagnosis of acute appendicitis.

BACKGROUNDCarcinoma of Stomach is the fourth most common malignancy. Before planning an operation, correct staging of the disease is important. Contrast Enhanced Computerized Tomography (CECT) is considered to be important for this purpose. Much controversies exist as to the value of CECT in the preoperative staging of carcinoma of stomach. The objective of the present study was to compare the efficiency of CECT with the operative findings in cases of carcinoma of stomach.

Background: For successful management of acute appendicitis, early diagnosis and intervention is needed. Incorrect diagnosis may allow significantly increased morbidity and mortality. Several studies across the globe shows that Modified Alvarado Scoring System (MASS) does not need high end instrument and can be done in emergency situation for accessing acute appendicitis and reducing the chances of unnecessary surgery. To access the efficacy of MASS for diagnosis of acute appendicitis in remote areas with primary health care facilities, present study was done at Siliguri of Darjeeling district of West Bengal which was 580 km distant from state capital (Kolkata).Methods: A cross sectional study over a period of 16 months was conducted among the patients admitted at North Bengal Medical College and Hospital suspected to have acute appendicitis. The diagnosis was confirmed by histopathological examination. Written consent was obtained from the patients before commencement of the study. MASS was applied to the patients and the results were compared with histopathological findings. Appropriate statistical analysis has been done by SPSS (version 16.0).Results: A total of 75 patients (44 males and 31 females) were considered. The sensitivity and specificity of MASS in this study were 75.86% (71.43% for males and 80% for females) and 82.61% (80% for males and 87.5% for females) respectively. Study revealed statistically significant (p<0.000) association between Histopathological report and MASS.Conclusions: To reduce the chances of negative appendectomy and for better diagnosis of appendicitis, MASS may be more useful at primary health care centres those are located in remote areas as it was very simple, easy and cost effective.

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