Search

Background: Acute appendicitis is a very common cause of acute abdominal pain, requiring surgical intervention with a 7% life time risk. Various clinical scoring systems like Alvarado, appendicitis inflammatory response (AIR), Tzanaki scores enables risk stratification. In this study, we have validated the diagnostic accuracy of various scoring systems like Alvarado, Tzanaki and AIR scores. Methods: We conducted a prospective observational study for patients admitted in a tertiary care hospital. A total of 81 patients were selected based on the inclusion and exclusion criteria. A detailed clinical history, physical examination, relevant blood investigations and necessary imaging were done for all the patients. Using the above data, the probability of acute appendicitis is calculated using the Alvarado, Tzanaki and AIR scores. The various scores obtained were compared with the histopathological examination (HPE) reports (reference standard) and values like sensitivity, specificity, positive and negative predictive values (PPV and NPV) were calculated.Results: With regard to scores, Alvarado scores has a sensitivity 95.24%, specificity 77.78%, PPV of 93.75%, NPV of 82.35%. Tzanaki score has a sensitivity of 100%, specificity 23.5%, PPV of 83.12% and NPV of 100%. AIR score has a sensitivity of 95%, specificity of 66.67%, PPV of 89.06% and NPV of 82.35%. Conclusions: Alvarado score (cut off 7) has the best PPV (93.75%) and hence is the best scoring system to “rule in” a positive diagnosis. However, Tzanaki score (cut off 8) has the best NPV (100%) and hence is the best score to “rule out” a diagnosis of acute appendicitis.

Role of chromium(III) in biological systems is controversial and no significant conclusions can be arrived with the available data. Chromium(VI) enters in to the cell readily and gets reduced to form stable chromium(III) complexes. Chromium(III) complexes react slowly and were considered non-toxic. Recent studies suggest that chromium(III) indeed produce damage to cellular organelle, DNA and proteins and can be lethal to organisms and their offspring. Several chromium(III) complexes synthesized are shown to interact with DNA and bring changes in the conformation of DNA and proteins. In this work, effects of these interactions in the vital process like transcription have been studied. Three Cr(III) complexes with varied ligand environment, ionic character and charge have been chosen for the study to evaluate their ability to interrupt the binding of two different transcription factors Sp1 and TFIID, with their consensus sequences and interruption of the transcription process. Of the three complexes tested [Cr(salen)(H 2 O) 2 ] + is the most efficient inhibitor of transcription factors–DNA (TF–DNA) complex formation and transcription. Inhibition of TF–DNA complex formation and transcription by this complex is concentration-dependent. [Cr(pic) 3 ] does not inhibit both TF–DNA complex formation and transcription. [Cr(ttpy) 2 ] +3 inhibits TF–DNA complex formation at higher concentrations but does not inhibit transcription even at very high concentrations compared to that of [Cr(salen)(H 2 O) 2 ] + . Results of these studies suggest that chromium(III) complexes, though less reactive can still interfere in the important biological process and this interactions are determined by the ligand environment around the complex.