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Item type:Publication, Usefulness of the Pediatric Appendicitis Score and Neutrophil to Lymphocyte Ratio for Assessing the Complicated Appendicitis in Children(Scientific Research Publishing, 2020-01-01); ; ; ;Ganbayar LuuzanIntroduction: Acute appendicitis (AA) is a common surgical disease which occurs in almost all age groups, and especially in childhood. Acute appendicitis is one of the most common causes of acute abdomen. The lifetime occurrence of this disease is approximately 7%, with perforation rate of up to 20%. In spite of the well-known classical symptoms and clinical findings of acute appendicitis, early diagnosis can be sometimes challenging. For the treatment of simple appendicitis (SA) in children, the effectiveness of antibiotic treatment has been reported. We aimed to determine predictive value of combination NLR and PAS in pediatric patients with clinical suspicion of acute appendicitis and complicated appendicitis Methods: Our study was performed on 480 children admitted for suspected acute appendicitis and underwent appendectomy at the MNCMCH, Ulaanbaatar Mongolia, between May 2019 and December 2019. White blood count (WBC), Neutrophil, NLR and PAS were compared between groups. Results: The sensitivity, specificity, PPV, NPV of PAS + NLR for differentiating complicated and noncomplicated appendicitis were 86.8%, 89.4%, 92.1% and 76% respectively. The sensitivity, specificity, PPV, NPV of PAS + NLR for diagnosis of acute appendicitis were 90.5%, 68.1%, 97.68% and 32.6% respectively. Conclusion: In the era of conservative antibiotic-based management of uncomplicated acute appendicitis, we advocate that combination of NLR and PAS is a useful aid in predicting complicated appendicitis. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Ultrasound for Appendicitis: Performance and Integration with Clinical and Laboratory Parameters(Mongolian National University of Medical Sciences, 2021-07-01); ; ; ;Ganbayar LuuzanObjective: We aimed to assess the relationship between white blood cell count, pediatric appendicitis score and the measurement of the outer diameter of the appendix. Methods: The study was performed on 480 children admitted for suspected acute appendicitis and underwent an appendectomy at the National Center for Maternal and Child Health, Ulaanbaatar, Mongolia, between May 2019 and December 2019. Clinical diagnosis was performed using the pediatric appendicitis score based on the pre-operative blood test results, including white blood cell count, neutrophil count, lymphocytes count, and neutrophil-lymphocyte ratio. The diameter of the appendix was determined by ultrasound. Results: 516 pediatric patients (≤ 18 years old) were suspected of having acute appendicitis and subsequently underwent surgery. The pediatric appendicitis score and neutrophil-lymphocyte ratio were moderately correlated (r = 0.494), but the neutrophil-lymphocyte ratio and outer diameter of the appendix were poorly correlated (r = 0.169). In patients with an appendix outer diameter of ≤ 6 mm, 44% were inflamed, and 56% were not. Conclusions: Ultrasonic measurement of the outer diameter of the appendix had a 79.8% accuracy. This diagnostic accuracy can be enhanced with the combined usage of the pediatric appendicitis score and the neutrophil-lymphocyte ratio. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Хүүхдийн мухар олгойн цочмог үрэвслийн оношлогоонд PAS болон Alvarado үнэлгээг харьцуулан судалсан ньҮндэслэл: МОЦҮ-ийг эрт оношлон, цаашдын хүндрэлээс сэргийлэх, үрэвсэлгүй мухар олгой авах мэс заслын тоог бууруулахын тулд олон улсад оношлогооны хэд хэдэн онооны системүүдийг эмнэлзүйд нэвтрүүлэн судалж байна1-6 Зорилго: Хүүхдийн мухар олгойн цочмог үрэвслийн оношлогоонд PAS болон Alvarado үнэлгээний оношийн идэвхийг үнэлэх Арга, аргачлал: 2019 оны 9 сараас 2019 оны 12 сарын хооронд ЭХЭМҮТ дээр мухар олгой авах мэс засал хийлгэсэн 3-17 настай хүүхдүүдийн өвчний түүхээс эргэн судлах аргаар хийв. Судалгаанд хамрагсдад дээрх хоёр онооны системийг тус бүр тооцон гаргаж, ROC муруйн шинжилгээгээр босго утгыг тодорхойлов. Үр дүн: Судалгаанд 107 өвчтөнийг хамруулсан ба 89(83.17%) өвчтөнд эмгэгсудлалын шинжилгээгээр онош батлагдсан. Alvarado үнэлгээний дундаж нь МОЦҮ-тэй болон үрэвсэлгүй бүлэгт 6.7 ба 4.2 (P<0.001). PAS үнэлгээний дундаж тус хоёр бүлэгт 7.1 ба 4.8 (P<0.001). ROC муруйн шинжилгээгээр тодорхойлсон босго утга хоёр үнэлгээнд ≥6 байлаа. Дүгнэлт: 1. Alvarado болон PAS үнэлгээ хийж эмгэг судлалын шинжилгээтэй харьцуулан үр дүнг тооцоход мухар олгойн үрэвслийг илтгэх босго оноо 2 үнэлгээнд ≥6 байв. 2. Босго оноог ≥6 үед Alvarado болон PAS үнэлгээний өвөрмөц болон мэдрэг чанарын хувьд ач холбогдол бүхий ялгаагүй байв.
