W Indian Med J
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Comparative Study
Ultrasound and white blood cell counts in suspected acute appendicitis.
The use of radiological studies as diagnostic tools in patients with suspected acute appendicitis has increased recently. In this setting, abdominal ultrasonography is viewed as a possible means of avoiding unnecessary surgery. This retrospective study of patients who underwent laparotomy for suspected acute appendicitis was undertaken to determine the sensitivity and specificity of ultrasound in diagnosing acute appendicitis and the frequency of leucocytosis in patients in whom the diagnosis was confirmed by histology. ⋯ Ultrasound showed 92% specificity and 29% sensitivity for the pre-operative diagnosis of appendicitis. The positive predictive value of ultrasonography (83%) was higher than that of leucocytosis (69%). The sensitivity and specificity of ultrasound and leucocytosis in this study indicate limited utility as preoperative diagnostic tools.
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The development of policies in health and healthcare should incorporate ethical premises as well as thoughtful consideration of the values pertinent to the particular society and the goals to be achieved by specific policies. Social inequalities, changing values, and emergent challenges to traditional beliefs, add complexities that require a thorough analysis to compile policies that are fair and equitable. This article provides some recommendations for clinicians, health administrators, policy makers and technocrats who often grapple with complex health issues.