Comparison between RIPASA and ALVARADO scoring in diagnosing acute appendicitis

BACKGROUND AND OBJECTIVE: Acute appendicitis is one of the most common cause of acute abdominal pain and emergency appendicectomy is the most common emergency surgery. The confirmed diagnosis of appendicitis is by histopathological examination which is not possible before appendicectomy. Also the rate of negative exploration remains high in the rate of 15-30%. Scoring systems based on history , clinical examination and basic investigations are there in aiding the diagnosis of acute appendicitis and decreasing negative exploration. This study compares RIPASA and Alvarado scoring systems in diagnosing acute appendicitis. METHODS: A comparative study was done between November 2015 to June 2015. Patients diagnosed as acute appendicitis in department of General Surgery, Govt. Royapettah Hospital. 100 of them are to be selected on the basis of non probability (purposive) sampling method. After considering the inclusion and exclusion criteria 96 were enrolled into the study. A full history, clinical examination and both scoring systems were done on the patients. RESULTS: Out of the 96 patients 46 patients (48%) were male and 50 patients (52%) were female.65 patients underwent emergency appendicectomy based on the clinical decision of a senior surgeon. The sensitivity and specificity of the RIPASA scoring system was 98.0% and 80.43% respectively. The sensitivity and specificity of the Alvarado scoring system was 80.43% and 86.95% respectively. The PPV of RIPASA and ALVARADO was 84% and 85% respectively. The NPP of RIPASA and ALVARADO was 97% and 71% respectively. The Diagnostic Accuracy was 89% for RIPASA and 77% for Alvarado. The Sensitivity, NPV, and Diagnostic accuracy of RIPASA scoring was significantly higher than the Alvarado scoring. (p<0.0001). CONCLUSION: The RIPASA scoring appeared to be a better test for scoring the probability of Acute Appendicitis

Optimization of Gallic Acid Production from Terminalia Chebula by Aspergillus niger

A method for producing gallic acid by microbiological hydrolysis of the tannins of myrobalan seed powder is described in the present work. Hydrolysis of gallotannins of the substrate to gallic acid by Aspergillus niger MTCC 282 was studied. A simple extraction procedure is used. Fungal mycelia pre-induced with 5 g/L gallotannin was used as inoculums. Optimal conditions of production were determined using various parameters including gallotannin concentration, nutritional source and metal ions are determined. Gallotannin is hydrolyzed with acid, and gallic acid in the hydrolyses is then assayed using rhodanine. This method is very specific: no interferences from other plant phenolics, including ellagic acid and condensed tannin, have been observed. The yield of gallic acid with respect to gallotannins present in the substrate is estimated. Yields of gallic acid are about 74% with respect to gallotannin concentration, which suggests that this method is exploitable industrially for the manufacturing trimethoprim drug

Tannase Production by Aspergillus niger

A method for assay of microbial tannase (Tannin acyl hydrolase) based on the formation of chromogen between gallic acid and rhodanine is reported. Maximum Tannase production occurred in the culture broth containing 1-2% (w/v) tannic acid and 0.05 – 0.1% (w/v) glucose. The pH, incubation period, temperature and Glucose concentration optima of Tannase production was found at 5.5, 36 h, 35°C and 0.5% respectively. These properties make the enzyme suitable for pollution control and bioprocess industry. This assay is very simple, reproducible, and very convenient, and with it Tannase activity can be measured in relation to the growth of the organism. Aspergillus niger exhibited higher enzyme activity showing about 65 mole percent conversion respectively after a 36 h incubation period. The assay is complete in a short time, very convenient and reproducible

Optimization of Protease Production from Aspergillus Oryzae Sp. Using Box-Behnken Experimental Design

Protease production by Aspergillus oryzae was optimized in shake-flask cultures using Box-Behnken experimental design. An empirical model was developed through response surface methodology to describe the relationship between tested variable (peptone, glucose, soyabeanmeal and pH). Maximum enzyme activity was attained with Peptone at 4 g∕L; temperature at 30 °C glucose at 6 g∕L; 30 °C and pH at 10. Experimental verification of the model showed a validation of 95%, which is more than 3-fold increase compare to the basal medium