Abbas Hussain, Rahil M Rahman, Muhammad Jawaid Akhbar, Omer Fateh, Jamaluddin M, Tanveer Alam.
Assessment of knowledge & management of cases of acute appendicitis by general practitioners.
Pak J Surg Jan ;22(2):116-8.

Objective: To evaluate the knowledge, attitude and practices of local Family Physicians/GeneralPractitioners towards the management of acute appendicitis, in order to provide guidelines for prompt referral and thus avoid unnecessary complications. Design & Duration: A survey conducted from June to July 2005 on the basis of non probability convenience sampling. Setting: Department of Surgery (Unit I), Abbasi Shaheed Hospital, Karachi. Methodology: A performa was designed, containing 13 different questions, to assess the various aspects of the diagnosis and early management of acute appendicitis. General Practitioners (GPs) belonging to different areas of Karachi were then visited and requested to fill the performa, and the data analyzed. Results: A total of 64 GPs were enrolled in this study. All replied that clinical examination is the most important step for the diagnosis of acute appendicitis and it must be operated immediately. Sixteen (25 %) thought that acute appendicitis can not be diagnosed on history and examination alone. About 73% responded that increase in the Total Leucocyte Count is needed for the confirmation of the diagnosis. Twenty three (36%) felt that Urine DR (Detailed Report) is not important for the differential diagnosis of acute appendicitis. Ultrasound Abdomen was considered to be mandatory for suspected male patients by 6 (10%) GPs, while 54 (85%) were of the opinion that ultrasound of the lower abdomen and pelvis is essential to rule out other causes amongst female patients. Conclusion: Acute appendicitis is a common surgical problem, its understanding among local GPs is reasonably good, except a few points that needs to be discussed through continuous medical education programme.

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