IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 19, Issue 1 Ser.12 (January. 2020), PP 26-29 www.iosrjournals.org DOI: 10.9790/0853-1901122629 www.iosrjournals.org 26 | Page A Comparative Study on Alvarado Scoring Vs Tzanakis Score System in Diagnosis of Acute Appendicitis Dr. Upendra Kumar 1 , Dr. Milandeep 2 , Dr. Gajendra Pandit 3 , Prof. Dr. Sudhir Khichy 4 , Prof. Dr. R. S. Sharma 5 1 Rajendra institute of medical sciences, Ranchi 2 Guru Gobind Singh Medical College, Faridkot 3 Rajendra institute of medical sciences, Ranchi 4 Guru Gobind Singh Medical College, Faridkot 5 Rajendra institute of medical sciences, Ranchi Corresponding Author:- Dr. Milandeep Abstract: Background: Acute appendicitis is the most frequent surgical emergency encountered worldwide. Diagnostic errors are common resulting in median incidence of perforation 20% and negative appendicectomy 2% to 30%.This study was conducted to compare the efficacy of Alvarado scoring and Tzanaki scoring in diagnosing acute appendicitisand to reduce the negative appendicectomy rate. Methodology: Prospective observational nonrandomized study conducted in general surgery department. which included 50 clinically diagnosed cases of acute appendicitis who underwent emergency open appendicectomy from Jan 2019 to Dec 2019.Final diagnosis was based on histological findings given by the pathologist. Results: The sensitivity, specificity, positive predictive value and negative predictive value of Tzanakis score was 79.62%,83.3%,97.72% and 31.25% respectively and of Alvarado score was 61.9%,50.0%,86.6% and 15% respectively. Negative appendicectomy in Tzanakis scoring was 12% and in Alvarado scoring was 16%. Conclusion: Tzanakis score is an effective modality to establish the accurate diagnosis of acute appendicitis and helps in reducing negative appendicectomy rate. Keywords: Acute appendicitis; Tzanakis score; Alvarado score --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 07-01-2020 Date of Acceptance: 23-01-2020 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Acute appendicitis has a lifetime risk of 8.6% and 6.7% in men and women respectively [1-3]. The accuracy of clinical examination in diagnosing acute appendicitis is 70 to 87% [4,5]. Approximately 20% to 33% of patients with suspected acute appendicitis have atypical findings making clinical diagnosis difficult.[6,7]. Diagnostic errors are common resulting in median incidence of perforation 20% and negative appendicectomy 2% to 30%. Alvarado score [8] is widely used in diagnosing acute appendicitis; a score of 7 or more is considered diagnostic requiring surgery [9]. Its sensitivity and specificity ranges from 73-90% and 87- 92% respectively [10,11]. Tzanaki score [12] is a combination of clinical evaluation and ultrasonography and inflammatory markers.There are together 4 variables and 15 points and a score of more than 8 is diagnostic for appendicitis requiring surgery. Its sensitivity, specificity are 95.4% and 97.4% respectively [12]. This study compares the efficacy of Tzanaki and alvarado scoring to diagnose acute appendicitis and reduce the rate of negative appendicectomy. II. Materials and methods It is a prospective study nonrandomized observational study conducted in general surgery department. Written informed consent was taken from each study subject at the time of enrolment. A total of 50 patients clinically diagnosed to have acute appendicitis are studied who underwent clinically diagnosed cases of acute appendicitis emergency open appendectomy from Jan 2019 to Dec 2019. Tzanakis and alvarado scores were obtained at the time of admission. and postoperatively specimen is sent for histopathological examination. Final diagnosis of acute appendicitis is based on histopathological reports. Alvarado scoring:  Migratory abdominal pain-1  Anorexia-1  Nausea/vomiting-1