Introduction: Distinguishing between ruptured and non-ruptured acute appendicitis presents a significant challenge. This study aimed to validate the accuracy of RAMA-WeRA Risk Score in predicting ruptured appendicitis (RA) in emergency department. Methods: This study was a multicenter diagnostic accuracy study conducted across six hospitals in Thailand from February 1, 2022, to January 20, 2023. The eligibility criteria included individuals aged >15 years suspected of acute appendicitis, presenting to the ED, and having an available pathology report following appendectomy or intraoperative diagnosis by the surgeon. We assessed the screening performance characteristics of RAMA-WeRA Risk Score, in detecting the ruptured appendicitis (RA) cases. Results: 860 patients met the study criteria. 168 (19. 38%) had RA and 692 (80. 62%) patients had non-RA. The area under the receiver operating characteristic curve (AuROC) of RAMA-WeRA Risk Score was 75. 11% (95% CI: 71. 10, 79. 11). The RAMA-WeRA Risk Score > 6 points (high-risk group) demonstrated a positive likelihood ratio (LR) of 3. 22 in detecting the ruptured cases. The sensitivity and specificity of score in > 6 cutoff point was 43. 8% (95%CI: 36. 2, 51. 6) and 86. 4% (95%CI: 83. 6, 88. 9), respectively. Conclusions: The RAMA-WeRA Risk Score can predict rupture in patients presenting with suspected acute appendicitis in the emergency department with total accuracy of 75% for high-risk cases.

Background: Musculoskeletal symptoms are the main cause of loss of working time, and increase in labor costs. Poor posture is the most important risk factor for work-related musculoskeletal symptoms. This study aimed at evaluating the role of ergonomic risk factors in different surgical (open surgery, laparoscopy, and microsurgery) in the frequency or resonance frequency of musculoskeletal symptoms. Methods: This descriptive-analytic study was conducted on 81 surgeons in a hospital in Tehran. In this study, the prevalence of musculoskeletal symptoms was evaluated using the Nordic Questionnaire. Moreover, Workplace ergonomic risk assessment method (WERA) was used to evaluate ergonomic risk factors in 3 types of open surgery, laparoscopy, and microsurgery. Results: The results revealed that the prevalence of musculoskeletal symptoms of the neck, back, shoulder, and arm is high in surgeons (over 75%). The mean final score of WERA was 40. 11, representing the high risk of the 3 types of surgery for the prevalence of musculoskeletal symptoms. Results revealed that the prevalence of musculoskeletal symptoms in the neck, waist and wrists had a significant relationship with the body posture in the 3 types of open surgery, laparoscopy, and microsurgery (p<0. 05). Conclusion: In the present study, the prevalence of musculoskeletal symptoms was high in the neck, waist, and hands surgeries. Depending on the type of surgery, teaching correct working methods, using proper seats and ergonomic equipment are the best strategies to reduce musculoskeletal symptoms in the surgical profession.

Background and Aim: Sedentary life style increases risk of cardiovascular diseases (CVDs). Physical activity and green tea supplementation can reduce cardiovascular risk factors by improving inflammation and body composition. The aim of study was to determine benefits of 8 weeks of spinning training and green tea supplementation on risk factors cardiovascular and body composition in overweight women. Materials and Methods: A total 32 overweight women based on BMI (Body Mass Index) (27. 1±, 1. 6) and (24. 9±, 3. 6 years) were randomly divided into three groups: Spinning+green tea (n=11), spinning+placebo (n=11) and control (placebo+ no training) (n=10). Training groups carried out 8 weeks of spinning training with an intensity of 11-17 Rating of Perceived Exertion (RPE). Blood sampling were obtained 48 h before starting the interventions and then 48 h after last training session. Serum concentration of hs-CRP (high sensitive C-reactive protein) and blood level of fibrinogen were measured. In addition, BMI and BF% (Body fat percent), bioelectrical impedance analysis was performed. Results: After 8 weeks of interventions only hs-CRP was significantly decreased in spinning+green tea group (P=0. 005). In addition, fibrinogen (P=0. 001), BF% (P=0. 001) and BMI (P=0. 001) were significantly decreased in both training groups. Also, there was significant difference of hs-CRP in the training groups (P=0. 028). However, no significant difference of fibrinogen and BF% were observed between the training groups. In the case of fibrinogen both spinning+green and spinning+placebo groups had a significant difference with control group (P=0. 004), (P=0. 014) respectively. Regarding BF% and BMI only a significant difference wera between the spinning+green and control (P=0. 006), (P=0. 007) respectively. Conclusion: It seems that spinning training has improved risk factors of cardiovascular and body composition. Indeed, green tea supplementation has increased the effectiveness of spinning training.