scholarly journals Prediction of Severity of Acute Pancreatitis Using Total Serum Calcium and Albumin-Corrected Calcium: A Prospective Study in Tertiary Center Hospital in Nepal

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Ashik Pokharel ◽  
Prem Raj Sigdel ◽  
Suman Phuyal ◽  
Prasan Bir Singh Kansakar ◽  
Pradeep Vaidya
Keyword(s):  
Acute Pancreatitis ◽  
Care Center ◽  
University Teaching ◽  
Total Serum ◽  
Total Calcium ◽  
Health Care Center ◽  
Total Serum Calcium ◽  
Tertiary Center ◽  
Marshall Score ◽  
A Prospective Study

Introduction. Total calcium (TC) and albumin-corrected calcium (ACC) are easily accessible AP severity tests in the Primary Health Care Center of Nepal. The aim of the study was to evaluate TC and ACC as prognostic severity markers in acute pancreatitis (AP). Methods. All patients admitted in Tribhuvan University Teaching Hospital with the diagnosis of AP were studied prospectively over a period of one year from January 2015 to January 2016. TC and ACC were measured in the first 24 hours of admission in each patient. The modified Marshall score was determined at admission and at 48 hours and at any point of time during admission as per the need of the patient. Severity of acute pancreatitis was defined as per the Revised Atlanta Classification 2012. Results. 80 patients of AP were included in the study. Among them, 14% were categorized as having severe AP. The mean total calcium was 8.22, 7.51, and 6.98 for mild, moderate, and severe AP, respectively, which was significant at 0.001. Conclusion. TC and ACC, measured within the first 24 hours, are useful severity predictors in acute pancreatitis.

scholarly journals To Study the Association of Total Serum Calcium Level in Assessing the Severity of Pancreatitis

2021 ◽  
pp. 781-785
Author(s):  
V. Lingesh Kumar ◽  
Saravanan Sundaram
Keyword(s):  
Acute Pancreatitis ◽  
Serum Calcium ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Tertiary Care ◽  
Total Serum ◽  
Total Calcium ◽  
Blood Calcium ◽  
Total Serum Calcium ◽  
Total Serum Calcium Level

Background: Pancreatitis is an inflammatory condition that affects the pancreas and may also affect other tissues or distant organ. In this study our aim is to see if blood calcium level can be used as a prognostic marker in determining the severity of acute pancreatitis because hypocalcaemia is linked to higher mortality and hospitalization. Method: A retrospective study was conducted in the medical records department of a tertiary care health facility. A total of 75 participants were included in the research. .demographic details of all patients were collected .Patients above 18 years who presented with of epigastric pain, pre-Diagnosed gallstones, alcoholism were included int this study. The lowest total calcium levels were collected in order to examine total calcium as a predictive factor for severity. All of these information were collected and analyzed to get the appropriate findings. Results: A total of 75 patients were included in the research. The age of patients in each severity grade did not differ significantly (p value>0.05). The gender distribution of the two groups did not differ. (P >0.05). For mild and severe acute pancreatitis, mean total calcium levels were 7.98 and 6.67, respectively, which was statistically significant (p< 0.05). Conclusion: The total serum calcium level is a useful indicator for assessing  pancreatitis.

scholarly journals Total serum calcium and corrected calcium as severity predictors in acute pancreatitis: a prospective study in a tertiary hospital in South India

2017 ◽  
Vol 4 (2) ◽  
pp. 560
Author(s):  
Unnikrishnan Edakkepuram ◽  
Muhammad Navas N. K. ◽  
Sasi M. Parambil ◽  
Siddharth Matad
Keyword(s):  
Acute Pancreatitis ◽  
Prospective Study ◽  
Serum Calcium ◽  
Gall Stone ◽  
Tertiary Hospital ◽  
Total Serum ◽  
Total Serum Calcium ◽  
Systemic Complication ◽  
Maximum Period ◽  
A Prospective Study

Background: Acute pancreatitis still remains a disease of growing burden to mankind; it is an unpredictable, potentially lethal disease with a high mortality. The incidence of acute Pancreatitis appears to be increasing. Aim of the study was to evaluate total serum calcium and corrected calcium as prognostic severity factors in acute pancreatitis.Methods: This prospective study was conducted in a tertiary hospital from July2015 to June 2016. All the patients who were diagnosed to have acute pancreatitis by clinical examination, laboratory, radiological and biochemical investigations were considered as cases. Serum calcium and albumin corrected calcium measured within 24 hours of admission. Patients followed up for a maximum period of 4 weeks and outcome studied, in terms of whether patient had local or systemic complication, mortality. Significance of serum calcium and albumin corrected calcium in predicting outcome of acute pancreatitis is assessed and compared with BISAP score.Results: Acute pancreatitis most commonly occurs in the age group of 30-50. 80% of acute pancreatitis occurs in male and 20% in female. Alcoholism accounts for 58% cases of acute pancreatitis and gall stone account for 28% of acute pancreatitis.Conclusions: Hypocalcaemia and low ACC can predict severity of acute pancreatitis, as with BISAP score, but it is not superior to BISAP score.

scholarly journals Total serum calcium and corrected calcium as a predictor of severity in acute pancreatitis

2018 ◽  
Vol 5 (11) ◽  
pp. 3558
Author(s):  
Kemparaj T. ◽  
Narasimhamurthy K. N. ◽  
Archit Muralidhar
Keyword(s):  
Acute Pancreatitis ◽  
Hospital Admission ◽  
Epigastric Pain ◽  
Tertiary Care ◽  
Previous History ◽  
Total Serum ◽  
P Value ◽  
Total Calcium ◽  
Total Serum Calcium ◽  
Significant Difference

Background: Acute pancreatitis is an acute inflammatory process of the pancreas. The Ranson and the modified Glasgow scores require 48 hours of data collection to asses’ severity. Hypocalcaemia is one of the components of Ranson's scoring system done to assess the severity of pancreatitis. Albumin-corrected calcium (ACC) has also been associated with severity, but no study has evaluated it as a prognostic severity factor within the first 24 h of the patient’s hospital admission. This study tries to evaluate total calcium and albumin corrected calcium as prognostic severity markers in acute pancreatitis within first 24 hour of admission.Methods: This prospective study was conducted in Bowring and Lady Curzon hospital, a tertiary care centre from June 2016 to May 2018. Inclusion criteria included all patients above 18 years of age, who presented within 72 hours of onset of epigastric pain. The clinical and demographic data with respect to gender, age, previous history of pancreatitis, total calcium taken 24 h after admission. In order to evaluate total calcium and albumin corrected calcium as prognostic factors of severity, the lowest total calcium values were collected within the first 24 h of hospital admission. These values were then corrected according to the serum albumin level.Results: A total of ninety-four patients were included in the study. There was no significant difference in the age of patients in each severity grade (p value: 0.242). No difference was observed in gender distribution of three groups. (P >0.05). As compared to total calcium, mean values of albumin corrected calcium were 8.03, 7.18 and 6.28 for mild, moderate and severe acute pancreatitis respectively, which were also significant at 0.05.Conclusions: Total calcium and albumin-corrected calcium obtained within the first 24 hours of hospital admission are useful predictors of severity in acute pancreatitis.

scholarly journals HYPOCALCEMIA AFTER PARATHYROIDECTOMY

2020 ◽  
Vol 23 (2) ◽  
pp. 75-79
Author(s):  
L. P. Kotelnikova ◽  
G. Yu. Mokina ◽  
N. G. Polyakova
Keyword(s):  
Parathyroid Hormone ◽  
Calcium Level ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Total Serum ◽  
Primary Group ◽  
Total Calcium ◽  
Baseline Serum ◽  
Median Baseline ◽  
Total Serum Calcium

The aim of the study was to estimate the frequency and timing of hypocalcemia after surgical treatment for primary, secondary and tertiary hyperparathyroidism. Materials and methods. 21 patients were operated for hyperparathyroidism, 15 - for primary (group 1), 6 - for secondary and tertiary (group 2). In I group the median baseline level of total serum calcium was 3.06 mmol/l, phosphorus0.9 mmol/l, and parathyroid hormone360 pmol/l. In II group all patients were on program dialysis for end-stage chronic kidney failure for at least five years. The median baseline serum total calcium level was 2.29 mmol/l, phosphorus2.64 mmol/l, and parathyroid hormone-1822 pmol/l. Results. A day after removal of the parathyroid adenoma (1 group) the level of calcium and phosphorus was normalized, the content of parathyroid hormone (median 21.4 pmol/l) significantly decreased. In one case (6.7%) on the fifth day there were clinical signs of hypocalcemia and the level of calcium decreased to 1.86 mmol/l. All patients of the second group underwent subtotal parathyroidectomy. After a day the level of parathyroid hormone significantly decreased (median227 pmol/l). The phosphorus content has returned to normal. The calcium level in all cases exceeded 2 mmol/l. On day 4-5 the total calcium content decreased and ranged from 1.14 mmol/l to 2.04 mmol/l. Four patients (66,7%) showed clinical signs of hypocalcemia. It was found that the development of hypocalcemia has a positive correlation of average value with the level of parathyroid hormone, phosphorus and negative with the content of calcium before surgery. Conclusion. The decrease in the level of total calcium with the development of clinical symptoms occurs on 4-5 days after surgery for primary hyperparathyroidism in 6.7% and for secondary or tertiary - in 66.7%. Risk factors for hypocalcemia are the baseline low level of calcium and high of parathyroid hormone, phosphorus.

scholarly journals A Prospective Study to Observe the Results and Complications of Lateral Internal Sphincterotomy in Anal Fissure

2015 ◽  
Vol 2 (2) ◽  
pp. 81
Author(s):  
Sandesh Pawar ◽  
Sudhir D. Bhamre ◽  
Vijay Malpathak ◽  
Yamini Sorate
Keyword(s):  
Anal Fissure ◽  
Care Center ◽  
Time Frame ◽  
Lateral Internal Sphincterotomy ◽  
Health Care Center ◽  
Internal Sphincterotomy ◽  
Medical College ◽  
A Prospective Study ◽  
Surgery Department

<strong>Aim</strong>: To observe the results and complications of lateral internal sphincterotomy in anal fissure. <strong>Materials&amp;Methods:</strong> The study was carried out as a prospective observational study of 40 patients at surgery department of a medical college&amp;tertiary health care center, over a period of two years that included cases of anal fissure in the age group of 16 years and above for conservative&amp;surgical management. <strong>Results</strong>: The recovery of the patient after this marvellous operation was fast and the pain relief was dramatic. On follow-up at 2 weeks post-operatively pain and other symptoms were present only in 11 patients (27.5%). On follow-up at 8 weeks post-operatively all 40 patients (100%) were symptom-free in this study. The complications that were observed within time frame of this study were Soiling in 4 patients (10%) and incontinence to flatus in 1 patient (2.5%). There was no recurrence of anal fissure observed in this study group within the time frame of this study. <strong>Conclusion</strong>: It is very evident from the above study that 'Lateral Internal Sphincterotomy' is by far the best operation for an indolent anal fissure.

scholarly journals Ultra-widefield retinal imaging for adjunctive resident training in retinal break detection

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253227
Author(s):  
I-Hung Lin ◽  
Chien-Cheng Chien ◽  
Yi-Hao Chen ◽  
Shu-i Pao ◽  
Jiann-Torng Chen ◽  
...  
Keyword(s):  
Care Center ◽  
Resident Training ◽  
Junior Resident ◽  
Health Care Center ◽  
Indirect Ophthalmoscopy ◽  
Retinal Breaks ◽  
Significant Difference ◽  
Central Image ◽  
A Prospective Study ◽  
Junior Residents

We evaluated the clinical utility of ultra-widefield imaging as an adjunctive tool for training resident ophthalmologists in the detection of retinal breaks. This was a prospective study conducted at a secondary health care center (Tri-Service General Hospital) in Taiwan. Participants were 44 patients (53 eyes) who were referred to our hospital after being diagnosed with retinal breaks. Patients first underwent an indirect ophthalmoscopy examination of the total fundus without scleral depression by our junior (first and second year) or senior (third and fourth year) resident ophthalmologist and then underwent an ultra-widefield imaging examination with a central image and four gaze-steered (up, down, nasal, and temporal) images to determine the number of retinal breaks in the total fundus and the four quadrants. Of the total 53 eyes, 31 were examined by junior residents and 22 were examined by senior residents. In the group of junior residents, ultra-widefield imaging was significantly better at detecting retinal breaks of the total fundus (49 vs. 33 retinal breaks, p < 0.001) and the temporal quadrant (17 vs. 10 retinal breaks, p = 0.018) than indirect ophthalmoscopy. In the group of senior residents, there was no significant difference in the ability to detect retinal breaks in the total fundus or each of the four quadrants with ultra-widefield imaging or indirect ophthalmoscopy. Our results indicate that, compared to indirect ophthalmoscopy, ultra-widefield imaging with a central image and four gaze-steered images has a better performance and is a useful adjunct tool for the detection of retinal breaks in junior resident training. Additionally, it could be a useful method for teaching indirect ophthalmoscopy examination to junior residents.

Biological and Analytic Components of Variation in Long-Term Studies of Serum Constituents in Normal Subjects

1971 ◽  
Vol 17 (10) ◽  
pp. 983-987 ◽  
Author(s):  
Eugene K Harris ◽  
David L DeMets
Keyword(s):  
Normal Individual ◽  
Normal Subjects ◽  
Total Serum Protein ◽  
Total Serum ◽  
Total Calcium ◽  
Intraindividual Variation ◽  
Total Serum Calcium ◽  
Normal Individuals ◽  
Long Term Studies

Abstract Intra- and interindividual components of variation in ionized calcium among normal individuals have been estimated. The basic data were means of duplicate analyses of total serum calcium, total serum protein, and serum albumin from 68 normal subjects, 10-12 weekly samples per person. The McLean-Hastings equation was used to estimate [Ca2+]. Use of observed albumin/globulin ratios, instead of an assumed constant, had negligible effect on mean [Ca2+] or components of variation. The interindividual component of variation in [Ca2+] was found to be the same as that in total calcium: 3%. Average intraindividual variation (0.045-0.05 mmol/liter), appeared to be entirely attributable to analytical deviations in total protein and total calcium determinations. Thus, in the average normal individual, no physiologic variation in [Ca2+] could be detected. Results agreed with recent data on [Ca2+] measured by calcium ion-selective electrodes.

Interference by hemolysis with various methods for total calcium and its correction by trichloroacetic acid precipitation.

1983 ◽  
Vol 29 (8) ◽  
pp. 1497-1500 ◽  
Author(s):  
K M Chan ◽  
C Arriaga ◽  
M Landt ◽  
C H Smith ◽  
R H Ng
Keyword(s):  
Atomic Absorption ◽  
Trichloroacetic Acid ◽  
Acid Treatment ◽  
Acid Precipitation ◽  
Total Serum ◽  
Direct Reaction ◽  
Positive Bias ◽  
Total Calcium ◽  
Serum Samples ◽  
Total Serum Calcium

Abstract We evaluated the influence of hemolysis on total serum calcium as determined with the Du Pont aca, SMA 12/60, Ektachem 400, Corning 940 EGTA titrator, and the Beckman Astra 8, comparing results with those obtained by atomic absorption spectroscopy. We find that hemoglobin does not influence calcium measurements with the SMA 12/60, Ektachem 400, or Beckman Astra 8. The presence of hemoglobin exceeding 2 to 3 g/L caused falsely high results with the aca and falsely low results with the Corning 940 titrator. Similar interferences may be observed with other titrating or colorimetric procedures that involve direct reaction of the sample with o-cresolphthalein complexone or calcein. Upon removal of the hemoglobin by precipitation with trichloroacetic acid, the values obtained with the aca and the Corning 940 EGTA titrator were similar to those measured by atomic absorption. With nonhemolyzed serum samples the acid treatment had little or no effect on the aca procedure but resulted in a positive bias of approximately 10% with the EGTA procedure. Thus we recommend this trichloroacetic acid procedure for measuring calcium in hemolyzed samples with the aca and, with certain reservations, with the EGTA titrator.

scholarly journals Study of discrepancies in ABO blood grouping: experience of a tertiary health-care center

2021 ◽  
Vol 9 (12) ◽  
pp. 3621
Author(s):  
Kruti J. Nathani ◽  
Jitendra N. Patel ◽  
Kamal A. Patel ◽  
Sangeeta J. Wadhwani
Keyword(s):  
Blood Group ◽  
Care Center ◽  
Tertiary Care ◽  
Blood Bank ◽  
Red Cell ◽  
Group Iii ◽  
Health Care Center ◽  
Abo Incompatibility ◽  
Group I ◽  
A Prospective Study

Background: An accurate ABO grouping is the most important test which is done in the blood bank. Mistyping can lead to transfusion with ABO incompatible blood which results in severe intravascular haemolysis and may even result in the death of the recipient. An ABO discrepancy implies that the forward or red cell ABO grouping does not agree with the reverse or serum ABO grouping. The study was conducted to evaluate the frequency of ABO blood group discrepancies, to identified main causes of discrepancies, to avoid chances of wrong interpretation of blood group and to mitigate clinical impact associated with mismatch ABO transfusion.Methods: A prospective study of ABO discrepancies and their causes was performed on 25,129 samples of the patients and 13,251 samples of blood donors at the red cell serology laboratory in tertiary care teaching hospital and blood bank over the period from February 2017 to July 2018.Results: ABO group discrepancies were mainly divided in 4 different groups. Out of 51 discrepancies 32 (62.74%) were found in group-IV category, being highest amongst all; 10 (19.60%) in group-II which was second highest; other were 8 (15.69%) in group-I and 1 (1.96%) in group-III category.Conclusions: All discrepancies reported on ABO cell and serum grouping must be investigated further, so that correct blood group is reported, minimizing the chances of transfusion reaction. A note of caution should be mentioned on the blood group card to prevent ABO incompatibility in case of transfusion.

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