scholarly journals Serial estimation of serum myeloperoxidase in patients of acute pancreatitis: A pilot study

2021 ◽  
Vol 3 (2) ◽  
pp. 43-50
Author(s):  
Faraz Ahmed ◽  
Gursagar Singh Sahota ◽  
Vijay Kumar Singh ◽  
Anit Parihaar ◽  
Wahid Ali ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Pilot Study ◽  
Colorimetric Assay ◽  
Severe Disease ◽  
Severity Index ◽  
Prognostic Indicator ◽  
Cross Sectional ◽  
Systemic Complications ◽  
Abdominal Symptoms ◽  
The Mean

Acute pancreatitis (AP) is an inflammatory condition having varied presentation ranging from a mild self-limiting illness to a severe disease with multi organ failure. Excessive recruitment of leukocytosis is an important pathophysiological feature and Myelo-peroxidase (MPO) forms an important part of neutrophil induced inflammation. The current prognostic criteria are complex and cumbersome.: The present cross sectional pilot study serial estimation of plasma MPO levels were done at the time of admission and on 3, 7 and 14 days in patient of Acute Pancreatitis (n=64) patient with acute abdominal symptoms (n=15) otherthan acute pancreatitidand healthy volunteers (n=15). The values of serum MPO levels were correlated with Ransons`s score, Apache score, CT severity index and patient developing local and systemic complications due to acute pancreatitis. Serum MPO levels in (mU/ml) were measured by colorimetric Assay kit (bio Vision, USA). Statistical Analysis on SPSS (Windows version 21.0): The mean serum MPO levels were significantly high in patients of AP as compared to controls comprising of patients with acute abdominal conditions and healthy individuals (mean 12.73 vs 1.67 mU/ml. p< 0.001). The highest levels of serum MPO were observed on the first day of mild and severe AP. The mean MPO levels in mild diseases (n=21 patients) were 3-10 mU/ml and 10-20 mU/ml in severe AP (n=43 patients) who also experienced higher local complications and worse outcome in terms of mortality. MPO returned to normal levels within 7-10days in mild but were persistently raised in patients with severe diseases. The higher serum MPO levels correlated with more severe diseases, worse outcome and can be a simple and effective prognostic indicator in AP.

Clinical Profile and Outcomes in Patients with Acute Pancreatitis attending a Teaching Hospital at Gandaki Province, Nepal

2020 ◽  
Vol 16 (3) ◽  
Author(s):  
Subash Bhattarai ◽  
Merina Gyawali
Keyword(s):  
Acute Pancreatitis ◽  
Severe Acute Pancreatitis ◽  
Age Groups ◽  
Data Entry ◽  
Kidney Injury ◽  
Severity Index ◽  
Clinical Profile ◽  
Cross Sectional ◽  
Systemic Complications ◽  
Keywords Alcohol

Background: Acute pancreatitis (AP) is inflammatory process of pancreas presenting with acute abdominal pain.The majority of patients have mild disease. Some patients develop local and systemic complications with increased morbidity and mortality. This study was undertaken to describe the clinical profile and outcomes in patients with acute pancreatitis.   Methods:  A cross-sectional hospital based study comprising of 62 consecutive patients with acute pancreatitis were enrolled between Jan 2019 to August 2020. Clinical profile at admission, complications and clinical outcomes including mortality were studied. Patients were classified into mild, moderately severe and severe acute pancreatitis based on revised Atlanta classification and modified CT severity index.  Data entry was done in Statistical Packages for the Social Sciences version 20. Results: The mean age of study subjects was 44±10.87 years with 43 (56%) males and 19 (44%) females (M:F=2.1:1). The commonest etiology of pancreatitis was alcohol (53.2%) followed by biliary pancreatitis (37.1%)  The most common presentation was abdominal pain (100%). The most common complication was pancreatic necrosis (21%) followed by acute kidney injury (19.4%) and pleural effusion (17.3%). Majority( 72.6%) was mild and 17.7% had severe acute pancreatitis. Mortality was seen in 6.5% patients. Mortality was observed in patients with persistent complications, organ failure, low serum calcium and high modified CT severity index.   Conclusions: Alcohol and gallstones were the two main etiologies of acute pancreatitis and were common in males, and in middle age groups. Majority presented with mild severity. Mortality was observed in some patients with severe acute pancreatitis.   Keywords: alcohol; biliary; CT severity index; mortality; outcome; pancreatitis          

scholarly journals C reactive protein as a prognostic indicator of severity in patients with acute pancreatitis

2020 ◽  
Vol 7 (4) ◽  
pp. 1169
Author(s):  
Bharath Nayak Ganesh ◽  
Srinivas Nanjangud Masana Setty
Keyword(s):  
Acute Pancreatitis ◽  
Severe Disease ◽  
Scoring Systems ◽  
Prognostic Indicator ◽  
P Value ◽  
High Morbidity ◽  
C Reactive Protein ◽  
Systemic Complications ◽  
Mild Disease ◽  
Reactive Protein

Background: Acute pancreatitis ranges from a mild illness to a severe disease with high morbidity and mortality. Severity affects the treatment and outcome. The existing scoring systems for assessment of its severity require are time consuming and expensive. This study was an attempt to evaluate the effectiveness of C-reactive protein (CRP) as a prognostic indicator and a marker of severity of acute pancreatitis.Methods: This was a prospective observational study conducted between among 50 patients diagnosed with acute pancreatitis. The Ranson’s score and CTSI was calculated for these patients. CRP levels were measured 48 hours after the onset of symptoms. They were observed for the development of local and systemic complications, and outcome. These were compared with the CRP values. Pearson coefficient was used to study the correlation between the variables. A p value of less than 0.05 was considered to be statistically significant.Results: 30 of the 50 patients had no local complications. 14 patients (28%) had peripancreatic collection and 6 (12%) had pancreatic necrosis. 24 of the 50 patients had systemic complications (48%). 25 patients had mild disease and 25 had severe disease as evidenced by the Ranson’s score. These 25 patients with severe disease also had raised CRP (p<0.05). There was no statistically significant correlation between the CTSI and CRP values. 4 patients with CRP values more than 400 succumbed to the illness.Conclusions: CRP can serve as an inexpensive alternative to the conventional severity assessment methods for the prediction of severity and outcome of patients with acute pancreatitis.

Advantages of Modified Computed Tomography Severity Index of Acute Pancreatitis Over Other Scoring System

KYAMC Journal ◽  
2019 ◽  
Vol 10 (2) ◽  
pp. 110-113
Author(s):  
Md Mofazzal Sharif ◽  
Khaleda Parvin Rekha ◽  
Umme Iffat Siddiqua ◽  
Mst Monira Khatun ◽  
AKM Enamul Haque ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Clinical Outcome ◽  
Severe Disease ◽  
Severity Index ◽  
Observer Variation ◽  
Imaging Method ◽  
Close Monitoring ◽  
Early Assessment ◽  
Prompt Treatment

Pancreatitis is one of most complex and clinically challenging of all abdominal disorders. USG and abdominal Computed Tomography (CT) are the most commonly used diagnostic imaging modalities for the evaluation of pancreas. Computed Tomography (CT) is highly accurate and sensitive than USG in both diagnosing as well as demonstrating the extent. Early assessment of the cause and severity of acute pancreatitis is of utmost importance for prompt treatment and close monitoring of patient with severe disease. CT is the imaging method of choice for assessing the extent of acute pancreatitis and for evaluating complications. CT severity index is used to assess prognostic correlation and clinical outcome of acute pancreatitis. Modified CT severity index makes the score easier to calculate and reduces the inter-observer variation. KYAMC Journal Vol. 10, No.-2, July 2019, Page 110-113

scholarly journals Clinical course and outcome in diabetic patients with COVID-19

2020 ◽  
Vol 7 (2) ◽  
pp. e23-e23
Author(s):  
Zahra Davoudi ◽  
Ilad Alavi Darazam ◽  
Farnaz Saberian ◽  
Sina Homaee ◽  
Shervin Shokouhi ◽  
...  
Keyword(s):  
Glycated Hemoglobin ◽  
Clinical Course ◽  
Severe Disease ◽  
Invasive Mechanical Ventilation ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Risk Of Death ◽  
Patients With Diabetes ◽  
The Mean

Introduction: As diabetes is highly prevalent worldwide, understanding particular dimensions of COVID-19 infection in diabetic patients is of significant importance. Objectives: The present research aimed to evaluate the outcome of diabetic patients with COVID-19 infection, and the clinical and biochemical characteristics in survived and non-survived patients. Patients and Methods: The present single-center, cross-sectional study examined laboratory and clinical features of 160 patients with diabetes who had moderate to severe criteria. The obtained data were categorized as survived or non-survived patients and then we compared the clinical characteristics in two groups. Results: In this study, 160 diabetic patients (75 men and 85 women) admitted with moderate to severe Covid-19 were evaluated. The mean age of studied patients was 51-90 years old, with diabetes duration of 5 to 15 years. One hundred thirty-one patients (81.9%) survived, but twenty-nine patients (18.1%) did not survive. Regarding the comparison of symptoms, only the loss of consciousness on admission was higher in non- survived patients; however, a majority of the non-survivors have been admitted to ICU, 23(79.3%) and 26 (89.6%) needed invasive mechanical ventilation; in comparison to survived patients also had a shorter duration of hospital stay (5.5±5.1 versus 8.4±6.1days). Non–survivors more probably suffer from high blood pressure [23 (79.3%) patients versus 80 (61%) patients] and chronic kidney disease [20 (69%) patients versus 9 (6.9%) patients; P<0.001]. Glycated hemoglobin (HbA1c) of more than 9%, and high fasting blood sugar, severe inflammatory response, hepatic, renal, and coagulation impairment was higher in non–survived than those who survived. Conclusion: Multifactorial parameters result in the poor prognosis in diabetic patients; therefore, it is critical for identifying the key clinical, as well as laboratory characteristics of COVID-19 cases that lead to severe disease and increase the risk of death.

scholarly journals Assessment of Thickened Renal Fascia as a Finding at Computed Tomography in the Diagnosis of Acute Pancreatitis

2015 ◽  
Vol 27 (1) ◽  
pp. 4-7
Author(s):  
Rehena Parvin ◽  
Md Naushad Ali ◽  
ASQ Md Sadeque ◽  
AS Mohiuddin ◽  
Nazmun Nahar
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Selection Criteria ◽  
Cross Sectional Study ◽  
Clinical Suspicion ◽  
Sectional Study ◽  
Cross Sectional ◽  
Renal Fascia ◽  
The Mean ◽  
Normal Thickness

This cross sectional study was carried out in the department of Radiology & Imaging, BIRDEM, Dhaka, from January 2012 to December 2012 to find out the sensitivity of thickened renal fascia in diagnosis of acute pancreatitis at CT. Total 50 patients (mean age was 41.64 years with range from 18 to 65 years, 34M/ 16F) with clinical suspicion of acute pancreatitis included in this study after analyzing selection criteria. Total 32(64%) of the 50 clinically suspected cases were diagnosed as acute pancreatitis according to the criteria mentioned in material and methods. The mean thickness of renal fascia in acute pancreatitis was 7.20 ± 3.32 mm (mean±SD) with range from 1 to 13 mm and maximum 18(40%) patients were found having thickened fascia within 4.0 to 6.9 mm. The extension of acute panceatitis only in left side was 71.8%. In 21.8%, the extension was bilateral. In 3.1% the renal fascial thickening was present on right side only .In the remaining 3.1%, renal fascia was not thickened.In 31 (96.8%) patients, the process extended into the anterior pararenal space. Both anterior and posterior renal fascia thickening was observed in 2(6.2%) patients. Normal thickness of renal fascia was found in 1(3.1%) patient. Sensitivity of thickened renal fascia in diagnosis of acute pancreatitis at CT was found 97%, specificity 50%, accuracy 80%, positive predictive value77%, negative predictive value 90%.It can be concluded that renal fascia thickening is an important as well as sensitive (97%) CT feature in the diagnosis of acute pancreatitis.Medicine Today 2015 Vol.27(1): 4-7

scholarly journals Harmless Acute Pancreatitis Score

2022 ◽  
Vol 19 (1) ◽  
pp. 47-50
Author(s):  
Shiv Vansh Bharti ◽  
Anup Sharma
Keyword(s):  
Acute Pancreatitis ◽  
Scoring System ◽  
Poor Prognosis ◽  
Severe Disease ◽  
Cross Sectional Study ◽  
Common Disease ◽  
Intensive Care Unit Care ◽  
Close Monitoring ◽  
Cross Sectional ◽  
Severe Pancreatitis

Introduction: Acute Pancreatitis is a common disease in our region. It can range from mild to severe disease with high mortality rate. It is critical to identify patients who are at high risk for a severe disease course, since they require close monitoring and immediate aggressive treatment. Aims: To compare the effectiveness of Harmless Acute Pancreatitis Score with Ranson’s scoring system in predicting the severity of Acute Pancreatitis. Methods: A prospective cross sectional study was done among 45 patients who were admitted in surgery department over a period of one year with diagnosis of acute pancreatitis. If haematocrit was less than39% in female and less than43% in male, serum creatinine less than two miligram /deciliter and no sign of peritonitis, it was assigned as Harmless Acute Pancreatitis Score Zero. If at least one parameter was abnormal it was assigned as Harmless Acute Pancreatitis Score +. Severe pancreatitis (poor prognosis) was considered in those who required Intensive Care Unit care, who had in hospital mortality and who had hospitalization of more than five days. Patients with on admission Ranson’s score of more than three were suspected to have severe Pancreatitis. Results: There were total 45 patients, 18 females and 27 males. Twenty four patients were assigned as Harmless Acute Pancreatitis Score zero and 21 patients were assigned as Harmless Acute Pancreatitis Score +. Harmless Acute Pancreatitis Score was able to predict correctly in 18 out of 26 patients who fulfilled the criteria of poor prognosis (p<0.001). Conclusion: Harmless Acute Pancreatitis Score proved to be a better screening tool compared to on admission Ranson’s scoring system to predict the severity of Acute Pancreatitis, which may help predict the prognosis of the patient.

scholarly journals An Observational Study to Evaluate Quality of Life in Patients with Melasma in A Tertiary Level Hospital of Pokhara

2021 ◽  
Vol 19 (1) ◽  
pp. 37-41
Author(s):  
Prajwal Pudasaini ◽  
Saraswoti Neupane
Keyword(s):  
Quality Of Life ◽  
Age Of Onset ◽  
Life Quality ◽  
Sun Exposure ◽  
Severity Index ◽  
Cross Sectional ◽  
Medical College ◽  
The Mean ◽  
Hormonal Therapies

Introduction: Melasma is an acquired hyper melanosis that becomes more pronounced after sun exposure. Centro facial which is the commonest pattern followed by Malar and Mandibular are three clinical patterns of Melasma. Genetic influences, exposure to UV radiation, pregnancy, hormonal therapies, contribute to the pathogenesis of melasma. Melasma may considerably have significant effect on quality of life of patients.   Objectives: The present study was conducted to evaluate the effects of melasma in quality of life (QoL) in the form of DLQI (Dermatology Life Quality Index) and severity of melasma according to Melasma Area and Severity Index (MASI).   Materials and Methods: This is a hospital based cross-sectional prospective study conducted in 193 Melasma patients in the Department of Dermatology, Venereology and Leprology, Gandaki Medical College and Teaching Hospital, Pokhara from November 2018 to November 2019. MASI score was calculated and the patients were provided with a Nepali version of DLQI to fill up.   Results: This study included 193 patients. Mean age of patients with melasma was 29.4 ± 8.5 years with maximum reported age of 59 years. The Mean age of onset of disease was 26.5 years. The Mean age of onset of disease had little impact on DLQI. The mean DLQI score was 10.9 ± 5.9, thus indicating “very large effect on patient’s life”. The mean MASI score was 6.6 ± 5.2. It was found that there was no correlation between severity of disease and DLQI scores (p=0.317) Conclusion: Melasma commonly affected females during second and third decades of life. It had a very large effect on patient’s life as assessed by DLQI.    

scholarly journals Prevalence of Sleep Disturbances During COVID-19 Pandemic in a Nepalese Population: A Cross-Sectional Study

2021 ◽  
Vol 18 (3) ◽  
pp. 145-153
Author(s):  
Avinash Chandra ◽  
Pooja Prakash ◽  
Nabina Sharma ◽  
Ayush Chandra
Keyword(s):  
Sleep Quality ◽  
Sleep Disturbances ◽  
Severity Index ◽  
Cross Sectional Study ◽  
Descriptive Statistics ◽  
Sectional Study ◽  
Cross Sectional ◽  
Before And After ◽  
The Mean ◽  
Insomnia Severity

Objectives: The coronavirus disease (COVID-19) pandemic and news of daily increasing cases inside Nepal and worldwide is adding to the fear that leads to anger, anxiety, frustration, and stress, emotions that directly affect sleep quality. This study aimed to assess sleep disturbances during the COVID-19 pandemic in a Nepalese population.Methods: This cross-sectional study recruited 206 Nepali residents who completed anonymous self-administered questionnaires. The Insomnia Severity Index (ISI) questionnaire was used to measure sleep disturbances before and after the COVID-19 pandemic. The gathered data were analyzed using descriptive statistics and inferential statistics using SPSS version 20 statistical software.Results: There was a significant variation in sleep disturbances among Nepalese residents before versus after the COVID-19 pandemic (p<0.001). The prevalence of clinical moderate insomnia has increased tremendously in Nepalese individuals. Before the pandemic’s onset, only 3.9% of the participants had moderate to severe levels of clinical insomnia; after its onset, this value increased to 17.5%. The mean ISI scores were 6.35±4.65 and 8.01±6.01 before and after the pandemic’s onset, respectively.Conclusions: Our study findings suggest that people are suffering tremendously with sleep disturbances and calls for further research and active measures to help increase sleep quality during the COVID-19 pandemic.

scholarly journals Physician-reported Clinical Unmet Needs, Burden and Treatment Patterns of Paediatric Psoriasis Patients: a US and EU Real-world Evidence Study

2021 ◽  
Author(s):  
Marieke M.B. Seyger ◽  
Matthias Augustin ◽  
Michael Sticherling ◽  
Teresa Bachhuber ◽  
Juanzhi Fang ◽  
...  
Keyword(s):  
Severe Disease ◽  
Topical Therapy ◽  
Significant Proportion ◽  
Unmet Need ◽  
Severity Index ◽  
Paediatric Population ◽  
Cross Sectional Survey ◽  
Psoriasis Area Severity Index ◽  
Cross Sectional ◽  
Pasi Score

This study is a retrospective analysis using data collected from the Adelphi Paediatric Psoriasis Disease-Specific Programme cross-sectional survey. Despite being treated for their psoriasis, a substantial proportion of paediatric patients presented with moderate (18.3%) or severe (1.3%) disease at sampling; 42.9% and 92.0% had a body surface area (BSA) of >10%, and 38.8% and 100.0% had a Psoriasis Area Severity Index (PASI) score >10, respectively. Overall, 69.9% of patients had only ever been treated with a topical therapy for their psoriasis. For patients with moderate or severe disease at sampling, 16.3% and 14.4% were currently receiving conventional systemics or biologic therapy, respectively. There is a clinical unmet need in this paediatric population; a considerable percentage of patients still experienced moderate or severe disease and persistent psoriasis symptoms, with numerous body areas affected. A significant proportion of patients were undertreated, which may explain the high burden of disease observed.

scholarly journals Evaluation of KI-67 expression in uterine leiomyoma and in healthy myometrium: a pilot study

2019 ◽  
Vol 65 (12) ◽  
pp. 1459-1463
Author(s):  
Walberto Monteiro Neiva Eulálio Filho ◽  
Eduardo Augusto Sousa Soares ◽  
Maria Simone Oliveira Lima ◽  
Emerson Davi do Nascimento Brazil ◽  
Rodolfo Myronn de Melo Rodrigues ◽  
...  
Keyword(s):  
Pilot Study ◽  
Uterine Leiomyoma ◽  
Analytical Study ◽  
T Test ◽  
Uterine Leiomyomas ◽  
Clinical Parameters ◽  
Pain Level ◽  
Ki 67 ◽  
Cross Sectional ◽  
The Mean

SUMMARY OBJECTIVE Evaluate the expression of KI-67 in uterine leiomyomas and adjacent myometrial tissue and verify the existence of a correlation between clinical parameters and KI-67 expression in tumors. METHODS This is a cross-sectional, controlled, analytical study. Samples of leiomyomas and myometrium were obtained from patients who underwent hysterectomy. The samples were processed by immunohistochemistry using KI-67 antibody, and the expression was evaluated by two blinded observers. Student›s T-test was used for comparison of means, and Pearson›s P test for correlation with clinical parameters. RESULTS A total of 9 patients were included in the study. The mean age was 40.7 years, ranging from 35 to 44 years. The mean expression of KI-67 in myometrium was 1.63%, and, in leiomyomas, 5.96% (p <0.001). The highest expression of KI-67 was moderately related to the severity of anemia, bleeding, and pain level. CONCLUSION The expression of KI-67 in normal myometrium was significantly lower than in leiomyomas. The highest expression of KI-67 was moderately related to the severity of anemia, bleeding, and pain level in the patients of this study.

Sign in / Sign up

Export Citation Format

Share Document