Assessing the Severity of Acute Pancreatitis with CT Severity Index and Other Conventional Methods in a Tertiary Care Hospital in Tamil Nadu, India – A Comparative Cross-Sectional Study

2021 ◽  
Vol 8 (41) ◽  
pp. 3541-3546
Author(s):  
Jayaprakash Subramani ◽  
Rajesh Prabhu ◽  
Jagadeesapandian Palpandi
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Predictive Value ◽  
Tamil Nadu ◽  
Objective Assessment ◽  
Tertiary Care ◽  
Severity Index ◽  
Apache Ii ◽  
Care Hospital ◽  
Male Predominance

BACKGROUND Acute pancreatitis is not uncommon in surgical practice with variable clinical presentation. Because of its potential notable catastrophic complications, it is mandatory to assess the severity at the earliest. In recent times, the decision making in the management is quite difficult due to its complications and outcome. So, an objective assessment of severity based on clinical and laboratory scoring verses computed tomography (CT) severity is still debate, hence the need for study. The purpose of this study was to compare the efficiency of CT severity index verses APACHE II and Ranson criteria in predicting the severity of acute pancreatitis. METHODS A total number of 36 consecutive cases of acute pancreatitis who were admitted between January 2013 and December 2014 in Apollo Specialty Hospitals – Madurai were included in the study. Written informed consent was obtained from all study participants. RESULTS In our study, out of 36 patients, 30 (83.33 %) were males and 6 (16.66 %) were females. The sex distribution shows a clear male predominance. Most of the patients in the present study belonged to the middle age group. Alcohol was the most common cause accounting for 41.7 % of the cases followed by the billiary pathology. CT severity index was the superior tool for prediction of the prognosis and early complications. CONCLUSIONS When using contrast enhanced computed tomography, it was found that there was a significant correlation between the development of organ failure and severity of pancreatitis. The specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of Ranson and acute physiology and chronic health evaluation – II (APACHE II) at 48 hours of admission with acute pancreatitis does not correlate in determining the severity of acute pancreatitis. KEYWORDS Acute Pancreatitis, Severity Markers, CT Severity Index

scholarly journals Correlation between nasal endoscopy and computed tomography in a tertiary care hospital

2019 ◽  
Vol 6 (1) ◽  
pp. 181
Author(s):  
Vinnakota Sriprakash ◽  
Shalini Singh Sisodia
Keyword(s):  
Computed Tomography ◽  
Chronic Rhinosinusitis ◽  
Paranasal Sinuses ◽  
Predictive Value ◽  
Tertiary Care ◽  
Nasal Endoscopy ◽  
Nasal Discharge ◽  
Common Symptom ◽  
Care Hospital ◽  
The Right

<p class="abstract"><strong>Background:</strong> Chronic rhinosinusitis is associated with morbidity and affects the quality of life of the affected persons and increases their treatment costs. Diagnosis is mainly by nasal endoscopy or by computed tomography which is considered to be the gold standard.</p><p class="abstract"><strong>Methods:</strong> Nasal endoscopy was done for all the patients under local anaesthesia. All the patients also underwent computed tomography and paranasal sinuses and the findings were scored according to Lund Mackay scoring system.  </p><p class="abstract"><strong>Results:</strong> The most common age group was 31-40 years and nasal discharge was the most common symptom seen in 82% of the patients. The paranasal sinuses that were involved were predominantly maxillary sinus in a total of 88% of the patients. 22% of the patients have sinusitis in the anterior ethmoid of the left nose and 20% on the right nose. Bilateral was seen in 22% of the cases. The sensitivity of nasal endoscopy over computed tomography was 95.6% while the specificity was 80%. The positive predictive value was 97.7% and the negative predictive value was 66.7%. The accuracy of the test was 94%.</p><p class="abstract"><strong>Conclusions:</strong> Nasal endoscopy is found to be as good as the computed tomography for the diagnosis of chronic rhinosinusitis and can be used on a regular basis for its detection among the patients. It not only lacks radiation but is also economically viable.</p>

Balthazar Computed Tomography Severity Index Is Superior to Ranson Criteria and APACHE II and III Scoring Systems in Predicting Acute Pancreatitis Outcome

2003 ◽  
Vol 36 (3) ◽  
pp. 253-260 ◽  
Author(s):  
Constantinos Chatzicostas ◽  
Maria Roussomoustakaki ◽  
Emmanouel Vardas ◽  
John Romanos ◽  
Elias A. Kouroumalis
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Scoring Systems ◽  
Severity Index ◽  
Apache Ii

scholarly journals RAPID URINE TRYPSINOGEN-2 DIPSTICK ASSAY TO DIAGNOSE ACUTE PANCREATITIS IN EMERGENCY SETUP

2020 ◽  
pp. 1-4
Author(s):  
Shankar. S ◽  
Kolandasamy. C ◽  
Srinivasan.U. P ◽  
Naganath babu O. L.
Keyword(s):  
Acute Pancreatitis ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Tertiary Care ◽  
Care Hospital ◽  
Dipstick Test ◽  
Early Management ◽  
Laboratory Investigations ◽  
Set Up ◽  
Sensitivity Specificity

Background: Early diagnosis of acute pancreatitis remains a challenge in emergency set up. The early management results in better outcomes but none of the available investigations were rapid and accurate to guide the management in these patients. Hence in suspected cases of acute pancreatitis, the urinary trypsinogen 2 dipstick assay can be used to diagnose them at the earliest in the Emergency setup. The purpose of this study is to determine the accuracy of urine trypsinogen 2 assay in diagnosing acute pancreatitis. Methods: The patients presenting with symptoms consistent with acute pancreatitis to the emergency department, at a tertiary care hospital in Southern India between November 2018 to November 2019 were included in a prospective observational study after obtaining Institutional ethical committee clearance. In addition to the routine investigations done in cases of acute abdomen, patients underwent urine trypsinogen 2 dipstick test. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) were calculated. Results were compared. Results: A total of 50 cases were included in the study. The urine trypsinogen 2 dipstick test was positive in 35 of 37 patients with acute pancreatitis (sensitivity, 94.59%) and in none of 13 patients with abdominal pain but without any evidence of acute pancreatitis (specificity, 100%). The diagnostic accuracy of the urine trypsinogen 2 dipstick test was 96% in this study higher than other conventional laboratory investigations. Conclusion: This study shows that the dipstick test has high diagnostic accuracy and can be considered for regular use for diagnosing pancreatitis along with the conventional methods.

scholarly journals Efficacy of morphological indexing of ovarian tumor: preoperative determination of risk of malignancy

2017 ◽  
Vol 6 (8) ◽  
pp. 3458
Author(s):  
Jagan Aishwarya ◽  
Ramasamy Sasikala ◽  
Syed Dilshath
Keyword(s):  
Predictive Value ◽  
Tamil Nadu ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Female Genital Tract ◽  
Wall Structure ◽  
Care Hospital ◽  
Malignant Tumours ◽  
Morphological Index ◽  
Risk Of Malignancy

Background: Ovarian cancers ranks fifth in cancer death worldwide and in India it ranks third among the female genital tract malignancies. Objective of present study was to assess prospectively the efficacy of morphological indexing (MI) as a method to predict malignancy in sonographically confirmed ovarian tumors.Methods: A prospective study conducted in a tertiary care hospital in Tamil Nadu from September 2011 to August 2012.  The risk of malignancy is preoperatively assessed in 136 patients with ovarian tumour using a morphological index based on tumour volume and wall structure. Each tumour was assigned a score of 0 to 10 based on increasing volume and morphologic complexity. The efficacy of the index was assessed by histopathological examination of the tumour.Results: The benign tumours had a mean MI score of 4.3 and malignant tumours had a mean of 8.3 which was statistically significant. Of the 54 tumours with MI <5, only 2 (3.7%) were malignant where else out of the remaining 82 tumours with MI >5, 54 (51.2%) were malignant. With MI >5 as a predictor of malignancy the present study had a Sensitivity-95.5%, Specificity-56.5%, Positive predictive value-51.2%, Negative predictive value-94%, and Accuracy-68%.Conclusions: Morphological index is a simple, valuable and inexpensive diagnostic tool to rule out malignancy in pre operative evaluations of ovarian tumors.

Diagnostic Accuracy of BISAP Score for Detecting Acute Pancreatitis Keeping Computed Tomography Severity Index as GS

2021 ◽  
Vol 15 (11) ◽  
pp. 3164-3165
Author(s):  
Mohammad Iltaf ◽  
Sana Akhtar ◽  
Dilaram Khan
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Severe Acute Pancreatitis ◽  
Predictive Value ◽  
Gold Standard ◽  
Severity Index ◽  
Cross Sectional

Objective: To establish the diagnostic accuracy of BISAP in detecting the severe acute pancreatitis keeping computed tomography severity index as gold standard. Study Design: Cross-sectional study Place and Duration of Study: Department of Gastroenterology, Hayatabad Medical Complex, Peshawar from April 16th 2018 to 16th October 2018. Methodology: One hundred and twenty nine patients of age range of 18-60, of either gender having severe acute pancreatitis were included. While patients already diagnosed as severe acute pancreatitis and having known history of chronic pancreatitis were excluded. Patients were subjected to CT scan to confirm whether the severe acute pancreatitis is present or not. All CT scans were reported by single experiences radiologist. Results: There were 30.3% were males and 69.7% were females with mean age 42±11.03 years. BISAP had sensitivity 92.74%, specificity 80%, positive predictive value 99.13%, negative predictive value 20.76% and the overall diagnostic accuracy was 92.24%. Conclusion: BISAP had sensitivity 93.61%, specificity 100%, positive predictive value 100%, negative predictive value 40% and the overall diagnostic accuracy was 93.87% in severe acute pancreatitis keeping CT severity index as gold standard. Keywords: Accuracy, Severe acute pancreatitis, Computed tomography

scholarly journals A randomised study of outcome of acute pancreatitis in tertiary care hospital, Gujarat, India (retrospective study of 30 cases)

2018 ◽  
Vol 5 (6) ◽  
pp. 2268
Author(s):  
Jayeshkumar S. Jadav ◽  
Parth H. Shah
Keyword(s):  
Acute Pancreatitis ◽  
Retrospective Study ◽  
Tertiary Care ◽  
Disease Process ◽  
Surrounding Tissue ◽  
Care Hospital ◽  
Surgical Interventions ◽  
Randomised Study ◽  
Male Predominance ◽  
High Risk Factors

Background: Acute pancreatitis is common and lethal condition, often associated with one or more complications in varying degree. Aim of this study is to identify etiological factors and high-risk factors in the patients that can significantly alter the disease process and various presentations of acute pancreatitis and correlate them clinically to assess the severity of disease, to observe the clinical course of the disease, to predict beforehand the possible outcome clinically and to study the different prognostic factors evaluated on the basis of clinical assessment, serial laboratory and radiological investigations; to predict the clinical outcome of the disease, either favourable or unfavourable.Methods: Most of patient (74%) recover well by conservative management. Only 26% patients required surgical management and mortality rate is 6.6% Only.Results: In this retrospective study, we found that incidence of colorectal carcinoma is more between 40-60 years of age with male predominance; lymph node metastasis is more than metastasis in any other sites. CT scan can diagnose lymphatic metastasis and infiltration in surrounding tissue more accurately. Percentage of sphincter saving procedure were low in rectal malignancies in our study.Conclusions: Study shows that not all patient of acute pancreatitis need surgical interventions, rather conservative approach is preferred over surgery now a day. Etiology of pancreatitis was most of the time idiopathic followed by cholelithiasis and alcoholism. Ascites and pleural effusion are two most common complications.

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