scholarly journals Clinical profile, degree of severity and underlying factors of acute pancreatitis among a group of Bangladeshi patients

2018 ◽  
Vol 12 (1) ◽  
pp. 6-10
Author(s):  
Indrajit Kumar Datta ◽  
Md Nazmul Haque ◽  
Tareq M Bhuiyan
Keyword(s):  
Acute Pancreatitis ◽  
Gall Stone ◽  
Clinical Findings ◽  
Clinical Profile ◽  
Clinical Feature ◽  
Specific Clinical Feature ◽  
The Mean ◽  
Severity Of The Disease ◽  
Degree Of Severity ◽  
Recorded Diagnosis

Background and objectives: Acute pancreatitis is a common condition for hospital admission. In Bangladesh, no study has yet investigated the clinical profile, degree of severity and underlying factors of acute pancreatitis. The aim of the present study was to determine the clinical profile, degree of severity and underlying factors of acute pancreatitis in a cohort of Bangladeshi patients.Methods: This prospective study was conducted from April 2016 to March 2017 on patients admitted with acute pancreatitis at Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital, Dhaka, Bangladesh. History and clinical features of each patient was systematically recorded. Diagnosis of acute pancreatitis was made by clinical findings, serum amylase and lipase levels (> 3 times the upper limit of normal values), evidences of acute pancreatitis by ultrasonography and computed tomography (CT). Severity of acute pancreatitis was classified according to the revised version of Atlanta classification.Results: A total of 40 patients with acute pancreatitis were enrolled in the study. Male and female were equally distributed. The mean age was 44.3±2.7 years. Among 40 cases, 26 (65.0%) and 14 (35%) had moderate and severe acute pancreatitis respectively. No specific clinical feature including ascites or pleural effusion was found significantly related to severity of the disease. Gall stone and metabolic (hypertriglyceridaemia/hypercalcemia) causes were present in 62.5% cases, but none had significant association with the severity of the disease.Conclusion: The present study has demonstrated that no specific observed clinical feature or underlying factor was related to the degree of severity of acute pancreatitis in a cohort of Bangladeshi patients.IMC J Med Sci 2018; 12(1): 6-10

scholarly journals Clinical Profile and Underlying Cause of Acute Pancreatitis among a Group of Bangladeshi Patients

2020 ◽  
Vol 32 (1) ◽  
pp. 21-24
Author(s):  
ANM Saifullah ◽  
Madhu Sudan Saha ◽  
Bimal Chandra Shil ◽  
Ali Monsur Md Shariful Islam ◽  
Arifa Akhter ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Gall Stone ◽  
Clinical Profile ◽  
Medical Emergency ◽  
High Morbidity ◽  
Cross Sectional ◽  
Medical College ◽  
North East ◽  
Medicine Today

Introduction:Acute Pancreatitis is a medical emergency, which is one of the most common conditions for hospital admission. Very few studies have yet investigated in Bangladesh. Objective of this study was to define demographic characteristics, clinical profile & underlying etiologies. Materials and Methods: This hospital based cross sectional descriptive study was performed in Sir Salimullah Medical College Mitford Hospital, Dhaka & North East Medical College, Sylhet, Bangladesh from January 2015 to December 2017. One hundred and five consecutive patients of acute pancreatitis (AP) were enrolled for this study. Clinical features and investigations were systematically recorded. Diagnosis of acute pancreatitis was made by the presence of the two of the three following criteria: i. abdominal pain consistent with the disease ii. serum amylase and /or lipase greater than three times from the upper limit of normal, and/or iii. characteristic findings of abdominal imaging. Results: Total of 105 patients took part in the study, of them 65 were male. The mean age was 42.76 ±15.88. Abdominal pain & vomiting was the most common mode of presentation. Gall stone and hypertriglyceridaemia were responsible of 20% of acute pancreatitis. Ascariasis also causes acute pancreatitis in two patients. Conclusion: Acute pancreatitis is a condition associated with high morbidity and mortality. Ascariasis also causes acute pancreatitis in endemic area. Patients usually respond conservative treatment but endoscopic treatment is effective in few cases. Surgery is rarely required. Medicine Today 2020 Vol.32(1): 21-24

scholarly journals Role of Computed Tomography In The Evaluation of Severity of Acute Pancreatitis

KYAMC Journal ◽  
2017 ◽  
Vol 7 (2) ◽  
pp. 738-744
Author(s):  
Md Mofazzal Sharif ◽  
Mahfuz Ara Ferdousi ◽  
Md Towhidur Rahman ◽  
Nayeema Rahman ◽  
Md Nayeem Ullah ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Acute Pancreatitis ◽  
Clinical Outcome ◽  
Surgical Intervention ◽  
Gall Stone ◽  
Severity Index ◽  
Clinical Findings ◽  
Time Period ◽  
Mild Acute Pancreatitis

Title: Role of computed tomography in the evaluation of severity of acute pancreatitis.Introduction: Early diagnosis and determination of severity of acute pancreatitis is important for management and it depends largely on severity of disease. Medical treatment of mild acute pancreatitis includes conservative management while severe acute pancreatitis requires intensive care to surgical intervention (open or minimally invasive) in selected cases.Methodology: This prospective study was carried out to find out the correlation between modified CT severity index and patient's clinical outcome in acute pancreatitis enrolling 96 subjects in the department of Radiology and Imaging, BIRDEM during two years time period. Severity of acute pancreatitis was assessed by both clinical and imaging staging (Modified CT severity index) in mild, moderate and severe groups.Result: Mean age ( ± SD) of the study subjects was 35.48 ± 14.59 years and number of male was 60 (62.50%) and female was 36 (37.50%). Acute pancreatitis was associated with hypertriglyceridemia (19.79%), gall stone (12.5%), post ERCP (6.25%) and alcoholism (2.08%). Aetiology was unidentified in 59.73% subjects. Majority of the subjects with acute pancreatitis presented with abdominal pain, fever (20.08%), vomiting (54.41%) and oedema (25%). On imaging, diffuse pancreatic enlargement was noted in 29.16% subjects. Pancreatic inflammation with and without peripancreatic fat involvement were observed in 27.08% and 72.91% subjects respectively. Pseudocyst formation (13.54%), ascites (30.20%), renal fascia involvement (46.87%) and pleural effusion (37.5%) were seen in CT scan. Severity of acute pancreatitis was evaluated by clinical findings and CT severity index and the measure of agreement between clinical and imaging staging was almost perfect. CT severity index in acute pancreatitis had statically significant relation with clinical outcome (0.573), organ failure (0.674), need for surgical intervention (0.463) and hospital stay (0.235).Conclusion: Modified CT severity index in acute pancreatitis correlates with patient outcome. During reporting if this simple scoring system is applied then we can easily measure the severity and determine whether patient need medical or surgical intervention.KYAMC Journal Vol. 7, No.-2, Jan 2017, Page 738-744

scholarly journals BANDS NEUTROPHILS LEVELS CHARACTERIZATION AND THEIR DYNAMICS AT TREATMENT OF ACUTE ALIMENTARY PANCREATITIS PATIENTS

2019 ◽  
Vol 43 (4) ◽  
pp. 16-20
Author(s):  
Y. V. Avdosiev ◽  
K. M. Pankiv ◽  
S. D. Khimich ◽  
I. V. Belozоrov ◽  
O. M. Kudrevych ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Inflammatory Process ◽  
Primary Treatment ◽  
Repeated Measurements ◽  
Surgical Department ◽  
Course Materials ◽  
Significant Difference ◽  
Severity Of The Disease ◽  
Process Damage ◽  
Degree Of Severity

Abstract Purpose of the study. To evaluate changes of bands nuclear neutrophils level and their dynamics parameters during treatment in patients with acute alimentary pancreatitis based on repeated measurements and taking into account the severity of the course. Materials and methods. Seventy patients with acute alimentary pancreatitis were examined, who treated in Surgical Department of Vinnitsa Regional M. I. Pirogov Clinical Hospital. Average age was 45,4 ± 13,87 years. Severe pancreatitis was found in 34 (48,57%) people, in 25 (35,72%) – moderate, 11 (15,71%) persons had mild forms. The severity of the disease was assessed using the Atlanta classification (2012). To achieve aim of study the repeated measurements of the stabs neutrophils levels were performed for all patients. Statistical analysis was performed using STATISTICA 13. Results. The significant difference between the stabs neutrophils values identified in patients with acute alimentary pancreatitis was proved, taking into account the severity of the course, both during the primary measured (p = 0,04), during treatment (p = 0,004), and after its completion (p < 0,00001). The significant increase of stabs neutrophils level associated with increasing severity of acute pancreatitis, as in the primary treatment of patients (τ = 0,23, p = 0,005), with determination during treatment (τ = 0,31, p = 0,0001) and after its termination (τ = 0,49, p ≤ 0,00001) was determined. When comparing the indexes of stabs neutrophils determined by repeated measurements, a rapid and continuous decrease of their values was found, as a whole in the group – by 3,76 times, and in the groups with a mild course of the inflammatory process – 6,75 times, the average degree of severity – in 5,11 times and severe forms – 3,05 times. Conclusions. High informativeness of evaluation stabs neutrophils level and their dynamic during repeated measurements in patients with acute alimentary pancreatitis taking into account the severity of the course has been proved. Keywords: acute alimentary pancreatitis, stabs neutrophils level, inflammatory process, damage to the pancreas, acute pancreatitis of alimentary genesis.

scholarly journals Clinical profile and outcomes of patients with acute pancreatitis and correlation with severity index from a tertiary care centre in South India-retrospective analysis

2021 ◽  
Vol 8 (6) ◽  
pp. 814
Author(s):  
Sultan Nawahir ◽  
Babu Kumar S. ◽  
Bala Kasi Naik ◽  
Ealai Athmarao Parthasarathy
Keyword(s):  
Acute Pancreatitis ◽  
Negative Correlation ◽  
Clinical Profile ◽  
Systemic Hypertension ◽  
Serum Lipase ◽  
Positive Correlation ◽  
Weak Positive Correlation ◽  
Study Population ◽  
Weak Negative Correlation ◽  
The Mean

Background: Acute pancreatitis is an inflammatory condition of the pancreas having a varied clinical presentation. It is one of the commonest causes of abdominal pain requiring hospital admission. This retrospective study aims to describe the clinical profile and outcomes of patients with acute pancreatitis and its correlation with severity index.Methods: All patients admitted with a diagnosis of acute pancreatitis to medical gastroenterology department between January 2018 to December 2020 were included in this retrospective study.Results: A total of 61 subjects were included in the final analysis. The mean age was 41.64, the ranged between 19 to 88 years. Among the study population, 53 (86.89%) were male and 8 (13.11%) were female. Among the people 43 (70.49%) were alcoholics, 22 (36.07%) were smokers, 11(18.03%) had systemic hypertension and 5 (8.20%) participants had type 2 diabetic mellitus. The mean CTSI was 2.15±2.82, the mean Balthazar was 3.43±2.4 and the mean procalcitonin was 2.52±9.28. The mean Lipase was 7822. There was a weak positive correlation between CTSI and CRP (rs value: 0.147, p=0.260). There was a weak negative correlation between Balthazar and CRP (rs value:-0.067, p=0.606).Conclusions: Among the study population, 87% of the patients were males. 70% of the population were alcoholics. Mean serum lipase was 7822. There was a weak positive correlation between CTSI and CRP (rs value: 0.147, p=0.260). There was a weak negative correlation between Balthazar and CRP (rs value:-0.067, p=0.606).

Immunoreactive phospholipase A2 in serum in acute pancreatitis and pancreatic cancer.

1985 ◽  
Vol 31 (7) ◽  
pp. 1116-1120 ◽  
Author(s):  
T J Nevalainen ◽  
J U Eskola ◽  
A J Aho ◽  
V T Havia ◽  
T N Lövgren ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Acute Pancreatitis ◽  
Phospholipase A2 ◽  
Clinical Severity ◽  
Pancreatic Acinar Cells ◽  
Alcoholic Pancreatitis ◽  
Time Resolved ◽  
The Mean ◽  
Immunoreactive Phospholipase A2 ◽  
Severity Of The Disease

Abstract Immunoreactive phospholipase A2 (EC 3.1.1.4) was measured by a new sensitive time-resolved fluoroimmunoassay in the serum of 58 healthy subjects and 103 patients with acute pancreatitis. Patients with acute pancreatitis were grouped according to the etiology and clinical severity of the disease. The mean phospholipase A2 concentration in the reference (healthy) group was 5.5 (SD 1.9) micrograms/L. In acute pancreatitis the mean phospholipase A2 concentration was increased on the first day after hospital admission in all groups, and returned to normal somewhat more slowly than did serum amylase, especially in the patients with severe alcoholic pancreatitis. In this latter group the mean concentration of serum phospholipase A2 on the first day was 42.6 (SD 29.5) micrograms/L. In patients with pancreatic cancer, serum phospholipase A2 was 29.2 (SD 21.3) micrograms/L. The phospholipase A2 and amylase values were closely associated in all groups. The clinical sensitivities were 90.9% for severe alcoholic pancreatitis and 87.5% for pancreatic cancer. Immunochemical determination of phospholipase A2 in serum provides fast and specific detection of injury to pancreatic acinar cells. In addition to the early diagnosis of acute pancreatitis, follow-up determinations of phospholipase A2 seem to be useful in differentiating between mild and severe forms of pancreatitis.

scholarly journals Clinical profile of patients with acute pancreatitis in a tertiary care centre in Tripura: A retrospective study

2020 ◽  
Vol 11 (6) ◽  
pp. 96-100
Author(s):  
Surajit Kumar Das ◽  
Saswati Das
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Retrospective Study ◽  
Necrotizing Pancreatitis ◽  
Gall Stone ◽  
Clinical Profile ◽  
Morbidity And Mortality ◽  
Common Disease ◽  
Grading System ◽  
Etiological Factors

Background: Acute Pancreatitis is a common disease with wide clinical variation and its incidence is increasing. Acute pancreatitis is an inflammatory process leading to abdominal pain, progressive destruction of exocrine tissue and in some patients a loss of endocrine tissue as well, with multiple organ failure and high mortality. Severity of acute pancreatitis is linked to the presence of systemic organ dysfunction and/or necrotizing pancreatitis. Aims and Objective: The present study was aimed to study the clinical profile of acute pancreatitis, the etiology and complications of acute pancreatitis received treatment in the Department of Surgery, Tripura Medical College & Dr. BRAM Teaching Hospital, Agartala, Tripura. Materials and Methods: This was a hospital based retrospective study which was conducted from January 2019 to December 2019. All patients with a diagnosis of acute pancreatitis were included in this study in order to find out the clinical presentations from the available clinical, laboratory and radiological data. Result: Of the 100 patients in this study, 96 were male and 4 were female. Minimum age in our study was 10 years and maximum were 70 years. Maximum numbers of patients were below 45 years of age. Alcohol was identified as the most important etiological factor associated with acute pancreatitis. Among the known etiological factors 90% of the cases were related to alcoholism and 4% were due to gall stone disease. Abdominal pain and vomiting were the most common symptoms in our study. Epigastric tenderness was present in 90% of the cases and guarding/rigidity in 50% of cases. 14% patients showed jaundice as a sign of acute pancreatitis. There was no major difference between the CT grading system and clinical grading system. Most of the patients recovered with conservative treatment. Adverse outcome was noted in one patient with acute necrotizing pancreatitis. Conclusion: Acute pancreatitis is one of the leading causes of increase in morbidity and mortality to society. Clinical assessment along with radiological findings correlated well with the morbidity and mortality. Our study identifies alcoholism as one of the most important etiological factors.  

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          

Clinico-Haematological Alterations in Goats Affected with Ruminal Acidosis

2017 ◽  
Vol 13 (02) ◽  
Author(s):  
P. R. Chavelikar ◽  
G. C. Mandali ◽  
D. M. Patel
Keyword(s):  
Clinical Signs ◽  
Clinical Manifestations ◽  
Nasal Discharge ◽  
Mean Values ◽  
Ruminal Acidosis ◽  
Reduced Body ◽  
Muscle Twitching ◽  
Haematological Profile ◽  
The Mean ◽  
Severity Of The Disease

Ruminal acidosis is one of the most important clinical emergencies in sheep and goats resulting into high mortality rate. In the present study, eight healthy farm goats and 24 goats presented to the TVCC of the college with clinical signs of ruminal acidosis like anorexia, tympany, increased pulse and respiratory rate, reduced body temperature, doughy rumen, enteritis, oliguria, grinding of teeth, purulent nasal discharge, muscle twitching, arched back, dehydration and recumbency with rumen liquor pH below 6 were examined for haematological alterations using autohaematoanalyzer. Among various haematological parameters evaluated from acidotic goats, the mean values of Hb (12.21±0.17 vs. 10.86±0.15 g/dl), TEC (14.28±0.16 vs. 12.04±0.36 ×106/ μl), TLC (13.43±0.11 vs. 11.11±0.27 ×103/μl), PCV (36.91±0.53 vs. 29.88±0.55%), neutrophils (64.54±0.93 vs. 28.13±0.92%), MCV (23.38±0.37 vs. 19.38±1.34 fl) and MCH (7.03±0.08 vs. 6.31±0.25 pg) were found significantly increased, while the mean values of lymphocytes (28.00±0.82 vs. 65.38±0.80%) and MCHC (24.55 ±0.26 vs. 34.88±0.97 g/dl) were decreased significantly from the base values of healthy goats. It was concluded that ruminal acidosis induced due to accidental heavy ingestion of readily fermentable carbohydrate rich grains and food waste significantly altered the haematological profile concurrent with clinical manifestations in goats, and hence can be used to assess the severity of the disease.

scholarly journals Rhinocerebral mucormycosis secondary to severe acute pancreatitis and diabetic ketoacidosis: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jinjing Wang ◽  
Yao Li ◽  
Shuai Luo ◽  
Hong Zheng
Keyword(s):  
Acute Pancreatitis ◽  
Diabetic Ketoacidosis ◽  
Severe Acute Pancreatitis ◽  
Clinical Findings ◽  
Severe Form ◽  
Optimal Treatment ◽  
Diabetic Patients ◽  
Rhinocerebral Mucormycosis ◽  
Patient Prognosis ◽  
Treatment Window

Abstract Introduction Rhinocerebral mucormycosis is a rare and severe form of opportunistic fungal infection that can develop rapidly and cause significant mortality, particularly among diabetic patients suffering from ketoacidosis. Diagnosing rhinocerebral mucormycosis during the early stages of infection is challenging. Case presentation We describe a case of rhinocerebral mucormycosis secondary to severe acute pancreatitis in a patient suffering from diabetic ketoacidosis. In this case, the condition was not diagnosed during the optimal treatment window. we therefore provide a thorough overview of related clinical findings and histopathological characteristics, and we discuss potential differential diagnoses. Conclusions In summary, we described a case of rhinocerebral mucormycosis secondary to severe acute pancreatitis in a patient suffering from diabetic ketoacidosis, with the optimal treatment window for this condition having been missed. This report suggests that a definitive mucormycosis diagnosis can be made based upon tissue biopsy that reveals the presence of characteristic hyphae. Early diagnosis and treatment are essential in order to improve patient prognosis.

scholarly journals Disease phenotype analyses of relapsing-remitting multiple sclerosis in Canada and Saudi Arabia

2015 ◽  
Vol 42 (S1) ◽  
pp. S32-S32
Author(s):  
M Alluqmani ◽  
M Alqermli ◽  
G Blevins ◽  
B Alotibi ◽  
F Giuliani ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Saudi Arabia ◽  
Geographic Location ◽  
Clinical Findings ◽  
Cross Sectional ◽  
Relapsing Remitting ◽  
Similar Disease ◽  
The Mean ◽  
Sectional Analysis ◽  
Relapsing Remitting Multiple Sclerosis

Background: Multiple sclerosis (MS) exhibits a spectrum of clinical findings, especially in relapsing-remitting MS (RR-MS). To assess the effects of geographic location and ethnicity on RR-MS phenotype, we investigated RR-MS patients in Canada and Saudi Arabia. Methods: A retrospective cross-sectional analysis of patients receiving active care in MS Clinics was performed in Medina, Saudi Arabia and Edmonton, Alberta. Demographic and clinical data was collected for each patient. Results: 98 patients with treated RR-MS were recruited (n=51, Medina; n=47, Edmonton); 40 patients were Caucasian (Edmonton) while 46 patients were Bedouin (Medina). Although the disease duration was longer in the Edmonton (5.7+2.3 yr) compared to the Medina group (4.4+1.4 yr) (p<0.05), the mean age of RR-MS onset, relapse rate and EDSS change were similar. The female:male ratio was comparable in Edmonton (35:12) and Medina (32:19), as was the risk of optic neuritis. The likelihood of an infratentorial lesion-associated presentation differed (Edmonton, n=23; Medina; n=13) among groups (p<0.05). Spinal cord lesions on MRI were more frequent in Edmonton (n=18) compared to Medina (n=1) patients (p<0.05). Conclusions: Despite differences in location, ethnicity, and a predominance of infratentorial lesion burden the Edmonton group, the RR-MS phenotype displayed similar disease severity and trajectory in these cohorts.

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