scholarly journals Serum Amylase Level in Acute Organophosphorus Compound Poisoning in a Tertiary Level Hospital

2021 ◽  
Vol 22 (2) ◽  
pp. 119-126
Author(s):  
Palash Kumar Biswas ◽  
Partha Sarathi Sarker ◽  
Md Monjurul Kader Chowdhury ◽  
Muntasir Islam Chowdhury ◽  
Kashfia Shawki ◽  
...  

Background: Organophosphorus compound (OPC) poisoning is an important clinical problem in the developing world and kills an estimated 3,00,000 people every year. In spite of high case fatality rate early and proper management is crucial to save the lives and alleviate the sufferings. Amylase level is an important biochemical marker, which is closely related to severity of acute OPC poisoning. Therefore, to assess Serum amylase level in acute organophosphorus compound poisoning in a tertiary level hospital was the objective of the study. Methods: This research was a hospital based descriptive cross-sectional study and was conducted at the inpatient department of Medicine in Dhaka Medical College. 50 Patient admitted in medicine department due to OPC poisoning and evidenced by history taking and physical examination were included in the study. Ethical issues were ensured properly. After written informed consent history and physical examination were done. Rest of the data were collected by interviewing each patient or from attendant of the patient by using a semi-structured questionnaire. Scoring of the severity were done by researcher himself by Peradeniya Organophosphorus Poisoning (POP) scale (Score range 0 to 11). Values of amylase level were collected from patient record file. All the Data was analysed by computer with the help of SPSS 16. Results: Out of a total of 50 patients, 24 (48%) were males and 26 (52%) were females. OPC poisoning was most frequent (52%) in age group 21-30 years. Mean age was 23.96 ± 6.071 SD. 96% (48) study population were Muslim and rest 4 % (2) were Hindus with diverse occupation. 86% population came from rural area whereas only 14% population reside in urban area. Among them suicidal attempts were seen significantly which was 96% and rest of them were accidental ingestion. Amylase level estimation were done in each case and 32 % (16) patient had elevated amylase level (>100U/L) and 68% (34) patient had amylase level within normal limit. Mean amylase concentration was 62.2U/L (SD±18.77) and among the 16 patients who had elevated serum amylase level mean concentration was 376.56U/L (SD±266.124). Mean amylase level differed significantly between these two groups (p value < 0.0001) estimated by one way ANOVA. Spearman Correlation and One way ANOVA both showed significant association between severity (assessed by POP scale) and elevated level of serum amylase (p value <0.0001). Outcome analysis showed that 47 patients recovered and 3 patients died. Their mean hospital stay was 3.87 (±1.76) days and relationship between serum amylase level and duration of hospital stay and was found to be significant in chi-square analysis (p value- <0.0001). Conclusion: Hyperamylasaemia in OPC poisoning can be used an important biomarker to assess the severity of the patient which may guide the clinicians for further management. J MEDICINE 2021; 22: 119-126

Author(s):  
Aniket Patil ◽  
Sunil Kumar ◽  
Anil Inamdar ◽  
Sourya Acharya ◽  
Anil Wanjari ◽  
...  

Abstract Introduction Prompt recognition and aggressive management of acute intoxication due to organophosphorus poisoning are essential to minimize the morbidity and mortality. The present study was undertaken to know the prognosis and outcome of organophosphorus poisoning patients with the estimation of low-cost enzymes like the serum amylase level in a population with financial constraints. Method In this cross-sectional study, we had enrolled 100 cases that had a history of exposure to organophosphorus compounds, and the serum amylase level was measured in all the patients. We assessed the outcome of all the patients in the form of discharge, need of ventilators, intensive care unit stay, and death. Results The mean serum amylase level in discharge patients was 335.40 ± 192.45, and in the patients who died it was 843.37 ± 22.60. It was significant to predict the outcome (t-value 7.07, p-value 0.0001, statistically significant). Conclusion Serum amylase level shows significant correlation with clinical outcomes in organophosphorus poisoning.


2021 ◽  
Vol 29 (1) ◽  
pp. 230949902098821
Author(s):  
Md Kamrul Ahsan ◽  
Md Sariful Hasan ◽  
Md Shahidul Islam Khan ◽  
Najmus Sakeb

Purpose: To perform retrospective analysis of 75 post-operative disc space infections after open lumbar discectomy (OLD) and to assess the outcome of their medical and surgical management in a tertiary-level hospital. Methods: Records of 50 men and 25 women aged 26–65 (mean, 42.53) years who underwent treatment for post-operative discitis (POD) after single level OLD at L3–4 (n = 8), L4–5 (n = 42), L5–S1 (n = 25) level. The POD was diagnosed according to specific clinical signs, laboratory and radiographic investigations and all of them received initial intravenous antibiotics (IVA) for at least 4–6 weeks followed by oral ones. Successful responders (n = 55) were considered in Group-C and remainder [Group-S (n = 20)] were operated at least after 4 weeks of failure. Demographic data, clinical variables, hospital stay, duration of antibiotic treatment and post-treatment complications were collected from the hospital record and assessment before and after treatment were done by using visual analogue scale (VAS) and Japanese Orthopaedic Association (JOA) score. Comprehensive outcome was evaluated by modified criteria of Kirkaldy-Willis. Results: The mean follows up was 36.38 months. Significant improvement of mean VAS and JOA score was achieved in both conservative (76.36% satisfactory) and operative (90% satisfactory) groups although the difference was statistically insignificant. Conclusion: Although insignificant, early surgical intervention provided better results (e.g. functional outcomes, length of hospital stay and duration of antibiotic treatment therapy) than conventional conservative treatment in post-operative discitis.


2021 ◽  
pp. 57-59
Author(s):  
Hakimuddin Malvi ◽  
Syed Maqsood Husain

Background: India has been recognized as the diabetes capital of the world by the year of 2025 Hypertension is a signicant danger factor for cardiovascular infection, stroke and ischemic coronary illness. Objective: The aim of this paper is prevalence of hypertension amid patients with type 2 diabetes mellitus- at a tertiary level hospital in central India. Methods: Present work is hospital based cross-sectional study was conduct in Chirayu Medical College & Hospital, Bhopal. The study population consisted of total 300 subjects. Data obtained directly from patients and patients medical les, and the following data were included in the study . Results: The results showed that the after using chi-square test we found that hypertension was signicantly higher p value(<0.05) among female patients (69%),patients with long duration diabetes (77%)10 years and more, also it was signicantly higher among patients with current smokers (69%). Conclusion: In this study the prevalence of hypertension is increasing in patient with T2DM. Hypertension was the most danger factor for micro vascular and macro vascular confusion of T2DM.


2009 ◽  
Vol 2009 ◽  
pp. 1-3
Author(s):  
Masayuki Obatake ◽  
Yusuke Yamane ◽  
Takayuki Tokunaga ◽  
Yasuaki Taura ◽  
Yukio Inamura ◽  
...  

A case of traumatic pancreatitis with subsequent joint pain and osteolytic lesions is presented. A 10-year-old girl was admitted to our hospital with abdominal pain caused by blunt epigastric injury. She was diagnosed with traumatic pancreatitis, and multiple pancreatic pseudocysts subsequently developed. Two weeks after admission, she complained of joint pain, and MR revealed osteolytic lesions of both knee joints. On the 58th day, endoscopic transgastric pseudocyst drainage was performed. Joint pain and osteolytic lesions resolved rapidly, in parallel with the decrease in serum amylase level and pseudocyst size.


2013 ◽  
Vol 12 (3) ◽  
pp. 163-165
Author(s):  
IO Oluwatowoju ◽  
◽  
EO Abu ◽  
G Lawson ◽  
◽  
...  

We report the case of a 72 year old man with a history of COPD and heavy alcohol consumption who was initially diagnosed with acute pancreatitis based on a presentation with epigastric pain and elevated serum amylase. Review of his notes revealed several previous similar admissions and extensive normal investigations apart from persistently elevated amylase. Further analysis showed evidence of macroamylasaemia which accounted for the apparently high serum amylase level.


2016 ◽  
Vol 4 (2) ◽  
pp. 115-121
Author(s):  
Arezu Nejabatian ◽  
Farzad Rahmani ◽  
Rozbeh Rajaei Ghafori ◽  
Samad Shams Vahdati ◽  
Parizad Varghayi ◽  
...  

Author(s):  
Anita Verma ◽  
Prerna Harsh

Background: Gallstone disease (GSD) is one of the most common gastrointestinal diseases. Gallstones represent a significant burden for health care systems worldwide and are one of the most common disorders presenting to emergency room. Methods: Hospital based case control study conducted at Department of Biochemistry with close collaboration of Department of General Surgery, S. P. Medical College and associated group of PBM Hospital, Bikaner, Rajasthan. Results: The insignificant serum amylase level difference in case group (47.80± 21.24) as compares to control group (45.97± 16.38). Conclusion: In this study comparison of amylase between case and controls group showed that the levels of amylase in cholelithiasis patients were higher than that of the control group, but there was no significant variation in amylase. Keywords: Amylase, cholelithiasis, Gallstone disease (GSD).


2020 ◽  
Author(s):  
Ze-Hui Lv ◽  
Da-Qing Kou ◽  
Shi-Bin Guo

Abstract Background: To evaluate the value of the 3-hour post-ERCP serum amylase level for early prediction of post-ERCP pancreatitis (PEP). Method: A study of 206 patients performed ERCP was analysed. The patients with PEP were recorded. ROC curves were used to statistically analyze the data. Results: PEP occurred in 21 patients (10.19%). The 3-hour post-ERCP pancreatic amylase level was used as the test variable, and the PEP occurrence as the state variable to plot ROC curve. The area under the curve (AUC) was 0.816 , and was statistically significant (P<0.001). The standard error (SE) was 0.0507, the 95% confidence interval (CI) was 0.756-0.866, and the optimal cut-off value was 351U/L (sensitivity 76.19%, specificity 83.24%, positive likelihood ratio 4.55, negative likelihood ratio 0.29, Youden index 59.43%). The ROC curves were plotted for both serum amylase and lipase respectively. The areas under the ROC curves were statistically significant(P<0.001). The area under the ROC curve for the 3-hour post-ERCP lipase was 0.778, the 95% confidence interval was 0.673-0.862, and optimal cut-off value was 1834 U/L. The area under the ROC curve for the 3-hour post-ERCP serum amylase was 0.780, and the 95% confidence interval was 0.676-0.864. The optimal cut-off is 380U/L, and there was no statistically significant difference between the two for diagnostic accuracy. According to gender, there was no statistically significant difference in the diagnostic accuracy. In the male group, 436 U/L serum amylase provided the greatest diagnostic accuracy with sensitivity(SE) of 70.5%, specificity(SP) of 89.2%, positive predictive value (PPV) 87.5%, and negative predictive value (NPV) 78.1%. Whereas, in the female group, 357U/L serum amylase provided the greatest diagnostic accuracy with sensitivity of 76.9%, specificity of 81.2%, positive predictive value of 80.4%, negative predictive value of 77.9%. Conclusions: 1. The 3-hour post-ERCP serum amylase level is a useful measurement for predicting post-ERCP pancreatitis. 2. There was no significant difference between serum amylase and lipase 3-hour post-ERCP for predicting PEP. 3. There was no statistically significant difference between male and female using the 3-hour post-ERCP serum amylase level to predict PEP. For female, the optimal cut-off value was 357 U/L, whereas male 436U/L .


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