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Background: Myocardial Pleural TB is one of the most frequent extra-pulmonary manifestations of tuberculosis. Extra Pulmonary tuberculosis is the area of concern for the diagnosis of tuberculosis. Aim of this study is to estimate enzyme Amylase levels in serum and pleural fluids of HIV seronegative exudative tuberculous pleural fluids and their possible role in the diagnosis of tubercular pleural effusion. Methods: A total number of 100 patients were selected to do this study. Selected individuals were randomly included in this study as cases and controls, 50 members each. The samples of blood and pleural fluid were tested for amylase within the stipulated time, on the same day, to prevent the loss of analyte by CNPG method. Results: Among Group I or Cases, the mean value of serum amylase and pleural fluid amylase was 53.044 and 77.122 respectively. Among Group II or controls, the mean value of serum and pleural fluid amylase was 49.508 and 63.238 respectively. Conclusion: Serum and pleural fluid Amylase levels indicate a coexisting pathology of pancreas, gastrointestinal tract and malignancies. According to our study, diagnosing Tuberculous pleural effusion by assessing amylase levels has less sensitivity and specificity.
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Introduction: Etiology of Pancreatitis continues to stir up controversy. The incidence of acute pancreatitis has been reported to vary around the world in different studies. The etiological profile of pancreatitis may be different in different parts of the world and it is therefore important that experiences from different parts of the country be recorded. Alcohol was once thought to be most common etiology. Recent studies in western countries show that non-alcoholic causes include more than 50% of causes of pancreatitis. Aim: The aim this study was to know the etiological factors of pancreatitis and to compare the serum amylase, lipase levels in alcoholic and non- alcoholic patients. Materials and methods: This was a prospective observational study conducted in Gandhi Medical College and Hospital, Secunderabad from December 2012 to November 2014 with duration of 2 years. 75 patients were included in this study according to inclusion and exclusion criteria. Detailed history along with physical examination and laboratory investigations for confirmation of diagnosis and etiology were done. Results: In the present study, out of 75 cases, 40 had significant history of alcohol consumption, while 35 were found to be non-alcoholics. The age group of patients in our study was from 18yrs to 62 years. 20 out of 45 alcoholics were less than 40 years old while 21 out of 35 non alcoholics were less than 40 years old. Out of the 75 cases, 51 were males while 24 were females. In our study alcohol causes pancreatitis in 60% of the cases while non-alcoholic causes of pancreatitis included 40% of cases. Mean amylase, mean lipase and amylase: lipase ratio values were raised more in alcoholics than non-alcoholics. Recurrent pancreatitis was also observed in alcoholics than non-alcoholics. N L Varunmai, Mudumala Issac Abhilash, M Uma Devi, P Shravan Kumar. Incidence and etiology of pancreatitis among alcoholic and non-alcoholic patients. IAIM, 2017; 4(5): 117-121. Page 118 Conclusion: Within limitations of this study, concluded that alcohol remains to be most common cause of pancreatitis in south India (Telangana), incidence of recurrent pancreatitis was significantly high in alcoholics and Serum lipase: amylase ratio more in alcoholics than non-alcoholics.
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Introduction: In India, OP compounds cause more self-poisoning deaths in southern and central India. In Northern India, aluminum phosphide causes most deaths with a fatality ratio. Poisoning due to occupational exposure, accounted for about one fifth of the incidents, with a fatality ratio of less than 1%. More than 90% of the non-occupational incidents were suicidal, with a fatality rate more than 10% and the majority of the subjects are young males. Accidental exposures accounted for 8- 10% of the incidents and homicidal use (less than 1%) were other forms of poisoning. The reported overall mortality following OP insecticide poisoning varies from 4-30% in different countries and institutions. Aim: To estimate serum Amylase levels in acute organophosphorus compound poisoning and the find out the clinical outcomes. Materials and methods: The study was conducted in Government Dharmapuri Medical College Hospital, Dharmapuri. Study duration was from January 2017 to June 2017. Of a total of 145 patients with organophosphorus compound poisoning admitted to the hospital during the study period, 40 were included in the study. 10 healthy (age matched) individuals were kept as a control. Biochemical evaluation which includes Serum Amylase Blood glucose, urea, creatinine, and Liver function tests were analyzed and matched among the two groups. Results: The biochemical results have not shown much variation from the normal levels in our study. P. Elango, G. Indumathi. A study of serum amylase levels in acute organophosphorous poisoning at Government Dharmapuri Medical College Hospital, Dharmapuri. IAIM, 2017; 4(9): 6-11. Page 7 In the study, the Amylase levels were significantly elevated at the time of admission (185.2 U/L) and have shown a gradual remission with proper treatment. The mean Amylase level in severely poisoned patients was 297.7 U/L which was significantly (P < 0.01) higher than the healthy control group. On comparing the Amylase levels in first 24 hours against control, the variations were considered to be significant (P < 0.01). Conclusion: From the observation we made, it could be suggested that OP pesticide poisoning is a serious condition that needs rapid diagnosis and treatment. The mean Amylase level in first 24 hours of OP poisoning was 154 U/L which is significantly higher than the control groups.
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Objective To investigate the clinical risk factors of diabetic ketoacidosis (DKA ) combined with elevated serum amylase(AMS). Methods Totally 263 patients with DKA were enrolled in our study. They were divided into 2 groups according to the level of AMS:DKA with normal AMS (DKA,n=188);DKA with elevated AMS(HAMS,n = 75 ). HAMS patients then were divided into two subgroups according to the diagnosis with acute pancreatitis(AP)(HAMS+ AP,n = 25 )and without AP (HAMS,n = 50 ). TG,FPG and AMS were measured and analyzed with univariate analysis and multivariate analysis. Results HAMS group patients had a ratio of 28.5％ with elevated AMS and 9.5％ with AP.HAMS group had higher FPG,TG,HbA1 c,Na+ ,osmolality,BUN and Scr than DKA group(P <0.05).The levels of FPG,TG,osmolality,BUN and the time of CO2 CP recovery in HAMS+AP subgroup were all significantly higher than those in HAMS patients without AP (P < 0.05 ). Correlation analysis showed that HAMS was positively correlated with TG,FPG,Na+ ,Osmolality and BUN(P <0.05).Logistic regression analysis showed that hypertriglyceridemia was the independent risk factor of DKA combined with HAMS(OR 1.244,P <0.01),and was the independent risk factor of DKA combined with AP(OR 1.211,P <0.05). Conclusion Hypertriglyceridemia is the related risk factor of DKA combined with HAMS and AP. This study provides a theoretical basis to early screen patients with hyperamylasemia in DKA.
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Objective To explore the etiological factors,clinical characteristic and diagnosis of nonacute biliary pancreatitis (NABP) and acute biliary pancreatitis (ABP).Methods The Clinical data of 152 patients with NABP and 206 patients with ABP from January 2004 to December 2014 in the Hepatobiliary Surgery Department of Jinshan Branch of the Sixth People's Hospital of Shanghai were analyzed retrospectively.Results There were no statistically significant differences in terms of the Ranson score,blood amylase and C reactive protein (CRP) between two groups (P ＞ 0.05).The incidences rate of hepatic insufficiency,renal insufficiency and encephalopathy were 35.5％ (54/152),25.6％ (39/152) and 8.5％ (13/152) in the NABP group,and 25.7％(53/206),12.1％(25/206) and 3.3％(7/206) in the ABP group,with significant difference between the two groups (x2 =4.01,10.89,4.41;P ＜ 0.05).Conclusion The key to reduce the complications and improve the cure rate is to make clear the etiology of NABP and ABP and to take active and effective treatment for the cause of the disease.
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ObjectiveTo explore the value of elevated amylase in assessment of severity of the disease and its inlfuencing factors in critically ill children.MethodThe clinical data from critically ill children hospitalized in pediatric intensive care unit were retrospectively analyzed from November 2009 to June 2014. According to levels of serum amylase, the critically ill children were divided into normal serum amylase group (≤103 IU/L) and elevated serum amylase group (>103 IU/L). The differences between two groups were compared.ResultsA total of 1920 critically ill children were enrolled, most of whom had primary respiratory and neurological diseases. Among them, 1470 children had normal serum amylase (76.6%) and 450 children had ele-vated serum amylase (23.4%). The elevated serum amylase group had signiifcantly higher rate of organs failure (≥4), lower rate of PCIS (<70), higher rate of invasive mechanical ventilation and mortality than those in normal serum amylase group (P<0.001). The correlation of serum amylase with lipase blood, urine amylase, blood urea nitrogen and creatinine were signiifcant (r=0.246 to 0.683,P<0.001). Blood amylase was positively correlated with shock index (r=0.111,P=0.002) and negatively correlated with respiratory failure index (r=0.133,P<0.001).ConclusionsSerum amylase could be used to assess the severity of disease. The elevated amylase was closely related to pancreatic exocrine function, renal function, ischemia, and hypoxia. The elevated serum amylase in critically ill children is a warning sign.
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Objective To analyze the value of the detection mode of serum amylase (AMY)and lipase (LPS)in the diagnosis of acute pancreatitis.Methods 100 patients with acute pancreatitis and 100 individuals of healthy physical examination in our hospital from January 2012 to February 2014 were selected and detected serum AMY and LPS.The detection results,sensitivity,accuracy and specificity were analyzed.Results The serum AMY and LPS levels in the severe acute pancreatitis group and the mild acute pancreatitis group were higher than that in the control group,the difference was statistically significant (P <0.05);the serum AMY and LPS levels in the severe acute pancreatitis group were higher than those in the mild acute pancreatitis group,the difference was statistically significant (P <0.05);the accuracy,specificity and sensitivity of the combined detection of AMY and LPS was higher than that of the single index detection.Conclusion The joint detection of AMY and LPS can provide the important diagnostic basis for acute pancreatitis.
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Critically ill children are often complicated with multiple organ damage. When the pancreas was involved, kinds of pancreatic enzymes would elevate, which suggested the high risk complication of pancreatic damage was really existed. The changes of pancreatic enzymes under different critical conditions such as shock, surgery, injury, etc. were reviewed, as well as the clinical significance of different pancreatic enzymes, so as to provide evidence for acknowledge the early biological signs in early phase of critically ill children with pancreatic damage,to decrease the mortality of complications and to improve the prognosis of critically ill children.
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Objective To study on comparison of different age group patients with acute abdomen who received laboratory check-ups.Methods 126 patients with acute abdomen were divided into 0.05).2.Of 126 patients,65 cases(51.6%)received abdominal B ultrasonography check-up,among which 41 cases(44.1%)were in
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Objective To compare the influence between target controlled infusion propofol vein anesthesia and midazolam vein anesthesia toward serum amylase and triglyceride in children with cleft lip and palate.To make a definitude that the feasibility of target controlled infusion propofol used in children′s anesthesia.Methods Sixty children with cleft lip and palate aged from 4 months to 3 years,weighting 6.5-15.9 kg,American Society of Anesthesiologists(ASA)Ⅰ-Ⅱ,were randomly allocated to group P and group M(n=30,each).Group P received target controlled infusion propofol.Anesthesia was induced with target controlled infusion propofol at the target effect-site concentration 3.0 mg/L,remifentanyl 2.0 ?g/kg and vecuronium 0.1 mg/kg.Anesthesia was maintained with a continuous remifentanyl infusion at 0.2 ?g/(kg?min) and vecuronium 0.01 mg/(kg?min) and target controlled infusion propofol at the effect-site concentration 3.0 mg/L.Group M received intermittent boluses of midazolam 0.1 mg/kg.Anesthesia was induced with midazolam 0.2 mg/kg,remifentanyl 2.0 ?g/kg and vecuronium 0.1 mg/kg.Anesthesia was maintained with a continuous remifentanyl infusion at 0.2 ?g/(kg?min) and vecuronium 0.01 mg/(kg?min) and intermittent boluses of midazolam 0.1 mg/kg every hour.The venous blood samples were taken before anesthesia induction(T1),4 hours(T2) and 24 hours(T3) after surgery to measure the serum concentration of serum amylase and triglycride.Results The duration of anesthesia induction,extubation and emergence were shorter in group P compared with group M(Pa0.05).Conclusions The serum concentration of triglyceride may increase because of the stress of anesthasion and operation,and can be higher during target controlled infusion propofol,but does not exceed the normal value.The serum amylase concentration does not increase during target controlled infusion propofol in children.
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OBJECTIVE:To observe the pharmacological effect of Ulinastatin on acute necrotizing pancreatitis in rats.METHODS:Animal models were divided into3groups:group A,sham operation;group B,acute necrotic pancreatitis given no treatment;group C,acute necrotic pancreatitis treated with Ulinastatin.The changes of AMS and TNF-?were compared at different time among3groups.RESULTS:AMS and TNF-?in group C were significantly different from those in group A and in group B.CONCLUSION:Ulinastatin could remarkably improve the prognosis of acute necrotic pancreatitis.
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Hyperamylasemia may follow hepatic resection; Akagi reports 15(62.5%) of his 24 patients with hepatic resection experienced hyperamylasemia, and almost none of those patients had clinical symptoms or complications. The mechanism of postoperative hyperamylasemia is not clear yet, but Makuuchi states that the cause of hyperamylasemia is pancreatic congestion due to vascular occlusion methods used during hepatic resection. The frequency of hyperamylasemia, occurrence of pancreatitis, and factors likely to cause hyperamylasemia following hepatic resection were studied by the authors. The subjects consisted of 31 patients without history of pancreatitis or DM who underwent hepatic resection. In all of the cases, serum amylase levels were measured on the preoperative day, operative day, and postoperative days 1, 3, 5 and 7. Total serum amylase level was found to be significantly elevated postoperatively in 14(42.5%) of 31 patients undergoing hepatic resection. These patients did not have pancreatitis nor fatal complications. The serum amylase was at its lowest level(153+/-79U/L) immediately after operation, and highest(321+/-176U/L) on postoperative day 1, and eventually returned to preoperative level. When the difference in serum amylase level based on the patient's preoperative state was considered, patient's in the liver cirrhosis group(n=17) had significantly elevated postoperative serum amylase level on postoperative days 3, 5 and 7 in comparison with the group of patients without liver cirrhosis (p<0.05). The differences in the level of serum amylase based on ICG R15 retention rate, extent of hepatic resection, age and vascular occlusion time used during hepatic resection did not show any statistical signifcance. Since postoperative hyperamylasemia was not related to vascular occlusion time used during hepatic resection, and the level of serum amylase was higher in the liver cirrhosis group than in the normal liver group, the cause of hyperamylasemia following hepatic resection cannot be explained by pancreatic congestion due to vascular occlusion time used during hepatic resection.