Role of total calcium and corrected calcium in comparisons with computed tomography to predict severity of acute pancreatitis

Background: The objective of the study was to evaluate corrected calcium levels in patient of acute pancreatitis and to evaluate role of corrected calcium as predictor of severity in acute pancreatitis in comparison to computed tomography (CT) scan.Methods: The study was conducted in Department of Biochemistry of G.G.S Medical College in collaboration with the Department of Surgery and Department of Radio diagnosis. 50 patients, with clinical diagnosis of acute pancreatitis, attending the Inpatient Department of Department of Surgery, were taken. 50 patients, of either sex of 18 to 70 age groups suffering from acute pancreatitis were enrolled for the study.Results: On exploring the data, highly significant negative correlation found between CT severity index (CTSI) and serum calcium (p≤0.001; r value=-0.520) whereas the non-significant correlation found between CTSI and amylase (p=0.778; r value=-0.041). The corrected calcium and CTSI shows highly negative significant correlation (p≤0.001; r value=-0.654). Serum albumin with CTSI also shows significant correlation (p=0.006; r value=0.385). But no significant association with lipase (p≥0.05).Conclusions: We observed that corrected calcium and calcium is better and alternative marker for predicating the severity of disease because corrected calcium and calcium is having good positive predictive value to indicate progression of damage and also a highly significant negative predictive value to rule out severity of acute pancreatitis.

Peripheral Vascular Disease: An Unusual Presentation of Peripartum Cardiomyopathy.

Peripartum cardiomyopathy (PPCM) usually presents with the heart failure in the last month of pregnancy or up to 5 months post-partum period, without any underlying cause of cardiac failure. This is a hypercoagulable state associated with left ventricular (LV) systolic dysfunction, thereby causing thromboembolic complications. We report a case of 2 months post-partum female who presented with left lower limb arterial thrombotic occlusion which turned out to be secondary to embolization from a large LV thrombus resulting from PPCM. The present case is an unusual presentation of PPCM that usually presents with a clinical feature of cardiac failure.

Focal Caroli’s Disease Presenting as Fusiform Dilatation of Intrahepatic Biliary Radicles.

Background Caroli's disease is a rare congenital disorder characterized by segmental, non obstructive, cystic dilatation of intra hepatic bile ducts. It belongs to the spectrum of fibropolycystic liver disease which results from in utero malformation of ductal plate. Two forms of this disorder have been described, the less common 'Pure' form involves only the large intrahepatic bile ducts and the more 'complex' form is associated with congenital hepatic fibrosis (CHF), and is known as Caroli's Syndrome. Case A young female presented with features of cholangitis and in addition to all the routine investigations, non invasive imaging in the form of ultrasonography, computed tomography and magnetic resonance imaging was done. Diagnosis Final diagnosis of focal Caroli's disease with cholangitis was made on clinical and imaging findings. Treatment Conservative treatment was given and patient referred to gastro surgery department for partial hepatectomy. Conclusion An early recognition of Caroli's disease with non invasive imaging can bring down the morbidity.

Awareness and Attitude Appraisal toward Hepatitis-C among North West Population of India- A Cross Sectional Study.

Background: Hepatitis C is increasingly found to be a significant etiological agent causing liver disease in India. Prevention is the best safeguard against this silent killer but a major obstacle has been the low awareness. Attitudes and awareness of general population can play a key role in prevention of spread of infection. Aims: The objectives of the present survey were to assess the knowledge and attitudes of general population vis a vis risk factors, route of transmission, vaccination and treatment of Hepatitis-C virus (HCV). Study Design: Cross-sectional questionnaire based study. Place and Duration of Study: South west border region of Northern Indian State of Punjab from 2012-2014. Methodology: This random survey was conducted in south west border region population of northern Indian state of Punjab. Results: Overall, 24.2%, 29.2% and 46.6% respondents had good, fair and poor awareness levels respectively. Conclusion: The study highlights and calls for a targeted and effective HCV awareness, by innovative means and on an emergency basis, to control the spread of this silent killer.