RESUMO
BACKGROUND: Acute pancreatitis is a common disease with wide clinical variation and its incidence is increasing. Acute pancreatitis may vary in severity, from mild self-limiting pancreatic inflammation to pancreatic necrosis with life-threatening sequelae. Severity of acute pancreatitis is linked to the presence of systemic organ dysfunctions and/or necrotizing pancreatitis. AIM AND OBJECTIVES: The present study was aimed to assess the clinical profile of acute pancreatitis and to assess the efficacy of various severity indices in predicting the outcome of patients. METHODOLOGY: This was a prospective study done in Sri Ramachandra Medical College and Hospital from April 2012-September 2014. All patients with a diagnosis of acute pancreatitis were included in this study. Along with routine lab parameters, serum amylase, lipase, lipid profile, calcium, CRP, LDH, CT abdomen, CXR and 2D Echo was done for all patients. RESULTS: A total of 110 patients were analysed. 50 patients required Intensive care, among them 9 patients (18%) died. 20 patients (18.2%) had MODS, 15 patients (13.6%) had pleural effusion, 9 patients (8.2%) had pseudocyst, 2 patients(1.8%) had hypotension, 2 patients(1.8%) had ARDS and 2 patients(1.8%) had DKA. In relation to various severity indices, high score of CRP, LDH and CT severity index was associated with increased morbidity and mortality. 15 patients (13.6%) underwent open necrosectomy surgery, 3 patients (2.7%) underwent laparoscopic necrosectomy and 7 patients (6.4%) were tried step up approach but could not avoid surgery. Step up approach and surgery did not have a significant reduction in the mortality. CONCLUSION: Initial assessment of severity by CRP, LDH and lipase could be reliable indicators of outcome in acute pancreatitis.
RESUMO
BACKGROUND AND AIMS: Rheumatic manifestations are a common feature of leprosy. The present study was performed to assess the incidence of rheumatic manifestations in leprosy. METHODS: Seventy cases of leprosy attending the indoor and outdoor departments were studied. RESULTS: Out of the 70 cases studied, rheumatic manifestations were seen in 61.42% of cases: arthritis in 54.28% and soft tissue rheumatism in 17.14%. Enthesitis was seen in 2.84% of cases. The incidence of arthritis in lepra reactions was 57.57%. CONCLUSIONS: Musculoskeletal manifestations can occur at any time during the infection. Articular inflammation in leprosy usually occurs in reactive states, particularly erythema nodosum leprosum (ENL). Leprosy can present with arthritis as the first symptom.
RESUMO
BACKGROUND AND AIMS: Rheumatic manifestations are a common feature of leprosy. The present study was perfomed to assess the incidence of rheumatic manifestations in leprosy. METHODS: Seventhy cases of leprosy attending the indoor and outdoor departments were studied. RESULTS: Out of the 70 cases studied, rheumatic manifestations were seen in 61.42% of cases: arthritis in 54.28% and soft tissue rheumatism in 17.14%. Enthesitis was seen in 2.84% of cases. The incidence of arthritis in lepra reactions was 57.57%. CONCLUSIONS: Musculoskeletal manifestations can occur at any time during the infection. Articular inflammation in leprosy usually occurs in reactive states, particularly eryhtema nosodum leprosun (ENL). Leprosy can present with arthritis as the first symptom.