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V. Balasubramaniam

Bio: V. Balasubramaniam is an academic researcher. The author has contributed to research in topics: Acute pancreatitis. The author has an hindex of 1, co-authored 1 publications receiving 2 citations.

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TL;DR: The BISAP scoring system is not inferior to Ranson’s scoring system in predicting the severity of acute pancreatitis and showed higher sensitivity in the prediction of systemic complications than that of local complications.
Abstract: Background: Acute pancreatitis has widely variable clinical and systemic manifestations spanning the spectrum from a mild, self-limiting episode of epigastric pain to severe, life-threatening, multi-organ failure. Since the morbidity and mortality of acute pancreatitis differ markedly between mild and severe disease (mild <5% versus severe 20–25%), it is very important to assess severity as early as possible. To assess the accuracy of the BISAP scoring system versus Ranson scoring system in predicting severity in an attack of acute pancreatitis. Methods: It is a prospective and retro prospective study that was conducted, from August 2018 to November 2019. All surgical units in the headquarters hospital, Ooty. BISAP score and Ranson’s score is calculated in all such patients based on data obtained within 48 hours of hospitalization. Results: Ranson’s score of more than 3 and the BISAP score of less than or equal to 3 had the best accuracy of predicting the severity of acute pancreatitis. Both Ranson’s score and BISAP score showed higher sensitivity in the prediction of systemic complications than that of local complications. Conclusions: From this study, we can conclude that the BISAP scoring system is not inferior to Ranson’s scoring system in predicting the severity of acute pancreatitis. BISAP scoring system is very simple, cheap, easy to remember and calculate. BISAP scoring system accurately predicts the outcome in patients with acute pancreatitis.

3 citations


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TL;DR: The mainstay of therapy is supportive intensive care, prevention of sepsis and multiple organ failure and identification and treatment of infected pancreatic necrosis, with surgical approach justified in verified infected necrosis.
Abstract: Acute pancreatitis ranges from mild to severe necrotizing form complicated by multiorgan failure with high mortality rate. It has different causes, not entirely clear pathogenesis and unpredictable and variable course. Therapeutic measures are limited. The mainstay of therapy is supportive intensive care, prevention of sepsis and multiple organ failure and identification and treatment of infected pancreatic necrosis. Surgical approach is justified in verified infected necrosis. In case of sterile pancreatic necrosis complicated by organ failures is the role of surgical intervention debatable.

140 citations

Journal ArticleDOI
25 Nov 2022
TL;DR: In this article , the authors established criteria based on laboratory tests for the differential diagnosis between acute pancreatitis of biliary and nonbiliary causes and to identify laboratory tests with sufficient sensitivity to propose the creation of an algorithm for differential diagnosis among the causes.
Abstract: ABSTRACT BACKGROUND: The differential diagnosis of the causal factors of acute pancreatitis is fundamental for its clinical follow-up, becoming relevant to establishing laboratory criteria that elucidate the difference between biliary and nonbiliary causes. AIM: The aim of this study was to establish criteria based on laboratory tests for the differential diagnosis between acute pancreatitis of biliary and nonbiliary causes and to identify laboratory tests with sufficient sensitivity to propose the creation of an algorithm for differential diagnosis between the causes. METHODS: The research consisted of observational analysis, with a cross-sectional design of laboratory tests of two groups of patients with acute pancreatitis: group A: nonbiliary cause and group B: biliary cause. Hematocrit, white blood cell count, lactate dehydrogenase, glucose, lipase, amylase, total bilirubin, oxalacetic transaminase, pyruvic transaminase, gamma-glutamyltransferase, and alkaline phosphatase were investigated. Data were submitted to nonparametric tests and receiver operating characteristics. RESULTS: Hematocrit values, number of leukocytes, lactate dehydrogenase, and glucose showed no significant difference between the groups (p>0.1). Lipase, amylase, total bilirubin, oxalacetic transaminase, pyruvic transaminase, gamma-glutamyltransferase, and alkaline phosphatase values showed a significant difference between groups (p<0.05). The oxalacetic transaminase, pyruvic transaminase, and alkaline phosphatase tests were most sensitive in determining the biliary cause, allowing the establishment of a cutoff point by the receiver operating characteristic test: pyruvic transaminase: 123.0 U/L (sensitivity: 69.2%; specificity: 81.5%), oxalacetic transaminase: 123.5 U/L (sensitivity: 57.3%; specificity: 78.8%), and alkaline phosphatase: 126.5 U/L (sensitivity: 66.1%; specificity: 69.4%), from which the probability of a correct answer increases. CONCLUSION: It was possible to establish criteria based on laboratory tests for the differential diagnosis between acute pancreatitis of biliary and nonbiliary origin; however, the tests did not show enough sensitivity to propose the creation of an algorithm for differential diagnosis between the same causes.