Background: About 15-20% of cases of acute pancreatitis progress to a severe form, leading to high mortality rates. Thus early prediction of severity is utmost important so as to provide better management and decrease mortality. Objective: To explore the efficiency of PANC 3 SCORE in predicting the severity in patients with acute pancreatitis on admission and its relation to clinical outcome. Methods: Patients with Acute pancreatitis were assessed to sex, age, body mass index (BMI), etiology of pancreatitis, Hematocrit and presence or absence of pleural effusion at the time of admission intensive care need, length of hospital stay, length of stay in intensive care unit and mortality. The PANC 3 score was determined on admission and compared to acute pancreatitis grade of the Revised Atlanta classification. Results: Out of 46 patients diagnosed with acute pancreatitis, 46 patients met the inclusion criteria. The PANC 3 score was positive in 4 cases (8.69%), pancreatitis progressed to a severe form in 7 cases (15.2%) and 3 patients (6.5%) died. Patients with a positive score and severe pancreatitis required intensive care more often, and stayed for a longer period in intensive care units. The PANC 3 score showed sensitivity of 42.85%, specificity of 97.45%, accuracy of 90.17%, positive predictive value of 75% and negative predictive value of 89.13% in prediction of severe acute pancreatitis. Conclusion: The PANC 3 score has high specificity, high accuracy and high predictive value in prediction of severe acute pancreatitis. It has only 3 parameters which can be easily done in any healthcare system. It does not need much expertise to analyze PANC3 at the time of admission which adds the advantage of this score over other scoring systems.

Background: Appendicitis is one of the most common surgical emergency in general surgical practices. Early and prompt diagnosis is necessary to avoid life-threatening complications associated with it. Hence this study was conducted to evaluate the hyperbilirunemia as predictive marker in acute appendicitis and appendiceal perforation. Methods: Al cases of acute appendicitis and appendicecal perforation fulfilling inclusion and exclusion criteria taken up for this prospective observational single center study which were confirmed histopathologically in per operative setting. Results: Total 100 patients were in the study of which 33 patients had appendicecal perforation of which 23 patients had hyperbilirubinemia (70%) . 67 patients had acute appendicitis of which 42 patients had hyperbilirubinemia , 37%. Hyperbilirubinemia with a cutoff point of 0.9 mg% for appendicitis patients has a sensitivity of 85.3%, a specificity of 77.2%, a positive predictive value of 36%, and a negative predictive value of 91%. Hyperbilirubinemia with a cutoff point of >1.3 mg% for appendiceal perforations has a sensitivity of 75%, a specificity of 81.2%, a positive predictive value of 83%, and a negative predictive value of 88%. Conclusion:Hyperbilinemia is seen in acute appendicitis predominantly in appendiceal perforation hence evaluation of serum bilirubin level preoperatively can predict possibility of appendiceal perforation as it is easily available , cheap and simple laboratory test.