Background: Acute appendicitis occurs through bacterial invasion in appendix leads to transmigration of bacteria and release of tumour necrosis factor (TNF)-alpha, Interleukin-6 (IL6) and cytokines. These reach the liver through a superior mesenteric vein and may produce inflammation or dysfunction of liver either directly or indirectly by altering hepatic blood flow with rising of total serum bilirubin. Objective: To evaluate the validity of elevated serum total bilirubin as a diagnostic marker for acute appendicitis and if elevated serum total bilirubin levels have a predictive potential for the diagnosis of complicated appendicitis. Methods: This is a prospective cross-section study including ninety-four (94) of adult patients have right iliac fossa pain attending to the Emergency Department (ED) at Suez Canal University Hospital. All 94 patients undergo total serum bilirubin measuring and postoperative histopathological examination of the removed appendix. Results: Amongst the patients diagnosed with acute appendicitis post-operatively, 57 patients (70.4%) were found to have elevated serum total bilirubin (>1.2mg/dL) while 24 patients (29.6%) had normal serum total bilirubin levels (≤ 1.2 mg/dL). Conclusion: Serum total bilirubin level appears to be a promising new laboratory marker for diagnosing acute appendicitis and have a predictive potential for the diagnosis of complicated appendicitis.

Introduction: Chronic obstructive pulmonary disease is one of the main causes of morbidity, mortality, and health-care costs entire the world. During acute exacerbations, whether or not with a history of Cor pulmonale have an increased cardiac burden. Patients with COPD are at increased risk of cardiovascular disease, exacerbations increase strain on the heart. The prognostic and predictive value of highly sensitive troponin T seen during COPD exacerbations has been investigated.

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