Objective: Our aim was to prospectively evaluate the accuracy of the bedside index for severity in acute pancreatitis (BISAP) score in predicting mortality, as well as intermediate markers of severity, in a tertiary care centre in east central India, which caters mostly for an economically underprivileged population.Methods: A total of 119 consecutive cases with acute pancreatitis were admitted to our institution between November 2012 and October 2014. BISAP scores were calculated for all cases, within 24 hours of presentation. Ranson’s score and computed tomography severity index (CTSI) were also established. The respective abilities of the three scoring systems to predict mortality was evaluated using trend and discrimination analysis. The optimal cut-off score for mortality from the receiver operating characteristics (ROC) curve was used to evaluate the development of persistent organ failure and pancreatic necrosis (PNec).Results: Of the 119 cases, 42 (35.2%) developed organ failure and were classified as severe acute pancreatitis (SAP), 47 (39.5%) developed PNec, and 12 (10.1%) died. The area under the curve (AUC) results for BISAP score in predicting SAP, PNec, and mortality were 0.962, 0.934 and 0.846, respectively. Ranson’s score showed a slightly lower accuracy for predicting SAP (AUC 0.956) and mortality (AUC 0.841). CTSI was the most accurate in predicting PNec, with an AUC of 0.958. The sensitivity and specificity of BISAP score, with a cut-off of ≥3 in predicting mortality, were 100% and 69.2%, respectively.Conclusions: The BISAP score represents a simple way of identifying, within 24 hours of presentation, patients at greater risk of dying and the development of intermediate markers of severity. This risk stratification method can be utilized to improve clinical care and facilitate enrolment in clinical trials.

Abdominal compartment syndrome (ACS) and intra-abdominal hypertension (IAH) have been a cause of complications in ICU patients, especially those of trauma and acute abdomen. ACS affects almost every system of the body namely the cardiac, respiratory, renal, CNS and the GIT. It has been under-recognized as it primarily affects patients who are already critically ill and the organ dysfunction may be incorrectly attributed to the primary illness. Since ACS can improve with treatment, it is important that the diagnosis be considered in the appropriate patient. We will review here the definition, classification, incidence, etiology, pathophysiology, clinical presentation, diagnosis and management of intraabdominal hypertension and abdominal compartment syndrome. The method employed for literature search included web search of articles in various international and national bibliographic indices. The websites used for the search include Google, PubMed, NIH.gov, Medscape.com, Science direct and Scopus.

BACKGROUNDContracture of the hand poises great morbidity. Despite increasing sophistication in the overall management of acute thermal injuries, contractures still occur and are the most common cause of skin contracture in the hand. The problem of post burn contracture is largely preventable by good initial care. We studied 60 consecutive patients of post burn contracture of hand treated at Rajendra Institute of Medical Sciences, Ranchi, India with the aim to observe different patterns of post-traumatic contracture in hand and to assess the result of various treatment modalities.

Sialolipoma is a rare tumour found within both major and minor salivary glands. A total of 35 sialolipoma cases have been reported 18 within major salivary gland and 17 within minor salivary gland. Major gland sialolipoma most often are presented in the parotid gland (77%) and those from minor salivary glands were often seen in the palate (41%). All lesions were well circumscribed and contained mature adipose tissue admixed with benign salivary gland component. Treatment is surgical excision. We report a case of 52 years old male who presented with the complaint of swelling in the left parotid region for 22 years duration. Apart from cosmetic reason he has no other complain. All specific investigations done were inconclusive and suggested a benign tumor. Histopathological examination after superficial parotidectomy suggested sialolipoma.

Cases of extra uterine translocation of intrauterine contraceptive device (IUCD) to adjacent structures like peritoneal cavity, urinary bladder & sigmoid colon have been reported. Here is a case of translocation of IUCD into the caecum presenting as appendicitis. Appendicitis resulting from IUCD translocation is very rare. As per our knowledge only 19 cases have been reported earlier.