INTRODUCTIONAccording to Atlanta Symposium, acute pancreatitis (AP) was defined as an acute inflammatory process of the pancreas that may also involve peri-pancreatic tissues and/or remote organ systems. 1 The aetiology and pathogenesis of acute pancreatitis have been intensively investigated for centuries worldwide. Most descriptive studies attribute various etiological factors, which vary across populations. It can aetiological initiated by several factors, including gallstones, alcohol, trauma, infections and hereditary factors. Gallstone/ biliary stone are the leading cause in most study followed by alcohol; these two constitute 75% cases.2 Incidence in men is usually more compared to women. In children, abdominal blunt trauma and systemic diseases are the most common causes.The clinical definition of acute pancreatitis requires two of the following three features.• Abdominal pain strongly suggestive of acute pancreatitis ABSTRACT Background: According to Atlanta Symposium, acute pancreatitis (AP) was defined as an acute inflammatory process of the pancreas that may also involve peri-pancreatic tissues and/or remote organ systems. The objective of this study was to know the risk factors of acute pancreatitis in patients admitted in a tertiary care centre in north India Methods: A prospective study was performed with admitted cases of patients with acute pancreatitis over 2 years period. Total 104 patients were selected for study. All data concerning aetiology were recorded and analysed in all patients forming study groups. Results: Among 104 patients with acute pancreatitis 68 (65%) were females and 36 (35%) were males. Mean age of our study group was 40.9 years and maximum incidence was seen in 36-45 years. Most common cause was biliary pancreatitis (63%) followed by alcohol (27%), idiopathic (6%), trauma (3%), infections (1%). In females, most common aetiology was gall stone (88%), in males most commonly by alcohol (78%). As per Atlanta classification 81 patients (77.8%) had acute mild pancreatitis and 23 patients (22.2%) had acute severe pancreatitis. Majority females (66.7%) were admitted in mild acute pancreatitis. The mean age of patients in mild acute pancreatitis was 39.6 years and in severe group was 45.4 years. Gall stone were the leading cause in both mild and severe acute pancreatitis. Conclusions: Females were more commonly affected than men by acute pancreatitis. The most common aetiology was gall stone followed by alcohol which was leading cause in the males.

Background: Perforation peritonitis is one of the common acute abdomen admitted in emergency department for emergency laparotomy. Pattern and aetiology of ileal perforation varies from developed and developing countries where infectious diseases are still highly prevalent.Methods: This was a prospective study conducted over 3 years period in Indira Gandhi Institute of Medical Sciences, Patna. Total 118 patients were enrolled for this study after confirmation of ileal perforation on exploratory laparotomy.Results: Out of total 118 patients 52 cases (44%) were in traumatic, typhoid causes perforation in 86% (57 cases) tuberculosis in 14% (9 cases) and 66 cases (56%) were in non-traumatic group, penetrating injury is more common than blunt trauma abdomen. Males are more commonly affected than females in among all cases of ileal perforation. Patients with traumatic ileal perforation seek early medical attention as most of the patients (44%) admitted within 12 hours after accident where as in case of non-traumatic cases 53% patients admitted after 2 days. Most common operative procedure performed is Loop ileostomy in case of non-traumatic perforation (49%) and Resection and anastomosis preferred in traumatic perforation (63%). Mortality rate is about 20% in all types of perforation.Conclusions: In developing countries like India typhoid perforation is still most common cause of ileal perforation. Loop ileostomy is more preferred procedure in infectious cases but resection and anastomosis in case of traumatic perforation in our institute.

test scores nor confidence levels in TEE insertion, identification of anatomy with TEE, and using TEE to guide resuscitation. Conclusions: The training session, using cadavers as a tissue model, was feasible and may be an effective method of improving knowledge, confidence and technical skill in TEE insertion among novices.