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Background: Acute Pancreatitis (AP) is one among the major diseases in the surgery wards with high rate of mortality. In spite of many scoring systems introduced to grade the severity of AP for optimal and timely management, mortality rate is still in a high pace. The aim of this study is to compare BISAP scoring system and APACHE II scoring system for accuracy and easiness in predicting the severity and mortality of AP and to deliver appropriate and timely intervention.Methods: The first 100 patients with AP in the year 2016 (January to August) were studied prospectively by calculating APACHE II score and BISAP score. According to Revised Atlanta classification severe AP was ascertained and the sensitivity and specificity of both scoring systems were assessed from chi square table. By using ROC curve accuracy and diagnostic value of two scoring systems were compared.Results: 100 patients with an age ranging from 20 to 80 years with a mean of 41.18 and male female ratio of 10.1:1 were studied. 95% of the patients presented with a symptom of abdominal pain and 49 out of 100 were having alcoholism as etiology. The average hospital stay of the patients was 12.03 days. Four patients died out of 11 severe AP and rest 89 were grouped into mild AP. BISAP score more than or equal to three have 64.2% chance of severe AP and was statistically significant in predicting the severity of AP. Areas under curve of the ROC curve after depicting the sensitivity and specificity of BISAP scores for severity and mortality were 0.90 and 0.96 respectively. APACHE II scores more than or equal to nine have 23.8% chance of severe AP and was statistically significant in predicting severity of AP. When sensitivity and specificity of APACHE II score were charted in ROC curve, areas under curve were 0.853 and 0.75 for severity and mortality in AP respectively.Conclusions: Compared to APACE II, BISAP is better scoring system in predicting both severity and mortality of AP on considering accuracy and easiness.

Background: Secondary peritonitis carries high mortality and morbidity. Many scoring systems have been designed to assess its severity. This study was undertaken to compare the Mannheim peritonitis index (MPI) and revised multiple organ failure score (Revised MOFS) in predicting the mortality and morbidity.Methods: A prospective observational study was undertaken in adults operated for gastrointestinal perforation. Clinical and biochemical parameters as required for MPI and Revised MOFS were recorded. Each of the scores were divided under four categories; MPI <14, 14-21, 22-29 and >29; Revised MOFS 0, 1, 2 and >2. Data was compared for predicting mortality and morbidity. P-value, ROC curve and 95% CI were used as statistical tools.Results: Two thirds of 120 patients studied presented after 48 hours. MPI score of <14, 14-21, 21-29 and >29 had mortality of 0%, 2.2%, 27.2% and 50% respectively. ROC curve showed highest sensitivity and specificity of 79% and 70% respectively at MPI of 25. Significant value for mortality was obtained with MPI >25 (p= 0.000012) and with Revised MOFS >1 (p< 0.001); for morbidity with MPI >21 (p= 0.010) and with Revised MOFS >1 (p< 0.001). 20% patients with Revised MOFS zero were also morbid.Conclusions: Both MPI and Revised MOFS systems are good in predicting the mortality, but MPI is easy scoring system and a better option for predicting morbidity. MPI score >25 for mortality and >21 for morbidity are significant.