No abstract

Plasma procalcitonin (PCT) is a highly specific marker for the diagnosis of bacterial infection and sepsis. Studies have demonstrated its role in the setting of sepsis and acute pancreatitis. This study aims to analyze and compare the prognostic efficacy of plasma procalcitonin strip test in acute pancreatitis. A prospective study was conducted in the department of general surgery from June 2012 to June 2013. Plasma procalcitonin was estimated by the semiquantitative strip test. The study included a total of 50 patients diagnosed to have acute pancreatitis. Data was collected and statistically analyzed using SPSS version 17. Thirty-nine out of the 50 patients (78 %) were males with a mean age of 46.8 years (range, 25-78 years) and 25 patients (50 %) had ethanol-induced pancreatitis, while 13 patients (26 %) had gall stone pancreatitis. Plasma PCT values were found to correlate better than CRP levels and total leukocyte count with the total duration of hospitalization, ITU, and ICU stay, as well as with the progression to severe acute pancreatitis. A cut off for plasma PCT of >2 ng/mL was found to be 100 % sensitive and 100 % specific and a cut off for CRP of >19 mg/dL was 70 % sensitive and 65 % specific for predicting the progression to severe acute pancreatitis. Plasma PCT also correlated well with antibiotic requirement. A cut off value of >0.5 ng/mL for plasma PCT was 100 % sensitive and 80 % specific and a cut off value of >18 mg/dL for CRP was 86 % sensitive and 63 % specific for predicting antibiotic requirement. Plasma procalcitonin is an early and reliable prognostic indicator in acute pancreatitis. The procalcitonin strip test is a rapid test which is useful in analyzing prognosis in patients with acute pancreatitis.

Background: Imaging techniques such as ultrasound and CT (computerised tomography) offer to improve clinical outcome by increasing the accuracy of diagnosis. Ultrasound has the great advantage of being radiation free, however it is operator dependant. In comparison, CT can overcome these limitations and greater sensitivity in the diagnosis of acute appendicitis, with reported accuracies of 93-98% but it is expensive and not available at all centre, particularly in countries, like India. Hence we need a scoring system such as MASS (modified Alvarado scoring system) and RIPASA (Raja Isteri Pengiran Anak Saleha appendicitis) scoring system with good sensitivity and specificity. Aim of the present study was to explore the disease on clinical presentation and to compare both scoring systems in diagnosis of acute appendicitis and correlating both the scoring systems with the intra-operative findings.Methods: This was a prospective study done between October 2019 and October 2020 on hundred patients who underwent appendicectomy at Kempegowda institute of medical sciences and research centre, Bengaluru, Karnataka, India.Results: In the study among subjects with appendicitis, there was significant association between combined MASS and RIPASA score and intra-operative findings.Conclusions: In the study combined MASS and RIPASA score with correlated intra-operative findings had diagnostic accuracy in prediction of acute appendicitis.