GS Mridul | University of Kannur, Kerala (original) (raw)

Papers by GS Mridul

International Surgery Journal, Apr 21, 2018

Acute pancreatitis is a common condition involving the pancreas. The estimated incidence is about... more Acute pancreatitis is a common condition involving the pancreas. The estimated incidence is about 3% of cases presenting with pain abdomen. 1 Although most episodes are mild and self-limiting, up to a 20% of patients develop severe attacks that can be fatal. Gall stones and sustained alcohol abuse together account for 80% of acute pancreatitis. The relative frequency of these two factors depends on prevalence of alcoholism in the population studied. 2 Of the mechanical causes of acute pancreatitis, choledocholithiasis is the most common and between 36% and 63% will develop recurrent acute pancreatitis if stone persists. In about 10-30%, cause of acute pancreatitis is idiopathic, other rare causes include ischemia, drug induced, hyperparathyroidism, ERCP, hypercalcemia, trauma, pancreas divisum, autoimmune, hereditary, infectious, malnutrition, scorpion bite, hyperlipoprotenemia, pregnancy. The severity of acute pancreatitis can be predicted based upon clinical, ABSTRACT Background: Acute pancreatitis is a common condition involving the pancreas. The estimated incidence is about 3% of cases presenting with pain abdomen. The study is undertaken to study the various etiological factors and clinical factors of alcoholic and nonalcoholic acute pancreatitis and to assess the prognosis, outcome, management of an alcoholic and nonalcoholic acute pancreatitis. Methods: A total of 60 cases from BMCRI hospital attached selected during the study period from November 2015 to June 2017. Results: In the present study total 60 patients with acute pancreatitis were enrolled, 55% were alcoholic and remaining 45% were nonalcoholic. The mean age of presentation in our study was 39.2 years and in alcoholic it was 39.42 years, and nonalcoholic it was 39.07 years. There was a male predominance with males accounting for 90 percent in which 61.1% are alcoholic and 38.9 percent are nonalcoholic with 9:1 male to female ratio. In our study 100 % of patients had tenderness, 3% of alcoholic and 7.4 % of nonalcoholic presented as mass abdomen, and 21.2% alcoholic and 7.4% of nonalcoholic presented as ascites. USG abdomen was diagnostic in 93.3 % of the patients in our study. All of them managed conservatively, of the 8 patients of biliary pancreatitis 7 underwent interval cholecystectomy, and 1 underwent ERCP + ES. Conclusions: Acute pancreatitis is a common cause of acute abdomen. Alcohol being the most common cause of acute pancreatitis in the present study. Nonalcoholic pancreatitis contribute to a significant proportion of etiology of pancreatitis. Prompt identification and diagnostic work up to identify the etiology of pancreatitis followed by appropriate treatment results in cure and prevention of untoward complications.

International Surgery Journal, 2018

Background: The serum lipase/amylase (L/A) ratio had been proposed to distinguish the etiology of... more Background: The serum lipase/amylase (L/A) ratio had been proposed to distinguish the etiology of pancreatitis, the efficacy to predict the etiology of acute pancreatitis is assessed in our study as it may need different therapeutic approaches.Methods: From January 2017 to December 2017, 54 patients with acute pancreatitis were included 48 (88.9%) men and 6 (11.1%) women with a mean age of 39.2 years, ranging from 18 to 90 years. They were divided into 2 subgroups as alcohol (n=27), nonalcoholic (n=27), and their serum L/A ratio level were compared with a mean age 39.42±9.9 years in alcoholic group versus 39.04 ± 7.7 years in nonalcoholic group.Results: Male predominance in alcoholic and nonalcoholic group and all female patients (100%) etiology is nonalcoholic. The elevation of serum amylase level in nonalcoholic group on average is 600 versus in alcoholic group 512 and serum lipase level average in nonalcoholic group 766 versus in alcohol group 629. Instead, the serum L/A ratio sh...

International Surgery Journal, Apr 21, 2018

Acute pancreatitis is a common condition involving the pancreas. The estimated incidence is about... more Acute pancreatitis is a common condition involving the pancreas. The estimated incidence is about 3% of cases presenting with pain abdomen. 1 Although most episodes are mild and self-limiting, up to a 20% of patients develop severe attacks that can be fatal. Gall stones and sustained alcohol abuse together account for 80% of acute pancreatitis. The relative frequency of these two factors depends on prevalence of alcoholism in the population studied. 2 Of the mechanical causes of acute pancreatitis, choledocholithiasis is the most common and between 36% and 63% will develop recurrent acute pancreatitis if stone persists. In about 10-30%, cause of acute pancreatitis is idiopathic, other rare causes include ischemia, drug induced, hyperparathyroidism, ERCP, hypercalcemia, trauma, pancreas divisum, autoimmune, hereditary, infectious, malnutrition, scorpion bite, hyperlipoprotenemia, pregnancy. The severity of acute pancreatitis can be predicted based upon clinical, ABSTRACT Background: Acute pancreatitis is a common condition involving the pancreas. The estimated incidence is about 3% of cases presenting with pain abdomen. The study is undertaken to study the various etiological factors and clinical factors of alcoholic and nonalcoholic acute pancreatitis and to assess the prognosis, outcome, management of an alcoholic and nonalcoholic acute pancreatitis. Methods: A total of 60 cases from BMCRI hospital attached selected during the study period from November 2015 to June 2017. Results: In the present study total 60 patients with acute pancreatitis were enrolled, 55% were alcoholic and remaining 45% were nonalcoholic. The mean age of presentation in our study was 39.2 years and in alcoholic it was 39.42 years, and nonalcoholic it was 39.07 years. There was a male predominance with males accounting for 90 percent in which 61.1% are alcoholic and 38.9 percent are nonalcoholic with 9:1 male to female ratio. In our study 100 % of patients had tenderness, 3% of alcoholic and 7.4 % of nonalcoholic presented as mass abdomen, and 21.2% alcoholic and 7.4% of nonalcoholic presented as ascites. USG abdomen was diagnostic in 93.3 % of the patients in our study. All of them managed conservatively, of the 8 patients of biliary pancreatitis 7 underwent interval cholecystectomy, and 1 underwent ERCP + ES. Conclusions: Acute pancreatitis is a common cause of acute abdomen. Alcohol being the most common cause of acute pancreatitis in the present study. Nonalcoholic pancreatitis contribute to a significant proportion of etiology of pancreatitis. Prompt identification and diagnostic work up to identify the etiology of pancreatitis followed by appropriate treatment results in cure and prevention of untoward complications.

International Surgery Journal, 2018

Background: The serum lipase/amylase (L/A) ratio had been proposed to distinguish the etiology of... more Background: The serum lipase/amylase (L/A) ratio had been proposed to distinguish the etiology of pancreatitis, the efficacy to predict the etiology of acute pancreatitis is assessed in our study as it may need different therapeutic approaches.Methods: From January 2017 to December 2017, 54 patients with acute pancreatitis were included 48 (88.9%) men and 6 (11.1%) women with a mean age of 39.2 years, ranging from 18 to 90 years. They were divided into 2 subgroups as alcohol (n=27), nonalcoholic (n=27), and their serum L/A ratio level were compared with a mean age 39.42±9.9 years in alcoholic group versus 39.04 ± 7.7 years in nonalcoholic group.Results: Male predominance in alcoholic and nonalcoholic group and all female patients (100%) etiology is nonalcoholic. The elevation of serum amylase level in nonalcoholic group on average is 600 versus in alcoholic group 512 and serum lipase level average in nonalcoholic group 766 versus in alcohol group 629. Instead, the serum L/A ratio sh...