Online ISSN: 2515-8260

Keywords : Serum Amylase


Correlation Of Serum Amylase with Outcome in Acute Organophosphorous Poisoning

Dr Acharya Suvendu S, Dr Naik Deepak K, DrBiswal Pratap C, DrPadhy Rasmita K

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 254-264

Context:Organophosphorus (OP) poisoning is a common mode of suicidal poisoning. These compounds are widely available in developing country like India, resulting in high morbidity and mortality. The use of serum amylase in determining the severity of OP poisoning has showed promise.
Aims:This study was undertaken to estimate serum amylase levels in acute OP poisoning and to correlate it with the outcome.
Settings and Design:
Setting – tertiary care treating hospital
Design -cross-sectional observational study
Methods and Material:A hospital-based cross-sectional study was conducted on 80 patients who were clinically diagnosed with acute OP poisoning. Serum amylase was measured on days 1 and 2 of admission and correlated with clinical features and the end result.
Statistical analysis used was SPSS 23.0 version software, and the data was analyzed. To compare the variables across the groups, the H test and Chi-square test were used.
Results:The majority of the cases in the study (41%) were between the ages of 21 and 30. Males made up 65 % of the group, while females 28 %. Serum amylase levels were significantly elevated in patients with clinical features of OP poisoning. The median serum amylase level was 80 IU/l (IQR 50–224.5). Serum amylase levels were normal in 62.5 % (n-50), but elevated in 37.5 % (n-30). A bad outcome was linked to a persistently elevated serum amylase level on day 2.
Conclusions: Serum amylase levels is also considered as a prognostic marker of OP poisoning since it enables the first recognition of severity and to spot those in danger of developing the complications of OP poisoning.
 

The Use of Urinary Amylase Levels in the Diagnosis of Acute Pancreatitis

Syed Mohammed Sajjad Husayni, Mohammed Naqi Zain, Mohammed Shazad Ahmed

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5029-5038

Background:Acute pancreatitis is a relatively common but potentially fatal disease seen
in surgical practise. Clinical examination, laboratory investigations, and imaging
techniques are used to make a diagnosis of the disease. Patients usually present with
severe pain in the epigastric region that radiates to the back. Serum levels of amylase
and lipase that are more than three times the normal value usually indicate acute
pancreatic inflammation. When clinical and laboratory investigations fail to diagnose
the disease despite a strong suspicion of acute pancreatitis, radiological investigations
are used to make a diagnosis. Urinary clearance of pancreatic enzymes from the
circulation increases in acute pancreatitis. This is a study that will use urinary amylase
levels to diagnose acute pancreatitis in a non-invasive manner. Objectives: To diagnose
acute pancreatitis using urine amylase levels in conjunction with other specific tests
such as serum lipase and abdominal ultrasound, and to demonstrate that urine amylase
can be used to diagnose acute pancreatitis.
Materials and Methods: It is a case control study with 40 patients diagnosed with acute
pancreatitis and 40 patients admitted with other diagnoses. Patients admitted to Princes
Esra Hospital between November 2019 and May 2021 were chosen as cases and
controls. Serum amylase, serum lipase, and urinary amylase levels were measured in
both the case and control groups. After comparing serum amylase, serum lipase, and
urinary amylase levels in cases and controls, the sensitivity and specificity of these
enzymes were determined.The authors concluded that serum amylase had the highest
sensitivity (100 percent) and serum lipase had the highest specificity (100 percent) after
analysing serum amylase, serum lipase, and urinary amylase results in both cases and
controls (95 percent). Urine amylase's sensitivity and specificity were found to be
98.33% and 95%, respectively. The area under the curve for serum amylase, serum
lipase, and urinary amylase was found to be 0.987, 0.995, and 0.935, respectively, using
ROC curve analysis.
Conclusion: Because serum amylase, serum lipase, and urinary amylase have
comparable sensitivity and specificity, as well as comparable areas under the curve on
ROC analysis for the diagnosis of acute pancreatitis, the authors conclude that urinary
amylase can be used in the diagnosis of acute pancreatitis.

A STUDY ON EVALUATION OF SERUM AMYLASE LEVELS IN DUODENAL ULCER PERFORATION ANDITS COMPLICATIONS

Chennaiah M

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11533-11543

Background:High serum amylase is frequently found in perforated duodenal ulcer (PDU),the rise in serum amylase occurs in cases of perforated peptic ulcer partly as a result of increase leakage of pancreatic enzymes rich fluid from the perforation site with subsequent absorption by peritoneal lymphatics & partly due to damage of pancreases by digestive enzymes that spilled through the perforation. Interestingly, the start of these trends all predated the use of H2 receptor blockers, or proton pump inhibitors, fibre optic endoscopy, and highly selective vagotomy. However, the incidence of emergency surgeryand the death rate associated with peptic ulcers has not decreased nearly so dramatically. Aims and objectives: The purpose of this study is to study signs, symptoms, mode of presentation and post operative complications associated with duodenal perforation and importantly to assess the Serum Amylase levels in duodenal perforation and correlate the levels with post operative complications.
Materials and Methods: 60 patients who underwent surgery (Graham’s omental patch repair) for perforated duodenal ulcer in Department of Generla Surgery attached to SVS Medical College were studied from 1-1-2020 to 1-12-2021. The following factors were analysed in terms of morbidity and mortality: age > 18 years; gender; chronic ingestion of NSAIDs; alcohol ingestion and smoking, hemodynamic status on admission; ASA status; site and size of perforation; type of peritoneal collection and Serum Amylase level on the day of admission. Postoperative complications like wound infection, wound dehiscence, postoperative leak, septicaemia, respiratory complications, acute kidney injury and death were assessed and correlated with the Serum Amylase levels.
Results: 60 patients included in this study with proven perforated duodenal ulcer, 54 (90 %) were male and 6 (10 %) were female, male to female ratio was 9 :1. The mean age was 58.4 years, ranging from 31-75 years. The overall mortality was 28%. In 34 patients (57 %), the serum amylase was within normal range, the mortality in this group was NIL. The other 26 patients (43%) had level of 200 or above, the mortality in this group was 48 %. The size of perforation has prognostic significance, for the larger the perforation, the higher the mortality. Patients who were operated after 24 hours of admission and whohad shock (systolic BP <90 mm Hg) on admission had significantly elevated Serum amylase levels and mortality in this group was 100%.
Conclusion: Limiting surgical delay in patients with PDU seems to be of paramount importance in reducing the mortality in these patients. In patients with PPD, the high serum amylase the high mortality rate.

The levels of serum amylase in organophosphorus poisoning cases: clinical descriptive study

Dr. Manoj Chandra MC, Dr. Divya Chandra, Dr. Nagaraj M Bhat B, Dr. Sharanappa G Pattanshetty

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11926-11929

In Organophosphorus poisoning raised serum amylase (hyperamylasemia) level is secondary to pancreatic injury because of parasympathetic overstimulation and hypersecretion. There have been studies showing that elevated serum amylase on admission day was related to the development of respiratory failure need for ventilatory support and increased mortality. Observation method of primary source of information in the department of general medicine. Secondary source of information from published articles, journals, books, case sheets, discharge summary, related websites are used in planning, developing, synopsis and during dissertation as supporting document. In our study, mean AMYLASE levels in mild poisoning is 114.23, in moderate it is 312.77 and in severe it is 774.66.