Background Acute pancreatitis is one of the main causes of acute abdomen. It may cause multi-organ failure or even death. High morbidity and mortality are associated with it. The research study aimed at evaluating the clinical characteristics and results of acute pancreatitis in our community. Results Mean age of patients was 50.96 ± 9.71 years and 30 (60%) patients were males. Gallstone was the most frequent etiology (56%) followed by idiopathic pancreatitis (26%). The majority of patients improved and only four patients died. Old age, presence of comorbidities, and leucocytosis were risk factors for a severe attack while old ages, presence of comorbidities, severe pancreatitis, and presence of complications were associated with mortality. Conclusion Acute pancreatitis could have serious outcomes if not correctly and early managed. It is recommended to perform multicenter studies with a large sample of patients. A multi-disciplinary team is required to assess idiopathic pancreatitis.

Introduction and objectivesPleural fluid adenosine deaminase (pfADA) is a validated diagnostic marker for pleural tuberculosis (TB) in high prevalence areas, with good sensitivity and specificity reported at a threshold of 40 U/L. However, in north-west Europe pfADA is not routinely measured, due to a lack of evidence as to its diagnostic utility in areas of low TB prevalence. The aim of this study is to assess the sensitivity and specificity of pfADA in a low-prevalence area, evaluating its diagnostic value for pleural TB.MethodsA retrospective analysis considered all pfADA-tested suspected pleural TB patients within one hospital trust from 2009–2015. This cohort was then divided into two groups: those with a confirmed diagnosis of pleural TB and those without pleural TB. Those without pleural TB were used as a control group, to determine the sensitivity and specificity of pfADA at various thresholds.ResultsOf 156 patients tested for pfADA, 25 had confirmed pleural TB and 131 did not, with mean pfADA levels of 71.7 (±25.2) and 19.8 (±22.4), respectively. On a Receiver Operating Characteristic (ROC) curve (Figure 1), pfADA of 30 U/L has a sensitivity of 100%, specificity 83%, positive and negative predictive values of 53% and 100% respectively. At a threshold of 40 U/L, sensitivity was 88% with a specificity of 88%. The calculated area under ROC curve is 0.949 (95% CI 0.91–0.982).Abstract P252 Figure 1 ConclusionAlthough the positive predictive value of pfADA may be lower in areas of low TB prevalence, its negative predictive value is unaffected, retaining its value as a worthy screening test to exclude pleural TB, allowing focus on obtaining adequate culture samples and biopsies in suspected pleural TB.

Background: Diabetes is an important risk factor of extra and intracranial stenosis and hence can cause cerebrovascular stroke. In Egypt, prevalence of asymptomatic extra and intracranial blood vessels stenosis in diabetic patients is still unknown. Objectives: To estimate the prevalence of asymptomatic extra and intracranial vessels stenosis. Methods: 100 Patients with Type-2 Diabetes (T2D) were recruited consecutively from diabetes clinic of the department of internal medicine at Assiut University Hospitals in the period from 1st January 2016 to 31st January 2017. A detailed history was obtained for all participant. As well, thorough-out physical and neurologic examination were carried out for patients. All patients underwent extra cranial and transcranial colour coded ultrasound by two independent investigators. Patients with history of cerebrovascular stroke and transient ischemic attacks were excluded. Results: 36% of patients had increased IMT, 6% had stenosis 50-69% and 2% had stenosis ≥ 70%. There was a positive correlation between age and increased IMT (r = 0.272) (P = 0.006) and between uncontrolled DM and increased IMT (r = 0.211) (P = 0.035). 26% of patients had stenosis of < 50% in vertebral artery (21% in V0 segment, 5% in V1 segment); being male and uncontrolled diabetes escalate the stenosis risk. MCA pulsatility index was found to be higher among old diabetics in comparison to younger diabetics and control group (r = -0.225) (P = -0.025). Also, the longer the time since T2D onset, the higher was MCA PSV (r = 0.244) (P = 0.014). Conclusions: The cerebral blood vessels atherosclerotic changes (mainly extracranial) are higher among diabetics in comparison to healthy controls.

Background Acute pancreatitis is a relatively common acute medical presentation that may progress beyond the pancreas to cause multi-organ failure or death. It is associated with high morbidity and mortality with mortality rates changing little in the past few decades despite advances in intensive care and surgical management. Early evaluation of acute pancreatitis severity is essential to allow the clinician to predict the patient’s clinical course, estimate the prognosis, determine the need for intensive care unit admission, and prevent complications. So, the purpose of our study is to evaluate the prognostic value of the neutrophil to lymphocyte ratio, lactate dehydrogenase enzyme, and proteinuria in patients with acute pancreatitis and its correlation with Ranson’s criteria scoring system as new, rapid, and easy parameters to predict severity of acute pancreatitis. Results The mean age of patients in years was 47.97, and the median was 52 with a range of ages between 18 and 87; 38% of the patients included were males, and 61% were females. The mean Ranson’s score was 2.77 ± 1.4, and the median was 3 with a range of 0–6; 44.5% of patients included have low severity, 42.4% have mild severity, and 13.1% of patients have high severity. Neutrophil to lymphocyte ratio both at the time of admission and after 48 h of admission was significantly increasing with an increase in disease severity with a P value of < 0.001 that was statistically significant. Lactate dehydrogenase enzyme at the time of admission was also significantly increasing with diseased severity with a P value of 0.001 that was statistically significant and the same for lactate dehydrogenase enzyme level after 48 h of admission with a P value of 0.002 that was also statistically significant. Proteinuria is positive only in 15.2% of patients and with the same result after 48 h of admission. Conclusion The neutrophil to lymphocyte ratio gives a rapid impression of the extent of the inflammatory process, and it can effectively predict severity at the time of admission and even after 48 h of admission and can also differentiate between patients with mild and severe acute pancreatitis in both calcular and non-calcular cause-dependent acute pancreatitis patients. Lactate dehydrogenase can be used to predict severity in calcular cause-dependent acute pancreatitis patients only at the time of admission and after 48 h of admission. Proteinuria in urine analysis on admission and after 48 h does not seem to be a reliable predictor for disease severity in acute pancreatitis.