Colistin and tigecycline are best reserved as last-resort antibiotics. Fungal infection was found to be associated with increased mortality, median hospital stay, and intensive care unit stay.

Intestinal fatty acid binding protein is a promising prognostic marker in acute pancreatitis.

Endoscopic examination of the gastrointestinal (GI) tract plays a very important role in the diagnosis and follow-up of patients with Crohn’s disease (CD) and intestinal tuberculosis (TB). The clinical, morphological, and histological features of GI TB and CD are so similar that it becomes difficult to differentiate between these two entities. In geographical regions such as India where both GI TB and CD are prevalent, differential diagnosis between the two is challenging. While there is a lot of similarities between these two disorders, these two can be differentiated from each other with a combination of clinical, endoscopic, histological, radiological, and endoscopic features. The observation of the characteristic lesions at endoscopic examination and the extent of involvement in CD and intestinal TB is an important step in differentiation between these two disorders. While the most important endoscopic characteristics such as involvement of left side of the colon and presence of longitudinal ulcerations and cobblestoning support a diagnosis of CD, predominant involvement of ileocecal region and transverse ulcers support the diagnosis of intestinal TB. In this review, we have described the usefulness and limitations of endoscopic modalities in the diagnosis and differentiation of intestinal TB and CD.

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Background & objectives:In acute pancreatitis (AP) gut barrier dysfunction is considered as an important predisposing factor leading to increased intestinal permeability (IP). In this study a pooled analysis of data published in our previous four studies on various aspects of gut permeability and endotoxaemia in patients with AP was attempted to find an association between increased IP and severity of disease and associated complications.Methods:This study was a pooled analysis of data of four previously published prospective studies on AP. Gut permeability, assessed by lactulose/mannitol excretion in urine and endotoxin core antibodies type IgG and IgM (EndoCab IgG and IgM) were measured on days zero and seven (D0 and D7) of admission. All patients received standard treatment of AP. We studied whether IgG and IgM anti-endotoxin titres and lactulose-mannitol ratio (LMR) at admission and D7 were associated with organ failure, infection and mortality.Results:The titres of anti-endotoxin IgG and IgM were lower in all patients of AP (n=204), both in mild AP (n=24) and severe AP (n=180) in the first week, compared to controls (n=15). There was no significant difference in serum IgG and IgM anti-endotoxin levels and LMR at baseline and at D7 among patients with organ failure, infection and mortality.Interpretation & conclusions:Our findings showed that serum IgG and IgM anti-endotoxin titres and LMR at admission and at day 7 were not associated with organ failure, infection, and death of patients with AP.