European Journal of Molecular & Clinical Medicine

Introduction: The diagnosis of ACS is overlooked in about 2% of patients, which can lead to negative consequences. The term acute coronary syndrome comprises unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI) and ST-segment myocardial infarction (STEMI). ACS is often the first presentation of coronary artery disease (CAD), the leading cause of mortality and morbidity in many parts of the world.
Aims and objectives: 1. To find out the levels of serum Gamma glutamyl transferase (GGT) in patients admitted with acute coronary syndrome. 2. To determine the association of raised GGT levels with different sub types of ACS.
Material and methods: It is an observational study, constituted of 150 study cases presented with Acute Coronary Syndrome to the medicine intensive cardiac care unit Deptt. of Medicine at R.D. Gardi Medical College and C.R. Gardi Hospital, Ujjain from December 2017 to November 2018.
Observations and results: Out of one fifty study cases, ninety (60.0%) cases were STEMI and among them fifty four (60.0%) had raised GGT level while Thirty six (40.0%) case had normal GGT value. Forty five (30.0%) cases were NSTEMI and among them twenty four (53.3%) had raised GGT level while twenty one (46.7%) had normal. Fifteen (10.0%) cases were having Unstable angina and among them three (20.0%) had raised GGT level while twelve (80.0%) had it normal. Chi Square value 8.293, p value was 0.016. There was highly significant association of various sub types STEMI and NSTEMI of ACS with GGT levels.
Discussion: In present study majority ninety four (62.7%) patients were males and Fifty six (37.3%) females with a Male: Female ratio of 1.6:1. Males 55.3% and Females 48.2% had an elevated GGT value. However there was no significant Gender wise association with GGT levels (Chi square =0.176, p value = 0.674).The age group of our patients ranged from 35 to 90 years and the mean age was male 62.63+/-10.90 & female 57.79+/15.38 years with peak incidence in the sixth and seventh decades. In this study there was no statistical age wise significant association with GGT levels. Similarly Emiroglu MY et al in 2010 obtained the male preponderance in cases of each subset of ACS with a positive age wise association with GGT values and that was not with gender wise.
Conclusion: GGT may have a role in diagnosing cases of myocardial infarction especially in the presence of a non-diagnostic ECG. This will help in preventing MI cases to be missed in the ED. In addition to its diagnostic role in MI, GGT also has a discriminatory capacity to differentiate between STEMI, NSTEMI and UA. GGT can hence be an important laboratory tool alongside Troponin I and the electrocardiogram in the categorization of MI.  Further its prognostic impact could be utilized in the risk stratification and the need for urgent therapeutic intervention

ACS (abdominal compartment syndrome) is a serious condition that affects critically ill people. Because it predominantly affects individuals who are already sick, it may go unnoticed. The aim of study to find a link between IAP and the development of problems in patients with severe acute pancreatitis. We also wanted to see if there was a link between IAP and the development of complications in patients with severe acute pancreatitis (SAP). Patients and methods: This prospective study was conducted on 18 patients with AP hospitalised to the Surgical Intensive Care Unit at Zagazig University's Faculty of Medicine's General Surgery Department (SICU). During the first week after admission, all patients were divided into two groups based on their IAP. Patients with IAP 20 mmHg were assigned to the IAH group, whereas those with IAP 20mmHg were assigned to the normal IAP group. Results: Age, serum Lipase and APACHE were significantly higher among ACS cases and also ACS cases were significantly associated with DM. ACS cases were significantly associated with longer hospital stay also with bleeding, septic shock and mortality.The mean Lipase level was 959.72±103.58 with rang (800-1200). The mean Intra-abdominal pressure of studied patients was 12.94±4.12 and 38.9% of patients had IAH while 2 cases 11.1% had ACS. Conclusion: In patients hospitalised to the ICU with severe acute pancreatitis, IAH and ACS are common findings. IAH could make severe acute pancreatitis worse. Early detection of this possibly treatable aggravating condition could lead to early management and, in turn, a better prognosis.