Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

KNOWLEDGE, BEHAVIOUR AND ATTITUDES REGARDING HIV/AIDS AMONG UNDERGRADUATE STUDENTS IN AN IRISH UNIVERSITY

A descriptive cross sectional study was conducted in an Irish University among undergraduate students in 2012. A web questionnaire consisted of items related to HIV/AIDS knowledge, behaviour and attitudes was sent to all undergraduate students aged 18 years or above. Despite the fact that majority of students were aware about the transmission of HIV/AIDS, this study showed that students were less likely to translate their knowledge about HIV/AIDS transmission into healthy behaviour. In addition, they engaged in risky sexual behaviour which increases the likelihood of acquiring HIV/AIDS and other sexually transmitted diseases

REPORTING AN UNUSUAL CASE OF INFERTILITY; ISOLATED BILATERAL TUBERCULOUS EPIDIDYMO-ORCHITIS

Tuberculosis may infect any part of the body. Tuberculous orchitis is a rare disease that usually occurs as a result of direct extension from the epididymis. Only a paucity of cases regarding epididymo-orchitis and scrotal involvement without renal or pulmonary involvement has been reported until today. Isolated tuberculous epididymo-orchitis presents with a clinical picture and radiographic illustrations mimicking a scrotal neoplasm; therefore, diagnosis can be challenging for physicians. We are presenting a case of isolated bilateral tuberculous epidymo-orchitis resulting in infertility and discharging scrotal sinuses which responded to 6 months anti – tuberculous therapy