Amylase Test Research Articles

AB114. SOH23ABS_024. How reliable urinary amylase testing for acute pancreatitis is?

AB114. SOH23ABS_024. How reliable urinary amylase testing for acute pancreatitis is?

Exploration of Indian Traditional recipe “Tarvaani” from the drained rice gruel for nutritional and probiotic potential

Study backgroundTraditional fermented foods are the source of probiotic bacteria which can be envisaged as formulation ingredients in various food and beverages. Scope and approachThe present research aimed to explore one of the Indian traditional recipes, “Tarvaani,” for nutritional and probiotic potential as a part of its healthy perspectives.Main findings and conclusion: The traditional recipe was found to contain the lactic acid bacteria and isolated. The isolated product showed prominent curdling activity after 48 h, and bacterial growth was seen in all the pH (pH 3–7) tested. The antibiotic susceptibility test found that streptomycin, vancomycin, and kanamycin were resistant to the bacterial culture, and imipenem, gentamycin, rifampicin, and tetracycline were found to be resistant susceptible to the bacterial culture according to zone diameter interpretative criteria given in ICMR SOP 2015. A clear halo zone around the tested colony was obtained in the amylase test, which indicated that starch was degraded and α-amylase was produced. The culture also showed prominent antimicrobial action and inhibited the growth of the pathogenic strains tested by a well-diffusion assay. Moreover, the isolates only showed no haemolysis activity after incubation at 30 °C for 24 h under anaerobic conditions. Overall, the present research findings showcase the nutritional and probiotic potential of Lactobacillus sp. of “Tarvaani” as a viable option as a formulation ingredient in traditional-based functional foods.

Identifying Overused Lab Tests in Hospital Settings: A Delphi Study


 Unnecessary lab testing may lead to inaccurate diagnoses, inappropriate treatment or further testing, and increased strain on our health care system, and can expose patients to potential harm.
 To identify lab tests that could be considered by Choosing Wisely Canada’s Using Labs Wisely program, we convened a panel of experts that included physicians, medical laboratory professionals, patients, and decision-makers from across Canada. Our objective was to prioritize a list of high-volume laboratory tests that are often ordered unnecessarily in hospital settings.
 Through a consensus-generating process, the expert panel prioritized 7 lab tests as candidates for reduction or elimination in hospital settings. These were 25-hydroxy vitamin D testing, vitamin B12 testing, thyroid stimulating hormone (TSH) testing, free triiodothyronine (FT3) and free thyroxine (FT4) testing, international normalized ratio (INR) testing, and amylase testing.

A new insight into forensic odontology through salivary amylase amongst neurodevelopmental disorders: A review

Over the last decade, Saliva is being chosen as an alternative to blood and urine. Whole saliva contains mixture of secretions. Saliva is usually deposited in bite marks found in many homicides, assault and other criminal cases. Saliva is often detected in the crime scene along with bite marks or lip prints where the oral cavity may have been involved. Cellular and serological analysis of the obtained saliva is of immense use in identification of the accused. One such component of saliva is Amylase testing. It has been used as a presumptive test for crime scene. Neurodevelopmental disorders (NDDs) are multifaceted conditions characterized by impairments. People with NDD are overrepresented in criminal populations and evaluating them for criminal responsibility can often be a complex task for forensic examiners. Salivary Amylase can be used as a tool to evaluate the mental health of the offender.

Identification and Prevention of Microbial Contaminants in Musa paradisiaca Tissue Culture

Banana (Musa spp.) is an economically vital fruit crop in Malaysia and therefore, micropropagation was applied to meet the market demand for disease-free seedlings. However, microbial contamination is a significant obstacle in micropropagation techniques. In this research, the microorganisms that were present in the banana culture were characterized and the efficacy of antimicrobial and antifungal agents to inhibit contaminants was evaluated. Three bacterial and two fungal isolates were isolated from the contaminated culture. Klebsiella pneumoniae, Klebsiella quasipneumoniae, and Klebsiella variicola were identified by molecular identification based on the 16S rDNA sequence. The gram-staining method confirmed all three bacteria were gram-negative. Oxidase and catalase tests showed the presence of cytochrome oxidase system and catalase enzyme in all bacteria. The bacteria can also hydrolyze starch, ferment sugars, and reduce sulfur from the amylase test. Phenotypic identification of fungi revealed the presence of conidia and hyphae, indicating the presence of Colletotrichum spp. and Aspergillus spp. In fungi characterization, Colletotrichum gloeosporioides and Aspergillus flavus were detected. Chloramphenicol was identified as an effective antibacterial agent from the disc diffusion method. Fluconazole was a potent antifungal agent by screening the sterilizing agents. The findings may potentially lead the way for the implementation of reducing the contamination rate in banana micropropagation.

Physio-chemical properties of methyl red-degrading strains isolated from textile wastewater

Methyl red (MR)-reducing strains isolated from textile wastewater were identified and tested for physio-chemical properties. The bacterial colonies picked from the mineral medium supplemented with textile wastewater were transferred onto the mineral medium containing MR for the test. Two strains, namely SYK and STXL2, demonstrating the ability of MR decolorization in the agar medium were selected and purified. The strains SYK and STXL2 incubated in the liquid mineral medium with MR were able to reduce 100 % and 95.5 % of MR after 4 days incubation, respectively. Gram staining of both strains confirmed these two isolates were gram positive. The SYK strain has white, irregular and dry colonies while the STXL2 strain has orange, opaque, circular and glossy colonies. Both strains have short rod shape of cell under SEM images. The two strains were able to grow in the media such as Luria-Bertani medium, Meat-peptone broth, and Nutrient broth. The strain SYK were able to grow quickly in the medium with maltose while the strain STXL2 used glucose as the best carbon source. Biochemical tests showed that both strains had positive reaction in Voges-Proskauer test and negative reactions in lipase, cellulose, amylase, citrate, and gelatin hydrolysis tests. The SYK strain had positive reactions in protease, urease, and ammonia tests while the STXL2 strain had positive reaction in nitrate reduction test. The sequences of 16S rNA genes identified the SYK and STXL2 strains as Streptomyces cellulosae (100 % of similarity) and Rhodococcus ruber (99 % of similarity), and registered in the GenBank via the accessing number MZ414193 and MZ414194, respectively.

The killer outfit and timing: Impact of the fabric and time in body fluid identification and DNA profiling

The present work aimed to study the detection, through lateral flow immunochromatographic (LFI) tests, of saliva samples over time in three different types of fabrics, as well as, the possibility of DNA isolation and characterization from the sample tubes and the cassettes. Fifty microliters of saliva (three samples/time) were deposited in denim, cotton, and polyester. Saliva was identified by SERATEC® Amylase Test and the Crime Scene version SALIVA CS, being able to detect it up to six months of deposition, although with different band intensities. Polyester showed stronger bands than cotton, probably due to its synthetic nature, and denim, as an inked fabric, showed less band intensities. Statistical analyses confirmed significant differences among fabrics, but not over time in the same type of fabric. Total DNA from the sample tubes was successfully recovered, in contrast, from the cassettes, only polyester retrieved amplifiable DNA. These findings indicated that it is possible to recover and identify saliva up to six months after deposition, also obtaining DNA. Future research will be able to expand these results, analyzing the stability of other body fluids, and the sensitivity of lateral flow immunochromatographic tests to detect them.

S67 Overutilization of Amylase and Lipase Testing in Acute Pancreatitis

S67 Overutilization of Amylase and Lipase Testing in Acute Pancreatitis

Polyhydroxyalkanoate recovery from newly screened Bacillus sp. LPPI-18 using various methods of extraction from Loktak Lake sediment sample

BackgroundNowadays, the conventional plastic wastes are very challenging to environments and its production cost also creates an economic crisis due to petrochemical-based plastic. In order to solve this problem, the current studies were aimed at screening and characterizing these polyhydroxyalkanoate (PHA)-producing isolates and evaluating the suitability of some carbon source for newly screened PHA-producing isolates. Material and methodsSome carbon sources such as D-fructose, glucose, molasses, D-ribose and sucrose were evaluated for PHA production. Data were analyzed using SPSS version 20. The 16SrRNA gene sequence of these isolates was performed. These newly isolated taxa were related to Bacillus species. It was designated as Bacillus sp. LPPI-18 and affiliated Bacillus cereus ATCC 14577T (AE01687) (99.10%). Paenibacillus sp. 172 (AF273740.1) was used as an outgroup. ResultsBacillus sp. LPPI-18 is a gram-positive, rod-shaped, endospore former, and citrate test positive. This isolate showed positive for amylase, catalase, pectinase, and protease test. They produced intracellular PHA granules when this isolate was stained with Sudan Black B (SBB) and Nile blue A (NBA) preliminary and specific staining dyes, respectively. Both temperature and pH used to affect polyhydroxyalkanoates (PHA) productivity. Bacteria are able to reserve PHA in the form of granules during stress conditions. This isolate produces only when supplied with carbon sources. More PHA contents (PCs) were obtained from glucose, molasses, and D-fructose. In this regard, the maximum mean value of PC was obtained from glucose (40.55±0.7%) and the minimum was obtained from D-ribose (12.4±1.4%). Great variations (P≤0.05) of PCs were observed among glucose and sucrose, molasses and sucrose, and D-fructose and sucrose carbon sources for PHA productivity (PP) of cell dry weight (CDW) g/L. After extraction, PHA film was produced for this typical isolate using glucose as a sole carbon source. Fourier transform infrared spectrum was performed for this isolate and showed the feature of polyester at 1719.64 to 1721.16 wavelengths for these extracted samples. The peak of fingerprinting (band of carboxylic acid group) at this wavelength is a characteristic feature of polyhydroxybutyrate (PHB) and corresponds to the ester functional group (C=O). ConclusionIn this study, newly identified Bacillus sp. LPPI-18 is found to be producing biodegradable polymers that are used to replace highly pollutant conventional plastic polymers. This isolate is also used to employ certain cost-effective carbon sources for the production of PHA polymers. Graphical Abstract▪

The effect of acid use as a preservative on the results of biochemical tests measured in 24-h urine

Twenty-four-hour urine measurements play a crucial role in the diagnosis, follow-up and treatment of various diseases. There are different approaches to the collection of urine in patients who need to collect multiple urine samples at a time, especially in hospitals with heavy workloads. In this study, we compared the sodium, potassium, chloride, amylase, calcium, creatinine, phosphorus, microalbumin, protein, magnesium, urea, uric acid, adrenaline, noradrenaline, dopamine, metanephrine, normetanephrine, vanillylmandelic acid, 5-hydroxyindoleacetic acid and homovanillic acid results of 24-h urine samples analyzed immediately without acid addition, which we accepted as the reference and baseline measurement, with the results of the samples analyzed after waiting for 24 h without acid addition, analyzed immediately with acid addition and analyzed after waiting for 24 h with acid addition. Chloride, microalbumin, amylase and protein tests, which are recommended to be measured in the sample without preservatives, are affected by acid addition. Adrenaline, noradrenaline and dopamine, which are the tests recommended to be measured in acid-added urine are degraded in the samples without acid, and the levels of metanephrine and normetanephrine were not significantly degraded in the absence of preservatives.

The diagnostic value of laboratory tests in detecting solid organ injuries in pediatric patients with blunt abdominal trauma

BackgroundComputed tomography of the abdomen (CT) is used as the gold standard for detecting solid organ injuries (SOI) after blunt abdominal trauma (BAT). However, patient selection for CT is still controversial due to its potential risks. In this study, we aimed to investigate the usefulness of laboratory tests in the detection or exclusion of SOI in pediatric patients evaluated in the emergency department due to BAT. MethodsThe study was planned as a prospective, observational study and was conducted in the emergency department of a university hospital between February 2018 and February 2019. Patients under the age of 18 who were evaluated for BAT in the emergency department were included in the study. In the study, the diagnostic value of abnormal laboratory tests in detecting SOI was calculated by accepting CT results as the gold standard. ResultsOf the 323 patients included in the study, 118 (36%) were male. There were 283 patients who underwent CT. SOI was detected in 18 (6%) patients. Abnormal alanine aminotransferase, aspartate aminotransferase, amylase and lipase tests were found to be statistically significant in predicting SOI (p < 0.05). However, none of the tests were found to have sufficient sensitivity and specificity. Hemoglobin, hematocrit, lactate and base excess values were not found to be statistically significant in predicting SOI (p > 0.005). ConclusionsThe hematologic laboratory tests are insufficient to rule out solid organ injury in pediatric patient with BAT.

“Pseudomonas fluorescens” as an Antagonist to Control Okra Root Rotting Fungi Disease in Plants

The common bacteria found in fruit and vegetables are Pseudomonas fluorescens which is Germ-negative and is rod-shaped. Pseudomonas fluorescens has been originated from the rhizosphere of Roorkee-grown okra. The presented work involves recognizing and controlling the isolates of Pseudomonas fluorescens. The scope of the proposed work is that the technique used here is a unique strategy to plant protection and control of rotting fungus diseases based on the recognition and management of Pseudomonas fluorescens isolates. Antagonist effect occurs commonly in vegetable and fruit plants. The main goal of this study is to isolate, identify, and evaluate the development of these bacteria which effects on plant growth. In this research work, five isolates have been chosen for further research based on their morphological, biochemical, and physiological characteristics. All five isolates have been identified as Pseudomonas fluorescens from Bergey’s Manual for the determination of bacteriology. Catalase, urease, amylase, and citrate utilization test were all positive in all of the isolates. PFTT4 was identified to be a likely strain for all plant growth promoting exercises such as age of IAA, HCN, ammonia, and phosphate solubilization subsequent to being assessed for their plant development advancing properties. Further, in vitro exploring uncovered that PFTT4 diminished the development of phytopathogens such as Fusarium solani and extraordinarily further developed seed germination just as all development boundaries like shoot and root length. Furthermore, Pseudomonas sp. PFTT4’s plant growth promoting and antifungal activities put forward to it could be there used because of bioinoculant agents for Abelmoschus esculentus.

Rhein Protects Against Severe Acute Pancreatitis In vitro and In vivo by Regulating the JAK2/STAT3 Pathway.

Rhein is widely used in inflammation treatment in China, but its effects on severe acute pancreatitis (SAP) have not been studied closely. This study investigated rhein’s protective effects against SAP using in vitro and in vivo models to determine whether its protective mechanism regulated the Janus kinase two and signal transducer and activator of transcription 3 (JAK2/STAT3) signalling pathway. Thirty-six male Sprague–Dawley rats were randomised into sham operation, SAP and rhein groups. The SAP model was induced by retrograde pancreatic bile duct injection of sodium taurocholate. Serum TNF-α and interleukin (IL)-6 levels were determined by ELISA, whereas serum amylase and lipase concentrations were measured using test kits. Western blot and/or immunohistochemistry quantified JAK2 and STAT3 expression. Furthermore, histopathological pancreatic changes were detected by haematoxylin and eosin staining. AR42J cells were randomly divided into the control, cerulein and rhein groups. Amylase activity was assessed using an amylase test kit; the tumour necrosis factor-α (TNF-α) expression was determined by enzyme-linked immunosorbent assay (ELISA). JAK2 and STAT3 protein expression were evaluated by western blot. SAP was concomitant with increased JAK2 and STAT3 expressions in vivo. Pre-treatment with rhein attenuated serum TNF–α and IL-6 levels effectively, and notably reduced p-JAK2, p-STAT3, JAK2 and STAT3 protein expression. Rhein significantly alleviated pancreatic histopathology. Compared to untreated groups, rhein significantly reduced amylase activity in supernatants of AR42J cells induced by cerulein in vitro. Furthermore, rhein altered JAK2 and STAT3 protein levels in AR42J cells after cerulein induction. Overall, rhein exerted protective effect on SAP in vitro and in vivo, possibly through the JAK2/STAT3 signalling pathway.

Compliance to endoscopic retrograde cholangiopancreatography according to current guidelines and adverse outcomes of suspected choledocholithiasis in an acute care setting.

Common bile duct (CBD) stones are common among patients who underwent cholecystectomy. However, few studies have investigated the compliance with the guidelines for the prediction of choledochlithiasis (CL). Therefore, we aim to study the compliance with the American Society for Gastrointestinal Endoscopy (ASGE) guidelines for the identification of CL in a major hospital in Saudi Arabia's capital. We conducted a retrospective chart review on adult patients admitted to emergency department at King Abdulaziz Medical City, Riyadh with gallstones between January 2016 and January 2019. Our data collection includes demographics and level of suspicion based on Transabdominal Ultrasound, liver function, amylase, and lipase tests. We then determined the likelihood of CL based on ASGE guidelines in order to assess the adherence to ASGE guidelines, the procedure's outcomes and adverse outcomes. We identified 826 patients who met the study's criteria: 384 (46.4%) were compliant, while 442 (53.6%) were non-compliant with ASGE guidelines. There was a significant association between compliance and the presence of stones on ERCP in high likelihood patients. 48 (21.3%) of total ERCP procedures among all the likelihoods had adverse outcomes. 13 (40.6%) of non-compliant ERCP performed in intermediate likelihood have experienced adverse outcomes. There was a significant association between having adverse outcomes and being non-complaint with ASGE guidelines. Despite ASGE guidelines' recommendations, a third of high likelihood cases and the majority of intermediate likelihood cases were non-compliant. Additionally, the current guidelines for the intermediate group are somewhat vague, giving ample leeway for patients to be placed in the intermediate group, which might subject them to unnecessary interventions. To conclude, there was a great lack of compliance with ASGE guidelines that is significantly associated with adverse outcomes. Hence, reassessing the current guidelines and monitoring healthcare facilities' compliance with the updated guidelines is highly recommended.

Reducing Unnecessary Amylase Testing Within a Veterans Affairs Medical Center

Reducing Unnecessary Amylase Testing Within a Veterans Affairs Medical Center

Recovery of DNA from SERATECⓇ immunochromatographic PSA and saliva test strips.

There is an increased use of immunochromatographic test strips to presumptively identify bodily fluids of forensic interest, such as blood, semen, and saliva. Commonly, forensic samples are of low quantities. In the practice of conserving limited samples, it would be ideal to be able to recover the genetic material deposited on these testing membranes. This research aimed to determine whether DNA could be extracted from semen and saliva test strips, which part of the test strip is best to use, and to assess the quality of the DNA recovered. Semen and saliva samples were deposited on SERATEC® PSA Semiquant and Amylase Tests and analyzed. The testing membrane was then removed from the cassette and DNA extraction methods (forensicGEM Universal, forensicGEM Sperm, QIAamp® DNA Mini kit, Monarch® Nucleic Acid Purification kit, and organic extraction) were performed. Quality was evaluated by qPCR and STR analysis. DNA from semen was best extracted using the Monarch® Nucleic Acid Purification kit, while saliva was best extracted using the forensicGEM or QIAamp kits. No significant differences were observed between collection of the sample well pad and testing strip, thus use of the entire strip is encouraged. DNA from semen and saliva was quantifiable with a 1:1000 dilution. DNA quality analysis by qPCR showed that there is no difference in the DNA quality following elution from the test strip. However, degradation was noted in saliva samples and some semen samples by STR analysis. Scientists are encouraged to consider processed test strips for DNA profiling to preserve evidence.

Phytochemical and multi-biological characterization of two Cynara scolymus L. varieties: A glance into their potential large scale cultivation and valorization as bio-functional ingredients

Artichoke leaf (Cynarae folium) extracts are used as traditional herbal medicinal products to treat a wide range of human ailments, being widely commercialized as nutraceutical or pharmaceutical preparations. In the current study, the hydromethanolic dried leaf extracts of Cynara scolymus L. var. major Brotero and C. scolymus L. var. redonensis N.H.F. Desp. were phytochemically and biologically investigated. The liquid chromatography high-resolution tandem mass spectrometry (LC-HRMS/MS) metabolite profiling showed a complex composition, with phenolic acids (mostly mono- and di-caffeoylquinic acids), flavonoids and sesquiterpene lactones as the most representative classes. The strong antioxidant activity of the two C. scolymus varieties was evidenced in DPPH [64.84–65.21 mg trolox equivalents (TE)/g] and ABTS (86.39–95.55 mg TE/g) radical scavenging, cupric (160.49–171.07 mg TE/g) and ferric (71.47–78.95 mg TE/g) reducing capacity, metal chelating and phosphomolybdenum assays. In addition, the two extracts also displayed anti-enzymatic effects, as assessed in cholinesterase, tyrosinase, glucosidase and amylase tests. Lastly, the artichoke samples (at the concentration of 20 μg/mL) proved a very potent inhibition of the production of several pro-inflammatory cytokines, namely interleukin (IL)-1β [7.55–15.75% of lipopolysaccharide (LPS) + cells], IL-8 (11.72–13.46% of LPS + cells) and tumor necrosis factor (TNF)-α (4.07–10.35% LPS + cells), in LPS-stimulated human neutrophils. Overall, the results of our study indicate that the two C. scolymus varieties could be regarded as a rich source of biologically active compounds, opening thus the perspectives for their future large scale cultivation and valorization as bio-functional ingredients with putative antioxidant, anti-enzymatic and anti-inflammatory effects.

Production &amp; Characterisation of Fermented Coconut Water and a Report on Its Health Benefits

Coconut water known as nutritive liquid and a natural medium for microbial growth is obtained from the endosperm of coconuts (Cocos nucifera) and is largely consumed in tropical countries. Fermentation with known culture of microbes gives desirable quality and more shelf life to this perishable drink. Fermentation of coconut water to prepare a beverage of high health benefits and commercial value was attempted. Tender coconut was fermented with Saccharomyces cerevisiae yeast and observed for the fermentative changes in around 15 days. The sensory analysis of obtained fermented drink was done to prove the quality of fermented product. The physiochemical analysis revealed that the pH was 4 to 5 pH on 15th day of fermentation and was stable. Fermented coconut water prepared contained textural element tannin in very low concentration as desired. Tannin content was found in range of 0.016 to 0.25%. The phenol content was measured using folin cioclteu assay method and was 33.8 % in finished drink. The alcohol content was 7-8% in finished drink as measured by spectrophotometry. Fermented coconut water retained active enzymes like peroxidase, catalase, and dehydrogenase that aids in the digestion and metabolism of food, and was proved by enzyme activity tests such as Amylase test, catalase test, peroxidase test. Coconut water is known to be flourished with amino acids and the presence of amino acids like tyrosine, tryptophan, alanine and valine in fermented coconut water was confirmed by paper chromatography. GC-MS analysis of fermented coconut water showed the presence of compounds - benzene ethanol, cyclohexane, gamma sitosterol, di alpha tocopherol. These compounds are known to support antibacterial, antithrombotic and antioxidant properties. Protein prediction using Swiss prediction was done to identify the available ligands in the Bio active compounds reported by Gas Chromatogram.

P-P04 The cost of acute pancreatitis is amylasing!

Abstract Background Amylase is the key serum biomarker in the diagnosis of acute pancreatitis, however there is no indication for repeat/serial measurement once the diagnosis is established. It is estimated that £27,000pa is spent unnecessarily on repeat amylase investigations without clinical indication1. Anecdotally, within the department, unnecessary repeats were being routinely performed. Resultantly, we audited in 2019 and 2020 to understand the extent of the issue. Following the first cycle, pre-rotation departmental talks were given to all relevant healthcare staff. Aim(s) Methods Data was collected and analysed retrospectively over 2 audit cycles (C1 &amp; C2) from 79 patient episodes of admissions to the surgical department of a Northern Major Trauma Centre with confirmed diagnoses of acute pancreatitis between 01/05/2019 – 31/07/2019 and 01/08/2020 – 31/12/2020. Resources used included: patient notes, IMPAX and WebICE. Data was collected and analysed by one author in C1 but multiple authors in C2. Results Mean age = 60 years. Male:Female ratio was 8:16 and 24:31, respectively. Initial amylase was diagnostic in &amp;gt; 75% (61/79). 81 unnecessary repeats performed. Most patients underwent imaging (75% and 67%) however, only approximately one-third (30.8% and 32.4%) of scans were performed to confirm the diagnosis. • Despite imaging confirming the diagnosis in 88%, &amp;gt;50% of imaged patients had repeat amylase testing. Conclusions The results demonstrate that our intervention, a pre-rotation departmental talk, has significantly reduced the over-requesting of amylase and current practice is of a good standard. Improvements are still required. Resultantly, we are additionally producing an electronic ‘alert’ into our investigations software that, on requesting a repeat amylase, will prompt clinicians to consider its necessity. Other centres offering acute treatment for similar patients may benefit from performing a similar audit to optimise care while reducing overall clinical costs.

Serum pancreatic enzymes and imaging in paediatric acute pancreatitis: Does lipase diagnostic superiority justify eliminating amylase testing?

Background:In acute pancreatitis (AP), serum amylase, lipase and imaging help establish a diagnosis with recognised lipase superiority. Recent literature has debated serum amylase testing and proposed its elimination, but little is known about the diagnostic role of simultaneously measured serum amylase levels in patients with non-diagnostic lipase. This study examined the contribution of pancreatic enzymes and imaging and the role of simultaneously measured serum amylase in children with non-diagnostic serum lipase.Methods:Retrospective medical records review of children aged <18 years with a verified discharge diagnosis of first-attack AP between January 01, 1994, and December 31, 2016.Results:First-attack AP was confirmed in 127 children (median age, 12.5 years). The sensitivity was 90.4%, 54.3%, 42.2% and 36.4% for lipase, amylase, contrast-enhanced computed tomography and ultrasonography (US), respectively. Combination US and lipase identified 96.6% of AP cases. Simultaneous amylase and lipase measurements in 125 children showed that either was ≥3× the upper limit of normal (ULN) in 95.2%, while both were <3× the ULN in 4.8% of cases. Nondiagnostic lipase was seen in 12 (9.6%) children, and diagnosis was based on amylase level ≥3× the ULN in six children and imaging in the other six.Conclusions:Serum amylase, serum lipase and imaging should continue for the conclusive diagnosis of AP in children. Simultaneous serum amylase measurement helped diagnose AP with non-diagnostic lipase.