scholarly journals Serum lactate as a prognostic marker in patients with sepsis: a prospective study

2020 ◽  
Vol 7 (5) ◽  
pp. 1530
Author(s):  
Suhas T. Shetty ◽  
Dayanand S. Biradar ◽  
Ramakant Balookar ◽  
Shreedevi Kori
Keyword(s):  
Prospective Study ◽  
Prognostic Marker ◽  
Mean Value ◽  
Serum Lactate ◽  
Research Centre ◽  
P Value ◽  
College Hospital ◽  
The Mean ◽  
Lactate Levels ◽  
A Prospective Study

Background: A prospective study to estimate the serum lactate levels and as a prognostic marker in patients with sepsis.Methods: 170 patients admitted with sepsis in B.L.D.E. (Deemed to be University) Shri. B. M. Patil Medical College, Hospital and Research Centre, Vijayapur from October 2014 to June 2016.Results: In this study the mean serum lactate value of first sample in survivors (146 patients) is 3.8±1.2 and non-survivors (24 patients) is 6.2±1.9 with p value<0.001 which is significant. The serum lactate value of the second sample in survivors (146) is 2.7±1.0 and in non survivors (24) is 6.3±1.8 with p value<0.001 which is significant. The mean value of serum lactate 1st sample collected at the time of admission is 4.1±1.6 and the mean value of serum lactate second sample collected at 24 - 48 hours after admission is 3.1±1.6.Conclusions: Lactate level more than 4 mmol/l, patients are at highest risk of mortality and an aggressive resuscitation strategy shall be warranted. Hence serum lactate is considered as an independent and significant prognostic marker in patients with sepsis and evaluates the treatment outcome.

TO COMPARE THE EFFECTIVENESS OF NEBULISATION WITH ADRENALINE, 3% HYPERTONIC SALINE AND NORMAL SALINE IN BRONCHIOLITIS IN CHILDREN OF 2 TO 24 MONTHS OF AGE BASED ON CLINICAL SEVERITY SCORE AND NEBULISATION FREQUENCY.

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Priyanka Jain ◽  
Rakesh Jain
Keyword(s):  
Hypertonic Saline ◽  
Normal Saline ◽  
Mean Difference ◽  
Clinical Severity ◽  
Research Centre ◽  
P Value ◽  
College Hospital ◽  
Mean Values ◽  
Significant Difference ◽  
The Mean

Background & Method: We conducted a double blinded study at Index Medical College Hospital & Research Centre, Indore. The sample size was determined to be minimum of 120 cases as based upon previous years admission due to acute bronchiolitis. Initially, 146 cases were included in the study out of which 23 cases dropped out of the study after giving consent by guardian for participation in the study as they left against medical advice from the hospital. Result: The mean difference of CSS between 0 minutes to 60 minutes of nebulisation between groups in all cases was 0.4 ± 0.6, between 60 minutes and 4 hours was 0.8 ± 0.6, between 4 to 8 hours was 0.7 ± 0.6, between 8-12 hours was 0.6 ± 0.4, between 12-24 hours was 1.6 ± 0.9 and between 24-48 hours was 1.9 ± 0.9.The mean values and resultant p-value of ANOVA of various nebulising agents used for improvement in CSS shows significant association between various nebulising agents used along with improvement in CSS at the end of assessment at 48 hours of treatment. Conclusion: This study was conducted to establish the efficacy of each nebulisation agent (i.e.  adrenaline, 3% hypertonic saline and normal saline) currently used and compare the outcomes as there is not enough evidence amongst Indian population on level of efficacy of each drug in causing improvement in symptoms and signs in various severities of bronchiolitis in early childhood. Comparison of significant improvement in mean difference in CSS at various intervals in all cases compared between groups by post hoc test revealed non-significant difference (p-value 0.700) between 3% hypertonic saline and normal saline. Keywords: nebulisation, adrenaline, bronchiolitis & clinical.

scholarly journals Role of Arterial Serum Lactate as a Predictor of Undifferentiated Shock on Admission and its Outcome- A Cohort Study

2021 ◽  
Author(s):  
Avadhesh Kumar Sharma ◽  
Nandakumar Beke ◽  
Dattatray Patki ◽  
Arun Bahulikar ◽  
Deepak Sadashiv Phalgune
Keyword(s):  
Cohort Study ◽  
Hospital Mortality ◽  
Lactate Level ◽  
Serum Lactate ◽  
Research Centre ◽  
Secondary Outcome ◽  
P Value ◽  
Serum Lactate Level ◽  
Icu Stay ◽  
Lactate Levels

Introduction: Patients with elevated serum lactate levels may be at risk for considerable morbidity and mortality and require a prompt, thoughtful and systematic approach for diagnosis and treatment. Aim: To find an association of on admission arterial serum lactate with outcome in Intensive Care Unit (ICU) patients. Materials and Methods: This observational cohort study was conducted on 168 patients at Poona Hospital and Research Centre, Pune, India, between June 2018 to November 2019 after obtaining Institutional Ethical Clearance. The patients included were above 18 years of age who had Systolic Blood Pressure (SBP) <90 mmHg, Heart Rate (HR) >100/min and Respiratory Rate (RR) >20/min. The arterial serum lactate level were examined on the day of admission, 12 hours and 24 hours. The need of ionotropic support, duration of ICU stay and mortality in one month was noted. The primary outcome measures were to study the association of on admission arterial serum lactate level with a duration of ICU stay and in-hospital mortality, whereas the secondary outcome measure was to study the association of on admission arterial serum lactate with the requirement of ionotropic support. Analysis of data was done using Statistical Package for Social Sciences for Windows, version 20.0. Results: The incidence in-hospital mortality was 20 (22.7%) out of 88 and 3 (3.8%) out of 80 in patients whose serum lactate levels on admission were >36 mg/dL and ≤36 mg/dL, respectively (p-value=0.002). The median duration of ICU stay was six and three days in patients whose serum lactate levels on admission were >36 mg/dL and ≤36 mg/dL, respectively (p-value=0.001). A 87 (98.9%) patients whose serum lactate levels >36 mg/dL on admission had the higher requirement of inotropes as compared to 35 (50.7%) patients whose serum lactate levels were ≤36 mg/dL. The percentage of patients whose serum lactate level >36 mg/dL, had a significantly higher Quick Sequential Organ Failure Assessment (qSOFA) scores and higher Shock Index (SI). There was a statistically significant positive correlation between serum lactate levels and qSOFA score (r=0.555) and SI (r=0.559). Conclusion: Initial serum lactate level was associated with higher in-hospital mortality, the higher requirement of inotropic support and longer duration of ICU stay.

ROLE OF BILIRUBIN AS A POTENTIALANTIOXIDANT IN SMOKERS

2021 ◽  
pp. 43-45
Author(s):  
Varshini. S ◽  
A. Preethi ◽  
G. Udayakumari
Keyword(s):  
Oxidative Stress ◽  
Antioxidant Properties ◽  
Antioxidant Property ◽  
Mean Value ◽  
Paraoxonase 1 ◽  
P Value ◽  
College Hospital ◽  
Chronic Respiratory Diseases ◽  
The Mean

Introduction: Globally, smoking causes about 71% of lung cancer, 42% of chronic respiratory diseases and about 10% of cardiovascular disease. Smokers are exposed to potential oxidative damage. This leads to depletion of the body's defense against oxidative stress, like decrease in the levels of Paraoxanase -1. This study aimed to assess the antioxidant property of Bilirubin in comparison to Paraoxonase-1 in smokers. Materials & methods: This case control study was carried out at Govt. Kilpauk Medical College Hospital after obtaining ethical committee approval and informed consent. This study involves 2 groups with 90 chronic smokers and 90 apparently healthy individuals who are not smokers. Serum Bilirubin and Paraoxanase -1 levels were estimated and compared between these two groups. Correlation between Bilirubin and Paraoxanase-1 was analyzed. Statistical analysis was done using SPSS package version 20. Results: The mean value for Bilirubin is 0.566 +/- 0.03 mg/dL in smokers and 0.620 +/- 0.05 mg/dL in non-smokers. There is signicant difference in bilirubin levels between smokers and non smokers (p value - 0.049). The mean value for Paraoxonase-1 is 3.291+/- 0.75 ng/dL in smokers and 4.513+/- 0.96 ng/dL in non-smokers. There is signicant difference in Paraoxanase -1 levels between smokers and non smokers (p value - 0.025). The scatter plot between Paraoxanase -1 and Bilirubin shows no signicant correlation. Conclusion: The Paraoxanase -1 and Bilirubin values in smokers are considerably reduced in comparison to that of non-smokers. This shows that Paraoxanase -1 and Bilirubin exhibits potential antioxidant properties. Bilirubin estimation is inexpensive and can be easily measured rather than measuring other known antioxidants such as PON-1. Role of Bilirubin as a marker to detect the oxidative stress levels in smokers is established in this study

scholarly journals Effectiveness of Integrated Teaching Module among Final Year Medical students

2016 ◽  
Vol 06 (02) ◽  
pp. 024-026
Author(s):  
Akshatha Rao Aroor ◽  
Dileep K. S. ◽  
Rama Prakasha Saya ◽  
Sudheendra Rao
Keyword(s):  
Medical Students ◽  
Medical Curriculum ◽  
Teaching Method ◽  
Tertiary Care ◽  
General Medicine ◽  
P Value ◽  
College Hospital ◽  
Before And After ◽  
The Mean ◽  
A Prospective Study

AbstractBackground: Didactic lectures and the current practice of teaching in Medical colleges has many limitations. Correlation and integration of knowledge into practice becomes difficult in the absence of integrated teaching at appropriate levels in medical curriculum.Aim: To assess the effectiveness of the vertical integrated teaching method among the final year MBBS students and to study the attitude towards integrated teaching. Materials and Methods: This is a prospective study conducted among 102 final year MBBS students at a tertiary care medical college hospital in South India. The teaching was implemented by the active participation of faculty from the departments of Physiology, Pathology and General Medicine on a single topic. Students' knowledge about the subject before and after the session was evaluated by a questionnaire of 20 questions (Pre-test and Post-test). The mean score before and after the session was compared using the paired't' test. The students were also asked to give their feedback about the usefulness of this method in improving their knowledge.Results: The mean scores before and after the session were 8.8± 2.87 and 16.88±1.23 (p value < 0.001). Majority of the students (97.1%) opined the need for integrated teaching to be a part of medical curriculum. Most of them (54.9%) felt the need for integrated teaching to be conducted monthly. On self-grading the knowledge on a scale of 1 to 10 before and after the session, the mean scores were 4.73±1.84 and 7.83±1.86 respectively (p value < 0.001). Conclusion: The integrated teaching was found to be an effective method of teaching. Medical students had a positive attitude towards integrated teaching.

scholarly journals TO STUDY THE TIME TREND OF NORMALIZATION OF LACTATE THAT FAVORS SURVIVAL IN MAJOR TRAUMA AND SEPSIS.

2019 ◽  
Vol 3 (5) ◽  
Author(s):  
Dr. Nilesh Kumar Dehariya ◽  
Dr. Arvind Ghanghoria
Keyword(s):  
Time Trend ◽  
Major Trauma ◽  
Intervention Study ◽  
Serum Lactate ◽  
Research Centre ◽  
Time Duration ◽  
College Hospital ◽  
Medical College ◽  
Critical Patients ◽  
Lactate Levels

Background: A prospective, non-intervention study was undertaken To study the time trend of normalization of lactate that favors survival in major trauma and sepsis in the Department of Surgery, Index Medical College Hospital and Research Centre, Indore, M.P., India for 01 year time duration. A total of 50 patients were included into study. Result: persistent higher LACTATE levels in non-survivors in major trauma and sepsis after 48 hours. And gradually decrease level in survivor. Thus, rising serum lactate levels suggest early prediction of shock and mortality.(p values less than 0.01) Above table suggest that rising serum lactate levels predict mortality in trauma and sepsis irrespective of age of patients. Because results are statistically insignificant (p > 0.01) Conclusion:  Lactate values probably need to be followed for longer periods in critical patients even when they have tided over the present crisis. The utility of regular lactate analysis in these patients would depend on factors such as availability and cost of test also. There are no existing studies to support the above premise. Keywords: Normalization, Lactate, Survival, Trauma & Sepsis

scholarly journals A prospective study of clinicoepidemiology, metabolic and hormonal profile of women with hirsutism in Konaseema region of Andhra Pradesh

2021 ◽  
Vol 10 (10) ◽  
pp. 3875
Author(s):  
M. Smitha
Keyword(s):  
Insulin Resistance ◽  
Cushing Syndrome ◽  
Mean Value ◽  
P Value ◽  
Hormonal Profile ◽  
Number Of Patients ◽  
Menstrual Irregularities ◽  
Before And After ◽  
The Mean ◽  
A Prospective Study

Background: Hirsutism is defined as presence of excess coarse hairs appear in male pattern in women.There is various aetiology of hirsutism like Idiopathic hirsutism, PCOS, androgen secreting ovarian tumours, menopause, CAH, Cushing’s syndrome, drugs which increases testosterone level, insulin resistance and tumour secreting androgen. We have designed present study with an aim to study the clinicoepidemiology, metabolic and hormonal profile of women with hirsutism in Konaseema region of Andhra Pradesh.Methods: All patients with hirsutism attending gynaecology outpatient department were selected for study based on inclusion and exclusion criteria. After that patient were examined clinically, BMI was calculated for each patient. Patients were clinically evaluated for signs of excess androgen secretion, Cushing syndrome, metabolic syndrome and hyperprolactinemia. Modified Ferriman-Gallwey scoring system was used for evaluating and quantifying hirsutism.Results: The mean Fasting plasma insulin12.42±2.41 (mIU/dl), the mean of HOMA-IR was 3.14±1.18. The mean value of dehydroepiandrosteronesulphate (DHEAS) 355.78±15.41 mcg/dl. There was statistically significant reduction in modified Ferriman-Gallwey scoring in before and after treatment (12.38± 1.55 vs. 9.62±1.6), the p value was 0.00001. The number of patients with menstrual irregularities were reduced from 63.3% to 20% after treatment and this difference is statistically significant (p=0.04).Conclusions: Hirsutism is associated with insulin resistance and DHEAS concentration was high. Modified Ferriman-Gallwey score was significantly reduced and there was significant weight loss and improvement in menstrual irregularities after treatment.

Elevated serum lactate in lymphoma: Not always infection.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e19039-e19039
Author(s):  
Sangeetha Gandhi ◽  
Priyanka Avinash Pophali ◽  
Thomas E. Witzig
Keyword(s):  
Elevated Serum ◽  
Serum Lactate ◽  
Aggressive Lymphoma ◽  
Common Disease ◽  
True Incidence ◽  
Kaplan Meier ◽  
The Mean ◽  
Lactate Levels ◽  
A Prospective Study ◽  
Elevated Lactate

e19039 Background: In patients with lymphoma, lactate dehydrogenase (LDH) is an important prognostic marker. Serum lactate can also be elevated due to hypermetabolism from aggressive lymphoma. We have observed critically ill lymphoma patients with elevated serum lactate who had a delay in the diagnosis and treatment of their underlying lymphoma because the cause of the elevated lactate was presumed to be infection. This clinical observation led us to perform a study to evaluate the relationship between serum lactate and LDH levels in lymphoma patients. Methods: We used the Mayo Clinic Lymphoma Database to search for patients with lymphoma and elevated lactate during a recent two year time period, January 2014 through December 2015. Fifty patients met these initial criteria and underwent medical chart review. The patients were divided into two groups – those with documented infection (SepsisLA group) and those without infection (all cultures negative) where the elevated lactate was due to lymphoma hypermetabolism (LymLA group). The Wilcoxon/Kruskal-Wallis test was used to compare the SepsisLA and LymLA groups. Kaplan-Meier analysis was used to estimate survival. Results: The mean age of the 66 patients was 65 ± 14.8 years and 60% were male. At the time of presentation, the mean lactate and LDH values were 4.5 ± 2.81mmol/L (UNL < 2 mmol/L) and 835.1 ± 1741.4 U/L (UNL < 222 U/L), respectively. 64% (32/50) of patients had elevated LDH values. After review, 32 (64%) patients were in the SepsisLA group; 18 (36%) were in the LymLA group. DLBCL was the most common disease type in both the SepsisLA (50%; 16/32) and LymLA (88%; 16/18). The sepsisLA and LymLA groups were not significantly different in terms of age, sex, lactate levels, or maxSUV on PET scan (N = 13). However, patients in the LymLA group did have higher LDH values (p = 0.02) compared to those with SepsisLA. Patients with LymLA had a reduced overall survival (OS) (1.45 median months) compared to those with SepsisLA (7.83 median months) p = 0.02. Conclusions: This study demonstrates that the level of lactate elevation is not helpful indiscriminating SepsisLA vs LymLA; however an elevated LDH with elevated lactate is more likely LymLA. Lymphoma pts with LymLA had an inferior survival compared to SepsisLA. We are unable to define the true incidence and prognostic value of elevated serum lactate in lymphoma; this will require a prospective study with fresh samples. In summary, lymphoma activity can masquerade as infection with elevated lactate. Once sepsis is ruled out, treatment for the lymphoma should not be delayed as this presentation portends poor prognosis.

scholarly journals A prospective study on impact of patient counselling on quality of life of patients with atopic dermatitis

2020 ◽  
Vol 9 (12) ◽  
pp. 1860
Author(s):  
Ranjeth R. ◽  
Resmi Vijayasenan ◽  
Amritha M. S. ◽  
I. John Wesley
Keyword(s):  
Quality Of Life ◽  
Atopic Dermatitis ◽  
Prospective Study ◽  
Mean Value ◽  
P Value ◽  
Lifestyle Modifications ◽  
Patient Counselling ◽  
A Prospective Study ◽  
The Impact

Background: Atopic dermatitis is an acute, sub-acute or chronic relapsing skin disorder characterized by intense itching, pruritus and oozing. It adversely affects the routine activities of patients for which effective treatment is to be provided along with proper counselling. The aim of the current study was to evaluate the impact of patient counselling on quality of life (QoL).Methods: A prospective study was conducted in 108 patients recruited from the Department of Dermatology for a period of 6 months. A written informed consent was taken. Out of the 108 patients, 54 patients received tacrolimus and the remaining received corticosteroids. The collected data was analysed and presented. Data was collected by using a suitably designed proforma. Dermatology life quality index (DLQI) was used for assessing QoL. Patients were counselled regarding the disease, drugs and lifestyle modifications using patient information leaflet (PIL).Results: The current study found that patient counselling was effective for both the groups with a p value <0.05. The effect of disease in quality of life improved from severe to mild in both groups (prior to counselling QoL mean value of 2.93±0.61 shifted to 1.18±0.71 post counselling). In the tacrolimus group, QoL mean value of 2.81±0.61 shifted to 0.98±0.71 after counselling. In the corticosteroids group, a shift from a mean QoL value of 3.05±0.59 to a mean of 1.38±0.65 was observed post counselling.Conclusions: The provision of effective counselling was found to have a profound impact on improving patient’s quality of life. A transition from severe effects of the disease to milder effects of the disease on quality of life was observed.

scholarly journals Renal Function Status in the Newborn with Perinatal Asphyxia

2020 ◽  
Vol 32 (1) ◽  
pp. 48-51
Author(s):  
Tarun Kumar Roy ◽  
Mahmood A Chowdhury Arzu ◽  
Wazir Ahmed ◽  
Didarul Alam ◽  
Sanjana Islam ◽  
...  
Keyword(s):  
Renal Function ◽  
Perinatal Asphyxia ◽  
Renal Involvement ◽  
Cross Sectional Study ◽  
Mean Value ◽  
Stage Iii ◽  
P Value ◽  
College Hospital ◽  
Cross Sectional ◽  
The Mean

Introduction: Renal involvement is frequent in neonates with perinatal asphyxia. It is correlated with the severity of neurological damage and degree of involvement depends upon the severity of asphyxia. To assess the status of renal function in new born suffering from prenatal asphyxia and to precise the relationship between severity cerebral damage and renal failure. Materials and Methods: A hospital based cross-sectional study was conducted in the department of Neonatology, Chattogram Maa O Shishu Medical College Hospital, Agrabad, Chattogram on 180 full-term neonates (150 cases and 30 control). The cases were categorized according to HIE Sarnat stages. Results: Among cases, 83(53.4%) were with HIE I, 53 (35.3%) were HIE II and 14(9.3%) were HIE III. The mean value of S. Creatinine was high in cases 1.64 ± 0.33 mg/dl vs 0.41 ± 0.09 mg/dl (p value <0.001) and it is highest in HIE stage III 1.85 ± 0.20 mg/dl (p value is <0.001). Mean Serum Potassium was high in cases 5.88 ± 0.59 mmol/L vs 3.99 ± 0.36 (p value <0.001) and the values are abnormally high in HIE stage III 6.25 ± 0.33 (p value <0.001). The mean value of FeNa was high in cases 2.44 ± 0.55 compared with control 1.06 ± 0.38 (p value <0.001) and it is higher in HIE stage III 2.72 ± 0.22 (p value is <0.001). Conclusion: Severity of renal impairment correlates well with the degree of HIE. HIE stage wise assessment of renal function status using serum creatinine level, S. potassium, FeNa, can be used to assess the outcome of perinatal asphyxia. Medicine Today 2020 Vol.32(1): 48-51

scholarly journals Predictability of Fetal Birth Weight from Measurement of Fetal Thigh Circumference by Two-dimensional Ultrasound: A Prospective Study

2012 ◽  
Vol 4 (1) ◽  
pp. 35-38
Author(s):  
Shyamal Dasgupta ◽  
Tarun Kumar Ghosh ◽  
Amitava Mukherjee ◽  
Poushali Sanyal ◽  
Rezaul Karim ◽  
...  
Keyword(s):  
Birth Weight ◽  
Prospective Study ◽  
Fetal Weight ◽  
Abdominal Circumference ◽  
P Value ◽  
Two Dimensional ◽  
Thigh Circumference ◽  
Fetal Birth Weight ◽  
The Mean ◽  
A Prospective Study

ABSTRACT Objective The aim of this study was to compare the predictability of the Vintzileos’ formula with the Hadlock's formula in estimating the fetal weight nearest to the actual birth weight. Methods It was a prospective observational study conducted with 138 antenatal mothers with single viable fetus and no major congenital abnormalities. A two-dimensional ultrasound scan was performed between 38 and 40 weeks gestation, which measured the biparietal diameter (BPD), head circumference (HC), abdominal circumference (AC), femur length (FL) and thigh circumference (TC) at the level of midthigh, and incorporated them to estimate fetal weight using the Hadlock's and the Vintzileos’ formulae. Results For the majority of the study population (63.04%), the mean fetal weight estimated by the Vintzileos’ formula was nearer to the mean actual birth weight compared to the Hadlock's formula. There was strong correlation (Karl Pearson's correlation coefficient r = 0.98, p-value <0.05) between the sonologically estimated and the neonatal thigh circumference. Conclusion The results of this study show that the fetal thigh circumference, if incorporated with other standard biometric parameters in estimating fetal weight by ultrasound, improves the predictability of birth weight estimation, and can predict intrauterine growth restriction. How to cite this article Sanyal P, Ghosh TK, Dasgupta S, Karim R, Mukherjee A, Das A. Predictability of Fetal Birth Weight from Measurement of Fetal Thigh Circumference by Twodimensional Ultrasound: A Prospective Study. J South Asian Feder Obst Gynae 2012;4(1):35-38.

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