Objective:To explore the predictive value of neutrophil-to-lymphocyte ratio(NLR)in in-hospital mortality in sepsis patients.Methods:A prospective observational cross-sectional study was conducted on 100 patients with ...Objective:To explore the predictive value of neutrophil-to-lymphocyte ratio(NLR)in in-hospital mortality in sepsis patients.Methods:A prospective observational cross-sectional study was conducted on 100 patients with septicemia.The data about the patient’s demography,medical history,general examination including pulse rate,blood pressure,etc,use of vasopressor support,need for renal replacement therapy,mechanical ventilation,outcome,and lab parameters including total lymphocyte count with neutrophil-to-lymphocyte ratio were recorded.And parameters between survivals and non-survivals were compared.Results:Out of 100 patients,80%were from rural backgrounds.Most patients were 50 to 59 years old.26 Patients were dead.The patients in the nonsurvivor group were older and more had a history of diabetes mellitus when compared with the survivor group.The non-survivor group had a higher NLR,APACHE栻,and SOFA score.Conclusions:NLR is a readily available parameter and can be used as a good prognostic indicator for mortality in sepsis patients.展开更多
Objective:To validate a better scoring system between CURB-65 and the pneumonia severity index(PSI)to predict the need for intensive care unit admission and 30-day mortality in patients with COVID-19 pneumonia.Methods...Objective:To validate a better scoring system between CURB-65 and the pneumonia severity index(PSI)to predict the need for intensive care unit admission and 30-day mortality in patients with COVID-19 pneumonia.Methods:A retrospective cohort study was conducted on patients in a tertiary care hospital in Kota,Rajasthan.Relevant data about history,and general and systemic examination with laboratory investigations was collected.Patients were categorized into different risk groups for ICU admission and 30-day mortality according to CURB-65 and PSI.Sensitivity,specificity,positive predictive value,negative predictive value,and area under the curve were calculated.Continuous variables,means and percentages were compared using the t-test for numerical data and the Chi-square test for nominal data.Results:100 patients who tested positive for SARS-CoV-2 by RT-PCR were included;67 were male and 33 were female.58 patients had severe disease(SpO2≤90%)and 30 patients died.CURB-65 had an area under the curve(AUC)of 0.81 for predicting ICU admission,with a sensitivity of 92%and a specificity of 54%for high risk patients.Meanwhile,PSI had an AUC of 0.88,with a sensitivity of 83%and a specificity of 73%in high risk patients.In addition,CURB-65 had an AUC of 0.79 for predicting 30-day mortality,with a sensitivity of 60%and a specificity of 89%in high risk patients.PSI had an AUC of 0.71 for predicting 30-day mortality,with a sensitivity of 90%and a specificity of 46%in high risk patients.Conclusions:This single-centre retrospective study involving a cohort of COVID-19 patients demonstrates that CURB-65 and PSI are powerful tools for predicting mortality.However,PSI appears to be slightly better at predicting the need for intensive care unit admission in high-risk patients.展开更多
Objective:To study epidemiology,clinical manifestations,and laboratory parameters of scrub typhus in Hadoti region of Rajasthan,India.Methods:A cross-sectional study was conducted on 50 patients with scrub typhus betw...Objective:To study epidemiology,clinical manifestations,and laboratory parameters of scrub typhus in Hadoti region of Rajasthan,India.Methods:A cross-sectional study was conducted on 50 patients with scrub typhus between August 2022 and November 2022.Scrub typhus was diagnosed by ELISA IgM scrub typhus antibody.The data about demography,vital parameters,and lab investigations were collected and analyzed.Results:Ninety-two percent of the patients were from a rural background(92%),86% were farmers and the majority were females.Most patients were 40-60 years old.The major complaints were fever(100%),myalgia(100%),headache(82%),and body swelling(80%).Major complications were pneumonia(68%),multiple organ dysfunction syndrome(62%),hepatitis(44%),and acute kidney injury(42%).Triglyceride levels were>200 mg/dL in 80% of patients,albumin<3.5 g/dL in 98% and eschar mark was present in 24%of patients.Conclusions:Scrub typhus is a serious acute febrile illness that can lead to multi-organ dysfunction and is associated with significant mortality.Increasing awareness regarding disease in endemic regions,early screening of patients,and treatment as early as possible could help prevent the patient from severe life-threatening complications.展开更多
文摘Objective:To explore the predictive value of neutrophil-to-lymphocyte ratio(NLR)in in-hospital mortality in sepsis patients.Methods:A prospective observational cross-sectional study was conducted on 100 patients with septicemia.The data about the patient’s demography,medical history,general examination including pulse rate,blood pressure,etc,use of vasopressor support,need for renal replacement therapy,mechanical ventilation,outcome,and lab parameters including total lymphocyte count with neutrophil-to-lymphocyte ratio were recorded.And parameters between survivals and non-survivals were compared.Results:Out of 100 patients,80%were from rural backgrounds.Most patients were 50 to 59 years old.26 Patients were dead.The patients in the nonsurvivor group were older and more had a history of diabetes mellitus when compared with the survivor group.The non-survivor group had a higher NLR,APACHE栻,and SOFA score.Conclusions:NLR is a readily available parameter and can be used as a good prognostic indicator for mortality in sepsis patients.
文摘Objective:To validate a better scoring system between CURB-65 and the pneumonia severity index(PSI)to predict the need for intensive care unit admission and 30-day mortality in patients with COVID-19 pneumonia.Methods:A retrospective cohort study was conducted on patients in a tertiary care hospital in Kota,Rajasthan.Relevant data about history,and general and systemic examination with laboratory investigations was collected.Patients were categorized into different risk groups for ICU admission and 30-day mortality according to CURB-65 and PSI.Sensitivity,specificity,positive predictive value,negative predictive value,and area under the curve were calculated.Continuous variables,means and percentages were compared using the t-test for numerical data and the Chi-square test for nominal data.Results:100 patients who tested positive for SARS-CoV-2 by RT-PCR were included;67 were male and 33 were female.58 patients had severe disease(SpO2≤90%)and 30 patients died.CURB-65 had an area under the curve(AUC)of 0.81 for predicting ICU admission,with a sensitivity of 92%and a specificity of 54%for high risk patients.Meanwhile,PSI had an AUC of 0.88,with a sensitivity of 83%and a specificity of 73%in high risk patients.In addition,CURB-65 had an AUC of 0.79 for predicting 30-day mortality,with a sensitivity of 60%and a specificity of 89%in high risk patients.PSI had an AUC of 0.71 for predicting 30-day mortality,with a sensitivity of 90%and a specificity of 46%in high risk patients.Conclusions:This single-centre retrospective study involving a cohort of COVID-19 patients demonstrates that CURB-65 and PSI are powerful tools for predicting mortality.However,PSI appears to be slightly better at predicting the need for intensive care unit admission in high-risk patients.
文摘Objective:To study epidemiology,clinical manifestations,and laboratory parameters of scrub typhus in Hadoti region of Rajasthan,India.Methods:A cross-sectional study was conducted on 50 patients with scrub typhus between August 2022 and November 2022.Scrub typhus was diagnosed by ELISA IgM scrub typhus antibody.The data about demography,vital parameters,and lab investigations were collected and analyzed.Results:Ninety-two percent of the patients were from a rural background(92%),86% were farmers and the majority were females.Most patients were 40-60 years old.The major complaints were fever(100%),myalgia(100%),headache(82%),and body swelling(80%).Major complications were pneumonia(68%),multiple organ dysfunction syndrome(62%),hepatitis(44%),and acute kidney injury(42%).Triglyceride levels were>200 mg/dL in 80% of patients,albumin<3.5 g/dL in 98% and eschar mark was present in 24%of patients.Conclusions:Scrub typhus is a serious acute febrile illness that can lead to multi-organ dysfunction and is associated with significant mortality.Increasing awareness regarding disease in endemic regions,early screening of patients,and treatment as early as possible could help prevent the patient from severe life-threatening complications.