Online ISSN: 2515-8260

Keywords : Intensive Care Unit

Evaluation of Spectrum of Pulmonary Diseases Among Hospitalised Patients of the Respiratory Intensive Care Unit at a Tertiary Care Centre

Gaurav Sahu, Bhupendra Kumar Rajak, Rajdeep Dhandhukiya

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 3440-3443

Introduction: Respiratory diseases are reportedly the major forefront runner in causing the morbidity and mortality globally thus imposing great global health burden. , the present study was undertaken to assess the spectrum of pulmonary disease affecting the persons admitted to respiratory intensive care unit.
Materials and Methodology: For the study purpose, 120 subjects with various respiratory illnesses who were admitted in RICU were included. A written informed consent was obtained from all the study participants after briefly explaining the study protocols to the study subjects. Complete demographic detail for each of the study participants that include past medical and surgical history, family history, as well as history of present illness. The statistical analysis of the data was done using SPSS version 11.0 for windows.
Results: The age of participating patients ranged between 32 to 72 years. The number of male subjects was 76 and number of female subjects was 44. The lowest number of patients were seen with Bronchiectasis (n=8). The results on comparing were found to be statistically non-significant. (p>0.05)
Conclusion: This study provided enough support to show that bronchial asthma, pulmonary tuberculosis, COPD are considered to the most common and frequent nosocomial infections among those patients admitted in RICU. But future research are needed to be carried forward the study in a nurturing manner for the betterment

A Hospital Based Observational Study to Assess the Clinic-Etiological Profile and Prognostic Indicators in Critically Ill Patients who Develop Acute Respiratory Distress Syndrome (ARDS) in Medical Intensive Care Unit

Suman, V.B. Singh, Deepak Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2255-2260

Background: Aspiration pneumonia and pneumonia are the most common cause of ARDS in direct lung injury whereas sepsis is the most common cause of ARDS in Indirect lung injury. The aim of this study to assess the clinic-etiological profile and prognostic indicators in critically ill patients who develop acute respiratory distress syndrome (ARDS) in medical intensive care unit.
Materials& Methods: A hospital based prospective study done on 50 ARDS patients those were admitted in the medical ICU over a period of one year at SMS Medical College, Jaipur, Rajasthan, India. Baseline characteristics including comorbidities, routine investigations, initial SOFA Scores & APACHE II (Acute Physiology & Chronic Health Evaluation) score was evaluated. Descriptive & Statistical analysis and interpretation of the data collected is done by using SPSS version 22.0 with mean and standard deviations computed.
Results: Among 50 patients, 27 patients represent the male group and 23 patients represent the female group. Diabetes mellitus (36%) and SHT (20%) having a higher prevalence. Breathlessness and fever were the most common symptoms. Gender comparison of mean Fio2/Pao2 ratio, MAP, Initial SOFA and APACHE II scores are shown in table 4 showing a higher Fio2 requirement in female group when compared to the male group and more or less equal with the remaining variables. The mean duration of hospital stay was longer in the female group when compared to the male group (table 4). The mortality rate in our study was 16.0% (8 patients).
Conclusion: The incidence of ARDS studies in India are very few and lacking. Early identification and etiology work up for ARDS with timely administration of antibiotics/ antivirals or antimalarial drugs is necessary for the improvement in survival rates in view of increased morbidity and mortality associated with ARDS.

Prevalence of Antibiotics Associated Diarrhoea by Clostridium Difficile Through Detection of Toxins in a Tertiary Care Hospital, Patna

1Randhir Kumar, 2Samir Kumar, 3Namrata Kumari, 4Shailesh Kumar, 5Kumar Saurabh, 6Richa Sinha .

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 3264-3269

Background: Clostridium difficile (C. difficile) is the most common antibiotic-associated diarrhoea agent in selected patients. C. difficile strains are classified as toxigenic or non-toxigenic based on their ability to produce toxins.
Aim: The frequency of C. difficile and CDAD among patients in a tertiary hospital in Patna, India was investigated in this study.
Methods: From the patients, a total of 233 diarrheal samples were extracted. The samples were cultivated on Clostridium difficile medium with cycloserine (500 mg/L), cefoxitin (16 mg/L), and lysozyme (5mg/L) and 5 per cent defibrinated sheep blood. Polymerase chain reaction (PCR) of the 16s rRNA gene identified the isolates as C. difficile, as did the presence of toxins genes (tcdA, tcdB, cdtA, and cdtB). The toxin production of isolates was then assessed using Rapid Card (CerTest BioTech SL Spain).
Results: C. difficile was identified from 49 (21%) of the 233 samples tested. The total isolates were classified as A-/B-/GDH (48.97%), A+/B-/GDH- (28%), A+/B+/GDH (20.4%) and A+/B+/GDH+ (2%) types. Both types of C.difficile, A-/B-/GDHand A+/B-/GDH-, which account for 77.5 per cent of all isolates, were both unable to generate the toxin (nontoxigenic). However, A+/B+/GDH+ and A+/B+/GDH (22.5%), were able to manufacture toxin or were toxigenic.
Conclusion: The prevalence of C. difficile was approximately 21%, and only 22.4 percent of C. difficile isolates were capable of producing toxins. C. difficile A+/B+/GDH± are likely to be toxigenic and linked to C. difficile-associated diarrhoea (CDAD). Furthermore, approximately 4.7 percent of hospitalised patients had CDAD, which is greater than the rates reported in developed countries. Notably, 28% of the isolates were C. difficile A+/B-/GDH-, which only possesses tcdA genes but does not produce toxin

Role of vital parameters and biomarkers in predicting the outcome of patients in Covid ICU: A comparative study

SouravBansal, Arghadip Das,Nikhat Fatima Mansoori, Irshan Ali Mohammed, Vinodh Boopalraj

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1159-1168

Aim: The aim of the present study to compare the vital parameters and biomarkers in
predicting the outcome of patients in Covid ICU.
Methods: 200 patient were divided in to two groups, Group A of those who expired and
Group B of the survivors. The mean for each parameter was calculated and compared
among the two groups and based on which p value was calculated for each parameter
undertaken in clinical evaluation. Blood reports of investigations assessing the levels of
biomarkers like Procalcitonin (PCT), C- Reactive Protein (CRP), D-dimer, Ferritin,
Lactate dehydrogenase (LDH) and Interleukin-6 (IL-6) sent on first day and last day of
hospitalisation in covid ICU were collected for Group A (Expired) and Group B (Survived)
and master chart was prepared.
Results: The study population comprised of 200 confirmed Covid-19 cases, among which
those expired (Group A) were 103, and those who survived (Group B) were 97. The mean
age difference was statistically significant (p value = 0.003). The mean Heart Rate on day
of admission was statistically significant (p value = 0.005). The mean Heart Rate on last
day of hospitalisation difference was statistically significant (p value = 0.001). The
Median PCT levels along with along with its interquartile range in Group A (Expired)
versus Group B (Survivors) on day of admission the difference was statistically significant
(p value < 0.001). The Median Ferritin levels along with its interquartile range in Group A
(Expired) versus Group B (Survivors) on day of admission the difference was statistically
significant (p value < 0.0003). The Median Ferritin levels along with its interquartile range
in Group A (Expired) versus Group B (Survivors) on last day of hospitalisation the
difference was statistically significant (p value < 0.001).

Early Detection of Inborn Errors of Metabolism among Neonates Admitted to Neonatal Intensive Care Unit

MervatAbdallahHesham, Shams Sami Abdo,Wesam A. Mokhtar

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 2789-2798

Background:Early diagnosis and treatment are very important to reduce the rates
of morbidity and mortality related to Inborn errors of metabolism .The present
study aimedto detect the inborn errors of metabolism early among neonates.This
was a cross sectional study was carried out at neonatal intensive care unit in
pediatric department at Zagazig university children hospital. This study involved
114 neonates who were subjected to full medical history, thorough clinical
examination and laboratory investigations which included Complete blood count,
Coagulation profile ,C-reactive protein ,procalcitonin, Liver and renal function
tests , Serum levels of electrolytes, Plasma ammonia and lactate, Urine organic acid
analysis, Extended metabolic screening, Blood gas and serum anion gab and Blood
glucose level. Results:About 53.5% of the studied groups were males and 46.5%
were females. As regards mode of delivery 74.6% were by CS and 25.4% by NVD.
Also, 30.7% had positive consanguinity, 12.3% had sibling death, and 3.5% have
similar condition. History of abortion was found in 22.8% and genetic disease was
in 2.6% of the studied group. The main clinical presentations among the studied
group were RD, Encephalopathy and hypotonia. Only 6.1% of the studied group
had positive culture metabolic acidosis was detected only in 9.6% of the studied
group. About 90.4% of the studied group was alive and 9.6% were died.
Conclusion: IEM disorders are not rare disease in high-risk neonates with
attentions to consanguinity which is a common tradition in our country. The
manifestations of metabolic disorders are common, and many physicians
misdiagnose them as they are unaware about these disorders.