Online ISSN: 2515-8260

Keywords : Sepsis


Prognostic significance ofProcalcitonin, High sensitivity C-reactive proteinandwhite blood cell count incomparison withblood culture in ICU patients with Sepsis and Septic shock inatertiary care Hospital

Dr.Kondle Raghu; Dr. Krishnan Ramalingam

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 2263-2270

Background: Sepsis is a life-threatening condition in ICU with high morbidity and
mortality. Biomarkers which can act as a predictor for diagnosis, prognosis, and patient
outcome in sepsis are needed.
Aim:Aim of the study is to compare the significance of hs-C-reactive Protein (CRP),
Procalcitonin, White blood cell count, and blood culture in patients with bloodstream
infections and compare their prognostic significance with blood cultures in sepsis.
Materials and Methods: This hospital based prospective observational study was conducted
between July 2018 to July 2019 forone year with 216 cases of sepsis. Serial determination
of Procalcitonin and CRP at admission and Day 6 was done. Data was analyzed check to
compare the prognostic significance of the PCT, CRP, and WBC count.
Results:A blood culture positivity rate of 50.9% was reported with male preponderance.
WBC count has significantly reduced after 72hrs of admission (p= 0.007). CRP levels have
significantly reduced on day 6 (p = 0.043) in comparison to at the time of admission (p=
0.032). The serial determination of PCT levels at admission and on day 6 (p= 0.032) was
found to be a better prognostic indicator in patients with sepsis than at the time of
admission. The significant patient outcome in terms of mortality and reduction in length of
hospital stay has been found (p= 0.018, p=0.002). The positive correlation of PCT and CRP
and SOFA score has been reported.
Conclusion: Prognostic significance was found for the biomarkers PCT, CRP, and WBC
count with significant patient outcomes in terms of mortality and hospital stay reduction

Study of Factors associated with pathological and aerobic microbial colonization of Neonatal Gastrointestinal System – A hospital based Case control study

Faheem Moideen; Baliga Kiran; Harris M M; Davdidson Devasia; Ali Kumble

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 3165-3168

The rate and extent of neonatal gastrointestinal tract colonization depends on various perinatal
and neonatal factors. Colonization of gastrointestinal tract (GIT) after birth could be delayed because of
prematurity, caesarean delivery or total parental nutrition. The ill and preterm neonates in NICU acquire
intestinal flora that differ from that of healthy newborn. Objective: Hence we aim to study the factors associated
with pathological colonization of aerobic microbial flora in neonates and find pattern of pathogenic aerobic
microbial colonization of neonates. Methodology: The study was done on 94 neonates in a tertiary teaching
hospital NICU , 51 cases with pathological colonization ,43 control with normal colonization. Data collected
using Performa, Oral and rectal swabs taken Results: 68 neonates who received antibiotics 46 (90.2%) were
cases 22(51.3%) were controls. Staphylococcus aureus was predominant suggesting influence of maternal
colonization. Cases were more in babies born through LSCS and in babies whose mother had received
antibiotics Conclusion: Of all factors influencing establishment of pathological microbiota in neonatal GIT
which are interdependent , neonatal exposure to antibiotics was the most significant . Emergence of MRSA ,
ESBL are of particular concern as these are a constant threat as source of health care associated infection

Sepsis Markers at PICU and the Utility of Serum Neopterin

Osama GamalAbdElhamid, Samir Mohamed Zamzam, Amr Mogahed Abu Elnga, Nourhan Abdallah Saeed

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 3813-3823

Background:Septicemia is a potential clinical status which is a result of irresistible sickness or a
inflammatory process secondary to infection or injury. Clinical management of septicemia
requires brief research facility finding and plan of successful patient administration techniques that
might incorporate antimicrobial chemotherapy. Despite the fact that the accessible biomarkers of
septicemia, for example, CRP, procalcitonin has ended up being helpful, their disadvantages is
elevation in non-septic conditions like injury, surgery, and different conditions like systemic
inflammatory reaction disorder (SIRS), and insusceptible reaction amid septic conditions.
Considering the way that septicemia because of contamination is microbiologically affirmed just
in 30% of the cases, it is inescapable that there is requirement for different markers of septicemia.
Neopterin is one of biochemical markers of immune activity, which seems to be useful in
monitoring inflammatory diseases. Increased concentration of neopterin in serum is observed in
conditions with involvement of cell mediated immune response. Investigations on critically ill
patients on intensive care units evaluated neopterin levels as tool to discriminate patients with
systemic inflammatory response syndrome with and without infectious etiology. Neopterin levels
were found to have a specificity of 78% for discriminating infectious and noninfectious etiology of
critical illness

VITAMIN C IN TERMS OF COVID-19, CURRENT TRENDS

IlxamdjanKarimdjanov Asamovich,Nozima Sаdiqova Baxadirovna, BotirTadjiev Mirkhashimovich,NurlanDinmukhammadiev Aktamovich, BobirMirkhashimovBotirovich,YaxyayevaKomola Zokirovna,AnvarTursunbayev Karimberdiyevich,FatimaXoltayeva Fayziyevna

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 1, Pages 1341-1351

The role of vitamin C in the prevention and treatment of pneumonia andsepsis has been investigated for past decades. This reviewaimsto translatethese findings into patients with severe coronavirus disease (COVID-19). It has indicatedthat patients with pneumonia and sepsis have low vitamin C status and elevated oxidative stress.Additional oral or intravenous (IV) vitamin C administered patients with pneumonia can mitigate the severity and course ofthe disease. Severely ill patients with sepsis need for intravenous administration of amounts counted in grams ofthe vitamin to achieve adequate plasma levels, an intervention that some studies suggest reduces mortality.The vitamin has physiological functions like pleiotropic, many of which are closely connected to COVID-19.These are its antioxidant, antiinflammatory, antithrombotic and immunomodulatory functions.Previous observational studies found out low vitamin C status in critically ill patients with COVID-19.A number of randomized controlled trials (RCTs) conductedworldwideevaluate intravenous vitamin C as monotherapy in patients with COVID-19. Optimization of the intervention protocolsin future trials, e.g., earlier and continuously administration, is justified to potentially improve itsefficacy. In order to the excellent safety profile, low cost, and potential for rapid enlargement of production,administration of vitamin C to patients, especially with hypovitaminosis C and severe respiratory infections,e.g., COVID-19, appears warranted. In addition, there are few new ways of concurrent using vitamin C and other manipulations or medications.

Compatibility of Endocan Levels with SOFA Scorein Sepsis Patients at Dr.Wahidin Sudirohusodo Hospital Makassar

RizqahAulyna Rachmat; Sudirman Katu; Risna Halim; Syakib Bakri; Haerani Rasyid; Hasyim Kasim; Muhammad Ilyas; Tutik Harjianti; Arifin Seweng

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 969-977

Background:Sepsis is a life-threatening organ dysfunction and the leading cause of death in critically ill patients. The use of biomarkers and scoring systems is an attempt to assist in the diagnosis and assessing the severity of multi-organ dysfunction. C-reactive protein (CRP), procalcitonin (PCT), and the currently reported marker are endocan. Endocan is a biomarker for multiorgan dysfunction in sepsis. Endocan synthesis and release are triggered by proinflammatory cytokineswhich can increase endocan levels in sepsis while the Sequential (Sepsis-related) Organ Failure Assessment (SOFA) is a scoring method for identifying organ dysfunction in sepsis. A SOFA score ≥2 indicates organ dysfunction. Endocan and SOFA scores are both aimed at assessing multiorgan dysfunction and can determine the prognosis in sepsis. This study aims to determine the suitability of endocan levels with SOFA values in septic patients at Dr.WahidinSudirohusodoHospital Makassar.
Purpose: To determine the suitability of SOFA values with endocan levels in septic patients at the Dr.WahidinSudirohusodoHospital and its network hospital.
Methods: This cross-sectional observational study was conducted from December 2019-August 2020. The population of this study was all sepsis patients in the hospital. 
WahidinSudirohusodo. Data were analyzed descriptively. The compatibility of endocan levels with SOFA values in septic patients used the Spearman correlation test.
Results: From a total of 150 subjects, it was found that patients <60 years were 45 subjects (80.04%), men were 34 subjects (60.7%), patients with 2 comorbid were 21 subjects (37.5%), the mean Endocan levels were 361.9 ± 472.4 with tertileendocan 1 (<110.0) as many as 19 subjects (33.9%) and tertile 3 (> 232.0) as many as 19 subjects (33.9%) while SOFA scores Mean 5.6 ± 3.7 with SOFA scores 0-6 as many as 36 subjects (64.3%). The endocan level in sepsis was significantly lower than the control, namely 361.9 (p <0.01). Based on the Spearman correlation test, it was found that there was a significant negative correlation between endocan levels and the SOFA score (p <0.05). In women, there was a significant negative correlation between endocan levels and SOFA scores (p <0.05), at age <60 years, there was a significant negative correlation between endocan levels and SOFA scores (p <0.05). with the number of comorbid 1, there was a significant negative correlation between endocan levels and the SOFA score (p <0.05).
Conclusion: There is a significant negative correlation between endocan levels and SOFA score in septic patients at Dr.WahidinSudirohusodo Makassar.