ABSTRACT
Background: sepsis refers to the presence of a serious infection that correlates with systemic and uncontrolled immune activation. Few studies had analyzed eosinophil count as a prognostic marker of outcome in patients with infection. Eosinopenia is an interesting biomarker because the eosinophil count is always measured in clinical practice and the additional costs would therefore be negligible
The aim of this wrk: this study aimed to test the value of eosinopenia in the diagnosis of sepsis in critically ill patients admitted to ICUs
Patients and Methods: this prospective observational, randomized study was conducted on 50 adult critically ill patients who were admitted to ICU of Ahmed Maher Teaching Hospital in the period from March 2017to July 2017. They either had sepsis on admission or not. An informed written consent was obtained from patients and/or relatives before starting this study
Inclusion criteria were patients more than 18 years old and less than 60 years that were critically ill either in sepsis or not
Exclusion criteria were patients less than 18 years old and more than 60 years old, patient or relatives who refused to be included in this study, those with hematological cancer, HIV infection, bronchial asthma and other atopic disorders like hay fever, atopic dermatitis and allergic conjunctivitis and increased levels of eosinophil count as part of any parasitic infection or trauma patients
Results: comparison between infected and non-infected studied patients was statistically significant as regard variables of SOFA score, APACHE II score at admission, TLC and Eosinophil count at admission [p-value?0.05]. There were no statistical significant differences as regard length of ICU stay [p?0.05]. Multivariate regression analysis showed statistically significant differences and was independent predictors for infection as follow: total leucocytic count, eosinophil count at admission and SOFA score. The AUC for eosinophil count to predict was 95% with optimal cut off value was 50 cells/mm3 with a sensitivity of 92.85% and specificity of 93.33% with P value <0.001
Conclusion: the result of the present study revealed that eosinophil counts was <50 cells/mm3 at admission time to ICU was a predictor for diagnosis of sepsis in critically ill patients. However, eosinophil counts at admission time to ICU were not a specific indicator of mortality. Recommendations: eosinophil counts are cheap and easily accessible test can be used to guide for sepsis diagnosis and treatment.Larger studies are needed to determine the prognostic value of this test and establish better cutoff values
ABSTRACT
To determine the applicability, acceptance, and compliance of the option of clean intermittent catheterization [CIC] when needed by patients in our society. We retrospectively reviewed the files of all patients for whom CIC was conducted at King Khalid University Hospital and Security Forces Hospital, Riyadh, Saudi Arabia, between 1998, and 2006. We considered primary pathology, indication of CIC, age at CIC initiation, and who administered the CIC. We also documented the acceptance and compliance levels of the procedure by the patient over time. We included 280 patients, of which 118 [42%] were female and 162 [58%] were male in this study. The main pathology was myelodysplasia in 196 [70%] patients, posterior urethral valve in 52 [18.6%] patients, and non-neuropathic bladder sphincter dysfunction in 32 [11.4%] patients. The mean age was 6.49 +/- 4.25 years. Two hundred and fifty-seven [91.7%] families and their children accepted the idea of CIC, and 248 [88.6%] continued with the CIC program. Mothers were responsible for carrying out the procedure in 204 [72.9%] patients. However, in 76 [27.1%] cases, the patient was doing the procedure independently and the average age for a child to master the technique was 8 years. During the last 3 years, an urotherapist took over the educational services and performed outpatient education instead of our previous inpatient education. Clean intermittent catheterization is an appropriate method of treatment for our group of patients. They showed excellent acceptance of and compliance with the procedure, however, we suggest that for complete success, proper education, teaching, and follow-up should be conducted