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Introduction: Dengue fever is the most common mosquitoborne viral illness in humans. Study was done to determinethe serum levels of pro -inflammatory cytokines (IL-6, IFNgamma and TNF alpha) in patients with dengue infectionand to determine the correlation of level of cytokine withdisease severity, platelet count and SGOT values.Material and methods: Preserved samples of patients withthe clinical features compatible with dengue infection andNSI antigen positivity admitted during the month of Mayand June 2016 in Pushpagiri Institute of Medical science andResearch Centre, Thiruvalla were analysed for levels of pro-inflammatory cytokines (IL-6, IFN gamma, and TNF alpha).Disease severity of Dengue patients was assessed from theclinical details obtained from medical records. Total samplesused in this study were 80 of which 49 were patients withdengue fever,11 were patients with severe dengue,10 werepatients with other febrile illness and 10 are from healthyindividuals.Results: The levels of all three cytokines were found to beelevated in the infected groups (dengue and severe dengue)when compared to the control groups (healthy and nondengue). The level of interleukin 6 and TNF alpha were foundto be significantly elevated (p value <0.05) in the severe formof dengue. However no statistically significant difference(p value <0.05) between the infected and control group wasfound in Interferon gamma although it showed an elevation inthe infected group. It was observed that all the three cytokinesshowed a negative correlation with platelet count.Conclusions: IL6 and TNF alpha correlated with diseaseseverity suggesting that these cytokines can be used as amarker to predict the severity of the disease. Thus, necessarytreatments and precaution can be taken in advance. TNFalpha correlated with the degree of thrombocytopenia and IL6correlated with level of SGOT.
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Introduction: The GBS enables assessment of risk based on clinical variables alone without the use of endoscopic findings. Its purpose is to aid in identification of patients requiring intervention, such as blood transfusion, or endoscopic or surgical intervention to control UGI haemorrhage. Study objective was to correlate the requirement of blood transfusion in patients presenting with upper gastrointestinal bleeding and Blatchford scoring system.To analyse and correlate the score with prediction of rebleeding, duration of hospital stay. Material and Methods: A Cross sectional quantitative study was conducted in Medical ICU/Wards of Pushpagiri medical college. From (January 2016 to June 2017). All Patients admitted with upper gastrointestinal bleeding during this period was selected as sample size. A detailed history was taken, and a thorough clinical examination was done, complemented by relevant investigation as required for the study. Unpaired t-test,Chi square test and Correlation were used as Test of significance. P-value <0.05 is considered statistically significant using Epi-info 7 software. Results: Majority of patients were in the age group of 41 to 50 years (28.6%). 72.6% were males and the remaining females. 54.8% of patients did not require blood transfusion at all, 20.2% was transfused 1 unit of packed red cells and only 1.2% with 4 units. Only 3.6% patients who presented with upper GI bleed had a rebleeding which further tells the need of blood transfusion.majority of the patients had a mean hospital stay of 5 – 8 days around 48%. There was significant correlation between Blatchford score on admission and requirement of blood transfusion (p value 0.000) and duration of hospital stay (p value 0.008). Conclusion: There was a significant correlation between Blatchford scoring on admission and requirement of blood transfusion. There was also a significant correlation between initial Blatchford scoring and duration of hospital stay and outcome
ABSTRACT
Introduction: The Glasgow-Blatchford bleeding score (GBS) was developed in 2000 to predict the need for hospital-based intervention (transfusion, endoscopic therapy or surgery) or death following UGIB. Objective: To compare the requirement of blood transfusion in patients presenting with upper gastrointestinal bleeding using Blatchford scoring system. To determine the association of GB score with the outcomes of UGI. Materials and methods: A Cross-sectional observational study was conducted in Medical ICU/Wards of Pushpagiri Medical College from January 2016 to June 2017. All Patients admitted with upper gastrointestinal bleeding during this period was selected as sample size. A detailed history was taken, and a thorough clinical examination was done, complemented by relevant investigation as required for the study. Unpaired t-test and Chi square test were used as Test of significance. P-value <0.05 was considered statistically significant using Epi-info 7 software. Results: Majority of patients were in the age group of 41 to 50 years (28.6 %). 72.6% were males and the remaining females. 54.8% of patients did not require blood transfusion at all, 20.2% was transfused 1 unit of packed red cells and only 1.2% with 4 units. 59.5% of patients who presented Abraham Varghese V, Prasanna Hegde. A Cross Sectional Study on Requirement of Blood Transfusion in Upper Gastrointestinal Bleeding using Blatchford Bleeding Score. IAIM, 2019; 6(5): 149-153. Page 150 with Upper GI bleed had oesophageal/fundal varices and the rest (40.5%) had a non-variceal etiology. The minimum Blatchford scoring on admission was 1 and the maximum score was 16. Significant association between initial Blatchford scoring and outcome (p value 0.001) was noted. Conclusion: Patients should be triaged in casualty with Blatchford scoring. High score helps in predicting the requirement of blood transfusion and outcome of patients so that they can be managed judiciously.
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Background: Acute myocardial infarction is characterized by generalized autonomic dysfunction that results in enhanced automaticity of the myocardium and conduction system. Objectives: To assess the incidence of tachy- and bradyarrhythmic episodes in patients with acute myocardial infarction, to find out whether incidence of arrhythmias is higher in STEMI compared to NSTEMI and to evaluate are there any specific arrhythmias responsible for the increased mortality in acute MI. Materials and methods: Hundred patients admitted consecutively into PIMS CCU with the diagnosis of MI were studied. All of them had electrocardiographic evidence of infarction in case of STEMI. They also had electrocardiographic evidence of infarction and positive cardiac troponin I in case of NSTEMI. Results: 30% of study population had valvular heart diseases whereas 70% were free of any valvular disease. 92% of study population was TROP I positive and 8% were TROP I negative. 11% of study population underwent thrombolysis and 6% underwent angioplasty. 83% of study population had NSTEMI and 17% had STEMI. 9% of study population had heart failure and 91% were devoid of heart failure. Conclusion: 58% of study population had arrhythmias. 75.9% of arrhythmias were single and 24.1% were multiple 69% of arrhythmias were major and 31% were minor. There was no significant association between incidence of arrhythmias/ multiple arrythmias / major arrhythmias with valvular heart disease/ heart failure/ TROP I/ procedure/ Killips groups.
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We measured the Non-contact infrared temperature (NCIT) fromthe forehead, chest and abdomen, and compared it with Digitalaxillary temperature (DAT) by Bland Altman Plot. The DAT agreedbetter with NCIT chest (mean difference 0.13, 95% limit ofagreement 0.08, 0.18) as compared to NCIT forehead andabdomen.
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To describe histologic subtypes, clinical presentation and treatment outcome of Hodgkin's lymphoma in Kuwait. Subjects and Method: Patients older than 15 years, diagnosed with Hodgkin's lymphoma between 1980 and 1998, were included in this retrospective analysis. Data were collected using a standardized form that included demographics, histologic subtypes, clinical presentation, stage, extranodal involvement, treatment modality and follow-up. Histology reports were obtained from hospital records. There were 83 [59%] males and 57 [41%] females. Dominant histologic subtypes were nodular sclerosis 65 [46.4%] and mixed cellularity 42 [30%]. Constitutional symptoms were reported by 54 [38.6%] of the cases. Two thirds [64%] of the cases were advanced. Primary extranodular involvement included liver [8%], gastrointestinal tract [7%], lung and bone marrow [4% each]. Disease-free survival according to treatment groups were: radiotherapy alone 100%, chemotherapy alone 88%, and combined modality 65%. The 5-year Kaplan-Meier estimates of overall disease-free survival was 84%. In the cohort of 137 patients with Hodgkin's disease the treatment with combined radiotherapy and chemotherapy had a remarkable outcome. However, evaluation of long-term treatment complications is needed