Serum Procalcitonin vs SOFA Score in Predicting Outcome in Sepsis Patients in Medical Intensive Care Unit.

Background: Sepsis is a dysregulated host response to infection that leads to acute organ dysfunction. The Sequential Organ Failure Assessment (SOFA) score is one of the gold standard tests in assessing the patient's status during ICU stay and also to predict the clinical outcomes of the patients. Procalcitonin (PCT) is a more specific marker for bacterial infection. In this study, we compared PCT and SOFA scores in predicting morbidity and mortality outcomes in sepsis. Materials and methods: A prospective cohort study was conducted on 80 patients with suspected sepsis. Patients who were >18 years of age with suspected sepsis presenting to the emergency room within 24-36 hours of illness are included in the study. SOFA score was calculated, and blood was drawn for PCT at the time of admission. Results: The average SOFA score in survivors was 6.1 ± 1.93, whereas, in nonsurvivors, it was 8.3 ± 2.13. The average PCT level in survivors was 3.7 ± 1.5, whereas, in nonsurvivors, was 6.4 ± 3.13. Area under the curve (AUC) for serum procalcitonin was found to be 0.77 (p value = 0.001) with average procalcitonin level of 4.15 ng/mL with sensitivity of 70% and specificity of 60%. AUC of SOFA score was found to be 0.78 (p value = 0.001) with an average score of 8, having a sensitivity of 73% and specificity of 74%. Conclusion: Serum PCT and SOFA scores are significantly elevated in patients with sepsis and septic shock, indicating their utility in predicting the severity and also their ability to assess end-organ damage. How to cite this article: Shinde VV, Jha A, Natarajan MSS, Vijayakumari V, Govindaswamy G, Sivaasubramani S, et al. Serum Procalcitonin vs SOFA Score in Predicting Outcome in Sepsis Patients in Medical Intensive Care Unit. Indian J Crit Care Med 2023;27(5):348-351.

Uncertainty quantification in modeling of microfluidic T-sensor based diffusion immunoassay.

Comparison of experimental data with modeling predictions is essential for making quantitative measurements of species properties, such as diffusion coefficients and species concentrations using a T-sensor. To make valid comparisons between experimental data and model predictions, it is necessary to account for uncertainty in model predictions due to uncertain values of model parameters. We present an analysis of uncertainty induced in model predictions of a T-sensor based competitive diffusion immunoassay due to uncertainty in diffusion constants, binding reaction rate constants, and inlet flow speed. We use a non-intrusive stochastic uncertainty quantification method employing polynomial chaos expansions to represent the dependence of uncertain species concentrations on the uncertainty in model parameters. Our simulations show that the uncertainties in model parameters lead to significant spatially varying uncertainty in predicted concentration. In particular, the diffusivity of fluorescently labeled probe antigen dominates the overall uncertainty. The predicted uncertainty in fluorescence intensity is minimum near the centerline of T-sensor and relatively high in the regions with gradients in fluorescence intensity. We show that using centerline fluorescence intensity instead of first derivative of fluorescence intensity as the system response for measuring sample antigen concentration in T-sensor based competitive diffusion immunoassay leads to lower uncertainty and higher detection sensitivity.

Primary hyperparathyroidism: A changing scenario in India.

INTRODUCTION: Primary hyperparathyroidism (PHPT) is largely a symptomatic disease with varied systemic manifestations, complicated by coexisting Vitamin D (Vit D) deficiency. Increasing awareness, developments in diagnostics, and Vit D supplementation may have an impact on the disease profile of PHPT. METHODS: Clinical, biochemical, and pathological profile of PHPT presenting to a tertiary care center in South India were compared in two groups separated as per the period of presentation (Group A: January 1994-May 2007 - 51 cases and Group B: June 2007-January 2015 - 59 cases). RESULTS: PHPT has remained a disease of female preponderance with similar age of presentation. It is being diagnosed earlier (mean duration of symptoms prior to diagnosis was 38.7 months in Group A, significantly longer than 26 months in Group B). Bone pain and metabolic myopathy were the most common presentations (60%) followed by pathological fracture (16%), renal calculi (13%), and pancreatitis (7%). Pathological fractures have become less frequent. Vit D deficiency is still a widespread co-morbidity. Radionuclide scintigraphy is an effective localizing tool, but ultrasound can be an inexpensive and widely available screening modality. CONCLUSION: PHPT still remains asymptomatic disease of bones and stones, although it is being diagnosed early. Greater awareness, Vit D supplementation, and better diagnostic tools have made it a disease with lesser morbidity and effective cure.