Eosinopenia as a Marker of Sepsis in Intensive Care Unit Patients | Author : Mesbah Uddin Ahmed | Abstract | Full Text | Abstract :Sepsis is one of the most common cases of mortality and morbidity in the intensive care unit (ICU). This study was done to evaluate eonsinopenia as a marker of sepsis in intensive care unit patients. This cross sectional study was carried out in the Department of Clinical Pathology, Bangabandhu Sheikh Mujib Medical University, Dhaka from March 2012 to February 2013. Absolute Eosinophil Count (AEC) was done by automated cell counter and rechecked manually microscopically. In this study 74 suspected case of sepsis were enrolled from intensive care unit, BSMMU, Dhaka. Out of these patients 34 were included in the infection group and 40 in the non-infection group depending on blood culture report. The area under ROCcurve was 0.765 in current study. At the cutoff valve of AEC< 40 cell/cumm, the sensitivity and specificity of AEC for diagnosis of sepsis was 72.5% and 61.8% respectively. This present data revealed that decreased absolute eosinophil count was significantly associated with sepsis. So eosinopenia may be a reliable marker for early diagnosis of sepsis. |
| A higher cut-off for Thyroid-stimulating immunoglobulin (TSI) could better predict relapse in Graves’ disease? | Author : Rosita Fontes | Abstract | Full Text | Abstract :Background: TSH receptor (TSHr)-stimulating immunoglobulins (Igs) can be used as diagnostic markers of Graves’ disease (GD). Thyroid-stimulating immunoglobulin (TSI) assays exclusively detect these specific Igs. Materials and Methods: This was a prospective longitudinal study in which hyperthyroid patients with GD and toxic nodular goitres were evaluated at diagnosis. GD patients were also evaluated at antithyroid drug (ATD) withdrawal. An automated chemiluminescent assay measured TSI. According to the manufacturer TSI less than 0.55 IU/L was a non-reactive result. The authors evaluated the Se and Sp of the cutoff point provided by the TSI assay manufacturer, and tested other cutting points through a ROC curve, to assess relapse risk of Graves’ disease. Results: At diagnosis, were evaluated 92 (85.2%) GD patients aged 41.2 ± 2.0 years, and 16 patients (14.8%) with toxic multinodular goiter (TMNG) or toxic adenoma (TA), aged 60.8 ± 4.8 years. They were re-evaluated after 18 ± 4 months with methimazole (MMI) treatment. The follow-up after treatment suspension was of 20 ± 6 months. At diagnosis, the TSI (Se) and (Sp) were 98.9% and 100%, respectively. At ATD withdrawal, despite a high Se (95.5%), Sp was low (59.6%). By adjusting the cut-off to 1.11 (TSI <1.11 IU/L non-reactive), TSI presented the best Sp (89.4%) with a small decrease in Se (93.3%) in predicting GD relapse. Conclusions: TSI had high Se and Sp in GD differential diagnosis with nodular goiters. In the assessment for GD relapse, by raising the cutting point to 1.11 IU/L, a better Sp was obtained at the expense of a small drop in Se. A larger sample is needed to support a higher TSI cut-off point in the clinical routine to assess GD relapse after ATD. |
| A natural completely exhaust of the silted stones in Gallbladder managed with Chinese herbal medicine | Author : Dan Jiang | Abstract | Full Text | Abstract :Ms Xin suffered from gallbladder stores, Cholecystitis and Cholestasis in the bile duct with more or less attacks for four months of last sept to Dec 2019; Except a severe spasm on right costal and chest regions, he also manifested nausea, vomit and a bad jaundice who had been admitted to the accident & emergency department in a few of hospitals in Beijing for rescuing and pain managements, she was offered an operation to remove gallbladder as an only way to completely release her suffers. But she accepted herbal medicine granules prescribed by Dr Xin. After three days of herbal taking, he was completely exhausted all of silted stones from his gallbladder and was healed at all. His state of the gallbladder have been proved by CT scans and blood tests. Conclusion: the herbal medicine is the safe and effective treating method to the gallbladder silted stones. |
| Assessment of Quality Management System for Clinical Nutrition in Jiangsu | Author : Chen Pan | Abstract | Full Text | Abstract :Objective: To critically evaluate the Quality Management System (QMS) for Clinical Nutrition (CN) in Jiangsu. Monitor its performance in quality assessment as well as human resource management from nutrition aspect. Investigate the appliance and development of Artificial Intelligence (AI) in medical quality control.
Materials and Methods: The study source of this research was all the staffs of 70 Clinical Nutrition Department (CND) of the tertiary hospitals in Jiangsu Province, China. These departments are all members of the Quality Management System of Clinical Nutrition in Jiangsu (QMSNJ). An online survey was conducted on all 341 employees within all these CNDs based on the staff information from the surveyed medical institutions. The questionnaire contains 5 aspects, while data analysis and AI evaluation were focused on human resource information. An paired sample t-Test was conducted to determine differences between their situation in 2018 and 2020 the application of JPCNMP.
Results: 330 questionnaires were collected with the respondent rate of 96.77%. The QMS for CN has been build up for CNDs in Jiangsu, which achieved its target in human resource improvements, especially among dietitians. The increasing number of participated departments (42.8%) and the significant growth of dietitians (p=0.02, t=-0.42) are all expressions of the advancements of QMSNJ.
Conclusion: As the first innovation of an online platform for QM in Jiangsu, JPCNMP has been successfully implemented among QMS from this research. This multidimensional electronic system can help QMSNJ and CND achieve quality assessment from various aspects, so as to realize the continuous improvement of clinical nutrition. The instrument of online platform, as well as AI technology for quality assessment is worth to be recommended and promoted in the future. |
| Dengue Infection: Frequently Asked Questions by People in the Province of Aklan, Philippines | Author : Makarius Tel Aviv C. Dela Cruz III | Abstract | Full Text | Abstract :Dengue virus is the most common mosquito borne viral disease in humans, and poses a major challenge to global public health services. Infection can be caused by any of the 4 DENV serotypes, transmitted by female Aedes aegypti mosquitoes. Presenting features may vary from a mild self-limiting febrile illness to life-threatening symptoms of bleeding, organ impairment, and plasma leakage leading to shock. Early diagnosis and monitoring are critical to reduce mortality, especially in the context of the COVID-19 pandemic. Laboratory tests, such as the serological detection of either antigen or antibodies are useful in the diagnosis. Currently, although a vaccine for DENV is available, it remains a challenge to develop an effective vaccine against 4 discrete serotypes and antiviral drugs effective in reducing morbidity or improving disease outcome. |
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