Evaluation of level of consciousness has become essential for anticipation of sepsis and septic shock. Both the Sequential Organ Failure Assessment (SOFA) score and the quick SOFA score utilize the Glasgow Coma Score (GCS) for screening of sepsis. Objectives: the aim of this review is to determine and study the role of Glasgow coma score in anticipation of sepsis and septic shock. Methods: To achieve this aim, we have searched online database, namely PubMed and Cochrane Library for studies and review articles assessing the significance of assessment of Glasgow Coma Scale (GCS) for anticipating sepsis or septic shock. Thirteen appropriatelyrelated studies were selected for review. Results: Disturbed sensorium was found to be a sensitive early indicator for sepsis, thus GCS is used for assessment of both the Sequential Organ Failure Assessment (SOFA) and quick SOFA scores qSOFA scores. Lower GCS scores were associated with high mortality rates. Discussion: Encephalopathy is an early sign of sepsis and septic shock. Glasgow Coma score (GCS) was a good indicator of neurological dysfunction evaluated by the SOFA and qSOFA scores. The use of GCS was also a predictor of mortality in patients with sepsis. Some researchers, however, reported that GCS was not the best tool for measuring brain dysfunction in sepsis. Conclusions: Glasgow coma score can anticipate sepsis and septic shock, and predict the outcome of sepsis.
Background: Surgical wounds heal by essential purpose in all the elective and emergency surgical processes. Current practice is to place dressing over the closed wound before the patient leaves the sterile environment of the operating theatre. Dressing is a material used to protect a wound and help its healing. On the other hand, to leave wound open in direct contact to environment following any procedure by only applying some ointment on it, the purported open wound treatment is yet debatable one. In the current study we have compared open wound treatment versus occlusive dressings in elective surgical cases with respect to surgical site infections. Materials and Methods: The current study was directed on 50 patients experienced for elective general surgery. Patients were divided randomly in to two equal groups each containing of 25 patients. In Group 1, patients had occlusive dressing till removal of stitches and in Group 2, patients wounds were retained exposed to environment after the surgical procedure. The study was done after approval of ethical board of King Abdulaziz university. Results: In the current study, we perceived total 7% of postoperative wounds were infected of all the clean and clean contaminated wounds we studied. In Group 1, patients had occlusive dressing and these patients had 8% infection rate whereas in Group 2 patients, wounds were kept exposed to the environment and these patients had 6% infection rate. Conclusion: It is thus, concluded that in the elective surgical cases there was no damage in leaving the wounds open postoperatively. This process not only supports in arresting the infective pathology at a reduced stage but likewise saves surgeon's time and patient's cash.
Background: Poor asthma control remains a common cause of emergency department (ED) visits, presentation and hospital admission. The cost of uncontrolled asthma care is substantial in Saudi Arabia. Methods: A cross sectional observational and descriptive study that is conducted in Pediatric Hospital Allergy and Immunology Clinic (Pediatric Outpatient Department), King Saud Medical City in Riyadh, Saudi Arabia From: 2nd of September 2014 To: 2nd of September 2015. The study includes pediatric patients regardless of age (0-12 years old), gender and nationality who visited Allergy & Immunology Clinic (Outpatient Department). The data will be collected using a questionnaire and statistical analyses were performed using SPSS Version 16.0 with the confidence interval = 95% and P values= <0.05. Results: The study population showed that most of them have a regular visit to outpatient clinic 91% (95), among those 92% (88) visited Pediatric Allergy & Immunology in KSMC, on the other hand, 77% (80) are visiting emergency department within the year, the majority of them visited Pediatric ER in KSMC 63% (37), and less than half of them are visiting 1-3 times per year 43% (45). Asthmatic Children, who are admitted to the hospital, have average length of stay more than 1 week 52% (54) managed with medications. Conclusions: Availability of asthma medications, correct delivery of it and to have permanent asthma clinic with Asthma educators will be the most important factors that will decrease revisit to emergency department, long stay in hospital during admission and to control the asthma.
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