We evaluated the ability of perfusion index (PI) to predict vasopressor requirement during early resuscitation in patients with severe sepsis. All consecutive patients with clinically suspected severe sepsis as defined by the criteria of the American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference were included. Perfusion variables included PI, arterial lactate level, central venous oxygen saturation, and the difference between central venous carbon dioxide and arterial carbon dioxide pressures, and were recorded before resuscitation and 6 h thereafter. We enrolled 36 patients with severe sepsis. Twenty-one patients required vasopressors, whereas 15 did not. The cut-off of the PI value for predicting vasopressor requirement was ≤0.3. This cut-off value had a sensitivity of 100% and a specificity of 93%; the area under the curve was 0.96 (95% confidence interval 0.8-0.99, P < 0.0001). The cut-off of the arterial lactate level for predicting vasopressor requirement was ≥1.8 mg dL. This cut-off value had a sensitivity of 82% and a specificity of 80%; the area under the curve was 0.84 (95% confidence interval 0.68-0.94, P < 0.0001). Other perfusion variables failed to predict vasopressor requirement in patients with severe sepsis. We concluded that PI and arterial lactate level are good predictors of vasopressor requirement during early resuscitation in patients with severe sepsis. Further studies are warranted to investigate whether monitoring PI during resuscitation improves the outcome of patients with septic shock.

No abstract

We evaluate the correlation between the plasma level of C-reactive protein (CRP) in patients with erectile dysfunction (ED) and hypertension and to set up whether the CRP level affected by the treatment of vardenafil 10 mg orally once daily. A total of 116 male patients with ED and hypertension were enrolled in this prospective study. The patients were divided into two groups, group 1 (ED patients with Not controlled hypertension) and group 2 (ED patients with controlled hypertension). All patients completed the International Index of Erectile Function (IIEF) scores, performed a penile color Doppler ultrasound examination and high sensitivity (hs-CRP) levels. The patients were given vardenafil 10 mg once daily for 3 months and reassessed again. According to the IIEF-EF domain score, there were statistically significant differences between the two groups (P=0.012) with a median value 10.0 (4.0-14.5) and 15.0 (9.0-16.5) between group 1 and group 2, respectively. Regarding to the severe (score<11), moderate (score 11-16) and mild (score 17-25) there were statistically significant differences between the two groups (0.023), (0.001) and (0.001), respectively. The hs-CRP showed statistically significant difference between the two groups (P=0.050) with a median value 2.4 (1.5-3.1) and 1.8 (1.1-2.4) between group 1 and group 2, respectively. The peak systolic velocity (PSV) and end diastolic velocity (EDV) showed statistically significant differences between the two groups (P=0.011) and (P=0.046), respectively. After treatment, there were improvements in the IIEF-EF domain score, severe (score<11), moderate (score 11-16), mild (score 17-25), PSV and EDV in both groups and these improvement were more obvious in (group 2) than (group 1) with a statistically significant differences between the two groups (P<0.05) (except in moderate (score 11-16), no statistically significant difference). The hs-CRP showed statistically significant differences between the two groups after treatment (P=0.049) with a median 2.1 (1.6-2.9) and 1.2 (0.9-2.4) between group 1 and group 2, respectively. Serum hs-CRP was significantly elevated in patients with ED and not controlled hypertension than in ED patients with controlled hypertension. ED patients with controlled blood pressure gave better results with penile duplex than those with not controlled blood pressure. Serum hs-CRP level could be a marker for an endothelial condition in men with ED and hypertension.

Background: Psoriasis is a long lasting immune-mediated disease that has a significant ferocious effect on quality of life (QOL). It is often accompanied with social stigmatization, physical disability and psychological disorders that may reach to suicidal ideation. All these effects of psoriasis have a significant negative impact at patients' work productivity. Nevertheless, the effects of psoriasis on work-related factors have not been extensively studied. Objective: The aim of the current study is to assess the relationship between the severity of psoriasis, dermatology life quality index and work limitation among employed psoriatic patients. Patients and methods: A cross-sectional study was conducted at Benha University Hospital Dermatology Clinic from 1 st August 2022 till the end of October 2022. The study included 180 of psoriasis patients using an interview questionnaire incorporating the Dermatology Life Quality Index (DLQI) and Work limitation questionnaire (WLQ). An assessment of the disease severity was carried out using the Psoriasis Area Severity Index (PASI). Results: The majority of studied group were males (64.4%) with a median (IQR) age 45 (40-52) years old. Their median (IQR) disease duration was 12 years. About 48.9% of the studied patients have degree PASI score. DLQI and WLQ score significantly increased among studied patients have severe PASI grade and median 65 (IQR 50-75), respectively]. There were highly significant positive correlations between DLQI and WLQ score, age and disease duration among the studied patients. Conclusion: Psoriasis has a great impact on the workers, the organization and the society as a whole. So measures for good psoriasis management are recommended.

No abstract