Aim:C-reactive protein (CRP) is a commonly used biomarker of sepsis, the leading cause of mortality in Intensive Care Units (ICUs). However, sufficient data are still lacking to strongly recommend it in clinical practice. The present study is aimed to find out its reliability in diagnosing sepsis.Materials and Methods:CRP was measured in ICU-admitted patients with systemic inflammatory response syndrome and compared using a cutoff of 50 mg/L with the gold standard for diagnosing sepsis, taken as isolation of organism from a suspected source of infection or the Centers for Disease Control criteria for clinical sepsis.Results:CRP had a sensitivity and specificity of 84.3% and 46.15%, respectively. Area under the receiver operating characteristics curve was calculated to be 0.683 (±0.153, P < 0.05). The cutoff value with the best diagnostic accuracy was found to be 61 mg/L.Conclusion:CRP is a sensitive marker of sepsis, but it is not specific.
Background: Neurosurgery has developed as a separate specialty and neurosurgical patients are some of the most common admitted in the intensive care unit. The objective of the study was to study the profile of neurosurgical patients admitted in level III mixed, medical-surgical intensive care unit in a tertiary level teaching hospital in Nepal with the view to identify the causes of intensive care unit admission, types of neurosurgery performed, outcome of the patients, in terms of intensive care unit stay, mechanical ventilation days and mortality.Methods: A retrospective study was designed and all neurosurgical patients admitted to the intensive care unit of our center between 13 April 2017 and 13April 2018 (1st Baisakh 2074 to 30th Chaitra 2074) were enrolled in this study.Results: A total of 813 patients were admitted in ICU over a period of one year (2074 B.S.) of which 199 (24.48 %) were neurosurgical cases. Among these 170 (85.42%) cases were post-surgical, with 29 (14.58%) being pre-operative patients. One hundred forty nine patients (74.9%) were on mechanical ventilation. One hundred and thirty two (66.3%) patients improved and were transferred to a step down ward. Forty-three (22.5%) died in the intensive care unit, 14 (7.03%) left the hospital against medical advice and 9 (4.5%) patients expired after withdrawal of life support.Conclusions: Despite improved care over the recent years the mortality and morbidity of neurosurgical patients is high.Keywords: Intensive care unit; mortality; neurosurgery; outcome.
Men and women suffering from the problems of various psychoactive substance abuse were helped to comeout of the problem by the Department of Psychiatry and Mental Health since it’s establishment in 1986.Since the De-addiction ward started functioning under the Department of Psychiatry and Mental Health,T.U. Teaching Hospital (TUTH) from February, 2000 A.D., people suffering from various drugs relatedproblems have received in-patient care. This study describes the profile of first 100 psychoactive substanceabusers admitted in this ward. The first hundred patients were admitted in a period of 5 months and 2weeks, in an average of 18 patients per month. Eighty eight males, the average age being 33.3+10.98 years.Seventy were married. The average years of education was 8.56+4.94 years. Alcohol (n=58) was the commonestinitial substance, followed by cannabis (n=19) and cigarette (n=11). Currently 60 were predominantly alcoholusers and 36 predominantly opiate users. The majority were multiple substance users: 79 used alcohol, 37used opiates, 25 used cannabis and 18 used benzodiazepines. Age at first use was 19.57+5.54 years andduration of continuous use was 5.88+4.47 years. Eleven (8 males) were HIV ELISA reactive, all of whomwere parenteral opiate abusers. Thirty-nine (35 males) had fatty changes in liver and 6 (all males) hadcirrhotic changes in liver. Those 45 persons with liver abnormality were all alcohol users.Key Words: psychoactive substance, alcohol, opiates, HIV, liver changes.
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