Introduction Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) can be fatal. In 2012, a comprehensive score was developed to predict the risk of in-hospital mortality in AECOPD called the dyspnoea, eosinopenia, consolidation, acidemia, and atrial fibrillation (DECAF) score. We conducted this study to assess the value of the DECAF score as a clinical prediction tool that claims to stratify all patients with AECOPD by risk accurately. Methods We conducted a prospective study of patients admitted to the intensive care unit (ICU) of the Department of Pulmonology in Civil Hospital, Jamshoro, from January 2016 to December 2018. Our inclusion criteria were that the patient must be age 35 years or older, have a primary clinical diagnosis of AECOPD, spirometry consistent with airflow obstruction, and have a smoking history of ≥10 cigarette pack per year. We excluded patients who had domiciliary ventilation, survival-limiting comorbidities (such as metastatic malignancy), and a primary reason for admission other than AECOPD. All sociodemographic data were collected at the time of admission, including age, gender, co-morbidities, housebound status, and number of previous AECOPD. Clinical data collected included plain chest x-ray, spirometry, electrocardiogram, arterial blood gases analysis, complete blood count, kidney function test, liver function test, and serum electrolytes. A DECAF score was applied to each patient. We noted in-hospital mortality and compared the characteristics of survivors and non-survivors. Data were analyzed using IBM SPSS for Windows, version 19.0 (IBM Corp, Armonk, NY). Results A total of 162 patients were included in the study. The mortality rate was 13% (n=21). More survivors had a DECAF score from zero to three than non-survivors. The difference in the number of survivors vs. non-survivors was statistically significant for DECAF scores zero and one. For DECAF scores four and five, there were more patients in the “non-survivors” group, and the differences were statistically significant. None of the patients scored six on DECAF. Conclusion Patients with a DECAF score of four or higher have a significant risk of mortality. DECAF is a simple tool that predicts mortality that incorporates routinely available indices to stratify AECOPD patients into mortality risk categories.
Objective Patients with Complex the Dyspnoea, Eosinopenia, Consolidation, Acidaemia, and atrial Fibrillation (DECAF) scores prolong the hospital stay of patients suffering from Chronic Obstructive Pulmonary Disease (COPD). Method Patients admitted to respiratory wards in tertiary care hospital, Baluchistan with COPD between June 2016 to September, 2015 were prospectively reviewed and DECAF score applied to each patient. Duration of hospitalization was then correlated with total DECAF scores. Result Out of 118 total admissions, 103 were reviewed as 15 patients died. 71% were male, mean age was 69.6 years and average of 15 days of hospitalization. The duration was longest in those with DECAF scores of 3-5 and lowest in those with scores of 0-1. Conclusion The DECAF Score is a simple and effective clinical tool that can risk stratify hospitalized patients with COPD and could therefore help clinicians managing this fatal condition.
Objective The objective of this study was to measure the pulmonary function tests in population living in Baluchistan, Pakistan. Method The study area was conducted in province of Baluchistan, which is the largest province of Pakistan. A cross sectional study has been carried out to observe Normal lung functioning in residents of Baluchistan followed by a randomized Sample selection of individuals from five strata of Baluchistan. Brief detail was told to the subjects that why the test were being done to make their cooperation better. Written consent from all subjects was taken after explaining the experimental procedure. Results The results of present study, as shown in (Table 4.2.1) shows significance difference on the comparison of FVC, FEV1, PEFR and FEV1\FVC the mean value of FVC, FEV1, PEFR and FEV1\FVC in Baluchistan with the standard Chamanern mean values according to their gender, age and height.it was found 3.46, 2.56, 379.8 and 0.741 on average with an standard deviation of 0.21, 0.14, 46.75 and 0.043 respectively. Conclusion It is concluded that FVC, FEV1, PEFR, and FEV1/FVC have significant differences in mean, the means of Baluchistan city were less than a per standard Chamanern mean values, it also gives significant differences within Citys of Baluchistan city as spirometric values exclusively depends upon body shape, chest size, BMI, Age, environment, life style, anatomical differences, altitude and lung development.
Objective: This research aimed to evaluate the relative benefits of intravenous ciprofloxacin and ceftriaxone for the treatment of bacterial peritonitis in cirrhotic liver patients. Study Design: Randomized control trial Place and Duration: Department of Gastroenterology, Shaikh Zayed Hospital Lahore in the period from March, 2022 to August, 2022. Methods: Total 130 patients of bacterial peritonitis in liver cirrhosis were included. Patients were undergone for abdomen ultrasound to diagnose liver cirrhosis. Following the acquisition of written informed consent, participants' personal information (such as age, sex, and residence) was meticulously documented. Patients were equally divided in two groups. Group I received intravenous ceftriaxone 1g 12 hourly among 65 patients and 65 cases of group II received ciprofloxacin 200mg 12 hourly for 6 days. Effectiveness among both groups were assessed. Results: There were 44 (67.7%) males and 21 (32.3%) females in group I and in group II 52 (80%) males and 13 (20%) females. Patients mean age in group I was 39.10±6.29 years and in group II mean age was 41.7±3.50 years. We found that majority of the cases were from urban areas 37 (56.9%) in group I and 39 (60%) cases in group II. Frequency of effectiveness in group I was 49 (75.4%) and in group II efficacy found in 47 (72.3%) cases. Post-treatment complications in group I was 7 (10.8%) and in group II found in 6 (9.2%) cases. Satisfaction rate among patients was almost equal 46 (70.8%) and 45 (62.9%) in group I and II. Conclusion: The findings of this research indicate that the administration of ciprofloxacin intravenously is just as effective as the administration of ceftriaxone intravenously for the treatment of spontaneous bacterial peritonitis in cirrhotic cases.
Objective: This study was carried out to assess the prevalence of overweight, obesity, and risk factors among young adults in Pakistan. Study Design: A cross-sectional anthropometric study in local population to assess the prevalence of overweight, obesity, and risk factors among young male and female. Place and Duration: Present study was conducted in 25 high schools of Lahore, Islamabad and Karachi from January 2022 to November 2022. Methodology: In this study 1000 young adults (500 girls and 500 boys) of age 15-17 years were selected and used population-based stratified cluster sampling method. To determine the prevalence of overweight and obesity, the participant’s body mass indices (BMI) were compared to the BMI guidelines for Pakistani children and adolescents. In order to gather information about the study group's sociodemographic traits, Internet use, TV watching, physical activity, and family history of obesity, a standardized questionnaire was administered. Results: According to the findings, there were 8.9% of teenagers who were obese overall (9.6% of females and 7.2% of boys). It was shown that BMI went up when computer use did. Compared to their peers who were of normal weight, a higher percentage of overweight and obese teenagers watched TV and used computers for longer than two hours each day. It was discovered that the patients with normal weight participated more frequently in regular physical activity. 59.6% of the households of overweight adolescents were obese. Practical Implication:It will spread awareness among community about obesity prevalence in young adults and the risk factors associated with them ,controlling methods and things to prevent. Conclusion: Comparatively it was concluded that Pakistan has lower frequency of adolescent obesity than several developed countries. The usage of computer, mobile, television, physical exercise, and family dynamics are all significant risk factors for obesity. Keywords: Adolescent, Obesity, Body mass indices, Risk factors, Anthropometric
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