Prospective data on infections in systemic lupus erythematosus (SLE) from India are scarce. We studied the frequency and predictors of infections in hospitalized SLE patients. All data on infections were prospectively recorded. During the study period, 212 SLE patients (91% women) were hospitalised. Sixty-three (29.7%) had infections. The most common infections were pneumonia, skin and soft-tissue infections and urinary-tract infections. Mortality was higher in the infection group compared to the no infection group (11.1% vs. 0.7%; p=0.01). At three months, 10/63 developed another episode of infection. On logistic regression, the predictors of infection were fever [odds ratio (OR) = 4.17], vasculitis (OR = 2.64), thrombocytopaenia (OR = 3.59), presence of co-morbidities (OR = 3.59) and duration of hospital stay >11 days (OR = 3.55); p<0.001 for all. High-sensitivity CRP (hsCRP) and procalcitonin were measured in 95 patients. hsCRP was significantly higher in the infection group compared to the no infection group (median 27 vs. 6.5 mg/L; p<0.001). Procalcitonin was similar in both groups. A hsCRP of 11.5 mg/L had a sensitivity of 66.7% and specificity of 72.9% to diagnose infection. To conclude, 29.7% of Indian SLE patients who are hospitalized have infections, resulting in a significantly increased duration of hospital stay. The presence of fever and co-morbidities are predictors of infection. The role of high hsCRP to support the diagnosis of infection in SLE is once again confirmed.
Background: Medical students today are tomorrow's future doctors. One of the key skills that students should develop during their graduation training is to be prepared for emergency life saving measures like cardiopulmonary resuscitation (CPR) anytime, anywhere. The students play integral role in learning, mastering and inculcating the most pragmatic clinical skill of CPR.Objectives: a) To evaluate the CPR awareness among undergraduate medical students. b) To screen the knowledge regarding accurate, effective CPR procedural techniques and various barriers of CPR failure in clinical practice from student perspective. c) To ascertain interest in CPR training programs and also inculcating CPR as an active part of clinical practice in future. Materials and Methods:The questionnaire comprised of three parts, first one dealing with general questions to know the importance of CPR in clinical practice, second one comprised of the main goal and accuracy of CPR intervention and the last segment consisted of questions targeting the indications, methods and effectiveness of CPR.Statistical Analysis: Descriptive statistics and multiple response analyses were done by using SPSS 17. Results:The students had good knowledge about the importance of CPR in clinical practice and stand average in knowing its indications and effectiveness. Whereas, only 1.2% of them were completely aware about the universal compression ventilation ratio, and 20.4% were aware of the current order of CPR being compression, airway and breathing. Conclusion:Though, CPR awareness is good among the students but skills of CPR have to be mastered by proper certified training programs at regular intervals and knowledge has to be updated with the changing trends in CPR. InTROduCTIOnCardiopulmonary resuscitation (CPR) is one of the most evolving areas of modern medicine which comprises a series of lifesaving actions that improve the survival rates following cardiac arrest [1]. "Although the optimal approach to CPR may vary, depending on the rescuer, the victim, and the available resources, the fundamental challenge remains: how to achieve early and effective CPR. Given this challenge, recognition of arrest and prompt action by the rescuer continue to be priorities for the 2010 AHA (American Heart Association) Guidelines for CPR and ECC (Emergency Cardiovascular Care)" [2]. Despite important advances in prevention, cardiac arrest remains a substantial public health problem and a leading cause of death in many parts of the world. Cardiac arrest occurs both in and out of the hospital.In earlier days CPR training was meant only for health care professionals. Later it was noticed that many of these events occurred outside the hospital setting, and that early CPR need to be performed by the bystanders who witnessed the scene. Hence, CPR is said to be a skill for all [3]. Quality of life is also found to be better for victims who immediately receive bystander CPR even in absence of professional assistance [4]. Studies have shown that immediate CPR after colla...
BackgroundInfections are one of the main causes of morbidity and mortality in SLE.1 The high prevalence of infection is attributed to use of immunosuppressive agents and disease activity. There is paucity of literature from India on infections, types of infections, predictors and outcome.ObjectivesTo determine the frequency, types and determinants of major infections in hospitalised patients with SLE.MethodsPatients with SLE (2012 SLICC-ACR criteria) aged ≥13 years, admitted to Clinical Immunology and Medicine wards were included. Clinical evaluation for major organ involvement of SLE, disease activity was assessed by SLEDAI-2K. Whenever there was a suspicion of infection appropriate work up to find the etiology of infections was done. Major infection was defined as presence of either one of the following a) sepsis b) pneumonia, or pyelonephritis, or endocarditis, or meningitis. c) skin or soft tissue infection requiring hospital admission for treatment d) Infection requiring IV antibiotic therapy. The diagnosis of infection was made by compatible clinical, microbiological and imaging criteria.ResultsFrom December 2016 till January 2018, 63 (55 women and 8 men) were included; Mean age was 28.8±9.8 years; mean SLEDAI-2K was 14.6±7.03. Median duration of hospital stay was 14 days; range 2–64 days. Disease manifestation (including present and ever present) were arthralgia/arthritis in 51 (81%), oral ulcers 56 (88.9%), myositis 10 (15.9%), lupus nephritis 35 (55.6%), CNS lupus 14 (22.2%), serositis 14 (22.2%), cardiac involvement 13 (20.6%), APS 3 (4.8%). At the time of enrollment thrombocytopenia was present in 13 (20.6%), and leukopenia 11 (17.5%).Twenty-three of 63 (36.5%) had infections (table 1), 14/23 (60.8) were microbiologically proven, remaining (39.2%) were confrrmed by compatible clinical features and imaging.Seven of 63 (11.1%) died; 5 (21.7%) in the infection group versus 2 (5%) in no infection group, p=0.08 OR 5.58 [CI 0.98–31.7]. Thirty-four of 63 (54%) had fever on admission; 17/23 (74%) patients with infection had fever compared to 17/40 (42.5%) in no infection group, p=0.02 [OR=3.8, CI 1.2–11.7]. There was no association of lupus nephritis, CNS lupus, leukopenia, receipt of cyclophosphamide, rituximab, methylprednisolone pulse therapy with occurrence of infection.Abstract AB0628 – Table 1Infections in SLE patientsType of Infectionsn=23 (%) Bacterial Pneumonia3 (13.7)Fungal Pneumonia(Invasive Aspergillosis)2 (8.7)Pulmonary tuberculosis2 (8.7)Disseminated tuberculosis2 (8.7)Urinary tract infection4 (17.4)Skin and soft tissue infection4 (17.4)Blood stream infections3 (13)Suspected brain abscess1 (4.3)Pyogenic meningitis1 (4.3)Disseminated Varicella1 (4.3)Viral bronchiolitis1 (4.3)ConclusionsAlmost 36% of SLE patients in hospital have infections. There appeared to be an increase in number of deaths among patients with infections. There was no association of infections with the dose of prednisolone or previous immunosuppression with cyclophosphamide.Reference[1] Shyam C, Malaviya AN. Infection-related mor...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.