Objectives:This study was designed to determine the comparative efficacy of different scoring system in assessing the prognosis of critically ill patients.Methods:This was a retrospective study conducted in medical intensive care unit (MICU) and high dependency unit (HDU) Medical Unit III, Civil Hospital, from April 2012 to August 2012. All patients over age 16 years old who have fulfilled the criteria for MICU admission were included. Predictive mortality of APACHE II, SAP II and SOFA were calculated. Calibration and discrimination were used for validity of each scoring model.Results:A total of 96 patients with equal gender distribution were enrolled. The average APACHE II score in non-survivors (27.97+8.53) was higher than survivors (15.82+8.79) with statistically significant p value (<0.001). The average SOFA score in non-survivors (9.68+4.88) was higher than survivors (5.63+3.63) with statistically significant p value (<0.001). SAP II average score in non-survivors (53.71+19.05) was higher than survivors (30.18+16.24) with statistically significant p value (<0.001).Conclusion:All three tested scoring models (APACHE II, SAP II and SOFA) would be accurate enough for a general description of our ICU patients. APACHE II has showed better calibration and discrimination power than SAP II and SOFA.
Objective: A majority of the diabetic patients experience sexual dysfunction. The objective of the study was to investigate the effect of allantoin on sexual dysfunction in diabetic rats. Methods: Streptozotocin-induced diabetic Wistar rats were divided into 3 groups: diabetic control group, diabetes + allantoin 100 mg/kg and diabetes + allantoin 200 mg/kg. Diabetic rats were treated with allantoin for 6 weeks and were assessed for its effect on sexual behavior, blood pressure, sperm count, sperm morphology, and levels of glycosylated hemoglobin, serum testosterone, and nitrite. Effects of treatment on diabetic rats were compared with diabetic control rats and normal healthy rats. Results: Diabetes decreased sexual behavior, sperm count and levels of serum testosterone and nitrite while increased blood pressure, the level of glycosylated hemoglobin and sperm defects in comparison to healthy rats. After a 6-week treatment period, there was a significant decrease in glycosylated hemoglobin (HbA1C) and blood pressure in the allantoin treatment groups when compared to diabetic control. Also, the rats treated with allantoin performed significantly well in sexual behavioural studies with a significant increase in body weight, sperm count, and levels of serum testosterone and nitrite compared to diabetic control. Conclusion: Oral administration of allantoin improves sexual function in diabetic rats by improving glycemic control and maintaining blood pressure. It also improves sexual function in diabetic rats by preventing the reduction in levels of nitrite and serum testosterone.
Objective: To evaluate Hepatitis C treatment by directly acting antiviral agents and its impact on glycemic control. Study Design: This is an observational study. Setting: This study was conducted in Medicine department Civil Hospital Karachi from March 2018 to December 2019. Materials and Methods: Patients visiting the outpatient department of the hospital having documented HCV infection having type 2 diabetes mellitus were included in the study. All participants were given directly acting antiviral treatment for 12 weeks. After treatment they were assessed for achievement of sustained virological response (SVR). Pre-treatment and post treatment fasting blood glucose levels and HbA1c levels were checked. SVR is defined as serum HCV RNA which is undetectable (<50IU/ml) after 12 weeks of antiviral treatment. Results: Around 332 patients matched our inclusion criteria. Amongst these there were 219 males and 113 females. The mean age of patients was 39.44 ± 2.19 years. All the selected participants started therapy on Sofosbuvir-velpatasvir (pangenotypic NS5A-NS5B inhibitor single-pill combination regimen that has potent activity against hepatitis C virus (HCV) genotypes 1, 2, 3, 4, 5, and 6.) plus ribavirin. After treatment with directly acting antiviral therapy 231 (69.57%) patients achieved sustained virological response. Patients who achieved SVR showed improved glycaemic control than those who didn’t. Patients with cirrhosis showed decreased chances of attainment of SVR. Fasting blood glucose levels and HbA1c were also decreased, decreasing the amount of insulin required for diabetes control. Conclusion: Our study showed that treatment with directly acting antiviral treatment improved glycaemic control in HCV infected patients. Other factors like BMI, presence of cirrhosis, mean serum HCV RNA levels and adherence to treatment were major predictors for achievement of SVR.
Aim and objective This study aimed to examine the relationship between serum ferritin levels and the degree of hepatic fibrosis as detected on Fibroscan in thalassemia patients. Materials and methods This was a single-center and cross-sectional study conducted from April 2021 to December 2022. The sample population comprised 55 beta-thalassemia patients receiving treatment at the National Institute of Blood Diseases and Bone Marrow Transplantation, Karachi, Pakistan. The data was compiled through a series of patient interviews, an examination of medical records and was analyzed to obtain the results. Descriptive statistics were used for several variables, including diagnosis, Fibroscan score, blood group, comorbidity, visceromegaly, consanguinity, serum glutamate pyruvate transaminase (SGPT), viral markers, and C reactive protein (CRP). The correlation analysis was done using Spearman’s correlation test. Results There were 55 participants in the study, 40 of whom were male and 15 of whom were female. The mean age of the patients was eight years, while the average age at diagnosis was nine months with a transfusion frequency of every 20 days. Spearman's rho (r = 0.287), and the significant value of (p = 0.033) confirmed a statistically significant positive correlation between serum ferritin levels and hepatic fibrosis. On Fibroscan, 74.5% of patients had F0-F1 stage fibrosis followed by 14.5% of the patients having F2 stage fibrosis. HCV seropositivity was the most prevalent comorbidity among the patients. 80% of patients had serum ferritin levels greater than 1000 ug/mL. Hepatosplenomegaly was present in 43.6% of the patients. 78.2% of patients were born out of consanguineous marriages. Conclusion In conclusion, this study found a statistically significant positive correlation between serum ferritin levels and hepatic fibrosis in beta-thalassemia patients. The study emphasizes the significance of monitoring serum ferritin levels in thalassemia patients to prevent hepatic fibrosis.
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