Background: Poor glycemic control has been reported to be associated with increased vascular complications in diabetes mellitus (DM) patients. High fibrinogen level has been described as an independent risk factor for cardiovascular diseases. High fibrinogen has been suggested to be involved in the excess rate of cardiovascular diseases in patients with type 2 DM. The present study was undertaken to find correlation between glycemic control and plasma fibrinogen level in patients with type 2 DM.Methods: Three hundred ten patients aged ≥30 years of either sex were included in this cross sectional study. Estimation of glycated haemoglobin (HbA1c), serum fibrinogen, serum total cholesterol (TC), serum triglycerides (TG), serum high density lipoprotein (HDL) cholesterol, and serum low density lipoprotein (LDL) cholesterol was done. Categorical and continuous variables were tested using Chi-Square test/Fisher’s exact test and unpaired ‘t’ test respectively. Pearson’s correlation was used to study correlation between serum fibrinogen levels and HbA1c, Body mass index (BMI), TC, LDL cholesterol, HDL cholesterol, and TG.Results: Mean serum fibrinogen levels were significantly higher in DM patients whose HbA1c, LDL cholesterol and TG levels were higher. Correlation between serum fibrinogen was 0.59, and 0.45 with HbA1c, and BMI respectively. Multivariate step-wise regression analysis showed higher HbA1c and higher BMI were the independent and significant predictors of higher serum fibrinogen levels. HbA1c was the stronger predictor of serum fibrinogen than BMI.Conclusions: Fibrinogen levels were independently associated with HbA1c value in patients with type 2 DM.
Background: The prognostic value of mean platelet volume (MPV) and plasma fibrinogen level in terms of survival in patients with sepsis and septic shock is still incompletely documented. The aim of the present study was to find a correlation between MPV and plasma fibrinogen with the severity of sepsis and mortality.Methods: Three hundred eleven patients having quick sequential organ failure assessment score 2/3, systolic blood pressure ≤100 mmHg, respiratory rate ≥22/minute and altered mentation <15 (Glasgow coma scale) were included for this prospective observational study. Acute physiology and chronic health evaluation (APACHE) II score, MPV on days one and four, fibrinogen on days one and seven were tested. The number of days of intensive care unit (ICU), and hospital stay, in-hospital mortality was recorded. Categorical and continuous variables were tested using the chi-square test/Fisher’s exact test and analysis of variance/Kruskal-Wallis H test respectively.Results: The mean plasma fibrinogen at day one and day seven was significantly higher in patients who had septic shock and in expired patients. The mean MPV at day four was significantly higher in patients who expired compared to those who survived. The mean MPV on day four was significantly higher compared to the mean MPV at day one in patients who expired.Conclusions: Fibrinogen level at admission is the predictor of mortality in patients with sepsis or septic shock. An increase in MPV was strongly correlated with mortality and can be used as a prognostic indicator.
Background: The Global initiative for chronic Obstructive Lung Disease (GOLD) criteria classified chronic obstructive pulmonary disease (COPD) by severity into four stages. Recently, Body mass index (BMI), Bronchial Obstruction, Dyspnea, Exercise (BODE) index, was proposed to provide useful prognostic information of COPD patients. Health-related quality of life (HRQOL) is measured by St. George’s Respiratory disease Questionnaire (SGRQ). Study was undertaken to assess correlations between BODE index and GOLD classification with SGRQ score.Methods: Fifty five COPD patients were included. Spirometry was performed in all patients. Modified Medical Research Council (mMRC) scale was used to label severity of dyspnea. Six-minute walking distance (6 MWD) was performed. BODE index was calculated by giving points to BMI, forced expiratory volume in one minute (FEV1), 6 MWD, and mMRC. SGRQ was used to determine HRQOL. Correlation analysis was done using Pearson’s method.Results: Mean symptoms, mean activity, mean impacts and mean total SGRQ score were significantly higher in patients having mMRC scale 0-1, patients who could walk ≤149 meters, and in patients who had GOLD III and IV class. Lesser the FEV1, higher the mMRC grade, and lesser the 6 MWD, worse was the quality of life. BODE index (r = 0.72) and GOLD classification (r =0.59) were significantly and positively correlated with symptoms score, activity score, impacts score and total SGRQ score.Conclusions: BODE index correlated better than the Gold classification with SGRQ score implying that apart from the airflow limitation, functional impairment measured by the 6MWT and mMRC also affect HRQOL.
Aim: This study aimed to evaluate whether the Cuff Leak Test (CLT) helps to predict post-extubation stridor (PES) in intubated patients.
Materials and Method:A prospective observational study was conducted in the adult ICUs of a tertiary care hospital. Patients who were intubated and ventilated for more than 3 days were enrolled in the study if inclusion and exclusion criteria were met.Standard cuff pressure was maintained throughout the course of intubation of the patients. CLT was conducted before the extubation and cuff leak volume was noted for all patients. A cuffleak volume of ≤140ml was considered a positive cuff leak test.Results: A total of 53 patients were enrolled in the study with a mean age of 62±16 years. The overall incidence of PES was found to be13.2%. A total of 19 (34.85%) patients had a positive CLT of which, 4 patients developed PES and of the 34 patients with negative cuff leak test, 3 patients developed PES. Overall, the cuff leak volume in PES group was comparatively lower than non-PES group. Age, gender, duration of intubation, chronic morbidities and even cuff leak volume were not statistically significant in predicting PES.
Conclusion:Positive CLT or the absolute leak volume does not accurately predict the PES in intubated patients
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