ABSTRACT
Background: sepsis refers to the presence of a serious infection that correlates with systemic and uncontrolled immune activation. Few studies had analyzed eosinophil count as a prognostic marker of outcome in patients with infection. Eosinopenia is an interesting biomarker because the eosinophil count is always measured in clinical practice and the additional costs would therefore be negligible
The aim of this wrk: this study aimed to test the value of eosinopenia in the diagnosis of sepsis in critically ill patients admitted to ICUs
Patients and Methods: this prospective observational, randomized study was conducted on 50 adult critically ill patients who were admitted to ICU of Ahmed Maher Teaching Hospital in the period from March 2017to July 2017. They either had sepsis on admission or not. An informed written consent was obtained from patients and/or relatives before starting this study
Inclusion criteria were patients more than 18 years old and less than 60 years that were critically ill either in sepsis or not
Exclusion criteria were patients less than 18 years old and more than 60 years old, patient or relatives who refused to be included in this study, those with hematological cancer, HIV infection, bronchial asthma and other atopic disorders like hay fever, atopic dermatitis and allergic conjunctivitis and increased levels of eosinophil count as part of any parasitic infection or trauma patients
Results: comparison between infected and non-infected studied patients was statistically significant as regard variables of SOFA score, APACHE II score at admission, TLC and Eosinophil count at admission [p-value?0.05]. There were no statistical significant differences as regard length of ICU stay [p?0.05]. Multivariate regression analysis showed statistically significant differences and was independent predictors for infection as follow: total leucocytic count, eosinophil count at admission and SOFA score. The AUC for eosinophil count to predict was 95% with optimal cut off value was 50 cells/mm3 with a sensitivity of 92.85% and specificity of 93.33% with P value <0.001
Conclusion: the result of the present study revealed that eosinophil counts was <50 cells/mm3 at admission time to ICU was a predictor for diagnosis of sepsis in critically ill patients. However, eosinophil counts at admission time to ICU were not a specific indicator of mortality. Recommendations: eosinophil counts are cheap and easily accessible test can be used to guide for sepsis diagnosis and treatment.Larger studies are needed to determine the prognostic value of this test and establish better cutoff values
ABSTRACT
To assess the epidemiologic and clinical manifestations of the first wave of H1N1 influenza A patients. This study is a retrospective chart review of all patients admitted in King Saud Medical Complex, Riyadh, Kingdom of Saudi Arabia, from 22nd May to 31st August 2009, with a proven diagnosis of H1N1 influenza A. Only patients with a positive nasopharyngeal swab were included, and excluded when the swab was negative. Charts were then analyzed for epidemiological and clinical data. A total of 153 patients with proven H1N1 infection were admitted, with a predominance of male patients [108 [71%]]. Most patients were Saudis [111 [73%]], with 83 males [75%], and 28 females [25%]. The mean age was 25 years [standard deviation; 9.45 years], and median age was 24 years. The most common symptoms in order of frequency were; fever [143 patients], cough [126 patients], sore throat [70 patients], headache [18 patients], shortness of breath [17 patients], myalgia [11 patients], diarrhea [9 patients], and vomiting [7 patients]. Average duration of symptoms before admission was 3.55 days, and the average time of hospitalization was 4.8 days. Full recovery was obtained in 150 patients. Death occurred in 3 patients. True to its designation as a pandemic, H1N1 influenza A, has reached Saudi Arabia and poses a risk to the young population without immunity, and those with co-morbid disease, particularly of the lungs [bronchial asthma], and the pregnant. Despite its virulence in infecting people, deaths are far less than anticipated for such a novel virus. Social distancing can be recommended. However, further observation has to continue to substantiate these tentative preliminary findings