Comparison of Clinical Outcomes Between Culture-Positive and Culture-Negative Sepsis and Septic Shock Patients: A Meta-Analysis.

This meta-analysis has been conducted to compare the clinical outcomes between culture-positive and culture-negative sepsis or septic patients. The present meta-analysis is reported as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic databases, including PubMed and EMBASE, were searched by two authors independently from the inception to January 25, 2023, using the following key terms: "culture positive," "culture negative," "sepsis," and "septic shock." The primary outcome assessed in the present meta-analysis was all-cause mortality. Secondary outcomes included the need for mechanical ventilation, renal replacement therapy, length of ICU stay in days, and length of hospital stay in days. Total 10 studies met the inclusion criteria and were included in the meta-analysis involving 23,973 patients. No statistically significant difference was found between culture-positive and culture-negative patients in terms of all-cause mortality (risk ratio [RR]: 1.09, 95% CI: 0.95-1.24, p-value: 0.23), the need for mechanical ventilation (RR: 0.99, 95% CI: 0.93-1.05, p-value: 0.79), renal replacement therapy requirements (RR: 1.11, 95% CI: 0.95-1.31, p-value: 0.19), and ICU length of stay (mean difference [MD]: 1.70 days, 95% CI: -1.10, 4.49, p-value: 0.23). However, The mean hospital length of stay in days was significantly longer in patients in a culture-positive group compared to the culture-negative group (MD: 3.04, 95% CI: 2.25-3.82, p-value<0.001). In conclusion, the present meta-analysis of 10 studies, including 23,973 patients, found no significant differences in all-cause mortality, need for mechanical ventilation, need for renal replacement therapy, and length of ICU stay between culture-positive and culture-negative sepsis or septic patients. However, a significant difference was found in hospital length of stay, with culture-positive patients having a longer stay.

A Meta-Analysis on Predictors of Mortality Among Patients Hospitalized for Acute Exacerbation of Asthma.

The aim of this meta-analysis is to systematically review published studies and identify clinically important factors predicting mortality among patients hospitalized for acute exacerbation of asthma. This study was a meta-analysis conducted in accordance with the MOOSE (Meta-analysis of Observational Studies in Epidemiology) guidelines. A systematic search was carried out on online databases such as PubMed and EMBASE to identify articles on predictors of mortality among patients hospitalized for acute exacerbation of asthma. The search used keywords such as "asthma," "exacerbation," "mortality," and "factors." A total of six articles met the inclusion criteria and were included in the present meta-analysis. The incidence of short-term mortality among patients hospitalized for acute exacerbation of asthma was 6% (95% CI= 3-9%, I-square=99%) with a range of 0.79% to 18% across the studies. The factors significantly associated with short-term mortality in patients hospitalized for acute exacerbation of asthma including diabetes mellitus (RR=2.02, 95% CI: 1.63-2.52, p-value=0.001), pneumonia (RR=3.71, 95% CI: 3.02-4.56, p-value=0.001), and mechanical ventilation (RR: 29.98, 95% CI: 15.46-58.15, p-value=0.001). The present study found that diabetes mellitus, pneumonia, and the use of mechanical ventilation are independently associated with mortality among patients hospitalized for acute exacerbation of asthma. Healthcare professionals need to understand the comorbidities and risk factors associated with mortality in patients hospitalized for acute exacerbation of asthma in order to identify patients who are at increased risk and provide prompt treatment.

A rare case of extensively drug-resistant Salmonella typhi meningitis in a 9-year old: a case report.

Meningitis caused by Salmonella typhi is rare and is generally seen in infants. We report a case of a 9-year-old boy with extensively drug-resistant S. typhi meningitis. The patient was diagnosed using a culture sensitivity test and successfully treated with meropenem. Culture sensitivity may be included in routine testing for the diagnosis of S. typhi especially in developing countries due to high burden of disease and emergence of drug resistance.

Primary Psychiatric Disorder Masking the Diagnosis of Lupus Cerebritis.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that is known to affect different organs in the body. Nervous system involvement is common and can manifest as neurological or neuropsychiatric symptoms. A 23-year-old female with no significant past medical history, presented with nausea and vomiting for two weeks and unusual behavior for three days. Brain magnetic resonance imaging (MRI) showed small vessel ischemic changes and abnormal T2 flair/periventricular signal. Lab workup was positive for anti-dsDNA antibodies. The patient was diagnosed with SLE; positive serology and multisystem involvement including neurologic, serositis, and musculoskeletal system. Acute onset of abnormal behavior and memory problems were attributed to lupus cerebritis. The patient was started on methylprednisolone and had significant improvement in neurologic status within the next two days.

Prevalence of rotavirus, adenovirus, hepatitis A virus and enterovirus in water samples collected from different region of Peshawar, Pakistan.

Viral gastroenteritis and other water-borne diseases are the most neglected areas of research in Pakistan. To determine the quality of water, 4 enteric viruses were studied from different localities of Peshawar, Pakistan. The study validates the viral detection method for Rotavirus (RV), Human adenovirus (HAdV), Enterovirus (EV) and Hepatitis A virus (HAV), directly from water sources of rural areas of Peshawar, KPK, Pakistan. Overall, 95 five water samples were tested; among them, 9.47% were positive for RV, 38.94% for HAdV, 48.42% for EV and 12.63% for HAV. The presence of these viruses in water was directly correlated with meteorological data. High prevalence of EV and HAdV was detected frequently in the wet season from May - September, which can be the potential cause of spreading of gastroenteritis in the population. Environmental surveillance is an additional tool to evaluate the epidemiology of enteric viruses circulating in a given community.