ABSTRACT
AIM: The present study was conducted to assess the presence of anemia in patients with advanced heart failure (HF) and compared the clinical characteristics of patients with anemia and without anemia. METHODOLOGY: The present study was conducted on 102 patients (60 males, 42 females) with advanced HF admitted in hospital. In all, general physical and clinical examinations were performed. All were subjected to complete blood count (CBC), hematocrit, and assessment of urea, creatinine, sodium, potassium, and brain natriuretic peptide (BNP). The levels of serum iron, ferritin, iron saturation, and iron-binding capacity were also evaluated. The causes of HF were assessed. RESULTS: Mean age was 48.2 ± 5.7 and 42.2 ± 6.2 years in males and females patients, respectively. Left ventricular ejection fraction (LVEF) was 0.26 ± 0.8 in males and 0.24 ± 0.5 in females. 71.5% males and 76.3% females were on inotropic support. The etiology of HF was ischemia in 29% males and 27% females, high blood pressure in 15% males and 12% females, obesity in 18% males and 19% females, valvular heart disease in 7% males and 5% females, diabetes in 11% males and 6% females, and idiopathy in 20% males and 31% females. There was a significant difference in mean age, initial HB, final HB, hypertension, creatinine, BNP, and initial hematocrit level in patients with anemia and without anemia (P < 0.05). Deaths in hospital were also significant (P < 0.05). CONCLUSION: Anemia was seen in one-third of the patients with HF. Anemia was an independent marker with poor prognosis. Anemic patients were older than non-anemic patients.
ABSTRACT
Background: Combination of vitamin C, hydrocortisone and thiamine have recently been used in sepsis but data of efficacy are conflicting and no data are available from developing countries. We sought to study the effect of addition of this combination to standard care in patients with sepsis/septic shock in a north Indian setting.Methods: In a prospective, open label, randomised fashion, 100 patients with sepsis/septic shock were recruited to receive either standard therapy alone (control group, n = 50) or a combination of vitamin C, thiamine and hydrocortisone (treatment group, n = 50) in addition. The patients were followed for various clinical and laboratory parameters, in-hospital and 30-day mortality, duration of vasopressor use, lactate clearance, duration of hospital stay, and change in serum lactate and the SOFA score over the first 4 days.Results: The 2 groups were matched for basic characteristics. The in-hospital mortality (28% in controls and 24% in treatment group, p = .82) and 30-day mortality (42% in controls and 40% in treatment group, p = 1.00) was not significantly different in the 2 groups. However, there was a significant difference in duration of vasopressor use (96.13 ± 40.50 h in control group v/s 75.72 ± 30.29 h in treatment group, p value = .010) and lactate clearance (control group: 41.81% v/s treatment group: 56.83%, p value =.031) between 2 groups.Conclusions: Addition of vitamin C, hydrocortisone, and thiamine into standard care of sepsis does not improve in-hospital or 30 day mortality. However lower vasopressor use and faster lactate clearance is observed with treatment.