Search or add a thesis

Advanced Search (Beta)
Home > Diagnostic Utility of Who Defined Sepsis Syndromic Criteria With Procalcitonin in Identification of Sepsis in Children With Suspected Infections

Diagnostic Utility of Who Defined Sepsis Syndromic Criteria With Procalcitonin in Identification of Sepsis in Children With Suspected Infections

Thesis Info

Author

Samuel Owuor Akech

Department

Paediatrics and Child Health (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2015

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728044625

Asian Research Index Whatsapp Chanel
Asian Research Index Whatsapp Chanel

Join our Whatsapp Channel to get regular updates.

Similar


Title: Diagnostic Utility of WHO Defined Sepsis syndromic Criteria with Procalcitonin in Identification of Sepsis in Children with Suspected Infections Background: Bacterial infections are a major cause of morbidity and mortality in children but accurate and timely diagnosis remains a challenge to the frontline clinicians. Cultures of sterile bodily specimens are considered the gold standard but are insensitive and results are delayed. Procalcitonin (PCT) has recently emerged as a biomarker with high sensitivity and specificity making it superior to culture based techniques performed in non-ideal circumstances which prevail in resource poor settings. This study investigated the diagnostic utility World Health Organization (WHO) defined criteria for sepsis in diagnosis of bacterial sepsis using procalcitonin (PCT) as the “gold standard”. Methods: This was a prospective survey conducted between July to October 2014 whose primary objective was to determine the sensitivity, specificity, and predictive values of WHO definitions of sepsis syndromes using procalcitonin as the ‘gold standard’ in children with suspected infections. Our secondary objective was to investigate association between PCT elevation and severity of disease and other markers of sepsis. The study was conducted at the paediatrics casualty of the Aga Khan University Hospital, Nairobi (AKUHN) and enrolled children aged >30 days and ≤15 years with suspected infection. This was defined as presence of systemic inflammatory response syndrome (SIRS) (abnormal temperature (>38.5°C or12hours. Children with obvious causes of SIRS such as mechanical/surgical trauma, severe burns, cancer, and without parental/guardian consent were excluded. A standard clinical proforma that allowed classification into various WHO clinical sepsis syndromes for enrolled patients was fulfilled by attending clinician. Blood sample of 0.5ml was collected and PCT test done. Sensitivity (Sp), specificity (Sn), negative and positive predictive values (NPV, PPV), and positive and negative likelihood ratios (LR+, LR-) were calculated for the WHO syndromic definitions. The gold standard for bacterial sepsis was defined as PCT level ≥0.5μg/l. Logistic regression was done and odds ratios calculated to test for association between procalcitonin and disease severity/clinical signs. Kaplan Meier survival analysis was done to compare duration of hospitalisation in various sub-groups. Results: A total of 231 children were enrolled and 22% (51 children) fulfilled criteria for WHO sepsis syndrome. WHO sepsis syndromes definitions had low Sn, 56.9% (95% CI; 50.5%, 63.3%) and Sp, 66.7% (95% CI; 60.6%, 72.8%) for diagnosis of sepsis. PPV was 32.6% (95% CI; 26.5%, 38.6%) and NPV was 84.5% (95% CI; 79.8% 89.2%). Presence of WHO
Loading...
Loading...

Similar Books

Loading...

Similar Chapters

Loading...

Similar News

Loading...

Similar Articles

Loading...

Similar Article Headings

Loading...

سید سبط علی صبا

سید سبط علی صبا(۱۹۳۵ء۔۱۹۸۰ء) کا اصل نام سبطِ علی اور صباؔ تخلص کرتے تھے۔ آپ سیالکوٹ کے قصبہ کوٹلی لوہاراں میں پیدا ہوئے۔ سبط علی صباؔ ابتدائی تعلیم کے بعد پاکستان فوج میں بھرتی ہو گئے۔ ۱۹۶۵ء کی جنگ میں لاہور محاذ پر بھارتی فوجیوں کا ڈٹ کر مقابلہ کیا۔ پاک بھارت جنگ کے دوران بھی آپ نے چند بڑی نظمیں لکھیں جو ہفت روزہ’’واہ کاریگر‘‘ واہ کینٹ اور ہفت روزہ’’ہلال‘‘ راولپنڈی میں شائع ہو چکی ہیں۔ آپ نے ۱۹۶۸ء کی عوامی جمہوری تحریک اور مقامی مزدور تحریکوں میں بھرپور حصہ لیا۔(۸۹۰)صباؔ کا شعری کلام ماہنامہ’’فنون‘‘ ماہنامہ’’ہلال‘‘ مجلہ’’ہماری زبان‘‘ دہلی’’ماہ نو‘‘ لاہور اور دیگر ملکی رسائل و جرائد میں شائع ہوتار ہا ہے۔ مجلس تصنیف و تالیف واہ کینٹ نے ۱۹۸۶ء کو سبط علی صبا کا شعری مجموعہ ’’طشت مراد‘‘ شائع کیا۔ سید سبط علی صباؔ نے پچاس کی دہائی میں باقاعدہ شاعری شروع کی تھی۔ صباؔ ابتدائے شاعری سے ہی طبقاتی اور رزمیہ طرز فکر کے حامل فنکا ر تھے۔ صبا ؔکی غزل کے مطالعہ سے معلوم ہوتا ہے کہ ان کے ہاں کسی تحریک یا نظریہ سے وابستہ طبقاتی شعور نہیں بلکہ وہ پوری دنیا کو ظالم اور مظلوم ،حاکم اور محکوم ،جابر اور مجبور ،امیر و غریب ،جاگیر دار اور کسان اور آجر اور مزدور کے حوالے سے دیکھتے ہیں۔ ان کی شاعری کرہ ارض کے ہر مظلوم کے ساتھ غیر مشروط و فاداری کا اعلان کرتی ہے۔ احمد ندیم قاسمی اس حوالے سے رقم طراز ہیں:

وہ اپنے آنگن سے باہر کی دنیا تک چار طرف جب چھینا جھپٹی کے مناظر دیکھتا تھا اور زر پرست معاشرے میں پسنے والے کروڑوں عوام پر نگاہ ڈالتا تھا تو ایسا ایسا قیامت کا شعر کہہ جاتا تھا کہ تجربات اور محسوسات کی اتنی صداقت اور ساتھ ہی خیال کی اتنی...

منهج المفتي عبد الله محدث في كتابه فتاوى أهل حديث

Issuing Fatwa is much important in the field of Islamic Theology. At least one of the contemporary famous three methodologies in the field of Fatwa for the mufti to adopt is necessary; as it leads mufti to extract ruling from the text of Holy Qur᾽ān or Sunnah of the Holy Prophet (ﷺ) and from what the Muslim Jurists have agreed upon. A thorough study of the book Fatāwā Ahl Ḥadīth has been conducted in this study in order to highlight the characteristics and main features which distinguish the method of the author, ‘Abdullāh Muḥaddith Rōpaṟi, a prominent scholar of his time in the main stream of Ahl e Ḥadīth, from other scholars of his time in issuing fatwa. The study approves that the author has adopted the depth has and (صلى الله عليه وسلم) Prophet Holy the of companions the of method understanding of the primary sources i. E. Holy Book Qur᾽ān, Sunnah and Ijmā‘, and secondary sources i. E. Qiyās and custom and vice versa and he has given best solutions to the matters posed to him at his time on the basis of textual and rational evidences which ultimately influenced people and made them to accept the author as an authority in his field.. His prominent work also tells us that he has expertise in the fields of Islamic literature, Islamic Jurisprudence, Ḥadīth and Tafsīr. Therefore, his book regarding fatwa has got admired by the scholars of the Subcontinent of all the main streams. Also in the court of Law in the country the book has been considered as a referencing book.

A Histological Study of Human Olfactory Mucosa: Regional Distribution and Age Related Changes

The present study on the morphology of human olfactory mucosa was carried out with emphasis on its regional distribution, and changes related with age and gender. Eighty tissue samples (forty for either sex) were collected from cadavers ranging from 30 to 82 years of age, available in the mortuary of King Edward Medical College, Lahore. Individual age groups of males and females included 10 specimens from each sex. The histological study of the mucosa included morphology, regional distribution, quantitative analysis of all four major types of epithelial cells, height of epithelium and thickness of lamina propria in the roof, medial and lateral walls of both nasal cavities. A detailed study of the epithelium revealed the presence of classically known three cells: olfactory cells, sustentacular cells and basal cells and a fourth type, microvillar cells. In the age group 30-39 years (male and female) the mucosa was seen in the roof lying next to cribriform plate of the ethmoid bone and extending on both sides of the nasal septum and on the lateral walls of both nasal cavities. At places the respiratory epithelium was seen in the area of the olfactory epithelium which was much thicker. In the age group of 40-49 years, early age related changes were observed in the shape of occasional short epithelial invaginations, and disturbance of the zonal distribution of olfactory and supporting cells. In the age group 50-59 years, major morphological changes were observed like substantial reduction in the number of nuclei resulting in decreased height of the epithelium, disturbance of zonal distribution and presence of epithelial invaginations. The age group of 60 years onwards showed gradual thinning of the epithelium, epithelial invaginations, and in few cases atrophied olfactory epithelium devoid of olfactory cells. ANOVA showed significant age related decrease in the number of olfactory and sustentacular cells and in the height of the olfactory epithelium among the male and female groups. There was no significant age related decrease in the number of basal cells and thickness of the lamina propria. The number of microvillar cells was markedly less when compared to other cells of the epithelium. These results suggest that loss of olfactory and sustentacular cells becomes pronounced in individuals of both sexes of 50+ years of age. The results of the present study suggest that the reduction in the number of olfactory receptors and in the height of neuroepithelium with advancing age is associated iiwith impairment of olfactory sensibility. There was no evidence of significant sex related differences in the olfactory mucosa. These results are in the accordance with the previous observations in humans and other mammals showing a decline in the olfactory capacity with aging, mostly attributable to a decline in the number of olfactory cells. Contrary to earlier observations, the present study did not reveal any conclusive evidence that females had an increased sense of smell based on histological observations alone.