Indian J Med Res
-
The need for quality over quantity in cancer survival is increasingly being recognised in the developing countries, and the efforts to monitor quality of life (QOL) are increasing. However, the non-availability of a valid and reliable tool in the local language is a common problem. Cross-culturally sensitive tools enable the researchers to compare different patient populations and identify cultural differences and variations. The present study was carried out to translate, validate and test for reliability a reliable QOL tool for the head and neck cancer patient population in a tertiary care hospital in south India. ⋯ The Malayalam translation of the FACT-H&N questionnaire was developed, tested and validated. It was found to satisfactorily measure QOL in head and neck cancer patients.
-
Realising the utility of scoring systems in mortality prediction of critically ill patients admitted to intensive care units (ICUs), studies worldwide have expressed a need to validate the Acute Physiology and Chronic Health Evaluation (APACHE) II score for databases of respective countries. Literature available in this area in the Indian context is scanty. The present study was undertaken to evaluate the performance of APACHE II score in prediction of mortality risk, as well as in determination of model validity in critically ill Indian patients with respiratory problems. ⋯ Despite the rise in observed and predicted mortality with 5-point APACHE II score, predicted mortality did not correlate with observed mortality for critically ill patients admitted to an Indian respiratory ICU. The scoring system also showed a poor calibration as well as discrimination. The model may be more useful for Indian patients by lowering down the cut-off value in allotment of age points and by awarding the weightage to factor like co-existing immunocompromised state.
-
Streptococcus pneumoniae has acquired virulence factors such as the polysaccharide capsule and various surface proteins, which prevent opsonization mediated by the complement system. PspC is one of the multi-functional pneumococcal surface proteins capable of eliciting an antibody response in mice. Our study further explores the role of pneumococcal surface proteins in resistance to complement mediated opsonophagocytosis by providing evidence that PspC binds human Factor H (FH), a regulatory protein of the alternative complement pathway. The present study was carried out to map the binding regions on PspC and FH, and to assess the functional activity of FH upon binding to PspC. ⋯ FH binding is specific to PspC on the pneumococcal cell surface. The binding region on PspC mapped to the non-conserved N-terminal region of the alpha-helical domain. The binding site on FH to PspC is different from the active site that functions in degradation of C3b. A haemolysis assay provided evidence that the functional activity of FH was maintained upon binding to PspC. Thus, binding of FH to PspC might be an important mechanism by which S. pneumoniae resist complement activation and opsonophagocytosis.
-
Among hospital-acquired infections, pneumonia is considered to be the leading cause of death mainly in patients with mechanical ventilation in intensive care units (ICUs). The present study was undertaken to estimate the occurrence of hospital-acquired pneumonia (HAP) as well as ventilator-associated pneumonia (VAP) along with the effect of different variables and to detect the presence of multi drug resistant (MDR) organisms in the intensive care unit (ICU). ⋯ Mechanical ventilation and duration of ICU stay emerged as important risk factors for the development of HAP and VAP. MDR Gram-negative bacilli were the commonest respiratory pathogens responsible for increased mortality in patients with VAP.
-
Randomized Controlled Trial Clinical Trial
Tranexamic acid in paediatric cardiac surgery.
Antifibrinolytic agents are used commonly in adult cardiac surgery to reduce postoperative blood loss. Paucity of literature on the use of a newer antifibrinolytic agent tranexamic acid (TA) in children undergoing cardiac surgery promoted us to conduct this study in children with cyanotic heart disease. ⋯ Tranexamine acid was highly effective in reducing post-operative blood loss, blood and blood product usage in children with congenital cyanotic heart disease undergoing corrective surgery.