Laboratory Findings In Patients Research Articles

The Relationship of Liver and Pancreas Density With Chest Computed Tomography Score Progression and Laboratory Findings in Patients With COVID-19.

Abdominal involvement of COVID-19 is a current issue. We aimed to evaluate hepatic and pancreatic density alterations on computed tomography (CT) and to analyze whether these alterations had a relationship with chest CT score and laboratory findings. Patients with reverse transcription-polymerase chain reaction-confirmed COVID-19 from March 11, 2020, to February 6, 2021, were retrospectively analyzed. Patients were divided into nonprogressive and progressive groups according to their chest CT scores. Liver and pancreas density, and liver-to-spleen (L/S) ratio were calculated. Laboratory findings, medication, intensive care unit stay, and survival were noted. There were 51 patients in the nonprogressive group and 123 patients in the progressive group. The median (minimum to maximum) L/S value of the nonprogressive group was 1 (0.28-1.53) at admission and 1.06 (0.33-1.83) at follow-up ( P < 0.001). In the progressive group, the median L/S value was 1.08 (0.35-1.51) at admission and 0.92 (0.33-1.75) at follow-up ( P < 0.001). A significant difference was found between the 2 groups at admission and follow-up ( P = 0.010 and P < 0.001, respectively). Pancreatic density measured at follow-up was significantly lower in the progressive group ( P = 0.045). In the progressive group, aspartate aminotransferase, total bilirubin, creatinine, urea, C-reactive protein, D-dimer, and white blood cell values were higher; albumin and lymphocyte values were lower ( P < 0.05). Patients with COVID-19 with progressive CT scores may have a decrease in L/S values, and their pancreatic density is lower than nonprogressives. Aspartate aminotransferase, total bilirubin, creatinine, urea, C-reactive protein, D-dimer, and white blood cell values tend to be higher in patients with a high chest CT score.

Prevalence of Anaemia Based on Laboratory Findings in Patients Attending a Tertiary Health Facility in South-Eastern Nigeria: A 2-Year Review

Prevalence of Anaemia Based on Laboratory Findings in Patients Attending a Tertiary Health Facility in South-Eastern Nigeria: A 2-Year Review

Prevalence of Anaemia Based on Laboratory Findings in Patients Attending a Tertiary Health Facility in South-Eastern Nigeria: A 2-Year Review

Prevalence of Anaemia Based on Laboratory Findings in Patients Attending a Tertiary Health Facility in South-Eastern Nigeria: A 2-Year Review

Clinical characteristics and laboratory findings of patients with COVID-19 in Rasht, Iran

In December 2019, an epidemic of an unknown respiratory virus emerged in Wuhan, China, and put the whole world in crisis; a newly emerged coronavirus, called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We aimed to evaluate epidemiological and clinical characteristics of coronavirus disease 2019 (COVID-19) patients in the North of Iran. We extracted demographics and baseline clinical characteristics from 126 patients with polymerase chain reaction (PCR) confirmed COVID-19 in Razi Hospital, Rasht, Iran. The mean age of patients was 62 years, ranging from 28 to 92 years old. Overall, 57.1% of cases were male and 42.9% were female. Totally, 17.5% of patients had direct contact with a SARS-CoV-2 infected patient. The most common underlying diseases were diabetes (11.9%) and cardiovascular disease (CVD) (7.1%). The mean±SD of lactate dehydrogenase (LDH), creatine phosphokinase (CPK), creatine kinase MB (CK-MB), serum glutamic oxaloacetic transaminase (SGOT), and e rythrocyte sedimentation rate (ESR) were remarkably higher than the normal range, (1231±866.4 U/L, 766.8±2288.6 U/L, 59.28±55.1 U/L, 112.28±213 U/L and 67.61±31 mm/hr), respectively. Also, the average O 2 Saturation (O 2 Sat) was 61.4±26.3%. Male gender, advanced age, a higher level of the cardiac enzyme, and a lower level of O 2 Sat are associated with severity in COVID-19 patients.

A Retrospective Evaluation of Spleen Hydatid Cyst Treatments: The Spleen-Preserving Conservative Approach is Preferable to Splenectomy.

Cystic echinococcosis (CE) is rarely encountered in the spleen, even in areas where the disease is endemic. There is no consensus in the literature concerning the treatment of splenic cystic echinococcosis. This study was intended to compare the treatment results and factors affecting the selection of the spleen- preserving approach or splenectomy in treatment. Four hundred and seventy patients operated for cystic echinococcosis at a university clinic between January 2010 and December 2019 were retrospectively evaluated. Splenic cystic echinococ- cosis was identified in 22 patients (4.7%). Demographic features as well as clinical and laboratory findings of patients who underwent splenectomy or spleen-preserving operations were compared between the groups. Spleen-preserving cystotomy was performed on 18 patients (81.8%), and splenectomy on 4 (18.2%). Eleven patients (50%) had isolated cystic echinococcosis in the spleen, while another 11 (50%) had hepatic and splenic cystic echinococcosis. The median cyst size was 10.0 cm (min: 3, max: 20). Splenectomy patients had significantly larger cyst sizes (median, min-max; 8.0 cm, 3-15 cm vs. 15.0 cm, 10-20) (Z=2.071, P=.042). Postoperatively, 1 patient from the splenectomy group (25.0%) developed deep vein thrombosis, and another from the cystotomy group (5.5%) developed pulmonary embolism. No other serious complications, re-operation requirements, or recurrence were observed after a median follow-up period of 27.0 months (min: 5, max: 92). Since no collections or recurrence were observed, and splenic functions were preserved in patients who underwent spleen-preserving cystotomy, we recommend the use of spleen-protective cys- totomy. Splenectomy should be employed in patients with cyst diameters exceeding 10 cm, with a central location, and in cases with difficult cavity management and a high risk of developing postoperative collections.

Examination of patients admitted to a university hospital with methanol intoxication

Objective: The aim of this study is to evaluate the demographic data, clinical features and laboratory findings of patients followed up with methanol poisoning in our internal medicine clinic. In addition, to examine the data of the patients followed in our intensive care unit and to contribute to the literature in this direction.&#x0D; Material and Method: In this study, 21 patients diagnosed with methanol intoxication who were hospitalized in the internal medicine clinic of our hospital between 01.01.2019 and 01.04.2022 were included. Demographic information of the patients, initial complaints, accompanying symptoms, laboratory results, blood gas values, intensive care unit requirements, mechanical ventilation needs, length of hospital stay and whether they received hemodialysis treatment were recorded from the hospital automation system.&#x0D; Results: 21 patients were included in the study. The mean time for patients to apply to the hospital after drinking alcohol was calculated as 31.42±4.27 hours. The mean hospital stay was 3.0±1.02 days. While 12 patients were followed up in the intensive care unit, it was found that 6 patients needed mechanical ventilation and 9 patients needed hemodialysis. Glucose, creatinine, acetyl aminotransferase (AST), partial carbon dioxide pressure (PaCO2), lactate, anion gap and base gap were found to be statistically significantly higher in the group treated in the intensive care unit (p

Early Prediction Model for Critical Illness of Hospitalized COVID-19 Patients Based on Machine Learning Techniques.

MotivationPatients with novel coronavirus disease 2019 (COVID-19) worsen into critical illness suddenly is a matter of great concern. Early identification and effective triaging of patients with a high risk of developing critical illness COVID-19 upon admission can aid in improving patient care, increasing the cure rate, and mitigating the burden on the medical care system. This study proposed and extended classical least absolute shrinkage and selection operator (LASSO) logistic regression to objectively identify clinical determination and risk factors for the early identification of patients at high risk of progression to critical illness at the time of hospital admission.MethodsIn this retrospective multicenter study, data of 1,929 patients with COVID-19 were assessed. The association between laboratory characteristics measured at admission and critical illness was screened with logistic regression. LASSO logistic regression was utilized to construct predictive models for estimating the risk that a patient with COVID-19 will develop a critical illness.ResultsThe development cohort consisted of 1,363 patients with COVID-19 with 133 (9.7%) patients developing the critical illness. Univariate logistic regression analysis revealed 28 variables were prognosis factors for critical illness COVID-19 (p < 0.05). Elevated CK-MB, neutrophils, PCT, α-HBDH, D-dimer, LDH, glucose, PT, APTT, RDW (SD and CV), fibrinogen, and AST were predictors for the early identification of patients at high risk of progression to critical illness. Lymphopenia, a low rate of basophils, eosinophils, thrombopenia, red blood cell, hematocrit, hemoglobin concentration, blood platelet count, and decreased levels of K, Na, albumin, albumin to globulin ratio, and uric acid were clinical determinations associated with the development of critical illness at the time of hospital admission. The risk score accurately predicted critical illness in the development cohort [area under the curve (AUC) = 0.83, 95% CI: 0.78–0.86], also in the external validation cohort (n = 566, AUC = 0.84).ConclusionA risk prediction model based on laboratory findings of patients with COVID-19 was developed for the early identification of patients at high risk of progression to critical illness. This cohort study identified 28 indicators associated with critical illness of patients with COVID-19. The risk model might contribute to the treatment of critical illness disease as early as possible and allow for optimized use of medical resources.

Epidemiological and Clinical Presentation of Dengue Infection in the Gadap Region of Karachi. A Survey Based Study

Introduction: Dengue fever has emerged as a major arboviral disease with a significant impact oF the disease burden in tropical countries.&#x0D; Aim: The goal of this study was to look at the clinical and laboratory profiles of dengue infection.&#x0D; Methodology: During 2018 and 2019; a cross-sectional study was conducted to investigate the epidemiological and clinical features of dengue fever in the Gadap region of Karachi, Pakistan.&#x0D; Results: Positive cases were reported during the study period, which spanned the months of August to December following the monsoon season. Among the 200 positive patients, 160 had dengue fever (DF) and 40 had dengue hemorrhagic fever (DHF) (male 160 and female 40). Fever was the most common symptom, followed by Arthralgia/Myalgia, Headache, and Vomiting. Patients with Dengue Hemorrhagic Fever had a higher rate of haemorrhage. Thrombocytopenia and leucopenia were discovered to be common laboratory findings in patients with Dengue fever and Dengue hemorrhagic fever.&#x0D; Conclusion: Clinical and laboratory characteristics of dengue cases studied could be used to identify patients at risk of severe dengue fever early on.

Caecal Gurgling - A new sign in the diagnosis of acute appendicitis and its correlation with intra operative findings

Background: Acute appendicitis is one of the most common surgical emergencies, with a lifetime prevalence rate of approximately one in seven. The incidence is 1.5–1.9/1,000 in the male and female population and is approximately 1.4 times greater in men than in women. The diagnosis of acute appendicitis is based purely on clinical history andexamination combined with laboratory investigations such as elevated white cell count. Aims and Objectives: To examine clinical and laboratory findings of patients with right iliac fossa pain attending general surgery outdoor, indoor, and emergency of BSMCH and the relation between caecal gurgling with acute appendicitis andits correlation with intraoperative findings. Materials and Methods: This study was a hospital-based cross-sectional analytical study. It was conducted in rural-based tertiary care hospital and medical college with a time frame of about 1½years from acceptance of synopsis. The period of study was from January 2019 to May 2020, in the Department of general surgery, Bankura Sammilani Medical College and Hospital, Bankura. Results: In Acute Appendicitis, 188(68.1%) patients were APL, and 88(31.9%) patients were BPL. In Normal Appendix, 85(68.5%) patients were APL and 39(31.5%) patient were BPL. Association of SES versusThe final diagnosis was not statistically significant (P=0.9315). Conclusion: Diagnosis of acute appendicitis is mainly clinical. Keeping in view the results of the present study, we conclude that caecal gurgling is an important positive clinical finding in the diagnosis of acute appendicitis. Incorporating caecal gurgling into Modified Alvarado Scoring System,especially in the patients with a MAS of 5–6 where there is a dilemma whether to operate the patient or not, it aids in our decision-making and thus helps to reduce the rate of negative appendectomies.

Validation and Efficiency of a Scoring System Used in the Differentiation of Uncomplicated Appendicitis

Aim: Various parameters are used to differentiate between complicated-uncomplicated appendicitis cases and even scoring systems are created where these parameters are used together. The aim of this study is to evaluate the effectiveness of one of these scoring systems by external validation.Method: Retrospective evaluation was performed on the clinical, radiological and laboratory findings of patients who underwent appendectomy between January 2018 and January 2021. Scoring was performed using the previously described scoring systems for each patient considered to have acute appendicitis as a result of imaging. They were divided into complicated appendicitis and uncomplicated appendicitis groups according to clinical and pathological evaluation results.Results: While evaluating 425 patients, ultrasonography was used in 48% and tomography in 52% of the patients. Significant effectiveness of the score of ≤6 was observed in the group using tomography (p&amp;lt;0.001, AUC: 0.838, Sensitivity 83.3%, positive predictive value 50.8%, specificity 84.3%, negative predictive value 96.3%). Significant effectiveness of the score of ≤5 was observed in the ultrasonography group (p&amp;lt;0.001, AUC: 0.790, Sensitivity 85.7%, positive predictive value 39.0%, specificity 72.2%, negative predictive value 96.1%).Conclusion: The scoring system created for the selection of uncomplicated appendicitis cases has been shown to be effective and has been externally validated. Since each of the parameters used in the scoring system has higher efficiency than its independent effectiveness, scoring systems that evaluate clinical, radiological and laboratory variables together give better results in clinical practice.

The effect of colchicine treatment on complete blood cell count-based parameters in patients with Behçet's disease

Aim: Behçet's disease (BD) is a systemic disease, with still unknown etiology and pathogenesis and varying disease presentations, characterized by recurrent oral aphthae, followed by genital ulcers, arthritis, variable skin and ocular lesions, gastrointestinal and central nervous system involvement, as well as, vascular disease. Colchicine is one of the oldest remedies still in use today. The study aimed to investigate the effect of colchicine on levels of the complete blood cell count-based parameters in BD.&#x0D; Material and Method: A total of 117 (participants 60 healthy control and 57 patients with BD) were recruited from the rheumatology department in a single-center case-control study. The laboratory data were obtained from the electronic registration database. Laboratory findings of patients and healthy controls were evaluated. In addition, patients with BD were evaluated for these parameters before colchicine therapy and after 3-month from the beginning of colchicine treatment.&#x0D; Results: The levels of inflammatory markers such as neutrophil count, neutrophil to lymphocyte ratio (NLR), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and systemic immune-inflammation index (SII), significantly higher than the control group before treatment, decreased to similar levels with the control group in the third month of colchicine use. However, red blood cell distribution width (RDW), mean platelet volume (MPV), and plateletcrit (PCT) were still statistically significantly different from the control group in BD patients.&#x0D; Conclusion: SII, CRP, ESR, and NLR are useful parameters to evaluate the colchicine response of patients with mucocutaneous BD.

Baş Ağrısı Olan Covid-19 Hastalarında Crp/Lenfosit Oranı

Aim: One of the most common neurologic symptoms observed in COVID-19 is headache. The pathogenesis of this headache is still not clearly defined. In our study, we aimed to reveal the relationship between headache observed in patients with COVID-19 and the C-reactive protein CRP/lymphocyte ratio, an indicator of inflammation.&#x0D; Material and Method: The demographic, clinical, and laboratory characteristics of patients followed up with a diagnosis of COVID-19 were recorded. The clinical and laboratory findings of patients with and without headache were compared.&#x0D; Results: A total of 106 patients were included in the study. The mean age of all patients was 60.81 ± 15.03 years and 50.9% were male. The mean age of the patient group with headache (57.77 ± 15.42 years) was significantly lower than the mean age of the group without headache (64.22 ± 13.95 years) (p=0.027). The smoking rate was also higher in this group (p=0.003). Smell and taste disorders were also found to be significantly higher in patients with headache compared with patients without headache (p=0.003). When the groups were compared in terms of the CRP/lymphocyte ratio, no significant difference was found (p

Acute Arterial Thrombosis of Lower Extremities in COVID-19 Patients.

Clinical signs and symptoms of COVID-19 varied from asymptomatic forms to severe, life-threatening conditions that required treatment in intensive care units. These severe forms of illness are connected with a hypercoagulable state due to excessive inflammation, hypoxia, immobilisation, and altered angiotensin-converting enzyme 2 (ACE-2). In total, 17 COVID-19 positive patients were diagnosed with peripheral arterial thrombosis (AT), 13 of them had COVID-19 pneumonia. Laboratory findings in patients with X-ray confirmed pneumonia showed a four times higher neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP) and three times higher lactate dehydrogenase level (LDH) than patients without confirmed pneumonia. Patients with pneumonia had significantly more bilateral occlusions of the lower extremities and a significantly higher percentage with complete occlusion of the arteries than patients without pneumonia. The rate of limb loss was 35.3%. They were all from the group with COVID-19 pneumonia. Ten out of thirteen patients with pneumonia died due to acute respiratory distress syndrome (ARDS). All patients without pneumonia were discharged from the hospital. The aim of this retrospective study was to report the incidence of arterial thrombosis of lower extremities and their complications in the acute phase of the infection among COVID-19 patients admitted to the hospital for treatment.

Ischemic ocular manifestations of giant cell arteritis: A Canadian case series

BackgroundDiagnosing giant cell arteritis (GCA) can be challenging due to the variable clinical presentation and lack of systemic symptoms in approximately 20% of cases, which are termed occult GCA. GCA affects the ocular circulation in more than half of cases and can cause irreversible bilateral blindness if not rapidly recognized and treated. We compared clinical and laboratory findings of patients with occult and systemic temporal artery biopsy (TAB)-positive GCA with ocular manifestations. MethodsRetrospective chart review of patients with TAB-positive GCA with ocular manifestations seen at a tertiary neuro-ophthalmology practice between 2015 and 2020. Results:GCA was occult in 14.3% (6/42) and systemic in 85.7% (36/42) of patients. Occult GCA affected older patients (average age 84.6 ± 5.3 vs 75.9 ± 8.2). There was no significant difference in ESR or CRP levels between two cohorts. In patients with occult GCA, 83.3% (5/6) presented with AION, and 16.7% (1/6) with isolated cranial nerve six palsy (CN6P). In the systemic GCA cohort, 47.2% (17) presented with AION, 5.6% (2) with CRAO, 2.8% (1) with PION, 2.8% (1) with isolated CWS, 2.8% (1) had both CRAO and AION, 2.8% (1) isolated cranial nerve 4 palsy (CN4P), 2.8% (1) isolated CN6P, 22.2% (8) had history of amaurosis fugax but normal examination, and 11.1% (4) had visual symptoms but a normal exam. Three of the above patients with AION also had CN4P. Of patients diagnosed with AION, presenting visual acuity in the affected eye(s) was significantly worse in patients with occult GCA. Involvement of multiple ocular circulations was seen in six patients in the systemic group but none in the occult group. ConclusionOccult GCA occurs more commonly in older patients who most of the time present with AION. Levels of inflammatory markers were similar in the occult and systemic groups. Though ocular ischemic manifestations were similar in both cohorts, in systemic GCA involvement of multiple ocular circulations is likely more common GCA should always be considered in older patients who present with signs of retinal and/or optic nerve head ischemia (AION and/or CWS) and new onset of CNPs, especially in patients where more than one ocular arterial circulation is involved.

Do histopathological features correlate with systemic manifestations in dermatomyositis? Analysis of 42 skin biopsy specimens from 22 patients.

Understanding whether specific histopathologic features on skin biopsy are predictive of systemic associations in dermatomyositis (DM) would be useful to guide clinical screening. Through retrospective medical record search, clinical and laboratory findings of patients with DM were documented. Existing skin biopsy slides were re-reviewed blindly. Of all biopsy specimens (n=42), the most frequent histopathological finding was vacuolar interface dermatitis (95%). Other features included perivascular lymphocytic infiltrate (71%), increased dermal mucin (40%), vessel wall thickening (12%), follicular plugging (9.5%), and dermal sclerosis (7%). Neutrophilic infiltrate was observed in three biopsies from a patient with adalimumab-associated DM. Vasculitis was not observed. There was no statistically significant difference in the presence of any histopathological feature and that of various systemic manifestations (i.e., myopathy, interstitial lung disease [ILD] and malignancy). However, we observed that dense lichenoid infiltrate rather than pauci-inflammatory changes correlated with severe itching (p < 0.001). Patients with MDA-5 antibodies were significantly more likely to have vasculopathy than those without (p= 0.029*). No dermatopathologic feature was reliably predictive of myopathy, ILD, or malignancy. This finding implies that, regardless of histopathologic findings, patients should be screened for associated conditions as clinically indicated.

Clinical Manifestations and Laboratory Findings in Patients with Leukocyte Adhesion Deficiency (LAD)

Objectives: Leukocyte Adhesion Deficiency (LAD) is a rare, inherited, immunodeficiency disease which is caused by defects in the leukocyte adhesion process. The migration of leukocytes to the blood vessel’s wall, needs multiple steps called adhesion cascade. In LAD, defects in rolling, integrin activation and firm adhesion of the leukocytes have been described. Methods: In this study, we selected 67 patients with the confirmed diagnosis of LADs, from Iranian immunodeficiency registry center. A demographic information of the clinical complications and laboratory data were obtained from all the patients to evaluate the clinical manifestations. Results: A total of 67 patients (38 male and 29 female), with a median age of 18 months old, were included in the present study. The first presentations were omphalitis in 28.35% of the cases, followed by delayed umbilical cord separation in 22.38% of the patients. The frequency of delayed umbilical cord separation was 41.8%, and was higher among other manifestations of our patients. Cellulitis and Omphalitis were observed in 40.3% and 38.8% of the patients, respectively. Regarding the laboratory findings, we found leukocytosis in 86.6 %( neutrophil dominant in 76.1%), and anemia in 77.6%, and thrombocytosis in 25.4% of the patients. Conclusion: We indicated in the present study that the most common clinical manifestations, were delayed umbilical cord separation and recurrent infection in Iranian patients with LAD disorders. In laboratory findings, we found leukocytosis in most of the patients. CD18 was decreased in more than 90 % of the patients.

Predictive Value of Glycemia and Free Fatty Acid Levels upon Admission of Children with Scorpionism in Egypt.

Scorpion envenomation is a life-threatening emergency and causes serious health problems in tropical and subtropical regions. The aim of this study was to correlate the serum levels of biochemical parameters at admission in children with scorpion envenomation with subsequent morbidity and mortality. It was a prospective, observational, and descriptive study conducted for scorpion-envenomed children who presented to emergency and intensive care units between April 2019 and September 2019. Demographic, clinical, and laboratory findings of patients were recorded and tabulated. Routine investigations were done for all patients in addition to blood levels of lactate, free fatty acids (FFA), and insulin. All patients were compared according to outcome as survivors and nonsurvivors and according to glucose level as normoglycemic and hyperglycemic groups. There were 62 scorpion sting cases; their mean age was 8.6 ± 3.2 years. Patients aged more than 6 years (74.2%), and males (66.1%) were more affected than others. As regards severity, 25.8% were suffering organ dysfunction, 40.3% suffered systemic manifestations without organ dysfunction, and (33.9%) with only local manifestations. Serum glucose and FFA were significantly higher in nonsurvivors compared with survivors. Shock, convulsion, coma, heart failure, and pulmonary edema were significantly more common in hyperglycemic than normoglycemic group. Hyperglycemia, and raised FFA were associated with severe scorpion envenomation. Raised FFA was well correlated with presence of heart failure, leucocytosis, and hyperglycemia. Adding serum glucose and FFA to monitoring parameters of scorpionism severity can help the prediction of high-risk patients.

RegiSCAR DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) Validation Scoring System and Japanese Consensus Group Criteria for Atypical Drug-Induced Hypersensitivity Syndrome (DiHS): A Comparative Analysis.

Context:Drug reaction with eosinphilia and systemic symptoms (DRESS) and drug-induced hypersensitivity syndrome (DiHS) represent the same spectrum of a drug reaction.Aims:To compare the clinical profile of patients diagnosed as definite/probable DRESS by the Registry of Severe Cutaneous Adverse Reaction (RegiSCAR) scoring system and as atypical DiHS by Japanese consensus group criteria.Settings and Design:We did a retrospective study in a tertiary referral center.Materials and Methods:We included patients who satisfied the criteria for definite/probable DRESS and/or atypical DiHS and who received inpatient care in our department from January 2011 to December 2018. We compared the clinical and laboratory findings in patients diagnosed by the two criteria.Statistical Analysis:Pearson Chi-square test was used to compare the proportion of patients with severe reactions diagnosed by the RegiSCAR DRESS validation scoring system and the Japanese consensus group criteria.Results:Among the 390 case records reviewed, 138 patients could be classified as definite/probable DRESS and/or atypical DiHS. Japanese criteria did not diagnose atypical DiHS in 88/137 (64.2%) patients with definite/probable DRESS. RegiSCAR scoring system made a diagnosis of definite/probable DRESS in 49/50 (98%) patients with atypical DiHS. A total of 58/138 (42%) patients had a severe reaction. RegiSCAR scoring system diagnosed 57/58 (98.3%) patients with severe reaction as definite/probable DRESS. A total of 32/58 (55.2%) patients with severe reactions were diagnosed as atypical DiHS. The difference was statistically significant (<0.001).Conclusion:Japanese criteria for atypical DiHS showed reduced sensitivity to diagnose definite/probable DRESS, and this included more than 40% of patients with severe DRESS.

A Descriptive Analysis of the Clinical and Laboratory Characteristics of Sepsis Patients admitted to the Emergency Department of a Tertiary Hospital in Nigeria.

Introduction: There is limited data on sepsis and sepsis outcomes in Nigeria. We described the clinical and laboratory characteristics of patients admitted with sepsis in a Nigerian tertiary hospital. Methods: This was a prospective cohort study of patients aged ≥18 years, admitted to the accident and emergency department (A&amp;E) of Lagos University Teaching Hospital (LUTH ), Idi-Araba , with physician -diagnosed sepsis between November 2021 and April 2022 . Presenting clinical and laboratory findings of patients that met the Systemic Inflammatory Response (SIRS) and/or the quick Sequential Organ Failure Assessment (qSOFA) criteria were documented. The primary outcome was all-cause in-hospital mortality. A bivariate analysis was conducted to determine factors associated with mortality. P-value

Deregulation of the Expression of Beclin1 and Light Chain 3(LC3), Autophagy-Related Genes, in COVID-19 Patients.

Background: The autophagy machinery is reported to be employed by Coronaviruses during their replication. Beclin-1 (BECN1) and protein 1 light chain 3 (LC3) are two key elements in the autophagy process, and their inhibition can prevent the replication of some coronaviruses in vitro. Here, we aimed to investigate the expression levels of Beclin-1 and LC3 in COVID-19 patients and healthy controls, hoping to find new therapeutic targets. Methods: This cross-sectional study was conducted in Imam Reza and Ghaem University Hospitals, Mashhad, Iran. Nasopharyngeal samples of 68 consecutive Covid-19 patients and 61 healthy controls, who have been referred to the laboratories for COVID-19 PCR testing between 21 March to 21 September 2021, were used in order to evaluate the expression of BECN1 and LC3 genes using the Real-time quantitative PCR method. Demographic and other laboratory findings of patients were extracted from the hospital electronic system. SPSS Statistics 16.0 and Graph Pad Prism 8.4.2 soft wares were used for statistical analysis. Non-parametric tests were used. Results: BECN1 expression was significantly higher in COVID-19 patients compared to the controls (14.37±18.84 vs. 4.26±7.39, p=0.001). The expression of LC3 gene was significantly lower in patients compared to the controls (1.01±1.06 vs. 1.49±1.12, p=0.007). There was no significant correlation between the expression levels of BECN1 and LC3. Patients with lower BECN1 expression showed significantly higher RBC counts, higher Urea and lower HCO3 levels. The patients in LC3Low group showed significantly lower MCH, MCHC and PH levels compared to the others. Conclusion: Regarding the significant difference in the expression of BECN1 and LC3 in COVID-19 patients compared to the controls, these molecules may have a role in the pathogenesis of this disease. In case of further confirmation of this role, these molecules may be used as possible therapeutic targets.