{"title":"The Origin and Evolution of Critical Laboratory Values.","authors":"George D Lundberg","doi":"10.25259/NMJI_1051_2023","DOIUrl":"https://doi.org/10.25259/NMJI_1051_2023","url":null,"abstract":"","PeriodicalId":201890,"journal":{"name":"The National Medical Journal of India","volume":"30 11","pages":"283-285"},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140966408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ravish Kumar, H. Dhillon, Uzma Hashim, G. Dhillon, S. Sasidharan
Background Infertility and its treatment are frequently associated with psychological distress. We assessed the prevalence of anxiety and depression in couples undergoing treatment for infertility with assisted reproductive techniques (ARTs). Methods We included 160 married couples undergoing treatment for infertility at an ART centre. The prevalence of anxiety and depression was assessed using the hospital anxiety and depression scale. Results The prevalence of anxiety and depression was 46.2% and 40.9%, respectively. Women had higher mean (SD) anxiety (10.76 [2.69]) and depression (9.86 [2.06]) scores; however, this gender difference was statistically significant only with respect to anxiety (p=0.02). The mean anxiety scores were highest among both genders when the cause of infertility was attributed to both partners and during the first year and 10 years after treatment. Men in the age groups of 20-24 years and 40-44 years and those with no prior treatment had a statistically significant association with the highest anxiety scores. The mean depression scores showed a statistically significant decline in both genders with increasing age. Among men, the mean depression scoreswere significantly higher in those with no prior treatment, male cause of infertility and during the first year and after 10 years of treatment. Conclusion The prevalence of anxiety and depression among infertile couples undergoing treatment with ART was almost twice as high as that in the general population. The mean anxiety scores were significantly associated with duration of treatment and gender-based attribution in both genders; however, age and prior treatment were associated with only men. The mean scores of depression were significantly associated with age in both genders, while duration of treatment, gender-based attribution and prior treatment were significantly associated only with men.
{"title":"Anxiety and depression among couples undergoing treatment for infertility with assisted reproductive techniques at an Indian centre.","authors":"Ravish Kumar, H. Dhillon, Uzma Hashim, G. Dhillon, S. Sasidharan","doi":"10.25259/NMJI_170_21","DOIUrl":"https://doi.org/10.25259/NMJI_170_21","url":null,"abstract":"Background Infertility and its treatment are frequently associated with psychological distress. We assessed the prevalence of anxiety and depression in couples undergoing treatment for infertility with assisted reproductive techniques (ARTs). Methods We included 160 married couples undergoing treatment for infertility at an ART centre. The prevalence of anxiety and depression was assessed using the hospital anxiety and depression scale. Results The prevalence of anxiety and depression was 46.2% and 40.9%, respectively. Women had higher mean (SD) anxiety (10.76 [2.69]) and depression (9.86 [2.06]) scores; however, this gender difference was statistically significant only with respect to anxiety (p=0.02). The mean anxiety scores were highest among both genders when the cause of infertility was attributed to both partners and during the first year and 10 years after treatment. Men in the age groups of 20-24 years and 40-44 years and those with no prior treatment had a statistically significant association with the highest anxiety scores. The mean depression scores showed a statistically significant decline in both genders with increasing age. Among men, the mean depression scoreswere significantly higher in those with no prior treatment, male cause of infertility and during the first year and after 10 years of treatment. Conclusion The prevalence of anxiety and depression among infertile couples undergoing treatment with ART was almost twice as high as that in the general population. The mean anxiety scores were significantly associated with duration of treatment and gender-based attribution in both genders; however, age and prior treatment were associated with only men. The mean scores of depression were significantly associated with age in both genders, while duration of treatment, gender-based attribution and prior treatment were significantly associated only with men.","PeriodicalId":201890,"journal":{"name":"The National Medical Journal of India","volume":"38 6","pages":"286-290"},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140970933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Although there are many studies on violence against physicians in the literature, there are few studies on violence against physicians working in intensive care units (ICUs). We aimed to investigate the frequency, type and underlying factors of violence against physicians working in ICUs in Turkey in the past 1 year. Methods We collected data by sending a questionnaire about violence against physicians working in ICUs via e-mail and WhatsApp between 1 and 15 May 2022. IBM SPSS Statistics V.24.0 was used for data analysis. The chi-square test and Fisher precision test were used to compare categorical data. Results Over one-third (38.6%) of the 354 physicians participating in our study reported that they had been exposed to violence in the past year, while 20.7% reported that they had been exposed to violence more than once in the past year. There was a significant relationship between the frequency of exposure to violence, female gender, age group, title, subspecialization status, working style and duration of working in the ICU (p<0.05). There was no relationship between the working area, type of hospital and ICU and exposure to violence (p>0.05). The presence of restriction and control points at the entrance to ICUs prevented violence (p<0.05). Conclusion Physicians working in ICUs encounter violence against them. The frequency of violence increased after the Covid-19 pandemic. A significant relationship was found between the frequency of violence and female gender, age group, title, subspecialization status, working style and duration of working in ICUs.
{"title":"Workplace violence against physicians in intensive care units in Turkey: A cross-sectional study.","authors":"Damla Ernur, V. Hancı, Necatý Gökmen","doi":"10.25259/NMJI_691_2022","DOIUrl":"https://doi.org/10.25259/NMJI_691_2022","url":null,"abstract":"Background Although there are many studies on violence against physicians in the literature, there are few studies on violence against physicians working in intensive care units (ICUs). We aimed to investigate the frequency, type and underlying factors of violence against physicians working in ICUs in Turkey in the past 1 year. Methods We collected data by sending a questionnaire about violence against physicians working in ICUs via e-mail and WhatsApp between 1 and 15 May 2022. IBM SPSS Statistics V.24.0 was used for data analysis. The chi-square test and Fisher precision test were used to compare categorical data. Results Over one-third (38.6%) of the 354 physicians participating in our study reported that they had been exposed to violence in the past year, while 20.7% reported that they had been exposed to violence more than once in the past year. There was a significant relationship between the frequency of exposure to violence, female gender, age group, title, subspecialization status, working style and duration of working in the ICU (p<0.05). There was no relationship between the working area, type of hospital and ICU and exposure to violence (p>0.05). The presence of restriction and control points at the entrance to ICUs prevented violence (p<0.05). Conclusion Physicians working in ICUs encounter violence against them. The frequency of violence increased after the Covid-19 pandemic. A significant relationship was found between the frequency of violence and female gender, age group, title, subspecialization status, working style and duration of working in ICUs.","PeriodicalId":201890,"journal":{"name":"The National Medical Journal of India","volume":"16 6","pages":"327-333"},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140967834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Veetil, Divya Pachat, K. Nikitha, Jesheera Mohammed Kutty
We report a 26-year-old girl who was diagnosed with diabetes mellitus in her childhood and was treated with insulin. With a history of visual disturbances during her childhood and anaemia, which was partially evaluated; the possibility of syndromic diabetes was considered. Genetic analysis was done and revealed a mutation in the SLC19A2 gene, confirming the diagnosis of thiamine-responsive megaloblastic anaemia. She was supplemented with thiamine, which dramatically improved her haemoglobin levels and glucose control. However, her vision could not be salvaged as the rod-cone dystrophy is a permanent damage.
{"title":"Thiamine-responsive megaloblastic anaemia.","authors":"V. Veetil, Divya Pachat, K. Nikitha, Jesheera Mohammed Kutty","doi":"10.25259/NMJI_20_21","DOIUrl":"https://doi.org/10.25259/NMJI_20_21","url":null,"abstract":"We report a 26-year-old girl who was diagnosed with diabetes mellitus in her childhood and was treated with insulin. With a history of visual disturbances during her childhood and anaemia, which was partially evaluated; the possibility of syndromic diabetes was considered. Genetic analysis was done and revealed a mutation in the SLC19A2 gene, confirming the diagnosis of thiamine-responsive megaloblastic anaemia. She was supplemented with thiamine, which dramatically improved her haemoglobin levels and glucose control. However, her vision could not be salvaged as the rod-cone dystrophy is a permanent damage.","PeriodicalId":201890,"journal":{"name":"The National Medical Journal of India","volume":"22 12","pages":"314-315"},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140968484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Fundus examination is an integral part of the clinical evaluation of patients with medical emergencies. It is done at the bedside using a portable direct ophthalmoscope. Smartphone fundus photography (SFP) is a novel technique of retinal imaging. We evaluated the use of SFP by a physician in medical emergencies and compared it with direct ophthalmoscopy (DO) findings of the ophthalmologist. Methods We did a prospective study on patients admitted with medical emergencies with an indication for fundus examination. The SFP was done by the physician, and its findings were noted. These were compared with the DO findings of the ophthalmologist. Results Of the 182 patients studied, 111 (61%) had fundus findings by SFP and 95 (52.5%) by DO. Papilloedema (21.4%), haemorrhages (20%) and Roth spots (12.5%) were most common. DO missed early papilloedema and findings in the peripheral retina. Conclusions SFP is as effective as DO, in detecting retinal findings in patients with medical emergencies and can be performed at the bedside by the physician.
背景眼底检查是内科急诊患者临床评估不可或缺的一部分。该检查使用便携式直接眼底镜在床边进行。智能手机眼底摄影（SFP）是一种新型视网膜成像技术。我们评估了医生在医疗紧急情况下使用 SFP 的情况，并将其与眼科医生的直接眼底镜检查结果进行了比较。方法 我们对有眼底检查指征的急诊入院患者进行了一项前瞻性研究。由医生进行 SFP 检查，并记录检查结果。这些结果与眼科医生的 DO 检查结果进行了比较。结果 在研究的 182 名患者中，111 人（61%）的眼底检查结果为 SFP，95 人（52.5%）的眼底检查结果为 DO。乳头水肿（21.4%）、出血（20%）和罗斯斑（12.5%）最为常见。DO 错过了早期乳头水肿和周边视网膜的发现。结论 在检测急诊病人视网膜病变方面，SFP 与 DO 一样有效，且可由医生在床边进行。
{"title":"Smartphone fundus photography by a physician in medical emergencies: An analytical cross-sectional study of 182 patients.","authors":"R. Pradeep, S. D. Amalnath, N. Kasturi","doi":"10.25259/NMJI_208_21","DOIUrl":"https://doi.org/10.25259/NMJI_208_21","url":null,"abstract":"Background Fundus examination is an integral part of the clinical evaluation of patients with medical emergencies. It is done at the bedside using a portable direct ophthalmoscope. Smartphone fundus photography (SFP) is a novel technique of retinal imaging. We evaluated the use of SFP by a physician in medical emergencies and compared it with direct ophthalmoscopy (DO) findings of the ophthalmologist. Methods We did a prospective study on patients admitted with medical emergencies with an indication for fundus examination. The SFP was done by the physician, and its findings were noted. These were compared with the DO findings of the ophthalmologist. Results Of the 182 patients studied, 111 (61%) had fundus findings by SFP and 95 (52.5%) by DO. Papilloedema (21.4%), haemorrhages (20%) and Roth spots (12.5%) were most common. DO missed early papilloedema and findings in the peripheral retina. Conclusions SFP is as effective as DO, in detecting retinal findings in patients with medical emergencies and can be performed at the bedside by the physician.","PeriodicalId":201890,"journal":{"name":"The National Medical Journal of India","volume":"58 1","pages":"291-294"},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140970810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shreyashi Jha, S. Vengalil, C. M. Ravindranadh, A. Nalini, Ravi Yadav
{"title":"Spastic quadriparesis in Fabry disease: A diagnostic challenge.","authors":"Shreyashi Jha, S. Vengalil, C. M. Ravindranadh, A. Nalini, Ravi Yadav","doi":"10.25259/NMJI_MS_133_21","DOIUrl":"https://doi.org/10.25259/NMJI_MS_133_21","url":null,"abstract":"","PeriodicalId":201890,"journal":{"name":"The National Medical Journal of India","volume":"33 42","pages":"340-341"},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140966602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Recommendations from 'Improving health outcomes of people with diabetes: Target setting for the WHO Global Diabetes Compact' for the Indian context: Laudable but are they achievable?","authors":"H. Sathanapally, K. Khunti","doi":"10.25259/NMJI_713_2023","DOIUrl":"https://doi.org/10.25259/NMJI_713_2023","url":null,"abstract":"","PeriodicalId":201890,"journal":{"name":"The National Medical Journal of India","volume":"52 29","pages":"281-282"},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140970562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Purushottam Upadhyaya (14 August 1928–8 March 2023)","authors":"Veereshwar Bhatnagar","doi":"10.25259/nmji_1165_2023","DOIUrl":"https://doi.org/10.25259/nmji_1165_2023","url":null,"abstract":"","PeriodicalId":201890,"journal":{"name":"The National Medical Journal of India","volume":"22 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140967275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Tripathy, P. Anirvan, M. Parida, D. Meher, Pankaj Bharali, Mrinal Gogoi, K. Pattnaik, Shivaram Prasad Singh, Bidyut Kumar Das
Hepatic involvement in sarcoidosis, though common, is usually asymptomatic. Hepatomegaly and deranged liver function tests are the usual manifestations. However, unexplained hepatomegaly in sarcoidosis not responding to immunosuppressive therapy could indicate an alternative pathology. Haemophagocytic lymphohistiocytosis (HLH), although seldom reported in sarcoidosis, can cause hepatosplenomegaly and cytopenias. HLH occurring concomitantly with hepatic sarcoidosis is extremely rare. We report a patient of systemic sarcoidosis who presented with fever, hepatosplenomegaly and jaundice despite being on steroid therapy. He was subsequently diagnosed with HLH. The clinical response to treatment with pulse steroid and oral cyclosporine was dramatic.
{"title":"Haemophagocytic lymphohistiocytosis associated with liver injury in systemic sarcoidosis.","authors":"S. Tripathy, P. Anirvan, M. Parida, D. Meher, Pankaj Bharali, Mrinal Gogoi, K. Pattnaik, Shivaram Prasad Singh, Bidyut Kumar Das","doi":"10.25259/NMJI_MS_314_21","DOIUrl":"https://doi.org/10.25259/NMJI_MS_314_21","url":null,"abstract":"Hepatic involvement in sarcoidosis, though common, is usually asymptomatic. Hepatomegaly and deranged liver function tests are the usual manifestations. However, unexplained hepatomegaly in sarcoidosis not responding to immunosuppressive therapy could indicate an alternative pathology. Haemophagocytic lymphohistiocytosis (HLH), although seldom reported in sarcoidosis, can cause hepatosplenomegaly and cytopenias. HLH occurring concomitantly with hepatic sarcoidosis is extremely rare. We report a patient of systemic sarcoidosis who presented with fever, hepatosplenomegaly and jaundice despite being on steroid therapy. He was subsequently diagnosed with HLH. The clinical response to treatment with pulse steroid and oral cyclosporine was dramatic.","PeriodicalId":201890,"journal":{"name":"The National Medical Journal of India","volume":"47 15","pages":"312-314"},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140970606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Narayan, K. Gudivada, Sumitra Sivakoti, B. Krishna
Background Thrombotic thrombocytopenic purpura (TTP) is a multisystem disorder characterized by widespread microthrombosis that can predispose to multiple organ failure. The literature is sparse on the outcomes of critically ill patients with TTP managed in intensive care units (ICUs). We aimed to determine the mortality of ICU patients admitted with TTP and evaluate the predictors of survival. We also compared the incidence of nosocomial infection among those who did or did not receive plasma exchange (PE). Methods We conducted a retrospective study in a tertiary ICU. Two authors screened patients for eligibility from the hospital information system based on peripheral smear reports. Adult critically ill TTP patients managed in ICU were included. Patients with a diagnosis of haemolytic uraemic syndrome, autoimmune causes of haemolysis and pregnancy-related conditions, etc. were excluded. Two authors extracted data from medical charts. No imputation of missing variables was done. Non-parametric statistics were used to report data. Statistical analyses were performed using Stata version 16. Results Of the 535 records that were screened, 33 patients were deemed eligible. Mortality among TTP patients was 14 (42%). The women to men ratio was 7:3. At admission, greater degree of anaemia, thrombocytopenia, and higher lactate dehydrogenase levels were observed in non-survivors compared to survivors (5.4 g/dl [4.8-7.1] v. 7.6 g/dl [6.1-8.9], p=0.05; 17x103 μl v. 21x103 μl, p=0.63; and 2987 (1904-3614) U/L v. 2126 U/L (1941-3319), p=0.71; respectively]. Nineteen (57%) patients had acute kidney injury (AKI), of which 11 survived: 6 recovered completely from renal failure and 5 progressed to end-stage renal disease. Nosocomial infection rates were not different among those receiving and not receiving PE therapy (7 [33%] v. 3 [25%], respectively). Conclusion TTP is more common in women and has a high mortality. Older age, low haemoglobin and higher platelet transfusions are predictors of poor survival. Nosocomial infection rates were similar irrespective of receiving PE therapy.
背景 血栓性血小板减少性紫癜（TTP）是一种多系统疾病，其特点是广泛的微血栓形成，可导致多器官功能衰竭。关于在重症监护病房（ICU）接受治疗的 TTP 重症患者的预后的文献很少。我们旨在确定重症监护病房 TTP 患者的死亡率，并评估生存率的预测因素。我们还比较了接受或未接受血浆置换（PE）的患者的院内感染发生率。方法 我们在一家三级重症监护病房开展了一项回顾性研究。两位作者根据外周涂片报告从医院信息系统中筛选出符合条件的患者。研究纳入了在重症监护室接受治疗的成年 TTP 重症患者。排除了诊断为溶血性尿毒症综合征、自身免疫性溶血和妊娠相关疾病等患者。两位作者从病历中提取了数据。未对缺失变量进行估算。报告数据时使用了非参数统计。统计分析使用 Stata 16 版本进行。结果 在筛选出的 535 份病历中，有 33 名患者被认为符合条件。TTP患者的死亡率为14例（42%）。男女比例为 7:3。入院时，与幸存者相比，非幸存者的贫血程度更严重，血小板减少，乳酸脱氢酶水平更高（5.4 g/dl [4.8-7.1] v. 7.6 g/dl [6.1-8.9]，p=0.05；17x103 μl v. 21x103 μl，p=0.63；2987 (1904-3614) U/L v. 2126 U/L (1941-3319)，p=0.71；]。19例（57%）患者出现急性肾损伤（AKI），其中11例存活：6 人从肾衰竭中完全康复，5 人发展为终末期肾病。接受和未接受 PE 治疗的患者的院内感染率没有差异（分别为 7 [33%] 对 3 [25%]）。结论 TTP 在女性中更为常见，死亡率较高。高龄、低血红蛋白和较多的血小板输注是预示存活率较低的因素。无论接受哪种 PE 治疗，非医院感染率都相似。
{"title":"Outcomes of patients with thrombotic thrombocytopenic purpura treated in an intensive care unit.","authors":"S. Narayan, K. Gudivada, Sumitra Sivakoti, B. Krishna","doi":"10.25259/NMJI_205_21","DOIUrl":"https://doi.org/10.25259/NMJI_205_21","url":null,"abstract":"Background Thrombotic thrombocytopenic purpura (TTP) is a multisystem disorder characterized by widespread microthrombosis that can predispose to multiple organ failure. The literature is sparse on the outcomes of critically ill patients with TTP managed in intensive care units (ICUs). We aimed to determine the mortality of ICU patients admitted with TTP and evaluate the predictors of survival. We also compared the incidence of nosocomial infection among those who did or did not receive plasma exchange (PE). Methods We conducted a retrospective study in a tertiary ICU. Two authors screened patients for eligibility from the hospital information system based on peripheral smear reports. Adult critically ill TTP patients managed in ICU were included. Patients with a diagnosis of haemolytic uraemic syndrome, autoimmune causes of haemolysis and pregnancy-related conditions, etc. were excluded. Two authors extracted data from medical charts. No imputation of missing variables was done. Non-parametric statistics were used to report data. Statistical analyses were performed using Stata version 16. Results Of the 535 records that were screened, 33 patients were deemed eligible. Mortality among TTP patients was 14 (42%). The women to men ratio was 7:3. At admission, greater degree of anaemia, thrombocytopenia, and higher lactate dehydrogenase levels were observed in non-survivors compared to survivors (5.4 g/dl [4.8-7.1] v. 7.6 g/dl [6.1-8.9], p=0.05; 17x103 μl v. 21x103 μl, p=0.63; and 2987 (1904-3614) U/L v. 2126 U/L (1941-3319), p=0.71; respectively]. Nineteen (57%) patients had acute kidney injury (AKI), of which 11 survived: 6 recovered completely from renal failure and 5 progressed to end-stage renal disease. Nosocomial infection rates were not different among those receiving and not receiving PE therapy (7 [33%] v. 3 [25%], respectively). Conclusion TTP is more common in women and has a high mortality. Older age, low haemoglobin and higher platelet transfusions are predictors of poor survival. Nosocomial infection rates were similar irrespective of receiving PE therapy.","PeriodicalId":201890,"journal":{"name":"The National Medical Journal of India","volume":"50 6","pages":"295-300"},"PeriodicalIF":0.0,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140969472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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