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Background: In recent decades, venous thromboembolism (VTE) has been acknowledged as a health issue that can be prevented. Among hospitalized patients, thromboembolism is a serious complication. Patients in the intensive care unit (ICU) are more susceptible to thrombotic events because of supplementary risk factors like central catheters, mechanical ventilation, and immobilization. Aim: This study aims to assess the appropriateness of VTE prophylaxis practices in a medical ICU of a tertiary care hospital. The IMPROVE VTE RAM was compared with clinical judgment for any significant difference in the risk assessment. Methods: It was a retrospective cross sectional observational study carried out on the patients admitted to the medical ICU of the Vascular Surgery department from March 2023 to August 2023. Medical records and risk assessment were done using the IMPROVE VTE RAM. The prophylaxis was given to patients based on American Society of Haematology (ASH) guidelines. Results: This was a 6 months retrospective study and a total number of 50 patients were included in the study. However, appropriate risk assessment was not done in any patient. Based on IMPROVE VTE RAM 1 patient (2%) was in low risk, 37 (74%) in moderate risk, and 12 (24%) in high risk for VTE. Thus Prophylaxis was given to a total of 44 patients out of which 27 received unfractionated heparin and the rest of all patients received Low Molecular Weight Heparin. Mechanical prophylaxis was given to 2 patients. The regular emphasis on DVT prophylaxis and the critical care nurses' ongoing daily audit were able to commence DVT prophylaxis in the majority of patients. According to IMPROVE VTE RAM, the accuracy of clinicians' judgment in comparison to validated risk assessment tools was only 89%. Conclusion: Critically ill admitted patients are more likely to experience VTE and bleeding episodes. Therefore adequate prophylaxis is essential but unfortunately is not routinely used in critical care settings. There is an urgent need to identify the gaps and address areas such as thromboprophylaxis and consistent care that require attention. Healthcare professionals must be made aware of the significance of risk assessment for bleeding and VTE in all critically ill patients, using any validated risk assessment tool. [ABSTRACT FROM AUTHOR]

Background: Stroke poses a significant societal burden, contributing to global mortality and disability. Second only to ischemic heart disease, stroke exhibits the highest mortality rates. Preventive measures involve addressing modifiable risk factors such as diabetes, hypertension, heart disease, obesity, atrial fibrillation, smoking, and alcoholism. This study aims to assess the demographic profile and associated risk factors among stroke patients younger than 45years admitted to PGIMER & Capital Hospital, Bhubaneswar, Odisha. Methods: Conducted between October 2022, and October 2023, this single-center, cross-sectional observational study enrolled 52 stroke patients at PGIMER & Capital Hospital, Bhubaneswar, Odisha. Data analysis was performed using SPSS version 20. Results: Of the 52 patients, 34 (65%) were male, and 18 (35%) were female, with a mean age of 32.57 ± 9.6 years. Ischemic stroke occurred in 39 (75 %) patients, while hemorrhagic stroke was observed in 13 (25 %). The middle cerebral artery territory was the most commonly affected in ischemic stroke (22, 42.30%), whereas intracerebral hemorrhage occurred in 11 (78.57%) cases. Smoking and hypertension were prevalent in 51.92% and 51.92 % of ischemic stroke cases, respectively, while hemorrhagic stroke cases showed rates of 23.07 % and 21.15%, respectively. Physical inactivity (50%), alcohol consumption (40.38%), central obesity (46.15%), and dyslipidemia (30.76%) were more frequently associated with ischemic stroke, while significant alcohol consumption (15.38%) was more linked to hemorrhagic stroke. Conclusions: Stroke predominantly affected males and increasing age groups, with ischemic stroke being more common than hemorrhagic stroke. The most prevalent risk factors for stroke in young patients were smoking, hypertension and central obesity. [ABSTRACT FROM AUTHOR]

Background: Sepsis is an emergency state in response to an infectious process ultimately leading to multiorgan dysfunction and death. There is an urgent need for sepsis detection methods, especially in emergency settings. To fill this gap, monocyte distribution width (MDW) was studied as an early indicator of sepsis. MDW is a routinely reported component of the automated complete blood count (CBC) performed by hematology analyzers. Overwhelming patient load and scarcity of health resources are among the major challenges that are faced in resource-limited settings. Materials and methods: This is an observational prospective, monocentric cohort study to evaluate the possible association of population cell data parameters with ensuing sepsis at the intensive care unit of Tertiary Care Teaching Hospital. Patients were consecutively enrolled whenever hospitalized for suspected infection or sepsis. Clinical characteristics of patients at entry, including demographics (age and gender); vital signs (heart rate, respiratory rate, body temperature, blood pressure), past medical history and other laboratory examinations (white blood cell counts, blood gas analysis, blood biochemistry) were prospectively collected. Result: Exactly 30 patients (33.3% of total cases enrolled in the trial) belonged to the group that survived till the 28th day of hospitalization, among them were 12 women (40%) and 15 men (50%). The rest of the patients from the research, precisely 60 of them, were deceased (66.7%). Among non-survivors were 15 women (25%) and 45 men (75%). Descriptive statistics for selected variables (MDW, age, CRP, PCT, lactate, and ICU days) in certain groups are expressed as mean, standard deviation, minimum and maximum values, and interquartile range. Test of normality (Shapiro-Wilk) for all parameters p < 0.05 showed a nonparametric distribution of data. The Chi-square test was used to compare differences between groups (survived and deceased on the 28th day), with cut-off values for MDW 26.0 µm, CRP 100 mg/mL, PCT 1 ng/mL, lactate 2 mmol/L respectively. Conclusion: MDW is an inexpensive and readily available biomarker that will help emergency clinicians to promptly identify sepsis accurately and start appropriate treatment in a timely manner. MDW as an early sepsis indicator would be a strong addition to current sepsis protocols, especially in resource-limited settings. [ABSTRACT FROM AUTHOR]

The current study was conducted to determine and compare the prevalence of known risk factors for CHD in south Odisha's urban and rural communities. A hospital-based epidemiological study from South Odisha was carried out at MKCG Medical College Hospital. Data was collected using a coded schedule that was designed in advance after receiving oral consent. Different known risk factors for CHD were examined. Questions were asked about family history of CHD, smoking / tobacco use, alcohol consumption, exercise and mental stress. Anthropometric parameters such as height, weight, waist circumference and hip circumference of the subjects were recorded. Blood pressure, fasting blood sugar and serum cholesterol for study subjects were also estimated. The prevalence of sedentary lifestyle, obesity, high blood pressure, diabetes and hypercholesterolemia appeared to be significantly higher among urban subjects compared to rural. High prevalence has been noted for obesity and the family history of CHD among urban subjects compared to that among rural. However, the difference in prevalence was not statistically significant. Smoking / tobacco use, stress and alcohol consumption were higher among rural subjects than those found in cities. Current research clearly shows that the increasing prevalence of CHD risk factors in Odisha is a major problem for public health in India. Population-based emergency measures are needed to control the risk factors in cardiovascular risk factors to prevent CHD in Odisha. [ABSTRACT FROM AUTHOR]