Prediction of outcomes in acute exacerbation of COPD with DECAF score and BAP 65 score in a rural population

Background: Prognostic research in exacerbations of chronic obstructive pulmonary disease (COPD) requiring hospitalization has been limited and there appears to be little common ground between predictors of mortality in stable disease and during AECOPD. Furthermore, none of the prognostic tools developed in stable disease have been tested on hospitalised patients, and most require clinical measurements not routinely available at hospital admission. This study intends to test dyspnoea, eosinopenia, consolidation, acidemia, and atrial fibrillation (DECAF) and biological assessment profile (BAP) 65 Scores on Indian patients in a tertiary care set up and validate the same to be used as a routine and effective score in predicting the outcome in AECOPD.  Methods: Hospital based prospective observational study was carried out in 100 patients with AECOPD who was present to general medicine. DECAF and BAP-65 Scores were calculated. Data was analyzed using SPSS 22 version software.Results: In our study both DECAF score and BAP‑65 score performed equally well for prediction of need for Mechanical Ventilation. The AUROC for need for Mechanical Ventilation was 0.77 (95% CI=0.67–0.84) for DECAF score and 0.77 (95% CI=0.67–0.85) for BAP‑65 score. The AUROC for prediction of mortality for DECAF score was 0.83 (95% confidence interval [CI]=0.74–0.89) and for BAP‑65 score was 0.79 (95% CI=0.69–0.86).Conclusions: DECAF and BAP-65 are good and also equal in predicting mortality as well as need for mechanical ventilation. Both scores can be easily applicable in AECOPD patients, so that death during hospitalization for AECOPD and need for mechanical ventilation can be minimized.

Correlation of serum calcium levels with infarct size and severity of stroke using NIHSS score in patients with acute ischemic stroke

Background: Normal cerebral membrane integration is important to maintain the cellular calcium homeostasis. Recent studies have suggested that elevated serum calcium levels at presentation correlates well with the infarct size and severity of stroke.Methods: A total of 73 patients with acute ischemic stroke satisfying inclusion and exclusion criteria were included in the study from November 1st 2017 to April 30th 2019 at a tertiary care centre in Kolar, Karnataka. Serum calcium (total, ionized and albumin corrected calcium) levels were measured at the time of presentation and compared with the infarct size and severity of stroke using NIHSS score (National Institute of Health Stroke Scale).Results: The levels of total calcium, albumin-corrected calcium, and ionized calcium were 9.13±0.89 mg/dL (range: 8.24-10.02), 9.56±0.82 mg/dL (range: 8.74-10.38), and 4.79±0.47 mg/dL (range: 4.3-5.2), respectively. Mean stroke size as measured on the CT scan was 47.38±17.7 cm (range: 21-88). Analysis revealed significant negative correlation between calcium levels (total, corrected, and ionized) and infarct size and severity of stroke.Conclusions: In this study, it was found that there was a statistically significant negative correlation between total, ionized and corrected calcium with the infarct size in patients with ischemic stroke and also the total calcium at presentation and severity of stroke calculated using NIHSS score