Journal of Acute Disease

89-95

Authors: Rushikesh S. Haridas, Sheetal Shelke, Girish Patrike, Deepak Patil, Sainath Dhumal

Objective: To evaluate morphine's risk-benefit profile in the treatment of acute heart failure. Method: Different electronic databases, including PubMed, MEDLINE, Cochrane Library, and Google Scholar, as well as clinicaltrails.gov, were searched for articles published between 2012 and 2022. The risk of bias in the present study was evaluated by employing randomized controlled trials (RCTs) checklist that assesses the effectiveness of new interventions through random assignment of participants to different treatment groups. The two-part tool was used to address the five specific domains such as selection bias, performance bias, detection bias, attrition bias, and selective reporting bias. Evaluation of the quality of diagnostic accuracy studies was conducted using the RevMan software (version 5.4), a quality assessment tool. Results: A total of 13 studies were included in the present review, in which there were 5 retrospective studies, 3 randomized-control studies, 2 prospective studies, 1 multicenter pharmacodynamics study, 1 multicenter cardiac magnetic resonance imaging study, and 1 open-label, cross-over study. The mortality of acute heart failure patients treated with morphine was higher compared to those without morphine. Conclusions: Acute heart failure patients who do not receive morphine have a lower mortality rate compared to those who receive morphine. Considering the adverse effects, including mortality associated with morphine, there is a pressing need for further research to explore alternative and effective treatment options in acute heart failure.

102-106

Authors: Sanjana Agrawal, Abhiruchi Galhotra, Saurabh Kumar Sahu, Senthilkumar Ramasamy

Objective: To investigate the impact of COVID-19 on the mortality trends and patterns in a tertiary teaching hospital in Raipur, Chhattisgarh, India. Methods: A hospital-based retrospective study was conducted to analyze the case reports of all deaths from January 2016 to December 2021 in a tertiary teaching hospital in Raipur, Chhattisgarh, India. The socio-demographic profile and the pattern of causes of death were recorded. The deaths were classified according to the 10th revision of the International Classification of Diseases. Results: A total of 6128 deaths were registered from 2016 to 2021 and the maximum death number was observed in 2021 (38.2%) followed by 2020 (32.5%) when the country was hit by the COVID-19 pandemic. The highest number of deaths was observed in the age group of 51 to 65 years i.e., 31.1% of the total deaths. In all five years, male deaths were more than female deaths, and more than 50% occurred within three days of hospitalization during the study period. Conclusions: Even though there is a rise in the death rate due to the sudden hit of COVID-19, the burden of both communicable and non-communicable diseases remains gradually increasing over the five years. There is a need for health awareness in the community about changing lifestyles and their harmful effects on health.

114-120

Authors: Sumbul Qamar, Mohd Ayub Ansari, J. N. Mohapatra, Sana Salim Khan

Objective: To determine the association of the three umbilical cord blood parameters: umbilical cord pH, base deficit, and lactate levels, with neonatal outcomes. Methods: This prospective observational study was conducted from April 2021 to September 2022 with 100 term and late preterm (>35 weeks) neonates whose umbilical cord blood pH was <7.10, Apgar score was <7 at 1 min, and required positive pressure ventilation. Umbilical cord blood was assessed for pH, base deficit, and blood lactate levels. The neonatal outcomes of neonatal intensive care unit admission, Apgar score at 1 min, and Apgar score at 5 min were assessed. Results: The mean of umbilical cord blood pH was 7.04±0.07, mean base deficit was (–9.3±3.9) mmol/L, and mean lactate levels were (6.51±2.29) mmol/L. Neonatal intensive care unit (NICU) admission was needed in 78 (78%) neonates. The mean NICU stay length was (2.4±2.2) days ranging from 0 to 12 days with a median of 2 days. Univariate analysis showed no significant difference in cord blood pH (P=0.736) and base deficit (P=0.393) between neonates without NICU admission and neonates who required NICU admission, but lactate level was significantly higher in neonates who required NICU admission (P<0.001). There was no significant difference in cord blood pH (P=0.400) and base deficit (P>0.999) between neonates with Apgar scores 4-7 at 1 min and neonates with Apgar scores <4, but lactate level was significantly higher in neonates with Apgar scores <4 at 1 min (P<0.001). Conclusions: Umbilical cord blood pH, base deficit, and lactate levels are useful novel markers showing a significant correlation with neonatal intensive care unit admission and adverse neonatal morbidities among hypoxic newborns. Overall, lactate was a better predictor of adverse neonatal outcomes as compared to umbilical cord blood pH and base deficit.

129-130

Authors: Wai Yan Lam, Sunny Chi Lik Au

NA