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Background: Sepsis is a complex, life-threatening, heterogeneous infectious disease associated with increased rates of morbidity and mortality. Early assessment of the prognosis of sepsis is key to achieving a favorable outcome for the disease. This study aimed to identify the prognostic value of PCT for sepsis patients. Materials and Methods: We conducted a prospective analytical study involving 100 adult patients with sepsis who were admitted to the Medicine dept and intensive care unit from 2019 to 2020. At least one blood test for PCT level was performed for all patients within the first 24 hours of suspecting an infection. Results: Our study found that a maximum number of patients (43.0%) were between 51-60 years age group, mean age of the patient was 49.35 ± 11.7 years. Out of 100 cases, 65% were male and 35% were female. The male and female ratio was 1.85:1. In this study serum, procalcitonin levels 0.5-2.0 ng/were detected in 15.0% of patients with mean±SD 1.3±0.8. Serum procalcitonin levels 2.1-10.0 ng/mL were detected in 29.0% of patients with mean±SD 5.9±2.5 and >10.0 ng/mL was detected in 56 patients. Based on the receiver-operator characteristic (ROC) curves, procalcitonin had the area under curve 0.923, with 89.4% sensitivity and 87.5% specificity. In our study, procalcitonin showed the best predictive value for the short-term outcome of sepsis with a cut-off value of 14.8 ng/mL (AUC 0.923). Study shows that 76.0% of the patients recovered completely, but 24.0% of patients expired during the hospital stay. Conclusion: There was a statistically significant correlation in serum procalcitonin with the outcome of sepsis (p < 0.001). So the effectiveness of serum procalcitonin has proven significant in the prediction of mortality in sepsis patients. J MEDICINE 2023; 24: 18-22

Solitary plasmacytoma of bone (SPB, also called osseous plasmacytoma) is a localized tumor in the bone comprised of a single clone of plasma cells in the absence of other features of MM (Multiple Myeloma). Most patients present with skeletal pain or a pathologic fracture of the affected bone. Patients with vertebral involvement may have severe back pain or neurologic compromise (e.g. cord compression). J MEDICINE 2022; 23: 173-175

A middle aged woman presenting with fatigue, pruritus, xanthelesma and hepatomegaly remains the typical presentation of primary biliary cirrhosis. Here, we present a case of primary biliary cirrhosis occurring in a male patient, who presented with fatigue and pruritus, had hepato-splenomegaly, raised serum alkaline phosphatase, positive anti-mitrochondrial antibody and negative antinuclear antibody.J MEDICINE July 2015; 16 (2) : 128-131

Objectives: To assess the prevalence and distribution of rheumatic diseases at rheumatology clinic in a tertiary level hospital. Methods: This retrospective study was done at rheumatology clinic of BIRDEM from July 2009 to December 2012. Diagnoses were reached by using clinical criteria supplemented by necessary investigations. Results: Total number of patients was 772 with female predominance (F:M ratio of 1.3:1). Mean age was 46.9 (range 13-83) years. Majority (85.9%) were in 3rd to 6th decades. Degenerative diseases (49.9%) were most common, followed by inflammatory conditions (33.5%), soft tissue rheumatism (7%), metabolic bone disease (4.8%) and connective tissue diseases (2.5%). Rheumatoid arthritis (27.7%) was the most prevalent disease, followed by osteoarthritis of knees (26.2%) and lumber spines (23.4). Tendinitis, osteoporosis, fibromyalgia and systemic lupus erythematosus prevailed in 5.6%, 4.8%, 1.4% and 1.3% cases respectively. Common comorbidities were diabetes mellitus (87.9%), hypertension (22.2%), ischaemic heart disease (12.4%), dyslipidaemia (10.1%), fatty liver (7.9%), chronic kidney disease (6.9%) and hypothyroidism (4.5%). Commonly prescribed medications were non-steroidal anti-inflammatory drugs (93%), disease modifying anti-rheumatic drugs (28.9%) and prednisolone (10.6%). Physiotherapy was required in 13.3% cases. In 56.6% cases various combination of treatment was required. In 12% patients receiving methotrexate, adverse effects occurred. Conclusion: Degenerative joint and spine diseases were more common but as an individual disease rheumatoid arthritis was the most prevalent condition. DOI: http://dx.doi.org/10.3329/jom.v15i1.19855 J Medicine 2014; 15: 23-27

Objectives: To describe the antibiotic sensitivity pattern ofSalmonella typhi and Salmonella paratyphi from blood culture specimens. Methods: This cross-sectional study was done in the Department of Medicine, BIRDEM from July 2009 to June 2012. Standard laboratory and microbiological procedures were followed for blood culture and antibiotic sensitivity tests. Results: Among the 97 blood culture positive samples, S. typhi was 71 (73.2%) and S. paratyphi was 26 (26.8%). Multi-drug resistant strains of S. typhi and S. paratyphi were 23 (32.4%) and 3 (11.5%) cases respectively. Azithromycin, nalidixic acid, ciprofloxacin, levofloxacin and amoxicillin resistance was also found in a good number of cases (S. typhi and S. paratyphi: 71.8% and 57.7%, 42.3% and 30.8%, 38% and 34.6%, 38% and 26.9% and 38% and 26.9% cases respectively). Nineteen (31.1%) of the 61ciprofloxacin sensitive organisms were resistant to nalidixic acid. Ceftriaxone was sensitive in 100% of S. typhi and S. paratyphi. Cefixim, ciprofloxacin, levofloxacin, imipenem were among the most common sensitive antibiotics (S. typhi and S. paratyphi: 83.1% and 73.1%, 62% and 65.4%, 53.5% and 65.4%, 76.1% and 65.4% cases respectively). Conclusion: Ceftriaxone was the most sensitive antibiotic for treating enteric fever followed by cefixim, imipenem and ciprofloxacin. However, in suspected cases of enteric fever, blood culture should be requested before prescribing antibiotic. DOI: http://dx.doi.org/10.3329/jom.v15i2.20684 J MEDICINE 2014; 15 : 122-124