Management of Sepsis in Intensive Care Units in Rajshahi Medical College, Bangladesh

Background: Sepsis was a life-threatening situation affecting roughly 27 million individuals globally every year. Devoid of proper management, sepsis could develop to austere sepsis and septic shock that reason certain eight million expiries every year. Initial identification and analysis of contaminations and quick introductions of antimicrobial management had long been predictable as essential principles of treatment. Methods: All patients were evaluated thoroughly by history, clinical and laboratory findings. Serum lactate levels were collected at 0 hr and 24 hrs of the total admission in the ICU. Blood culture and sensitivity was performed prior to antibiotic administration in this study. Results: In this research, total sample was 1367 patients. Among these sepsis patients were 305 (nearly 22%). These 305 studied sepsis cases, majority 128 (42%) of the patients were within the age group of 41 - 65 years, followed by 18 - 30 years consisting of 116 (38%) and the least number of sepsis patients were in the age group of >65 years (20%). This study found that 129 (42.3%) out of 305 blood samples screened from assumed sepsis infection were affirmative for the presence of sepsis causing pathogens. Among the 129 culture positive samples, majority of the isolated micro-organisms were gram negative bacteria 58% (75), followed by gram positive bacteria 38% (49), and 3.8% (5) were the fungi Candida albicans. Conclusion: At present, mortality & morbidity of sepsis subject was too big due to late identification, wrong & inadequate management of sepsis in the ward and also in the intensive care unit of Bangladesh.

Estimation of cytotoxic potency by brine shrimp lethality bioassay application of Clerodendrum infortunatum Linn.

Objective:To learn a scientific and systematic knowledge of anticancer,antimicrobial and pharmacological activities of natural products and estimate cytotoxic potency by using ethanol and chloroform extracts of root,leaf and stem of Clerodendrum infortunatum(Verbenaceae)due to its random use in customary and traditional medicine to cure common ailments such as intestinal disorder,diarrhea,tuberculosis and respiratory problems etc.Methods:The in vitro application was carried out with the bench-top bioassay method by using brine shrimp lethality bioassay.Results:All of the crude extracts were found to be lethal and effective.The LC50 value of ethyl alcohol fraction of root was 20.845 mg/L compared to the standard drug tetracycline of 14.675 mg/L to brine shrimp nauplii,indicating that the extracts were biologically active.Conclusions:The cytotoxic study of LC50 value showed that a good correlation with the antibiotic tetracycline.From the comparative correlation error bars and percentage,we understood that ethyl alcohol fraction of root extract was very effective.This study serves as a basis for further research to lead compounds to be isolated so that it may be as a template for the implications of these results for bioactivity and drug discovery potential of herbal products.