BACKGROUNDLaboratory Risk Indicator for Necrotizing Fasciitis (LRINEC score) is a simple laboratory tool used to distinguish between Necrotizing Soft-Tissue Infections (NSTI) and other soft-tissue infections. A LRINEC score of ≥6 is considered as denoting a high risk of necrotizing fasciitis. A very high LRINEC score might also be associated with mortality and other outcomes of patients with NSTI.

Background: Stroke is defined as an abrupt onset of a neurologic deficit that is attributable to a focal vascular cause. Acute ischemic stroke is the fourth leading cause of death and most common cause of long-term disability worldwide. Hyponatremia is the commonest electrolyte disturbance encountered in the neurological intensive care units. This study investigated to evaluate hyponatremia in acute ischemic stroke patients as a reliable prognostic marker on admission to ICU.Methods: A total of 150 patients admitted to M S Ramaiah Hospitals during the period of October 2014 to September 2016 who fulfilled the inclusion criteria were considered in the study. All patients were evaluated by neurologist/ physician and the diagnosis of Acute ischemic stroke was made by Clinical examination and confirmed by Computed Tomography (CT) and/ Magnetic resonance imaging (MRI) brain. Hyponatremia was defined as serum sodium level <135 mmol/L and recorded on admission. Outcome was assessed by National Institute of Health Stroke Scale (NIHSS) score at admission, day 5 and at discharge, duration of ICU stay, duration of hospital stay and in-patient mortality.Results: Among the 150 patients admitted with acute ischemic stroke, mean age was 60 years, 68% were males and 36% patients had hyponatremia. Baseline characteristics were similar between groups except for gender distribution (p=0.037). Hyponatremic patients had higher NIHSS score on admission, on day 5 and at discharge (p=<0.001). Hyponatremic patients had a longer duration of ICU stay (p=<0.001) and in hospital stay (p=<0.001). Hyponatremia was associated with higher mortality in hospital (p=0.026).Conclusions: Study demonstrates that hyponatremia at admission in acute ischemic stroke patients is associated with acute mortality, worse NIHSS score at admission and at discharge, and longer duration of ICU and hospital stay.

BACKGROUNDStroke affects 16.9 million people annually and the greatest burden of stroke is in low-and middle-income countries where 69% of all strokes occur. Stroke risk factors, mortality and outcomes differ in developing countries as compared to the developed world. Stroke incidence increases with increasing age and has an impact on daily living in many areas with increasing life expectancy. Old people constitute the majority of stroke victims. MATERIALS AND METHODSA total of 101 elderly patients of acute ischaemic stroke fulfilling inclusion and exclusion criteria who were admitted to M.S. Ramaiah Hospital between January 2014 and June 2016 were included in the study. Outcome was assessed by National Institute of Health Stroke Scale (NIHSS) score at admission, day 5 and at discharge, duration of hospital stay and inpatient mortality. RESULTSThe mean age of the patients was 67.70±8.77 years. 67.3% of the patients were males. Hypertension (72.3%), diabetes mellitus (51.5%) and dyslipidaemia (48.5%) were the most common co-morbid conditions. Mean NIHSS score at the time of admission was 12±5.1, on day 5 was 8.47±4.75 and at the time of discharge was 3.27±3.33. Mean duration of hospital stay was 9.01±6.45 days and mortality was seen in 4 patients (4%). Most common site for infarct was in the middle cerebral artery territory (71.71%). CONCLUSIONWith continuing rapid increase in life expectancy and improvement in medical care, the proportion of elderly with stroke will rise. Therefore, stroke in the elderly is rapidly becoming a major public health concern.