ObjectiveCytokines (IL-6, IL-8 and TNF-α), sCD163, and C-reactive protein were serially measured in an attempt to identify a set of tests which can reliably confirm or refute the diagnosis of neonatal sepsis at an early stage.MethodsOne hundred neonates suspected to have sepsis on clinical grounds and who met the inclusion criteria were enrolled for the study. Based on the positive or negative blood culture reports they were classified as infected (n = 50) and non-infected (n = 50) neonates respectively. Fifty healthy neonates without any signs of sepsis were also included in the study as control group. The initial blood sample was taken on day 0 (at the time of sepsis evaluation) and two further samples were taken on days 1 and 2 for monitoring the clinical progress and response to treatment. In the control group the cord blood and 48 hours venous sample was collected. Plasma CRP (ng/ml), IL-6 (pg/ml), IL-8 (pg/ml), TNF-α (ng/ml) and sCD163 (ng/ml) were determined by double antibody method Enzyme Linked Immunosorbent Assay in all the three blood samples.ResultsThe cut of levels for CRP at >19,689 ng/ml had a sensitivity of 68%, specificity of 92%, for IL-6 at >95.32 pg/ml had a sensitivity of 54%, specificity of 96%, for IL-8 at >70.86 pg/ml had a sensitivity of 78%, specificity of 70%, for sCD163 at >896.78 ng/ml had a sensitivity of 100%, specificity of 88% for the diagnosis of infection before antibiotics. TNF-α levels of >12.6 ng/ml showed 100% sensitivity and 72% specificity for the diagnosis of inflammation.ConclusionThe most powerful predictor to differentiate between the non-infected and infected neonates before antibiotics was sCD163. The most powerful indicator for evaluation of prognosis is IL-6. sCD163 can be used alone to screen for sepsis in neonates before the results of blood culture are received.

It becomes necessary for the students to have a good knowledge of mental health problems, their early symptoms, the most effective options for treatment and ABSTRACT Background: Medical College is recognized as a stressful environment that often exerts a negative effect on the academic performance, physical health and psychological wellbeing of the student. The objective of the study was to assess the depression, anxiety and stress levels among the medical students by using DASS. To compare the depression, anxiety and stress levels among the medical students. Methods: The cross sectional study was conducted in JSS medical college and Mysore Medical College of Mysore city. All the students studying in first year and final year MBBS who had spent more than six months in the medical college and willing to participate in the study were included. The Depression Anxiety Stress Scales (DASS), was used to assess the levels of depression, anxiety and stress among medical students. Results: Among 332 students enrolled in the study, majority 213 (64.1%) were in the age group of 17-20 years, 193 (55.0%) were females and 215 (64.8%) were studying in second term. The prevalence of depression, anxiety and stress were found to be 124 (37.3%), 168 (50.6%) and 109 (32.8%) respectively. Most of the students were having mild degree of depression, anxiety and stress. Conclusions: Prevalence of mental health problems like depression, anxiety and stress were more than 30% among medical students. As majority of the students were having milder degrees of illnesses they need to be addressed immediately before they manifest into severe forms.

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