Deccan College of Medical Science (DCMS) is a medical school situated in Hyderabad, India offering the courses MBBS, postgraduate degree / diploma and superspeciality courses. It has an approved intake of 150 MBBS seats annually.The college is affiliated to the KNR University of Health Sciences, Warangal from the academic year 2016-17 onwards. It was earlier affiliated to Dr. N. T. R. University of Health Sciences, Vijayawada. It is recognized by the Medical Council of India. It follows the syllabus prescribed by the University for MBBS course as mandated by Medical Council of India. The management observes such rules, regulation or orders which are applicable to minority institution without violating the rights conferred under Article 30(1) of the constitution of India. N.
Sepsis and septic shock are life-threatening conditions with high mortality, presenting challenges in predicting disease severity and outcomes. Cell-free mitochondrial DNA (mtDNA) has emerged as a potential mediator in sepsis pathogenesis, acting as a damage-associated molecular pattern (DAMP) that exacerbates inflammation. The present study aimed to assess cell-free mtDNA levels as predictors of mortality and disease severity, and to determine their correlation with established clinical markers. A prospective study enrolled 150 participants, including healthy controls (n = 50) and patients (n = 100, of which 50 had sepsis and 50 had septic shock). Plasma cell-free mtDNA levels were quantified using RT-qPCR, and Receiver operating characteristic (ROC) curves were used to evaluate the predictive ability of cell-free mtDNA for 28-day mortality. The cell-free mtDNA correlated with clinical markers, including C-reactive protein (CRP), Sequential Organ Failure Assessment (SOFA), Acute Physiology and Chronic Health Evaluation (APACHE II), Procalcitonin (PCT), neutrophil-to-lymphocyte ratio (NLR), and lactate. Cell-free mtDNA levels were significantly elevated in sepsis and septic shock patients compared to controls, and higher in septic shock compared to sepsis patients. Non-survivors exhibited significantly higher cell-free mtDNA levels than survivors across both sepsis and septic shock subgroups. Cell-free mtDNA demonstrated a superior predictive value for 28-day mortality, area under the curve (AUC = 0.865) compared to clinical markers (CRP, SOFA, PCT, NLR, and Lactate). Furthermore, cell-free mtDNA levels showed a positive correlation with CRP, followed by SOFA, NLR, and PCT. Elevated circulating cell-free mtDNA levels were associated with severity and mortality in sepsis and septic shock, and may act as a valuable molecular tool for predicting disease outcomes. The study’s findings warrant further investigation into the potential of cell-free mtDNA as a future component of clinical management strategies in sepsis. Sepsis triggers the release of mitochondrial DNA (mtDNA) from damaged cells. Circulating cell-free mtDNA activates PRRs such as TLR9 and cGAS, driving inflammation. Circulating cell-free mtDNA functions as a potent damage-associated molecular pattern (DAMP). We evaluated circulating cell-free mtDNA as a molecular predictor for sepsis and septic shock severity and mortality in Indian patients. Circulating cell-free mtDNA levels showed strong positive correlations with key clinical severity markers.
