Journal of Acute Disease
Most view articles
Jia-Yuan Dai
,
Lu Yin
,
Jun Xu
,
Joseph Harold Walline
,
Chuan-Zhu Lv
,
Xiao-Dong Zhao
,
Xue-Zhong Yu
2020(6):231-243.
DOI: 10.4103/2221-6189.299177
Abstract:
Acute upper gastrointestinal bleeding is one of the most common life-threatening diseases. Standardized diagnosis and treatment of acute upper gastrointestinal bleeding are of great importance for improving the prognosis. In 2015, the Emergency Physician Branch of the Chinese Medical Doctor Association updated an expert consensus statement on the emergency diagnosis and treatment procedures for acute upper gastrointestinal bleeding. Based on the 2015 consensus statement, members of the expert panel decided to reconvene and draw up a 2020 update on the advancements in the clinical care for acute upper gastrointestinal bleeding. The 2020 expert consensus statement is summarized in 10 sections: emergency assessment, diagnosis, stratified treatment, emergency treatment, comprehensive assessment, medication management, endoscopy, interventional radiology, multidisciplinary treatment, and evaluation of prognosis. The consensus statement is based on experts’ opinions combined with the latest relevant medical evidence.
Acute upper gastrointestinal bleeding is one of the most common life-threatening diseases. Standardized diagnosis and treatment of acute upper gastrointestinal bleeding are of great importance for improving the prognosis. In 2015, the Emergency Physician Branch of the Chinese Medical Doctor Association updated an expert consensus statement on the emergency diagnosis and treatment procedures for acute upper gastrointestinal bleeding. Based on the 2015 consensus statement, members of the expert panel decided to reconvene and draw up a 2020 update on the advancements in the clinical care for acute upper gastrointestinal bleeding. The 2020 expert consensus statement is summarized in 10 sections: emergency assessment, diagnosis, stratified treatment, emergency treatment, comprehensive assessment, medication management, endoscopy, interventional radiology, multidisciplinary treatment, and evaluation of prognosis. The consensus statement is based on experts’ opinions combined with the latest relevant medical evidence.
2017(5):260.
DOI: 10.4103/2221-6189.221289
Abstract:
Paraquat (PQ, methyl viologen) was widely used in agricultural production throughout the world in 1962 for its efficient herbicidal activity. PQ was also highly toxic drug. About 5 mL medicine including 20% paraquat was life-threatening that can cause poisoning. In 1966, some people died because of PQ poisoning. Most patients had acute respiratory distress syndrome after 2 wk, and 70% of them died due to the lack of effective detoxification drugs. Thus, it was particularly important to understand the pathogenesis of PQ poisoning and give some effective treatments. This article will review the toxicological mechanism and treatment on PQ poisoning of acute lung injury
Paraquat (PQ, methyl viologen) was widely used in agricultural production throughout the world in 1962 for its efficient herbicidal activity. PQ was also highly toxic drug. About 5 mL medicine including 20% paraquat was life-threatening that can cause poisoning. In 1966, some people died because of PQ poisoning. Most patients had acute respiratory distress syndrome after 2 wk, and 70% of them died due to the lack of effective detoxification drugs. Thus, it was particularly important to understand the pathogenesis of PQ poisoning and give some effective treatments. This article will review the toxicological mechanism and treatment on PQ poisoning of acute lung injury
2019(6):221-232.
DOI: 10.4103/2221-6189.272853
Abstract:
Legionellosis is the generic term used to describe infections caused by different varieties of Legionella spp., including Legionnaires’ disease (LD), a severe and potentially fatal form of pneumonia, and Pontiac fever, a self-limited flu-like illness. Legionellosis is usually acquired through inhalation or aspiration of aerosols containing Legionella spp. These bacteria can cause acute consolidating pneumonia in susceptible patients who are at an advanced age, have underlying debilitating diseases, or are immunodeficient. The main natural reservoir for Legionella is water and this pathogen colonizes many different natural and man-made freshwater environments such as water networks, cooling towers, and water systems in buildings and hospitals. In recent years, various laboratory diagnostic tests for Legionella infections have changed significantly. Although the sequencing method is nowadays considered the fastest and most reliable method for differentiation and detection of different Legionella species, the isolation of these bacteria from clinical specimens is the golden standard for diagnosis of Legionnaires’ disease. Today the urinary antigen test as the most rapid and inexpensive method is routinely used for diagnosis of LD caused by Legionella pneumophila serogroup 1. The macrolides and fluoroquinolones are still the mainstays for the treatment of Legionella infections. For the prevention of spreading the contaminated water aerosols and controlling Legionella infections, an effective water treatment procedure is necessary. This review describs and summarizes the latest available information about all aspects of Legionella and Legionnaires’ disease.
Legionellosis is the generic term used to describe infections caused by different varieties of Legionella spp., including Legionnaires’ disease (LD), a severe and potentially fatal form of pneumonia, and Pontiac fever, a self-limited flu-like illness. Legionellosis is usually acquired through inhalation or aspiration of aerosols containing Legionella spp. These bacteria can cause acute consolidating pneumonia in susceptible patients who are at an advanced age, have underlying debilitating diseases, or are immunodeficient. The main natural reservoir for Legionella is water and this pathogen colonizes many different natural and man-made freshwater environments such as water networks, cooling towers, and water systems in buildings and hospitals. In recent years, various laboratory diagnostic tests for Legionella infections have changed significantly. Although the sequencing method is nowadays considered the fastest and most reliable method for differentiation and detection of different Legionella species, the isolation of these bacteria from clinical specimens is the golden standard for diagnosis of Legionnaires’ disease. Today the urinary antigen test as the most rapid and inexpensive method is routinely used for diagnosis of LD caused by Legionella pneumophila serogroup 1. The macrolides and fluoroquinolones are still the mainstays for the treatment of Legionella infections. For the prevention of spreading the contaminated water aerosols and controlling Legionella infections, an effective water treatment procedure is necessary. This review describs and summarizes the latest available information about all aspects of Legionella and Legionnaires’ disease.
2018(6):225-233.
DOI: 10.4103/2221-6189.248026
Abstract:
The large amount of classifications about the concept of death from a medical-legal perspective leads us to think that there are still many aspects to accurately define that precise moment in which the end of our earthly existence is considered as a final and unalterable fact. An answer to such a question may come from a retrospective analysis of those victims of impending-death situations that have been rescued after both basic and advanced cardiac pulmonary resuscitation failure and their consequent medical-legal death declaration. The aim of the following work is to introduce a new phase within forensic thanatology, supported by a complementary resuscitation maneuver based upon millennial traditional Chinese medicine principles together with a detailed analysis of current global agreements on organ transplantation and an avant-garde perspective on actual knowledge about cell death. Those terms will then allow us to achieve a holistic view of said concept, still loosely defined at present. Such an innovative diagnostic-therapeutic resource can in turn enable us to evaluate and face the irreversibility of such extreme situation, analyzing the statistical feasibility of its promising results.
The large amount of classifications about the concept of death from a medical-legal perspective leads us to think that there are still many aspects to accurately define that precise moment in which the end of our earthly existence is considered as a final and unalterable fact. An answer to such a question may come from a retrospective analysis of those victims of impending-death situations that have been rescued after both basic and advanced cardiac pulmonary resuscitation failure and their consequent medical-legal death declaration. The aim of the following work is to introduce a new phase within forensic thanatology, supported by a complementary resuscitation maneuver based upon millennial traditional Chinese medicine principles together with a detailed analysis of current global agreements on organ transplantation and an avant-garde perspective on actual knowledge about cell death. Those terms will then allow us to achieve a holistic view of said concept, still loosely defined at present. Such an innovative diagnostic-therapeutic resource can in turn enable us to evaluate and face the irreversibility of such extreme situation, analyzing the statistical feasibility of its promising results.
2023(6):254-254.
DOI: 10.4103/2221-6189.390391
Abstract:
2019(6):233-238.
DOI: 10.4103/2221-6189.272854
Abstract:
Objective: To determine the effect of rehabilitation education on pain, knee stiffness and performance difficulty in patients undergoing knee replacement surgery. Methods: This randomized clinical trial study was performed on 96 patients undergoing knee replacement surgery, who were randomly divided into two groups: the control group and the intervention group, with 48 patients in each group. In the intervention group, the patients received educational intervention in four stages (one day before surgery, 24 h and 48 h later, upon discharge from the hospital. In the control group, only the routine of the hospital was performed. Questionnaires were completed before and 6 weeks after the intervention. Results: The mean scores of pain, knee stiffness and performance difficulty were significantly decreased in the intervention group (P=0.01). Compared to the control group, the intervention group had a better outcome of the illness, including pain, knee stiffness and performance difficulty (P=0.001). Conclusion: Rehabilitation education could be a suitable way to improve the surgical outcomes of patients undergoing total knee replacement.
Objective: To determine the effect of rehabilitation education on pain, knee stiffness and performance difficulty in patients undergoing knee replacement surgery. Methods: This randomized clinical trial study was performed on 96 patients undergoing knee replacement surgery, who were randomly divided into two groups: the control group and the intervention group, with 48 patients in each group. In the intervention group, the patients received educational intervention in four stages (one day before surgery, 24 h and 48 h later, upon discharge from the hospital. In the control group, only the routine of the hospital was performed. Questionnaires were completed before and 6 weeks after the intervention. Results: The mean scores of pain, knee stiffness and performance difficulty were significantly decreased in the intervention group (P=0.01). Compared to the control group, the intervention group had a better outcome of the illness, including pain, knee stiffness and performance difficulty (P=0.001). Conclusion: Rehabilitation education could be a suitable way to improve the surgical outcomes of patients undergoing total knee replacement.
2018(3):99-102.
DOI: 10.4103/2221-6189.236822
Abstract:
Pulmonary embolism (PE), with the incidence of about 60 per 100 000 annually, can be a life-threatening disease if it is not treated promptly. It has been estimated that some 10% of PE patients die within the first hour of the event. Untreated PE has a mortality of about 30%. PE is a condition that is treatable if suspected and diagnosed early. The chest radiograph is still the first investigation that is ordered in patients presenting with cardiorespiratory symptoms or symptoms suggestive of PE. The CXR is also helpful in identifying or excluding other conditions or diagnoses. Thus, knowing and understanding some of the more specific CXR signs can be useful. We suggest that physicians to be aware of and utilize CXR findings such as Palla's sign, Westermark sign and Hamptons hump to help with the diagnosis of PE and to exclude other conditions that can mimic venous thrombo-embolism. Even if these signs are not common, their presence, even in an unsuspected patient without a high pretest probability of PE, should prompt further investigations such as a D-dimer test, lung scintigraphy or computed tomography pulmonary angiography as required.
Pulmonary embolism (PE), with the incidence of about 60 per 100 000 annually, can be a life-threatening disease if it is not treated promptly. It has been estimated that some 10% of PE patients die within the first hour of the event. Untreated PE has a mortality of about 30%. PE is a condition that is treatable if suspected and diagnosed early. The chest radiograph is still the first investigation that is ordered in patients presenting with cardiorespiratory symptoms or symptoms suggestive of PE. The CXR is also helpful in identifying or excluding other conditions or diagnoses. Thus, knowing and understanding some of the more specific CXR signs can be useful. We suggest that physicians to be aware of and utilize CXR findings such as Palla's sign, Westermark sign and Hamptons hump to help with the diagnosis of PE and to exclude other conditions that can mimic venous thrombo-embolism. Even if these signs are not common, their presence, even in an unsuspected patient without a high pretest probability of PE, should prompt further investigations such as a D-dimer test, lung scintigraphy or computed tomography pulmonary angiography as required.
2023(6):255-256.
DOI: 10.4103/2221-6189.390392
Abstract:
2025(14):1-3.
DOI: 10.4103/jad.jad_4_25
Abstract:
Rationale: Advances in sleep research have introduced medications like lemborexant, a dual orexin receptor antagonist. While effective for regulating sleep, overdoses are a concern, especially in suicide attempts. However, limited data exist on lemborexant overdose, prompting this case report to elucidate its clinical course.
Patient’s Concern: A 91-year-old Japanese woman with multiple comorbidities, including insomnia and chronic kidney disease, was admitted after ingesting 315 mg of lemborexant in a suicide attempt.
Diagnosis: Lemborexant overdose.
Interventions: Supportive care with 500 mL of Ringer’s acetate solution at the emergency room.
Outcomes: She gradually regained full consciousness with no residual deficits. Due to persistent suicidal ideation, she was transferred to a psychiatric hospital after seven days of supportive care.
Lessons: A review of four lemborexant overdose cases managed at our hospital revealed that overdoses primarily induce altered consciousness and are unlikely to cause organ dysfunction. Supportive care is generally sufficient for management. However, given the limited data, further case accumulation is needed to enhance clinical understanding.
Rationale: Advances in sleep research have introduced medications like lemborexant, a dual orexin receptor antagonist. While effective for regulating sleep, overdoses are a concern, especially in suicide attempts. However, limited data exist on lemborexant overdose, prompting this case report to elucidate its clinical course.
Patient’s Concern: A 91-year-old Japanese woman with multiple comorbidities, including insomnia and chronic kidney disease, was admitted after ingesting 315 mg of lemborexant in a suicide attempt.
Diagnosis: Lemborexant overdose.
Interventions: Supportive care with 500 mL of Ringer’s acetate solution at the emergency room.
Outcomes: She gradually regained full consciousness with no residual deficits. Due to persistent suicidal ideation, she was transferred to a psychiatric hospital after seven days of supportive care.
Lessons: A review of four lemborexant overdose cases managed at our hospital revealed that overdoses primarily induce altered consciousness and are unlikely to cause organ dysfunction. Supportive care is generally sufficient for management. However, given the limited data, further case accumulation is needed to enhance clinical understanding.
Amankwa Richcane
,
Tay Samuel CK
,
Agbenorku Pius
,
Frimpong Enoch
,
Gyampomah Thomas K
,
Osei Sampene Paul Poku
2017(4):181.
DOI: 10.12980/jad.6.20170406
Abstract:
Objective: To determine the bacteriological profile and antimicrobial susceptibility patterns of burn wound isolates. Methods: Swabs were taken from burn wound of patients admitted to Ward D2C and Burns Intensive Care Unit (BICU) from December 2014 to November 2015. Samples were processed at the Microbiology Laboratory for identification and sensitivity. Bacteria isolated were identified using their morphological characteristics, Gram staining reaction and biochemical tests. The antimicrobial susceptibility testing was done using KirbyBauer disc diffusion method. Questionnaires were also administered to study participants to obtain information on demography, kind of first aid received, antibiotics received prior to culture and sensitivity. Results: A total of 86 patients comprising 45 patients from Ward D2C and 41 from BICU participated in the study. Males were 51(59.3%) and females 35 (40.7%). Age of participants ranged from 0–56+ years. Pseudomonas aeruginosa was the commonest pathogen isolated 26(30.2%), followed by Pseudomonas spp. 21(24.4%), Escherichia coli 17(19.8%), Klebsiella spp. 12(14.0%). Coagulase negative Staphylococcus accounted for 2(2.3%). Overall prevalence of infection in the study was 90.7%. Conclusions: Burn wound infection continues to be a major challenge in burn centers. Regular surveillance of commonly identified pathogens in the ward and their antimicrobial susceptibility will guide proper empiric selection of antibiotics for management of burn wounds.
Objective: To determine the bacteriological profile and antimicrobial susceptibility patterns of burn wound isolates. Methods: Swabs were taken from burn wound of patients admitted to Ward D2C and Burns Intensive Care Unit (BICU) from December 2014 to November 2015. Samples were processed at the Microbiology Laboratory for identification and sensitivity. Bacteria isolated were identified using their morphological characteristics, Gram staining reaction and biochemical tests. The antimicrobial susceptibility testing was done using KirbyBauer disc diffusion method. Questionnaires were also administered to study participants to obtain information on demography, kind of first aid received, antibiotics received prior to culture and sensitivity. Results: A total of 86 patients comprising 45 patients from Ward D2C and 41 from BICU participated in the study. Males were 51(59.3%) and females 35 (40.7%). Age of participants ranged from 0–56+ years. Pseudomonas aeruginosa was the commonest pathogen isolated 26(30.2%), followed by Pseudomonas spp. 21(24.4%), Escherichia coli 17(19.8%), Klebsiella spp. 12(14.0%). Coagulase negative Staphylococcus accounted for 2(2.3%). Overall prevalence of infection in the study was 90.7%. Conclusions: Burn wound infection continues to be a major challenge in burn centers. Regular surveillance of commonly identified pathogens in the ward and their antimicrobial susceptibility will guide proper empiric selection of antibiotics for management of burn wounds.
2018(3):93-98.
DOI: 10.4103/2221-6189.236821
Abstract:
Acupuncture is actually convoked for supporting Western Medicine. Its “Golden Points” can undoubtedly help patients during its neurological recovery. After almost thirty years of experience in saving patients at impending death situations and having made numerous contributions on the field, the author herein provides a reasoned survival bio-energetic circuit based on a detailed methodological and functional analysis of the Main Channels and the Wondrous Vessels (Qi jing ba mai) participating in it. K-1 Yongquan complementary resuscitation maneuver, systematized since 1987, has been consistently performed in sudden death and cardiac arrest conditions as a final resource in both basic and advanced CPR failure. Experimental analytical studies identify the prevention, control and assessment of treatments set up as well as the determination of their efficiency. Acupuncture K-1 Yongquan Resuscitation Maneuver is presented not only as a complementary CPR rescuer but as a protective aid for both traumatic and vascular acute brain injury. Current indications of KI-1 Yongquan are not limited to actuarial results in cardiac arrest resuscitations, but it functions as a brain protector in both traumatic and vascular brain injury situations should be included. Although many acupuncturists indicate only standard techniques for bio-energetic rehabilitation, it has not been noticed that they insist with greater emphasis in those specific points to stimulate the “Sea of Marrow” (encephalon). Divulgation of K-1 emergency therapeutic possibilities look for its inclusion into Critical Care Protocols, in order to upgrade survival rates in both cardiac arrest and stroke victims. Traditional Chinese Medical balancing effect principle can improve cognitive, intellectual and psycho-motor patterns after even severe brain injuries. Beyond the scientific methodology that supports it the efficiency of the maneuver derives mainly from the sustained increase in survival rates presented in the successive statistics published in renowned scientific journals since its application.
Acupuncture is actually convoked for supporting Western Medicine. Its “Golden Points” can undoubtedly help patients during its neurological recovery. After almost thirty years of experience in saving patients at impending death situations and having made numerous contributions on the field, the author herein provides a reasoned survival bio-energetic circuit based on a detailed methodological and functional analysis of the Main Channels and the Wondrous Vessels (Qi jing ba mai) participating in it. K-1 Yongquan complementary resuscitation maneuver, systematized since 1987, has been consistently performed in sudden death and cardiac arrest conditions as a final resource in both basic and advanced CPR failure. Experimental analytical studies identify the prevention, control and assessment of treatments set up as well as the determination of their efficiency. Acupuncture K-1 Yongquan Resuscitation Maneuver is presented not only as a complementary CPR rescuer but as a protective aid for both traumatic and vascular acute brain injury. Current indications of KI-1 Yongquan are not limited to actuarial results in cardiac arrest resuscitations, but it functions as a brain protector in both traumatic and vascular brain injury situations should be included. Although many acupuncturists indicate only standard techniques for bio-energetic rehabilitation, it has not been noticed that they insist with greater emphasis in those specific points to stimulate the “Sea of Marrow” (encephalon). Divulgation of K-1 emergency therapeutic possibilities look for its inclusion into Critical Care Protocols, in order to upgrade survival rates in both cardiac arrest and stroke victims. Traditional Chinese Medical balancing effect principle can improve cognitive, intellectual and psycho-motor patterns after even severe brain injuries. Beyond the scientific methodology that supports it the efficiency of the maneuver derives mainly from the sustained increase in survival rates presented in the successive statistics published in renowned scientific journals since its application.
2018(2):49-68.
DOI: 10.4103/2221-6189.233013
Abstract:
The I-Ching is one of the most significant texts in the literature of the world and embodies, as no other text does, the Chinese spirit and thought. Its perpetuation along millennia has exercised crucial influence on the development of Chinese philosophy and medicine. The hypotheses of its abstractions compose a “body of assumptions” that hierarchs concepts through a self-regulated process of reciprocal control, which allows the accurate prediction of specific sequences of events according to “fields of similarities”. This peculiarity enables this system of knowledge to make possible predictions based upon the Natural Laws with incredible accuracy, which is effective to process expectations and arguments or to affirm or reject its judgments. A detailed analysis of two consecutive hexagrams (N°23 & N°24) allows the understanding not only of the bases that consolidate the “Reconciliation vessel” but also of the specific determination of its function in the frame of Risk management that can be compared to present ISO standards.
The I-Ching is one of the most significant texts in the literature of the world and embodies, as no other text does, the Chinese spirit and thought. Its perpetuation along millennia has exercised crucial influence on the development of Chinese philosophy and medicine. The hypotheses of its abstractions compose a “body of assumptions” that hierarchs concepts through a self-regulated process of reciprocal control, which allows the accurate prediction of specific sequences of events according to “fields of similarities”. This peculiarity enables this system of knowledge to make possible predictions based upon the Natural Laws with incredible accuracy, which is effective to process expectations and arguments or to affirm or reject its judgments. A detailed analysis of two consecutive hexagrams (N°23 & N°24) allows the understanding not only of the bases that consolidate the “Reconciliation vessel” but also of the specific determination of its function in the frame of Risk management that can be compared to present ISO standards.
2019(2):45-52.
DOI: 10.4103/2221-6189.254411
Abstract:
Objective: To determine and compare the diagnostic efficiency of various biomarkers [C-reactive protein, neutrophil percentage, neutrophil-lymphocyte ratio (NLCR), lactate, procalcitonin, blood culture] in the identification of septic patients in emergency department (ED), and to assess the predictive value of combination of markers. Methods: This was a prospective, single centre study conducted in the ED of an urban, tertiary care hospital. We included patients who were admitted to the ED with symptoms of a possible infection. Blood cultures and serum measurement of the biomarkers were collected from 131 patients. Patients were determined to be septic or non-septic, based on the systemic inflammatory response syndrome criteria and the diagnosis was made at the ED. Sensitivity, specificity, positive predictive value, negative predictive value and area under curves (AUC) were calculated. Results: A total of 126 patients, 61 with sepsis and 65 without sepsis were eventually included in the study. Neutrophil to lymphocyte ratio displayed the highest accuracy in diagnosing sepsis (AUC 0.735, 95% CI=0648-0.822, P<0.001). The best combination of markers in predicting sepsis was NLCR and white blood cell (AUC: 0.801, 95% CI=0.724-0.878, P<0.001). Conclusions: The results of this small study showed that NLCR outperforms other markers in diagnosing sepsis in ED. It is readily available, cost efficient, non invasive and independent. It may be insufficient to rely on this single marker to diagnose sepsis, so some other diagnostic utilities should be taken into account as one part of the overall assessment. Our study also showed that combination of NLCR and white blood cell provides the highest diagnostic accuracy. More large scale studies across different population groups will be needed to confirm this finding.
Objective: To determine and compare the diagnostic efficiency of various biomarkers [C-reactive protein, neutrophil percentage, neutrophil-lymphocyte ratio (NLCR), lactate, procalcitonin, blood culture] in the identification of septic patients in emergency department (ED), and to assess the predictive value of combination of markers. Methods: This was a prospective, single centre study conducted in the ED of an urban, tertiary care hospital. We included patients who were admitted to the ED with symptoms of a possible infection. Blood cultures and serum measurement of the biomarkers were collected from 131 patients. Patients were determined to be septic or non-septic, based on the systemic inflammatory response syndrome criteria and the diagnosis was made at the ED. Sensitivity, specificity, positive predictive value, negative predictive value and area under curves (AUC) were calculated. Results: A total of 126 patients, 61 with sepsis and 65 without sepsis were eventually included in the study. Neutrophil to lymphocyte ratio displayed the highest accuracy in diagnosing sepsis (AUC 0.735, 95% CI=0648-0.822, P<0.001). The best combination of markers in predicting sepsis was NLCR and white blood cell (AUC: 0.801, 95% CI=0.724-0.878, P<0.001). Conclusions: The results of this small study showed that NLCR outperforms other markers in diagnosing sepsis in ED. It is readily available, cost efficient, non invasive and independent. It may be insufficient to rely on this single marker to diagnose sepsis, so some other diagnostic utilities should be taken into account as one part of the overall assessment. Our study also showed that combination of NLCR and white blood cell provides the highest diagnostic accuracy. More large scale studies across different population groups will be needed to confirm this finding.
2020(2):61-66.
DOI: 10.4103/2221-6189.281319
Abstract:
Objective: To investigate the relationship between serum C-reactive protein (CRP) level and left ventricular function in patients with acute ST-elevation myocardial infarction. Methods: This study is a descriptive-analytic study and was conducted on patients with ST-elevation myocardial infarction, who were admitted to the Urmia Hospital in Seyed Alshohada Hospital, and underwent primary percutaneous coronary intervention from October to March 2018. Demographic, angiographic, echocardiographic data were evaluated based on the patients’ records. All patients were evaluated for 90 min and CRP levels were measured during the first 6 h after the primary percutaneous coronary intervention. Results: A total of 114 patients were studied, among whom 71.9% (82 patients) were male, and their mean age was (57.86±9.57) years old. The mean BMI was (26.1±3.8) kg/m2. Altogether 38.6% (44 patients) had a history of smoking, 17.5% (20 patients) of diabetes, 38.6% (44 patients) of hypertension, 5.3% (6 patients) of hyperlipidemia and 7.0% (8 patient) of coronary artery disease. The results showed a significantly negative correlation between ejection fraction and CRP, left atrial volume and CRP (P<0.05), and a significantly positive correlation between the global longitudinal strain level and CRP. The CRP level was significantly different at various diastolic grades (P=0.001). The level of CRP in patients with grade 2 diastolic dysfunction was higher than grade 1 diastolic dysfunction, while the level of CRP in diastolic grade 1 diastolic dysfunction was higher than the normal function. Conclusions: High CRP levels are associated with ejection fraction, global longitudinal strain loss and left atrial volume.
Objective: To investigate the relationship between serum C-reactive protein (CRP) level and left ventricular function in patients with acute ST-elevation myocardial infarction. Methods: This study is a descriptive-analytic study and was conducted on patients with ST-elevation myocardial infarction, who were admitted to the Urmia Hospital in Seyed Alshohada Hospital, and underwent primary percutaneous coronary intervention from October to March 2018. Demographic, angiographic, echocardiographic data were evaluated based on the patients’ records. All patients were evaluated for 90 min and CRP levels were measured during the first 6 h after the primary percutaneous coronary intervention. Results: A total of 114 patients were studied, among whom 71.9% (82 patients) were male, and their mean age was (57.86±9.57) years old. The mean BMI was (26.1±3.8) kg/m2. Altogether 38.6% (44 patients) had a history of smoking, 17.5% (20 patients) of diabetes, 38.6% (44 patients) of hypertension, 5.3% (6 patients) of hyperlipidemia and 7.0% (8 patient) of coronary artery disease. The results showed a significantly negative correlation between ejection fraction and CRP, left atrial volume and CRP (P<0.05), and a significantly positive correlation between the global longitudinal strain level and CRP. The CRP level was significantly different at various diastolic grades (P=0.001). The level of CRP in patients with grade 2 diastolic dysfunction was higher than grade 1 diastolic dysfunction, while the level of CRP in diastolic grade 1 diastolic dysfunction was higher than the normal function. Conclusions: High CRP levels are associated with ejection fraction, global longitudinal strain loss and left atrial volume.
2025(14):1-6.
DOI: 10.4103/jad.jad_94_24
Abstract:
Objective: To investigate the diagnostic value of the neutrophil/ lymphocyte ratio, which has not been studied sufficiently to determine the cause of acute gastroenteritis worldwide. Methods: The prospective, observational study included patients diagnosed with acute gastroenteritis who were treated at Dışkapı Yıldırım Beyazıt Application and Research Center, Emergency Medicine Clinic between 1 September 2020 and 31 May 2021.
Demographic characteristics, as well as neutrophil count, lymphocyte count, white blood cell count, and the neutrophil-to lymphocyte ratio, were compared across the viral, bacterial, and parasitic acute gastroenteritis groups.
Results: A total of 168 acute gastroenteritis patients, 31 of whom had parasitic, 39 bacterial and 98 viral etiologies, were included in this study. Neutrophil/lymphocyte ratio was 2.73 (4.03) in the viral acute gastroenteritis group, 4.58 (8.61) in the bacterial acute gastroenteritis group, and 4.52 (5.49) in the parasite acute gastroenteritis group. A statistically significant difference was found among the groups regarding neutrophil/lymphocyte ratio (P=0.022). However, post-hoc analysis revealed no statistically significant differences in the neutrophil-to-lymphocyte ratio among the groups (P>0.05).
Conclusions: Neutrophil/lymphocyte ratio alone cannot distinguish etiological causes in patients admitted to the Emergency Medicine Clinic diagnosed with acute gastroenteritis.
Objective: To investigate the diagnostic value of the neutrophil/ lymphocyte ratio, which has not been studied sufficiently to determine the cause of acute gastroenteritis worldwide. Methods: The prospective, observational study included patients diagnosed with acute gastroenteritis who were treated at Dışkapı Yıldırım Beyazıt Application and Research Center, Emergency Medicine Clinic between 1 September 2020 and 31 May 2021.
Demographic characteristics, as well as neutrophil count, lymphocyte count, white blood cell count, and the neutrophil-to lymphocyte ratio, were compared across the viral, bacterial, and parasitic acute gastroenteritis groups.
Results: A total of 168 acute gastroenteritis patients, 31 of whom had parasitic, 39 bacterial and 98 viral etiologies, were included in this study. Neutrophil/lymphocyte ratio was 2.73 (4.03) in the viral acute gastroenteritis group, 4.58 (8.61) in the bacterial acute gastroenteritis group, and 4.52 (5.49) in the parasite acute gastroenteritis group. A statistically significant difference was found among the groups regarding neutrophil/lymphocyte ratio (P=0.022). However, post-hoc analysis revealed no statistically significant differences in the neutrophil-to-lymphocyte ratio among the groups (P>0.05).
Conclusions: Neutrophil/lymphocyte ratio alone cannot distinguish etiological causes in patients admitted to the Emergency Medicine Clinic diagnosed with acute gastroenteritis.
2019(5):215-220.
DOI: 10.4103/2221-6189.268412
Abstract:
Rationale: Acute myocardial infarction in the presence of right bundle branch block. Patient concerns: A 70-year-old, male heavy smoker presented with angina and hypertension. Interventions: Electrocardiography, intravenous nitroglycerin infusion, intravenous streptokinase infusion. Diagnosis: Acute myocardial infarction in the presence of with changeable trifascicular heart block. Outcomes: Dramatic clinical improvement with electrocardiographic ST-segment (whether elevation or reciprocal ST-depression) resolution. Lessons: Acute myocardial infarction may be associated right bundle branch block. Accompanied trifascicular heart block had pre-streptokinase left anterior fascicular block with left axis deviation and post-streptokinase left posterior fascicular block with right axis deviation.
Rationale: Acute myocardial infarction in the presence of right bundle branch block. Patient concerns: A 70-year-old, male heavy smoker presented with angina and hypertension. Interventions: Electrocardiography, intravenous nitroglycerin infusion, intravenous streptokinase infusion. Diagnosis: Acute myocardial infarction in the presence of with changeable trifascicular heart block. Outcomes: Dramatic clinical improvement with electrocardiographic ST-segment (whether elevation or reciprocal ST-depression) resolution. Lessons: Acute myocardial infarction may be associated right bundle branch block. Accompanied trifascicular heart block had pre-streptokinase left anterior fascicular block with left axis deviation and post-streptokinase left posterior fascicular block with right axis deviation.
Luis Rafael Moscote Salazar
,
Amit Agrawal
,
Guru Dutta Satyarthee
,
Huber S. Padilla-Zambrano
,
Boris Vladimir Cabrera-Nanclares
,
Romario Mendoza-Flórez
,
Samer Hoz
,
Alexis Narvaez-Rojas
2018(3):103-107.
DOI: 10.4103/2221-6189.236823
Abstract:
Hyponatremia is a common electrolyte disturbance usually observed in neurosurgical patients undergoing surgical management of traumatic, as well as, nontraumatic intracranial pathology. The spinal cord trauma is also associated with occasional development of such hyponatremia; it usually occurs within the first two-weeks of the injury. Hyponatremia can lead to alterations of consciousness, convulsions, coma, cardiac arrhythmias and on rare occasions, death. Authors present a practical oriented review of the literature.
Hyponatremia is a common electrolyte disturbance usually observed in neurosurgical patients undergoing surgical management of traumatic, as well as, nontraumatic intracranial pathology. The spinal cord trauma is also associated with occasional development of such hyponatremia; it usually occurs within the first two-weeks of the injury. Hyponatremia can lead to alterations of consciousness, convulsions, coma, cardiac arrhythmias and on rare occasions, death. Authors present a practical oriented review of the literature.
2018(2):90-92.
DOI: 10.4103/2221-6189.233019
Abstract:
Acute renal failure is an important acute renal disease. It is the totally acute impairment of the renal function and can be fatal if there is no proper and timely treatment. There are various causes of acute renal failure. The acute renal failure might be due to contact with nephrotoxic substance. The food borne acute renal failure is an important problem that is sporadically seen worldwide. Of several food borne acute renal failure disorders, the fish borne acute renal failure is an important problem. In this specific short review, the authors summarize and discuss the cases on important fish borne acute renal failure disorders.
Acute renal failure is an important acute renal disease. It is the totally acute impairment of the renal function and can be fatal if there is no proper and timely treatment. There are various causes of acute renal failure. The acute renal failure might be due to contact with nephrotoxic substance. The food borne acute renal failure is an important problem that is sporadically seen worldwide. Of several food borne acute renal failure disorders, the fish borne acute renal failure is an important problem. In this specific short review, the authors summarize and discuss the cases on important fish borne acute renal failure disorders.
Miaad K. Alkhudhairy
,
Morteza Saki
,
Sakineh Seyed-Mohammadi
,
Nabi Jomehzadeh
,
Saeed Khoshnood
,
Mina Moradzadeh
,
Sajjad Yazdansetad
2019(3):113-117.
DOI: 10.4103/2221-6189.259110
Abstract:
Objective: To investigate the frequency of integrase genes intI1, intI2 and intI3 of Escherichia coli strains, and their association with resistance to routinely used antibiotics. Methods: A total of 120 Escherichia coli strains were collected from patients with urinary tract infection in Ahvaz, Southwest of Iran. Antibiotic susceptibility testing was performed. The presence of intI1, intI2, andintI3 genes was determined by polymerase chain reaction. Results: Antibiotic susceptibility testing disclosed the highest resistance rate to ampicillin (91.7%) followed by trimethoprim/sulfamethoxazole (65.8%), and ceftazidime (56.7%). The imipenem susceptibility rate was 91.7%. IntI1 and intI2 were identified in 74 (61.6%) and 8 (6.6%) of Escherichia coli strains, respectively, but intI3 was not found in any isolates. The presence of integrons was significantly associated with resistance to ampicillin, trimethoprim/ sulfamethoxazole, ceftazidime, and ciprofloxacin antibiotics (P<0.05). Conclusions: The high resistant Escherichia coli isolates harboring class 1 integrons (intI1) were detected in patients with urinary tract infection in our region. Therefore, preventive strategies are necessary to restrict further dissemination of resistant strains.
Objective: To investigate the frequency of integrase genes intI1, intI2 and intI3 of Escherichia coli strains, and their association with resistance to routinely used antibiotics. Methods: A total of 120 Escherichia coli strains were collected from patients with urinary tract infection in Ahvaz, Southwest of Iran. Antibiotic susceptibility testing was performed. The presence of intI1, intI2, andintI3 genes was determined by polymerase chain reaction. Results: Antibiotic susceptibility testing disclosed the highest resistance rate to ampicillin (91.7%) followed by trimethoprim/sulfamethoxazole (65.8%), and ceftazidime (56.7%). The imipenem susceptibility rate was 91.7%. IntI1 and intI2 were identified in 74 (61.6%) and 8 (6.6%) of Escherichia coli strains, respectively, but intI3 was not found in any isolates. The presence of integrons was significantly associated with resistance to ampicillin, trimethoprim/ sulfamethoxazole, ceftazidime, and ciprofloxacin antibiotics (P<0.05). Conclusions: The high resistant Escherichia coli isolates harboring class 1 integrons (intI1) were detected in patients with urinary tract infection in our region. Therefore, preventive strategies are necessary to restrict further dissemination of resistant strains.
2018(1):45-48.
DOI: 10.4103/2221-6189.228878
Abstract:
Hemoptysis is a common emergency symptom for pulmonary embolism. It's important to differential diagnosis for this symptom. This article reports a case of pulmonary vein stenosis. The patient was transferred to a number of hospitals for medical treatment, but was misdiagnosed for 7 months. This article aims to improve clinician's ability to differentially diagnose hemoptysis, and to deepen the knowledge of pulmonary vein stenosis.
Hemoptysis is a common emergency symptom for pulmonary embolism. It's important to differential diagnosis for this symptom. This article reports a case of pulmonary vein stenosis. The patient was transferred to a number of hospitals for medical treatment, but was misdiagnosed for 7 months. This article aims to improve clinician's ability to differentially diagnose hemoptysis, and to deepen the knowledge of pulmonary vein stenosis.
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