scholarly journals A prospective evaluation of correlation between cholinesterase level and severity of organophosphorus poisoning

2020 ◽  
Vol 7 (2) ◽  
pp. 276
Author(s):  
M. Deepak Phanindra ◽  
P. V. V. Satyanarayana ◽  
Anand Acharya
Keyword(s):  
Severity Score ◽  
Standard Treatment ◽  
Organophosphorus Compounds ◽  
Treatment Protocol ◽  
Serum Cholinesterase ◽  
Inclusion Criteria ◽  
High Severity ◽  
Organophosphorus Poisoning ◽  
History Of ◽  
High Severity Score

Background: Organophosphorus compounds are anticholinesterases by inhibiting cholinesterase it protects acetyl chorine from hydrolysis. So, acetylcholine accumulates at the synapses, and all the clinical manifestation are due to that. So, this study has been designed to establish the reactive between level of serum and prognosis of op poisoning patients.Methods: Patient with history of organophosphorus poisoning admitted into the emergency department with following exclusion and inclusion criteria were included in this study. All patients were managed as per standard treatment protocol of op poisoning. Various parameters like demography of the patients, sign and symptoms, severity of intoxication, clinical and lab parameter manoring, Serum cholinesterase was measured every alternate day.Results: 22(47.84%) patients have mild symptom out of that 20 patient’s serum cholinesterase was more than 2000 IU/L, and 2(4.3%) patients serum cholinesterase was between 1000-2000 IU/L. In eighteen patient’s severity as per POP scale was moderate, out of that 2(4.3%) patients have serum cholinesterase was below 1000 IU/L, 8 having serum cholinesterase between 1000 to 2000 IU/L, and remaining eight having serum cholinesterase above 2000 IU/L.Conclusions: Serum cholinesterase was less in patient with high severity score or low serum concentration of cholinesterase was associated with high severity score. Serum cholinesterase was improved as days passes.

scholarly journals A study to assess the utility of poison severity score, pseudocholinesterase levels and Glasgow coma scale in predicting severity and clinical outcome of organophosphorus poisoning

2021 ◽  
Author(s):  
Nitin Bhat ◽  
Ramachandra Prabhu H. D. ◽  
Adarsha Gopadi Krishna Bhat
Keyword(s):  
Glasgow Coma Scale ◽  
Severity Score ◽  
Early Stage ◽  
Research Centre ◽  
Clinical Prognosis ◽  
Coma Scale ◽  
Organophosphorus Poisoning ◽  
History Of ◽  
Poisoning Severity Score ◽  
A Prospective Study

Background: Suicides due to organophosphate self-poisoning is a major cause of concern world over. Organophosphate compounds (OP) possess a major cause of suicide in India.  There is a greater need for tools to predict severity of OP poisoning. We in this study try to assess the utility of the Glasgow coma scale (GCS), pseudocholinesterase levels and the poisoning severity score (PSS) in estimating severity and clinical prognosis of OP poisoning in patients of south India.Methods: A prospective study was conducted over 2 years in department of medicine, KIMS hospital and research centre, patients who were >18 years of age were included. OP poisoning was determined by either history of consumption or clinical features. Pseudocholinesterase levels at admission, PPS and GCS scores were assessed at admission and at 24 hours. Clinical, demographical, and certain laboratory investigation were recorded. Patients were followed till the patient stayed in intensive care unit.Results: In present study 100 patients were enrolled. Significant association was observed between GCS (p<0.001), PSS (p<0.001) and outcome of OP poisoning. Unexpectedly no significant association was observed with pseudocholinesterase level (p=0.118). A total of 83% patients were improved after treatment and mortality rate observed was 17%. Out of these 83% severe complications were observed in 14% of the patients.Conclusions: The findings of this study highlight the usefulness of GCS and PSS systems for predicting severity of OP poisoning. Identification of severity at an early stage followed by prompt treatment can prevent deaths. Our study did not find any association between pseudocholinesterase levels at admission and severity of OP poisoning.

scholarly journals Creatinephosphokinase in organophosphorus poisoning

2017 ◽  
Vol 4 (6) ◽  
pp. 1537
Author(s):  
Amith Kumar ◽  
Virupakshappa V.
Keyword(s):  
Organophosphorus Compounds ◽  
Developed Countries ◽  
Serum Cholinesterase ◽  
Medical Sciences ◽  
Phosphorus Poisoning ◽  
Serum Creatine Phosphokinase ◽  
Organophosphorus Poisoning ◽  
Butyryl Cholinesterase ◽  
Serial Measurements ◽  
Comprehensive History

Background: Organophosphorus Poisoning has been found to be a major cause of death or morbidity in our country as it freely available without need of prescription unlike in developed countries where prescription is required to purchase insecticides, the various organophosphorus compounds available are Malathion, parathion, diazinon, fenthion, dichlorvos, chlorpyrifos, ethion. Erythrocyte cholinesterase (EchE) and pseudocholinesterase (Butyryl cholinesterase-BchE) are markers used for assessing the severity in OP poisoning, but estimation of these are costly, has variable values for different individuals and is not available at all centers. This study was done to estimate levels of serum Creatine Phosphokinase (CPK)serially in acute OP poisoning patients and to correlate with prognosis.Methods: 50 patients of organophosphorus poisoning admitted to Mcgann hospital attached to Shimoga institute of medical sciences Shimoga over a period of 6 months from 1st July 2016 to 31st December 2016 were taken up for the study. A comprehensive history and detailed clinical examination was performed and patients were clinically evaluated for severity. Level of serum cholinesterase and serum CPK were estimated at admission and CPK level was measured on day 3 and day 5. The outcome of these patients was evaluated.Results: Out of 50 patients, 78% (n=39) were males and 22% (n=11) were females. Majority of patients were in the age group 21 – 40 years. Chlorpyrifos was the most common compound used. 72% had mild, 20% had moderate and 8% had severe poisoning. Serial measurements of serum CPK levels showed significant correlation with the severity of acute OP poisoning patients. The CPK levels showed a sensitivity of 74% and a specificity of 81% with a positive predictive value of 92%.Conclusions: Severe organo phosphorus poisoning is correlated with CPK levels. This study recommends CPK level estimation in assessment of severity and prognosticate patients with organophosphorus compound as alternate marker to choline esterase.  

scholarly journals Correlation between the initial CT chest findings and short-term prognosis in Egyptian patients with COVID-19 pneumonia

2022 ◽  
Vol 53 (1) ◽  
Author(s):  
Mohamed Mohamed Hefeda ◽  
Dalia Ezzat Elsharawy ◽  
Tamer Mahmoud Dawoud
Keyword(s):  
Severity Score ◽  
Poor Prognosis ◽  
Good Prognosis ◽  
Short Term ◽  
High Severity ◽  
Halo Sign ◽  
The Mean ◽  
Ct Finding ◽  
High Severity Score ◽  
Patients With Poor Prognosis

Abstract Background The recent pandemic of COVID‐19 has thrown the world into chaos due to its high rate of transmissions. This study aimed to highlight the encountered CT findings in 910 patients with COVID-19 pneumonia in Egypt including the mean severity score and also correlation between the initial CT finding and the short-term prognosis in 320 patients. Results All patients had confirmed COVID-19 infection. Non-contrast CT chest was performed for all cases; in addition, the correlation between each CT finding and disease severity or the short-term prognosis was reported. The mean age was higher for patients with unfavorable prognosis (P < 0.01). The patchy pattern was the most common, found in 532/910 patients (58.4%), the nodular pattern was the least common 123/910 (13.5%). The diffuse pattern was reported in 124 (13.6%). The ground glass density was the most common reported density in the study 512/910 (56.2%). The crazy pavement sign was reported more frequently in patients required hospitalization or ICU and was reported in 53 (56.9%) of patients required hospitalization and in 29 (40.2%) patients needed ICU, and it was reported in 11 (39.2%) deceased patients. Air bronchogram was reported more frequently in patients with poor prognosis than patients with good prognosis (16/100; 26% Vs 12/220; 5.4%). The mean CT severity score for patients with poor prognosis was 15.2. The mean CT severity score for patients with good prognosis 8.7., with statistically significant difference (P = 0.001). Conclusion Our results confirm the important role of the initial CT findings in the prediction of clinical outcome and short-term prognosis. Some signs like subpleural lines, halo sign, reversed halo sign and nodular shape of the lesions predict mild disease and favorable prognosis. The crazy paving sign, dense vessel sign, consolidation, diffuse shape and high severity score predict more severe disease and probably warrant early hospitalization. The high severity score is most important in prediction of unfavorable prognosis. The nodular shape of the lesions is the most important predictor of good prognosis.

Acute encephalopathy followed by delayed myelopathy: A rare presentation of organophosphate poisoning

2020 ◽  
Vol 50 (2) ◽  
pp. 162-164
Author(s):  
Ayush Agarwal ◽  
Divyani Garg ◽  
Vinay Goyal ◽  
Vishnu VY ◽  
Mamta Bhushan Singh ◽  
...  
Keyword(s):  
Organophosphorus Compounds ◽  
Previous History ◽  
Spastic Paraparesis ◽  
Organophosphate Poisoning ◽  
Acute Encephalopathy ◽  
Rare Presentation ◽  
Clinical Syndromes ◽  
Organophosphorus Poisoning ◽  
History Of ◽  
Pure Motor

Organophosphorus compounds (OPC) are commonly used pesticides and suicidal ingestion is a common mode of poisoning. The manifestation of OPC poisoning and its severity depend upon the type, dose and potency of the OPC consumed. Neurological presentations are well defined clinical syndromes consisting of early, intermediate and delayed manifestations (rare), categorised on the basis of time elapsed since OPC exposure. We report a rare delayed manifestation of organophosphorus poisoning in the form of pure motor spastic paraparesis due to dorsal myelopathy. A possibility of delayed manifestations of toxicity should be considered in individuals presenting with features suggestive of myelopathy and a previous history of organophosphate exposure.

scholarly journals The association of triglyceride levels with the incidence of initial and recurrent acute pancreatitis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Robert J. Sanchez ◽  
Wenzhen Ge ◽  
Wenhui Wei ◽  
Manish P. Ponda ◽  
Robert S. Rosenson
Keyword(s):  
Acute Pancreatitis ◽  
Medical Records ◽  
Adult Population ◽  
Baseline Period ◽  
Prior History ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
Recurrent Acute Pancreatitis ◽  
History Of ◽  
Nationally Representative

Abstract Background This retrospective cohort study assessed the annualized incidence rate (IR) of acute pancreatitis (AP) in a nationally representative US adult population, as well as the variation in the risk of AP events across strata of triglyceride (TG) levels. Methods Data were obtained from IQVIA’s US Ambulatory Electronic Medical Records (EMR) database linked with its LRxDx Open Claims database. Inclusion criteria included ≥1 serum TG value during the overlapping study period of the EMR and claims databases, ≥1 claim in the 12-month baseline period, and ≥ 1 claim in the 12 months post index. All TG measurements were assigned to the highest category reached: < 2.26, ≥2.26 to ≤5.65, > 5.65 to ≤9.94, > 9.94, and > 11.29 mmol/L (< 200, ≥200 to ≤500, > 500 to ≤880, > 880, and > 1000 mg/dL, respectively). The outcome of interest was AP, defined as a hospitalization event with AP as the principal diagnosis. Results In total, 7,119,195 patients met the inclusion/exclusion criteria, of whom 4158 (0.058%) had ≥1 AP events in the prior 12 months. Most patients (83%) had TGs < 2.26 mmol/L (< 200 mg/dL), while < 1% had TGs > 9.94 mmol/L (> 880 mg/dL). Overall, the IR of AP was low (0.08%; 95% confidence internal [CI], 0.08–0.08%), but increased with increasing TGs (0.08% in TGs < 2.26 mmol/L [< 200 mg/dL] to 1.21% in TGs > 11.29 mmol/L [> 1000 mg/dL]). In patients with a prior history of AP, the IR of AP increased dramatically; patients with ≥2 AP events at baseline had an IR of 29.98% (95% CI, 25.1–34.9%). Conclusion The risk of AP increases with increasing TG strata; however, the risk increases dramatically among patients with a recent history of AP.

scholarly journals The natural history of Canavan disease: 23 new cases and comparison with patients from literature

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Annette Bley ◽  
Jonas Denecke ◽  
Alfried Kohlschütter ◽  
Gerhard Schön ◽  
Sandra Hischke ◽  
...  
Keyword(s):  
Severity Score ◽  
Canavan Disease ◽  
Psychomotor Development ◽  
Rank Test ◽  
First Year ◽  
Study Cohort ◽  
Pooled Data ◽  
Kaplan Meier ◽  
History Of ◽  
First Year Of Life

Abstract Background Canavan disease (CD, MIM # 271900) is a rare and devastating leukodystrophy of early childhood. To identify clinical features that could serve as endpoints for treatment trials, the clinical course of CD was studied retrospectively and prospectively in 23 CD patients. Results were compared with data of CD patients reported in three prior large series. Kaplan Meier survival analysis including log rank test was performed for pooled data of 82 CD patients (study cohort and literature patients). Results Onset of symptoms was between 0 and 6 months. Psychomotor development of patients was limited to abilities that are usually gained within the first year of life. Macrocephaly became apparent between 4 and 18 months of age. Seizure frequency was highest towards the end of the first decade. Ethnic background was more diverse than in studies previously reported. A CD severity score with assessment of 11 symptoms and abilities was developed. Conclusions Early hallmarks of CD are severe psychomotor disability and macrocephaly that develop within the first 18 months of life. While rare in the first year of life, seizures increase in frequency over time in most patients. CD occurs more frequently outside Ashkenazi Jewish communities than previously reported. Concordance of phenotypes between siblings but not patients with identical ASPA mutations suggest the influence of yet unknown modifiers. A CD severity score may allow for assessment of CD disease severity both retrospectively and prospectively.

scholarly journals Emotion Recognition in Adults With a History of Childhood Maltreatment: A Systematic Review

2021 ◽  
pp. 152483802110294
Author(s):  
Annie Bérubé ◽  
Jessica Turgeon ◽  
Caroline Blais ◽  
Daniel Fiset
Keyword(s):  
Systematic Review ◽  
Child Maltreatment ◽  
Emotion Recognition ◽  
Childhood Maltreatment ◽  
Mental Health Problems ◽  
Inclusion Criteria ◽  
History Of Childhood ◽  
History Of ◽  
Effects On Children ◽  
Meta Analyses

Child maltreatment has many well-documented lasting effects on children. Among its consequences, it affects children’s recognition of emotions. More and more studies are recognizing the lasting effect that a history of maltreatment can have on emotion recognition. A systematic literature review was conducted to better understand this relationship. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol was used and four databases were searched, MEDLINE/PubMed, PsycINFO, EMBASE, and FRANCIS, using three cross-referenced key words: child abuse, emotion recognition, and adults. The search process identified 23 studies that met the inclusion criteria. The review highlights the wide variety of measures used to assess child maltreatment as well as the different protocols used to measure emotion recognition. The results indicate that adults with a history of childhood maltreatment show a differentiated reaction to happiness, anger, and fear. Happiness is less detected, whereas negative emotions are recognized more rapidly and at a lower intensity compared to adults not exposed to such traumatic events. Emotion recognition is also related to greater brain activation for the maltreated group. However, the results are less consistent for adults who also have a diagnosis of mental health problems. The systematic review found that maltreatment affects the perception of emotions expressed on both adult and child faces. However, more research is needed to better understand how a history of maltreatment is related to adults’ perception of children’s emotions.

ROLE OF VITAMIN D IN COVID VACCINE EFFICACY IN ELDERLY IN INDIAN POPULATION

2021 ◽  
pp. 55-56
Author(s):  
Gujjarlapudi Deepika ◽  
Duvuru Nageshwar Reddy
Keyword(s):  
Older Adults ◽  
Vitamin D ◽  
Immune Response ◽  
Indian Population ◽  
Integrated Approach ◽  
Inclusion Criteria ◽  
Vitamin D Levels ◽  
History Of ◽  
Study Inclusion

Background: Aim of this study is to summarise the role of Vitamin D in supporting the immune system,in covid vaccinated recipients. This is a observational study done between April 2021 t Methods: o June 2021 in Indian population. We compared anti-SARS-CoV-2 spike RBDIgG antibody & antispike antibodies following vaccination of non-hospitalized participants along with vitamin D levels in recipients above 60 years. They were tested after vaccination after two doses between 15-45 days. Before study inclusion criteria is, we have checked whether they were as seropositive or seronegative based on nucleocapsid total antibody results. of 310 Results vaccine recipients, 46 reported a prior COVID-19 diagnosis and we have excluded them from the study of the 264 with no history of Covid-19, 70 were vitamin d decient (50M;20 F) & 194 (130 M:64 F) were vitamin d Sufcient. Responses were evaluated after two doses on an average post-vaccine RBD IgG concentration and Spike antibodies were each signicantly higher among the Vit d sufcient recipients compared to the vitamin D Decient recipients. An integrated approach is required to bett Conclusions: er understand aging and how vaccines work in elderly which will help in improving the immune response in older adults after vaccination.

scholarly journals Effectiveness of non-invasive ventilation in acute respiratory failure of obese patients: a brief narrative review

2018 ◽  
Vol 12 (1) ◽  
pp. 5
Author(s):  
Maurizio Alessandro Cavalleri ◽  
Elena Barbagelata ◽  
Marco Scudeletti ◽  
Antonello Nicolini
Keyword(s):  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Obese Patients ◽  
Invasive Ventilation ◽  
Acute Setting ◽  
Non Invasive ◽  
High Severity ◽  
Non Invasive Ventilation ◽  
Hypoventilation Syndrome ◽  
High Severity Score

Non-invasive ventilation (NIV) has been used successfully for the management of acute respiratory failure (ARF) more often in the last two decades compared to prior decades; nevertheless, NIV can have failure rates ranging from 5% to 50%. However, there are particular groups of patients that are more likely to benefit from NIV. One of these groups is patients with hypoventilation syndrome (OHS). The aim of this review is to seek evaluation of the effectiveness of NIV in acute setting. Only a few studies have investigated NIV success or failure in OHS patients. More than 30% of them were diagnosed when hospitalized for ARF. NIV rarely failed in reversing ARF. OHS patients who exhibited early NIV failure had a high severity score and a low HCO3 level at admission; more than half of hypercapnic patients with decompensated OHS exhibited a delayed but successful response to NIV. Patients with decompensation of OHS have a better prognosis and response to NIV than other hypercapnic patients. They require more aggressive NIV settings, a longer time to reduce PaCO2 levels, and more frequently a delayed but successful response to NIV.

scholarly journals THE MISSING LINK IN THE HISTORY OF THE LOCKED INTRAMEDULLARY NAIL

2021 ◽  
Vol 29 (4) ◽  
pp. 228-231
Author(s):  
FLÁVIO PIRES DE CAMARGO ◽  
GUILHERME PELOSINI GAIARSA ◽  
OLAVO PIRES DE CAMARGO ◽  
PAULO ROBERTO DOS REIS ◽  
JORGE DOS SANTOS SILVA ◽  
...  
Keyword(s):  
Standard Treatment ◽  
Femoral Shaft ◽  
Reference Level ◽  
Intramedullary Nails ◽  
Level Of Evidence ◽  
Femoral Shaft Fractures ◽  
Interlocking Nail ◽  
Major Development ◽  
The World ◽  
History Of

ABSTRACT Femoral Shaft intramedullary nails were first described by the Aztecs in 16th century, but the modern use of intramedullary nails as the gold standard treatment for femoral shaft fractures began with Gerald Kuntcher in 1939. From the first Kuntcher’s study in 1939, to the creation of interlocking nail, a long and some minor developments were described around the world. However, a major development is missing: the first nail to have a rotational and vertical stability locking system was described by Flavio Godoy Moreira, but was never published on an indexed journal for the correct historical reference. Level of Evidence V, Therapeutics Studies, Expert Opinion.

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