scholarly journals A STUDY OF HYPOKALEMIA IN ORGANOPHOSPHORUS POISONING IN DAHOD GUJARAT

2021 ◽  
pp. 37-38
Author(s):  
Mohit Desai ◽  
Brajendra kumar

Organophosphorus compounds (OPCs) are common pesticides used in agriculture in India. In this study, totally 24 patients had hypokalemia. Of 39 male patients,20 patients (51.3%) had hypokalemia. Of 11 female patients, 4 patients(36.4%)had hypokalemia. Of 50 patients totally, 14 had hyponatremia(<135 meq/dl) which constitutes 28%. Of this 6 patients had hypokalemia which accounts for 42.9%of hyponatremia.Of 24 patients with hypokalemia this 6 cases of hyponatremia accounts for 25%. Hypokalemia increases both morbidity and mortality in organophosphorus compound poisoning significantly.Hypokalemia can be used as a reliable and a cost effective marker of morbidity and mortality in organophosphorus compound poisoning

Author(s):  
MADHURI KULKARNI ◽  
ANANT PATIL

Objective: The objective of this study was to analyze demographics, management pattern, and clinical outcomes in patients with organophosphorus poisoning. Methods: In this subgroup analysis of retrospective data of patients admitted in intensive care unit (ICU) with a diagnosis of acute organophosphorus poisoning, demographic details, pattern of use of medicines, dose of atropine and pralidoxime (PRAM), duration of ICU stay, and clinical outcomes were analyzed. Results: A total of 92 patients with organophosphorus poisoning (mean age 34.7 years; male 69 [75%]) were included. The age of male patients was more than female patients (36.2 vs. 30.0 years; p=0.047). Atropine and PRAM were given to all patients. Ondansetron was used in all patients, whereas ranitidine was used in 91 (98.9%) patients. The mean total dose of atropine in male and female population was 99.5 mg and 89.0 mg, respectively (p=0.298). The mean total dose of PRAM in male and female population was 12.2 mg and 12.0 mg, respectively (p=0.772). There was no difference in the mean (standard deviation) duration of stay in ICU between male patients and female patients (7.6 [4.5] vs. 6.4 [3.9] days; p=0.249). A total of 61 (66.3%) patients were transferred to the ward, whereas 30 (32.6%) died. Conclusion: Atropine and PRAM are the primary drugs for the treatment of organophosphorus poisoning. Ondansetron and ranitidine are useful drugs for the treatment of vomiting and gastric irritation, respectively, in these patients.


e-CliniC ◽  
2013 ◽  
Vol 1 (2) ◽  
Author(s):  
Ariesta Zubiah Ramadhini ◽  
L. S. Angliadi ◽  
Engeline Angliadi

Abstract: Stroke may cause a serious problem that leads to a disability or even mortality. The purpose is to determine such an incidence caused by hypertension at the Installation of Medical Rehabilitation RSUP Prof. dr. R. D. Kandou Manado based on the characteristic of age, gender and occupation. This research was taken at the Installation of Medical Rehabilitation RSUP Prof. R. D. Kandou Manado by using retrospective descriptive study method as well as examining 228 new cases of stroke patients that correlated with conclusion criteria. The result showed 8,3% patients at ≤44th years old, 33,3% patients at 45th – 54th years old, 32% patients at 55th – 64th years old, 20,25% patients at 65th – 74th years old, 6,1% patients at 75th – 84th years old. 53,1% male patients, 46,9% female patients. 33,3% retirement, 18% farmers, 18% government officers, 5,3% private employees, 2,2% drivers, 0,9% teachers and, 3,1% housewives. Keywords: incidence, hypertension, stroke   Abstrak: Stroke dapat menimbulkan masalah besar karena menyebabkan kecacatan dan kematian. Tujuan, mengetahui gambaran angka kejadian stroke akibat hipertensi di Instalasi Rehabilitasi Medik RSUP Prof. Dr. R. D. Kandou Manado sesuai dengan karakteristik umur, jenis kelamin, dan jenis pekerjaan. Penelitian dilakukan di Instalasi Rehabilitasi Medik BLU RSUP Prof. dr. R. D. Kandou Manado, dilakukan secara retrospektif deskriptif dan didapatkan sampel sebanyak 228 data pasien kunjungan baru kasus stroke sesuai kriteria inklusi yang ditetapkan. Hasil penelitian, pasien stroke berumur ≤44 tahun 8,3%, berumur 45 – 54 tahun 33,3%, berumur 55 – 64 tahun 32%, berumur 65 – 74 tahun 20,25%, berumur 75 – 84 tahun 6,1%. Pasien stroke berjenis kelamin laki – laki 53,1%, perempuan 46,9%. Pasien stroke yang berstatus pekerjaan pensiunan 33,3%, petani 18%, PNS 18%, pegawai swasta 5,3%, supir 2,2%, guru 0,9%, IRT 3,1%. Kata Kunci: gambaran angka kejadian, hipertensi, stroke


2021 ◽  
Vol 9 (5) ◽  
pp. 232596712110064
Author(s):  
Matthew L. Vopat ◽  
Reed G. Coda ◽  
Nick E. Giusti ◽  
Jordan Baker ◽  
Armin Tarakemeh ◽  
...  

Background: The glenohumeral joint is one of the most frequently dislocated joints in the body, particularly in young, active adults. Purpose: To conduct a systematic review and meta-analysis to evaluate and compare outcomes between anterior versus posterior shoulder instability. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was performed using the PubMed, Cochrane Library, and MEDLINE databases (from inception to September 2019) according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were included if they were published in the English language, contained outcomes after anterior or posterior shoulder instability, had at least 1 year of follow-up, and included arthroscopic soft tissue labral repair of either anterior or posterior instability. Outcomes including return-to-sport (RTS) rate, postoperative instability rate, and pre- and postoperative American Shoulder and Elbow Surgeons (ASES) scores were recorded and analyzed. Results: Overall, 39 studies were included (2077 patients; 1716 male patients and 361 female patients). Patients with anterior instability had a mean age of 23.45 ± 5.40 years (range, 11-72 years), while patients with posterior instability had a mean age of 23.08 ± 8.41 years (range, 13-61 years). The percentage of male patients with anterior instability was significantly higher than that of female patients (odds ratio [OR], 1.36; 95% CI, 1.04-1.77; P = .021). Compared with patients with posterior instability, those with anterior instability were significantly more likely to RTS (OR, 2.31; 95% CI, 1.76-3.04; P < .001), and they were significantly more likely to have postoperative instability (OR, 1.53; 95% CI, 1.07-2.23; P = .018). Patients with anterior instability also had significantly higher ASES scores than those with posterior instability (difference in means, 6.74; 95% CI, 4.71-8.77; P < .001). There were no significant differences found in postoperative complications between the anterior group (11 complications; 1.8%) and the posterior group (3 complications; 1.6%) (OR, 1.12; 95% CI, 0.29-6.30; P = .999). Conclusion: Patients with anterior shoulder instability had higher RTS rates but were more likely to have postoperative instability compared with posterior instability patients. Overall, male patients were significantly more likely to have anterior shoulder instability, while female patients were significantly more likely to have posterior shoulder instability.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fares Qeadan ◽  
Nana A. Mensah ◽  
Benjamin Tingey ◽  
Joseph B. Stanford

Abstract Background Pregnant women are potentially a high-risk population during infectious disease outbreaks such as COVID-19, because of physiologic immune suppression in pregnancy. However, data on the morbidity and mortality of COVID-19 among pregnant women, compared to nonpregnant women, are sparse and inconclusive. We sought to assess the impact of pregnancy on COVID-19 associated morbidity and mortality, with particular attention to the impact of pre-existing comorbidity. Methods We used retrospective data from January through June 2020 on female patients aged 18–44 years old utilizing the Cerner COVID-19 de-identified cohort. We used mixed-effects logistic and exponential regression models to evaluate the risk of hospitalization, maximum hospital length of stay (LOS), moderate ventilation, invasive ventilation, and death for pregnant women while adjusting for age, race/ethnicity, insurance, Elixhauser AHRQ weighted Comorbidity Index, diabetes history, medication, and accounting for clustering of results in similar zip-code regions. Results Out of 22,493 female patients with associated COVID-19, 7.2% (n = 1609) were pregnant. Crude results indicate that pregnant women, compared to non-pregnant women, had higher rates of hospitalization (60.5% vs. 17.0%, P < 0.001), higher mean maximum LOS (0.15 day vs. 0.08 day, P < 0.001) among those who stayed < 1 day, lower mean maximum LOS (2.55 days vs. 3.32 days, P < 0.001) among those who stayed ≥1 day, and higher moderate ventilation use (1.7% vs. 0.7%, P < 0.001) but showed no significant differences in rates of invasive ventilation or death. After adjusting for potentially confounding variables, pregnant women, compared to non-pregnant women, saw higher odds in hospitalization (aOR: 12.26; 95% CI (10.69, 14.06)), moderate ventilation (aOR: 2.35; 95% CI (1.48, 3.74)), higher maximum LOS among those who stayed < 1 day, and lower maximum LOS among those who stayed ≥1 day. No significant associations were found with invasive ventilation or death. For moderate ventilation, differences were seen among age and race/ethnicity groups. Conclusions Among women with COVID-19 disease, pregnancy confers substantial additional risk of morbidity, but no difference in mortality. Knowing these variabilities in the risk is essential to inform decision-makers and guide clinical recommendations for the management of COVID-19 in pregnant women.


1993 ◽  
Vol 4 (4) ◽  
pp. 226-231 ◽  
Author(s):  
M Reynolds ◽  
M Murphy ◽  
M A Waugh ◽  
C J N Lacey

An audit of the treatment of patients (100 men and 90 women) presenting with a first episode of anogenital warts to the Genitourinary Medicine Department at Leeds General Infirmary was performed. Treatment of patients was monitored for a period of 6 months from the time of presentation. The management of patients with genital warts lacked a clearly defined strategy and treatment was unselective and poorly monitored. Excluding patients who defaulted, at follow-up 44 (44%) men and 36 (38%) women still had genital warts at 3 months. Of those patients clear of warts at 3 months, the mean time to remission for men and women was 7.1 and 8.3 weeks respectively. Podophyllin 25% in tincture of benzoin was by far the predominant therapeutic modality used. A total of 96 (96%) men and 76 (84%) women received treatment with podophyllin. Both male and female patients had a mean of 5 treatments with podophyllin 25% (range 1–19 and 1–12 respectively). Physical methods of treatment i.e. cryotherapy and electrocautery, were underutilized, both as primary therapies and when topical agents had failed. Patients saw an average of 3 (range 1–7) doctors over the course of their treatment. Patients with warts affecting 2 or more sites, male patients with anal/perianal warts, and female patients with cervical and vaginal warts had higher failure rates from treatment at 3 months. On the basis of these findings, specific treatment protocols for the management of anogenital warts have been devised.


2020 ◽  
Author(s):  
Guner Cakmak ◽  
Baris Mantoglu ◽  
Emre Gonullu ◽  
Kayhan Ozdemir ◽  
Burak Kamburoglu

Abstract Background: The objective of this study was to retrospectively compare clinical features and prognostic values between the patients who were referred to the general surgery clinic of our hospital with the presumed diagnosis of acute appendicitis and underwent positive or negative appendectomy.Methods: Patients were divided into two groups as positive (PA) (n:362) and negative appendectomy (NA) (n:284) and the data obtained were compared between these two groups.Laboratory investigations were performed in all patients, and white blood cell (WBC), mean platelet volume (MPV), neutrophils count (NEU), neutrophils (%) (NEU%), C-reactive protein (CRP) and total bilirubin (TBIL) values were studied.Results: The mean MPV value was found as 7.88 fl in PA groups and 8.09 fl in NA group, and the mean MPV value was not statistically significantly difference in PA group, compared to NA groups (p=0.012). Laboratory parameters were also compared between genders. Accordingly, the mean MPV value was statistically significantly higher in female patients compared to male patients in PA group (p = 0.04). The mean TBIL value was 0.97 mg/dl in PA group and 0.69 mg/dl in NA group, and the mean TBIL value was statistically significantly higher in PA group (p< 0.001). Finally, TBIL value was statistically significantly lower in female patients compared to male patients in NA and PA group (p < 0.05).Conclusions: According to the results of our study, MPV and T. BIL values differ in PA and NA groups depending on gender. Therefore, these values may not be used as specific biomarkers in predicting positive acute appendicitis. We believe that these results will contribute to the literature and will be guiding for future studies.


2021 ◽  
Vol 9 (Suppl 3) ◽  
pp. A96-A96
Author(s):  
Mariam Saad ◽  
Aik Choon Tan ◽  
Issam El Naqa ◽  
Sandra Lee ◽  
F Stephen Hodi ◽  
...  

BackgroundSex differences in tumor immunity and response to immunotherapy were shown in murine models and descriptive analyses from recent clinical trials. We recently reported that female gender is a favorable prognostic marker for survival benefit following ipilimumab and high dose interferon-alfa (HDI) adjuvant therapy of high-risk melanoma in the ECOG-ACRIN E1609 trial (N=1670). Therefore, we investigated differences in candidate immune biomarkers in the circulation and tumor microenvironment (TME) of female and male patients.MethodsGene expression profiling (GEP) was performed on the tumor biopsies of 718 (454 male, 264 female) patients. The primary endpoint was mRNA expression profiling using U133A 2.0 Affymetrix gene chips. Raw microarray data sets were normalized by using the Robust Multi-array Average (RMA) method using Affymetrix Power Tools (APT) as previously published. Multiple probe sets representing the same genes were collapsed by using the probe with maximum gene expression. Gene set enrichment analysis (GSEA) was performed by comparing the female and male tumor samples, and gene sets with FDR q-value <0.1 were deemed as significant. Similarly, peripheral blood (serum and PBMC) samples were tested for soluble (Luminex) and cellular (multicolor flow cytometry) prognostic biomarkers in a subset of patients (N=321; 109 female and 212 male). All patients provided an IRB-approved written informed consent.ResultsAmong the subset of patients tested for circulating biomarkers, females were significantly younger than males (P=0.03). Testing PBMCs, the percentages of CD3+ T cells (P=0.04) and CD3+CD4+ helper T cells (P=0.0005) were significantly higher in female patients compared to males. Also, there were trends toward higher levels of proinflammatory cytokines IL1beta (P=0.07) and IL6 (P=0.06) in females. On the other hand, males had significantly higher percentages of monocytes (P=0.03). Further, there were trends toward higher percentages of CD3+/CD4+/CD25hi+/Foxp3+ (P=0.1) and CD3+/CD4+/CD25+/CD127low+ (P=0.1) T-reg in male patients compared to females. Among the cohort of patients (N=718) with tumor GEP data, females were significantly younger than males (P=0.0009). GEP identified pathways and genes related to immune cell infiltration and activation that were significantly enriched in the tumors of females compared to males (table 1).Abstract 88 Table 1Immune pathways significantly enriched in tumors of femalesConclusionsFemale gender was associated with adjuvant immunotherapeutic benefits and female patients were more likely to have evidence of immune activation within the TME and the circulation, supporting a potentially important role for female related factors in the immune response against melanoma, and these require further investigation.AcknowledgementsWe are grateful to the patients and family members who participated in the E1609 trial and the E1609 trial investigators. This study was conducted by the ECOG-ACRIN Cancer Research Group (Peter J. O’Dwyer, MD and Mitchell D. Schnall, MD, PhD, Group Co-Chairs) and supported by the National Cancer Institute of the National Institutes of Health under the following award numbers: U10CA180794, U10CA180820, U10CA180888, UG1CA233180, UG1CA233184. Biomarkers studies were supported under the following award number: P50CA12197310 (Tarhini and Kirkwood). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.Trial RegistrationNCT01274338Ethics ApprovalThe E1609 study protocol was approved by the institutional review board of each participating institution and conducted in accordance with Good Clinical Practice guidelines as defined by the International Conference on Harmonization. All patients provided an IRB-approved written informed consent.ConsentNot applicable.


Author(s):  
Mengdie Wang ◽  
Nan Jiang ◽  
Changjun Li ◽  
Jing Wang ◽  
Heping Yang ◽  
...  

BackgroundSex and gender are crucial variables in coronavirus disease 2019 (COVID-19). We sought to provide information on differences in clinical characteristics and outcomes between male and female patients and to explore the effect of estrogen in disease outcomes in patients with COVID-19.MethodIn this retrospective, multi-center study, we included all confirmed cases of COVID-19 admitted to four hospitals in Hubei province, China from Dec 31, 2019 to Mar 31, 2020. Cases were confirmed by real-time RT-PCR and were analyzed for demographic, clinical, laboratory and radiographic parameters. Random-effect logistic regression analysis was used to assess the association between sex and disease outcomes.ResultsA total of 2501 hospitalized patients with COVID-19 were included in the present study. The clinical manifestations of male and female patients with COVID-19 were similar, while male patients have more comorbidities than female patients. In terms of laboratory findings, compared with female patients, male patients were more likely to have lymphopenia, thrombocytopenia, inflammatory response, hypoproteinemia, and extrapulmonary organ damage. Random-effect logistic regression analysis indicated that male patients were more likely to progress into severe type, and prone to ARDS, secondary bacterial infection, and death than females. However, there was no significant difference in disease outcomes between postmenopausal and premenopausal females after propensity score matching (PSM) by age.ConclusionsMale patients, especially those age-matched with postmenopausal females, are more likely to have poor outcomes. Sex-specific differences in clinical characteristics and outcomes do exist in patients with COVID-19, but estrogen may not be the primary cause. Further studies are needed to explore the causes of the differences in disease outcomes between the sexes.


Folia Medica ◽  
2021 ◽  
Vol 63 (3) ◽  
pp. 405-412
Author(s):  
Greta Yordanova ◽  
Gergana Gurgurova

Introduction: Eruption of central incisors occurs at a time when the mixed dentition starts to develop and their impaction is mostly a severe esthetic problem.Aim: Our aim was to assess the frequency of impaction of an upper central incisor and to analyse the factors which affect the successful outcome and the protocols for orthodontic treatment in cases of impacted upper central incisors.Materials and methods: In the present study, we used all medical records of 651 patients treated in our private practice over the last 3 years and also the medical records of 18 patients we diagnosed and treated for this problem over the last 8 years.Results: We found the ratio of impacted upper central incisors to be 1.4% as there were more male than female patients affected. There were 2.8% male patients and 0.7% female patients. The most frequent cause of impaction of the upper central incisor was the presence of mesiodentes and supernumerary teeth (55.5%), followed by presence of follicular cysts (44.4%) and odontoma collections (22.2%) or a combination of these.Several approaches have been used in treating the different positions of impacted incisors. It is necessary first to rotate the axle of the incisor and assure its root full bone coverage. We used directly TPA for support. In other patients, we waited for the spontaneous eruption after removal of the etiological factor and in another patient, we used conventional fixed techniques.Conclusions: It is important that dental doctors should monitor the formation of the dentition so that they detect the impacted tooth early in its development.


2021 ◽  
Vol 1-2 (33-34) ◽  
pp. 14-18
Author(s):  
V. Skybchyk ◽  
◽  
O. Pylypiv ◽  

Context. It is known that in addition to transient ischemic attacks and insults, hypertension is often the cause of asymptomatic brain damage, including cognitive impairment (CI). Most of these studies show a positive relationship between midlife hypertension and cognitive decline at the advanced age. CI significantly affect the quality of life of patients, reduce the ability to learn, acquire new knowledge and skills, force them to change their usual way of life and often stop or reduce professional activities. Objective. To analyze the condition of cognitive functions in patients with stage 1 and stage 2 hypertension of 2nd-3rd degrees, with moderate and high cardiovascular risk and evaluate their gender peculiarities. Materials and methods. The study included 90 patients with stage 1 and stage 2 hypertension. The average age of patients with hypertension was 49.66 ± 8.74 years old. The average course of the disease was 7.7 ± 3.9 years. The comparison group consisted of 46 healthy individuals with normal blood pressure levels and without hypertension in anamnesis (the average age - 45.88 ± 3.03 years old). Applied methods included general clinical, methods of neuropsychological testing (MMSE, GPCOG, W. Schulte test), standard general clinical and biochemical laboratory methods (blood lipid spectrum, blood glucose, creatinine with GFR, electrolytes), instrumental (12-lead ECG, ambulatory monitoring of blood pressure, echocardiography in B-, D-modes), and statistical methods. Results. Patients with hypertension scored significantly less on the MMSE scale (26.82 ± 1.41 scores vs. 28.89 ± 0.82 scores, p = 0.001) and GPCOG (6.63 ± 1.88 scores vs. 8.35 ± 0.71 scores, p = 0.001) compared with healthy individuals and spent more time on performing Walter Schulte test (46.51 ± 8.59 seconds vs. 36.69 ± 6.77 seconds, p = 0.001). Moderate CI were detected in 36 patients (40.00 %) among the examined hypertensive patients; it means that the total score of MMSE was 24-26 scores (the norm is 27-30 scores). The total score on the MMSE scale was 25.47 ± 0.88 in hypertensive patients with CI and was significantly lower than in hypertensive patients without CI (р = 0.001). Cognitive functions in patients with CI were characterized by poorer indices of memory, counting and executive functions. It should be noted that the revealed changes had more reliable manifestations in male hypertensive patients. In particular, the total score on the MMSE scale was 26.57 ± 1.37, while in female ones it was 27.19 ± 1.41 scores (p = 0.04). CI on the MMSE scale were diagnosed in 43.4 % (n = 23) of male patients and in 35.1 % (n = 13) of female patients. The total score was also higher on the GPCOG scale in female patients - 6.89 ± 1.85 scores vs. 6.45 ± 1.89 scores, p = 0.26. Instead, the time to complete the tasks according to the Walter Schulte tables was longer in male patients - 47.74 ± 8.85 seconds vs. 47.73 ± 7.99 seconds, p = 0.10, respectively. The parameters of counting functions were significantly lower (p = 0.01) in the group of male hypertensive patients compared with female ones. Besides, men had lower indicators of short-term memory and orientation, women reproduced worse verbal material, but the difference was statistically insignificant (p-value more than 0.05). The sum of scores on the MMSE scale conversely correlated with male gender (r = -0.22, p = 0.03). The risk of low values of MMSE indices in male patients with hypertension was 42.00 % higher than in female ones (OR = 1.42 ± 0.32, with 95% CІ [0.18-2.65]). Conclusions. Hypertension is a significant independent risk factor for developing new cases of cognitive impairment. In particular, among the patients with stage 1 and stage 2 hypertension of 2nd-3rd degrees, with moderate and high cardiovascular risk, moderate cognitive impairment was revealed in 36 patients (40,00 %), the revealed changes were more manifested in male hypertensive patients.


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