Search

Background: Carbon monoxide (CO) poisoning is one of the most common fatal poisoning worldwide. CO poisoning is known to have several complications and high fatality rate. Cardiac dysfunction including arrhythmias and myocardial ischemia have often been reported in CO poisoning; scattered punctiform hemorrhages throughout the heart have been documented in autopsy samples. Whilst it is one of the most common lethal poisonings, neurological or psychiatric sequelae occurs in up to 67% of survivors. This suggests that CO is implicated in neuronal death, or loss of function of the cells in the central nervous system. Approximately half of those who survive severe CO poisoning develop delayed neurological sequelae (DNS) after a latency period of 2-40 days, with varied clinical manifestations, persistent neuropsychological effects, and no guarantee of complete recovery. However, they are potentially preventable if they are early recognized and adequately treated. The work aimed to give an overview on cardiac and neurological complications of CO poisoning and the role of chemical biomarkers such as neutrophil-lymphocyte ratio (NLR), neuron specific enolase (NSE), creatine kinase, troponin, creatine kinase MB and N-terminal pro brain natriuretic peptide (NT pro-BNP) and scoring systems such as modified early warning score (MEWS) and poison severity score (PSS) in early prediction of these complications. Conclusions: Prediction of complications in CO poisoned patients is believed to be a challenging task. Laboratory parameters and imaging studies have been used to predict late cardiac and neurological complications in CO poisoned patients. Many physiologic scoring systems are demonstrated as effective predictors of outcomes for patients in the emergency department. However, very few studies have applied scoring systems as predictors of CO poisoning outcome. [ABSTRACT FROM AUTHOR]

Background: Insulin resistance is identified as an impaired biological response to insulin stimulation of target tissues, primarily the liver, muscle, and adipose tissue. The metabolic consequences of insulin resistance can result in hyperglycaemia, hypertension, dyslipidaemia, visceral adiposity, hyperuricemia, elevated inflammatory markers, endothelial dysfunction, and a prothrombotic state. Progression of insulin resistance can lead to metabolic syndrome, non-alcoholic fatty liver disease, and type 2 diabetes mellitus. Aim of the Work: We aimed by our study to assess the relationship of platelet distribution width and red blood cell distribution width with insulin resistance in patients with type 2 diabetes with and without non-alcoholic fatty liver disease (NAFLD) and to check if platelet distribution width or red blood cell distribution width could be easy predictors of insulin resistance. Patients and Methods: The present study is a Case Control Study was conducted in Ain Shams University Hospital. This study includes 80 subjects with matched age and sex. Results: The present study results confirmed that low RDW was associated with increased risk of developing diabetes mellitus. Their study found that RDW is negatively correlated with waist and FG, insulin and TG concentrations. We also found that the group with the lowest quartile of RDW had the highest glucose, insulin and HOMA levels. Moreover, our results were found that there is a significant negative correlation of RDW with poor glycemic control. Our results also found that decreased levels of red blood cell distribution widths (RDW) were all associated with increased fasting insulin. Our study was documented a negative correlation between HbA1c and the platelet index PDW. Conclusion: In our study, we found a relation between insulin resistance and red blood cell distribution width. RDW (fl) could be used to discriminate between patients with type II diabetes and controls. [ABSTRACT FROM AUTHOR]

Assessing and monitoring respiratory parameters, such as respiratory rate, oxygen saturation, and lung sounds, is crucial for the management and prognosis of pneumonia patients. Prone positioning has been shown to improve oxygenation in patients with respiratory disorders, including pneumonia, by reducing ventilation/perfusion mismatch. However, there is a lack of evidence supporting the benefits of self-proning in spontaneously breathing pneumonia patients. This study aims to evaluate the effect of self-proning on respiratory functions, pneumonia, and mortality risk among patients diagnosed with community-acquired pneumonia. The study used a pre- and post-test quasi-experimental design with a control group, adhering to the Transparent Reporting of Evaluations with Nonrandomized Designs guidelines. It was conducted in the Medical Respiratory Department inpatient wards at the Respiratory Diseases Hospital in Alexandria, Egypt. The study recruited 128 patients with community-acquired pneumonia, conveniently assigned to an intervention group (n = 64) and a control group (n = 64). Data were collected using socio-demographic and historical data sheets, respiratory parameters assessment sheets, the confusion uremia respiratory rate and blood pressure (CURB-65) severity of pneumonia score, and the Pneumonia Severity Index. Prone positioning significantly positively impacted respiratory parameters in the intervention group compared to the control group. Specifically, the intervention group exhibited improvements in respiratory rate, oxygen saturation, reduced need for supplemental oxygen, and cough (p < .05). Furthermore, the intervention group exhibited fewer changes in findings from chest inspection, palpation, and auscultation. In addition, the severity of pneumonia was reduced in the intervention group compared to the control group, as indicated by lower CURB-65 (p = .014) and pneumonia severity index scores (p = .005). The study demonstrated that self-proning interventions significantly improved respiratory functions and reduced the risk of death among participants with community-acquired pneumonia. These findings suggest that self-proning is a beneficial technique for managing respiratory distress, particularly in non-intubated patients, and can be an effective strategy to improve patient outcomes in clinical settings. [ABSTRACT FROM AUTHOR]