Background: This study presents the management of patients with war-related injuries and early results of vascular injuries treated at a secondary care hospital neighboring to civil war. Methods: Between December 2013-December 2014 ninety-six war-related injury patients evaluated by a single vascular surgeon and participating disciplines according to components of injury in polytrauma patients. Thirty-six patients who underwent vascular surgery were retrospectively registered to the study. Demographics, treatment and early results of patients reviewed. Results: Mean age was 26.69±11.80 (7-66) years and 91.66% (33/36) were males. Injuries were caused by shrapnel wound due to bombing 61.11% (22/36), stab wound 8.33% (3/36), gunshot wound 30.55 % (11/36). The number of patients with polytrauma was 29, seven patients had isolated vascular injury. Among 42 arterial and 31 venous injuries primary suture repair, autologous vein graft interposition and prosthetic graft interposition performed to 20.54% (15), 28.76% (21), 19.17% (14) respectively. Amputation and all-cause mortality were %8.3 (3/36), 13.8% (5/36) respectively. Conclusions: Vascular injury with concomitant trauma is the main issue of war-related injuries. Surgeons should be cautious about patients who were initially deemed not to need surgery for vascular injury and then were found to need it. Repetitive physical examination is very important in case of any suspicion, especially in limited conditions for diagnostic tools like CT angiography. A rapid, careful multidisciplinary evaluation of experienced surgeons for the diagnosis and the treatment priorities in war-related injury patients may lead to increase life and limb salvage rates with a better quality of life.
Background and aim. The presence of acute kidney injury (AKI) in subjects diagnosed with acute coronary syndromes (ACS) represents a major predictor of a negative outcome.The purpose of this study is to reveal the incidence of AKI in ACS subjects and to illustrate the prognosis of these subjects, using special models for mortality prediction, based on the creatinine values and the presence of acute heart failure (AHF). Methods. Using multiple linear regression, several models were designed to predict the mortality including: comorbidities of the subjects, initial and highest value of the serum creatinine (sCr) during hospitalization, presence of theAHF and Killip class compared with sCr values, the last model illustrating the influence of all the previous variables. Results. AKI had a significant incidence in the chronic kidney disease (CKD) group (53.11%). The mortality rate and the hospital readmission were higher in the CKD subjects (41.14%) versus the patients with normal kidney function (21.23%, p<0.01). The association of AKI and AHF, known as cardio-renal syndrome, was related to a negative outcome in the CKD group. The models for prediction of mortality emphasize that the age, dyslipidaemia, worst sCr, Killip class and AHF presence can be used to assess the mortality risk of patients with AKI and ACS. Previous pathological conditions such as diabetes, peripheral artery disease, coronary artery disease (CAD) and obesity, failed to achieve statistically significance for prediction of death. Conclusions. AKI represents a serious pathological condition with a high prevalence in subjects with CKD; the association with AHF increases the risk of hospital readmission and fatal outcome.
Introduction: Intensive care facilities may play an important role in reducing corona mortality. This study aimed to assess the epidemiological features, treatments, and prognosis of corona patients that admitted to the Intensive Care Unit (ICU) of Baqiyatallah Hospital. Methods: All patients with a corona that admitted to the ICU of Baqiyatallah Hospital from March 5 to May 20, 2020, were included. The epidemiological characteristics, pharmacological, non-pharmacological, and supportive therapies and prognosis were assessed. Underlying diseases, smoking, and severity of lung involvement based on CT scan findings (mild, moderate, severe) and length of hospital stay in the ICU were recorded in a questionnaire. Non-invasive ventilation (NIV) or tracheal intubation, ventilator ventilation, and duration of endotracheal intubation, if needed, were recorded in the questionnaire. Meanwhile, whether tracheostomy was performed, the time of the procedure, and its duration were also recorded. Results: Overall, 82 patients were included in the study that 68 (82.9%) of them were males. The mean age was 57.96±14.08 years. The mortality rate was 53 cases (64.6%). There were 57 subjects (73.1%) at a severe lung involvement and 21 subjects (26.9%) at a moderate lung involvement. There was a significant relationship between severity of lung involvement and mortality (Odds ratio= 14.3, P<0.001). There was a significant relationship between mortality and Armadile use (Odds ratio= 2.9, P=0.04). There was a significant relationship between mortality and tracheal intubation (Odds ratio= 27.2, P<0.001). There was no significant difference between mortality and discharge of patients regarding the intubation period (P=0.26). There was not a significant relationship between tracheostomy, NIV, and mortality status in the patients (P=0.14 and 0.33 respectively). Also, there was no significant difference between mortality and discharge of patients regarding tracheostomy and NIV period (P=0.51 and 0.17). There was no significant difference in age between severe and moderate lung involvement cases (P=0.63). There was a significant difference in the duration of ICU hospitalization between severe and moderate lung involvement cases (P=0.004). Conclusion: The results showed none of the factors of age, sex, underlying diseases other than hypertension, pharmacological methods other than Armadile, and non-pharmacological methods such as hemoperfusion, plasmapheresis, IVIG, hyperimmune plasma injection, and stem cell as well as Ozone therapy does not affect corona patient’s mortality. Only the severity of lung involvement leading to endotracheal intubation and mechanical ventilation is related to patients’ mortality
Background: NT-proB-type Natriuretic Peptide (BNP) (NT-pro BNP) is one of the biomarkers that has been studied in recent decades in connection with pediatric heart failure (HF) and congenital heart disease (CHD). Recently, infants hypothesized that serum. NT-pro BNP levels might be a good predictor of septicemia severity and response to treatment and prognosis in these patients. This study investigated the relationship between serum natriuretic type B peptide level and neonatal sepsis. Materials and Method: In this case-control study, all full-term and pre-term neonates admitted to children’s Hospital, Tabriz- Iran(2021), with sepsis and a septicemia diagnosis were confirmed after obtaining consent. The study was deliberately entered by the patient's parents or legal guardian. Complete Blood Count with Differential (CBC/Diff ), C - reactive protein (CRP) , Bacterial Culture (B/C) , Urine Analyze(U/A),Urine Culture (U/C) ,NT-pro BNP were checked and finally compared with laboratory results of the same number of infants who did not have clinical and laboratory symptoms of sepsis. After collecting samples, laboratory results, including serum levels of NT-pro BNP, were compared in case and control groups. Results: One hundred patients were studied in two groups. Thirty-eight patients (38%) were boys, and 62 patients (62%) were girls. The mean age of the patients was 7.58±7.46 days. The mean weight of the studied patients was 2811.80±620.33 grams, with a median of 2855 grams. The most common clinical symptom observed in patients in the case group was fever (100%) followed by Poor feeding (84%). In the control group, all patients had jaundice. Neonates with sepsis had significantly higher initial pro-BNP values than the control group (10023.80 vs. 2247.20; p=0.001). The NT-pro BNP level cut-off point in predicting the final treatment status and mortality of neonates with sepsis was 9583 pg/ml with 97.7% sensitivity and 93.6% specificity. Conclusion: Measurement of serum level of NT-Pro BNP in neonates with sepsis at the time of clinical signs with 97.7% sensitivity and 93.6% specificity with a cut-off point of 9583 is an important prognostic factor in the therapeutic management of patients.
Background and Aim: Respiratory system diseases (RSDs) represent the major burden of disease, including death worldwide. The main purpose of this study was to model and forecast the death rate due to diseases of the respiratory system Based on Lee Carter's model during the years 2011-2028. Methods: The type of study was a secondary analysis based on available data. The statistical population included all deaths registered in the health department of Golestan University of Medical Sciences during the years 2011-2018. Data analysis was performed using Demography 18.1 and StMoMo packages in R3.6.2 software. Results: The death rate due to RSDs in 2011 in the total population was 0.22, in women 0.19, and in men 0.25 per 1000 population. The death rate due to these diseases shows an increasing trend in 2018 to 0.33 in the total population, 0.29 in women, and 0.36 in men per 1000 population. In general, the death rate due to these diseases increased by approximately 0.10 per 1000 population from the years 2011 to 2018. It is predicted that the increasing trend of deaths due to RSDs will continue and in 2028 it will reach 4.88 in the total population, 3.56 in women, and 2.27 in men per 1000 population. Conclusions: Our findings show a significant increase in respiratory disease mortality over the past eight years. A combination of prevention and treatment strategies through urban planning, including the control of environmental pollutants and environmental health programs, is essential for the effective control of respiratory diseases.
Background and Objectives: Chronic Kidney Disease (CKD) affects 6,7% of the adult population in Romania and is associated with high morbidity. About one out of three adults with diabetes has kidney disease. According to current literature data, the prevalence of diabetes is very high, up to 11,6%, of whom 2,4% had undiagnosed diabetes, and is the leading cause of kidney damage and the need for renal replacement therapy (RRT). COVID-19 has brought with it a lot of unanswered questions, regarding the risk factors, the disease evolution, and the treatment possibilities. It became clear that diabetic kidney disease (DKD) is among the independent risk factors that predict unfavorable outcomes upon SARS-CoV-2 infection, so we aimed to evaluate the characteristics of diabetic and non-diabetic dialyzed patients, COVID-19 positive. Materials and Methods: It is an observational, single-center study that analyzed type 2 diabetes mellitus and non–diabetic patients in maintenance hemodialysis hospitalized for SARS CoV-2 infection. Results: A total of 101 adult dialyzed patients were admitted with a SARS-CoV-2 RT-PCR positive test, out of which 42 had a long history of diabetes mellitus type 2 and 59 of them have been known with other etiologies of CKD. Hypertension and heart disease were the most commonly associated comorbidities. Inflammatory markers and anemia were significantly increased in diabetic patients compared to non-diabetic. Conclusions: We found that anemia was more severe in patients COVID-19-positive MHD T2DM patients.
