A case of first degree AV block in carbon monoxide poisoning patient

Carbon monoxide (CO) intoxication is one of the most common types of poisoning. Cardiac manifestations of CO poisoning are limited to case reports of Electrocardiogram (ECG) changes, myocardial dysfunction and myocardial ischemia.A 22 year old Saudi male was admitted to the emergency department with decreased level of consciousness after being involved in a fire at home. ECG showed first degree AV block. To the best of our knowledge, this case report is the first CO poisoning case in the literature presented with first degree AV block.     

Intravenous magnesium for prevention of atrial fibrillation after coronary artery bypass surgery: a systematic review and meta-analysis

Atrial fibrillation (AF) is one of the most common complications after coronary artery bypass surgery. The objective of this study was to assess the effectiveness of intravenous magnesium in preventing postoperative atrial fibrillation. A meta-analysis of eight identified randomized controlled trials, reporting comparisons between magnesium and control was undertaken. The primary outcome was incidence of postoperative atrial fibrillation. Our review revealed that use of intravenous magnesium is associated with a significant reduction in the incidence of atrial fibrillation after coronary artery bypass surgery, with a relative risk of 0.64 (95% confidence interval = 0.47, 0.87, and p = 0.004).     

Role of neutrophils in acrylonitrile-induced gastric mucosal damage

Acrylonitrile (ACN) is a widely used intermediate in the manufacture of plastics, acrylic ?bers, synthetic rubbers and resins that are used in a variety of products including food containers and medical devices. ACN is a possible human carcinogen and a documented animal carcinogen, with the stomach being an important target of its toxicity. ACN has been previously reported to require metabolic activation to reactive intermediates and finally to cyanide (CN⁻). The current study aimed at exploring the potential role of neutrophils in ACN-induced gastric damage in rats. Experimental neutropenia was attained by injecting rats with methotrexate. This significantly ameliorated gastric mucosal injury induced by ACN. This is evidenced by protection against the increase in gastric ulcer index, myeloperoxidase (MPO) activity and CN⁻ level. Also, neutropenia guarded against the decrease in prostaglandin E2 (PGE2), induction of oxidative stress and reduction of total nitrites and alleviated histopathological alterations in rat stomachs. These data indicate that neutrophil infiltration is, at least partly, involved in ACN-induced gastric damage in rats.     

Use of octreotide for the prevention of pancreatic fistula after elective pancreatic surgery: a systematic review and meta-analysis

Objective

To assess the effectiveness of octreotide in preventing postoperative pancreatic fistula. Pancreatic fistula is one of the most common complications after elective pancreatic surgery. Several clinical trials have evaluated the use of octreotide to prevent the development of pancreatic fistula after pancreatic surgery with conflicting recommendations.

Methods

We undertook a meta-analysis of 7 identified randomized controlled trials, reporting comparisons between octreotide and a control. The primary outcome was the incidence of postoperative pancreatic fistula, and the secondary outcome was the postoperative mortality.

Results

Seven studies, involving 1359 patients, met the inclusion criteria for this review. In these studies, sample sizes ranged from 75 to 252 patients. In total, 679 patients were given octreotide and 680 patients formed the control group. Perioperative octreotide is associated with a significant reduction in the incidence of pancreatic fistula after elective pancreatic surgery, with a relative risk of 0.59 (95% confidence interval 0.41–0.85, p = 0.004). However, this risk reduction was not associated with a significant difference in postoperative mortality (p > 0.05).

Conclusions

The review revealed that perioperative octreotide is associated with a significant reduction in the incidence of pancreatic fistula after elective pancreatic surgery. However, this risk reduction was not associated with a significant difference in postoperative mortality; further studies are warranted to confirm the results of this metaanalysis and to define which patient subgroups might benefit the most from prophylactic octreotide administration.     

Treatments against Polymorphosal discrepancies in Glioblastoma Multiforme

Glioblastoma (GB) are aggressive tumors that obstruct normal brain function. While the skull cannot expand in response to cancer growth, the growing pressure in the brain is generally the first sign. It can produce more frequent headaches, unexplained nausea or vomiting, blurred peripheral vision, double vision, a loss of feeling or movement in an arm or leg, and difficulty speaking and concentrating; all depend on the tumor’s location. GB can also cause vascular thrombi, damaging endothelial cells and leading to red blood cell leakage. Latest studies have revealed the role of single nucleotide polymorphisms (SNPs) in developing and spreading cancers such as GB and breast cancer. Many discovered SNPs are associated with GB, particularly in great abundance in the promoter region, creating polygenetic vulnerability to glioma. This study aims to compile a list of some of the most frequent and significant SNPs implicated with GB formation and proliferation.

     

Synthesis,Characterization and Antimycobacterial Activity of Some Substituted Phenylpyridazinone Derivatives

Pharmaceutical Chemistry Journal - Aseries 6-phenyl-2-(substituted methyl)-dihydropyridazinone derivatives (3a–3f) were synthesized using the interaction of 6-phenylpyridazinone with cyclic...     

Venous thromboembolism prophylaxis in brain tumor patients undergoing craniotomy: a meta-analysis

Brain tumor patients undergoing craniotomy generally receive prophylaxis against venous thromboembolism (VTE), but modalities in use differ widely and have been debated in the literature. A systematic review and meta-analysis was conducted to assess the efficacy and safety of VTE prophylaxis among brain tumor patients undergoing craniotomy. Ten randomized controlled trials were included in the final efficacy analysis. The various prophylactic measures employed in these studies reduced the risk for thrombosis compared to controls with an overall risk ratio of 0.61 (95?% CI: 0.47–0.79) in the fixed effect model. Although Cochrane Q-test showed unimportant heterogeneity across studies (p?=?0.19) and the I², a measure of heterogeneity between studies, was reasonably low at 28?%, subgroup analysis indicated that intervention type was a potential effect modifier for efficacy (p?=?0.04). Unfractionated heparin alone showed a stronger reduction in VTE risk compared to placebo (RR?=?0.27; 95?% CI: 0.10–0.73), and LMWH combined with mechanical prophylaxis showed a lower VTE risk as compared to mechanical prophylaxis alone (0.61; 95?% CI: 0.46–0.82). This meta-analysis demonstrates a statistically significant VTE risk reduction among brain tumor patients receiving prophylaxis, with chemical prophylaxis showing the strongest risk reduction. Five studies were included in the safety analysis, which showed an overall increased risk of bleeding comparing different prophylactic measures to different controls (RR?=?2.02; 95?% CI: 1.14–3.58; I²?=?0?%; p?=?0.86). Interventions in these studies were associated with an increased risk of post-operative, minor hemorrhage (RR?=?2.20; 95?% CI?=?1.00; 4.85), while the risk of major hemorrhage was not increased by chemoprophylaxis.     

Effect of Different Positions on FVC and FEV1 Measurements of Asthmatic Patients

[Purpose] The purpose of our study was to investigate the effect of different positions on pulmonary function test (PFT) values such as forced vital capacity (FVC) and forced expiratory volume in one second (FEV₁) of asthmatic patients .[Subjects and Methods] Thirty subjects with severe asthma aged between 20–39 years were enrolled after they had signed a written consent. Subjects were selected using the inclusion criteria, and PFT were randomly administered. Spirometer measurements (FVC, FEV₁) were taken in the supine, side lying on right, side lying on left, sitting and standing positions. Each measurement was taken three times, and the average values were analyzed. [Results] One- way analysis of variance (ANOVA) and Tukey’s Test (post hoc) for pair- wise comparison indicated that there was a significant difference in the FEV₁ values of the asthmatic patients however a significant difference was obtained between standing and supine positions. There was also a significant difference in the FVC values between the standing and supine lying position in the pair -wise comparison. [Conclusion] This study showed standing is the best position for measuring FEV₁ and FVC of asthmatic subjects. The more upright the position, the higher the FEV₁ and FVC will be.Key words: Pulmonary function test, Standing position, Spirometry