Journal of Acute Disease

266-273

Authors: Adrian Angel Inchauspe

This risk management project aims to apply a global preventive and predictive measure in potential victims of acute death and heart failure. Among the main causes are identified sub-diagnosed genetic mutations; prescription, interaction, self-medication or abuse of suspected drugs due to internet prospect's consult; and a parasitic pandemia, the Chagas disease (over 100000000 population is potentially infected worldwide). Promoting a global extensive determination of the torsadogenic index which was successfully published in Frontiers of Pharmacology Journal, will allow to monitor general population, set security patterns to categorize silent high risk groups of serious prognosis of tachyarrhythmias. For this purpose, applications of known QT determinations are proposed, recommending Dr. Rautaharju's formula, actually improved with gender adult versions. Torsadogenic index will allow to establish an individual traceability, obtain comparative samples that are alert to possible QT enlargements. Thus, torsadogenic index results a valuable, simple and costless resource to consider in the fight against acute death and cardiac arrest. Torsadogenic index represents a global indicator capable of predicting and preventing acute death and heart failure for most relevant reasons.

277-279

Authors: Somsri Wiwanitkit, Viroj Wiwanitkit

Acute hemorrhagic disease is an important problem in medicine that can be seen in many countries, especially those in tropical world. There are many causes of acute hemorrhagic disease and the viral infection seems to be the common cause. The well-known infection is dengue, however, there are many new identified viruses that can cause acute hemorrhagic diseases. In this specific short review, the authors present and discuss on those new virus diseases that present as “acute hemorrhagic fever”.

287-291

Authors: Poh-Chin Lai, Chun Bong Chow, Ho Ting Wong, Kim Hung Kwong, Shao Haei Liu, Wah Kun Tong, Wai Keung Cheung, Wing Leung Wong, Yat Wah Kwan

Objective: To explore socio-demographic data of the population as proxies for risk factors in disease transmission modeling at different geographic scales. Methods: Patient records of confirmed H1N1 influenza were analyzed at three geographic aggregation levels together with population census statistics. Results: The study confirmed that four population factors were related in different degrees to disease incidence, but the results varied according to spatial resolution. The degree of association actually decreased when data of a higher spatial resolution were used. Conclusions: We concluded that variables at suitable spatial resolution may be useful in improving the predictive powers of models for disease outbreaks.

298-304

Authors: Jacob Kehinde Akintunde, Olakunle Enock Bolarin

Objectives: To evaluate the toxicity of lisinopril in liver of male rats and its reversal effect of garlic capsule (GAR) and selenium-vitamin A, vitamin B, vitamin C (SACE). Methods: Thirty five adult male wistar rats were randomly assigned into 5 groups of 7 animals per group. Group I serves as the control, animals in Groups II, III, IV and V received 28 mg/kg body weight of lisinopril via oral route. Group III was co-treated with GAR at therapeutic dose of 250 mg/kg body weight per day. Group IV was co-treated with SACE at dose of 500 mg/kg body weight. Lastly, group V was co-treated with GAR and SACE at doses of 250 and 500 mg/kg body weight respectively, and the experiment last for 8 days. Results: Administration of lisinopril caused systemic toxicity in liver as well as adverse histopathologic changes in the tested tissue. While GAR and SACE significantly (P < 0.05) reversed the toxic effects induced by lisinopril. Conclusions: Collectively, the results suggest that therapeutic dose of lisinopril elicits toxicity in male rats through induction of oxidative damage and depletion of cellular adenosine triphosphate. The reversal effects of GAR and SACE during lisinopril treatment suggest that these antioxidants may find clinical application in cellular damage involving ROS and adenosine triphosphate.

309-315

Authors: Muhammad Kifayatullah, Mohd. Shahimi Mustafa, Pinaki Sengupta, Md. Moklesur Rahman Sarker, Arindam Das, Sreemoy Kanti Das

Objective: To evaluate the safety dose range of ethanolic extract from the leaves of Pericampylus glaucus (Lam.) Merr. by acute and sub-acute oral toxicity study on animal model. Methods: The acute and sub-acute toxicity study was carried out as per Organization for Economic Co-operation and Development guidelines 423 and 407. In acute toxicity study, the oral dose (300, 2000 and 4000 mg/kg) of tested plant extract was administered to three groups in single dose and general behavior, adverse effects and mortality were determined up to 72 h and compared to normal group. In sub-acute study, the tested crude plant extract was administered orally at doses of 600 and 1000 mg/kg for 28 days to the two animals groups and their body weight, hematological, serum hepatic biochemical parameters were evaluated and compared to normal group by sacrificing all group animals. Results: In acute toxicity, all treated groups’ revealed neither mortality nor any significant alteration in behavior only drowsiness, sedation and lethargy were observed in two group, i.e. 2000 and 4000 mg/kg of the tested plant extract. In sub-acute toxicity study no change in hematological, biochemical parameter and organ body weight were observed during study compared to the normal group. The kidney function parameters [serum glutamic-oxaloacetic transaminase (aspartate transaminase), serum glutamic pyruvic transaminase (alanine transaminase)] were significantly increased following administration of tested crude plant extract (600, 1000 mg/kg). Conclusions: The result indicates that the oral administration of Pericampylus glaucus (Lam.) Merr. extract did not produce any significant toxic effect in BALB/c mice. Hence, the extract can be utilized safely for therapeutic use in pharmaceutical formulations.

322-326

Authors: Bogdan Stoica, Sorin Paun, Ioan Tanase, Ionut Negoi, Mircea Beuran

Objective: To analyze trauma epidemiology, pattern of lesions or death profile in a level I east-European trauma center. Methods: Prospective observational study of patients admitted to a level I east-European trauma center and enrolled in our trauma registry, between January 2012 to January 2013, was conducted, with the inclusion criteria: (1) trauma lesions, (2) new injury severity score (NISS) higher than 15. Results: There were 141 patients admitted during the study interval, including 102 (72.3%) males, with a mean age of (43.52 ± 19.00) years, and a mean NISS of 27.58 ± 11.32. The trauma etiology was traffic-related injuries 101 (71.6%), falls 28 (19.9%) and crushing injuries 7 (5.0%). Only one case of gunshot wound was encountered in our study. Out of traffic-related injuries, the automobiles were involved in 56 (55.4%) and motorcycles in 9 (8.9%) patients. The bicyclists accounted for 2 (2.0%) of patients and pedestrians hit by vehicles were in 33 (32.7%) cases. High-velocity falls were found in 7 (25.0%) patients, whereas low-velocity falls accounted for 21 (75.0%) of cases. The overall mortality was 30.00%, and these patients presented the mean NISS of 37.63. Conclusions: Our trauma pattern profile is similar to the one found in west-European countries, with a predominance of traffic-related injuries and falls. The severity and anatomical puzzle for trauma lesions were more complex secondary to motorcycle or bicycle-to-auto vehicles collisions. A trauma registry, with prospective enrollment of patients, is a very effective tool for constant improvements in trauma care.

331-334

Authors: Gabriele Falzarano, Antonio Medici, Predrag Grubor, Milan Grubor, Luigi Meccariello

Objective: To investigate that if the hybrid external fixation is the definitive treatment and management of tibial extra articular and intra-articular pilon fractures of the adult in emergency. Methods: We treated 237 cases of pilon fractures using hybrid external fixation with or without minimal osteosynthesis from February 1999 to December 2014. All fractures were classified according to the Association for the Study of Internal Fixation. The three groups were represented by 108 patients (45.5%) for the Type A; 75 patients (31.8%) for Type B and 54 patients (22.7%) for Type C. Road accidents [118 patients (50.0%)] were the most common cause of tibial pilon fractures. Results: According to a mean follow-up of 7.3 years we had bone healing after 4.8 months from surgery in the 61.18% of the patients. The results were subjectively excellent, while the 54.00% were objectively excellent according to Ovadia and Beals score, and the results showed 29 complications. Conlusions: From our data hybrid external fixation with or without minimal fixation is a good surgical method to treat pilon fractures.

338-340

Authors: Wee-Min Teh, Mohtar Ibrahim

A 53-year-old male was referred from another eye hospital for right eye corneal perforation secondary to infective keratitis. A penetrating keratoplasty was performed for tectonic purposes. Forty eight hours after penetrating keratoplasty, he developed a band keratopathy located at the interpalpebral area of the corneal button. Despite stopping topical and systemic ciprofloxacin which could have contributed to this, the band keratopathy became more severe. Surgical debridement of the band keratopathy was done and there was no recurrence after that. This case of acute band keratopathy is an uncommon condition that develops within days to weeks of a particular insult to the eye. Various offending medications have been implicated, and treatment options include chelation therapy, surgical debridement and penetrating keratoplasty. Recurrence is common despite treatment and the cessation of possible offending medications. As such, it is prudent to be aware of and recognise the early symptoms and signs of this potentially sight-threatening condition.

344-346

Authors: Alexander John Scumpia, Megan Elizabeth Dekok, Daniel Michael Aronovich, Gurpaul Bajwa, Randy Barros, Randy Katz, Jordan Ditchek

Acute chest pain resulting in spontaneous idiopathic hemomediastinum is a rare, potentially life-threatening occurrence. Acute chest pain is a common chief complaint of patients, accounting for 2.4%–6.0% of adult emergency room visits. The clinician's differential diagnoses for acute chest pain rarely include complications of hiatal hernias. An 83-year-old male presented with acute chest pain and was emergently diagnosed with hemomediastinum secondary to spontaneous gastric mesenteric vessel rupture due to a non-strangulated hiatal hernia after physical exertion.