Journal of Acute Disease

185–189

Authors: Wei Wang, Zhu-Sheng Feng, Wen Yin

Traumatic injury remains the leading cause of death with bleeding in the world, representing the main cause of preventable death. But if immediate management could be applied, the outcomes will be dramatically improved. Trauma-induced coagulopathy (TIC) as an early endogenous process in many traumatic patients is driven by the multitissue injury and shock, and is associated with increased mortality and bad outcomes in the multi-trauma patients. The understanding of the mechanisms of TIC and its effect on the outcomes of severely injured patients has been developed over the past few years. Here, we aim to review the current understanding and recent findings in the pathobiology of coagulopathy. The principal causes of TIC are hypoperfusion, inflammation response and the activation of the neurohumoral system. Hypoperfusion causes the activation of many biomarkers, like protein C, syndecan-1, plasminogen, and so on. The elevation of these markers indicates the damage of the endothelium, which will lead to autoheparinization in body. When accompanied with acidosis, hypothermia, and hemodilution, the mortality of trauma patients will rise significantly. This article aims to focus on our updated acknowledges on the principal mechanisms and causes of the TIC.

194–201

Authors: Adrián Angel Inchauspe´

After almost thirty years of experience in saving patients at impending death situations and having made numerous contributions on the field, the author herein provides a reasoned survival bio-energetic circuit based on a detailed methodological and functional analysis of the Main Channels [1.4.2 meridian and collateral theory] [0.0.16 meridian and collateral (study)] and the Wondrous Vessels (Qi jing ba mai) [1.4.24 eight extra meridians] participating in it. The area researched as well as the results obtained underwent strict evaluations, both as regards statistics and risk management standards, besides having been carefully supervised by the rules and parameters of traditional Chinese medicine.

206–209

Authors: Jonathan Bayuo, Pius Agbenorku, Richcane Amankwa

Objective: To explore the phenomenon of surviving burn injury and its associated issues and concerns. Methods: A cross sectional survey approach was utilized to obtain data from one hundred burn survivors who were purposely selected. Descriptive statistics and content analysis were used to analyze data. Results: Findings from the study indicate that burns from flames stood out as a major cause of burns. Physical discomfort/pain, anxiety, needing assistance in meeting self-care needs, financial and social limitations were identified as the major impact of the injury. Furthermore, participants perceived the existence of societal stigma. In addition, hope in God or a spiritual being as well as family support were the two key resources participants relied on to cope effectively. Conclusions: Surviving burn injury is associated with varied physical, social and psychological factors and survivors may need professional assistance to fully adjust after discharge.

216–221

Authors: Hossein Ali Nikbakht, Seyed Reza Hosseini, Heidar Sharifi-fathabad, Rahmat Habibzade, Amin Daemi, Saber Ghaffari-fam

Objective: To examine the clinical epidemiology and treatment findings of tuberculosis in Babol, Northern Iran. Methods: This cross-sectional study was carried out on medical records of tuberculosis registry pertaining to health center of Babol City, Mazandaran, Iran. The investigated variables included demographic characteristics and some clinical patterns of patients. To present the findings, the descriptive statistics such as mean (and SD) and frequency (%) was used. Analytical statistics was applied by using Chi-square test and independent samples t-test. Results: The average age of 200 patients infected with tuberculosis was 47.51 years (SD = 21.36), and 58.5% of the cases were male. In both genders, the highest number of tuberculosis patient was found in 18–38 age group. During the 5-year study period, 95% of the patients received treatment protocol 1 (including new cases with positive smear, negative smear, extra-pulmonary) and in the end of treatment given to patients, 90.5% were improved or treatment period completed. The most important clinical symptoms for referring the patients to the therapeutic centers were cough (75.1%) and fever (60.9%). Conclusions: Education and giving information to general population about the most important clinical symptoms of tuberculosis such as fever and cough might be effective in early detection and prevention of Mycobacterium tuberculosis. Then treatment might be effective in decreasing the burden of the disease.

227–231

Authors: Wan Fairos Wan Yaacob, Nor Suhana Mohamad Noor, Nor Ili Che A. Bakar, Nurulhuda Afisah Mat Zin, Fahisham Taib

Objective: To examine the impact of haze in the reduction of peak expiratory flow rate (PEFR) reading and identify the risk factors affecting respiratory function due to haze. Methods: This study was conducted during haze period among secondary school students in Kota Bharu. We analyzed data on a total of 126 secondary school children measuring the respiratory health and symptoms in October 2015 using standardized questionnaire and PEFR measurement. Clinical characteristics on the risk factor and prevalence of haze effect were explored. Chi-square test and independent sample t-test was used to investigate the relationship between risk factors and haze effect and logistic regression analysis for the odds of having haze effect. Results: The findings revealed a significant reduction in PEFR reading of more than 15% from the expected PEFR values. It was also noted that the children with headache, cough, mucus and sore throat respiratory symptoms had consistently higher rates of respiratory illness of having haze effect compared to those who did not. Conclusions: Student with haze effect documented much higher symptoms during haze especially female students. Symptoms such as headache, wheezing and mucus were noted among the normal secondary school children in Kota Bharu.

237–243

Authors: Hadiza Lami Muhammad, Adamu Yusuf Kabiru, Musa Bola Busari, Abdullah Mann, Abubakar Siddique Abdullah, Abdulrazaq Taye Usman, Usman Adamu

Objective: To evaluate the use of Ceiba pentandra (C. pentandra) as a glucose lowering agent and the attendant physiological changes in albino rats. Methods: Acute oral toxicity study of the extract was carried out by the administration of 10, 100, 1 000, 1 600, 2 900, and 5 000 mg/kg body weight of C. pentandra to rats in their respective groups. Twenty healthy albino rats weighing between 140 and 150 g were randomly allotted to five groups of four rats each. 100 mg/kg body weight of alloxan monohydrate was i.p. administered to rats and rats with blood glucose
200 mg/dL were considered diabetic. 5 mg/kg body weight of standard drug, 200 and 400 mg/kg body weight of ethanol extract of C. pentandra were orally administered to diabetic rats in their respective groups once daily for 12 days while the control groups received 0.1 mL of normal saline for the same period. The blood glucose was checked after every 4 days and the experiment was terminated on the 17th day. Results: The safe dose (LD50) of the extract was greater than 5 000 mg/kg body weight. The extract treated groups exhibited a remarkable reduction in blood glucose [(87.72 ± 7.67) mg/dL for 200 mg/kg body weight dose and (86.33 ± 4.54) mg/dL for 400 mg/kg body weight dose] competitively with the normoglycemic group [(88.71 ± 4.56) mg/dL]. The body weight of the extract and standard drug treated groups appreciated significantly (P < 0.05) as compared with normoglycemic group. High density lipoprotein increased significantly in the extract treated groups with the 400 mg/kg body weight having the highest value of (18.61 ± 3.44) mg/dL and a concomitant reduction in the concentrations of low density lipoprotein, triacylglycerol, and cholesterol of same group. The 400 mg/kg body weight dose of the extract also demonstrated the highest reduction in the activities of aspartate transaminase [(59.66 ± 3.45) IU/L], alanine aminotransferase [(33.33 ± 4.34) IU/L] and alkaline phosphatase [(48.36 ± 3.41) IU/L] that elevated as a result of diabetes. The two extract treated groups demonstrated a marked reduction in Cl−, and elevation in HCO3− and Na+ levels. K+, urea, creatinine, total and conjugated bilirubin that were elevated in the diabetic untreated group were all ameliorated in the treatment groups. Conclusions: Ethanol extract of C. pentandra has glucose lowering effect and can ameliorate the biochemical abnormalities associated with diabetes mellitus.

248–249

Authors: Zeynep Konyar, Gokhan Eyupoglu, Mehmet Tatli, Ozlem Guneysel

Teratomas are the most common germ cell tumors among pediatric and female patients, which originates from germ cells layers and can be located everywhere in bodies. They are diagnosed by ultrasonography (US), which was characterized by calcification and cystic anechoic view. Our aim is to attract attention to a 21-year-old female patient with complaint of acute abdominal pain diagnosed with teratoma by early radiological imaging. The female patient admitted to the emergency department with a new onset of abdominal pain at the lower and left sides of the abdomen for a week. The suprapubic and left costovertebral angle tenderness were found in her physical examination. We firstly chose US for imaging. The US of the abdomen showed multiple cystic masses around uterus. Heterogeneous cystic and calcified lesions were detected on the patients computerized tomography scan, and considered as teratoma. A laparotomy was performed by gynecologists. At laparotomy, lobulated cystic masses were removed and the left ovary had been detorsioned. She has been discharged after two days of postoperative observation. For patients of young females with abdominal pain such as rare gynecological diseases, teratoma and ovarian torsion, in the emergency department should be considered and early imaging should be performed.

252–254

Authors: Giancarlo De Nigris, Gabriele Falzarano, Antonio Medici, Steven James Mccabe, Grubor Predrag, Maria Liberata Meccariello, Luigi Meccariello

Medical staff hardly recognize fractures of trapezium due to the small size and the complex anatomy of the wrist and the hand. Seventy percent of all carpal fractures are scaphoid's fractures. Only 0.4% of all carpal injuries are trapezial fractures. In this paper, we presented a case of a high speed trauma where there were only trapezial fractures. Origin, diagnosis, differential diagnosis, treatment and complications are evaluated and described.

258–259

Authors: Pathoom Sukkaromdee, Viroj Wiwanitkit

The sterile pyuria is an interesting problem in urology. Acute gross sterile pyuria is not a common clinical problem and is difficult to make a correct diagnosis. Here, the authors reported a case of acute gross sterile pyuria after oral ciprofloxacin treatment of urinary tract infection. The patient developed problem after complete course of 7-day acute upper urinary tract treatment. The patient was observed with cloudy whitish urine that had never seen before. The urinalysis showed sterile pyuria. This case was treated by conservative method and the problem was resolved within 7 days.

264–266

Authors: Ilkay Cakir, Serkan Senol, Yasin Simsek, Zuleyha Karaca, Kursad Unluhizarci, Fatih Tanrıverdi

Primary hyperaldosteronism, is a well-known cause of secondary hypertension, mostly idiopathic hypertension or arising from aldosterone-producing adenomas. It is characterized with resistant hypertension, hypokalemia and metabolic alkalosis related with aldosterone production excess and plasma renin activity suppression. Hypokalemic rhabdomyolysis usually presents with muscle pain, cramps, fatigability and generalized weakness. Rhabdomyolysis due to hypokalemia is a rare complication of primary hyperaldosteronism reported within a limited number of cases in medical literature. Diagnosis and treatment of primary hyperaldosteronism is fundamentally important because of the probability of certain cure with accurate surgery. Here, we report a 38- year-old female with hypertension related with primary hyperaldosteronism who presented with rhabdomyolysis most likely due to profound hypokalemia.