Journal of Acute Disease

145-148

Authors: Mohammed Maan AbdulAzeez1? , Padilla-Zambrano Huber2 , Salima B. Alsaadi3 , Cabreras?Nanclares B. Vladimir2 , Luis Rafael Moscote Salazar4 , Samer S. Hoz5

The pneumatization of regions such as the apex of the temporal crag, the mastoid cells and the perilaberytic region is considered physiological in adults. The process of craniocervical pneumatization in unhealthy adults derives from a dysfunction at the level of the eustachian tube, which provides a valve effect causing an increase in pressure at the level of the middle ear, forcing the entry of air into the dome of the skull through the opening of the occipitomastoidal suture. The process of standard pneumatization of the temporal bones, begins in the final weeks preceding birth, characterized by a decrease in the embryonic mesenchyme at the antrum level and progresses through childhood until adolescence, when the stone portion at the level of the rock is pneumatized; Normal variants have been reported, such as pneumatization that extends from the temporal scale to behind the sigmoid sinus. With regard to the process of hyperneumatization, several etiologies have been proposed that a congenital process versus an acquired process to develop this condition should be compared. The present illustrative case is a seventy-three years old male presented to the outpatient clinic with chronic recurrent occipital headache, already investigated by general practitioner for elevated blood pressure which was excluded. We had checked him to exclude the cervical spinal origin of the occipital headache which was then excluded too. This case scenario demonstrates the debate about how to deal with such cases and thus the review will bring the attention of those who take care of such radiological findings to keep in mind the possible causes and complications according to the reported cases till now. We concluded that the hyperpneumatization of the craniocervical junction is an uncommon radiological finding that is usually asymptomatic although it can entail serious complications in some instances, especially when it enlarges progressively, which may be due to an acquired process. Thus, craniocervical hyperpneumatization deserves highlighting for the managing team to gain fluent treatment and better patient outcome.

152-157

Authors: Derouiche Samir? , Rezzag Mohcen Om Selma, Serouti Asma

Objective: To evaluate the acute toxicity effect of metribuzin at low dose on liver of mother rabbits and its fetus. Methods: Pregnant female rabbits Oryctolagus cuniculus were divided into three groups (n=5). The first group of non-treated pregnancy rabbits served as control; the second group of pregnancy rabbits were treated with 1/100 LD50 of metribuzin and the third group of pregnancy rabbits were treated with 1/50 LD50 of metribuzin. Metribuzin was added in their drinking water for 60 d before and during pregnancy. Levels of liver malondialdehyde, liver glutathione S transferase, serum glutamic oxaloacetic transaminase and serum glutamic?pyruvic transaminase were determined. Liver reduced glutathione level was also determined by a colorimetric method. And hepatic homogenate was analyzed by HPLC analysis to determine the existence of traces of metribuzin. Results: Results revealed a significant increase in level of liver malondialdehyde, glutathione S transferase, serum glutamic oxalacetic transaminase and serum glutamic-pyruvic transaminase activities in mother and fetuses rabbits of both metribuzin treatment groups as compared to the control group. However the level of reduced glutathione was decreased in mother and fetuses rabbits of both groups treated with metribuzin compared to control group. Also, the results obtained by HPLC technique showed the presence of trace metribuzin in liver cells of mothers and fetuses rabbits of the both metribuzin treated groups. Conclusions: In conclusion, this study shows that exposure to metribuzin at low concentrations causes a acute toxicity in liver of mother rabbits and its fetus, also the trace of the metribuzin detected in the liver is the origin of possible malformation of the fetuses or abortion of the rabbits.

163-166

Authors: Babak Mahshidfar1 , Fatemeh Motaghed2 , Mansour Nateghi3 , Davood Farsi1 , Saeid Abbasi1 , Mani Mofidi1 , Peyman Hafezimoghadam1 , Mahdi Rezai1?

Objective: To determine the amount and type of changes in the Emergency Department, in order to hasten treatment and disposition process of patients in the Emergency Department to expedite by eliminating or minimizing such changes that decreases the cost of treatment and drug resistance Methods: In this study, 1 005 patients’ file admitted to emergency department of Rasool Akram Hospital were reviewed to see at least two different health services or two shifts of one service with written orders. Results: In total, the rate of drug changes studied cases was obtained as 5.47%. The largest pharmaceutical group in which the changes were developed was antibiotic (2.8% from all cases and 50% of total drug changes). Among the various health services, the internal service had imposed the most changes (67.3% of total drug changes). Conclusions: Considering that after the removal of trauma patients, the frequency of drug changes had been 11.47%, then it should be noted that the frequency was high and it was not desirable. The greatest change has been operated by internal services due to the fact that most treatments in this department was carried out by drugs.

175-177

Authors: Yusuf Savran1? , Tugce Mengi1 , Merve Keskinkilic2

Levothyroxine intoxication is a rare clinical entity which is usually asymptomatic. However, severe symptoms such as respiratory failure, malignant hyperthermia, seizures, arrhythmia, and coma have been reported. In this case report, a patient who ingested high dose (15 mg) levothyroxine for suicide and admitted to intensive care unit was presented. There was a decrease in Glasgow coma score in the follow-up. The patient was intubated due to acute respiratory failure. Gastric lavage, activated charcoal, methylprednisolone, cholestyramine and therapeuthic plasma exchange were administered. Despite ingestion of high dose of levothyroxine, thyrotoxicosis symptoms resolved with appropriate treatment and the patient was discharged from the intensive care unit.

180

Authors: Beuy Joob1? , Viroj Wiwanitkit2