Single injection volar digital nerve block technique is a suitable alternative for digital anesthesias in emergency departments.

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Background: Community-acquired pneumonia is an important cause of mortality and morbidity in all age groups. Oxidant and antioxidant mechanisms play an important role in the pathogenesis and mortality of community-acquired pneumonia. Objectives: In this study, the role of thiol/disulfide homeostasis in the diagnosis and prognosis of community-acquired pneumonia was investigated. Methods: This was a prospective, controlled, observational study involving 73 community-acquired pneumonia patients and 68 healthy volunteers. Results: The native thiol and total thiol, which are thiol/disulfide homeostasis components, were significantly lower in the community-acquired pneumonia group. It was also found that the native thiol was lower in the high-risk community-acquired pneumonia group and that the native thiol and total thiol were associated with the Pneumonia Severity Index, CRB65 (confusion, respiratory rate, blood pressure, ⩾65 years old), and CURB65 (confusion, uremia, respiratory rate, blood pressure, ⩾65 years old) scores. The thiol compound levels were also associated with the C-reactive protein and procalcitonin levels. However, there was no significant difference between the survivors and non-survivors in terms of the thiol/disulfide homeostasis parameters. Conclusion: This study demonstrated the important role that oxidative stress plays in the pathogenesis of community-acquired pneumonia. The thiol/disulfide homeostasis biomarkers especially the native thiol and index-1 levels were significantly lower in patients with community-acquired pneumonia. Further studies are needed to investigate the diagnostic and prognostic value of thiol/disulfide homeostasis parameters in community-acquired pneumonia.

Supposedly herbal weight loss pills are sold online and are widely used in the world. Some of these products are found to contain sibutramine by FDA and their sale is prohibited. We report a case of a female patient who presented to the emergency department after taking slimming pills. 17-year-old female patient presented to the emergency room with palpitations, dizziness, anxiety, and insomnia. She stated that she had taken 3 pills named La Jiao Shou Shen for slimming purposes during the day. Her vital signs revealed tachycardia. On her physical examination, she was restless, her oropharynx was dry, her pupils were mydriatic, and no other pathological findings were found. Sibutramine intoxication was suspected. She was given 5 mg IV diazepam for restlessness. After supportive therapy and observation in emergency department for 12 hours there were no complications and the patient was discharged home. Some herbal pills that are sold online for weight loss have sibutramine hidden as an active ingredient, and their sale is prohibited for this reason. For people who use herbal weight loss drugs, sibutramine excessive intake should be kept in mind at all times.

IntroductionCoronary artery disease (CAD) presents the summary of all complications (ischemia, necrosis, etc.) caused by an atherosclerotic occlusive lesion, narrowing the wall of one or more coronary artery and causing coronary blood flow not to meet the increased demand for oxygen in the myocardium (Stary, 1994;Stary et al., 1995). Atherosclerosis makes approximately up to 99% of the pathogenesis of CAD. Atherosclerosis is a chronic, multifactorial disease and usually affects the entire arterial system. The initial step of atherosclerosis is a vascular wall damage, and resulting endothelial cell dysfunction. Following important processes include inflammatory responses in vascular bed, cell proliferation, atherosclerotic plaque formation and revascularization. Acute coronary syndrome (ACS) is a complication of CAD and one of the major life-threatening emergencies. Rapid diagnosis and appropriate treatment is life-saving. Classification of ACS is based on ECG. Patients with acute chest pain and persistent (>20 minutes) elevation in ST-segment are classified as '' ST-elevation acute coronary syndrome'' (STE-ACS), and patients with acute chest pain without persistent ST-segment elevation are named as, ''non-