Acute poisoning is a frequent cause of admission to emergency departments and intensive care units, as it is considered as an important medical emergency requiring early diagnosis and rapid initiation of therapy. The aim of the present study was to assess characteristics, and outcomes of acutely intoxicated patients who were admitted to ICU. Also, design a scoring system regarding priority for ICU admission. The present study was carried out on 40 patients who were admitted to intensive care unit of El Mansoura General Hospitals-Egypt during a period of 6 months. Personal, toxicological, and medical histories, clinical examination and routine investigations were recorded for each patient. At discharge; all patients were reassessed for determination of patients' outcome. The patients were mostly females, single; student aged less than 30 years and from rural areas. The majority of the patients (72.5%) were recovered, 22.5% were died and 5% were referred to hyperbaric oxygen therapy units after carbon monoxide intoxication. Many patients were presented by constricted pupil (45%), respiratory depression (42.5%), altered mental status (42.5%), tachycardia (47.5%), and nausea & vomiting (75%). The highest numbers of cases were poisoned by medicinal drugs (40%) followed by agricultural chemicals (35%). Statistically significant difference between occupation, toxicological amount & frequency, pulse rate, Glasgow coma score, PH & PCO2 and type of poison (zinc phosphide) and patient outcomes was observed. Although many of the patients' characteristics were significantly associated with patient outcome yet none of them was considered significant predictors for death. So, the suggested scoring system depended mainly on clinical data and simple rapid investigation that may be helpful for rapid assessment of the patients after further validation. We recommend the presence of a channel of communication between the general care centers and the poison control centers for consultation about the protocol of treatment of poisoned patients. Nationwide, a mechanism of communication between the poison centers must be done to benefit from the different expertise and to make a uniform protocol for treatment of poisoned cases to decrease the mortality rate and the burden on hospitals resources.

Introduction: The Neonatal Resuscitation and Adaptation Score (NRAS) was developed to address the concerns regarding how resuscitation impacts the Apgar score and how it can be accounted for in the scoring assessment. Aims: The objective of this work was to compare between the Neonatal Resuscitation and Adaptation Score (NRAS) and the Apgar score, to determine the correlation between the two scoring systems, and their predictive ability for mortality and short-term morbidities.                Methodology: This study was a prospective cohort study. It was carried out on 410 neonates in Tanta University Hospital. Both Apgar and NRAS scores were recorded for all cases at 1st and 5th minutes of life. The scores were divided into three categories: Low (0-3), Middle (4-6), High (7-10). All neonates were followed up for 48 hours. Correlation between both scores and neonatal outcome were recorded. Results: There was a significant positive correlation between Apgar and NRAS scores at both 1st and 5th minutes. NRAS score was more précised in discriminating neonatal admissions, mortality, need for respiratory support and morbidities than Apgar score at both 1st and 5th minutes. The regression model revealed that Apgar 5th min and both of NRAS 1st and 5th minutes were significant predictors for neonatal mortality and morbidities. The most significant predictor was NRAS 1st min. Conclusion: Both scores can be used in assessing the neonatal condition. The most significant predictor for neonatal mortality and morbidities was NRAS 1st min.

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Background: Preterm birth (< 37 weeks gestation) is a major cause of death and a significant cause of long-term loss of human potential amongst survivors all around the world. Aim: Compare between two neonatal mortality risk scores, Score for neonatal acute physiology perinatal extension (SNAP-PE II) and Clinical risk index for babies (CRIB), in predicting the neonatal mortality in septic preterm admitted to neonatal intensive care unit (NICU) of Tanta University Hospital (TUH) over a period of one year. Patients and Methods: This was a prospective cohort study carried out on 200 septic preterm newborns admitted to NICU of TUH over 1 year period. 89 cases representing (44.5 %) were female and 111 cases representing (55.5%) were male. All of them were admitted to NICU [within their first 48 hours of birth]. All septic preterm neonates will be followed up till their death or discharge. SNAP-PE II and CRIB scores applied to all the septic preterm neonates in this study during the first 12 hours after diagnosis of sepsis in NICU according to Modified Hematological scoring system (MHSS). Results: There was a weak positive correlation between MHSS score for neonatal infection and both of the SNAP II and CRIB scores. Conclusion: Both SNAP-PE II and CRIB scores have good sensitivity for predicting neonatal mortality which was slightly higher in SNAPPE II score. Neonatal Mortality rate was significantly correlated with high MHSS.

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