Intra-articular injection of lidocaine before closed reduction of anterior shoulder dislocation produces the same pain relief as intravenous meperidine and diazepam.
Background:Little is known about biomarkers which are used to classification of patients in order to diagnosis severity of sepsis among clients of emergency units. It seems that Lactate’s clearance can be used in this regard. This study aimed to determine the relationship between Lactate’s clearance, mortality and organ’s dysfunction with severe sepsis.Materials and methods:In this study 90 patients with severe sepsis, were visited and examined exactly. Para clinical tests, serum venous lactate, organ’s dysfunction scores, Acute Physiology and Chronic Health Evaluation II (APACHE-II) and Sequential Organ Failure Assessment (SOFA) were applied upon admission and 6 hours after it. According to clinical and laboratory criteria, dysfunction in main organs were examined and Lactate’s Clearance was accounted. All the patients were cured according to early goal-directed therapy protocol.Results:Among the participants 49 and 41 were male and female respectively. The mean age of the group was 49.37±1.41. The patients were classified to groups, less or more than 10% lactate’s clearance. Mortality rate of the patients was 18.9% (17 people). Mean age of the dead group was 49.71±13.33. The mean of dysfunctional organs which is assessed in terms of clinical, laboratory and SOFA criteria was significantly higher among the dead group than other. The Lactate’s clearance in the dead group was significantly lower than the other group (p<.05).Conclusion:It was concluded that patients with severe sepsis is a marker which is related to tissue hypoxia, also lactate’s clearance increasing is related to drastic reduction in biomarkers, mortality, and incidence of organ’s dysfunction. Overall, patients with lower lactate’s clearance are counted a high risk group for mortality and organs’ dysfunction.
BACKGROUND:In recent years, the prevalence of poisoning has increased dramatically due to population growth and access to drugs and toxins. Today poisoning is one of the important reasons for visiting hospitals.AIM:The present study aimed to investigate the effect of magnesium sulfate on organophosphorous toxicity.METHODS:Patients who had inclusion criteria in the study were randomly assigned to one of two groups (control group or case group) by an emergency medicine specialist. Patients’ data including age, sex, ECG, vital signs, arterial oxygen saturation were recorded for patients. Patients in the case group (40 subjects) received 2 mg magnesium sulfate 50%, while the control group (40 subjects) received 100 cc normal saline (as placebo) as an intravenous infusionRESULTS:The distribution of gender in the two groups of patients was the same. Also, the mean age, Stature and weight of patients were similar in both groups. In the group receiving magnesium sulfate, diastolic blood pressure was lower when compared with another group, at 0 and 2 hours after intervention. Moreover, the mean of systolic blood pressure in both groups was determined to be the same at all hours. Furthermore, the heart rate in the group receiving sulfate was lower as compared to the control group for 8 hours, 16 and 24 hours after intervention.CONCLUSION:The use of magnesium sulfate in organophosphate poisoning reduces therapeutic costs an average hospital length of stay and mortality compared to those who did not receive magnesium sulfate.
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