Background: Polytrauma has a significant impact on the wellbeing and provided healthcare for the populations. More than fifteen percent of emergency room admission worldwide are due to blunt chest trauma (BCT), which comes in second most common cause of death in vehicle collisions after head injuries. Exposure of anterior chest wall to an abrupt high-speed deceleration injury results in thorax compression, which is a common cause of BCT. The trauma may cause damage to all thoracic structures. Objective: In patients with acute chest injuries, the goal of this study was to identify the early onset of myocardial contusion and its consequences. Patients and methods: This study was carried out over the course of a year in the Emergency Department of the Mansoura University Hospital. The research comprised 153 individuals who presented with solitary BCT. Results: When compared to patients without myocardial contusions, the mean heart rate was statistically significantly greater in the cases with myocardial contusions. The global circumferential strains (GCS) and the mean arterial pressure (MAP) were statistically significantly lower in the cases with myocardial contusions as compared with the cases with no myocardial contusions. In patients with myocardial contusions, the length of hospital as well as the length of intensive care unit (ICU) stays were statistically significantly longer. Conclusion:The diagnosis of blunt chest trauma is exceedingly difficult since it can result in a broad variety of clinical manifestations and damage. Patients may arrive at the hospital with stable hemodynamics and no symptoms.

Background: Septic shock is a life-threatening state characterized by inability of the organism to maintain sufficient blood pressure and thus end-organ perfusion because of sepsis. The cornerstones of treatment of sepsis and septic shock largely consist of early diagnosis of sepsis, control of infection source, early antimicrobials and supportive treatment with adequate hydration and vasopressor drugs. Objective: The current study aimed to evaluate the efficacy of Marik protocol treatment for septic shock. Patients and Methods: This was a prospective study that included 100 patients with septic shock who arrived to Emergency Departments of both Al-Azhar and Al-Mansoura University Hospitals over one year (January 2021-December 2021). Entire subjected were divided into a control group who administered a standard treatment and a treatment group who administered IV vitamin C, thiamine and hydrocortisone within 24 h after intensive care unit (ICU) admission. Results: Marik group was linked to a significant decrease in hospital mortality 4 (8%) and ICU mortality rate 45 (90%) in comparison with controls (P<0.001). A significant decrease in SOFA score was recorded among Marik group in comparison with control subjects (P<0.05). A statistically reduction in lactate co concentration during follow-up was recorded in Marik group only. Conclusion: Marik group was linked to a significant reduction in hospital and ICU mortality rate. A significant reduction in SOFA score was recorded among Marik group.

Background: NLR is advantageous in regard to simplicity, low cost, and availability compared to many other previously proposed biomarkers, which makes it promising for diagnostic clinicians. Several studies have reported that the NLR is useful in various clinical situations. Objective: To determine whether NLR obtained from complete blood count (CBC) and with simple calculation can be used to predict mortality in patients with sepsis and septic shock in the ICU in comparison with intensive care unit (ICU) severity scores. Patients and methods: This prospective trial was carried out on 84 ICU cases with severe sepsis, who were admitted to Specialized Medical Hospital ICUs from June 2020 to June 2021. Results: There was statistically significantly higher systolic blood pressure (mmHg), mean arterial pressure, rate pressure product *10^3, EF, INR, RBS, PH, HCO3, L *10^3, platelet count, CRP on admission, ABACHEII score, SOFA score on admission, duration of hospital stay (days), and a statistically significantly lower age (years), diastolic blood pressure (mmHg), heart rate, respiratory rate (RR), GCS, serum creatinine (mg/dl), serum albumin, serum bilirubin, Na, K, total leucocytic count *10^3, N *10^3, in group B NLR >10 vs. group A NLR≤ 10. Conclusion:Neutrophil to lymphocyte ratio is a cheap and rapidly available predictor of sepsis and has shown a significant correlation with other relatively expensive and non-rapidly existing markers of inflammation and sepsis with comparable efficacy with ICU severity scores [SOFA and APACHE II].