These results generate the hypothesis that inpatients with cardiac arrest may have different benefits from lidocaine and amiodarone than previously demonstrated. Inadequate dosing and later administration of amiodarone in the code were two confounding factors in this study. Prospective studies evaluating these agents are warranted.

No abstract

The recent publication of the Institute of Medicine/Board on Health Care Services reports on the future of emergency care in the US health system has identified the main limitations of the care provided by emergency departments (EDs). Increased development of ED pharmacy services and increased involvement of pharmacists in the ED can contribute to improvements in shortcomings identified in the report. Pharmacy training programs must take the initiative to incorporate emergency care into their curricula to meet the predicted increase in demand for ED pharmacists. Pharmacy associations, administrators, and ED practitioners must direct research on the impact of the pharmacist in the ED.

Oral agents used for the management of type 2 diabetes mellitus include sulfonylureas, biguanides, thiazolidinediones, metglitinides, and/or α -glucosidase inhibitors. These medication classes can be further classified as hypoglycemic and antihyperglycemic agents. Hypoglycemia is a major symptom of toxicity of these agents, particularly with the sulfonylureas, including combination medications that include sulfonylureas. In overdose situations, metformin, a biguanide, can lead to considerable gastrointestinal adverse effects and potentially lactic acidosis in severe cases. Data on the management of toxicities of the other classes are limited. This article will review the treatment modalities that have been used for treating symptomatic hypoglycemia and metformin-induced lactic acidosis.

At present time portal hypertension is perceived as one of the complications of advanced liver disease. It results in various vascular changes in gastrointestinal tract (GI), including esophageal varices, gastric varices and portal hypertensive gastropathy (PHG). PHG and gastric varices are a common cause of acute as well as chronic bleeding from GI tract which resulted in significant mortality among patients. Objectives: To determine the frequency of gastric vascular changes in various causes of cirrhosis. Patients of age ≥30 years, with clinical evidence of cirrhosis and without prior treatment of esophagiogastric varices were included in the study. Results: A total of 100 patients were enrolled in the study out of which 47 were male and 53 were females with mean age of 53.6 years. The most common type of cirrhosis was turned out to be Hepatitis C affecting 50% of patients and most of the patients were in Child class C. Portal hypertensive gastropathy was present in 74% of patients. Among them 24.3% have mild changes while severe changes were present in75.7% of patients. Gastric varices were found in 40% of the patients and the most common type was IGV type I which was present in 29(72.5%) of the patients. Correlation of severity of PHG was seen with grading of esophageal varices, grading of gastric varices and Child class. Conclusion: Frequency of severe gastropathy is higher than the mild gastropathy. It is also concluded that gastric vascular changes are associated with cause of cirrhosis, child class and degree of portal hypertension.