Clinical features in toxic coma in children

Stanca, Simona; Ulmeanu, Coriolan; Stanca, Horia Tudor; Iovănescu, Gheorghe

doi:10.3892/etm.2019.7857

Cited by 6 publications

(6 citation statements)

References 9 publications

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“…As regard Reed scale, the present results are in harmony with Stanca et al (8) results as they concluded that the increase of the degree of Reed scale were associated with bad prognosis. Convulsions, disturbance of heart beats and respiratory distress syndrome were more severe and frequent with 4 th degree Reed scale than the other lower degrees.…”

Section: Discussionsupporting

confidence: 91%

Validity of Vital Signs, Coma Scales and Modified APACHE Score in Prediction of Prognosis and Outcome of Acutely Poisoned Patients

Zaghary

Radwan

Elsayed

2021

The Egyptian Journal of Hospital Medicine

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Introduction: Acute toxicity management is a major medical problem in the whole world as poisoning is one of the most common causes for coming to hospital emergency departments. Early diagnosis and treatment in emergency department and ICU are critical for the poisoned patient to reduce hospital morbidity and mortality. Objective: Evaluation of the validity of coma scaling systems as Glasgow coma scale (GCS), Reed scale, poisoning severity score (PSS), modified acute physiology and chronic health evaluation (APACHE) score (MAS) and vital signs as predictors of clinical course and outcome of acutely poisoned patients. Patients and Methods: This retrospective study was carried out on 100 acutely intoxicated patients. They were selected from patients attended Sohag University Hospitals with age more than 18 years old who were in need for intermediate or intensive care unit. The study was conducted during the period from March 2018 to the end of February 2021. Results: this study revealed that 62% of the patients were in the age group 18-30 years old and 63% were females. The majority of them intoxicated by oral route (91%) and most of them were suicidal (68%). For the outcome, 75% of patients had been survived and 25% of patients died. PSS, Reed, MAS and GCS as coma scaling scores at admission showed significant difference between survivors and non-survivors of these patients. Systole and diastole as parameters of vital signs also showed significant difference between survivors and non-survivors. While, pulse, temperature and respiratory rate showed non-significant difference between survivors and non-survivors. Conclusion:The study concluded that PSS, Reed scale, MAS, GCS, diastole and systole respectively are valid prognostic tools for the outcome in acutely poisoned patients.

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Section: Discussionsupporting

confidence: 91%

Validity of Vital Signs, Coma Scales and Modified APACHE Score in Prediction of Prognosis and Outcome of Acutely Poisoned Patients

Zaghary

Radwan

Elsayed

2021

The Egyptian Journal of Hospital Medicine

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“…Patients with grade III had impaired reflexes. Patients in the grade IV toxic coma were unstable with affected vital center functions (Stanca et al, 2019).…”

Section: Methodsmentioning

confidence: 99%

Evaluation of Snake Bite Poisoned Cases "Clinical and Biochemical Predictors"

Abouhatab,

kandeel

2023

The Egyptian Journal of Forensic Sciences and Applied Toxicolog

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Background: in Egypt, there are several species of poisonous snakes. The current work aimed to evaluate the clinical and biochemical predictors of snakebite-poisoned patients admitted to Menoufia university poison control center (MPCC). Patients and methods: this work was an observational study done on 67 snakebite cases. Patient's data included sociodemographic data, site of bite, season of bite occurrence, time of presentation to hospital, and clinical manifestations with local and systemic examination. Required laboratory investigations were arterial blood gases (ABGS), complete blood count (CBC), international normalized ratio (INR), prothrombin time (pt), liver enzymes (ALT and AST), serum creatinine and blood electrolytes (sodium and potassium). Cases were classified according to the snakebite weakness and paralysis scoring into symptomatized four groups. The outcome is categorized as cured or dead. Results: the total number of cases was 67 patients manifested with neurotoxicity. Patients were sorted into grade 1 (38 cases), grade 2 (14 cases) grade 3 (8 cases), and grade 4 (7 cases). Most of the cases in whole and in different severity groups were males, in the age group 18-60 years, and from rural areas. As regards the time of presentation, 44.8% of all cases were presented in less than 4 hours. Regarding the place of admission, 77.6% of patients were admitted to the toxicology department. The most common local manifestations were fang marks and pain. Ptosis was the most common neuromuscular manifestation. Most cases were cured (97.0 %). Mortality rate was 3%. Patients with grade 3 and grade 4 snake severity scores were associated with affection of ABGS findings with hypoxia and respiratory acidosis, and with increased white blood cell count, elevated serum creatinine, and liver enzymes (AST, and ALT). Conclusion and recommendations: snakebites are a life-threatening condition. In the present study, neurotoxic snakebites were the most common type of snake in the Menoufia governorate. Patients with respiratory failure and needing mechanical ventilation were associated with increased mortality. Laboratory parameters such as ABGS, WBC, serum creatinine, AST, and alt were important predictors of severity.

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“…Considering the autoimmune nature of uveitis, patients should be tested for associated diseases before administering intraocular steroids (8)(9)(10)(11)(12). In order to exclude an infectious cause of uveitis, general examination and blood tests should be performed (13)(14)(15)(16)(17)(18). Triamcinolone acetonide (TA) belongs to the glucocorticoid family.…”

Section: Triamcinolone Acetonide Induces Sterile Endophthalmitis In Pmentioning

confidence: 99%

Triamcinolone acetonide induces sterile endophthalmitis in patients with intermediate uveitis: A case report series

Suta

Karancsi

Mușat³

et al. 2020

Exp Ther Med

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Due to their anti-inflammatory, antiangiogenic and antiedematous properties, corticosteroids have been commonly used in the treatment of retinal diseases. Intravitreal administration of steroids offers the maximal drug efficacy and the lowest risk of systemic side effects. The authors report three cases of presumed sterile endophthalmitis induced by triamcinolone acetonide (TA) in three eyes with intermediate non-infectious uveitis. Each patient received a single intravitreal injection of TA of 4 mg. Because of the intense vitreous inflammatory reaction, retina examination and the optical coherence tomography could not be performed, although vitreous opacities were observed on the ocular ultrasound. The dense vitreous opacity is a defining factor, the anterior segment inflammation is mild to moderate and a hypopyon is present, which may be a sterile inflammatory reaction or the triamcinolone material itself. In cases of sterile endophthalmitis, the visual acuity increases progressively as the intraocular inflammation diminishes. Local treatment with topical antibiotics, prednisolone acetate and cycloplegic eyedrops is recommended to control the inflammatory reaction.

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Clinical features in toxic coma in children

Cited by 6 publications

References 9 publications

Validity of Vital Signs, Coma Scales and Modified APACHE Score in Prediction of Prognosis and Outcome of Acutely Poisoned Patients

Validity of Vital Signs, Coma Scales and Modified APACHE Score in Prediction of Prognosis and Outcome of Acutely Poisoned Patients

Evaluation of Snake Bite Poisoned Cases "Clinical and Biochemical Predictors"

Triamcinolone acetonide induces sterile endophthalmitis in patients with intermediate uveitis: A case report series

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