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International Journal of Critical Illness and Injury Science

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https://www.readbyqxmd.com/read/29963416/wild-tuber-poisoning-arum-maculatum-a-rare-case-report
#1
K N J Prakash Raju, Kishen Goel, D Anandhi, Vinay R Pandit, R Surendar, M Sasikumar
Arum maculatum , commonly known as wild Arum , is a woodland plant species of the Araceae family. All parts of this plant are considered toxic. We report a case of a young man who allegedly consumed poisonous wild tuber with suicidal intention. He presented to our emergency department 3 h later with features of angioedema. He was managed successfully with adrenaline and hydrocortisone. He was discharged after 4 days of observation. Later, the wild tuber plant was identified to be A. maculatum . We recommend that all patients who present with unknown substance poisoning should be managed according to the principles of intensive care, irrespective of the diagnosis...
April 2018: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29963415/perioperative-management-of-massive-fat-embolism-syndrome-presenting-as-refractory-status-epilepticus
#2
William Watson, Jack Louro, Roman Dudaryk
Fat embolism syndrome (FES) most commonly can occur after trauma in patients with long bone fractures. While the majority of FES cases present as a mild decrease in mental status, some may manifest as seizure activity. We describe a case of a young patient with traumatic fractures who developed FES leading to refractory status epilepticus and simultaneously required damage controlled orthopedic surgery. The role of imaging modalities including magnetic resonance imaging, transcranial Doppler, and transesophageal echocardiography in diagnosis is discussed, and a multidisciplinary approach to successful perioperative management is described...
April 2018: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29963414/-clostridium-perfringens-empyema-in-a-patient-with-metastatic-squamous-cell-carcinoma-of-the-lung
#3
Daniel Jungmyung Oh, Stephen Brecher, Marcus Ruopp
We report a rare case of Clostridium perfringens (CP) empyema in a patient with metastatic squamous cell cancer of the lung. Clostridial empyemas are rare and clinically variable with some reports noting consequent necrotizing infections and septic shock and others noting quick resolution with source control and antibiotic treatment. This is the first case report to our knowledge to report a CP empyema in a patient with lung malignancy. Given the comorbid lung malignancy, the patient's presenting symptoms were mild with only mild shortness of breath, fevers, and generalized weakness despite the large CP empyema...
April 2018: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29963413/ultrasound-guided-peripheral-nerve-blocks-in-high-risk-patients-requiring-lower-limb-above-and-below-knee-amputation
#4
Faisal Shamim, Malika Hameed, Nadeem Siddiqui, Shemila Abbasi
A case series of five high-risk patients with lower limb ischemia, sepsis, altered coagulation, and multi-organ dysfunction requiring emergent or urgent lower limb amputation is presented. Use of peripheral nerve blocks for below and above knee amputations is quite uncommon which provides better hemodynamic stability and pain management, especially in the very sick patients. The surgeries were successfully carried out under ultrasound-guided combined femoral and sciatic nerve blocks. All five patients obtained adequate level of block at the area of amputation...
April 2018: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29963412/primary-cecal-pathologies-presenting-as-acute-abdomen-and-critical-appraisal-of-their-current-management-strategies-in-emergency-settings-with-review-of-literature
#5
Singh Mathuria Kaushal-Deep, Afzal Anees, Shehtaj Khan, Mohammad Amanullah Khan, Mehershree Lodhi
Background: The importance of cecal pathologies lie in the fact that being the first part of the large intestine, any disease involving the cecum affects the overall functioning of the large bowel. Primary cecal pathologies presenting as acute abdomen have not been described in any previous study in terms of presentation, management, and outcome. Objectives: The objective of this study was to identify the reported causes of primary cecal pathologies presenting as acute abdomen and the various causes presenting in our setting, the to discuss morbidity and mortality associated with cecal pathologies, and to critically analyze the various management modalities employed in an emergency setting...
April 2018: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29963411/antibiotic-stewardship-program-in-intensive-care-unit-first-report-from-iran
#6
Ghoncheh Vahidi, Mostafa Mohammadi, Lida Shojaei, Masoud Ramezani, Sirus Jafari, Hossein Khalili
Introduction: Few data regarding antibiotic stewardship programs in critically ill patients are available. In the present study, the consequence of changing an empirical antibiotic regimen from a carbapenem (meropenem) to a noncarbapenem antibiotic (piperacillin-tazobactam) was evaluated in critically ill patients with a suspicion of sepsis. Methods: This open-label randomized clinical trial was conducted during May 2015-January 2017 at the general Intensive Care Unit of the Imam Khomeini Hospital Complex, Tehran, Iran...
April 2018: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29963410/prevalence-of-common-nosocomial-organisms-in-surgical-intensive-care-unit-in-north-india-a-hospital-based-study
#7
Arshi Taj, Anjum Shamim, Shoiab Bashir Khanday, Mohamad Ommid
Background: Nosocomial infection presents with high mortality rate, and it remains a diagnostic and treatment challenge for health-care providers, with developing countries having the highest incidence and mortality rates.[1]. Aim: The present study was undertaken to evaluate prevalence of commonly isolated nosocomial organisms in patients admitted in Surgical Intensive Care Unit (ICU) in Government Medical College Srinagar. Materials and Methods: The study was proposed to be conducted in surgical ICU of Shri Maharaja Hari Singh - a Tertiary Care Hospital in Jammu and Kashmir (India) from March 2015 to March 2016...
April 2018: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29963409/portal-vein-thrombosis-what-surgeons-need-to-know
#8
REVIEW
Ricardo Quarrie, Stanislaw P Stawicki
Key points: (a) The lifetime risk of portal vein thrombosis (PVT) is approximately 1%; (b) The portal vein is formed by the union of the splenic and superior mesenteric veins posterior to the pancreas; (c) Imaging modalities most frequently used to diagnose PVT include sonography, computed tomography, and magnetic resonance imaging; (d) Malignancy, hepatic cirrhosis, surgical trauma, and hypercoagulable conditions are the most common risk factors for the development of PVT; (e) PVT eventually leads to the formation of numerous collateral vessels around the thrombosed portal vein; (f) First-line treatment for PVT is therapeutic anticoagulation-it helps prevent the progression of the thrombotic process; (g) Other therapeutic options include surgery and interventional radiographic procedures including mechanical thrombectomy and thrombolysis; (h) Portal biliopathy is a clinicopathologic entity characterized by biliary abnormalities due to portal hypertension secondary to PVT and appears to be more common in cases of extrahepatic PVT...
April 2018: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29963408/an-evidence-based-approach-to-evaluation-and-management-of-the-febrile-child-in-indian-emergency-department
#9
REVIEW
Prerna Batra, Neha Thakur, Prashant Mahajan, Reena Patel, Narendra Rai, Nitin Trivedi, Bernhard Fassl, Binita Shah, Abhijeet Saha, Marie Lozon, Rockefeller A Oteng, Dheeraj Shah, Sagar Galwankar
Fever is the most common complaint for a child to visit hospital. Under the aegis of INDO-US Emergency and Trauma Collaborative, Pediatric Emergency Medicine chapter of Academic College of Emergency Experts in India developed evidence-based consensus for evaluation and management of febrile child in emergency department. An extensive literature search and further online communication of the group led to the development of a detailed approach for the evaluation and management of individual conditions associated with fever...
April 2018: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29963407/evidence-based-approach-to-the-trauma-patient-in-extremis-transitioning-from-exclusive-emergency-department-thoracotomy-use-to-protocolized-approaches-incorporating-resuscitative-endovascular-balloon-occlusion-of-the-aorta
#10
M Chance Spalding, Peter G Thomas, M Shay O'Mara, Christine L Ramirez, Franz S Yanagawa, Heidi H Hon, Brian A Hoey, William S Hoff, James Cipolla, Stanislaw P Stawicki
No abstract text is available yet for this article.
April 2018: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29963406/what-s-new-in-critical-illness-and-injury-science-case-reports-the-first-step-on-a-path-toward-cure
#11
EDITORIAL
Ankush Gosain
No abstract text is available yet for this article.
April 2018: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29619342/never-over-until-it-is-over-carotid-cutaneous-fistula
#12
Craig Kornbau, Michael S Firstenberg
No abstract text is available yet for this article.
January 2018: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29619341/right-carotid-cutaneous-fistula-and-right-carotid-pseudoaneurysm-formation-secondary-to-a-chronically-infected-polyethylene-terephthalate-patch
#13
W T Hillman Terzian, Samuel Schadt, Sharvil U Sheth
Carotid endarterectomy (CEA) remains the treatment for significant carotid stenosis and stroke prevention. Approximately 100,000 CEAs are performed in the United States every year. Randomized trials have demonstrated an advantage of patch carotid angioplasty over primary closure. Complications from patches include thrombosis, transient ischemic attack, stroke, restenosis, pseudoaneurysm (PA), and infection. PA after CEA is rare, with a reported average of 0.37% of cases. We describe an unusual case of PA after polyethylene terephthalate (PTFE) patching for CEA...
January 2018: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29619340/takotsubo-cardiomyopathy-with-basal-hypertrophy-and-outflow-obstruction-in-a-patient-with-bowel-ischemia
#14
Ahmad Abuarqoub, Rana Garis, Hamid Shaaban, Ibrahim Khaddash, Fayez Shamoon
Basal septal hypertrophy is a rare and unique anatomical finding associated with hypertrophic cardiomyopathy (HCM). It is also described as a sigmoid hypertrophy and is linked with aging and chronic hypertension. Takotsubo cardiomyopathy is a transient cardiomyopathy that occurs during periods of high physical or emotional stress. Its occurrence with HCM is relatively common; however, this presentation occurs more often with the classic asymmetrical septal hypertrophy or the apical variant. This case demonstrates its coexistence with isolated sigmoid hypertrophy in an elderly, hypertensive female with severe ischemic bowel disease...
January 2018: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29619339/abortion-may-be-associated-with-elevated-risk-of-future-hypothyroidism
#15
Vivek Chauhan, Anurag Thakur, Gurudutt Sharma
Objective: Fetal microchimerism during pregnancy and abortion has been linked with autoimmune hypothyroidism in females. We conducted a case-control study to investigate the odds of "abortion in the past" in the newly diagnosed hypothyroid females compared to their age-matched euthyroid controls. Methods: All consecutive newly diagnosed hypothyroid females, over 1 year, were enrolled as cases. Age-matched euthyroid controls were selected from the same region...
January 2018: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29619338/three-versus-four-factor-prothrombin-complex-concentrate-for-the-reversal-of-warfarin-induced-bleeding
#16
Tara Holt, Scott Taylor, Prasad Abraham, Wesley Mcmillian, Serena Harris, James Curtis, Tai Elder
Objective: The objective of this study was to evaluate the effectiveness of 3-factor prothrombin complex concentrate (3F-PCC) compared to 4-factor PCC (4F-PCC) in warfarin-associated bleeding. Methods: This multicenter, retrospective, cohort study analyzed data from patients admitted between May 2011 and October 2014 who received PCC for warfarin-associated bleeding. The primary outcome was the rate of international normalized ratio (INR) normalization, defined as an INR ≤1...
January 2018: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29619337/prevalence-and-prognostic-significance-of-prolonged-qtc-interval-in-emergency-medical-patients-a-prospective-observational-study
#17
Chhagan Lal Birda, Susheel Kumar, Ashish Bhalla, Navneet Sharma, Savita Kumari
Introduction: QTc interval is affected by many factors and prolongation of same may have prognostic significance. A significant number of patients admitted in medical emergency are acutely ill, have multiple comorbidities and are on medications, all of these factors might affect QTc interval and prognosis. Materials and Methods: Single-center, prospective, observational study was carried out on 279 patients of different illnesses recruited from emergency medical services attached to the Department of Internal Medicine at Postgraduate Institute of Medical Education and Research, Chandigarh, India, a tertiary care hospital...
January 2018: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29619336/risk-of-acute-kidney-injury-in-critically-ill-surgical-patients-with-presumed-pneumonia-is-not-impacted-by-choice-of-methicillin-resistant-staphylococcus-aureus-therapy
#18
Kelsey B Billups, Erica E Reed, Gary S Phillips, Kurt B Stevenson, Steven M Steinberg, Claire V Murphy
Background: Vancomycin and linezolid are standard treatment options for nosocomial methicillin-resistant Staphylococcus aureus (MRSA) pneumonia. While acute kidney injury (AKI) is commonly attributed to vancomycin, existing data has not definitely confirmed vancomycin as an independent risk factor for AKI. Aims: This study aimed to quantify the incidence of AKI in Surgical Intensive Care Unit (ICU) patients receiving empiric vancomycin or linezolid for nosocomial pneumonia and to identify risk factors for AKI with a focus on MRSA antibiotic therapy...
January 2018: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29619335/role-of-neomycin-polymyxin-sulfate-solution-bladder-wash-for-prevention-of-catheter-associated-urinary-tract-infection-in-traumatic-brain-injury-patient-admitted-to-intensive-care-unit-a-prospective-randomized-study
#19
Neeraj Kumar, Yashpal Singh, Ghanshyam Yadav, S K Mathur, Umesh Kumar Bhadani
Background: Catheter - associated urinary tract infection (CAUTI) remains a critical threat for patients in intensive care unit especially in traumatic brain injury patients with low Glasgow coma score (GCS). Almost all patients in ICU receive antibiotic either prophylactic or therapeutic based on local antibiogram of particular ICU or hospital. For prophylaxis, systemic antibiotics are used. It will be helpful to avoid systemic side effects by introducing antibiotics locally through bladder irrigation...
January 2018: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29619334/factors-determining-outcomes-in-adult-patient-undergoing-mechanical-ventilation-a-real-world-retrospective-study-in-an-indian-intensive-care-unit
#20
Khalid Ismail Khatib, Subhal Bhalchandra Dixit, Mukund Manohar Joshi
Background: Characteristics of patients admitted to intensive care units with respiratory failure (RF) and undergoing mechanical ventilation (MV) have been described for particular indications and diseases, but there are few studies in the general Intensive Care Unit (ICU) population and even lesser from developing countries. Objective: This study aims to study clinical characteristics, outcomes, and factors affecting outcomes in adult patients with RF on MV admitted to ICU...
January 2018: International Journal of Critical Illness and Injury Science
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