Berat huseini, Afrodita

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Berat huseini, Afrodita
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Berat huseini, Afrodita

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    Ingestion of corrosive substances and the endoscopic role in assessing the severity of caustic injury
    (2023)
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    Irena Jurukov
    Introduction: The ingestion of caustic substances into the upper gastrointestinal tract is an unusual but potentially life-threatening problem. Aim: To evaluate the most commonly ingested corrosive substances, and the endoscopic findings, complications, and final outcomes of caustic intake. Material and methods: This cross-sectional study included 220 inpatient participants with corrosive poisonings during a 3-year period (2017–2019). Data from the national patient electronic system “My term” and from the “Poisoning information centre” at the University Clinic for Toxicology, Skopje were used. Demographic characteristics, type of corrosive substance, endoscopic findings by Kikendall classification, emerging complications, fatal outcome, and hospitalization were analysed. Data obtained were analysed with the SPSS software package, version 22.0 for Windows. Results: During the period 2017–2019, out of 220 hospitalized cases with corrosive substance intake, 132 (60%) were with ingestion of acids, 19 (8.6%) with bases, 32 (14.6%) with bleaches, and 37 (16.8%) with other household products (p = 0.3469). The mean age of patients was 49.89 ±19.86 years. The most severe endoscopy findings (high-grade injury) were significantly more often associated with acid and base ingestion (p = 0.00001). Out of all strictures, 25 (64.1%) were on one location (either oesophagus or stomach), and 12 (30.8%) were on 2 locations. Conclusions: Upper gastrointestinal endoscopy is very important procedure for rapid assessment of severity of caustic injury, early appropriate therapy, as well as the potential development of strictures. The obtained data are very important for the development of a national program for the prevention of corrosive poisoning in our country.
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    Rhabdomyolysis and Aminotransferase Activity Due to Acute Intoxication With Psychotropic and Chemical Substances
    (Arak University of Medical Sciences, 2023-01)
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    Background: Rhabdomyolysis is caused by the release of enzymes from skeletal muscles into the blood, which leads to systemic complications with diverse etiologies. This study evaluated the serum aminotransferases in patients with rhabdomyolysis following acute intoxication with either psychotropic drugs or other chemical agents. Methods: This study randomly recruited 140 patients suffering from rhabdomyolysis. They were divided into two groups affected by either psychotropic drugs or chemical agents. Rhabdomyolysis was defined as having serum creatine kinase (CK) levels greater than 250 U/L, based on the poisoning severity score. Results: On day 1, the CK/AST correlation was significantly stronger in the psychotropic than the chemical group (P=0.0009). On day 5, patients in the psychotropic group had significantly higher AST (P=0.0138) and ALT (P=0.0129) than those poisoned with other chemicals. The difference in the strength of the CK/ALT correlation between the two groups was insignificant. Between the two groups, the differences between the CK levels and the following serum parameters were insignificant: Alkaline phosphatase; gamma-glutamyl transferase; prothrombin time; total bilirubin; and albumin. Conclusion: The elevated aminotransferases in patients with rhabdomyolysis due to acute psychotropic toxicity might have resulted from the skeletal muscle injury rather than hepatotoxicity. In rhabdomyolysis patients poisoned with other chemicals, the elevated serum aminotransferases are likely due to liver toxicity arising from the consumed substances. These patients are likely to manifest clinically severe long-term multi-organ failure. Intoxications with typical agents, such as herbicides, petroleum distillates, and corrosives were responsible for the rhabdomyolysis in the second group