Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina
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Randomized Controlled Trial
Comparison of intubation condition and the quality of muscle relaxation between rocuronium and vecuronium using "timing principle".
Aim To compare the quality of the conditions for endotracheal intubation and muscle relaxation between rocuronium bromide and vecuronium bromide using the ''timing principle'' method for induction in anaesthesia. The "timing principle" includes the administration of muscle relaxants before the hypnotic agent during induction in anaesthesia. Method Sixty patients who had undergone elective surgery were randomly allocated into two equal groups using muscle relaxants: rocuronium (group R) and vecuronium (group V). ⋯ The absence of TOF twitches (the level of muscle relaxation of 100%) at intubation recorded in 25 (83.3%) patients in the group R versus five (16.7%) patients in the group V (p<0.000). Duration of direct laryngoscopy did not significantly differ between the groups. Conclusion Rocuronium bromide provides better intubation conditions and greater quality of muscle relaxation than vecuronium bromide using ''timing principle'' technique.
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Aim BRAF mutation inhibits many tumour suppressor genes, increases pro-angiogenic molecules and reduces radioactive iodine uptake of tumour in papillary thyroid cancer (PTC), giving it more aggressive clinical characteristics. In this study, we aimed to evaluate the effect of BRAF V600E mutation on the clinicopathological features in patients with PTC. Methods The laboratory and clinical findings of 256 PTC patients who were referred to our clinic between 2007 and 2017 were assessed. ⋯ During a followup period, four patients with BRAF V600E (+) and two patients with BRAF V600E (-) status underwent lateral neck dissection due to lymph node metastasis (p=0.01). Conclusion The presence of BRAF V600E mutation was proved to be a poor prognostic factor. However, in order to further assess the prognostic effect of BRAF V600E mutation in this group of patients and particularly its effect on mortality, long term followup results must be evaluated.
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Aim To describe the experience of healthcare professionals in assessing pain and communication in patients with hip fractures and dementia in an emergency department. Methods Data were collected through focus group interviews using open-ended questions, following an interview guide and qualitative content analysis. Twenty one registered nurses participated in the interviews, five male and 16 female, aged 26 to 55 years. ⋯ Conclusion The situation of patients with hip fracture and dementia on the emergency department and healthcare professionals who communicate and assess their pain can be said to be untenable. The care environment in the emergency department is not adapted to patients and can of course depend on several factors. To meet the needs of the future and increased numbers of those patients, some improvements such as more extensive research and more studies on the experiences of both the patients and healthcare professionals are required.
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Aim Wild mushroom intoxication is a public health problem, which causes a wide range of symptoms: from mild gastrointestinal symptoms to multiple organ failure and death. The present study aims to evaluate the epidemiology of mushroom intoxication in 4-year admissions of Razi Hospital, Qaemshahr, Mazandaran, Iran. Methods Medical records of all identified cases of mushroom poisoning admitted during the period between 2015 and 2018 were extracted and patients' demographic data including age, sex, latency period, season of poisoning, clinical presentations, laboratory findings, prognosis, duration of hospitalization and therapeutic interventions were recorded. ⋯ In 93% of patients ranitidine, in 7% Penicillin G, and in 3.6% cefaclor and ceftriaxone was administrated. Conclusion People and health care providers must be educated about mushroom poisoning. Prompt transfer of suspicious cases with history of wild mushroom ingestion to the emergency department is crucial since patients showing toxicity symptoms after 6 hours might have worse and mortal prognosis despite treatment.
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Aim Distal femoral shaft fractures are characterized by increasing incidence and complexity and are still considered a challenging problem. No consensus on best surgical option has been achieved. The aim of this study is to investigate mineral bone densitometry, radiographic and clinical outcomes of locking retrograde intramedullary nailing (LRN) and non-locking retrograde intramedullary nailing (NLRN) regarding surgical treatment of distal femoral shaft fractures in adults based on the hypothesis that there is no statistical difference among the results of both surgical options. ⋯ Only one patient of LRN group had reduction of mineral bone densitometry values. Conclusion No statistical difference in terms of radiographic, bone densitometry and clinical outcomes among LNR and NLNR for the treatment of distal femur fractures was found. The presence of no statistical difference regarding radiological findings is the main factor supporting our hypothesis given their strong objectivity.