Diagnostic utility of simple hematologic markers in acute gastroenteritis patients admitted to the emergency department

The contributions of hematologic parameters to the inflammatory response via different leukocyte and platelet pathways are well known. However, the diagnostic yield of these parameters in acute gastroenteritis (AGE) is not yet well understood. This study was planned to investigate the diagnostic value of simple hematological markers, including mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR), red cell distribution width (RDW), platelet distribution width (PDW), and platelet-to-lymphocyte ratio (PLR), in patients with AGE admitted to the emergency department. A total of 57 patients with AGE of either viral or bacterial origin and 69 age and sex-matched control subjects were studied. NLR, PLR, MPV, PDW, and RDW values in all patients were calculated and recorded from complete blood cell counts. A total of 126 patients (57 men [45.2%] and 69 women [54.8%]) were included in the study. The mean NLR and PLR values of AGE patients were significantly higher than those of health controls (NLR = 4.44 ± 4.1 for AGE patients and 2.22 ± 1.2 for controls [P < 0.001]; PLR = 160.4 ± 102.4 for AGE patients and 113.8 ± 42.6 for controls [P = 0.02]. ROC curve analysis suggested that the optimum NLR cut-off point for AGE was 2.08, with a sensitivity, specificity, PPV, and NPV of 70%, 65%, 62%, and 72%, respectively (AUC = 0.704). The optimum PLR cut-off point for AGE was 105.55, with sensitivity, specificity, PPV, and NPV of 71%, 50%, 54%, and 68%, respectively (AUC = 0.648). We demonstrated that NLR and PLR levels are elevated in AGE patients. Thus, NLR and PLR levels can be considered a valuable tool to differentiate acute gastroenteritis from other non-inflammatory emergent conditions. [Med-Science 2020; 9(2.000): 376-80

Case Report Rhabdomyolysis Secondary to Bee Sting

Insect stings belonging to Hymenoptera defined as wasps, yellow jackets, bees, or hornets by human usually result in unserious clinical pictures that go with pain. Rhabdomyolysis following a bee sting is a rare condition. This paper emphasizes "rhabdomyolysis" as a rare complication of this frequently observed envenomation. Rare but severe clinical results may occur due to multiple bee stings, such as intravascular hemolysis, rhabdomyolysis, acute renal insufficiency, and hepatic dysfunction. In bee stings as in our case, clinicians should be alert for rhabdomyolysis in cases with generalized body and muscle pain. Early onset alkaline diuresis and management in patients with rhabdomyolysis are vital in protecting the renal functions and preventing morbidity and mortality

Rhabdomyolysis Secondary to Bee Sting

Insect stings belonging to Hymenoptera defined as wasps, yellow jackets, bees, or hornets by human usually result in unserious clinical pictures that go with pain. Rhabdomyolysis following a bee sting is a rare condition. This paper emphasizes “rhabdomyolysis” as a rare complication of this frequently observed envenomation. Rare but severe clinical results may occur due to multiple bee stings, such as intravascular hemolysis, rhabdomyolysis, acute renal insufficiency, and hepatic dysfunction. In bee stings as in our case, clinicians should be alert for rhabdomyolysis in cases with generalized body and muscle pain. Early onset alkaline diuresis and management in patients with rhabdomyolysis are vital in protecting the renal functions and preventing morbidity and mortality

The value of the serum I-FABP level for diagnosing acute mesenteric ischemia

Purpose This study examined the feasibility of using the serum intestinal fatty acid binding protein (I-FABP) level for the early diagnosis of acute mesenteric ischemia, and investigated whether it contributes to the clinical decision-making process

Poisoning severity score, Glasgow coma scale, corrected QT interval in acute organophosphate poisoning

The aim of this study was to investigate effectiveness of the poisoning severity score (PSS), Glasgow coma scale (GCS), and corrected QT (QTc) interval in predicting outcomes in acute organophosphates (OP) poisoning. Over a period of 2 years, 62 patients with OP poisoning were admitted to emergency department (ED) of Erciyes University Medical School Hospital. The age, sex, cause of contact, compound involved, time elapsed between exposure and admission to the ED, duration of hospital stay, and cardiac manifestations at the time of presentation were recorded. GCS and poisoning severity score (PSS) was calculated for each patient. Electrocardiogram (ECG) analysis included the rate, rhythm, ST-T abnormalities, conduction defects, and measurement of PR and QT intervals. Sixty-two patients with OP poisoning presented to our ED from January 2007 to December 2008 from which 54 patients were included in the study. The mean age was 34.1 +/- 14.8 years. Of the cases, 53.7% were female. Twenty-six patients had a prolonged QTc interval. Mean PSS of men and women was 1.8 +/- 1.0. No statistically significant correlation was found between the PSS and QTc intervals of the cases. A significant correlation was determined between the GCS and PSS of grade 3 and grade 4 cases. GCS is a parameter that helps clinician to identify advanced grade OP poisoning patients in the initial assessment in the ED. However, ECG findings, such as prolonged QTc interval, are not effective in determination of short-term prognosis and show no relationship with PSS