A Rare Case of Gastrointestinal Tract Foreign Body; Glassy Stomach

Ingestion of foreign bodies is common and conservative treatment can eliminated most particlesfrom the gastrointestinal tractunless peritoneal signs appear. A 22-year-old man presented to emergency department who had ingested glass particles of a crushed beverage bottle. He complained of epigastric and periumbilical pain. Physical examination did not revealany peritoneal signs. Abdominal X-ray showed stomach full of small glass particles. Conservative treatment, without any surgical intervention,resulted insafely eliminating glass particlesin this patient

The effect of physiologic dose of intravenous hydrocortisone in patients with refractory septic shock: a randomized control trial

Objective: Septic shock is a response to infection and tissue hypoperfusion which does not respond to fluid therapy and eventually leads to organ dysfunction. Aggressive treatment of a broad-spectrum antimicrobial and supportive measures are the cornerstones of successful treatment. In addition to the main treatment, there are adjunctive therapies. Steroids are one of the treatments which have been studied in the management of refractory septic shock. Despite numerous studies on the role of steroids in the mortality of severe sepsis and septic shock, still lots of controversies exist. These conflicts are often about the steroid dose and duration of administration. Methods: This was a prospective, randomized-controlled, two-group assignment study. Patients referred to Imam Reza (AS) hospital in Mashhad who had refractory septic shock criteria were randomly divided into two groups: 80 patients were included in each group. After obtaining the baseline cortisol level and cosyntropin test, one group was treated with intravenous hydrocortisone, and the other group was treated with placebo. The response to hydrocortisone, the return of shock duration, and mortality at 28 days were investigated. The data were analyzed using SPSS version 16. For the normally distributed variables, a t test was used for comparisons. Concerning qualitative variables, the chi-square test or Fisher exact test were applied accordingly. Results: The return of shock duration and mortality in intervention group patients was more than control group, but it was not statistically significant. Conclusion: Despite numerous studies in this field, there are various outcomes (mortality rate, rate of return of shock, time of return of shock). These differences can be attributed to high degree of heterogeneity. Perhaps considering the underlying disease and more differentiation could change the return of shock and mortality rate

The Effects of Pantoprazole on the Treatment of Palpitation in Patients with Gastro esophageal Reflux Disease (GERD): A Case Series

Introduction: Atrial arrhythmia is a common complication in patients with gastro esophageal reflux disease (GERD). The treatment of palpitation is relatively problematic in these patients, especially if there is not enough evidence of cardiovascular or systemic diseases. The esophagus is in close proximity to the left atrium posterior wall. Hypothetically, locally released cytokines from esophageal injuries could stimulate the left atrium and produce premature atrial contractions. In this study we aimed to evaluate the effects of pantoprazole on palpitation in patients with reflux palpitation. Materials and Methods: This study was conducted on patients presented with palpitation and symptom of GERD from January 2014 to June 2014 in the General Clinic of Imam Reza Hospital. In order to establish the precise effects of pantoprazole on the treatment of palpitation in GERD patients, pantoprazole was added to the beta-blockers during treatment, and the patients were followed-up for one month. Results: In total, 10 patients within the age range of 21-35 years with a history of palpitation were enrolled in this study. The mean age of the subjects was 25 years, and the study group consisted of 6 men and 4 women. After a one-month follow-up, a significant reduction was observed in the palpitation of these patients (