What are the effects of taking 300 pills of sodium valproate? - case report

INTRODUCTION: Sodium valproate is one of the most important antiepileptic drugs. It can be effective as a preventive treatment for migraine, it has also found use in the maintenance treatment of bipolar disorder and acute mania,it is sometimes used in the treatment of chronic neuropathic pain and fibromyalgia, in the treatment of schizophrenia borderline personality disorder and acquired brain injury, this drug is used off-label. Its overdose can be fatal. MATERIALS    AND  METHOD:  Patient  information  was  collected  from  hospital  records available in the clinical toxicology department. In addition, we conducted a literature review on sodium valproate treatment, its toxicity, side effects and pharmacokinetics using PubMed. CASE  REPORT:  A 57-year-old patient with a history of depressive disorders was admitted to the Clinical Department of Toxicology and Cardiology in Lublin for intentional intoxication with the drug Absenor (sodium valproate). The patient had taken 3 packages of Absenor 500 mg (300 tablets in total) for suicidal purposes. The determined concentration of valproic acid was 841 µg/ml, and the patient's condition was very severe. Despite the treatment administered-multiple attempts at gastric lavage, administration of activated charcoal, performance of hemodialysis procedures, administration of infusion of catecholamines, the patient died on the fifth day of hospitalization. CONCLUSION:  An overdose of sodium valproate can be fatal. Keep this in mind when ordering this drug for patients with a positive history of suicide attempts.&nbsp

Diet and physical activity in the treatment of obesity - current knowledge

Introduction: Obesity is now becoming a growing problem and challenge for medicine. The number of people with excessive body weight has now reached more than 2 billion, or about 30% of the world's population. The purpose of this article is to identify and describe some of the already known treatments for obesity, along with the latest research on the subject, in order to show the importance of developing and introducing new methods of weight loss.Aim of the study: The purpose of this article is to review the impact of obesity on health and the diets offered to people struggling with the disease.Materials and methods: We reviewed the literature available in the PubMed database up to November 2022, using the keywords.Results: Consistently limiting caloric intake is a must when losing weight. There are also diets such as low-carbohydrate, low-fat and high-protein diets, but following them can also have some side effects. For example, a high-protein diet can lead to kidney stones. The Mediterranean diet is also a good option for people with obesity. It lowers the risk of cardiovascular disease and cancer. All obesity treatment suggestions consistently recommend a balanced and low-calorie diet with reduced fat (along with saturated fatty acids) and optimal amounts of fiber. In addition to diet, physical activity is an important topic. The primary recommendation for people with obesity is at least moderate to vigorous physical activity of at least 150 minutes per week.Summary: In conclusion, the overarching goal of obesity treatment is to improve quality of life. Calorie restriction, regular exercise or a combination of both is accepted as an effective strategy for preventing or treating obesity

What affects chronic lithium poisoning in psychiatric patients? - a case report

INTRODUCTION: Despite medical developments, drug poisoning still occurs. Lithium is a drug that has been used for more than 60 years as a mood stabilizer in the treatment and prevention of bipolar disorder, mania and recurrent depression. Lithium is the most commonly prescribed mood stabilizer. It has a narrow therapeutic index.  Its target concentration in acute mania should be 0.6-1.5 mEq/L and 0.6-0.8 mEq/L for maintenance therapy. Because of this, there is a risk of lithium intoxication. We would like to present to you the case of a patient with chronic lithium poisoning. MATERIALS  AND METHOD: Patient information was collected from hospital records available in the clinical toxicology department. In addition, we conducted a literature review on lithium treatment, its toxicity, side effects and pharmacokinetics using PubMed. CASE REPORT: The patient, 58, was referred for lithium poisoning and admitted to the Clinical Toxicology and Cardiology Department in Lublin for treatment. The patient had a previous diagnosis of bipolar affective disorder, hypertension and obesity. According to the history, the patient was admitted to the psychiatric ward due to deterioration of her mental state for a month. She was found to have a high lithium level -2.98 mmol/L and elevated renal function parameters-creatinine 2.13 mg/dl.  During treatment with hemodialysis, these parameters returned to normal. CONCLUSION: It is important to remember that lithium has a narrow therapeutic range. Attention should be paid during lithium treatment to situations that increase the risk of adverse effects and the development of toxicity, and serum lithium concentrations should be monitored during treatment

Treatment of bilateral staghorn nephrolithiasis using percutaneous nephrolithotripsy in a patient chronically infected with Proteus mirabilis: a case report with literature review

Although urolithiasis is a common disease in the European population, bilateral staghorn stones are a relatively rare variant of nephrolithiasis. It is often associated with a chronic urinary tract infection or a metabolic disorder. The aim of this paper is to show an example of the treatment of bilateral staghorn  stones in a patient chronically infected with a resistant strain of Proteus mirabilis. Percutaneous nephrolithotripsy (PCNL) is currently the gold standard of treatment.  And this is the way the patient was managed. In the following section, the authors sought to describe new reports on this treatment method and how it could be improved.  Conservative treatment does not appear to be a safe alternative. And of the other surgical treatments, PCNL has the greatest benefits. Nearly 68% of patients with bilateral staghorn  stones have some underlying metabolic disorder in a small sample of patients. It seems reasonable, therefore, to introduce genetic and metabolic diagnosis in younger patients with the aim of prevention through diet or pharmacotherapy

Unintentional overdose of paracetamol as a problem of modern times - a case report

INTRODUCTION Paracetamol is one of the most widely used analgesics and antipyretics in the world. An overdose of this drug can occur after a single ingestion of a large amount of paracetamol or after repeated ingestion of smaller amounts that eventually exceed the recommended total dose and can result in liver damage.  It is believed that the maximum daily dose of paracetamol for an adult is 4g. MATERIALS AND METHOD Patient information was collected from hospital records available in the clinical toxicology department. In addition, we conducted a literature review on paracetamol using PubMed. CASE REPORT A patient, 16 years old, was admitted from a district hospital to the Clinical Toxicology and Cardiology Department in Lublin for paracetamol intoxication and suspected intoxication with a psychoactive substance. The patient's history revealed that he had taken a total of 20 paracetamol 500mg (10g) tablets in short intervals of 2 h for abdominal pain. The patient was treated with a full dose of antidote (ACC), and the drug infusion was continued at a maintenance dose. Despite the treatment administered, increasing features of liver damage were observed (INR 2.78, AST 6273 U/l, ALT 8854 U/l, bilirubin 3.83 mg/dl).The patient was consulted to qualify for a possible liver transplant. With intensive treatment maintained, a downward trend in liver damage parameters was achieved. The patient was discharged from the Department in good general condition, without complaints. CONCLUSION Due to the increasing number of paracetamol overdoses (intentional or accidental), strategies should be implemented to raise awareness and prevent this-educating patients, encouraging label/leaflet reading, reducing the amount of paracetamol in packages, more visible warnings on packages

The role of the skin microbiome in the development of alopecia areata

Human skin is a habitat to a variety of microbes that, along with their host genetic material, make up microbiome of the human skin. The composition of the microbiota in the gut and skin is influenced by many factors, such as life stage, nutrition, lifestyle and gender. Recently, there is more and more discussions about the increasing role of the microbiome in the development of other diseases. According to many studies, any changes in the skin microbiota are associated with the development of several dermatoses. Better understanding of the human microbiome and its interactions with the immune system could help us understand many diseases as well as could have an impact on the development of some new therapeutic methods. In this article, the current knowledge on the skin microbiome and its influence on the development of alopecia areata will be discussed. Alopecia areata (AA) is caused by an autoimmune process that destroys the hair follicles. The exact pathogenesis is unknown, but the triggering factors include: immune disorders, environmental exposures, genetic predisposition, and possibly the microbiome

Management of confirmed mushroom poisoning

During the autumn season, it is common for mushroom pickers to eat poisonous mushrooms. This is due to many reasons, including the ignorance of pickers. The most common is the misidentification of inedible species as edible mushrooms. The result is poisoning, which in many cases requires hospitalization. This paper presents a case report of toadstool poisoning by a 62-year-old female patient. In addition, other relevant publications on intoxication, diagnostic methods and treatment are reviewed. The purpose of this paper is to present the management and treatment of a case of toadstool poisoning. The effects of mushroom poisoning can range from mild disorders, mainly gastrointestinal to organ failure and even death. Significant elevations of liver enzymes and prothrombin time are important in laboratory tests in cases of intoxication. Treatment most often involves specific antidotes, such as Sylimarin, Acetylcysteine. The diagnosis in most cases is made on the basis of the clinical picture and a thorough interview with the patient, and the diagnosis is established by detecting toxins in a urine test. The prognosis is better if patients with toadstool poisoning are admitted to the hospital early. It is worth noting that gastrointestinal syndromes can also result from eating raw or inadequately cooked mushrooms, and by eating them excessively or too often. Proper diagnosis and treatment of mushroom poisoning can save lives. It is very important to raise public awareness of mushroom poisoning, as well as early detection of potential signs of intoxication. Cooperation with the poison center and mycologists is very important, especially in high-risk cases

On catatonia again... - literature review

Introduction: In addition to the symptoms, the symptoms of catatonia have been classified as a subtype of schizophrenia (catatonic schizophrenia). Currently, however, catatonia is treated as a single psychopathological syndrome that can occur in the course of various disorders. Catatonia has been the subject of many disputes in the scientific community over the years, and many of its elements remain unexplored. Material and method: The aim of the study is to review current research on catatonia in the field of: main, leading to catatonia, neuroimaging, immunology, methods of treatment and psychoactive compounds, COVID-19, therapy of pediatric and geriatric patients. The article reviews research and scientific papers from 2014-2022 on catatonia, interest in the PubMed and Google Scholar databases. Results: Studies showing a prevalence of catatonia of approximately 10.6 cases per 100,000 tax recipients. The assessment of the prevalence of individual catatonias varies depending on the criteria. Deep vein embolism has been confirmed in approximately 25.3% of patients with cardiac catatonia. Conclusions: Catatonia is a common neuropsychiatric syndrome that significantly prolongs hospitalization time. Additional studies using the technique of functional neuroimaging of the brain are needed. Effects of treatment with the effect of: zolpidem, memantine, amantadine and augmentation with amisulpiride

COVID-19 vaccination in pregnant and lactating women

Introduction: The COVID-19 pandemic significantly changed the lifestyle of pregnant women. Pregnant women with COVID-19 are more likely to suffer from severe disease, as well as unfavorable pregnancy and childbirth. Currently, there is no causal treatment for this disease available, so attention should be paid to preventing infection with vaccines. Aim of the study: A review of the literature on the influence of COVID-19 vaccines on the course of pregnancy and summary of recommendations regarding the use of COVID-19 vaccines during pregnancy and breastfeeding.  State of knwoledge: Three types of COVID-19 vaccines are most commonly used: mRNA vaccines, vector vaccines as well as subunit vaccines. In preclinical developmental and reproductive toxicity studies in animal models, there were no alarming safety signals, and observations of vaccinated pregnant women did not reveal any complications with respect to the course of pregnancy and development of the fetus. No cases of neonatal death have been reported in the first 28 days after birth. Most of the side effects following vaccination, such as injection site pain or tenderness, fatigue, fever or muscle pain, were moderate and resolved within 24 hours. The current research results confirm a positive immune response in pregnant women. Moreover, it is important that the presence of antibodies in the umbilical cord blood makes it possible to protect and reduce the risk of SARS-CoV-2 infection of the newborn. Summary: All pregnant women, irrespective of trimester, and breastfeeding mothers are advised to administer a booster dose of the COVID-19 vaccine within an appropriate period of time after the primary vaccination schedule

The role of environmental factors in the etiology of schizophrenia

Introduction: Schizophrenia is a psychotic disease characterized by multifaceted psychopathology. To date, research has shown that it is an inherited disease and significant progress has been made in identifying genetic risk factors. Methods: This paper summarizes the current and most recent findings on the role of environmental factors, and demonstrates the continued need for more in-depth research to better understand how this type of disorder occurs. Results: Recent studies show that 15-40% of the risk that comes from environmental sources is not fully understood. Environmental factors that have been repeatedly studied and have been proven to influence the development of the disease include: obstetric complications, infections, childbirth in the winter or spring month, living in the city, severe childhood events or marijuana use. Discussion: Schizophrenia is a devastating mental illness that remains poorly understood. A full picture of how genetic and environmental risk factors affect the risk of developing schizophrenia requires an understanding of the interactions between them. It should be taken into account that for this disorder, the interactions between genetic and environmental risk factors are also not well understood and deserve further research in the future. In the case of schizophrenia, the interactions between environmental and genetic risk factors are not well understood and still require further research. Elucidating the mechanisms underlying the disease is extremely important, as it may have an impact on taking measures to prevent the development of the disorder. In addition, their discovery will help improve treatment. In conclusion, it is important to emphasize the need for further research to better understand the impact of environmental factors on the development of susceptibility to a mental disorder such as schizophrenia