The effect of wet cupping on reactive airway dysfunction syndrome (RADS) caused by early exposure to chlorine gas: A randomized clinical trial

Objective: In the absence of targeted antidotes for chlorine gas poisoning, a common yet concerning problem, this study investigates the effect of Wet Cupping Therapy (WCT, or “Hijamat”) on the recovery process in chlorine-induced reactive airway dysfunction syndrome (RADS) patients. Materials and Methods: This randomized controlled trial enrolled 24 patients experiencing acute inhalation of chlorine poisoning in Tehran, Iran (2020-2021). Patients were randomly divided into control (n=12, receiving conventional treatment) and intervention (n=12, receiving conventional treatment plus WCT) groups. Signs and symptoms were assessed pre-intervention, and in the first hour, first week, and first month post-intervention.Results: Medical records of 24 patients, including 3(12.5%) men and 21(87.5%) women, with a mean age of 42.92 years old, were evaluated. Baseline characteristics were similar between the groups. WCT significantly improved symptoms (dyspnea, cough, chest tightness, etc.) within the first hour (p=0.003) compared to the controls, with no future significant changes during the first week and first-month post-WCT. Comparison between the groups revealed substantial differences in the following variables: dyspnea scale (p=0.009), respiratory rate (p=0.026), cough (p=0.001), breath shortness (p=0.006), chest tightness (p=0.002), chest pain (p=0.010), substernal burning (p=0.015), throat sore (p=0.005) and hoarseness (p=0.027). Peak flow meter readings, reflecting lung function, were also significantly higher in the WCT group at all time-points (p<0.007).Conclusion: WCT may offer a rapid and sustained improvement in pulmonary and respiratory symptoms following acute chlorine inhalation injury

THE EFFECT OF COVID-19 OUTBREAK ON THE MENTAL STATUS OF HEALTH CARE PROFESSIONALS IN THE PEDIATRIC INTENSIVE CARE UNIT

Background: Coronavirus disease 2019 (COVID-19) may affect the mental status of health care professionals. The purpose of our study is to evaluate the mental health effects of the COVID-19 epidemic on health care professionals in the pediatric intensive care units (PICUs). Subjects and methods: Our study was conducted prospectively between 01.04.20 and 10.04.20. The created questionnaire was applied to health care professionals through online platforms. Thus it was involved in 5 different institutions that participated from different regions of Turkey. With the questionnaire, we applied; the participants\u27 age, gender, the general status of contamination and the level of COVID-19 knowledge were questioned. Besides; Beck Anxiety Scale, Acute Stress Scale (PCL-5), STAI-1 and STAI-2 (State and Trait Anxiety Inventory 1-2) scales were used to determine the anxiety levels. Results: A survey of 210 participants, 86 (41%) doctors, 124 (59%) nurses, were included in our study. When we evaluate the Beck anxiety levels, the majority of the participants (44%) were normal, while about one third had mild anxiety. When we evaluated the acute stress scale, all participants had a certain amount of stress levels. The majority (80 people each (38%)) experienced mild and moderate acute stress. Being female and having chronic disease poses a high risk for anxiety (OR, 0.330; 95% CI, 0.087-1.250, p <0.05 and OR, 0.246; 95% CI, 0.068-1.116, p<0.05), preoccupation (OR, 0.603; 95% CI 0.261-1.395, p<0.05 and OR, 0.433; 95% CI, 0.122-1.538, p<0.05) and acute stress (OR, 0.294; 95% CI, 0.033-2.649, p<0.05 and OR, 0.317; 95 % CI 0.060-1.679, p<0.05). Professional definition, marital status and having a child do not pose any risk factors. Conclusion: Our study has shown that the COVID-19 outbreak affects the mental status of health care professionals working at PICU at various levels

THE EFFECT OF COVID-19 OUTBREAK ON THE MENTAL STATUS OF HEALTH CARE PROFESSIONALS IN THE PEDIATRIC INTENSIVE CARE UNIT

Background: Coronavirus disease 2019 (COVID-19) may affect the mental status of health care professionals. The purpose of our study is to evaluate the mental health effects of the COVID-19 epidemic on health care professionals in the pediatric intensive care units (PICUs). Subjects and methods: Our study was conducted prospectively between 01.04.20 and 10.04.20. The created questionnaire was applied to health care professionals through online platforms. Thus it was involved in 5 different institutions that participated from different regions of Turkey. With the questionnaire, we applied; the participants\u27 age, gender, the general status of contamination and the level of COVID-19 knowledge were questioned. Besides; Beck Anxiety Scale, Acute Stress Scale (PCL-5), STAI-1 and STAI-2 (State and Trait Anxiety Inventory 1-2) scales were used to determine the anxiety levels. Results: A survey of 210 participants, 86 (41%) doctors, 124 (59%) nurses, were included in our study. When we evaluate the Beck anxiety levels, the majority of the participants (44%) were normal, while about one third had mild anxiety. When we evaluated the acute stress scale, all participants had a certain amount of stress levels. The majority (80 people each (38%)) experienced mild and moderate acute stress. Being female and having chronic disease poses a high risk for anxiety (OR, 0.330; 95% CI, 0.087-1.250, p <0.05 and OR, 0.246; 95% CI, 0.068-1.116, p<0.05), preoccupation (OR, 0.603; 95% CI 0.261-1.395, p<0.05 and OR, 0.433; 95% CI, 0.122-1.538, p<0.05) and acute stress (OR, 0.294; 95% CI, 0.033-2.649, p<0.05 and OR, 0.317; 95 % CI 0.060-1.679, p<0.05). Professional definition, marital status and having a child do not pose any risk factors. Conclusion: Our study has shown that the COVID-19 outbreak affects the mental status of health care professionals working at PICU at various levels

Evaluation of nutritional status in pediatric intensive care unit patients: the results of a multicenter, prospective study in Turkey

IntroductionMalnutrition is defined as a pathological condition arising from deficient or imbalanced intake of nutritional elements. Factors such as increasing metabolic demands during the disease course in the hospitalized patients and inadequate calorie intake increase the risk of malnutrition. The aim of the present study is to evaluate nutritional status of patients admitted to pediatric intensive care units (PICU) in Turkey, examine the effect of nutrition on the treatment process and draw attention to the need for regulating nutritional support of patients while continuing existing therapies.Material and MethodIn this prospective multicenter study, the data was collected over a period of one month from PICUs participating in the PICU Nutrition Study Group in Turkey. Anthropometric data of the patients, calorie intake, 90-day mortality, need for mechanical ventilation, length of hospital stay and length of stay in intensive care unit were recorded and the relationship between these parameters was examined.ResultsOf the 614 patients included in the study, malnutrition was detected in 45.4% of the patients. Enteral feeding was initiated in 40.6% (n = 249) of the patients at day one upon admission to the intensive care unit. In the first 48 h, 86.82% (n = 533) of the patients achieved the target calorie intake, and 81.65% (n = 307) of the 376 patients remaining in the intensive care unit achieved the target calorie intake at the end of one week. The risk of mortality decreased with increasing upper mid-arm circumference and triceps skin fold thickness Z-score (OR = 0.871/0.894; p = 0.027/0.024). The risk of mortality was 2.723 times higher in patients who did not achieve the target calorie intake at first 48 h (p = 0.006) and the risk was 3.829 times higher in patients who did not achieve the target calorie intake at the end of one week (p = 0.001). The risk of mortality decreased with increasing triceps skin fold thickness Z-score (OR = 0.894; p = 0.024).ConclusionTimely and appropriate nutritional support in critically ill patients favorably affects the clinical course. The results of the present study suggest that mortality rate is higher in patients who fail to achieve the target calorie intake at first 48 h and day seven of admission to the intensive care unit. The risk of mortality decreases with increasing triceps skin fold thickness Z-score

Numerical study of effusion cooling on an adiabatic flat plate

AbstractThe present study aims to investigate the effectiveness of effusion film cooling on an adiabatic flat plate. Cylindrical holes of 30° inclination are used for supplying cold air to the hot primary flow. A non-dimensional parameter called the film cooling effectiveness is calculated for studying the influence of the velocity ratio for a continuous array of cooling holes. A new approach by splitting the full coverage of film holes into two zones of cooling rows is presented in this paper. The computational results from the investigation show that there exists strong relationship between velocity ratio and adiabatic film cooling effectiveness. The simulations of two zones indicate that a careful analysis of the distribution of cooling holes can significantly reduce the demand for the supply of cold air

The Differences in Viral Etiologies between Children with and without Severe Disability Admitted to the Pediatric Intensive Care Unit with Acute Respiratory Illness

Objectives The objectives of this study were to evaluate the differences in the viral etiologies and variability in the clinical course between children with and without severe disability (SD) admitted to the pediatric intensive care unit (PICU) with acute respiratory illness (ARI)

Propofol infusion syndrome or adrenoleukodystrophy?

Following a propofol anesthetic, a 5-year-old girl with lower extremity spasticity seized and developed hypertriglyceridemia, hyperkalemia, and metabolic acidosis. A presumed diagnosis of propofol infusion syndrome (PRIS) was made, but further investigation revealed neonatal adrenoleukodystrophy. PRIS should be considered with this constellation of symptoms, but other neurometabolic disorders must always be ruled out

A Comparison of Intravenous Levetiracetam and Valproate for the Treatment of Refractory Status Epilepticus in Children

Because of the lack of studies comparing the efficacy and safety of levetiracetam and valproate before the induction of general anesthesia in the treatment of convulsive refractory status epilepticus in children, we aimed to compare the effectiveness of these antiepileptic drugs in patients with convulsive status epilepticus admitted to the Pediatric Intensive Care Unit between 2011 and 2014. Forty-six (59%) of the 78 patients received levetiracetam, and 32 (41%) received valproate for the treatment of refractory status epilepticus. The response rate was not significantly different between the 2 groups. Although no adverse event was noted in patients who received levetiracetam, 4 (12.5%) patients in the valproate group experienced liver dysfunction (P = .025). According to our results, levetiracetam and valproate may be used in the treatment of refractory status epilepticus before the induction of general anesthesia. Levetiracetam appears as effective as valproate, and also safer