Comparison of Three Methods for NG Tube Placement in Intubated Patients in the Emergency Department

Introduction: Tubular feeding is used, in patients who cannot take food through their mouths, but their digestive system is able to digest food. This method is safe and affordable for the patient and results in maintaining the function of the digestive system and reducing the risk of infection and sepsis. Objective: The purpose of this study was to compare the three methods of the NG tube placement in intubated patients in the emergency department. Methods: This study is a randomized, prospective clinical trial conducted between 2016 and 2018. 75 patients who had been referred to the emergency department were enrolled in the study and divided into three groups, to have their NG tube insertion using either the conventional method (Group C), or using brake cable (Group B) or applying Rusch intubation stylet (Group S) for highwayman's hitch or draw hitch. Results: The mean duration of NG tube insertion was not significant between three groups (p=0.459), but the mean duration of NG tube insertion in group B was 18.43 ± 2.71 seconds and less than the other groups. NG tube insertion by first attempt in the group B was associated with the highest success rate. There was no significant difference, however, in the success rate in NG tube insertion on first and second attempts (p=0.376, p=0.353). Conclusions: The use of brake cable as a guide wire during insertion of a nasogastric tube increases the success rate on first attempt. No meaningful difference, however, was noted in the overall success rate in NG tube insertion on first and second attempts

Comparison of Three Methods for NG Tube Placement in Intubated Patients in the Emergency Department

Introduction: Tubular feeding is used, in patients who cannot take food through their mouths, but their digestive system is able to digest food. This method is safe and affordable for the patient and results in maintaining the function of the digestive system and reducing the risk of infection and sepsis. Objective: The purpose of this study was to compare the three methods of the NG tube placement in intubated patients in the emergency department. Methods: This study is a randomized, prospective clinical trial conducted between 2016 and 2018. 75 patients who had been referred to the emergency department were enrolled in the study and divided into three groups, to have their NG tube insertion using either the conventional method (Group C), or using brake cable (Group B) or applying Rusch intubation stylet (Group S) for highwayman's hitch or draw hitch. Results: The mean duration of NG tube insertion was not significant between three groups (p=0.459), but the mean duration of NG tube insertion in group B was 18.43 ± 2.71 seconds and less than the other groups. NG tube insertion by first attempt in the group B was associated with the highest success rate. There was no significant difference, however, in the success rate in NG tube insertion on first and second attempts (p=0.376, p=0.353). Conclusions: The use of brake cable as a guide wire during insertion of a nasogastric tube increases the success rate on first attempt. No meaningful difference, however, was noted in the overall success rate in NG tube insertion on first and second attempts

The nephroprotective effect of Eryngium caucasicum extract alone and in combination with metformin in adult male diabetic rats

Introduction: Diabetes mellitus (DM) is a metabolic disease associated with the disorders in the metabolism of carbohydrates, proteins, and lipids that affect insulin action. Objectives: The present study was designed to evaluate the nephroprotective effect of Eryngium caucasicum (Eryngo) extract alone and in combination with metformin (MET) in adult male diabetic rats. Materials and Methods: Thirty male Wistar rats randomly were designated into five groups (n = 6) including; group I (Control); rats received normal saline by gavage for 15 days. Group II; rats received a single injection of STZ at a dose of 60 mg/kg intraperitoneally. Group III; rats, after STZ injection, received 30 mg/kg of MET by gavage for 15 days. Group IV; rats, after STZ injection, received 30 ml/kg of Eryngo extract by gavage for 15 days. Group V; rats, after STZ injection, received the combination of MET and Eryngo extract at a dose of 30 mg/kg by gavage for 15 days. The kidneys were removed immediately after sacrificing and prepared for morphological examination. Kidney sections were examined for the intensity of kidney damage (vacuolization, flattening, degeneration, and necrosis). Results: Significant differences were observed in types of morphologic injury to renal tubular cells between groups (P < 0.05). Eryngo extract had more protective effect against kidney damage due to DM compared to MET and the combination of MET+Eryngo. Additionally, in pairwise comparisons of groups, the relationship between group II (DM group) and group IV (DM + Eryngo) was significant (P < 0.05). Conclusion: The administration of MET and Eryngo extract alone and their combination ameliorate types of morphologic injury to renal tubular cells in diabetic rats, however, the renoprotective effect of Eryngo extract alone is more remarkable

Comparative study of nephroprotective effects of resveratrol and silymarin in diabetic rats; an experimental histopathologic study

Introduction: Diabetes mellitus (DM) is distinguished as a serious health problem worldwide. The universal outbreak of DM because of urban life and alteration of lifestyle, day to day is increasing. Objectives: The present investigation was designed to evaluate the nephroprotective effects of resveratrol (RSV) and silymarin (SM) on morphologic injury to renal tubular cells in adult male diabetic rats. Materials and Methods: Twenty-five male Wistar rats randomly were designated into five groups (n = 5) including group I (control); rats received normal saline by gavage for 14 days. Group II; rats received a single injection of STZ at a dose of 60 mg/kg intraperitoneally and were also given isotonic saline orally for 14 days. Group III; Rats, after STZ injection, received 100 mg/kg of SM by gavage for 14 days. Group IV; Rats, after STZ injection, received 100 ml/kg of RSV by gavage for 14 days. Group V; rats, after STZ injection, received the combination of SM and RSV at a dose of 100 mg/kg by gavage for 14 days. The kidneys were removed immediately after sacrificing and prepared for morphological examination. Kidney sections were examined for the intensity of kidney damage (vacuolization, flattening, degeneration and necrosis). Results: Significant differences were observed in types of morphologic injury to renal tubular cells (vacuolization, flattening, degeneration and necrosis) between groups (P<0.05). Significantly, both the SM and RSV reduced the injury of renal tubular cells in diabetic rats (P<0.05). Conclusion: The findings of the present study indicated that although the protective effect of SM and RSV was more significant on necrosis and flattening, respectively, SM and RSV produced a nephroprotective impact on the injury of renal tubular cells in diabetic rats than their combination influences

Multivariable analysis of clinical and laboratory data manifestations predicting severity and mortality risk in patients with Coronavirus disease 2019 in the mountainous west of Iran: a retrospective single-center study

Background Few reports have addressed the clinical and laboratory features of patients with coronavirus disease-2019 (COVID-19) in mountainous areas, especially in Iran. Objectives To report the clinical and laboratory data and manifestations predicting mortality of patients with COVID-19 in the west of Iran. Methods We conducted a retrospective cohort study of 286 patients hospitalized with COVID-19 between 25 February 2020 and 12 May 2020 to describe their clinical symptoms and laboratory test findings when they were admitted at the Hajar Hospital affiliated with the Shahrekord University of Medical Sciences, and a multivariable analysis of factors that predict their disease severity and mortality. Results After hospital admission, 18 patients died and 268 were discharged. Older age [odds ratio (OR) = 1.02, 95% confidence interval (CI) = 1.01-1.04, P = 0.001], presence of underlying diseases (OR = 1.86, 95% CI = 1.01-3.45, P = 0.04), elevated hematocrit (OR = 1.08, 95% CI = 1.03-1.13, P = 0.002), and increase in red blood cell distribution width (RDW) coefficient of variation (OR = 1.18, 95% CI = 1.02-1.36, P = 0.02) were significantly associated with disease severity. Older age (OR = 1.00, 95% CI = 1.00-1.07, P = 0.03), hypocalcemia (OR = 0.20, 95% CI = 0.09-0.58, P = 0.002), hypophosphatemia (OR = 0.50, 95% CI = 0.26-1.02, P = 0.04), and increase in platelet-larger cell ratio (P-LCR; OR = 1.10, 95% CI = 1.00-1.15, P = 0.04) were significantly associated with mortality. The areas under the receiver operating characteristic curves were as follows: calcium 0.759; lactate dehydrogenase (LDH) 0.731; phosphorus 0.725; bilirubin 0.689; C-reactive protein 0.679; and RDW - standard deviation (RDW-SD) 0.624. Conclusions Those who did not survive tended to be elderly and had a greater incidence of comorbidities. Elevated LDH, decreased levels of calcium and phosphorus, and anemia at diagnosis were associated with greater risk of death for these Iranian patients hospitalized with COVID-19. Regular assessment of these markers would help to manage patients with COVID-19