Predictive Factors of Hospitalization and Dialysis Requirement in Alcohol Poisoning; a Cross-Sectional Study

Introduction: Alcohol abuse is one of the health problems that all societies have involved with. Although in Iran the percent of alcohol consuming due to social and cultural preventions is lesser that other countries, its outcome and predictive factors are not accessible. Thus, this study was designed with the aim of determining the consequences of alcohol consuming and finding its effective factors in Tabriz. Method: This cross-sectional study has been done through September 2013 to July 2014 in Sina Hospital, Tabriz, Iran. All individuals with alcohol poisoning referred to the emergency department were included in the study. Demographic and clinical factors of patients, laboratory tests, dialysis and hospitalization in hospital wards were evaluated. Finally, independent effective factors for dialysis and hospitalization were assessed by using multivariate logistic regression. Results: At the end, 81(91.4% male) patients with the mean age of 27.9±10.4 years were entered to the study. Ten (12.3%) patients needed dialysis and 34 (42.0%) were hospitalized. Increasing the serum creatinine level (OR-1.6; 95% Cl: 1.004-2.4; p-0.048) and time interval between consumption until referring to the emergency (OR-1.1; 95% Cl: 1.03-1.15; p-0.004) were the independent predictive factors of dialysis. Also, predictive agents of hospitalization included smoking (OR-3.4; 95% Cl: 1.6-5.5; p-0.01) and need to do dialysis (OR-7.9; 95% Cl: 5.4-10.5; p&lt;0.001). Conclusion: In the present project 12.3% of patients needed dialysis. Increasing the serum creatinine and time interval between alcohol consuming until referring to the emergency were the most important predictive factors. In addition, the probability of hospitalization for smoking and dialyzed poisoned persons in hospital wards was more than other patients.</p

عوامل پیشگویی کننده نیاز به بستری و دیالیز در مسمومیت با الکل؛ یک مطالعه مقطعی

Introduction: Alcohol abuse is one of the health problems that all societies have involved with. Although in Iran the percent of alcohol consuming due to social and cultural preventions is lesser that other countries, its outcome and predictive factors are not accessible. Thus, this study was designed with the aim of determining the consequences of alcohol consuming and finding its effective factors in Tabriz. Method: This cross-sectional study has been done through September 2013 to July 2014 in Sina Hospital, Tabriz, Iran. All individuals with alcohol poisoning referred to the emergency department were included in the study. Demographic and clinical factors of patients, laboratory tests, dialysis and hospitalization in hospital wards were evaluated. Finally, independent effective factors for dialysis and hospitalization were assessed by using multivariate logistic regression.Results: At the end, 81(91.4% male) patients with the mean age of 27.9±10.4 years were entered to the study. Ten (12.3%) patients needed dialysis and 34 (42.0%) were hospitalized. Increasing the serum creatinine level (OR-1.6; 95% Cl: 1.004-2.4; p-0.048) and time interval between consumption until referring to the emergency (OR-1.1; 95% Cl: 1.03-1.15; p-0.004) were the independent predictive factors of dialysis. Also, predictive agents of hospitalization included smoking (OR-3.4; 95% Cl: 1.6-5.5; p-0.01) and need to do dialysis (OR-7.9; 95% Cl: 5.4-10.5; p&lt;0.001). Conclusion: In the present project 12.3% of patients needed dialysis. Increasing the serum creatinine and time interval between alcohol consuming until referring to the emergency were the most important predictive factors. In addition, the probability of hospitalization for smoking and dialyzed poisoned persons in hospital wards was more than other patients.مقدمه: سوء مصرف الکل از مشکلات بهداشتی است که تمامی جوامع با آن درگیر هستند. هر چند در کشور ایران درصد مصرف کنندگان الکل به دلیل موانع اجتماعی و فرهنگی کمتر از سایر کشورهاست اما اطلاعات دقیقی از عوارض، پیامدها و عوامل پیشگویی کننده آن در دست نیست. بر این مبنا مطالعه حاضر با هدف تعیین عوارض و پیامدهای ناشی از الکل و شناسایی فاکتورهای تاثیرگذار بر آن در شهر تبریز طراحی شد. روش کار: پژوهش مقطعی حاضر بین مهر ماه 1392 تا مرداد ماه 1393 در بیمارستان سینا شهر تبریز انجام پذیرفت. تمامی مسمومین با الکل مراجعه کننده به اورژانس این مرکز وارد مطالعه گردیدند. فاکتورهای دموگرافیک و کلینیکی بیماران، تست های آزمایشگاهی، انجام دیالیز و بستری در بخش های بیمارستانی مورد ارزیابی واقع شد. در نهایت نیز با استفاده از رگرسیون لجستیک چند متغیره، فاکتورهای مستقل تاثیر گذار بر نیاز به انجام دیالیز و بستری بیماران بررسی شد. یافته ها: در نهایت 81 بیمار (91/4 درصد مرد) با میانگین سنی 10/4±27/9 وارد مطالعه شدند. 10 (12/3 درصد) بیمار نیاز به دیالیز داشته و 34 (42/0 درصد) بیمار بستری شدند. افزایش سطح کراتینین (0/048=p؛ 2/4-1/004: CI 95%؛ 1/6=OR) و افزایش فاصله زمانی بین مصرف تا مراجعه به اورژانس (0/004=p؛ 1/15-1/03 :CI 95%؛ 1/1=OR) عوامل پیشگویی کننده مستقل دیالیز در بیماران بودند. به علاوه عوامل پیشگویی کننده بستری نیز شامل مصرف سیگار (0/01=p؛ 5/5-1/6: CI 95%؛ 3/4=OR) و نیاز به انجام دیالیز (0/001&gt;p؛ 10/5-5/4 :CI 95%؛ 7/9=OR) بدست آمد. نتیجه گیری: در پژوهش حاضر 12/3 درصد بیماران نیاز به دیالیز داشتند که افزایش سطح کراتینین سرم و افزایش فاصله زمانی بین مصرف الکل تا مراجعه به اورژانس مهمترین عوامل پیشگویی کننده آن بود. به علاوه احتمال بستری شدن مسمومین سیگاری و دیالیز شده در بخش های بیمارستانی بیشتر از سایر بیماران بود

First report of a disease by rhazes 10 centuries ago

Introduction: Abu Bakr Mohammad Ibn Zakariya Al-Razi (865–925 CE), who was known as “Rhazes” in the west, was a famous scientist of medieval ages. He has more than 200 books and treatises. His masterpiece on medicine “Kitab Al-Hawi Fi Al-Tibb” contains around 900 case reports. Some of the diseases which seem to be recently reported have been stated previously, but not well described. Considering symptoms of the patient described at that time, differential diagnosis will be discussed. Case presentation: Rhazes described a patient with bilious fever. He had developed bloody urine and stool on the fourth day and fatigue. Subsequently, the patient's urine and stool color turned into dark and black, respectively, and died the following day. According to Rhazes attitude, it was malignant measles. Meyerhof in his book has referred to post-measles acute glomerulonephritis, but more appropriate differential diagnoses are compatible with this patient. Discussion: One of the best diagnoses for this case can be Weil's syndrome. Presence of fever, icterus, hemorrhage and renal injury, all suggest Weil's syndrome without pulmonary involvement. The other probable diagnosis is thrombotic thrombocytopenic purpura (TTP). Meningococcal sepsis is the other possible diagnosis. Conclusion: To sum up, as three compatible diseases with the case; have been described more than a thousand years after Rhazes (Weil's syndrome 1886, TTP 1925 and meningococcemia 1805); if the case is either Weil's or TTP or meningococcal sepsis, it is the first report of the disease in the world by Rhazes

Microtubule Protofilament Number Is Modulated in a Stepwise Fashion by the Charge Density of an Enveloping Layer

Microtubules are able to adjust their protofilament (PF) number and, as a consequence, their dynamics and function, to the assembly conditions and presence of cofactors. However, the principle behind such variations is poorly understood. Using synchrotron x-ray scattering and transmission electron microscopy, we studied how charged membranes, which under certain conditions can envelop preassembled MTs, regulate the PF number of those MTs. We show that the mean PF number, 〈N〉, is modulated primarily by the charge density of the membranes. 〈N〉 decreases in a stepwise fashion with increasing membrane charge density. 〈N〉 does not depend on the membrane-protein stoichiometry or the solution ionic strength. We studied the effect of taxol and found that 〈N〉 increases logarithmically with taxol/tubulin stoichiometry. We present a theoretical model, which by balancing the electrostatic and elastic interactions in the system accounts for the trends in our findings and reveals an effective MT bending stiffness of order 10–100 k(B)T/nm, associated with the observed changes in PF number