Today, despite significant progress in developing skin tissue engineering products, the fabrication of an ideal wound dressing that could meet the essential criteria, such as promoting angiogenesis -mainly in a diabetic wound- still remains a challenge. A diabetic wound is a chronic wound in which vascularization is low, and the wound healing process may stop. In this regard, Nitric oxide (NO) enhances the healing of diabetic wounds by promoting angiogenesis and providing antibacterial activity in wound sites. In this study, we produced a NO-releasing wound dressing (CMC-ALg-GSNO) composed of Carboxymethyl chitosan (CMC), sodium alginate (ALg), and Snitrosoglutathione (GSNO). The results obtained from the scanning electron microscopy (SEM) show that wound dressing has a porous structure. The water uptake and water vapor transmission for the wound dressing were obtained 4354.1 ± 179.3 % and 2753.8 ± 54.6 g/m2 per day, respectively. NO release study showed that NO release from CMC-ALg-GSNO continuously occurred within 168 hours. In vivo test, The CMC-ALg-GSNO wound dressing developed wound healing in a rat model of full-thickness diabetic wounds compared to the CMC-ALg and Gauze wound dressings. Thus, this study showed that CMC-ALg-GSNO wound dressing could lead to novel therapeutic invasions to treat diabetic wounds.
Background Examination of serum lactate Level and its changes, as an indicator of tissue oxygenation, as well as level of creatine kinase (CK) inhibitors, as a factor of mortality which partially expresses heart, brain, and muscle damage, may be considered as tools to determine prognosis in critically ill patients. We aimed to evaluate these two factors as potential prognostic factors in critically poisoned patients admitted to our toxicology ICU.Method: This is a cross-sectional descriptive-analytic study that was performed on poisoned patients referred to emergency department of Loghman Hakim Hospital. One-hundred critically poisoned patients who had been admitted to ICU were conveniently chosen using a random number table and included into the study after obtaining consent forms form their next of kin. Their serum lactate and CK levels were checked on admission. These levels were compared subsequently between survivors and non-survivors to seek for their potential prognostic role.Results: In a total of 100 patients enrolled, 61 were male. Serum level of lactate (with a cut off of 26 mg/dL) and serum CK with a cutoff point of 169 U/L could have prognosticated death with sensitivity and specificity of 78% and 77% (for lactate) and 74% and 62% (for serum CK), respectively.Conclusions: In poisoned patients, serum lactate and CK can be used as possible prognostic factors because they rapidly increase in the serum and are easily detectable.
Introduction: Toleration of the complexity and pain of interventions such as endoscopy and colonoscopy is highly difficult for patients. Considering the disagreement on the method of injection of propofol, this study was performed to evaluate the quality of anesthesia using the three methods of propofol + fentanyl, propofol + fentanyl + lidocaine, and propofol + fentanyl + lidocaine + ketamine. Methods: This one-way blind clinical trial study included 99 patients who were admitted in three groups by block randomization method. In a group of patients that were sedated with propofol + fentanyl + lidocaine + ketamine, the dose of all drugs is reduced by half the amount of the other groups. Variables included age, sex, frequency of cough, apnea, need for jaw thrust maneuver, O 2 saturation, duration of recovery, and procedural satisfaction. Data were analyzed using SPSS version 20.0. P value of < 0.05 was considered to be significant. Results: The three groups were similar in terms of demographic characteristics. The effects of the three sedation protocols on the variables showed that patient’s apnea, cough, O 2 saturation, and also proceduralist satisfaction in the group of the patient that sedated with four drugs was significantly higher ( P < 0.05) than other groups. But there was no significant difference between the three groups when comparing the recovery time and need for jaw thrust during the procedure. Conclusion: The findings of the present study showed that the use of combination of “propofol + fentanyl + lidocaine + ketamine” with lower doses, significantly results in higher quality sedation compared with higher doses of “propofol + fentanyl + lidocaine” or “propofol + fentanyl” for scoping procedures.
Background Examination of serum lactate Level and its changes, as an indicator of tissue oxygenation, as well as level of creatine kinase (CK) inhibitors, as a factor of mortality which partially expresses heart, brain, and muscle damage, may be considered as tools to determine prognosis in critically ill patients. We aimed to evaluate these two factors as potential prognostic factors in critically poisoned patients admitted to our toxicology ICU. Method: This is a cross-sectional descriptive-analytic study that was performed on poisoned patients referred to emergency department of Loghman Hakim Hospital. One-hundred critically poisoned patients who had been admitted to ICU were conveniently chosen using a random number table and included into the study after obtaining consent forms form their next of kin. Their serum lactate and CK levels were checked on admission. These levels were compared subsequently between survivors and non-survivors to seek for their potential prognostic role. Results: In a total of 100 patients enrolled, 61 were male. Serum level of lactate (with a cut off of 26 mg/dL) and serum CK with a cutoff point of 169 U/L could have prognosticated death with sensitivity and specificity of 78% and 77% (for lactate) and 74% and 62% (for serum CK), respectively. Conclusions: In poisoned patients, serum lactate and CK can be used as possible prognostic factors because they rapidly increase in the serum and are easily detectable.
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