We aimed to find the most useful biomarker by examining the prognostic effect of neutrophil‐lymphocyte ratio (NLR), lymphocyte‐monocyte ratio (LMR), platelet‐lymphocyte ratio (PLR), and lymphocyte‐C reactive protein ratio (LCR) in patients with coronavirus disease 2019 (COVID‐19). Three hundred and four patients diagnosed with COVID‐19 infection in our hospital within 5 months (April–August 2020) were examined. Laboratory values and demographic findings of the patients were analyzed retrospectively. Thirty‐six patients were diagnosed with severe cases. The ratio of NLR, LMR, PLR, and LCR of patients with severe and those with nonsevere clinical symptoms were statistically analyzed. The NLR and PLR ratios of those with severe clinical symptoms were significantly higher (
p
< 0.001), the LCR rate was significantly lower (
p
< 0.001), and there was no significant difference in the LMR rate (
p
= 0.199). When we examined other peripheral blood parameters, we found that CRP was high, lymphocyte and monocyte were low (
p
< 0.001), but neutrophil (
p
= 0.416) and platelet (
p
= 0.998) were not statistically different between the groups. According to the results, routine blood values are abnormal in patients with COVID‐19. NLR, PLR, and LCR ratios can be used as more significant biomarkers than other values in predicting the prognosis of patients.
BackgroundWorldwide, over 10 million individuals suffer from drug-resistant epilepsy. New therapeutic strategies are needed to address this debilitating disease. Inhibition of sodium-glucose linked transporters (SGLTs), which are variably expressed in the brain, has been demonstrated to reduce seizure activity in murine models of epilepsy. Here we investigated the effects of dapagliflozin, a highly competitive SGLT2 inhibitor currently used as a drug for diabetes mellitus, on seizure activity in rats with pentylenetetrazol (PTZ) induced seizures.MethodsLaboratory rats (n = 48) were evenly randomized into two experiments, each with four study arms: (1) a vehicle-treated (placebo) arm infused with saline; (2) a control arm infused with PTZ; (3) a treatment arm with PTZ and dapagliflozin at 75 mg/kg, and (4) another treatment arm with PTZ and dapagliflozin at 150 mg/kg. Study subjects were assessed for seizures either via EEG as measured by spike wave percentage (SWP), or clinically via Racine’s scales scores (RSS) and time to first myoclonic jerk (TFMJ).ResultsRats treated with dapagliflozin had lower mean SWP on EEG (20.4% versus 75.3% for untreated rats). Behaviorally, treatment with dapagliflozin improved means RSS (2.33 versus 5.5) and mean TFMJ (68.3 versus 196.7 s). All of these findings were statistically significant with p-values of < 0.0001. There was a trend towards even better seizure control with the higher dose of dapagliflozin at 150 mg/kg, however this was not consistently statistically significant.ConclusionsDapagliflozin decreased seizure activity in rats with PTZ–induced seizures. This may be explained by the anti-seizure effects of decreased glucose availability and a reduction in sodium transport across neuronal membranes which can confer a stabilizing effect against excitability and unwanted depolarization. The potential clinical role of dapagliflozin and other SGLT2 inhibitors as anti-seizure medications should be further explored.
İzoniazid (İNH) tüberküloz tedavisinde ve profilaksisinde yaygın olarak kullanınlan bir antitüberküloz ilaçtır. Akut İNH zehirlenmesi, standart antikonvülsanlara dirençli nöbetlere, sodyum bikarbonat tedavisine dirençli yüksek anyon açıklı metabolik asidoza ve komaya neden olur. Alınan İNH dozuna eş miktarda parenteral piridoksin verilmesi en etkili tedavidir. Tedavi edilmemiş vakalar ölümle sonuçlanabilir. Biz akut İNH zehirlenmesi nedeniyle jeneralize tonik klonik nöbete sekonder sol omuz dislokasyonu ve fraktürü saptanan 24 yaşında bir kadın hasta olgusunu sunuyoruz. Senkop nedeniyle acil servise başvuran hasta muayene sedyesine alınır alınmaz nöbet geçirdi, izlemde bilinç bulanıklığı ve kan gazında metabolik asidoz saptandı. Klinik gözlem ve semptomatik tedavi sonrası bilinci açılan hastanın tüberküloz deri tutulumu için İNH kullandığı, akşam dozunu içtiğini unutarak tekrar içtiği tespit edildi. Hasta 24 saat acil serviste monitorize olarak takip edildi. İzlemde nöbet olmaması, başka ek semptomların gelişmemesi ve metabolik değerlerin düzelmesi üzerine şifa ile taburcu edildi. Sonuç olarak durdurulamayan nöbetlerle acil servislere başvuran hastalarda, metabolik asidoz ve koma birlikteliğinde İNH zehirlenmesi de düşünülmeli ve acil servislerde parenteral piridoksin mutlaka bulundurulmalıdır.
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