Haloperidol is an antipsychotic drug that exerts its' antipsychotic effects by inhibiting dopaminergic neurons. Although the exact pathophysiology of haloperidol extrapyramidal symptoms are not known, the role of reactive oxygen species in inducing oxidative stress has been proposed as one of the mechanisms of prolonged haloperidol-induced neurotoxicity. In the present study, we evaluate the protective effect of alpha lipoic acid against haloperidol-induced oxidative stress in the rat brain. Sprague Dawley rats were divided into control, alpha lipoic acid alone (100 mg/kg p.o for 21 days), haloperidol alone (2 mg/kg i.p for 21 days), and haloperidol with alpha lipoic acid groups (for 21 days). Haloperidol treatment significantly decreased levels of the brain antioxidant enzymes super oxide dismutase and glutathione peroxidase and concurrent treatment with alpha lipoic acid significantly reversed the oxidative effects of haloperidol. Histopathological changes revealed significant haloperidol-induced damage in the cerebral cortex, internal capsule, and substantia nigra. Alpha lipoic acid significantly reduced this damage and there were very little neuronal atrophy. Areas of angiogenesis were also seen in the alpha lipoic acid-treated group. In conclusion, the study proves that alpha lipoic acid treatment significantly reduces haloperidol-induced neuronal damage.
Rare case of concurrent subarachnoid haemorrhage and ST elevation myocardial infarction, highlighting the importance of detailed history in an emergency.
Background/Introduction Untreated, symptomatic, severe aortic stenosis carries significant mortality and morbidity. Timely intervention is pivotal to ensure patient safety. The COVID-19 pandemic created unprecedented challenges to the UK's National Health Service (NHS), resulting in the deferral of all Abstract 16 Figure 1 Weekly physical activity prior to and during the COVID-19 pandemic Abstract 16 Figure 2 Reasons for decreased physical activity during the COVID-19 pandemic lockdown
management occurred in 46% of cases (n=96). Transferred patients were more likely to undergo operative management (OR 3.3 , 95% CI: 1.8, 5.8). Although men were more likely to undergo surgical management than women (OR 2.0, 95% CI: 1.1, 4.2), this is explained by women being six times more likely to be IVDUs (OR 6.1 CI: 2.3, 16.3) and have right-sided IE (OR 6.2 CI: 2.2, 17.4). When including only left-sided IE, the rate of surgery was not different between males and females (p=0.1). There was no difference in in-hospital or 12-month mortality in patients admitted directly to SCC and those referred (p=0.56) and there was no mortality difference between the sexes (p=0.20). In-hospital mortality of surgically managed patients was predicted by the Risk-E Score and EuroSCORE II as 18 and 12 cases respectively. We observed 11 in-hospital deaths. This difference was not significant (p=0.22). Transferred patients had a higher mean Risk-E Score (p<0.05) and a higher score was associated with a shorter time between diagnosis and surgery (p<0.05, figure 2). Conclusions There has been an increase in IE cases managed at the SCC over the last 5 years, with more transfers from other hospitals. This could be due to an increase in absolute IE numbers as well as better awareness of the need for early surgery and the involvement of an IE MDT. We report a previously unidentified male predominance in IE across all major organisms and a significant increase in oral streptococci infection; both require further exploration. In this population the Risk-E Score tended to overestimate in-hospital mortality. Larger multi-centre studies are required to explore these trends in sub-grouped populations.
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