OBJECTIVESManagement of hyperglycemia during an acute sickness in adults is accompanied by improved outcomes. We have designed a prospective study with meticulous attention to exclude all diabetes patients by checking hemoglobin A1c (HbA1c or glycated hemoglobin) to avoid the ill-effects of hyperglycemia in patients with traumatic head injury admitted to the intensive care unit (ICU).METHODSThis prospective study included adults with traumatic primary brain injury with a Glasgow coma score of ≤8 necessitating mechanical ventilation treated in the period 2012–2015. After screening 311 patients, 220 were included in the study. Both blood glucose and HbA1c levels of all the patients at admission, as well as blood glucose level after 72 hours, were obtained from the records. The patients were later grouped based on their admission blood glucose levels (<200 mg/dL or ≥200 mg/dL). Injury severity score (ISS) was documented for every patient. As a final point, the outcomes were determined based on the hospital length of stay (HLS) and ICU length of stay (ILS), plusmortality rates.RESULTSAbout 39% (n = 85) of patients were admitted with hyperglycemia during the study period. The mortality rate in patients with glucose ≥200 mg/dL was 65.8% (N = 56), against 23.7% (N = 32) in the group with glucose <200 mg/dL, with mortality rising as the blood glucose level increased (P = 0.014).CONCLUSIONSWe conclude that admission hyperglycemia is related with increased mortality rate in head injury patients, and comprehensive treatment of hyperglycemia can improve the outcome of severe head injury patients.
Context: Substance abuse has remained a worldwide issue for many years and in recent decades there has been a major growth in the number of individuals consuming opioids. Several studies have discovered that young kids who have been exposed to opioids develop greater damages in overall intellectual capabilities and neurobehavioral functions than non-exposed children. Evidence Acquisition: The purpose of this study was to evaluate the surviving texts on the incidence of challenging behavior among kids due to prenatal medication contact. Overall, out of 84 identified manuscripts, 18 were established to consider intellectual, psychomotor, and behavior consequences in opioid-exposed infants, precollege and college children when matched with healthy no-opioid-exposed controls. Results:The results indicate that children exposed to opioid in utero may be cognitively affected over time, even once located in stable families on an actual early age. Somewhat, susceptibilities seem to rise by age for girls, and the unprotected boys persist behind non exposed boys entirely through infancy and into college age. Therefore, there looks to be a constant deleterious consequence of factors associated with prenatal medication contact over time. Conclusions:The results indicate children exposed to opioid in utero may be cognitively affected over time, even once located in stable families on an actual early age. The natural susceptibilities of prenatally drug-exposed children can affect initial intellectual skills which yet again are extremely associated with advanced mental capabilities. It is feasible that pre-and postnatal genetic susceptibilities and ecological issues cooperate in a transactional method through the child's lifespan.
Background: Facial emotion recognition (FER) is an important social skill. Some studies have determined the capability of FER in substance abusers, but their results are contradictory. Objectives: This study aimed to investigate FER ability in opioid antecedent subjects and mixed opioid-methamphetamine antecedent subjects under methadone maintenance therapy compared to a control group. Methods: Following a retrospective cohort design, 71 methadone-maintained subjects (MMS) (40 individuals with a history of only opioid use disorder and 31 patients with a history of both opioid and methamphetamine use disorder) and 40 healthy participants filled the Persian version of Ackman and Friesen facial emotion experiment, which were matched based on age, education, and gender. Demographic and substance use characteristics were evaluated. Both groups were similar concerning the duration of the opioid use disorder, methadone maintenance treatment, and currently prescribed methadone dose. Data were analyzed using the chi-square, independent t-test, one-way ANOVA, and Welch test. Statistical significance was considered when P-value < 0.05. Results: Total FER scores were significantly lower in MMS compared to the control group. Concerning the subgroups, recognition of sadness was impaired in patients with a history of opioid use disorder (with and without a history of methamphetamine use disorder), while in recognition of anger and wonder, patients with both opioid and methamphetamine use disorder history had a significantly lower performance. There was no other significant difference between the groups. Conclusions: The findings suggest that social cognition deficit should be considered in strategies related to the addiction (both treatment and rehabilitation).
Background: Some studies indicated that the study of stories in which physical or mental illnesses are described helps to better understand the patient and his/her sickness; but unfortunately, this approach is neglected in the Persian literature. Paying attention to this issue can increase the attractiveness of studying such literary works for the Iranian and non-Iranian audience and can grant new sights to readers, as well. Objectives: This research is conducted to describe and explain the symptoms of the PTSD in the characters of modern Persian fiction, based on the clinical symptoms. Methods: This is qualitative research. Seven characters from the seven stories were selected purposefully to fit the researcher’s goals. Then, they were analyzed according to the DSM-5 criteria. Results: The results indicated that the selected stories represent individuals with PTSD consistent with the clinical criteria for the diagnostic of the disorder. In these stories, the authors, in addition to describing clinical symptoms, have considered inheritance, gender, and cultural factors to create characters in accordance with the specifications of the people who have been damaged in the real world. Conclusions: Reading these stories can be useful due to applying descriptions based on clinical criteria for the diagnosis of this disorder (PTSD), and thanks to the use of literary language in representing the victim’s inner and spiritual status, are useful in creating an engagement resulting from a proper understanding of the person who is suffering from such disorder.
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