kamila Hashemzadeh; Ali Esparham; Farnoosh Ebrahimzadeh; Konstantinos Triantafyllias; Zahra Mirfeizi; Maryam Sahebari; Mohammad Hassan J Joker; Mandana Khodashahi; Masoumeh Salari; Bita Abbasi; Delaram Omidvar; Mahtab Ghaemi; Hassan Mehrad-Majd
Abstract
Introduction: Health care systems all over the world face numerous challenges as a result of the rapid spread of the COVID-19 virus that has resulted in increased mortality rates. About 40% of ICU-admitted COVID-19 patients were not severely ill at the time of admission. Thus, by using appropriate ICU ...
Read More
Introduction: Health care systems all over the world face numerous challenges as a result of the rapid spread of the COVID-19 virus that has resulted in increased mortality rates. About 40% of ICU-admitted COVID-19 patients were not severely ill at the time of admission. Thus, by using appropriate ICU admission predictors, clinicians can identify potential critical patients early on. It can also result in suitable resource allocation and consideration for these patients. Therefore, the current study was done with the aim of identifying clinical characteristics and laboratory data that could predict ICU admission in cases with COVID-19.Methods: This two-center retrospective observational study was done in Imam Reza and Ghaem Hospitals, Mashhad, Iran. Overall, 334 COVID-19 patients who referred to these hospitals from February to May 2020 were enrolled in this study. The participants were separated into two groups according to ICU admission status. All demographic, clinical, and paraclinical information were extracted from the medical records of the patients. Results: The present study composed of 88 ICU and 246 non-ICU-admitted COVID-19 patients. No significant differences were found in age between the two groups of patients (P=0.154). Multivariate regression analysis revealed that higher levels of CRP (OR=1.01, 95%CI 1.001-1.010, P=0.016), WBC (OR=1.11, 95% CI 1.01-1.22, P=0.03), and HRCT scores (OR=1.08, 95%CI=1.01-1.16, P=0.037) were linked to higher odds of ICU admission.Conclusion: This study suggests that higher levels of CRP, WBC, and LDH, as well as the HRCT score at the time of admission, were potential independent predictors of ICU admission during inpatient treatment in COVID-19 patients.
Mehran Beiraghi Toosi; Farnoosh Ebrahimzadeh
Abstract
A seizure is defined as a paroxysmal and transient occurrence of signs or symptoms resulting from abnormal synchronous or excessive neuronal activity in the brain. About 15 to 40 percent of children who have any type of seizure are resistant to standard anti-seizure drugs, so called intractable epilepsy. ...
Read More
A seizure is defined as a paroxysmal and transient occurrence of signs or symptoms resulting from abnormal synchronous or excessive neuronal activity in the brain. About 15 to 40 percent of children who have any type of seizure are resistant to standard anti-seizure drugs, so called intractable epilepsy. Before documenting the seizure attacks as refractory, the selected drugs using for the type of seizure and dose of them should be checked. There are several factors that predict development of refractory seizures. These include age <1 year, multiple seizures before starting the treatment, myoclonic seizures, neurologic defects, neonatal and daily seizures, male gender, and first abnormal electroencephalogram and brain imaging (including computerized tomography scan and / or MRI). Options for the management of refractory epilepsy, after prescribing routine anti-seizure drugs are: Second line drugs (IVIG treatment, Ketogenic diet, Prednisolone treatment or Herbal treatment), Surgery and Stem cell therapy. Because none of these methods can stop all the drug-resistant epilepsies, researches are going on.