Comparison of Postoperative Outcomes Between Intra-aortic Balloon Pump and Levosimendan in Patients Undergoing Coronary Artery Bypass Graft: A Systematic Review and Meta-Analysis.

This study was conducted to compare the postoperative outcomes between intra-aortic balloon pump (IABP) and levosimendan in patients undergoing coronary artery bypass graft (CABG) surgery. This meta-analysis was conducted following the recommendations of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). For this meta-analysis, a literature search was performed on PubMed, Cochrane Central Register of Controlled Trials, and EMBASE from inception to July 15, 2023. Keywords used to search for relevant articles included "intra-aortic balloon," "levosimendan," and "cardiac surgery" along with their key terms and Medical Subject Headings (MeSH) terms. Outcomes assessed in this study included postoperative outcomes like all-cause mortality, postoperative arrhythmias, need for inotropic support, length of intensive care unit stay (ICU) in days, and duration of mechanical ventilation in hours. Other outcomes included two-hour, six-hour, and 24-hour postoperative central venous pressure (CVP), mean atrial pressure (MAP), and heart rate (HR). A total of eight studies were included in the pooled analysis. The pooled results found that the length of ICU stay and the duration of mechanical ventilation were significantly higher in patients receiving IABP. Additionally, the findings of this meta-analysis showed a higher need for inotropic support in patients receiving IABP compared to patients receiving levosimendan but the difference was statistically insignificant. However, no significant differences were found between the two groups in terms of mortality and arrhythmias. In conclusion, patients treated with levosimendan exhibited significant advantages, as they experienced shorter ICU stays and reduced duration of mechanical ventilation compared to the IABP group and less requirement for inotropic support.

A short review on the role of thyroxine in fast wound healing and tissue regeneration.

Wound healing is a multiplex interaction process that involves extracellular matrix, blood vessels, proteases, cytokines, and chemokine. So far, a number of studies have been performed to understand the basis of the wound-healing process and multiple wound-healing products have been designed. However, significant morbidity and mortality incidents still occurred due to poor wound healing. Thus, there is a dire need to understand the effects of topical applications of various therapeutic options that lead to fast wound healing. Thyroxine is one great panacea for wound healing that has been vigorously mooted throughout the years but a conclusive result regarding its effectiveness is still not achieved. This review is intended to find a rational basis for its positive role in wound healing. To accomplish the objective, this review highlights the different aspects of thyroxine's role in wound healing like keratin synthesis, skin thickening, and pro-angiogenesis, the basis of controversy on its wound healing ability and its potential to be used as a wound healing agent. This study will be helpful for researchers and surgeons to assess the importance of thyroxine as a candidate to comprehensively research to develop a potent, effective, and affordable wound healing drug.

A Rare Case of Salmonella Gastroenteritis Presenting as Aspiration Pneumonia With Pleural Empyema in an Immunocompetent Patient.

Non-typhoidal salmonella (NTS) can cause infections ranging from self-limited chronic carriers to gastroenteritis, bacteremia, and extraintestinal infections. Pulmonary involvement, particularly empyema, is quite rare and generally found in immunosuppressed individuals. We present a case of salmonellosis in an immunocompetent patient with rare pulmonary complications of empyema. The patient, with no underlying immunocompromised illness, presented with a one-day history of worsening generalized weakness, fever, shortness of breath, and productive cough after having gastroenteritis symptoms of five days duration, which stopped two days prior to admission. On further investigation, imaging revealed right lower lobe pneumonia with empyema. The patient was managed with intravenous antibiotics and chest tube placement with good clinical response. Pleural fluid analysis showed exudative fluid and grew Salmonella enteritidis with negative blood and sputum cultures. The patient, in stable condition, was discharged on four weeks of amoxicillin/clavulanic acid after consulting the infectious disease specialist for presumed aspiration pneumonia complicated with empyema in the setting of multiple episodes of vomiting due to gastroenteritis. The lung is an atypical site for salmonellosis. Pulmonary infections in immunocompetent hosts are rare in the medical literature. Early recognition and timely management of pulmonary complications can lead to better outcomes.