Systematic Review on the Effects of Prompt Antibiotic Treatment on Survival in Septic Shock and Sepsis Patients in Different Hospital Settings.

This study aims to determine the impact of prompt administration of antibiotics in evaluating the prognosis of patients with septic shock or sepsis. On January 1, 2022, we searched the Cochrane Library, EMBASE, and MEDLINE databases for English-language articles regarding when antibiotics should be administered to patients with septic shock or sepsis. These articles were required to be published between 2010 and 2021. The primary objective was sudden or expected death from any cause at a specified time. In the study, 154,330 patients from 35 sepsis trials were included. In 19 trials, the effectiveness of antibiotics administered to 20,062 patients was evaluated. Of those, 16,652 received the correct medications. In 24 studies, the length of time it took to administer antibiotics was associated with an increased mortality rate. In fourteen studies, the time limits associated with patient outcomes ranged from 1 to 125 minutes to three to six hours. In eight studies, there were hourly delays, and in two, the time it took to receive an antibiotic played a role. Separately analyzed, the outcomes for septic shock (12,756 patients in 11 trials) and sepsis (24,282 patients in six studies) were identical. Two-thirds of sepsis studies discovered a correlation between early antibiotic treatment and the patient's prognosis. However, antimicrobial timing metrics varied significantly between studies, and there were no clear time limits.

Role of Cod Liver Oil in Reducing Elevated Lipid Parameters.

Introduction The health benefits of cod oil, which includes omega-3 fatty acids, have been of considerable interest to medicine due to its promising results. Studies have shown successful therapeutic effects of a high dietary intake of omega-3 fatty acids by reducing the synthesis of very-low-density lipoprotein, with subsequent low levels of serum triglycerides.  Methods This single-blind placebo-controlled two-arm interventional study was conducted in the internal medicine unit of a tertiary care hospital from October 2020 to April 2021. 600 treatment naïve patients with elevated cholesterol levels and/or elevated low-density lipoprotein (LDL) were enrolled in the study and randomized into two groups. The study group received 415 mg cod liver oil daily as a capsule in a bottle, in addition to 10 mg rosuvastatin. On the other hand, the control group received 10 mg rosuvastatin with placebo capsules in an identical bottle. Participants were followed up on day 30. Results There was relatively more significant reductions in the total cholesterol (152.22 ± 29.75 mg/dL vs. 171.65 ± 31.21 mg/dL; p-value: <0.0001) and LDL (72.41 ± 27.52 mg/dL vs. 79.15 ± 29.12 mg/dL; p-value: <0.0001) in the intervention group compared to the placebo group after day 30. There was a significant reduction in all lipid values in both groups at day 30 as compared to day 0. Conclusion Our study indicates that cod liver oil in addition to rosuvastatin reduces cholesterol more compared to rosuvastatin alone. However, in all cases, lifestyle changes should be the first modification adopted by the patients. Further large-scale trials are needed to examine the role of cod liver oil in reducing lipid values.

Association Between Diabetic Retinopathy and Carotid Intima-Media Thickness.

Introduction Patients with diabetes having advanced stage of diabetic retinopathy (DR) may predict future risk of coronary artery disease. To predict cardiovascular outcomes carotid intima-media thickness (CIMT) is utilized in diabetic patients. The aim of our study was the evaluation of the relationship between retinopathy and CIMT as two valuable non-invasive methods for early detection of micro- and macrovascular complication of diabetes. Methods This comparative cross-sectional study was conducted in the internal medicine ward of tertiary care hospital in Pakistan from November 2020 to January 2021. Three hundred patients with type 2 diabetes mellitus and 300 control subjects were enrolled in the study after taking informed consent. Ophthalmological examination was done to screen patients for DR. CIMT was evaluated by a Doppler ultrasound for both carotid arteries. Results Carotid artery intimal thickness was more in patients with retinopathy compared to patients without retinopathy in both right (0.77 ± 0.16 vs. 0.66 ± 0.12; p-value: <0.0001) and left carotid artery (0.77 ± 0.15 vs. 0.65 ± 0.11; p-value: <0.0001). Conclusion In our study, there was a correlation between DR and CIMT. Screening for DR, which may be a potential early marker for complications, may help detect patients at risk of various macro and microvascular complications.

Comparison of Iron Profile in Patients With and Without Coronary Heart Disease.

Introduction Atherosclerosis is considered a major cause of coronary artery disease (CAD). Pathogenesis of atherosclerosis involves the oxidation of low-density lipoprotein (LDL) within the lysosomes of macrophages. Ferritin and iron have pro-oxidant properties, and ferritin is an independent positive determinant of oxidized LDL level. In this study, we will determine the association between ferritin and serum iron levels and CAD. Methods This case-control study was conducted in the cardiology unit of a tertiary care hospital in Pakistan from December 2020 to April 2021. After taking informed consent, 400 patients with a confirmed diagnosis of CAD were enrolled. Another set of 400 patients without a history of CAD were included in the control group. A blood sample of 5 ml was drawn and sent to the laboratory to test for ferritin, serum iron, and total iron-binding capacity (TIBC). Ferritin, serum iron, and iron-binding capacity were compared between the case and control groups.  Results Serum ferritin was significantly higher in patients with CAD compared to patients without CAD (921.21 ± 201.21 ug/L vs. 101.21 ± 92.21 ug/L; p-value: <0.0001). Serum TIBC was significantly lower in patients with CAD compared to patients without CAD (302.12 ± 101.75 umol/L vs. 362.12 ± 82.16 umol/L). Conclusion Patients with raised levels of ferritin should consult a physician to manage their ferritin levels since they are at a greater risk of CAD. Treatment ranges from lifestyle changes to pharmacological therapy, thus reducing the overall risk and normalizing the ferritin levels.

Synergetic Effect of Water, Temperature, and Pressure on Methane Adsorption in Shale Gas Reservoirs.

Adsorption is one of the most important forms of storage of gas in shale reservoirs. Shale gas adsorption in the actual reservoir is not only affected by individual factors such as water content, temperature, and pressure but also by the synergetic effect of these factors. In this study, we conducted laboratory experiments on methane adsorption in dry and wet shale at different pressures and temperatures. The synergetic effect of water content, temperature, and pressure on shale gas adsorption is explored. The results show that increasing temperature weakens the interaction between methane and shale and reduces adsorption capacity due to the exothermic nature of adsorption. Water reduces methane adsorption capacity by occupying adsorption sites and blocking pores in the shale system. Although temperature and water reduce methane adsorption individually, the effect of these two factors weakens each other. Temperature has a more significant effect on methane adsorption in shales with low water content, while water has a more remarkable impact on methane adsorption at a low temperature. Furthermore, the increase in pressure reduces the negative influence of water and temperature on methane adsorption. By quantitatively analyzing the relationship between methane adsorption in dry and wet shales, a predictive adsorption model for wet shale considering the influence of in situ conditions is proposed and validated. Validation shows that the proposed model has high accuracy and broad applicability to shales with different properties.

Experimental Investigation of Polymer Enhanced Oil Recovery under Different Injection Modes.

To solve the problem of poor adaptability of the single slug polymer injection mode which lead to profile inversion, non-effective circulation of polymer solution in the high permeability zone during the development of conventional heavy oil, new technology of alternative injection, and three-stage slug injection for further improving polymer flooding performance were developed. Parallel sandpack flooding experiment was conducted to study the oil displacement efficiency of different injection modes, and reasonable injection mode and optimal slug combination of polymer flooding are selected. The results show that under the same polymer dosage, the high and low mass concentration polymer slug alternative injection is better than the three-stage slug and single slug polymer flooding, and with the increase of the alternating rounds, the polymer flooding performance increased first and then decreased. Compared with the single slug injection, the alternative injection increased the recovery factor by 4%. When the three-stage slug is injected, the concentration of the front and post slug has a significant effect on the oil displacement process. The optimal oil displacement formulations are as follows: main slug 5000 mg/L × 0.125 PV, secondary slug 3000 mg/L × 0.208 PV, alternating two rounds.