RESUMEN
Yellow oleander (Thevetia peruviana), which belongs to the Apocyanaceae family, is a common shrub seen throughout the tropics. All parts of the plant contain high concentrations of cardiac glycosides, which are toxic to cardiac muscle and the autonomic nervous system. The main objective of this study was to socio-clinical, biochemical and electrocardiographic changes of yellow oleander seed poisoning. This prospective observational study was conducted over a period of 6 months (March 2022 to September 2022). Oleander seed poison in most prevalent in the 21-40 years age. More the crushed seeds consumed and the delay to admission to the hospital for treatment poorer was the outcome. The most common GI symptoms of yellow oleander poisoning were vomiting (58 %), abdominal pain (28%), diarrhoea (9%), and palpitations (20%), dizziness (18%).Serum potassium levels that were measured during the admission were directly related to the ECG changes. ECG changes were more observed with patients those who consumed seeds in crushed form and this difference is statistically significant (P = 0.0001). Higher incidence of cardiotoxicity was noted with patients those who consumed poison on empty stomach compare to who consumed after food. The Electrocardiographic manifestations was found even with consumption of one seed, number of seeds consumptions independent of cardiotoxicity.Additonally higher mean Potassium value observed in patients who had cardiotoxicity when compared to patient who had no cardiotoxicity. Death of the patients in yellow oleander seed poisoning was independent of quantity of the seeds they have ingested.
RESUMEN
Diabetic nephropathy/diabetic kidney disease (DKD) is one of the leading causes of renal failure. Early identification of the development or progression of diabetic nephropathy using appropriate screening and diagnostic tools is very important in order to provide timely and proper management. Inflammation plays a crucial role in development and progression of diabetic nephropathy. The aim of this study was to evaluate the relationship of inflammatory markers (neutrophil-to-lymphocyte ratio-NLR) as an early indicator to prevent the progression of diabetic kidney disease. A total of 158 patients with type 2 diabetes mellitus were distributed into three groups according urinary albumin-to-creatinine ratio. Levels of inflammatory markers neutrophil-to-lymphocyte ratio was recorded and compared among the three groups. Significant differences were detected between the groups in terms of neutrophil-to-lymphocyte ratio (p = 0.000).Characteristic curve analysis of inflammatory markers and microalbuminuria prediction demonstrated an area under curve (AUC) of 0.869 for neutrophil-to-lymphocyte ratio (p = 0.000). A NLR cut-off point of 2.2 has 72.3 % sensitivity and 78.1 % specificity, which suggested sufficient accuracy. Increased neutrophil-to-lymphocyte ratio was significantly correlated with diabetic nephropathy progression and increased neutrophil-to-lymphocyte ratio can be considered as an early indicator and a prognostic risk marker of diabetic nephropathy.