Emergency medicine
Navid Kalani; Masoud Tavasolian; Khaterh Dehghani; Seyed Reza Mousavi; Erfan Ghanbarzadeh; Masihallah Shakeri; Elahe Rahmanian; Poorya Aryanpoor; Naser Hatami; Zhila Rahmanian; Samaneh Abiri
Volume 9, Issue 1 , January 2023, , Pages 19-24
Abstract
Objective: The goal of our study was to determine the prognostic value of CURB-65,Sequential Organ Failure Assessment (SOFA), pneumonia severity index (PSI), MuLBSTA,and Acute Physiology and Chronic Health Evaluation (APACHE) II upon admission inpatients with coronavirus disease 2019 (COVID-19, as well ...
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Objective: The goal of our study was to determine the prognostic value of CURB-65,Sequential Organ Failure Assessment (SOFA), pneumonia severity index (PSI), MuLBSTA,and Acute Physiology and Chronic Health Evaluation (APACHE) II upon admission inpatients with coronavirus disease 2019 (COVID-19, as well as the prediction cut-off valuefor death regarding these parameters.Methods: This observational retrospective study was performed in COVID-19 triagein Peymaniyeh hospital in Jahrom in 2021. In order to calculate SOFA, APACHE II, PSI,MuLBSTA, and CURB-65, data were collected from patients who were selected by availablesampling method from PCR-confirmed COVID-19 patients. Thirty-day mortality wasassessed as the primary outcome. ROC analysis was conducted using the STATA software toevaluate the prognostic value of the scoring systems. DeLong test was utilized to compareAUC of scores using a web based tool.Results:Ninety-two patients were included in this study with the mean age of 51.02±17.81years (male to female ratio was 1:1). SOFA had an AUC of 0.656 (P=0.130), but other indiceshad statistically significant values of AUC. Based on the comparison of the AUCs, SOFAwas the worst scoring system in COVID-19 as it had significantly lower AUC than PSI andAPACHE II (P<0.05); while its comparison with MULBSTA and CURB65 was not statisticallysignificant (P>0.05).Conclusion: It seems that APACHE II and PSI are the best prognostic factors in our studywith no statistical difference compared together (P>0.05). The sensitivity of APACHE II andPSI was 0.857 with the specificity of 0.927 and 0.976, respectively. The optimal cut-off pointwas 13 and 50 for APACHE II and PSI, respectively
Clinical Toxicology
Saeedeh Derhami; Ehsan Bolvardi; Reza Akhavan; Mahdi Foroughian; Behzad Shahi; Arman Hakemi; Zhila Rahmanian; Samaneh Abiri
Volume 7, Issue 2 , July 2021, , Pages 82-87
Abstract
Objective: Acute poisoning is a major health problem and one of the most common causes of emergency visits worldwide. Since most poisoning subjects present with a decreased level of consciousness and due to unreliable disease history, recognizing the etiological cause of the poisoning represents a critical ...
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Objective: Acute poisoning is a major health problem and one of the most common causes of emergency visits worldwide. Since most poisoning subjects present with a decreased level of consciousness and due to unreliable disease history, recognizing the etiological cause of the poisoning represents a critical part in arranging the treatment strategy. This study aimed at examining the prevalence of etiological causes of poisoning in Iran in a systematic review and meta-analysis. Method: This systematic review and meta-analysis investigated the cross-sectional studies published from 1990 to 2020, reporting specific poisoning agents among acute poisoning cases in Iran. Persian and English articles on this subject were collected by searching the Scientific Information Database (SID), ScienceDirect, PubMed, Medlib, IranMedex, Scopus, Magiran, and Google Scholar databases. The heterogeneity of the studies was investigated using the I2 index and the probability of bias in the publication was assessed by the Begg and Mazumdar test with a significance level of 0.1. Data analysis was performed by Comprehensive Meta-analysis software version 3 (Biostat, Englewood, NJ, USA). Results: In our review, 19 studies appraising 143,251 cases of poisoning were included. The ranking of the OR of each agent was done; Opium poisoning was the most prevalent poisoning case followed by benzodiazepine, acetaminophen, antipsychotic medications, organophosphates, aluminum phosphide, amphetamine, pesticide, tricyclic antidepressant (TCA), alcohol, chemicals, carbon monoxide (CO), nonsteroidal anti-inflammatory drugs (NSAIDs), and selective serotonin reuptake inhibitors (SSRIs). Conclusion: While proper judgment on the cause of poisoning and selection of suitable treatment manners could be followed by a very good prognosis in patients with acute poisoning; this demands an epidemiological perception of the prevalence of the etiological poisoning agents. Our study ranked the most likely agents leading to the poisoning, to be at the top of the list of differential diagnoses of physicians.
Emergency medicine
Seyed Reza Habibzadeh; Samaneh Abiri; Saeed Barazandehpour; Mohammad Javad Zarei; Mahdi Foroughian; Hamideh Akbari; Navid Kalani; Esmaeil Rayat Dost; Seyed Hamed Hojati
Volume 7, Issue 2 , July 2021, , Pages 130-132
Abstract
Objective: Brugada syndrome (BrS) is a disorder in which the electrical activity in the heart is abnormal and affects individuals with cardiac dysrhythmia. In the present study, we introduce a case diagnosed with BrS, admitted to intensive care unit (ICU) and received treatments following sudden cardiac ...
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Objective: Brugada syndrome (BrS) is a disorder in which the electrical activity in the heart is abnormal and affects individuals with cardiac dysrhythmia. In the present study, we introduce a case diagnosed with BrS, admitted to intensive care unit (ICU) and received treatments following sudden cardiac arrest. Case Report: The patient was a male 25-year-old medical student enrolled in the sixth academic year who suffered from loss of consciousness due to sudden cardiac arrest. The patient immediately received cardiopulmonary resuscitation (CPR) measures, was visited by a cardiologist and a neurologist, and was consequently treated with medications. After an 8-day stay in the coronary care unit (CCU), the patient regained his level of consciousness and he was transferred to the ICU of Faghihi hospital in the city of Shiraz, Iran. Being diagnosed with BrS and following pulmonary aspiration treatments, he finally implanted with an implantable cardioverter defibrillator (ICD). Conclusion: Fortunately, necessary measures had been taken on time for the introduced patient and he was discharged with full recovery after 6 days
Emergency medicine
Esmaeal Rayat Dost; Saeed Barazandehpour; Navid Kalani; Samaneh Abiri
Volume 7, Issue 1 , January 2021, , Pages 71-73
Abstract
Objective: Aortic dissection is an uncommon disorder with a high mortality rate, especially if misdiagnosis and mistreatment are not considered. Case Presentation: We present a 67-year old female with slurred speech and left sided plegia during her brother’s funeral. The patient did not have ...
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Objective: Aortic dissection is an uncommon disorder with a high mortality rate, especially if misdiagnosis and mistreatment are not considered. Case Presentation: We present a 67-year old female with slurred speech and left sided plegia during her brother’s funeral. The patient did not have any chest pain. she was referred to our emergency department by EMS due to being suspicious of cerebrovascular accident (CVA) )as code 724). However, owing to low blood pressure and atypical symptoms of the patient, we did RUSH exam in the emergency department to detect aortic dissection. After doing the Computed tomography (CT) angiography, the diagnosis of aortic dissection was confirmed. As the vascular surgeon was not present in our surgery department, we transferred the patient to Namazi hospital by air ambulance to undergo the surgery. She was discharged from hospital with complete recovery.Conclusion: Aortic dissection symptoms can be manifested in different ways such as pulmonary embolism, ACS, and CVA. Therefore, clinicians must always have the differential diagnosis of aortic dissection in their mind and be aware of its various manifestations.
Emergency medicine
Samaneh Abiri; Mahdi Foroughian; Hamideh Akbar; Neema John Mehramiz; Naser Hatami; Abdol Ali Ameri; Navid Kalani; Esmaeil Rayat Dost; Saeed Barazandehpour
Volume 6, Issue 2 , July 2020, , Pages 55-58
Abstract
Objective: The purpose of this study was to evaluate a valid model for patients’ admission or discharge from emergency services to improve the health system and reduce costs.Methods: This study was carried out using a prospective cohort method. The study population was patients with limb cellulitis ...
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Objective: The purpose of this study was to evaluate a valid model for patients’ admission or discharge from emergency services to improve the health system and reduce costs.Methods: This study was carried out using a prospective cohort method. The study population was patients with limb cellulitis referring to the emergency department of Peymanieh hospital. In this research, the study participants were separated into two groups based on the duration of hospitalization (hospital stay less than 24 hours or longer than 24 hours), then the patients were again separated into 4 groups based on the classification of the the Clinical Resource Efficiency Support Team (CREST) guideline, which in each of these groups the mean age, gender, and the prevalence of underlying diseases were identified and the final outcome for each group was determined after one week from the visit to the hospital.Results: Peripheral vascular disease, history of injection drug use, immunodeficiency and congenital immune deficiency had a significant relationship with the rate of hospitalization and recurrence. There was a significant relationship between class 1 disease and hospitalization for less than 24 hours, classes 2 and 3, and hospitalization for more than 24 hours (P < 0.001). There was a significant relationship between grade 1 disease and non-recourse, grade 3 and recurrence within one week after initiation of the treatment (P < 0.001). But there was no relationship between grade 2 and grade 4 and the referral of the patient after treatment.Conclusion: Corset Scale is a reliable scale for assessing the severity of the disease to determine the process of cellulite treatment for outpatient or hospitalization.