Emergency medicine
Mehdi Momeni; Elnaz Vahidi; Neda Karimi Tafti; Zeinab Naderpour; Javad Seyedhosseini; Morteza Saeedi
Volume 9, Issue 1 , January 2023, , Pages 13-18
Abstract
Objective: Hand lacerations are among the most frequent causes of visiting emergencydepartments (EDs). Wound infection is one of its complications. There is still an ongoingdisagreement on the administration of oral versus intravenous (IV) antibiotics (ABs). Theobjective of this study is to compare the ...
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Objective: Hand lacerations are among the most frequent causes of visiting emergencydepartments (EDs). Wound infection is one of its complications. There is still an ongoingdisagreement on the administration of oral versus intravenous (IV) antibiotics (ABs). Theobjective of this study is to compare the effectiveness of oral versus IV ABs in preventingwound infection of hand lacerations.Methods: In this double-blind, randomized clinical trial, we enrolled all patients with handlacerations (based on the inclusion criteria) during 6 months in the EDs of 2 tertiary referralcenters. Convenient sampling was done. Finally, in the first group, 382 patients receivedoral AB (two 500 mg cephalexin capsules) and the other 382 patients in the second groupreceived IV AB (1 gr IV cefazolin) before wound management. Both groups were followedand received oral cephalexin during 48 hours after suturing. Rates of wound infection anddifferent complications were compared between the two groups. T-test, Mann-Whitney Utest, Chi square and Fisher analysis were used.Results: Both groups had the same age and gender distribution rate (79.8% of males withthe mean age of 30.8 years in the first group, and 83.5% of males with the mean age of 32.6years in the second group (P = 0.19 and 0.39, respectively). In our study, wound infectiondeveloped in 2.6% and 1.8% of patients in the first and second groups, respectively (P =0.46).Conclusion: Based on the results of this study, oral and IV ABs were not significantlydifferent in terms of preventing wound infection
Cardiology
Javad Seyedhosseini; Rasha Ahmadi; Ehsan Karimialavijeh; Mehrad Aghili
Volume 9, Issue 1 , January 2023, , Pages 32-37
Abstract
Objective: Cardiopulmonary arrest is a devastating outcome of some clinical situationsand requires strict implementation of cardiopulmonary resuscitation (CPR) protocols.Since ultrasound is one of the recommended tools to determine the presence of cardiacmovements and may be a predictor of the outcome, ...
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Objective: Cardiopulmonary arrest is a devastating outcome of some clinical situationsand requires strict implementation of cardiopulmonary resuscitation (CPR) protocols.Since ultrasound is one of the recommended tools to determine the presence of cardiacmovements and may be a predictor of the outcome, this study examined the relationshipbetween echocardiographic findings during CPR with patients’ outcomes.Methods: This cross-sectional prospective observational study was conducted on patientswith cardio-respiratory arrest in the emergency department of Shariaty hospital during2019. sampling method was random. Echocardiography was done at the patient’s bedsideduring the CPR process in accordance with the last advanced cardiac life support (ACLS)guidelines, on two points, after the end of the second and 10th minutes from the start ofCPR. The echocardiography findings (cardiac movement vs standstill) were recorded, andpatient outcomes were followed. Thirty-two patients enrolled in this study with a meanage of 56.9±15.3 years. Chi-square and Mann-Whitney U tests were used to calculate theassociation between heart contractions during resuscitation and the outcomes via SPSSV.22. Fisher’s exact test and Kruskal-Wallis test were used to evaluate the relationshipbetween heart rhythm in the second and tenth minutes with the outcomes of CPR.Results: The presence of cardiac movement in the 10th minute of CPR, in contrast to thefindings of the second minute, had a significant correlation with the success rate of CPRand outcomes (P<0.05). Moreover, patients with ventricular tachycardia (VT)/ventricularfibrillation (VF) cardiac rhythm had a better resuscitation rate, 24-hour survival rate, andbetter outcome than patients with other cardiac rhythms and asystole (P<0.05).Conclusion: Echocardiographic findings in the 10th minute of the CPR process can beused as a prognostic factor for cardiac arrest
Cardiology
elnaz vahidi; Maryam Beladi; Ahmad Abbasian; Amirhosein Jahanshir; Javad Seyedhosseini
Volume 8, Issue 1 , January 2022, , Pages 19-25
Abstract
Objective: Disposition in acute coronary syndrome (ACS) is pivotal in an emergency department (ED). HEART score is a recent scoring system for finding primary endpoints in undetermined ACS. This study aimed at evaluating the predictive value of HEART score in ACS outcome and disposition.Methods: In this ...
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Objective: Disposition in acute coronary syndrome (ACS) is pivotal in an emergency department (ED). HEART score is a recent scoring system for finding primary endpoints in undetermined ACS. This study aimed at evaluating the predictive value of HEART score in ACS outcome and disposition.Methods: In this prospective study, all patients with chest pain presentation compatible with our inclusion criteria referring to ED were enrolled during one year. Demographic data, triage level, hospital length of stay, admission ward, coronary angiography result, HEART score, thrombolysis in myocardial infarction (TIMI) score, 1-month primary ACS endpoints and major adverse cardiac events (MACE) were evaluated.Results: In our studied population (200 cases), 49 patients (24.5%) had at least one score for MACE. Comparing the prognostic values of TIMI vs HEART score in MACE revealed that the HEART had a larger AUC. The best cut-off point of HEART score in MACE prediction was calculated to be ≥5. There was a statistically significant relation between HEART score and hospital length of stay. The higher the HEART score, the more probability of patients being admitted to either hospital cardiac ward or coronary care unit (CCU). There was a significant relationship between the triage level and HEART score. Patients with higher HEART score had more acuity (lower triage level 1 or 2).Conclusion: HEART predicted MACE better than TIMI in low risk ACS. Patients with higher HEART score were more admitted to the hospital with longer hospital stay and patients with lower HEART score had higher triage level with less acuity.