Clinical Toxicology
Mohammad Rafiqul Islam; Sarmistha Biswas; Syed Zakir Hossain; Nafizul Islam; Gourab Dewan; Mohammad Robed Amin
Volume 5, Issue 1 , January 2019, , Pages 23-28
Abstract
Objective: Acute poisoning is a common cause of hospital admission in Bangladesh. But, risk factors and characteristics of victims of different modes of poisoning have not been evaluated for possible intervention strategies. So, in this study we aimed to describe the pattern of acute poisoning in central ...
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Objective: Acute poisoning is a common cause of hospital admission in Bangladesh. But, risk factors and characteristics of victims of different modes of poisoning have not been evaluated for possible intervention strategies. So, in this study we aimed to describe the pattern of acute poisoning in central Bangladesh as well as identifying risk factors for various mode of poisoning.Methods: A prospective observational study was undertaken in Dhaka Medical College Hospital in 2015. Consenting adult acute poisoning victims were included as study subjects. A pretested structured case record form was used to systematically record the cases. The poisoning cases were defined by clinical toxidrome (sympathomimetic, antimuscarinic, opioids, cholinergic, sedative, etc) during acute presentation with suspected poisoning and groups accordingly. SPSS 20 was used for data analysis and statistical tests including mean ± standard division (SD), percentage, t test and chi-square were used accordingly.Results: Total poisoning cases were 1155. Suicidal (62.25%, n = 719), commuter poisoning (24.16%, n = 279) and accidental poisoning (12.38%, n = 143) were main types of poisoning. Risk factors of suicidal poisoning were young females of 11 to 30 years, married, housewives and students (P < 0.0001). Stressful relationship was the commonest reason of suicidal poisoning. Pesticides and sedatives were frequently chosen for easy availability. Commuter poisoning was common in males and urban areas (P < 0.0001). Accidental poisoning was more in males and rural areas (P < 0.0001) and snake envenomation was the main cause.Conclusion: Poisoning burden is high in central Bangladesh. Identified risk factors will help develop poisoning prevention strategies.
Emergency medicine
Shiva Salmasi; Navideh Robai; Hanieh Ebrahimi Bakhtavar; Farzad Rahmani; Farnaz Rahmani
Volume 3, Issue 1 , January 2017, , Pages 26-29
Abstract
Objective: According to the definition of World Health Organization (WHO), attempting suicide is an act that a person intentionally and without others’ interference shows an abnormal behavior (such as harming themselves or eating a drug higher than treatment dose) and his objective is realizing ...
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Objective: According to the definition of World Health Organization (WHO), attempting suicide is an act that a person intentionally and without others’ interference shows an abnormal behavior (such as harming themselves or eating a drug higher than treatment dose) and his objective is realizing his expected changes. The purpose of this study was to investigate the demographic characteristics of married women with suicidal attempt and a variety of methods used to suicide among them who referred to the emergency department of Sina hospital in Tabriz.
Methods: In a cross-sectional study 472 married female patients with suicide attempt who referred to the emergency department of Sina hospital in Tabriz in 2014 entered the study and relevant information was collected. Obtained information was analyzed using SPSS version 17.0.
Results: Findings showed that the most frequent method of suicide was drug use (99.8%). A significant relationship was found between the type of drug used and seasons of the year. The majority of the population (90.5%) lived in urban areas and based on statistical analyses, a significant relationship was found between residency and type of drug used.
Conclusion: According to the results of this study it can be concluded that drug use is the most frequent method of suicide that is done with a higher frequency in summer. Thus, rational prescription of drugs by physicians can be considered as one of the factors that can prevent suicide.
Emergency medicine
Samad Shams Vahdati; Kavous Shahsavari Nia; Sarvin Dalil; Paria Habibollahi; Behzad Yousefi
Volume 3, Issue 2 , July 2017, , Pages 46-48
Abstract
Objective: Trauma is a disease of modern societies and one of the reasons for the deaths of all ages in those societies. It is estimated that each year about 8.5 million people worldwide lose their lives as a result of trauma. Among the types of injuries around the world, road accidents are more common. ...
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Objective: Trauma is a disease of modern societies and one of the reasons for the deaths of all ages in those societies. It is estimated that each year about 8.5 million people worldwide lose their lives as a result of trauma. Among the types of injuries around the world, road accidents are more common. We conducted this study to compare types of trauma in different seasons in patients referred to Imam Reza hospital trauma center in 2013. Methods: In this cross-sectional study, all trauma patients admitted to Trauma Emergency Department of Imam Reza hospital in Tabriz entered the study. As this study did not focus on the diagnosis and treatment of diseases, we used epidemiological data from history and physical examination as a source. Descriptive statistics such as frequency, percentage, mean and standard deviation were used for data analysis. All data were analyzed using SPSS version 15.0. Results: Of all 23 876 patients, 18 044 patients (75.6%) were male and 5832 (24.4%) were female. The prevalence of majority of trauma cases was 11.2% (2671) and occurred in September. Traffic accidents were the most common cause of trauma in patients with a prevalence of 33.9% (8095). Head injury had a prevalence of 38.6%. We did not find any correlation between age of patients, gender, type of injuries and the affected limb. Conclusion: Findings showed that trauma is more prevalent among males and younger people. Thus, proper planning and stringent traffic rules can reduce accident rate.
Critical Care
Maryam Ziaee; Amirhossein Mirafzal
Volume 2, Issue 2 , July 2016, , Pages 50-54
Abstract
Objective: To evaluate the association of base deficit (BD) with mortality in traumatized children, and to assess this association in a subgroup of patients with traumatic brain injury (TBI). Methods: In this cross-sectional study performed prospectively on a convenience sample of patients ...
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Objective: To evaluate the association of base deficit (BD) with mortality in traumatized children, and to assess this association in a subgroup of patients with traumatic brain injury (TBI). Methods: In this cross-sectional study performed prospectively on a convenience sample of patients under 16 years of age with trauma presenting to an academic level ІІ trauma center, we obtained venous BD values initially and followed the patients for in-hospital mortality. Initial vital signs were measured and injury severity score (ISS), randomized trauma score (RTS), and pediatric trauma score (PTS) were calculated. Results: A total of 102 patients were included, with 48 patients diagnosed with TBI. Nine patients (8.8%) died during admission, of which 6 were diagnosed with TBI. Based on the univariate analysis, BD was associated with mortality in the whole group (P = 0.01), but not in the TBI subgroup (P = 0.08). In multivariable analysis, RTS was the only variable independently associated with mortality (P = 0.001, odds ratio [OR] = 0.197). Linear regression model showed that BD was predictive of ISS, RTS, and PTS. Receiver operating characteristics (ROC) curve showed a cutoff point of -7 mmol/L for BD, below which there is a 12 fold increased risk for mortality. Conclusion: BD is a useful parameter in mortality prediction in pediatric trauma like in adult age group, but this predictive role in TBI patients is not supported by our results.
Emergency medicine
Mohammad Hasan Lotfi; Hossein Lashkardoost; Andishe Hamedi
Volume 5, Issue 2 , July 2019, , Pages 51-55
Abstract
Objective: The rate of road traffic accidents in Iran per capita and for the number of vehicles is much higher than the average in the world. The present study was conducted to investigate road traffic accidents in Yazd province during 2011-2015.Methods: The present study is a descriptive-analytic study ...
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Objective: The rate of road traffic accidents in Iran per capita and for the number of vehicles is much higher than the average in the world. The present study was conducted to investigate road traffic accidents in Yazd province during 2011-2015.Methods: The present study is a descriptive-analytic study in which data were obtained from data collection forms related to deaths from driving accidents of forensic medicine organizations. Data were entered into SPSS version 23. We calculated the frequency, percentage, and mean indices. We used Fisher exact test for data analysis.Results: In this research, 1437 individuals were studied. The number of deaths in men was three times more than women. Most fatal accidents occurred in the age group of 20-30 years. The most common accident which occurred during these years was the collision of vehicles with each other and in terms of the final cause of death, 1045 people died due to head injuries. In this study, we showed that the incidence decreased from 29.03 in 2011 to 22.03 in 2015.Conclusion: According to the results of this study, the most cases of fatal accidents occurred in the age group of 20-30 years, in people with elementary education and in the summer. Therefore, preventive action is necessary by raising awareness.
Hossein Alimohammadi; Papak Babaie; Hamid Reza Hatamabadi; Anita Sabzghabaei; Hojat Derakhshanfar; Farahnaz Bidari Zerehpoosh
Volume 1, Issue 2 , July 2015, , Pages 56-59
Abstract
Objective: Standardization of hospital emergency units is a major goal in developed countries to decrease the duration of patients stay in these units. The present study was undertaken to evaluate the prevalence of long-term staying in an emergency ward.
Methods: In the present 2-month cross-sectional ...
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Objective: Standardization of hospital emergency units is a major goal in developed countries to decrease the duration of patients stay in these units. The present study was undertaken to evaluate the prevalence of long-term staying in an emergency ward.
Methods: In the present 2-month cross-sectional study, patients referring to the emergency ward of Imam Hossein hospital were assessed. The patients’ demographic data, including age, the presenting symptoms and signs, reasons for delays, and the final outcome in relation to the location of hospitalization and discharge information were recorded. Data were reported as frequencies and percentages. The results were reported as means and standard deviations using SPSS version 20.
Results: Of 10087 patients admitted into the emergency ward during a 2-month period, 75 patients (0.7%) needed to stay and wait for more than 24 hours. The mean ± standard deviation of the patients’ ages was 62.5 ± 20.2 years, with 60% of the patients being over 60 years of age. The most common reason for overcrowding in the emergency ward was a lack of empty beds, with the need for ICU beds as the most important reason for bed deficiency in 59% of the cases. Nervous system problems were the most common reasons for referring to the emergency unit (41%) in patients under study. Finally, 81% of the patients were hospitalized, 10% died, 7% were discharged based on personal request and 1.3% were transferred to another hospital.
Conclusion: The prevalence of patients staying and waiting in the emergency ward for more than 24 hours was 0.7%. Lack of empty ICU beds was the most important reason for such delays; however, paraclinical problems had no role in these delays which were associated with the death of 10% of patients.
Emergency medicine
Payman Asadi; Vahid Monsef Kasmaei; Seyyed Mahdi Zia Ziabari; Shiva Bakian; Amir Noyani
Volume 6, Issue 2 , July 2020, , Pages 68-72
Abstract
Objective: Emergency medical services (EMS) is a critical component of health care system and the forefront of stroke care. The prominent role of EMS in stroke care is timely and accurate diagnosis of acute ischemic stroke and transfer of the patients to stroke centers. The present study aimed to assess ...
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Objective: Emergency medical services (EMS) is a critical component of health care system and the forefront of stroke care. The prominent role of EMS in stroke care is timely and accurate diagnosis of acute ischemic stroke and transfer of the patients to stroke centers. The present study aimed to assess the “awareness” and “attitude” of EMS personnel concerning prehospital stroke care based on American Stroke Association (ASA) guideline in Rasht town.Methods: This was an analytical cross-sectional study. The participants, consisted of all EMS personnel (n = 115) in Rasht town in 2012, entered the study based on census method. Awareness and attitude of EMS personnel toward prehospital stroke care were assessed using a questionnaire based on ASA guideline. The questionnaire had two sections. The first part contained demographic data and the second part had multiple choice items (Likert-type scale response anchors) to assess awareness and attitude of the personnel. The questionnaires were filled out by the personnel. The collected data were analyzed using descriptive and inferential statistics using SPSS software version 20. P-value less than 5% was considered significant.Results: Ninety people participated in this study. The average of age and working experience of participants were 36.84 ± 8.02 and 11.36 ± 5.71, respectively. Most of the participants had bachelor degree (n = 33, 36.7%) and majored in medical emergency (n = 43, 47.8%). Most of them were contract employees (47.8%). Mean scores of awareness and attitude of the personnel were 26.68 (the total number of score = 51) and 32.56 (the total number of score = 80), respectively.Conclusion: Findings revealed poor awareness and attitude of EMS personnel toward prehospital stroke care based on ASA guideline in
Emergency medicine
Hammoda Abu-Odah; Akram Abu Salah; Ali El-Khateeb; Khawla El-Nems
Volume 4, Issue 2 , July 2018, , Pages 77-81
Abstract
Objective: Patients’ satisfaction (PS) is recognized as an important emergency department service design and it has received a high interest and attention in the health management where many studies have focused on determining factors affecting PS in health-related circumstances. In this study, ...
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Objective: Patients’ satisfaction (PS) is recognized as an important emergency department service design and it has received a high interest and attention in the health management where many studies have focused on determining factors affecting PS in health-related circumstances. In this study, we aimed to examine PS in emergency department (ED) of the European Gaza Hospital (EGH) in the Gaza Strip (GS).Methods: A descriptive-analytical cross sectional study was performed at ED-EGH between March, 15 and June 20, 2015. Press Ganey questionnaire was used as a tool for data collection. For each patient, a self-administered questionnaire including 22 questions was filled based on a Likert scale. Results were analyzed using SPSS version 22.Results: Overall, 200 respondents were included in the study. About 73% of respondents were satisfied with overall medical services. The term of nurses’ concern provided to patients elicited the highest score (83.1%), followed by physicians’ concern with patients (72.0%) and communication skills with patients (71.4%), while the lowest score was reported in waiting time and security staff. Furthermore, our findings show an association between PS and level of education, gender differences, living area, and work shifts.Conclusion: The study results conclude that areas of medical and nursing care, respects of staff, physical comfort and waiting time ED-EGH is highly acceptable and offer in appropriate manners.
Emergency medicine
Arash Amirrafiei; Seyyed Mahdi Zia Ziabari; Fatemeh Haghshenas-Bakerdar; Ehsan Kazemnejad-Leili; Payman Asadi
Volume 7, Issue 2 , July 2021, , Pages 101-105
Abstract
Objective: Evaluating the abilities of emergency medical services (EMS) staff who are in the frontline of the diseases could be an excellent reflection of the accuracy of curriculum both before and after graduation. This study was done to determine the clinical competencies of Guilan EMS staff in responding ...
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Objective: Evaluating the abilities of emergency medical services (EMS) staff who are in the frontline of the diseases could be an excellent reflection of the accuracy of curriculum both before and after graduation. This study was done to determine the clinical competencies of Guilan EMS staff in responding to emergency conditions using Objective Structured Clinical Examination (OSCE). Methods: In this descriptive study, 70 EMS staff from selected Emergency Centres in Guilan were recruited. Data were collected using a questionnaire and a checklist which included 9 different skills. Validity of the checklist was assessed by obtaining the opinions of 10 experts. The content validity index (CVI) and content validity ratio (CVR) of the checklist were 0.7 and 0.8, respectively. The reliability of the checklist was obtained using the test-retest method (r=0.89). In order to collect data, observations were done using the designated checklist. Data were analysed using SPSS software version 22 and descriptive statistical tests. Results: Findings showed that 56.3% of the paramedics got good scores for trauma competency but the mean scores for two competencies of spinal cord immobilization and vehicle extrication were low, indicating major skills problem. There was a statistically significant relationship between education (P=0.02) and work experience (P=0.03) as well as clinical skills in confronting trauma. Conclusion: Although the EMS staff had an acceptable range of performance in most of the skills, it seems that there is a need for training of performance-based competencies in which paramedics had a poor performance.
Emergency medicine
Mohammad Mohammadi; Abdolghani Abdollahimohammad; Mohammadreza Firouzkouhi; Maryam Shivanpour
Articles in Press, Corrected Proof, Available Online from 03 December 2021
Abstract
Objective: Pre-hospital emergency staff are involved in the front line of care for COVID-19 patients and face many challenges. The aim of this study was to explore the challenges of prehospital emergency staff in the COVID-19 pandemic.Methods: This qualitative research was conducted with a descriptive ...
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Objective: Pre-hospital emergency staff are involved in the front line of care for COVID-19 patients and face many challenges. The aim of this study was to explore the challenges of prehospital emergency staff in the COVID-19 pandemic.Methods: This qualitative research was conducted with a descriptive phenomenological approach. Purposeful sampling was applied and data collection was done through semi-structured interviews. Participants consisted of 16 pre-hospital emergency staff. Data analysis was performed using the Colaizzi approach.Results: Data analysis revealed five main themes including safety against COVID-19, knowledge deficit, fear and worry, challenges of transporting patients to the hospital, and selflessness.Conclusion: Pre-hospital emergency staff face many problems in personal, professional, equipment and cultural fields in the COVID-19 epidemic. In this regard, special attention from health systems is mandatory.
Emergency medicine
Maryam Eshghi; Farzad Rahmani; Behjat Derakhti; Fariba Abdollahi; Shahrad Tajoddini
Volume 2, Issue 1 , January 2016, , Pages 15-20
Abstract
Objective: Patient satisfaction is one of the most important indicators for measuring the quality of emergency services and health care. The purpose of this study was to evaluate the patients’ satisfaction in the emergency department (ED) of Sina hospital. Methods: This descriptive, cross-sectional ...
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Objective: Patient satisfaction is one of the most important indicators for measuring the quality of emergency services and health care. The purpose of this study was to evaluate the patients’ satisfaction in the emergency department (ED) of Sina hospital. Methods: This descriptive, cross-sectional study was performed during one month in Sina hospital in 2014. Data were collected by a questionnaire which its validity and reliability were confirmed in previous studies. The questionnaire consisted of 2 parts. Part 1 included the demographic characteristics and part 2 encompassed the scales of satisfactory. Data analysis was conducted by SPSS version 15. Results: Totally, 425 patients participated in this study. The mean age of patients was 41.6±17.6 years. The mean total score of patient satisfaction was 17.43±1.56. The maximum satisfaction was related to the knowledge of physicians and the minimum satisfaction was related to the remaining period in the ED. Additionally, there was a desirable satisfaction for nurses’ performances. In terms of satisfaction regarding the physical environment and the workflow of the ED, the results were moderate. There was a significant statistical difference regarding nurses and physicians behavior in the ED during different working shifts, vacation days, and workdays. Conclusion: Based on the results obtained, patients had good satisfaction for the received services in the ED. It is necessary to develop physical spaces and improve the workflow of patients in the ED.
Emergency medicine
Ali Reza Shafiee-Kandjani; Seyed Gholamreza Noorazar; Saeed Aslanabadi; Nasim Rashedi; Mehrnaz Dadkhah; Mohsen Jafarzadeh-Gharehziaaddin
Volume 4, Issue 1 , January 2018, , Pages 18-23
Abstract
Objective: Attention-deficit/hyperactivity disorder (ADHD) is characterized by persistent and impairing levels of inattention, impulsivity and hyperactivity. Evidence shows that adolescents with ADHD are more exposed to trauma. This study aimed to investigate the relationship between ADHD symptom severity ...
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Objective: Attention-deficit/hyperactivity disorder (ADHD) is characterized by persistent and impairing levels of inattention, impulsivity and hyperactivity. Evidence shows that adolescents with ADHD are more exposed to trauma. This study aimed to investigate the relationship between ADHD symptom severity and trauma severity. Methods: In this descriptive correlational study, the study population included traumatic adolescents aged 12-18 years referred to Shohada hospital in Tabriz, Iran in 2016. Among this population, 91 subjects were selected. In order to exclude subjects with other psychiatric disorders, a psychiatrist performed clinical interviews with them. In this regard, the short form of Conner’s Comprehensive Behavior Rating Scales Revised Edition (CBRS-R) and Pediatric Trauma Scale were used. For data analysis, Pearson correlation coefficient and independent t test were applied. Data were analyzed using SPSS software version 22. Results: There was a significant positive relationship between trauma severity and ADHD score, hyperactivity, and oppositional/Impulsivity (P < 0.01). Conversely, no statistical significance was observed between attention deficiency and trauma severity. The severity of trauma was higher among ADHD group than normal individuals. There were also correlations between socioeconomic status (SES) and oppositional/impulsive patients. In this regard, higher scores of oppositional/impulsivity were observed among patients with lower SES. Conclusion: Traumas have significant effects on economic and humanistic aspects of life in modern era. Our findings showed that there was a statistically significant relationship between hyperactivity-inattention and trauma intensity in adolescents. Therefore, to prevent traumatic events, ADHD screening at schools is suggested. By the same token, informing parents through mass media can help reduce the consequences of inattention/ hyperactivity disorder in the society.
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.
Emergency medicine
Surendar Ravipragasam; Deepika Chandar; Vinay R Pandit
Volume 6, Issue 1 , January 2020, , Pages 23-27
Abstract
Objective: Survival-to-discharge rates following in-hospital cardiac arrest (IHCA) patients remain significantly low. The use of initial documented cardiac rhythm as predictor of Survival-to-discharge is still unclear. This study aimed to assess whether the initial documented rhythm can be used as a ...
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Objective: Survival-to-discharge rates following in-hospital cardiac arrest (IHCA) patients remain significantly low. The use of initial documented cardiac rhythm as predictor of Survival-to-discharge is still unclear. This study aimed to assess whether the initial documented rhythm can be used as a predictor of survival-to-discharge following IHCA in an emergency department of the tertiary care referral institute, south India. Methods: This observational study was conducted for six months from January to June 2017 among all patients above 12 years, with witnessed cardiac arrest after arrival at the emergency department. After obtaining informed consent from the patients’ caregivers, data of socio-demographic details, previous relevant medical history, initial documented rhythm, neurologic status and survival-to-discharge were collected and analyzed. Results: The mean age of participants was 50 ± 17.15 years. Of the 252 study participants, 77.4% had non-shockable and 22.6% had shockable rhythm as initial documented rhythm. The overall survival-to-discharge rate was 17.5% (n=44) in our study. The overall proportion of participants who survived to discharge after IHCA was higher among participants with shockable rhythm (16/57, 28%) in comparison to participants with non-shockable rhythm (28/195, 14.3%). These differences were found to be statistically significant. Among the patients with shockable rhythm, 61.1% had good cerebral performance. Conclusion: Survival-to-discharge rates after IHCA can be predicted based on the initial documented cardiac rhythm. Early identification of patients with impending cardiac arrest and providing prompt management of patients with cardiac arrest will improve the survival rates significantly
Emergency medicine
Siamak Mousazadeh; Iraj Feizi; Khatereh Isazadeh
Volume 7, Issue 1 , January 2021, , Pages 28-31
Abstract
Objective: Inguinal hernia surgery is one of the most commonly used surgical procedures in the world. The aim of this study was to compare the recurrence and postoperative complications between a new mesh implant technique in the floor of the inguinal canal with limited tissue repair on it and Liechtenstein ...
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Objective: Inguinal hernia surgery is one of the most commonly used surgical procedures in the world. The aim of this study was to compare the recurrence and postoperative complications between a new mesh implant technique in the floor of the inguinal canal with limited tissue repair on it and Liechtenstein technique for inguinal hernia repair.Methods: In this cross-sectional study, patients were studied by Liechtenstein technique and a new technique of insertion of mesh at the foam of the inguinal canal with a limited tissue repair on it. Data were collected by interview and we assessed the recurrence rate, urinary retention and post-operative pain. Data were analyzed using SPSS software version 24. Chi-square test and t test were used for quantitative data and P value less than 0.05 was considered significant.Results: The mean age of patients was 49.28 ± 15.84. The mean age and sex ratio between the two groups were similar. Recurrence was seen in 11 (1.83%) of all patients and the difference between the two groups was not significant. Of all patients, 28 (4.7%) had urinary retention after surgery and the difference between the two groups was significant (p=0.01). Of all patients, 91 (15.2%) had pain after three weeks and 29 (4.8%) had pain after six months.Conclusion: The results showed that the new method had less complications concerning post-operative pain and urinary retention in comparison with the Liechtenstein method as an acceptable method for inguinal hernia repair in future.
Cardiology
Samad Shams Vahdati; Neda Parnianfard; Sanaz Beigzali; Shahrad Tajoddini
Volume 1, Issue 1 , January 2015, , Pages 29-34
Abstract
Objective: Acute chest pain is an important and frequently occurring symptom in patients. Chest pain is often a sign of ischemic heart disease. Chest pain due to suspected Acute Coronary Syndrome (ACS) is responsible for a large and ijncreasing number of hospital attendances and admissions. Current practice ...
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Objective: Acute chest pain is an important and frequently occurring symptom in patients. Chest pain is often a sign of ischemic heart disease. Chest pain due to suspected Acute Coronary Syndrome (ACS) is responsible for a large and ijncreasing number of hospital attendances and admissions. Current practice for suspected ACS involves troponin testing 10–12 hours after symptom onset to diagnose Myocardial Infarction (MI). Patients with a negative troponin can be investigated further with Computed Tomographic Coronary Angiography (CTCA) or exercise Electrocardiography (ECG). A review of cardiac biomarkers as screening test in acute chest pain over 15 years was conducted. Separate searches were under taken for biomarkers. We Searched electronic databases up to 2004-2014, reviewed citation lists and contacted experts to identify diagnostic and prognostic studies comparing a relevant index test (biomarker, CTCA or exercise ECG) to the appropriate reference standard. We classified studies to two part early rise biomarkers, high sensitivity biomarkers.
Conclusion: Although presentation troponin has suboptimal sensitivity, measurement of a 10-hour troponin level is unlikely to be cost-effective in most scenarios compared with a high sensitivity presentation troponin. Measurement of cardiac troponin using a sensitive method was the best test for the early diagnosis of an Acute Myocardial Infarction (AMI). Measurement of myoglobin or Creatine Kinase-MB (CK-MB) in addition to a sensitive troponin test is not recommended. Heart-type Fatty Acid-Binding Protein (H-FABP) shows promise as an early marker and requires further study.
Clinical Toxicology
Seyed Hesam Rahmani; Gholamreza Faridaalaee
Volume 5, Issue 1 , January 2019, , Pages 29-31
Abstract
Hypokalemic periodic paralysis is anautosomal dominantdisease characterized by muscle weakness or paralysis with a matching fall in blood potassium levels. Paralysis attacks often occur in adolescence and are induced by strenuous exercise followed by rest, high carbohydrateor high sodiummeal content, ...
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Hypokalemic periodic paralysis is anautosomal dominantdisease characterized by muscle weakness or paralysis with a matching fall in blood potassium levels. Paralysis attacks often occur in adolescence and are induced by strenuous exercise followed by rest, high carbohydrateor high sodiummeal content, sudden changes in temperature, and even excitement, noise, flashing lights and cold temperatures. Despite global daily use of intravenous and oral potassium in the treatment of patients, data about intravenous bolus potassium is rare. Here we report a 29-year-old man complaining of weakness in the upper and lower limbs. By initial diagnosis of periodic hypokalemic paralysis, potassium chloride was ordered by oral route. After a few minutes, we heard patient screaming in pain. He complained of severe acute pain in peripheral intravenous line, palpitation and dyspnea. We noticed that potassium chloride vial was infused directly via cubital vein in few minutes erroneously. Physical exam revealed sinus tachycardia and hypertension. We began hyperkalemia treatment immediately. With appropriate treatment,the patient was discharged with good condition after 12 hours of admission.
Critical Care
Akbar Fadaei Haghi; Rouya Shokri; Samad Shams Vahdati; Farid Eftekhar Milani; Shahrad Tajoddini
Volume 3, Issue 1 , January 2017, , Pages 30-31
Abstract
We report a 54-year-old woman with the history of end-stage renal disease (ESRD) who was admitted to our hospital because of volume overload. Due to long-term use of peripheral veins and arteriovenous fistula (AVF) failure, central venous catheterization was the only choice for hemodialysis. She developed ...
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We report a 54-year-old woman with the history of end-stage renal disease (ESRD) who was admitted to our hospital because of volume overload. Due to long-term use of peripheral veins and arteriovenous fistula (AVF) failure, central venous catheterization was the only choice for hemodialysis. She developed right upper extremiti’s pain and paresis during hemodialysis. A posteroanterior chest x-ray showed the catheter tip was accidently pushed from right internal jugular vein into right subclavian vein during hemodialysis by the dialysis center nurse. Therefore, we believe that the physician should be aware of any changes in the catheter size after insertion. And a chest x-ray should ensure the catheter’s correct position in any patient who develops complications.
Emergency medicine
Seyed Hossein Ojaghi Haghighi; Samad Shams Vahdati; Tarannom Mahmoudie; Pegah Sepehri Majd; Mohammad Mirza-Aghazadeh-Attari
Volume 3, Issue 2 , July 2017, , Pages 49-52
Abstract
Objective: Cardiopulmonary resuscitation (CPR) is a lifesaving technique useful in the prevention of death or delaying it in a person with cardiac arrest. In this regard, demographic information about patients who need CPR is vital. Methods: In this cross-sectional study patients with cardiopulmonary ...
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Objective: Cardiopulmonary resuscitation (CPR) is a lifesaving technique useful in the prevention of death or delaying it in a person with cardiac arrest. In this regard, demographic information about patients who need CPR is vital. Methods: In this cross-sectional study patients with cardiopulmonary arrest or arrhythmias admitted to Imam Reza and Sina educational hospitals of Tabriz University of Medical Sciences from 22 December 2013 to 21 December 2014 entered the study. Demographic information such as age, sex, cardiopulmonary resuscitation time, the place of cardiopulmonary arrest (outside or inside the hospital), the duration of resuscitation process, success or failure of the resuscitation process and the mechanism of cardiopulmonary arrest were obtained. Results: From a total of 354 cases of cardiopulmonary resuscitation, 281 cases (79%) were unsuccessful and 73 cases (21%) were successful. The average age of patients was 59 ± 22 years. The average time of the resuscitation process was 31 ± 12 minutes. There was a significant difference between the mean of age and resuscitation time in patients who had experienced successful or unsuccessful resuscitation (P = 0.0001). There was a significant relationship between sex and the success rate of resuscitation (P = 0.0001). In addition, a significant relationship between the success of the resuscitation operation and the ward of resuscitation was observed (P = 0.0001). Conclusion: The most common mechanism leading to cardiopulmonary arrest among patients was asystole. In this regard, no significant difference was observed between successful and unsuccessful resuscitation processes. It was also observed that the success of resuscitation from 8 am to 4 pm was more than any other time period.
Clinical Toxicology
Parash Ullah; Alamgir Chowdhury; Ishrat Tahsin Isha; Sultan Mahmood; Fazle Rabbi Chowdhury; Mohammad Zeesan-ul- Abir; Aziz Al Manna; Muhammad Ismail Patwary
Volume 2, Issue 2 , July 2016, , Pages 55-57
Abstract
Wasp sting is a relatively common arthropod assault. This usually results in pain and mild allergic reactions, but sometimes may cause severe systemic reaction and multiorgan dysfunction including rhabdomyolysis, hemolysis, coagulopathy, hepatic, renal and cardiac complications. Along with several ...
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Wasp sting is a relatively common arthropod assault. This usually results in pain and mild allergic reactions, but sometimes may cause severe systemic reaction and multiorgan dysfunction including rhabdomyolysis, hemolysis, coagulopathy, hepatic, renal and cardiac complications. Along with several other pathomechanisms, rhabdomyolysis is a distinguished cause of acute kidney injury (AKI) in patients with wasp sting. We herein report a case in which the patient developed rhabdomyolysis followed by AKI due to multiple wasp stings. The offending wasp was brought to the hospital and the species was confirmed by a zoologist (Vespa affinis).
Emergency medicine
Hassan Amiri; Mojtaba Chardoli; Maryam Sarvari; Samad Shams Vahdati; Niloufar Ghodrati; Roshan Fahimi
Volume 5, Issue 2 , July 2019, , Pages 56-60
Abstract
Objective: This study investigates the possible magnetic resonance imaging (MRI) findings in patients with cervical trauma having a normal level of consciousness and normal CT reports. These patients have tenderness or an uncomfortable feeling in the traumatized area as well.Methods: In this cross-sectional ...
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Objective: This study investigates the possible magnetic resonance imaging (MRI) findings in patients with cervical trauma having a normal level of consciousness and normal CT reports. These patients have tenderness or an uncomfortable feeling in the traumatized area as well.Methods: In this cross-sectional anterograde study, cases were selected among patients referred to the emergency department of Hafte Tir, Iran University of Medical Sciences from 2012 to 2014. Inclusion criteria to select cases were: age above 15, blunt neck trauma, GCS=15, normal CT scan reports of neck, no past medical history of cervical vertebral surgery, and no persistent neurologic lesions. In order to analyse qualitative data, chi-square test was used and for quantitative data t test was applied accordingly.Results: Two hundred eighty patients with chief complaints of neck pain due to trauma entered our study. Among this batch, 264 of them had normal CT scan reports and MRI was done for all of them. According to the results, the maximum injury in MRI was related to intervertebral disc injury (38 cases), ligamentous edema (35 cases), and muscle edema (22 cases), respectively. Neck tenderness from the beginning of the accident and transient neurologic signs had a significant role in MRI results (P < 0.05).Conclusion: In patients with acute cervical trauma having normal CT reports, MRI must be done in those with the average age of 45 or more, tenderness in the neck area, and in those with neurologic transient symptoms.
emergency nursing
Amin Beigzadeh; Bahareh Bahmanbijari; Mahla Salajegheh; Ali Akbar Haghdoost; Habibolah Rezaei
Volume 1, Issue 2 , July 2015, , Pages 60-66
Abstract
Organ donation is an integral part of the health care system. Many patients who have had an accident or have undergone a progressive disease are in need of an organ transplant and if they do not receive the required organ they would die. It is important to know that the most important source of organ ...
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Organ donation is an integral part of the health care system. Many patients who have had an accident or have undergone a progressive disease are in need of an organ transplant and if they do not receive the required organ they would die. It is important to know that the most important source of organ donation is the brain death patients. It is highly essential to determine the pivotal factors that have an effect on organ donation. The aim of this study was to determine factors influencing decisions on organ donation in brain death patients. This study was conducted in 2014 and was based on a literature review both in English and Persian databases. In addition, some relevant books were scrutinized. Overall, 2 categories were identified as factors associated with the acceptance of organ donation and factors associated with the refusal of organ donation. Based on the results obtained, these factors have an effect organ donation and policy makers and management authorities should consider these factors to increase the likelihood of organ donation
Emergency medicine
Fares Najari; Hadi Jafari; Ali Mohammad Alimohammadi; Dorsa Najari
Volume 6, Issue 2 , July 2020, , Pages 73-76
Abstract
Objective: Determination of victim’s clothes in gunshot wounds is important due to the necessity of immediate workup in the emergency room as well as the legal aspects of cases. The aim of this study is to evaluate the importance of victim’s clothes in gunshot wounds referred to autopsy hall ...
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Objective: Determination of victim’s clothes in gunshot wounds is important due to the necessity of immediate workup in the emergency room as well as the legal aspects of cases. The aim of this study is to evaluate the importance of victim’s clothes in gunshot wounds referred to autopsy hall of legal medicine bureau of Tehran, Iran from 2014 to 2017.Methods: In this analytical comparative study, 202 consecutive cadavers of gunshot victims, referred to Tehran Legal Medical Hall from 2014 to 2017, were enrolled and the effect of shotgun and gunshot wound were determined and compared. Data were collected using a researcher-made questionnaire. The significance level of the tests was considered as P < 0.05. Spearman correlation coefficient and chi-square tests were used accordingly. The data were analyzed using SPSS software version 22.Results: In this study, all women were killed by gunshot. Also, all of the 26 people who were killed by shotgun were men. The mean of age only in males was 39-48 years for shotgun, and 29-38 years in both genders for gunshot. Evaluation of their clothes in the emergency room and autopsy hall was helpful in 70% of cases in order to determine shot distance and type of gun (P = 0.0001). Conversely, we did not observe a significant difference between sex (P = 0.082) and the pattern of death (P = 0.211).Conclusion: Based on the obtained results, it seems that some characteristics of victim’s clothes may be useful to differentiate shotgun and gunshot.
Clinical Toxicology
Behnam Behnush; Roya Kordrostami; Nahid Dadashzadeh; Maryam Ameri
Volume 4, Issue 2 , July 2018, , Pages 82-85
Abstract
This study aimed to evaluate the shoulder dislocation following tramadol-induced seizure and its potential difference with other shoulder dislocations. We evaluated six cases that used tramadol tablets and some of them had a history of seizure. All of the cases had shoulder dislocation. According to ...
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This study aimed to evaluate the shoulder dislocation following tramadol-induced seizure and its potential difference with other shoulder dislocations. We evaluated six cases that used tramadol tablets and some of them had a history of seizure. All of the cases had shoulder dislocation. According to the findings, tramadol use and tramadol-induced seizure may increase the risk of shoulder dislocation.
Emergency medicine
Payman Asadi; Seyyed Mahdi Zia Ziabari; Vahid Monsef-Kasmaei1
Volume 7, Issue 2 , July 2021, , Pages 106-110
Abstract
Objective: Awareness of the changes concerning the clinical guidelines for cardiopulmonary resuscitation (CPR) is essential for nurses. This study aimed at assessing the nurses’ knowledge of the 2015 American Heart Association basic life support guideline algorithm. Methods: In a cross-sectional ...
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Objective: Awareness of the changes concerning the clinical guidelines for cardiopulmonary resuscitation (CPR) is essential for nurses. This study aimed at assessing the nurses’ knowledge of the 2015 American Heart Association basic life support guideline algorithm. Methods: In a cross-sectional study, the knowledge of 183 nurses working in emergency departments, intensive care unit (ICU) and coronary care unit (CCU) regarding the 2015 American Heart Association basic life support guideline algorithm was investigated. Data were collected by a 20-item questionnaire regarding the knowledge needed for resuscitation operations as well as the identification of the early stages of cardiac arrest. Nurses with a score of 10 and less were put in the poor group, 11-15 in the fair group, and score of more than 15 in the good group . Results: Results showed that the highest percentage of the right answer was observed in questions 20 (98.4%), 11 (93.4%), and 1 (88%), while the lowest percentage of the correct answer was found in questions 13 (30.6%), 2 (31.1%), and 3 (32.8%). Mean ± SD of knowledge score was 12.3±2.2. A statistically significant difference was observed between knowledge of ICU nurses with an experience of basic life support educational course and those with no experience of such education. The knowledge score of educated and noneducated nurses was 11.5±2.2 and 13.2±2.5, respectively. Conclusion: This study indicated that ICU nurses do not have enough knowledge about basic life support of the 2015 American Heart Association guideline. Development of knowledge is one of the important components of professional expansion in nursing education programs.