sayyed majid sadrzadeh; Vahid Talebzadeh; Seyed Mohamad Mousavi; Behrang Rezvani Kakhki; elnaz vafadar moradi; Hamideh Feiz Disfani
Volume 13, Issue 1 , January 2025, , Pages 32-36
Abstract
Objectives: This study aimed to investigate the prognostic role of lactate clearance in predicting outcomes among trauma patients admitted to the emergency department.Methods: This retrospective cohort study was conducted on patients referred to the Emergency Department. Serum lactate levels were measured ...
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Objectives: This study aimed to investigate the prognostic role of lactate clearance in predicting outcomes among trauma patients admitted to the emergency department.Methods: This retrospective cohort study was conducted on patients referred to the Emergency Department. Serum lactate levels were measured at admission and 2 hours later. The patients were followed up for 72 hours to assess outcomes, including discharge, hospitalization in other wards, and mortality.Results: The results showed a significant difference between the mean age, Glasgow Coma Scale (GCS), systolic blood pressure (SBP), pulse rate (PR), and oxygen saturation (O2 Sat) of the trauma patients in relation to mortality prognosis (p<0.05). Additionally, significant differences were found in primary lactate, lactate levels two hours post-admission, and lactate clearance levels based on the patient’s prognosis (p<0.01). Multivariate logistic regression analysis revealed that lactate clearance was associated with a reduced mortality rate among trauma patients (OR=0.907, p<0.05).Conclusion: The findings of this study showed that lactate clearance, as an independent predictive factor, was associated with poorer prognosis and increased mortality rates in trauma patients.
Hosein Zakeri; Elham Pishbin; Behrang Rezvani Kakhki; Hanie Ghashghaee; Sayyed majid Sadrzadeh; Masumeh Sadeghi; Elnaz Vafadar Moradi
Volume 12, Issue 3 , July 2024, , Pages 124-129
Abstract
Objective: Geriatric trauma refers to injuries sustained by elderly individuals, typically those aged 65 years andolder. The management of geriatric trauma in the Emergency Department requires a comprehensive approachthat takes into account the physiological changes associated with aging, as well as ...
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Objective: Geriatric trauma refers to injuries sustained by elderly individuals, typically those aged 65 years andolder. The management of geriatric trauma in the Emergency Department requires a comprehensive approachthat takes into account the physiological changes associated with aging, as well as the increased vulnerabilityand complexity of injuries in this population.Methods: This is a cross-sectional study aimed at evaluating the etiology of trauma in geriatric patients referredto the ED of level-1 an academic center. All patients with complaints of trauma are evaluated and patients over65 years enrolled in the study. Data were analyzed by SPSS 26.Results: 319 patients were investigated, 49.8% male and 50.2% female. The most common underlying diseasesare high blood pressure, diabetes type 2, and ischemic heart disease. The most common trauma cause wasfalling from the same level (48.9%), followed by a fall from a height (16.6%), accidents with cars (16%), andmotorcycles (9.1%). The most common injury was extremities trauma (71.5%) following head trauma (13.2%)and chest trauma (6%). The severity of injury in extremities was higher in women, and chest trauma was moresevere in men.Conclusion: The fall and subsequent car accident had the highest frequency as a cause of trauma in elderlypatients admitted to our academic trauma center. Hypertension and diabetes have also been the most commonunderlying diseases. Head and neck injuries are life-threatening and critical in a larger number of patients thanother injuries, and protecting them can be effective in reducing mortality and serious injuries in elderly traumapatients.
Elham Pishbin; Maryam Ziyaei; elnaz vafadar moradi; Mohsen Foroughipour; Rahim Javadzadeh; Mahdi Foroughian
Volume 12, Issue 1 , January 2024, , Pages 8-14
Abstract
Objective: Cerebral Venous Sinus Thrombosis (CVST), a complex and infrequent cerebrovascular disordercharacterized by the formation of clots within the cerebral venous sinuses, occurs as a result of multiple riskfactors and casualties, and its epidemiological picture should be investigated.Methods: This ...
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Objective: Cerebral Venous Sinus Thrombosis (CVST), a complex and infrequent cerebrovascular disordercharacterized by the formation of clots within the cerebral venous sinuses, occurs as a result of multiple riskfactors and casualties, and its epidemiological picture should be investigated.Methods: This descriptive study was conducted retrospectively on patients with a final diagnosis of cerebralvein thrombosis, who were referred to the emergency room of Ghaem Hospital (Mashhad, Iran) between 2009and 2019. The study included all patients with cerebral vein thrombosis who were older than 18 years. Clinicalsymptoms and causes were documented and contrasted according to demographics.Results: During the 10 years of this study, 749 cases of cerebral vein thrombosis were observed, with womenaccounting for the majority (72.8%). The most prevalent symptom was headache (554 cases; 74.0%), followedby seizures (23.1%), blurred vision (16.0%), nausea (7.5%), vomiting (6.9%), double nose (4.9%), and dizziness(3.3%). There was no significant difference in the frequency of symptoms between the two genders (p<0.05). Themost commonly identified risk factors were OCP (110 cases; 14.7%), followed by infection (103 cases; 13.8%),malignancies (78 cases; 10.4%), and fasting (15 cases; 2.0%). There was no significant difference in risk factorsbetween the two genders, with the exception that all cases of fasting were in women, and the differences weresignificant (p=0.015). The most common site of involvement according to Magnetic Resonance Venography(MRV) was the upper sagittal sinus (427 cases; 57.0%). There was no significant difference in terms of the siteof the conflict between the two genders (p<0.05).Conclusion: The findings of the present study showed that deep vein thrombosis occurred mainly in womenand manifested itself mostly as a headache. Moreover, the upper sagittal sinus was the most common site ofinvolvement.
Sayed Reza Ahmadi; Maliheh Ziaee; Humain Baharvahdat; Zahra Ahmadi; Morteza Talebi delouee; Behrange Rezvani Kakhki; Mohammad Salehi kareshk; Elnaz Vafadar Moradi
Volume 12, Issue 1 , January 2024, , Pages 35-41
Abstract
Objective: Subarachnoid hemorrhage (SAH) is still considered a life-threatening medical condition witha high mortality rate, particularly in developing countries. Thus, the present study aimed to investigate theangiographic findings of non-traumatic or spontaneous SAH.Methods: This retrospective cohort ...
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Objective: Subarachnoid hemorrhage (SAH) is still considered a life-threatening medical condition witha high mortality rate, particularly in developing countries. Thus, the present study aimed to investigate theangiographic findings of non-traumatic or spontaneous SAH.Methods: This retrospective cohort study included 642 health records of patients with non-traumatic SAH overa 10-year period, from 2010 to 2020. The required data, including demographic information, aneurysm type,size, location, disease severity classification, and secondary complications, were extracted.Results: The study included 642 patients, with 262 (40.8%) being male. The mean age of the participants was54.72±13.51 years. The most prevalent type of aneurysm was saccular (89.1%), while serpentine (0.2%) anddissecting saccular (0.2%) aneurysms had the least prevalence. The most frequently involved arteries were theanterior communicating artery (ACoA; 38%), internal carotid artery (ICA; 27.6%), and middle cerebral artery(MCA; 13.4%). There was a significant correlation between sex and aneurysms occurring at ACoA and ICA(p< 0.0001), and ACoA – A1 (p=0.02). Patient age and sex were also significantly correlated with one another(p<0.0001). There was no statistically significant correlation between sex, aneurysm size, Glasgow coma scale(GCS), and modified Rankin scale (MRS).Conclusion: Based on our findings, the presence of aneurysms at ACoA, ACoA – A1, and ICA should bethoroughly ruled out in patients with severe headaches of sudden onset, particularly male patients of youngerages.
Behrang Rezvani Kakhki; Melika Fugerdi; Zahra Abbasi; Hamideh Feiz Dysfani; elnaz vafadar moradi
Volume 11, Issue 1 , January 2023, , Pages 13-18
Abstract
Objective: To design and conduct the effectiveness of Ketamine vs Dexmedetomidine in children’s sedation atemergency department (ED).Methods: This randomized clinical trial study was carried out at the two trauma centers in Mashhad, Iran. Thepatients were divided into two groups by means of a random ...
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Objective: To design and conduct the effectiveness of Ketamine vs Dexmedetomidine in children’s sedation atemergency department (ED).Methods: This randomized clinical trial study was carried out at the two trauma centers in Mashhad, Iran. Thepatients were divided into two groups by means of a random numbers table to be treated with Ketamine (N=20)or Dexmedetomidine (N=20). Their demographic information and sedation times of drugs were collected andanalyzed.Results: In general, sedation time was significantly higher in the ketamine group, 14.35 minutes (IQR:9.82-19) than in the dexmedetomidine group, 9.7 minutes (8.35-14.23) (p=0.023). Time of injection to completeanesthesia was 45.25 (IQR:30-58) and 72 (IQR:60.25-82) minutes in ketamine and dexmedetomidine groups,respectively (p<0.01). In the case of recovery, grade 4 of the Ramsey scale was statistically more prevalent indexmedetomidine (45%) than in the ketamine group (p=0.0001).Conclusion: This study demonstrated that dexmedetomidine could be used in cases where a shorter sedationtime is vital. Ketamine could be a better choice where full recovery time (from injection) matters most.
