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.
Sayyed Majid Sadrzadeh; Bahram Shahri; Mostafa Kamandi; Maryam Adimolmasali; Behrang Rezvani Kakhki; Hamideh Feiz Disfani
Volume 12, Issue 3 , July 2024, , Pages 130-135
Abstract
Introduction: Recently, various serum markers have been used for the diagnosis and prognosis of acute heart diseases in emergency departments. Thus, the present study was designed and conducted to determine such a role.Methods: This is an Analytical Cross-Sectional study conducted on the patients with ...
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Introduction: Recently, various serum markers have been used for the diagnosis and prognosis of acute heart diseases in emergency departments. Thus, the present study was designed and conducted to determine such a role.Methods: This is an Analytical Cross-Sectional study conducted on the patients with syncope complaints. The patients were entered the study based on the inclusion and exclusion criteria and were subjected to initial evaluations including history, physical examination, ECG, blood sugar measurement, and, if necessary, brain CT scan, Doppler echocardiography, and CTA.Results: A hundred people complaining of syncope were included in this study. The results showed that 19% and 81% of the subjects were suffering from cardiac and non-cardiac syncope, respectively. The average Pro BNP of the studied individuals was 196.06 ± 128.45 pg/ml. according to the results, age and length of hospitalization had a positive and significant relationship with the average Pro BNP (P value<0.01). Furthermore, the average Pro BNP was significantly higher in the people with positive TPI, cardiac syncope, and abnormalities in ECG and Doppler findings (P value<0.01). The results of the diagnostic value of Pro BNP in identifying cardiac syncope also showed that its sensitivity and specificity were 94.73% and 56.79%, respectively.Conclusion: The results of this study showed that the increase in the Pro BNP values was associated with age, increased length of hospitalization, and ECG abnormalities. In addition, as an independent marker, Pro BNP had good acceptability in identifying cardiac syncope cases.
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.
Mohsen Ebrahimi; Behrang Rezvani Kakhki; Baharak Davoudpour; Zahra Abbasi Shaye; Hossein Zakeri; Seyed Mohammad Mousavi; Sayyed Majid Sadrzadeh; Seyed Aliakbar Shamsian; Azadeh Mahmoudi Gharaee
Volume 10, Issue 2 , April 2022, , Pages 59-64
Abstract
Objective: To investigate the relationship between salivary amylase level and computed tomoraphy (CT scan) findings in patients with isolated mild traumatic Brain Injury (mTBI) referred to the emergency department of Shahid Hasheminejad Hospital. Methods: Patients with isolated mTBI and indication ...
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Objective: To investigate the relationship between salivary amylase level and computed tomoraphy (CT scan) findings in patients with isolated mild traumatic Brain Injury (mTBI) referred to the emergency department of Shahid Hasheminejad Hospital. Methods: Patients with isolated mTBI and indication for brain CT scan who referred to the trauma center of Shahid Hasheminejad Hospital, Mashhad, Iran in 2019 were included in a cross-sectional study. In the initial examination, the patient’s level of consciousness was measured using the Glasgow Coma Scale (GCS), and saliva samples were taken at the emergency department to determine the level of salivary amylase. A brain CT scan was performed for all patients. Age, gender, cause of trauma, the trauma severity and CT scan results were recorded. Statistical analysis was performed on the data. Results: One-hundred fifty patients were enrolled in this study (men=101, women=49). The trauma causes were included accidents (n=88; 58%), falls (n=37; 25%) and miscellaneous factors (e.g., quarrels; n=25; 17%). GCS was 15 in 142 patients and 14 in the rest. In all patients, the trauma severity was mild to high risk (Minor). CT scan results unfolded pathology in 10 cases (7%), while the residues (93%) had normal CT scans with no pathological evidence. Salivary amylase level in the patients’ saliva samples was between 137 to 8000 units per liter. Using the t-test to evaluate the relationship between salivary amylase levels and CT scan results uncovered a significant relationship. Spearman correlation revealed no significant relationship between the amylase and GCS levels. Conclusion: Data statistical analysis from 150 patients with isolated head trauma manifested that salivary amylase levels were significantly higher in the patients with pathological findings on CT scans. However, no significant relationship was found between salivary amylase level and age, gender, cause of trauma, and level of consciousness.