Clinical Toxicology
Rouhullah Dehghani; Kobra Taji; Amrollah Mahmoudi; Masoomeh Varzandeh
Volume 8, Issue 1 , January 2022, , Pages 83-85
Abstract
Objective: A Scorpion sting is one of the most important health and medical problems in most parts of Iran.Case Presentation: This case report occurred in Chaharmahal Bakhtiari province of Bazoft city. The injured person was a 48-year-old woman, weighing about 69 kg. Two documentary filmmakers were on ...
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Objective: A Scorpion sting is one of the most important health and medical problems in most parts of Iran.Case Presentation: This case report occurred in Chaharmahal Bakhtiari province of Bazoft city. The injured person was a 48-year-old woman, weighing about 69 kg. Two documentary filmmakers were on their way to work and suddenly one of them felt pain caused by a sting in the thigh area of her lower limb. The patient was referred to the medical center with the ‘scorpion’ sample, where she was examined by a doctor. The doctor prescribed some medicine for the patient. The pain from the sting lasted for about three hours. The patient recovered after taking the medication and received counseling three days after the sting. A photo of the dorsal and ventral surface of the scorpion specimen was sent to the animal identification specialist along with the size and color record. Scorpion specimen with a size of 4 cm was identified as Compsobuthus matthiesseni.Conclusion: According to the findings of this report, the clinical signs of C. matthiesseni sting are mild in the injured person and comparable to the stings of yellow bees Vespa germania. There is local pain two to three hours after the sting. Other systemic clinical manifestations can improve after a maximum of 2 to 3 days.
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
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.
Clinical Toxicology
Mehran Shahi; Seyed Hamid Moosavy; Hossein Sanaei-Zadeh
Volume 6, Issue 2 , July 2020, , Pages 121-125
Abstract
Objective: Scorpion stings are common in tropical regions of Iran. Hemiscorpius enischnochela are distributed in southern part of Iran. The venom of this scorpion causes severe hemolysis, hemoglobinuria, and occasionally death.Case Presentation: This report describes the clinical manifestations of envenomation ...
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Objective: Scorpion stings are common in tropical regions of Iran. Hemiscorpius enischnochela are distributed in southern part of Iran. The venom of this scorpion causes severe hemolysis, hemoglobinuria, and occasionally death.Case Presentation: This report describes the clinical manifestations of envenomation by H. enischnochela in a 3-year-old boy from Ruydar city in south of Iran.Conclusion: Special attention should be paid to the painless stings of yellow scorpions and more studies are needed to set out a protocol for the management of these cases in areas with this envenomation to be a common one.
Emergency Medical Services
Sahar Mirbaha; Mohammadmehd Forouzanfar; Amin Saberinia; Amir Salimi; Hamid Kariman; Mozhgan Farmahini Farahani
Volume 6, Issue 1 , January 2020, , Pages 43-46
Abstract
Objective: Each imaging technique has a special application and usage, and should be used in the right situation. Physicians choose the type of imaging technique by considering the type of tissue and the benefits and disadvantages of the imaging method as well as its financial burden on the patient. ...
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Objective: Each imaging technique has a special application and usage, and should be used in the right situation. Physicians choose the type of imaging technique by considering the type of tissue and the benefits and disadvantages of the imaging method as well as its financial burden on the patient. The aim of this study was to estimate the cost of imaging tests performed in the emergency department (ED) of an educational hospital and determine their financial burden on both the patients and the healthcare system of the country. Methods: This retrospective descriptive cross-sectional single-center study was conducted in Shohadaye Tajrish, an educational hospital, during one year. The study population consisted of all patients who had undergone some type of imaging (CT scan, ultrasound, radiography, magnetic resonance imaging [MRI]) in the ED. The information was collected using a predesigned checklist. The costs of a variety of imaging methods for patients referred to the ED were calculated using different types of accounting units and PACS system. Results: The number of patients who visited the ED of the studied hospital during a one year period was 63507. The total cost of performing different types of imaging methods in the studied center throughout the one-year target period was 44018695695 Rials (≃$US 423745) (59.27% of which was spent on CT scan, 16.09% on ultrasound, 13.75% on plain radiography and 10.87% on MRI). Conclusion: According to the collected data, the total cost of radiology was 44018695695 Rials. The highest cost was related to CT scan modality, and the lowest belonged to MRI.
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.
Forensic Medicine
Maryam Ameri; Maryam Akhgari; Roya Kordrostami
Volume 5, Issue 2 , July 2019, , Pages 71-74
Abstract
This study aimed at describing demographic information of the deceased resulting from hanging by means of different methods of suicide. In this cross-sectional study, the file of suicide cases referred to the Central Legal Medicine Organization was investigated retrospectively. Of 1681 suicide cases, ...
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This study aimed at describing demographic information of the deceased resulting from hanging by means of different methods of suicide. In this cross-sectional study, the file of suicide cases referred to the Central Legal Medicine Organization was investigated retrospectively. Of 1681 suicide cases, the highest suicide mode was hanging by 993 cases (57.4%) and intoxication by 674 cases (39%). The mean age of hanging was 36.22±15.76 and for other suicide methods it was 32.61±13.70 (P=0.000). Hanging was higher in males. Female victims used other methods like intoxication (P=0.000). The most common seasons for hanging were spring and winter. Toxicological analysis in cases of hanging was positive with opioid alkaloids in 95 cases (9/9%) and methamphetamine in 68 cases (7%). Intoxication with aluminum phosphide was in 35.8% of cases. Most of the cases (68.3%) were self-employed victims. A total of 534 (63%) cases were married. There was a statistically significant difference between hanging and other suicide modes concerning age, gender, occupation, marital status, and drug abuse history (P<0.001). The frequency of hanging was higher in males, marrieds, self-employed, unemployed and drug abusers. Students were victims of intoxication. Self-employed victims, unemployed victims and drug abusers were exposed to successful attempts more than others. Screening plans can be helpful in preventing suicide by prioritizing the people at risk.
Emergency medicine
Ali Arhami Dolatabadi; Elham Memari; Majid Shojaee; Hossein Alimohammadi; Hamid Kariman; Ali Shahrami; Abdelrahman Ibrahim Abushouk3
Volume 3, Issue 1 , January 2017, , Pages 22-25
Abstract
Objective: Cardiopulmonary resuscitation (CPR) has been known in its present form since 1960. Different studies have reported variable outcomes among different countries. Therefore, the purpose of this study was to assess the rate of CPR success and the survival rate in managing cardiac arrest among ...
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Objective: Cardiopulmonary resuscitation (CPR) has been known in its present form since 1960. Different studies have reported variable outcomes among different countries. Therefore, the purpose of this study was to assess the rate of CPR success and the survival rate in managing cardiac arrest among patients in an educational medical center.
Methods: This cross-sectional study was performed at Imam Hosein hospital, Tehran, Iran. All patients, admitted to the emergency department with cardiac arrest between March 2007 and January 2008 were included. We used a formerly designed registration form and hospital documentation to retrieve the data of included patients. The main outcomes were the rate of CPR success and the survival rate of these patients.
Results: Totally 855 patients were included, from which 510 (59.64%) were males. The mean age of included patients was 63 ± 17.6. The CPR process was successful among 364 (42.58%) patients. A total number of 101 (11.82%) patients were discharged from the hospital. Different factors as the cause of cardiac arrest and past medical problems affected the probability of CPR success and the survival of patients with cardiac arrest.
Conclusion: Survival rate at hospital discharge was less than one-third of patients and nearly half of the patients received successful CPR. More intensive care unit (ICU) facilities and educational interventions for the emergency staff and the community can enhance the survival of cardiac arrest patients in our health system.
Disaster
Alireza Baratloo; Marzieh Maleki
Volume 1, Issue 2 , July 2015, , Pages 39-39
Abstract
Today, overcrowding in emergencies has turned out to be one of the biggest problems in health systems around the world. In this case, a short and an accessible solution could not be reached. In fact, several basic reasons play a role in such a problem, and eliminating each of them would require long-term ...
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Today, overcrowding in emergencies has turned out to be one of the biggest problems in health systems around the world. In this case, a short and an accessible solution could not be reached. In fact, several basic reasons play a role in such a problem, and eliminating each of them would require long-term planning. This issue not only has a negative effect on the quality of services presented to the patients, but also produces both psychological and physical effects on the emergency staff such as physicians and nurses. In addition, it also causes increased dissatisfaction among referees as well as imposing excessive exhaustion on medical staff.
Trauma
Davood Soroush; Morteza Talebi Deloei; Hamidreza Reihani; Vida Vakili; Azadeh Mahmoodi Gharaee; Azadeh Tafakori; Reza Farahmand Rad; Elham Pishbin
Volume 1, Issue 2 , July 2015, , Pages 48-51
Abstract
Objective: Road traffic injuries (RTIs) are the second leading causes of death in Iran. One of the most important steps in the prevention of traffic-related trauma and its consequences is gaining insight into the epidemiology of injuries. We conducted this study to describe the characteristics of RTIs ...
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Objective: Road traffic injuries (RTIs) are the second leading causes of death in Iran. One of the most important steps in the prevention of traffic-related trauma and its consequences is gaining insight into the epidemiology of injuries. We conducted this study to describe the characteristics of RTIs and to find strategies for its prevention.
Methods: This was a prospective cross-sectional study on consecutive road traffic trauma patients admitted to the emergency department (ED) of the second largest trauma center in the northeast of Iran, during July to September 2013. Demographic characteristics, type of vehicle, and injured area of the body were documented for each patient.
Results: Of 666 included patients, 562 (84.4%) were male and 104 (15.6%) were female, with a mean age of 28.89 ± 16.62 years. Most of the patients were uneducated. The highest frequency of RTIs was related to motorcyclists with an attributed risk of RTIs for motorcycles at 75.8%. The most common traumatized area was head, face, and lower extremities.
Conclusion: The largest number of traumatized patients was among motorcyclists and uneducated population underscores the importance of public training about motorcycle usage and security and increase social awareness about reasons behind traffic law.
Clinical Toxicology
Samad Shams Vahdati; Narges Moradi; Jamil Hemat Ghadim; Shahrad Tajoddini
Volume 1, Issue 1 , January 2015, , Pages 1-2
Abstract
Deliberate Self-Poisoning (DSP) or drug induced suicide is the most common method of suicide in the developed countries and is associated with significant morbidity and mortality (1-3). Factors associated with DSP include economic and social factors, culture, religion, and health (4-6). Other symptoms ...
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Deliberate Self-Poisoning (DSP) or drug induced suicide is the most common method of suicide in the developed countries and is associated with significant morbidity and mortality (1-3). Factors associated with DSP include economic and social factors, culture, religion, and health (4-6). Other symptoms that may influence suicide encompass demographic information like age, sex, and, ethnicity (6-8)