Infectious disease
Abbas Edalatkhah; Fateme Samadi Khorshidi; Hamidreza Mohammadi; Razieh Hassannejad; Faezeh Jafari; Mohammad Lame; Amirhossein Zarepur; Ehsan Zarepur
Volume 8, Issue 2 , July 2022, , Pages 115-121
Abstract
Objective: An outbreak of coronavirus disease 2019 (COVID-19) occurred in late 2019. A better understanding of this disease will help us in preventing and managing it. This study evaluated the risk factors and clinical and laboratory characteristics of patients admitted to Shahid Sadoughi hospital in ...
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Objective: An outbreak of coronavirus disease 2019 (COVID-19) occurred in late 2019. A better understanding of this disease will help us in preventing and managing it. This study evaluated the risk factors and clinical and laboratory characteristics of patients admitted to Shahid Sadoughi hospital in Yazd with a diagnosis of COVID-19.Methods: This cross-sectional study was conducted on patients with the diagnosis of COVID-19 admitted to Shahid Sadoughi hospital in Yazd in May 2020, Iran. Patients’ clinical information, including their symptoms at admission, history of smoking or drug/ alcohol abuse, history of Td (tetanus, diphtheria) vaccine, radiographic/computed tomography (CT) scan findings, and blood oxygen saturation, was recorded. The patients were also asked about their previous history of diabetes, hypertension, autoimmune disorder, and cancer or history of diseases in heart, lung, liver, and thyroid. Laboratory findings, height, weight and body mass index of the patients were also recorded. Statistical analyses were performed using SPSS 21.Results: The mean age of 86 patients enrolled in the study was 61.40±17.37 years, of which 56 (65.11%) had mild pulmonary involvement and 30 (34.89%) had severe pulmonary involvement, according to CT scan results. Also, 26 (30.2%) of all patients had diabetes and about 30 (36%) had high blood pressure, but current smokers (6%) were rare. In patients with severe pulmonary involvement, the level of neutrophil, creatinine, and lactate dehydrogenase (LDH) was higher than patients with mild pulmonary involvement. Out of 56 patients with mild pulmonary involvement, 47 patients had a history of Td vaccination in the last 5 years. Only one patient in the severe group had a history of Td vaccination.Conclusion: A lower percentage of blood lymphocytes as well as higher levels of neutrophils, creatinine, and LDH were observed in patients with severe pulmonary involvement. Numerous factors, especially more prominent laboratory abnormalities, determine the severity of the disease, and a better understanding of these factors can help physicians know the severity of the disease and its prognosis. These findings help us to further clarify the characteristics of COVID-19. Also, the effect of Td vaccine should be investigated in future studies.
Emergency medicine
Ali Arhami Dolatabadi; Parvin Kashani; Hamidreza Hatamabadi; Hamid Kariman; Alireza Baratloo
Volume 1, Issue 1 , January 2015, , Pages 3-6
Abstract
Objective: This study aimed to determine the association of cardiac risk factors and the risk of Acute Myocardial Infarction (AMI) in Emergency Department (ED) patients with non-diagnostic ECG changes.
Methods: This cross-sectional study was conducted in the ED of Imam Hossein Hospital during a period ...
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Objective: This study aimed to determine the association of cardiac risk factors and the risk of Acute Myocardial Infarction (AMI) in Emergency Department (ED) patients with non-diagnostic ECG changes.
Methods: This cross-sectional study was conducted in the ED of Imam Hossein Hospital during a period of one year. In this study, patients with symptoms suggestive of AMI including chest pain, dyspnea, palpitation, syncope, cerebrovascular incidents, nausea, vomitting, dizziness and loss of consciousness were included. The demographic data and risk factors, such as age, gender, history of diabetes, Hypertension (HTN), Hyperlipidemia (HLP), renal failure, positive family history of Coronary Artery Disease (CAD), smoking, substance abuse, alcohol consumption within the past 24 hours and cocaine use within the past 48 hours were recorded. Non-diagnostic ECG included: normal, non-specific, abnormal without ischemic symptoms such as old bundle branch block, Left Ventricular Hypertrophy (LVH), etc. The final diagnosis of AMI was determined by Creatine Phosphokinase-MB (CPK-MB) serum markers and Troponin I. The data were analyzed by using SPSS V. 20 and the level of statistical significance was considered to be P< 0.05.
Results: HTN, HLP, family history of heart disease were significantly higher in those who had non-diagnostic ECG (P< 0.05). However, the ischemic heart diseases were significantly lower in those with non-diagnostic ECG. History of diabetes, stroke, renal failure, alcohol or opium and menopause showed no significant association with non-diagnostic or diagnostic ECG.
Conclusion: Overall, the risk factors are limitedly associated with the occurrence of Myocardial Infarction (MI) in cases where ECG is not diagnostic and it is better to use other criteria to diagnose AMI.
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.