Search

Difficult endotracheal intubation has been associated with a number of anatomic factors. According to our experience, the range of movement of thyroid cartilage can be used as a useful test to determine the difficulty in endotracheal intubation. The aim of this study was to evaluate the association between the range of movement of thyroid cartilage and difficulty in intubation.Cross-sectional study.This study was carried out on 400 patients at (Shohada Ashayer Hospital, Khorramabad). After obtaining consent letters from the patients who were between 18 and 60 years of age, the patients underwent general anesthesia. The participants were evaluated by Mallampati and other evaluating tests. The range of movement of thyroid cartilage from the midline was measured and recorded.There were significant correlation between the range of movement of thyroid cartilage and thyromental distance. In addition, in patients with Cormack-Lehane class 1, the mean range of movement of thyroid cartilage was significantly more than the patients with Cormack-Lehane class 3 and 4.The outcomes of our study indicate that the range of movement of thyroid cartilage can be used for predication of difficult intubation. However, further randomized trials should be conducted in this regard.

Pre-hospital emergency care is a critical part of the health care system. Helicopter emergency medical service (HEMS) is a novel part of the medical services of the health care delivery system. The goal of these medical services is to provide appropriate treatments at the right place and time. The pre-hospital emergency is the first line of providing emergency care to patients and injured. To reduce the death and disability of patients, the optimal performance of various pre-hospital emergency branches, such as HEMS, is needed. Thereby, it is essential to pay attention to the importance of hospital wards and patient transfer. However, the HEMS can impose a high cost on the health care system. Due to a lack of evidence, in this study, we will investigate the reasons and consequences of transferring patients by HEMS in Shahid Beheshti Hospital in Qom.This study is a cross-sectional descriptive study. In this study, sampling was done by the census, and all patients were transferred by air ambulance during the year 1400 (March 2021 to 2022) using the emergency department of Qom province, and the study of patient health records was performed.A significant percentage of patients (46.8%) were discharged from the emergency department in the first 6 hours. Most of the patients (79%) did not need surgery. 41.1% of the patients were traumatic patients with no pathological findings in their imaging.Many cases did not necessarily need HEMS to transfer. It is recommended to choose the candidates more carefully for air ambulance transfer to reduce unnecessary costs.

Predicting the outcome of trauma helps clinician to prioritize patients and provide timely and effective treatment. Several scoring systems are implemented to predict prognosis and mortality among these patients. Our study aims to use four scoring systems to predict mortality among multiple trauma patients.In retrospective descriptive study, the data was collected from records of (XXX) of multiple trauma patients referred to the hospital from June 2019-January 2020. The patients were scored using four scoring systems: MGAP (mechanism, Glasgow coma scale, age, and arterial pressure), GAP (Glasgow coma scale, age, and arterial pressure), ISS (injury severity score) and RTS (revised trauma score).The mean age of the patients was 37.4 ± 4.2 years and of 112 patients, 92 patients (82.1%) were males. Sensitivity of GAP, RTS and ISS was 100% in predicting mortality where MGAP had highest specificity, 97.2%. All four scoring systems significantly predicted mortality, p 0.001, respectively and the highest area under the curve was for RTS criteria, 0.969.MGAP, GAP, RTS and ISS were all effective in predicting mortality among multiple trauma patients whereas MGAP had both, highest sensitivity and specificity. Scoring trauma for mortality can be achieved by using any of the systems, provided the information required for score can be obtained.

Background Coronavirus disease 2019 (COVID-19) is associated acute respiratory distress syndrome that leads to intensive care unit admission and subsequent need of invasive ventilation. The aim of this study is to evaluate mortality rate and associated parameters among COVID 19 patients under invasive ventilation. Methods In this retrospective studies, COVID 19 patients referred to our center we evaluated. The data regarding demographic characteristics, comorbidities, biochemical and radiographic findings, need of invasive ventilation and mortality were collected and recorded for all the patients. Statistical analysis was performed to evaluate the risk of mortality in invasive ventilation patients relative to each risk factor or paraclinical or clinical feature. Results Among patients included in the study, 63 patients underwent invasive ventilation where 53 (84%) of these died. The mortality rate among invasive ventilation was significantly associated with advanced age, p = 0.006 whereas it was not significantly associated with smoking, gender, c-reactive protein, platelet count, hypertension, lymphopenia, leukopenia, creatinine kinase, addiction, blood urea nitrogen to creatinine ratio, malignancy, cough, fever, nausea, chronic obstructive pulmonary disease and erythrocyte sedimentation rate. Conclusions The findings of our study indicate that advanced age can increase the risk of mortality in COVID 19 patients under invasive ventilation whereas, mortality among invasive ventilation patients is high, irrespective of their characteristic. Guidelines are therefore, required regarding the use of invasive ventilation among these patients., Highlights • COVID-19 is acute respiratory distress syndrome that leads to intensive care unit admission. • The findings of our study indicate that advanced age can increase the risk of mortality in COVID 19. • Patients under invasive ventilation, mortality among invasive ventilation patients. • Guidelines are required regarding the use of invasive ventilation among these patients.

Introduction: The use of computer-assisted diagnostic tools has increased dramatically in various fields of medicine, especially cancer. It is essential and inevitable to use these tools, especially when there is a need to process large volumes of data, but new diagnostic methods was based on the use of Nano-sensors that have many advantages and they can be used to diagnose breast cancer, one of the most common neoplastic malignancies in the world. The study aims to investigate the relationship between new diagnostic methods and information technology in cancer diagnosis by categorizing research topics and important known aspects of cancer related illness from 1984 to 2017. Methods: The evaluation conducted in March 2018 and used to access the articles on diagnostic and therapeutic methods from the PubMed, Medline, and Cochran library, WHO, Iranmedex and PsycINFO databases. Results: The findings of this study in two sections of cancer and biological sensors show that biomarkers detect disease, and health information technology is expanding and innovating new methods. This can play an important role in managing chronic diseases such as cancer. Conclusion: Primal diagnosis, reducing the time to diagnose and improving the quality of care during treatment, is one of the health’s information technology (IT) benefits of diagnosing cancer. In general, the results this study indicate that the use of information technology to increase the speed of effective therapeutic stages. Resulting in general health, as well as the relationship of information technology with diagnostic and therapeutic methods in our country can greatly increase the level of health and well-being and development, and create a new way of linking information technology and new diagnostic methods to cancer.

Introduction: The aim of this study was to improve accurate diagnosis and higher quality of treatment in patients with acute abdominal pain. Methods: 350 patients with acute abdominal pain (AP) referred to emergency department (ED) of Baqiyatallah Hospital were studied during the last three months of 2016. For each patient, the form of hospitalization was completed and symptoms, location of pain, pain intensity, gender and age were recorded. Results: Of the 350 patients, 168 cases (48%) were male and 182 (52%) were female. In addition, 84 cases (24%) were ultimately diagnosed with acute surgical pain and required action was taken. The most common cause of surgical acute paint was obtained appendicitis with 29 cases (34.53%) and the least cases were pancreatitis. Authors showed that AP was diagnosed in 266 (76%) patients as an internal source, most cases referred to ED with pain in right lower quadrant (RLQ) 134 cases (10.5%) and the least cases with diffuse pain (7 cases) (2%). The most frequent causes of AP in patients was kidney stone disease 27 cases (10.5%), and the lowest cause was herpes zoster with one case (0.38%), hypothyroidism and etc. Conclusion: The frequency of the causes of surgery acute AP was similar to reviewed studies.

Objective The detection of pulmonary embolism in emergency department requires an urgent therapeutic and diagnostic attention. This study was performed to determine the accuracy and efficacy of ultrasound in the diagnosis of pulmonary embolism. Methods In this study, 110 patients who referred to the emergency department with traumatic embolism symptoms were enrolled. All the patients underwent computed tomography (CT) angiography. Patients were divided into positive and negative outcomes according to the results of transthoracic ultrasonography and CT angiography. Results In this study, 110 patients were enrolled, of whom 52 (47.3%) were male and 58 (52.7%) were female. Among the patients, 100 (90.9%) patients presented with dyspnea, whereas the frequency of pleural pain was 27% (24.5%). Sensitivity, specificity, positive predictive value, and negative predictive value for ultrasound were 45.67%, 77.41%, 88.09%, and 35.29%, respectively. The positive outcomes from CT scan were significantly associated with gender, p = 0.005. The gender and transthoracic ultrasonography outcomes were also significantly correlated, p = 0.019, and the outcomes of ultrasound were significantly different from those of CT scan, p = 0.008. Conclusion Transthoracic ultrasonography may be used to diagnose pulmonary embolism as a technique in the emergency department, especially in patients who are unable to move due to the severity of the disease. However, further comparative studies are required in this aspect.

Background Severity of corona virus disease 2019 (COVID19) is presented with respiratory distress and requires mechanical ventilation. Advanced age is one of the significant risk factors of the worst prognosis and mortality in this disease. The aim of this study is to investigate the clinical parameter among COVID19 patients under mechanical ventilation in regard to the age groups. Method In this retrospective study, COVID19 patients under invasive mechanical ventilation at Shahid Beheshti Hospital in Qom were included. The patients were divided in two age groups, those aged ≥50 years and 0.05, respectively. Conclusions The findings of the study indicated that prognosis of COVID19 patients under invasive mechanical ventilation in terms of changes in clinical parameters might not be associated with the age.

Background Coronavirus 2019 (COVID 19) has been reported as a pandemic by the world health organization. Increasing number of cases and associated mortality have demanded the need for clinical studies and researches. Objective The aim of this study is to evaluate intubation prognosis of the COVID 19 patients referred to Shahid Beheshti hospital in Qom city. Method COVID 19 patients referred to (XXX)were included in this study. Clinical sign and symptoms were recorded for each patient in a questionnaire. The diagnosis was made using real time polymerase chain reaction and chest CT scans. Lab findings from renal and liver function tests, blood count, c-reactive protein and electrolytes were also recorded. Shortness of breath was measured using oxygen saturation levels in these patients. The data was recorded in the electronic form and was analyzed using SPSS v21. Result Of 317 patients included in this study, the average age of COVID 19 patients were 59.71 ± 16.46 years. The need of ventilation among the patients older than 50 years was significantly higher than younger patients, p = 0.013. Smoking status, gender and drug addiction was not associated with the need of invasive mechanical ventilation, p = 0.73, p = 0.44 and p = 0.76. Patients need invasive mechanical ventilation compared to those receiving non-invasive ventilation were significantly older, p = 0.001. Conclusion The need of mechanical ventilation is significantly greater in advanced age COVID-19 patients., Highlights • COVID 19 has been reported as a pandemic by the world health organization. • Increasing number of cases and associated mortality have demanded the need for clinical studies. • The need of mechanical ventilation is significantly greater in advanced age COVID-19 patients.

The severity of COVID-19 has been to be associated with comorbidities. It is defined as the presentation of severe respiratory dysfunction or failure, leading to the need for ventilation and mortality. The aim of this study is the evaluate the factors predicting the rate of invasive ventilation among these patients. This retrospective study involved 317 COVID-19 patients referred to (XXX) Hospital in Qom, Iran. The following data were obtained for all the patients: demographic parameters, comorbidities, need for mechanical ventilation, signs and symptoms and lab findings. The results from the demographic data of the study indicated that the need for mechanical ventilation is significantly associated with advanced age, p = 0.001. Additionally, hypertension, leukopenia and blood urea nitrogen to creatinine ratio p = 0.008. p = 0.042 and p 0.001, respectively, are significantly associated with an increased need for mechanical ventilation. Malignancy, diabetes, asthma, chronic obstructive pulmonary disease, headache, fever, platelet count, prothrombin time, c-reactive protein, erythrocyte sedimentation rate and creatinine phosphatase were not significantly different in the two groups, p 0.05. Prediction of the extent of severity among COVID-19 patients using clinical parameters and comorbidities prepare medical practitioners and health care centres to take immediate measurements and reduce the burden of the scarcity of health supplies and care.