Acta medica Iranica
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Acta medica Iranica · Jan 2013
Effect of door-to-antibiotic time on mortality of patients with sepsis in emergency department: a prospective cohort study.
Sepsis constitutes an important cause of hospital admission with a high mortality rate. Appropriate antibiotic therapy is the cornerstone of therapy in patients with sepsis. Although numerous studies have recommended early antibiotic initiation in severe sepsis or septic shock stages of sepsis syndrome, its role in treatment of patients with sepsis who have not entered these stages remains to be investigated. ⋯ The mean door-to-antibiotic time for our patients was 104.4 minutes. Antibiotic administration time and mortality in patients with APACHE scores of 21 or higher (P=0.05) were significantly related; whereas such a relationship was not observed for patients with APACHE scores of 11- 20 (P=0.46). We observed early antibiotic initiation for patients in sepsis phase with higher severity scores was associated with significant improvement in survival rate.
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Acta medica Iranica · Jan 2012
Randomized Controlled Trial Comparative StudyComparison of effects of ephedrine, lidocaine and ketamine with placebo on injection pain, hypotension and bradycardia due to propofol injection: a randomized placebo controlled clinical trial.
Propofol is a widely used anesthetic drug because of its minor complication and also its fast effect. One of most popular complication in using this drug is pain during injection that is more sever in new generation of its components (lipid-free microemulsion). Other complications of propofol are bradycardia and hypotension. ⋯ Our data shows that in pain management all tested drugs can decrease pain significantly comparing with placebo (P=0.017). In control of hemodynamic parameters ephedrine could efficiently control SBP, DBP, MAP at the time 1 min after intubation. Based on our study ephedrine can be an appropriate suggestion for control of both pain and hemodynamic changes induced by propofol, although because of inconsistent result in other studies it is recommended to design a systematic review to draw a broader view on this issue.
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Acta medica Iranica · Jan 2012
Randomized Controlled Trial Comparative StudyThe effect of ondansetron and meperedin on preventing shivering after off-pump coronary artery bypass graft.
One of the most common complications of operation and anesthesia is shivering. The purpose of this study was to compare the effectiveness of Ondanseton and Meperedine in preventing shivering after off-pump coronary artery bypass graft (OPCAB). In this double-blind randomized clinical trial, the sample consisted of 90 patients, who were candidates of CABG under general anesthesia. ⋯ Bradycardia was 3.3% in group (A) and 0.0 % in group (B). Other variables (myoclonus, seizure and rash) showed no statistically significant difference (P=0.353). According to the findings, it was demonstrated that ondansetron is more effective in preventing shivering after Off-pump CABG than meperedine.
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Acta medica Iranica · Jan 2012
Designing a model for trauma system management using public health approach: the case of Iran.
Trauma is a leading cause of death and disability around the world. Injuries are responsible for about six million deaths annually, of which ninety percent occur in developing countries. In Iran, injuries are the most common cause of death among age groups below fifty. ⋯ This model may be implemented in two phases: the exclusive phase, focusing on resource integration and the inclusive phase, which concentrates on system development. The model could facilitate the development of trauma system in Iran through pilot studies as the assurance phase of public health approach. Furthermore, the model can provide a practical framework for trauma system management at the international level.
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The aim of this study was investigating the characteristic and outcome of self-immolation cases admitted to the Burn Centre of Birjand, Iran over an eight year period. This study is a retrospective review of case notes for patients with self-Immolation and admitted to our referral burn centre in the last 8 years (January 2003-January 2011). A performa was designed to collect the data such as: demographic information, length of hospital stay, extent of the burn injuries as %TBSA (Total Body Surface Area) and final outcome. ⋯ The mean and median survival times were 6 days (CI 95%: 4.8-7.2) and 17.5 days (CI 95%: 13.3-21.6), respectively. Our study has shown a lower incidence of self-immolation (5.3%) in the South Khorasan region, when compared with other parts of Iran, as well as a relatively low mortality rate. We have also reported self-immolation in pregnant women which has rarely been reported in medical literature.