Acta medica Iranica
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Acta medica Iranica · Jan 2014
Evaluation of emergency medicine residents competencies in electrocardiogram interpretation.
An electrocardiogram (ECG) leads physicians to diagnose many potentially life-threatening cardiac, metabolic, electrolyte, and toxicological conditions. This study was designed to evaluate the competency of emergency medicine residents (EMRs) in comparison with cardiologists in the interpretation of ECG when an interpretation checklist is used. This clinical trial was done in the emergency wards of the first grand general hospital of Iran. ⋯ In second-year EMRs, both ECG interpretation and ECG diagnosis scores improved significantly (P<0.05 and P<0.01, respectively). In third year EMRs, ECG interpretation was not improved but ECG diagnosis based on two methods improved significantly (P<0.05). The significant increase in accuracy of ECG interpretation and final diagnosis can be attributed to the utilization of a checklist by EMRs especially in the first year and second residents.
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Acta medica Iranica · Jan 2014
Investigating the effect of clinical governess approach on patients' length of stay in emergency department: an action research study.
Over the past decade, clinical governance approach with aims to improve the quality of health services has been proposed in Iran. Considering the obvious problems especially patients' length of stay (LOS) in the emergency departments (EDs); the present study has been carried out with the purpose of Investigating the effect of clinical governess approach on patients' LOS in the one of the largest medical centers in the country. After the problem was specified by the 17 interviews with employees and managers of the ED; the emergency clinical governance committee was formed by two academic researchers and seven ED staff (key participants) that had the most involvement with the subject of study. ⋯ Make regular patients visits by medical groups especially orthopedists and neurologists; Decision making about patients situation by emergency physicians and transferring patients to the relevant units by bed managers; Refusing to admit elective patients during overcrowding times; to regulate the list of patients requiring ICU by anesthesiologists. Prolonged LOS can be due to various causes and a team approach, which is one of the requirements of clinical governance approach, is needed to manage it. The results showed that the multidisciplinary team could make positive changes and reduce LOS in emergency setting.
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Antibiotic resistance to microorganisms is one of the major problems faced in the field of wound care in burns patients. Silver nanoparticles have come up as potent antimicrobial agent and are being evaluated in diverse medical applications ranging from silver based dressings to silver coated medical devices. We aimed in present study to test the release of nanosilver from nanosilver wound dressing and compare the dermal and systemic toxicity of nanosilver dressings in a repeated dose (21 days) model. ⋯ In toxicity assessment, this dressing didn't cause any hematological and histopathological abnormalities in treatment group but biochemical studies showed significant rise of plasma transaminase (ALT) at the endpoint (21 days) of the study (P=0.027). Portal mononuclear lymphoid and polymorphonuclear leukocyte infiltrations in three to four adjacent foci were recognized around the central hepatic vein in treatment group. Mild hepatotoxic effects of nanosilver wound dressing in wistar rat emphasize the necessity of more studies on toxicity potentials of low dose nanosilver by dermal applications.
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Acta medica Iranica · Mar 2013
Case ReportsSpontaneous transanal protrusion of ventriculoperitoneal catheter: a case report.
Ventriculoperitoneal (VP) shunt placement that diverts the cerebrospinal fluid (CSF) into the peritoneal cavity is the most common method of treatment of hydrocephalus. This shunt has a high incidence of malfunction mainly due to catheter obstruction or infection. ⋯ The patient was treated successfully after extrusion of the shunt through the anus, receiving antibiotics and being carefully observed. He was discharged from the hospital after one week.
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Acta medica Iranica · Jan 2013
Randomized Controlled TrialThe effect of acupressure on nausea and vomiting after cesarean section under spinal anesthesia.
Postoperative nausea and vomiting (PONV) is one of the most common postoperative complications. Aside from pharmacological interventions, other complementary healing modalities have been introduced to assist patients in decreasing PONV and improving postoperative outcomes. This study examined acupressure as a safe complement to the more traditional approach of using drugs to prevent and/or relieve nausea and vomiting in the Cesarean section (C/S) under spinal anesthesia. ⋯ The amount of vomitus and the degree of discomfort were, respectively, less and lower in the study group. In view of the total absence of side-effects in acupressure, its application is worthy. Our study confirmed the effectiveness of acupressure in preventing post-operative nausea and vomiting, when applied 30 minutes prior to surgery.