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Abstract Background and Aim Taxi drivers play a significant role in urban mobility and safety as professional drivers. They typically have poor incomes, long work hours, lack of sleep, and high levels of stress, which increase the risk of physical and mental illnesses. The goal of this study was to explore the relationship between sleep disorders and depression among Tabriz metropolis taxi drivers. Methods Using the street intercept technique, a cross‐sectional study was conducted with the participation of 402 taxi drivers in Tabriz during January and March 2020. Data collection tools included the Pittsburgh Sleep Quality Index (PSQI) and Patient Health Questionnaire as well as demographic information. Twenty taxi stops were used as sampling sites, and the method used was random sampling based on the number of drivers at each stop. Statistical analysis was performed using Stata 13. Results The majority of drivers worked an average of 6 days each week, with a mean tenure of 13.3 years. The sleep quality mean score for drivers was 5 (SD = 2.3). Approximately, 21% of them had sleep disorder (PSQI >6). Moderate depression was recognized in 13% of drivers and moderately severe depression has been found in 5% of them. Drivers were more likely to experience sleep disorders if they had mild (odds ratio [OR] = 3.9), moderate (OR = 16.4), or fairly severe depression symptoms (OR = 35.3). A seven times higher risk of depression was identified among drivers with sleep disorders. Conclusion It might be contended that a mutual relationship has been found between sleep disorders and depression, and disregarding this will deteriorate sleep turbulences. Considering the pivotal role of taxi drivers in urban mobility, accommodating initiatives that give a break time for drivers and improve their mental health is recommended.

Introduction: Acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH) are among the acute cerebrovascular diseases (CVDs) that have been reported as a result of COVID-19. It will be a significant step forward if our research helps improve the compilation and analysis of existing data from other studies. Methods: The study is registered on PROSPERO with an ID of CRD42023464058. It encompasses articles published until December 2023 and involves searching databases such as PubMed, Scopus, Web of Knowledge, Embase, and Cochrane. Additionally, we conducted manual searches in respected publications within this discipline, utilized the Google Scholar search engine, and conducted reference checks, citation checks, and study of gray literature. The publications’ reporting quality was assessed using the "Assessment of Multiple Systematic Reviews" (AMSTAR) checklist. The meta-analysis was conducted using Stata software (StataCorp, version 16). Results: We analyzed the findings of 23 meta-analyses, which included 795 articles and encompassed 5,937 patients who had previously experienced a stroke. The average age of these patients was 62.3 years, and 68.3% were male. The findings indicated that the collective incidence of stroke among individuals with COVID-19 is roughly 1.75% [95% confidence interval (CI): 0.4%-3.03], with 1.59% for ischemic strokes and 0.3% for hemorrhagic strokes. 32.3% (95% CI: 27.8%-36.9%) of COVID-19 patients with stroke passed away, approximately 27% were discharged from the hospital with very mild or no complications, and around 28.1% (95% CI: 14.1%-42.1%) were referred for rehabilitation. Conclusions: The overall rate of stroke in COVID-19 patients was approximately 1.75%, with a higher incidence in males and those with an average age of 62.3 years. Almost 80% of the strokes were ischemic, and the mortality rate was approximately 32%. Finally, 27% of the patients were discharged without complications, and 28% required rehabilitation.

Abstract Introduction This study aimed to compare the predictive abilities of macrocirculation markers (mean arterial pressure, heart rate, and central venous pressure), microcirculation markers (capillary refill time and peripheral perfusion index), as well as fluid balance, lactate level, and lactate clearance on the outcomes of patients with septic shock during initial resuscitation. Methods In this prospective, single-center observational study, adult patients with septic shock admitted to the intensive care unit (ICU) at Shohada Hospital in Tabriz, Iran, between December 2020 and September 2021, were included. Receiver operating characteristic (ROC) curve analysis and multivariate logistic regression were used to assess the associations between macrocirculation markers (heart rate, mean arterial pressure, central venous pressure, and fluid balance) and microcirculation markers (capillary refill time, peripheral perfusion index, mottling score, lactate level, and lactate clearance level) with outcomes such as ICU length of stay, need for renal replacement therapy (RRT), vasopressor requirements, duration of mechanical ventilation (MV), and mortality rate. Assessments were performed at baseline, 6 h, and 24 h after fluid resuscitation. Results A total of 100 patients with septic shock (55 men and 45 women) were enrolled in the study. The area under the curve (AUC) values for the macrocirculation and microcirculation markers in predicting mortality ranged from 0.517 to 0.770 and 0.695 to 0.993, respectively. Among the macrocirculation markers, central venous pressure and mean arterial pressure at baseline showed the best predictive values for mortality, with AUCs of 0.770 and 0.753, respectively. Conclusion In patients with septic shock, microcirculation markers, particularly the peripheral perfusion index (PPI), demonstrated better predictive accuracy for mortality compared to macrocirculation markers. Furthermore, the combination of markers had a higher AUC, sensitivity, and specificity for predicting outcomes compared to individual markers alone.

Background: Distraction is one of the main driver's behavioral factors that reduces the performance of the drivers and might increase the accident risk. Distraction while driving holds significant importance, especially among professional drivers, and failure to address this matter may result in adverse implications for traffic safety. The present study was conducted to investigate distraction and related risk factors between two groups of private vehicle drivers and taxi drivers. Methods: This analytical cross-sectional study was carried out in Tabriz, Iran in 2022. The total sample size in this study was 701 taxi drivers, professional drivers, and private vehicle drivers. The independent samples t-test was used to determine the statistically significant difference between groups and its sub-scales between the two studied groups. Moreover, the multivariable linear regression analysis was used to determine the predictors that affect distraction score. The test's level of significance was considered at 0.05. Results: The mean distraction score among taxi drivers surpasses that of private vehicle drivers (2.82 vs. 2.32, p-value

Background: Pressure lesions are chronic wounds causing the development of infection and inflammation into deeper structures and finally necrosis. In Persian medicine, Alkanna orientalis (Boraginaceae) has been used for centuries as a naturally derived remedy for managing lesions. A cross-sectional pilot clinical trial was conducted to assess the wound healing effect of an ointment made of chloroform extract of roots of A. orientalis (CERAO). Methods: Sixty patients (36 men and 24 women) diagnosed with bedsore staging 1-2 entered the study for one year. They were divided into two groups of control and treatment with equal proportions. The control group received conventional treatment from the hospital, including irrigation serum, mupirocin, phenytoin ointments, and gauze dressing. After rinsing and cleansing with normal saline, in the intervention group, patients received a thin layer of CERAO once daily for four weeks. Clinical outcomes were measured at weeks 2 and 4. Results: Recovery assessment was carried out by measuring wound area, days of epithelia formation, and complete wound closure. The difference between the two groups was statistically significant (P-value

Background. Effective triage is a viable solution to improve performance indicators in the emergency department. This study aimed to compare the effect of conventional triage and team triage methods on the performance indicators of emergency department. Methods. In this descriptive cross-sectional research, all 749 patients referred to the emergency department of Tabriz Sina Hospital were triaged using conventional and team methods for two consecutive weeks in July 2020. A researcher-made checklist was used to collect emergency performance indicators. The data were extracted from patient records and recorded in the checklist. Data analysis was performed using descriptive statistics, Chi-square and Mann-Whitney tests in the SPSS.19 software. Results. Among the patients, 86.9% in the triage group using the conventional method (52.7% female) and 86.7% in the group using the team method (52% female) were older than 40 years. The results showed that in the team triage group, the number of temporarily hospitalized patients was significantly higher and the frequency of self-responsible exit was lower compared to the conventional method. In addition, the waiting time for patients triaged with the team method was shorter, and the difference in values was significant for all three triage levels. Conclusion. According to our results, team triage had a more positive effect on improving emergency performance indicators compared to the conventional method. Therefore, it is recommended to consider this method in hospital emergency departments to provide better services and increase patient satisfaction.

Introduction: A comprehensive analysis of the epidemiological features of aortic dissections in Azerbaijan Province, Iran, and their influence on patient survival remains unexplored. This study aimed to determine the incidence of aortic dissection and identify the associated factors of mortality in these patients. Methods: A retrospective longitudinal study was conducted using hospital records of patients diagnosed with aortic dissection in Tabriz, Iran, between 2017 and 2021. The 3-month mortality was followed up via telephone calls using the contact numbers provided in the patients’ records. Then, independently associated factors of mortality were identified using a multivariate stepwise logistic regression analysis. Results: Among the 150 cases of aortic dissection identified, 74% (n = 111) were classified as type A, and 26% (n = 39) were classified as type B. The overall incidence proportion of aortic dissections was 2.35 per 100000 population. In type A dissections, 64% (71 out of 111) of patients received surgical treatment, while 21.6% (24 out of 111) received medical treatment. Among type B dissections, only 23.1% (9 out of 39) underwent surgery. The all-cause mortality rate at 3 months was 52.5% (73 out of 139 patients with complete follow-up), 47 male (54%) and 26 female (50%). Multivariate analysis showed that higher age was independently associated with increased mortality (odds ratio [OR] = 1.03; 95% confidence interval [CI]: 1.00-1.06, p = 0.027). In contrast, patients with DeBakey Type III classification (OR = 0.29; 95% CI: 0.01-0.87, p = 0.027), hypothyroidism (OR = 0.12; 95% CI: 0.01-0.99, p = 0.049), and those who received either surgical treatment (OR = 0.19; 95% CI: 0.05-0.76, p = 0.019) or medical treatment (OR = 0.18; 95% CI: 0.04-0.80, p = 0.024) had a lower chance of mortality. Gender was not found to be associated with the outcome. Conclusion: The study revealed an annual incidence rate of aortic dissection as 2.35 per 100000 population. Aortic dissection, regardless of type, remains a highly fatal condition, with over half of patients dying within 3 months of the initial event. To reduce the high mortality rates associated with aortic dissections, it is crucial to implement specific measures for the early identification of patients and ensure prompt and appropriate care.

Abstract Background Etomidate is an imidazole derivative that is widely used in the emergency department for Rapid Sequence Intubation (RSI). Although it has a safe hemodynamic profile, there are some concerns about its suppressant effects on the adreno-cortical axis. Vitamin C, as an antioxidant, can play a protective role in this issue. Method In a controlled clinical trial, we studied adult traumatic patients who needed RSI with etomidate. In one group underwent RSI with etomidate and cortisol levels were measured three hours later. In the other group, we administered one gram of vitamin C before etomidate administration, and the cortisol level was measured three hours later. Results Fifty-one patients have been studied. The serum cortisol level was significantly lower after RSI with etomidate in both groups. In the Vitamin C group, there was a significantly higher cortisol level after RSI in comparison to the control group. Conclusion Etomidate can suppress the cortisol level in trauma patients who undergo RSI. Vitamin C can reduce this suppressant effect of etomidate. Trial registration IRCT registration number: IRCT20090923002496N11, URL of trial registry record: https://en.irct.ir/trial/34586 , Date of trial registration: 19/04/2019. Full date of the first registration: 30/05/2019.

Introduction: In low- and middle-income countries, a large proportion of road users include pedestrians, cyclists, and motorcyclists, and nearly half of road traffic fatalities occur among motorcyclists. This study aimed to examine the pattern of motorcyclists' death due to accidents in East Azerbaijan, Iran between 2006 and 2021 and present a forecast. Methods: We used death data due to motorcycle accidents of Legal Medicine Department between 2006 and 2021. For time series analysis, the Box-Jenkins model was used and three stages of identification, estimation, and diagnosis were successively performed and repeated several times to achieve the best prediction model. The Box-cox transformation method was used to stabilize the variance, and the first-order seasonal differential method with a period of 12 was used to control the seasonality. Due to seasonal variations, the Seasonality Auto-Regressive Integrated Moving Average model: SARIMA (p, d, q) (P, D, Q)s was employed and the death trend was predicted for 36 months. The candidate models were compared based on Log-likelihood, AIC, and BIC indices. STATA 17 was used for data analysis. Results: About 18.6% of all accident deaths are attributed to motorcycle accidents. The death rate for all causes of accidents and motorcycle accidents were 23.13 and 4.30 per 100,000 population, respectively. Seven models were considered as candidates. The SARIMA (0, 0, 0) (1, 1, 1)12 model was selected as the best model due to better fit and used to predict the number and trend of motorcycle accident deaths. Motorcycle accident deaths are predicted to decrease gradually in the next 36 months, from June 2021 to May 2024, affected by seasonal changes. Conclusion: The trend of death due to motorcycle accidents from 2006 to 2021 in East Azerbaijan was declining, and it is predicted to decrease slightly in the next three years as well. As this reduction may be attributed to many factors, it is recommended to investigate effective factors in future studies.

Background. This systematic review evaluated the studies conducted on Guillain-Barré syndrome (GBS) due to COVID-19 vaccination to clarify any possible connections and the type of vaccines causing GBS. Methods. A comprehensive search was performed on July 2021 through MEDLINE (via PubMed), Scopus, Cochrane, and Web of Science databases to detect published and unpublished papers. Our PICO was all COVID-19 vaccinated individuals as the population, COVID-19 vaccines as the intervention, and patients experiencing GBS following COVID-19 vaccination as the outcome. Critical appraisal instruments from the Joanna Briggs Institute case series or case report were used to evaluate the quality of included studies. Results. In the present systematic review, 12 case reports and case series including 21 patients were assessed. More than half of the patients were male, and the mean age of male patients was lower than females. In terms of vaccine type, the most common kind of vaccine injected was Oxford/AstraZeneca, and all the cases except one patient had received only one dose of the vaccine. Regarding the interval between receiving the vaccine and the onset of GBS symptoms, the mean duration was 14 days. The lowest mean time interval between receiving the vaccine and the onset of symptoms of GBS was related to the unnamed vector-based COVID-19 vaccine, and the highest was associated with Oxford/AstraZeneca. Conclusion. Through this systematic review of case reports, we neither attempt to establish nor rule out a causal link between the COVID-19 vaccine and GBS, because such a link requires extensive case-control studies. However, we must highlight any events that may occur following the injection of existing vaccines. Practical Implications. The most common symptoms seen in patients experiencing GBS after vaccination included progressive bilateral lower limb weakness, paresthesia, numbness of limbs, generalized body aches, and back pain.

Background and Purpose: Emergency Department (ED) staff are frequently faced with road traffic injury victims and also play role as various road users. This study was conducted to investigate the knowledge, attitude, and practices of ED staff towards road safety at referral trauma hospitals of Tabriz. Materials and Methods: This cross-sectional study was conducted in 2020 in the referral trauma hospitals of Tabriz. Data were collected using a standard questionnaire. Census sampling was used to select the participants. Descriptive statistics, Pearson’s correlation test and logistic regression model were used for the data analysis using SPSS Software. Results: The mean score of the ED staff in traffic safety knowledge, attitude and practices was 9.73 ± 2.28 out of 15, 95.3±11.4 out of 118, and 61.3±8 out of 76, respectively. The staff’s traffic safety knowledge was associated with their attitude and practices. Moreover, the univariate logistic regression modeling results revealed that participants' traffic safety attitude (OR= 0.96 (95% CI= 0.93-0.99)) and practices (OR= 0.95 (95% CI= 0.91-0.99)) were, independently, correlated with a reduction in road traffic accidents. Conclusions: The ED staff’s attitudes towards traffic safety had a positive correlation with their practices and also accident experience. Nonetheless, after adjusting the data in terms of knowledge and attitude, road traffic safety practice was not associated with participants' accident experience. It is crucial to consider road safety education in colleges to promote safety knowledge of graduate individuals which will have conspicuous results in risk reduction.

Objective: Having cosmetic breast implants increases a woman's chance of suicide, which is now a global challenge. This systematic review evaluated the possible risk of suicide among women who undergo cosmetic breast implants. Method: This meta-analysis was done based on Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). In the current systematic review and meta-analysis, we systematically searched for all articles written in both English or Persian that estimated the prevalence of suicidal ideation in women who had cosmetic breast implants. We systematically searched different databases, including MEDLINE (PubMed), Web of Science, Embase, Cochrane, Library ProQuest, Scopus, and Google Scholar, from inception to March 2021. There was also a search for references. Suicidal ideation, a suicide plan, or suicide attempts were the outcomes. In order to determine the total pooled prevalence of suicidal ideation, we utilized a random-effects model. To examine the risks of bias in each study, we applied the Joanna Briggs Institute Critical Appraisal method. Results: We identified 218 citations in our initial search. After omitting duplicated citations and excluding irrelevant studies according to the title and abstract selection, 42 studies were chosen for the full text analysis. Finally, 11 research, examining a total of 324,332 women were incorporated into the systematic review and critical appraisal assessment. Eight of these studies were found to be eligible for meta-analysis. The frequency of suicide in women with cosmetic breast implant was 0.2% (95% CI: 0.1% to 0.4%; P < 0.001) (Q-value: 168.143, I2:95.83). Most of the included studies had moderate quality. Conclusion: There might be a correlation between cosmetic breast implants and suicide risk, which could be stronger in the presence of a history of mental illnesses. The evidence about the possible effects of breast implants on the risk of suicide is still inconclusive, and there is a need for future well-designed studies on this topic.

Abstract Background On March 11th, 2020, the World Health Organization (WHO) proclaimed Coronavirus Disease of 2019 (COVID-19) a pandemic. In addition to severe health problems, the disease has had a major psychological impact on the public. The aim of this research was to examine the association between Post-Traumatic Stress Disorder (PTSD) related to COVID-19 in emergency staff and self-compassion and perceived social support. Methods Data were collected from 222 emergency staff working in two referral educational and health centers for COVID-19 affiliated to Tabriz University of Medical Sciences. The participants were recruited six months following the first case of hospitalization for COVID-19 in these two hospitals in Tabriz, Iran. Four questionnaires were used to measure the variables, including a researcher-made demographic checklist, PTSD Checklist for DSM-5 (PCL-5), the Multidimensional Perceived Social Support Scale (MSPSS) and the Self-Compassion Scale. Results The findings showed that age (r = 0.17, P = 0.034), self-judgment (r = 0. 36, P

Background: Many of the known coronaviruses cause a wide range of respiratory infections in humans, and the novel coronavirus is no exception to this rule. Although no drug has yet been discovered to prevent or treat this disease, chloroquine (CQ) and hydroxychloroquine (HCQ)have been widely used in studies showing different results. Methods: The present study is an umbrella study. The search was conducted for the articles published from January 2020 to November 2020 using the keywords ("COVID-19" OR "SARSCoV-2" AND "Hydroxychloroquine" OR "Chloroquine" AND "Systematic Review" OR"Metanalysis"). This study was limited to human samples and systematic reviews with or without meta-analysis. The quality of the articles was also evaluated independently by two researchers. Results: To evaluate the clinical efficacy of HCQ and CQ, a total of 176 papers and 643569 cases ranging from patients with mild pneumonia to intubated critically ill patients were evaluated. Finally, 8 studies were included. Conclusion: There are conflicting results regarding HCQ or CQ efficacy and safety in the systematic reviews. More evidence is needed to confirm whether these drugs are useful in COVID-19 infection, and their usage as the standard care cannot be recommended based on the majority of the studies included in this umbrella review.

Introduction Patients with a type D personality have worse social functioning and mental health and more affective constraints than non-type D personalities. They have a negative outlook on life and health-related issues. The aim of this study was to examine the mediating role of stress and anxiety in the relationship between type D personality and COVID-19 by adjustment of the effect of demographic characteristics and perceived symptoms as confounder variables. Material and methods A total of 196 patients out of those suspected of having COVID-19 and visiting the reference hospitals were selected. They had completed the type D personality and the anxiety and stress scales along with their hospital admission form before undergoing COVID-19 testing. After their COVID-19 test, the participants were divided into two groups based on their disease, an infected group (n = 90) and a non-infected group (n = 106). Results Type D personality has no significant direct effect on infection with the disease, but taking into account the mediating variable of stress, the odds of an event in those with type D personality is 2.21 times higher than those without this personality (p = .027) and, taking into account the mediating variable of anxiety, having a type D personality increases the odds of an event by 2.62 times (p = .011), holding demographic characteristics and perceived symptoms constant. Conclusions Given the indirect relationship between COVID-19 and type D personality, the mediating variables of stress and anxiety can be considered full mediating variables.

Abstract Background Determining people’s healthy behaviors related to COVID-19 could be effective in providing preventive measures. The present study aims to investigate preventive behaviors associated with COVID-19 including wearing masks and keeping physical distance among the passengers on buses and public taxis measures to evaluate the ventilation systems in these vehicles. Methods This cross-sectional study was performed on 753 passengers on buses and taxis in Tabriz, northwestern Iran, from 15 February to 1 March 2021. Multistage sampling method was used to select the participants. Tabriz was socioeconomically divided into three areas, including high, moderate, and low socioeconomic status. Three researchers were observed passengers behaviors standing at the selected stations and assessed their behaviors according to study checklist. Results In total, the data were gathered from 358 (47.5%) female and 395 (52.5%) male in public transport systems. The results of this study indicated that female passengers used masks significantly more than men (P

Background and Objectives Burns is one of the most common and potentially dangerous public health problems. Burn patients' hospitalization facilitates the provision of medical services. However, prolonging the length of hospital stay can not only impose an economic cost, but also cause various infections in patients. Various factors affect patients’ hospitalization length including patients age and gender, burn cause, anatomic place and its severity. Identifying and considering these factors will reduce burn patient’s hospitalization and its consequences. The aim of this study was to evaluate the factors affecting hospitalization length in burn patients admitted to Sina Hospital as burn referral hospital in Northwest of Iran. Material and Methods In this cross-sectional study, the medical records of burn patients who were admitted to Sina Hospital in Tabriz during 2018, were included. Data collection was performed using a goal-based researcher data collection form. The form included patient’s demographics (age, gende, marital status, education level, occupation, comorbidity) and Status of vital signs at admission including respiratory rate, heart rate, body temperature, Glasgow Coma Scale score (less than 12 moderate injuries, 13 and 14 mild injuries, 15 or more normal) and systolic and diastolic blood pressure, burn place, date, cause, TBSA, burn severity, length of stay and outcome. Data were analyzed using Stata 16 software and through quantile regression modeling. Data normality was evaluated using Kolmogorov-Smirnov test, skewness and kurtosis. Due to the skewness of the hospitalization variable distribution (hospitalization length was a non-negative variable with right skew and skewness coefficient of 4.72 and kurtosis coefficient equal to 6.53), to obtain a complete picture of how the conditioned distribution of the response variable changes from variables Independently, Quantile regression was used for modeling with a significance level of P

Acute exacerbations are the important reasons for hospitalization and death in chronic obstructive pulmonary disease (COPD) patients. We aimed to evaluate the relationship between serum concentrations of cardiac troponin I (cTnI) and the outcome of COPD patients visiting the emergency department with acute exacerbation of COPD (AECOPD). In this study, we included 90 AECOPD patients between October 2018 and October 2019. Serum cTnI was measured during the first 24 and 48 hours after admission. Patients were categorized into two groups positive cTnI values (≥0.3 ng/dl) and negative cTnI (

Abstract Objectives In the present study, we sought to investigate the association between red cell distribution width (RDW) and stroke severity and outcome in patients who underwent anti-thrombolytic therapy with tissue plasminogen activator (tPA). Results In this prospective study, 282 stroke patients who underwent tPA injection were included. The categorization of RDW to 13% values revealed insignificant difference in stroke severity score, accounting for the mean 36-h NIHSS of 8.19 ± 8.2 in normal RDW values and 9.94 ± 8.28in higher RDW group (p = 0.64). In seventh day, NIHSS was 6.46 ± 7.28 in normal RDW group and was 8.52 ± 8.35 in increased RDW group (p = 0.058). Neither the 36-h, nor the seventh day and 3-month mRS demonstrated significant difference between those with normal and higher RDW values.

مقدمه: تکنیک تصویربرداری نقش مهمی در مدیریت ترومای قفسه سینه دارد و از گرافی ساده و سونوگرافی و سی تی اسکن برای تشخیص آسیبهای قفسه سینه استفاده می شود. سی تی اسكن قفسه سینه گلد استاندارد تشخیص آسیب های قفسه سینه می باشد. این مطالعه با هدف بررسی یافته های مثبت سی تي اسکن سینه بیماران مراجعه کننده به اورژانس بیمارستان امام رضا (ع) تبریز در سال ۹۵ انجام شده است. روش کار: این مقاله یک مطالعه توصیفی است که در بیماران مولتیپل ترومای مراجعه کننده به بیمارستان امام رضا تبریز از فروردین تا اسفند سال ۱۳۹۵ انجام شده است. روش نمونه گیری تمام شماری بوده و تمام بیماران مولتیپل تروما و ترومای سینه که در سال ۱3۹۵ به بیمارستان امام رضا مراجعه کرده بودند و سی تی اسپیرال قفسه سینه برای آنها انجام شده بود وارد مطالعه شدند. از آزمون T مستقل برای مقایسه داده های کمی و از مجذور K برای مقایسه داده های کیفی استفاده شد. يافته ها: در طول سال ۱۳۹۵ شمسی ۳۹۰ بیمار با ترومای سینه و مولتیپل تروما مورد سی تی قفسه سینه قرار گرفته بودند. که تعداد ۲۹۶ نفر مرد (۹/۷۵٪) و ۹۴ نفر (۱/۲۴٪) زن بودند. میانگین سنی بیماران ۳۵/۴۸ سال بود. حوادث ترافیکی بیشترین میزان علل تروما را تشکیل می داد. در نزدیک به نیمی از بیماران یافته ای در سی تی اسكن اسپیرال قفسه سینه یافت نشد. همچنین در ۲۱ بیمار یافته های متعدد وجود داشت. شايع ترين آسيب ها شکستگی دنده (3/11 %)، پنوموتوراکس (3/12%)، پنومومدياستن (2%) هموتوراکس (6/4 %) و كنتوزيون ريه (9/4 %) بودند. نتیجه گيري: در بیماران مولتيپل تروما, شایع ترین یافته های مثبت سی تی شامل شکستگی دنده بود و بعد آن پنوموتوراکس، آمفیزم زیرجلدی و هموتوراکس بودند. در مواردی که شکستگی سه دنده اول یا flail chest وجود دارد یا شکستگی اسکاپولا و ترومای با انرژی بالا وارد شده است میزان آسیب های احشا ء داخل قفسه سینه و شکم بیشتر است و ویژگی سی تی اسکن قفسه سينه تشخیص هموتوراکس و پنوموتوراکس های جزئی می باشد که در گرافی ساده قابل تشخیص نمی باشد.

Background: The current study aimed to evaluate the predictive value of mortality in patients admitted to the Intensive Care Unit (ICU) through the emergency department and based on Quick Sequential Organ Failure Assessment (qSOFA), National Early Warning Score (NEWS) and NEWS2 criteria. Methods: In this cross-sectional study, all patients referred to the emergency department with a need of admission to ICU for any reason, were evaluated. Demographic data such as age and sex were recorded for data collection. Also, the main diagnosis, length of stay and hospitalization outcome along with data related to qSOFA, NEWS and NEWS2 indices were included in the researcher's checklist. Results: Of 89 included patients, 52 (58.4%) were male and 37 (41.6%) were female, with mean age of 60.25±20.8. Our findings indicated that qSOFA is a good predictor for mortality in non-traumatic patients so that qSOFA has 48% sensitivity and 100% specificity in the diagnosis of mortality in non-trauma patients. NEWS also has a sensitivity of 72% and a specificity of 71.4% in the diagnosis of non-traumatic mortality. And NEWS2 has 72% sensitivity and 78.6% specificity in non-traumatic mortality diagnosis. Conclusion: Our findings suggested that the sensitivity and specificity of qSOFA, NEWS and NEWS2 in predicting the mortality of non-traumatic patients who were admitted in emergency departments and hospitalized in ICU, are high and reliablen.

Introduction: Infectious diseases have threatened human health throughout the history. One way of transmission of such diseases is exposing to the needle sticks. The present study was carried out aiming to introduce and investigate risk factors related to needle sticks and ways of prevention of infectious diseases related to needle stick among health care staff. Methods: Searching key words including needle sticks, occupational injuries, occupational exposures (OEs) and infectious diseases, the researchers undertook a comprehensive investigation regardless of publication year of the reviewed articles in references including, Medline, CINAHL, Google Scholar, ScienceDirect and Scopus. Then the collected articles were scrutinized and processed. Results: Dealing with needle sticks can transmit more than 20 types of pathogens including Hepatitis B, C and human immunodeficiency virus (HIV). Among health care staff, nurses are more vulnerable compared to others. Conclusion: Exposure to blood and other risky body liquids is a serious risk factor among health care workers. Training medical staff, establishing reporting systems, changing high risk behaviors and vaccination can play an important role in prevention of the infectious diseases.

Introduction: Carcinogen antigen 125 (CA-125) is a glycoprotein antigen, which has shown potentials in predicting peritoneal inflammation. The aim of this study is to determine the value of CA-125 in predicting acute appendicitis (AA). Methods: This prospective diagnostic accuracy study was conducted on 15 – 70 year-old patients with acute abdominal pain, suspected to AA, referred to emergency department. The serum level of CA-125 was measured for all patients before appendectomy and its screening characteristics in detection of AA case (confirmed by histology findings) were calculated and reported with 95% confidence interval (CI). Results: 95 patients with the mean age of 31.65 ± 12.9 (15-75) years were studied (54.3% male). Based on the histologic findings, 72 (75.8%) cases were categorized as AA (23 cases as severe). AA and non-AA (NAA) groups were similar regarding the mean age (p = 0.59), mean duration of symptoms (p = 0.08), mean white blood cell (WBC) count (p = 0.37), and mean PMN percentage (p = 0.55).  Mean CA-125 level was 16.5 ± 20.0 U/mL in the AA group and 30.5 ± 6.1 U/mL in the NAA group (p = 0.001). Adjustment of analysis based on gender revealed a significant correlation between CA-125 level and diagnosis of AA only in females (34.23 ± 39 U/mL in NAA versus 20.7 ± 26.7 U/mL in AA, p = 0.012). The area under the ROC curve of CA-125 was 0.62 (95%CI: 0.51 to 0.72). Sensitivity, specificity, NPV, PPV, NLR, and PLR of CA-125 in 16.4 U/mL cut off (best point) were 77.8% (95%CI: 66.4 - 86.7), 50.0% (95%CI: 28.2 - 71.8), 83.6% (95%CI: 76.7 - 88.7), and 40.7% (95%CI: 27.4 - 55.6), 0.44 (95%CI 0.2 - 0.8), and 1.56 (95%CI: 1.0 - 2.4), respectively. Conclusion: Considering the lower levels of CA-125 in patients with AA compared with NAA cases and also weak screening performance characteristics, it seems that it could not be considered as an accurate screening tool in this regard.

Background: Intravascular volume is the most important factor in determining patients' hemodynamic status. This present study aimed to assay the predictive value of aorta artery diameter and inferior vena cava (IVC) diameter in trauma patients with hemorrhagic shock. Materials and Methods: This was a cross-sectional study conducted on 69 trauma patients who referred to Imam Reza Hospital in Tabriz. Inclusion criteria were all trauma patients with hemorrhagic shock. Patients with diseases such as liver disease,cardiovascular,coronary heart disease and concurrent dehydration were excluded. Odds ratios and Adjusted odds ratios for the risk of events were obtained using cumulative logit ordinal regression model with version 15 of Stata software. Results: There were 58 men (84/1%) and 11 women (15/9%) with an average age of 36.4±12.4 year. Findings showed that for one unit increase in the diameter of the aorta by controlling the effect of other variables, the odds of mortality decreased for 2% compared with hospitalization in ward or intensive care unit (ICU). The reduction was also statistically significant (P=0.037). Furthermore, by modifying the effect of other variables, one unit increase in the diameter of IVC during inhale and exhale, increases the odds of hospitalization in ward or ICU. Conclusion: This study showed that the diameter of the aorta and also the diameter of IVC during inhale and exhale can be used to predict the outcome of trauma patients with hemorrhagic shock and eventually to take steps for emergent and effective treatment.

Objective: Scorpion is one of the world’s most venomous arthropods and every year many people are bitten by it. In Iran, scorpion sting is a common health issue. The aim of this study was to evaluate the epidemiological and clinical status of patients with scorpion sting in the emergency department of Sina hospital in 2014. Methods: In this descriptive cross-sectional study, all patients with a history of scorpion sting during 2014 in the emergency department of Sina hospital in Tabriz entered the study. Required information such as sex, age, location and time of the sting, the patient’s symptoms, etc were extracted from the medical records. These findings were analyzed using SPSS version 15. Results: Based on our results, 47.2% of patients were male. The mean ± SD of their age was 35.63 ± 18.87. Of 176 patients, 83% lived in urban areas, 87% of scorpion sting cases occurred in houses, and 81.3% of stings were done by yellow scorpion. Most of the bites were in upper extremities (47.2%). In evaluation of symptoms and signs of patients, 89.8% had pain, 48.8% had local erythema and redness, 21% had inflation of sting position and 0.6% had pulmonary symptoms. Conclusion: Scorpion stings are more common in young people as they are more active. Scorpion stings occur more frequently during the night and in the summer. In our study, most of scorpion stings occurred in houses.

Background & Objective: Anatomy is the basis of medical education and is conducted by the dissection of the cadaver The cadaver is a book which can provide great educational grounds for medical and paramedical students However cadaver shortage is one of the most important problems of medical schools in Iran; a subject that despite high levels of theoretical training of the anatomy has created problems for the practical training of this science Methods: In this study scientific references articles and reports have been analyzed to determine the role of cadaver donation and its obstacles and the effect of bequeathment in the elimination of these obstacles Results: Findings have shown that experiences gained through dissecting cadaver are better and more effective than knowledge obtained from books or models For more effective education cadavers are constantly required Cadaver shortage has been the topic of discussions and complaints of anatomy professors and medical students for consecutive years Providing cadavers or dissection is a complicated subject which requires cultural training The provision of unidentified cadavers by morgues can result in both remuneration for the deceased and steps towards the acquiring of knowledge Conclusion: The field of anatomy can only survive through cadaver donation Cadaver donation is an actual and effective way to support medical development and facilitate life of future generations Legal religious and cultural obstacles impede cadaver bequest The elimination of these obstacles is possible through the establishment of cadaver donation institutes cultural promotion and creation of motive and awareness in the society

Background & Aim: In recent years, health care workerschr('39') mobile phones have been considered important as a source of infection because they could have a significant role in nosocomial infections. The aim of this study is to determine the type of microbial contamination of health care workerschr('39') mobile phones in Sina hospital in Tabriz. Methods & Materials: In this descriptive-analytical study, 140 samples were taken from health care workerschr('39') mobile phones by convenience sampling, in 2015. The samples were taken by a sterile swab and immediately transferred to the hospital laboratory. They were cultured after incubation for 48 hrs in two plates at 37° C. Finally, the grown microorganisms were identified by biochemical tests. The data were analyzed using descriptive statistics and Chi-square test on SPSS software version 13. A level of P

Introduction: AThe aim of this study was to evaluate the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) colonization in the health care workers of emergency department of Imam Reza hospital, Tabriz, Iran Methods: In a total of 63 physicians and nurses in the emergency department of Imam Reza hospital, after obtaining written consent and completing a checklist, a sample of nasal mucosa was collected for microbiological examination and isolation of Staphylococcus aureus (SA) strain. Determination of resistance patterns (by diffusion method) was performed according to the standard methods of methicillin. Results: Out of 63 participants, 8 subjects (12.7%) had colonization of S. aureus; 4 of them were physicians (17.3% of the participated physicians) and 4 were nurses (10% of the participated nurses). Out of 8 isolated SA, 2 cases (25%) and overall 3.1% were methicillin-resistant. In our study, there was a significant relationship between co-employment in other hospitals and patient care at home with SA colonization, but there was not a significant relationship with specialty, work experience, sinusitis, history of antibiotic use, history of skin disease, hand washing habits and use of personal protective equipment. Conclusion: Prevalence of MRSA was not high among health workers of emergency department.

Purpose: Atrial fibrillation (AF) is one of the most common types of sustained dysrhythmia and there are some disagreements about its treatment. The goals of AF treatment include the control of ventricular rate, the establishment of sinus rhythm and the prevention of thromboembolic events. In this study, the effect of verapamil was compared to digoxin on heart rate control in patients with AF. Methods:This descriptive study was conducted in an emergency department (ED) in Iran. Sixty patients with a new onset AF and rapid ventricular response receiving digoxin or verapamil were included and observed. Results:Two thirty-patient groups receiving verapamil or digoxin were evaluated. The heart rate was significantly decreased in both groups (p = 0.002); however, the cardioversion was not noticed in both of them. The best rate control in verapamil and digoxin groups was observed after 5.9 mg (46.7%) and 0.6 mg (36.7%), respectively. Conclusion: Administration of verapamil in comparison with digoxin has no difference to control the heart rate in AF patients. It should be taken into consideration that prospective randomized studies should be conducted to identify the efficacy and select the best of these two drugs to treat AF patients.