Taghi Riahi; Sima Shokri; Seyed Hamid Reza Faiz; Karim Hemati; Seyed Hamzeh Mousavie; Amir Baghestani; Ali Khazaeian; Babak Hassanlouei
Volume 23, Issue 5 , 2021
Abstract
Background: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a variety of symptoms and laboratory and radiologic features whose identification can help diagnose and manage patients with COVID-19 more effectively.
Objectives: This ...
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Background: Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a variety of symptoms and laboratory and radiologic features whose identification can help diagnose and manage patients with COVID-19 more effectively.
Objectives: This study aimed to describe the epidemiological, clinical, and laboratory features of patients with COVID-19, compare clinical features of patients in the intensive care unit (ICU) with those of non-ICU admitted patients, and define mortality risk factors for this disease.
Methods: This cross-sectional study was carried out on 781 COVID-19 patients hospitalized in Rasool Akram Medical Complex, Tehran, Iran, from February to May 2020. Patients epidemiological, demographic, clinical, laboratory findings were collected. Routine blood tests included complete blood count, coagulation profile, and serum biochemical tests. Confirmed infection was defined as positive reverse transcription-polymerase chain reaction (RT-PCR) to SARS-CoV-2 in their nasopharyngeal specimens or typical clinical, laboratory, and imaging findings of COVID-19 infection altogether. All data were analyzed using SPSS software (version 21).
Results: In this study, the majority of patients were male (n=470, 60.2%) and the remainder were female. The median age of the patients was 64 years. Hypertension (31.8%) and tuberculosis (1.4%) were the most common and the least common underlying condition among the patients, respectively. Moreover, cough and seizure were the most common (75.7%) and the least common (2.4%) symptoms in patients. The history of diabetes mellitus, the presence of dyspnea, loss of taste, and the occurrence of seizure were associated with a higher risk of ICU admission. On the other hand, advanced age, positive PCR, presence of dyspnea, myalgia, loss of taste, and elevated liver enzymes, and lactate dehydrogenase (LDH) were associated with a higher risk of mortality. Based on the results, smoking had a preventive effect on mortality (OR=0.292, P=0.048); however, it had no significant effect on ICU admission.
Conclusion: According to the obtained results, positive PCR and initial symptoms of dyspnea and myalgia were associated with increased odds of mortality by two times. In addition, elevated alanine aminotransferase and lactate dehydrogenase were associated with a higher rate of mortality. ICU admission was the main variable to increase the odds of mortality. Eventually, smoking might play a protective role against COVID-19 mortality.
Poupak Rahimzadeh; Salome Sehat Kashani; Karim Hemmati; Farnad Imani; Akram Salimi; Seyed Hamid Reza Faiz
Volume 22, Issue 12 , 2020
Abstract
Background: There are various protocols for pain management after anterior cruciate ligament (ACL) reconstruction surgery.
Objective: This study aimed to compare two blocking protocols, including femoral nerve block (FNB) and infrapatellar nerve block (IPNB) in terms of pain severity, patient ...
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Background: There are various protocols for pain management after anterior cruciate ligament (ACL) reconstruction surgery.
Objective: This study aimed to compare two blocking protocols, including femoral nerve block (FNB) and infrapatellar nerve block (IPNB) in terms of pain severity, patient satisfaction, and muscle force preservation.
Materials and Methods: This single-blind clinical trial study investigated the patients who underwent elective knee arthroscopic ACL surgery randomly either by ultrasound-guided FNB or IPNB. Subsequently, the patients were evaluated 1, 3, 6, 12, and 24 h following NB for pain severity, patient satisfaction level, and muscle force.
Results: The pain score (both at rest and in flexion) was significantly lower in the first three h after the intervention in the FNB group. Moreover, the mean score of the patients satisfaction in the first hours was significantly higher in the FNB group after the procedure. Additionally, the IPNB group obtained a significantly faster mean time required for the first dose of opioid request. The mean dose of used opioids over 24 h was significantly lower in the FNB group. There was a significant difference between the groups in terms of the muscle strength score within 24 h; moreover, the FNB group obtained a significantly greater delay in muscle recovery.
Conclusion: The FNB is associated with greater pain relief and satisfaction in patients who underwent arthroscopic ACL reconstruction surgery, compared to the IFNB technique. However, a further delay in the recovery of quadriceps muscle force is evident in the FNB group.
Seyed Hamid Reza Faiz; Nasim Nikoubakht; Azadeh Sayarifard; Poupak Rahimzadeh
Volume 20, Issue 12 , 2018, Pages 1-6
Abstract
Background: Postoperative pain is a major complication in patients undergoing eye surgery. N-methyl-D-aspartate (NMDA) recep- tor antagonists are widely used to manage postoperative pains. Dextromethorphan, as an NMDA antagonist, is commonly used as an oral drug. Objectives: This study was conducted ...
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Background: Postoperative pain is a major complication in patients undergoing eye surgery. N-methyl-D-aspartate (NMDA) recep- tor antagonists are widely used to manage postoperative pains. Dextromethorphan, as an NMDA antagonist, is commonly used as an oral drug. Objectives: This study was conducted to evaluate the effect of Dextromethorphan on post-operation pain and sedative effect in comparison to placebo. Methods: A double-blinded, placebo-controlled, randomized clinical trial, upon 60 patients undergoing vitrectomy surgery wasdone. Thirty patients received 30 mg oral Dextromethorphan before the operation, and 30 patients received a placebo. Post- operation pain and sedation were evaluated after zero, one, two, and six hours. Results: Post-operation pain was significantly lower in patients who received Dextromethorphan at zero, one, and two hours afteroperation (P < 0.001); however, not at six hours after operation (P = 0.11). Sedative effect was higher in the Dextromethorphan group at zero (P = 0.03) and one hour (P = 0.01) after operation. Conclusions: Prescribing oral Dextromethorphan before a vitrectomy surgery could reduce postoperative pain. It also has postop-erative sedation effects.
Poupak Rahimzadeh; Seyed Hamid Reza Faiz; Farnad Imani; Masoumeh Rahimian Jahromi
Volume 20, Issue 9 , 2018, Pages 1-7
Abstract
Background: Postoperative pain is a common complication after Cesarean Section (CS) and its management is essential to prevent adverse effects of pain. Various methods are used to control pain after CS. Regional anesthesia using Transversalis Fascia Plane (TFP) and Transversus Abdominis Plane (TAP) block ...
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Background: Postoperative pain is a common complication after Cesarean Section (CS) and its management is essential to prevent adverse effects of pain. Various methods are used to control pain after CS. Regional anesthesia using Transversalis Fascia Plane (TFP) and Transversus Abdominis Plane (TAP) block is shown to reduce pain after abdominal surgery. Objectives: This study aimed at evaluating the efficacy of these two methods in controlling pain after CS.Methods: In this randomized clinical trial, 56 patients undergoing elective CS under spinal anesthesia were randomly allocated to receive TFP or TAP block after surgery with ultrasound guidance. The pain severity using Visual Analogue Scale (VAS) at rest and during coughing at 0, 2, 4, 6, 12, 24, and 36 hours after surgery, time to first analgesic request, and dosage of analgesic use and complications were compared between groups. Results: There were no significant differences between groups in pain severity at rest or coughing at0, 2, 4, 6, 12, 24 and 36 hours,postoperatively. There was no considerable nausea and vomiting between groups (14.3% vs. 10.7%, P = 0.68), and time to the first analgesia (100.00 ± 69.28 versus 123.12 ± 50.19 minutes, P = 0.47) and total analgesic use (33.33 ± 14.43 vs. 25.00 ± 15.81 mg, P = 0.57) were comparable between groups. There were no complications in any of the groups. Patients in both groups were mostly satisfied for pain control after surgery (good to perfect, 89.3% versus 82.1%, P = 0.7).Conclusions: Ultrasound-guided TFP provided pain control the same as TAP block after CS with a comparable decreased need of analgesics.
