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Comparison of Mortality, Length of Stay, and Hospitalization Costs of Hospitalized COVID-19 Patients with Cardiac and Non-Cardiac Disease

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Open Journal of Emergency Medicine 2023年第3期11卷 57-67页

作者： Babak Heidari Aghdam Zahra Kamali Seyedbaglou amin shams akhtari Department of Cardiology Jam Hospital Tehran Iran Jam Hospital Tehran Iran Department of Emergency Medicine Jam Hospital Tehran Iran Emergency Department of Hervey Bay Hospital Queensland Hervey Bay Australia

Background: The COVID-19 pandemic has presented unprecedented challenges to global healthcare systems. As the pandemic unfolded, it became evident that certain groups of individuals were at an elevated risk of experiencing severe disease outcomes. Among these high-risk groups, individuals with pre-existing cardiac conditions emerged as particularly vulnerable. Objective: This study aimed to investigate the relationship between the length of stay, mortality, and costs of COVID-19 patients with and without a history of cardiac disease. Design: This retrospective study was conducted in Jam Hospital in Tehran, Iran, from March 21, 2021, to March 21, 2022. All patients with laboratory-confirmed COVID-19 who were hospitalized during this period were included. Results: A total of 500 COVID-19 patients were hospitalized, with 31.6% having a history of cardiac disease and 68.4% without any cardiac disease. Patients with cardiac disease were significantly older (median [range] age, 69.35 [37 - 94] years) compared to non-cardiac patients (54.95 [13 - 97] years) (p Conclusion: Patients with cardiac disease who are hospitalized with COVID-19 have a higher mortality rate, longer hospital stays, greater disease severity, ICU admission, and higher costs. Therefore, improved prevention and management strategies are crucial for these patients.

关键词： COVID-19 Cardiac Disease Length of Hospital Stay Costs Mortality

BMI-Adjusted Tube Current in Chest CT and Comparison of Lifetime Attributable Risk (LAR) of Breast Cancer in Two Different BMI-Based Protocols

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Open Journal of Emergency Medicine 2023年第3期11卷 115-125页

作者： amin shams akhtari Babak Heidariaghdam Faeze Vahid Alireza Oloumi Latif Gachkar Mehrdad Taghizadeh Seyedeh Hedieh Mousavipaak Clinical Research Development Unit of Loghman Hakim Hospital Tehran Iran Emergency Department of Hervey Bay Hospital Queensland Australia Jam Hospital Tehran Iran Independent Researcher Tehran Iran Loghman Hakim Hospital Tehran Iran Department of Basic Sciences Islamic Azad University Tehran Medical Branch

Possible strategies to reduce radiation dose during CT scanning have been investigated over recent decades;here the optimization of the tube current and its link with patient’s cancer incidence are being evaluated. 154 consecutive trauma patients with the need for chest CT scan were included. Two different BMI-adjusted CT protocols at a fixed voltage tube and the same scan length were applied. Dose estimation parameters like CT dose index (CTDI), dose length product (DLP) and effective breast dose were calculated. Breast surface dose was obtained by using thermoluminescence dosimeters (TLDs) and eventually, the life attributable risk (LAR) of cancer incidence was estimated. The mean effective dose was 4.87 ± 2.3 mSv and 5.12 ± 2.8 mSv for patients who were scanned with tube currents of 120 mAs and 200 mAs, respectively. There was no significant difference between organ surface doses for females but in males it was notable. The risk of cancer incidence is lower for protocol 1 in comparison with protocol 2. Optimizing tube current of 120 mAs reduced breast surface dose up to 50% in comparison with the tube current of 200 mAs. In trauma patients, using lower tube current based on BMI has notable impact on the absorbed dose in the breast and can reduce the breast cancer risk by nearly 33.6% for women.

关键词： Radiation Dose Trauma Patients Cancer Risk

The coast and benefits of helicopter emergency medical services instead of the ground unit in traumatic patients: A cost-effectiveness analysis

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Health 2013年第5期5卷 903-907页

作者： amin shams akhtari Naghmeh Sadat Jafari Hamid Kariman Afshin amini Vahid Monsef Mohamad Noorizadeh Neda Gholizadeh Department of Emergency Medicine Gilan University of Medical Sceince Rasht Iran Department of Emergency Medicine Shahid Beheshti University of Medical Science Tehran Iran Department of Forensic Medicine and Traumatic Pathology Alborz University of Medical Science Karaj Iran Department of Radiation Medical Engineering Isfahan University Isfahan Iran Research Committee of Medical Science Jondishapour University of Medical Science Ahvaz Iran

Study objective: Aero medical crews offer an advanced level of practice and rapid transport to definitive care;however, their efficacy remains unproven. Previous studies have used relatively small sample sizes or have been unable to adequately control the effect of other potentially influential variables. Here we explore the impact of aeromedical response in patients with moderate to severe traumatic brain injury. Methods: This was a cross-sectional study using our county trauma registry. All patients with trauma injury, who referred to our emergency department by helicopter or car, were included. The impact of aeromedical response was determined using logistic regression, adjusting for age, sex, mechanism, preadmissionGlasgowComa Scale score and?Injury Severity Score. Finally, the aeromedical patients undergoing field intubation were compared with ground patients undergoing emergency department (ED) intubation. Results: A total of 243 patients meeting all inclusion and exclusion criteria and with complete data sets were identified. Overall mortality was 25% in the air- and ground-transported cohorts, but outcomes were not significantly better for the aeromedical patients when adjusted for age, sex, mechanism of injury, hypotension, Glasgow Coma Scale score, head Abbreviated Injury Score, and Injury Severity Score (adjusted odds ratio [OR] 1.90;95% confidence interval [CI] 1.60 to 2.25;P: 0001). Good outcomes (discharge to home, jail, psychiatric facility, rehabilitation, or leaving against medical advice) were also higher in aeromedical patients (adjusted OR 1.36;95% CI 1.18 to 1.58;P: 0001). Conclusion: Here we analyze a large database of patients with moderate to severe traumatic brain injury. Aeromedical response appears to yield no significantly improved outcomes after adjustment for multiple influential factors in patients with moderate to severe traumatic brain injury.

关键词： Emergency Traumatic Patients Aero Medical

Comparison of the Use of Conventional and Antibiotic-Coated Tracheal Tubes and EVAC on the Incidence of Ventilator-Associated Pneumonia (VAP)

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Open Journal of Emergency Medicine 2023年第3期11卷 45-56页

作者： Mehrdad Taghizadeh amin shams akhtari Babak Heidariaghdam Seyedeh Hedieh Mousavipak Siamak Moghadamzadeh Mohammad Reza Haji Esmaili Faeze Vahid Department of Emergency Medicine Loghman Hakim Hospital Shahid Beheshti University of Medical Sciences Tehran Iran Clinical Research Development Unit of Loghman Hakim Hospital Shahid Beheshti University of Medical Sciences Tehran Iran Emergency Department of Hervey Bay Hospital Queensland Hervey Bay Australia Department of Cardiology Jam Hospital Tehran Iran Department of Basic Sciences Islamic Azad University Tehran Iran Department of Anesthesia Loghman Hakim Hospital Shahid Beheshti University of Medical Sciences Tehran Iran Independent Researcher Tehran Iran

Ventilator-associated pneumonia (VAP) is one of the most important hospital infections in hospitalized patients, which is associated with increased mortality and patient costs. The tracheal tube itself seems to be a major risk factor for VAP. Contaminated secretions pass through the endotracheal tube and reach the lungs. Also, bacteria form a bacterial biofilm on the tracheal tube and are transferred from there to the lungs. Different tracheal tube designs have been produced to overcome these cases. The purpose of this study is to investigate the effect of an Evac tracheal tube covered with antibiotics and normal on the incidence of pneumonia caused by the ventilator. Research method: 180 patients were randomly intubated in three groups of 60 people with three types of tracheal tubes, Evac and Bactiguard. Clinical examinations, endotracheal tube aspiration culture, and chest radiography were obtained from the patients and the incidence of VAP was calculated based on the CPIS standard. The relationship between the type of endotracheal tube and the incidence of VAP and the length of stay in the intensive care unit (ICU) and being discharged alive from the ICU were investigated. Findings and conclusions: The average incidence of VAP for the group of patients intubated with a conventional tracheal tube was 50%, EVAC was 45% and Bactiguard was 40%. The results showed that there is no significant relationship between the incidence of ventilator-induced pneumonia and the type of tracheal tube. The incidence of ventilator-induced pneumonia was not significantly reduced by suctioning subglottic secretions and Bactiguard tracheal tubes. It seems that using one method alone is not effective in reducing ventilator-induced pneumonia.

关键词： Intensive Care Unit Pneumonia Suction Ventilator

Optimization of Liver Iron Load Assessment by Pixel-Based T2* MRI in Thalassemic Patients

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Open Journal of Radiology 2012年第2期2卷 46-51页

作者： Neda Gholizadeh Shahram Akhlaghpoor Hamid Soltanian-Zadeh Emad Fatemizadeh Mohammad Reza Alinaghizadeh amin shams akhtari Mohammad Nourizadeh Cardivascular Disease Research Center Ahvaz Joundishapour University Ahvaz Iran Control and Intelligent Processing Center of Excellence (CIPCE) School of Electrical Engineering College of Engineering University of Tehran Tehran Iran Department of CT & MRI Imaging Tehran Medical Imaging Center Tehran Iran Department of Magnetic Resonance Imaging Noor Medical Imaging Center Tehran Iran Department of Nuclear Engineering Science and Research Branch of Azad University Tehran Iran School of Electrical Engineering Sharif University of Technology Tehran Iran

Purpose: To improve liver iron load assessment by investigating the precision of different approaches of T2* Measurement. Background: Iron overload is a major problem in the treatment of thalassemic patients. Liver iron concentration (LIC) is an important index toward the management of body iron load. The accuracy of iron load estimation may suffer from the methodology of T2* measurement and there is no complete agreement upon the best approach of T2* calculation. Methods: 32 β-thallasemic patients (18 male) with the mean age of 20.0 ± 6.5 years were involved in this study. A multi-echo fast gradient-echo technique on a 1.5 T MRI system was used to measure liver iron overload and the T2* map of liver was reconstructed on a pixel-by-pixel basis. The T2* map and MRI images were utilized to deter- mine accurate location of ROI (region of interest). The mean of T2* were computed from the ROIs. The reproducibility of calculated T2* values in two methods were obtained. Moreover, the mean of the pixel’s T2* was calculated in the entire liver parenchyma of one slice. The T2* value of the entire slice was compared with the ROI approach. Results: In the ROI based method, the CoV for the intra-observer reproducibility was 8.5% and for the inter-observer was 9.78%. In the pixel based method, the CoVs for intra-observer and inter-observer reproducibility were 2.79% and 3.91%. There was an acceptable correlation (r = 0.96) between the T2* values calculated by the ROI and the entire slice. Conclusions: The pixel-based approach is more precise to determine the appropriate placement of the ROI. The assessment of T2* in the entire slice reduces the user-based errors significantly.

关键词： Thalassemia Liver Iron Overload MRI T2*

Promising effect of Magliasa, a traditional Iranian formula, on experimental colitis on the basis of biochemical and cellular findings

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World Journal of Gastroenterology 2013年第12期19卷 1901-1911页

作者： Roja Rahimi Amir Baghaei Maryam Baeeri Gholamreza amin Mohammad Reza shams-Ardekani Mahnaz Khanavi Mohammad Abdollahi Department of Traditional Pharmacy Tehran University of Medical Sciences Pharmaceutical Sciences Research Center Tehran University of Medical Sciences Department of Pharmacology and Toxicology Tehran University of Medical Sciences Department of Pharmacognosy Tehran University of Medical Sciences

AIM: To investigate the efficacy of Magliasa, a traditional Iranian formula, on experimental colitis. METHODS: After botanical authentication of herbal ingredients, formulation of Magliasa, quantitative determination of total glucosinolates and total phenolic content, and analysis of the thin layer chromatography profile were performed. Colitis was then induced in male rats by instillation of 2,4,6-trinitrobenzenesulfonic acid (TNBS) in all groups, aside from the Sham *** experimental groups consisted of: the Sham group that received only normal saline; the Mag-50, Mag-100 and Mag-200 groups, which received 50, 100 and 200 mg/kg per day of Magliasa, respectively; the control group, which received vehicle water orally; the infliximab group, which received infliximab (5 mg/kg per day, subcutaneously); and the Dexa group, which received dexamethasone (1 mg/kg per day, orally). After completing the treatment period (2 wk), the rats were sacrificed, the colon was removed, its macroscopic and microscopic changes were recorded, and tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1b), total antioxidant capacity, myeloperoxidase (MPO), and lipid peroxidation (LPO) were assessed in colon ***: The mean value of total glucosinolates in one gram of Magliasa was 19 ± 1 μmol. The mean value of the total phenolic content was 293.8 ± 17.6 mg gallic acid equivalents per 100 gram of Magliasa. Macroscopic scores were significantly decreased in Mag-100 (1.80 ± 0.58, P = 0.019) and Mag-200 (1.20 ± 0.20, P = 0.001) compared to the control group (3.40 ± 0.24), although some inflammation and hyperemia were evident. Treatment of rats by dexamethasone (0.33 ± 0.21, P < 0.001) and infliximab (0.83 ± 0.31, P < 0.001) remarkably attenuated scores where mild hyperemia was observed macroscopically. In comparison to the control group (4.00 ± 0.32), only Mag-200 (1.60 ± 0.40) showed a significant decrease in colonic histopathological scores (P = 0.005). Minimal mucos

关键词： Magliasa Traditional Iranian medicine Colitis Neutrophil infiltration Inflammatory cytokines Oxidative stress

Surgical management of complicated hydatid cysts of the liver

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World Journal of Gastrointestinal Surgery 2010年第3期2卷 78-84页

作者： Ajaz A Malik shams UL Bari Ruquia amin Masooda Jan Department of Surgery Sheri Kashmir Institute of Medical Sciences SouraSrinagarKashmir 190006India Department of General Surgery Sheri Kashmir Institute of Medical SciencesMedical College BeminaSrinagarKashmir 190006India Department of Social and Preventive Medicine Sheri Kashmir Institute of Medical SciencesSrinagarKashmir 190006India Department of Social and Preventive Medicine Government Medical College SrinagarKashmir 190006India

AIM: To review the clinical presentation and surgical management of complicated hydatid cysts of the liver and to assess whether conservative surgery is adequate in the management of complicated hydatid cysts of ***:The study was carried out at Sher-i-Kashmir Institute of Medical Science,Srinagar,Kashmir,*** nine patients with hydatid disease of the liver were surgically managed from April 2004 to October 2005 with a follow up period of three *** included 27 men and 42 women with a median age of 35 *** abdominal ultrasound,computed tomography and serology established *** with jaundice and high suspicion of intrabiliary rupture were subjected to preoperative endoscopic retrograde *** with infection,rupture into the biliary tract and peritoneal cavity were categorized as complicated *** patients(26%)had complicated cysts and formed the basis for this ***:Common complications were infection(14%),intrabiliary rupture(9%)and intraperitoneal rupture(3%).All the patients with infected cysts presented with pain and *** the patients with intrabiliary rupture had jaundice,while only four with intrabiliary rupture had pain and only two had *** procedures performed in complicated cysts were:infection-omentoplasty in three and external drainage in seven;intrabiliary rupture-omentoplasty in two and internal drainage in four *** patients with intraperitoneal rupture underwent external *** was no *** postoperative morbidity was 50%in complicated cysts and 16%in uncomplicated ***:Complicated hydatid cyst of the liver can be successfully managed surgically with good long term results.

关键词： Liver hydatid disease Complicated liver hydatid Drainage Operative techniques

Role of dissolved oxygen reduction in improvement inhibition performance of ascorbic acid during copper corrosion in 0.50 mol/L sulphuric acid

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Chinese Chemical Letters 2010年第3期21卷 341-345页

作者： Mohammed A.amin Chemistry Department Faculty of ScienceAin Shams University

The kinetics of dissolved O_2 reduction and hydrogen evolution reactions on copper surface was studied in naturally aerated and air and O_2-saturated 0.50 mol/L H_2SO_4 solutions using polarization measurements combined with the rotating disc electrode (RDE).The Koutecky-Levich plot indicated that the dissolved O_2 reduction at the copper electrode was an apparent four-electron process.A correlation between the presence of dissolved O_2 and the formation of Cu_2O,confirmed from XRD,was discussed. Ascorbic a...

关键词： Copper Sulphuric acid solutions Corrosion inhibition Ascorbic acid RDE O_2 reduction

Effect of green tea consumption in treatment of mild to moderate depression in Iranian patients living with HIV: A double-blind randomized clinical trial

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Chinese Herbal Medicines 2021年第1期13卷 136-141页

作者： Dehghan Manshadi Seyed Ali Mousavi Seyed Alireza Salehi Mohammad Reza Zebardast Jayran SeyedAlinaghi SeyedAhmad Rezazade shams Ali Mirhoseinian Seyed Saeid Asadollahi-amin Ali Department of Infectious Diseases and Tropical Medicine Imam-Khomeini Hospital ComplexTehran University of Medical SciencesTehranTehran 11519Iran Department of Infectious Diseases and Tropical Medicine Shahid Sadoughi HospitalShahid Sadoughi University of Medical Sciences and Health ServicesYazd 11519Iran Cognitive Neuroscience Linguistics Institute for Cognitive Science Studies(ICSS)Tehran 11519Iran Iranian Research Center for HIV/AIDS Iranian Institute for Reduction of High-Risk BehaviorsTehran University of Medical SciencesTehran 11519Iran Medicinal Plants Research Center Institute of Medicinal PlantsACECRTehran 11519Iran Department of Pharmacognosy Faculty of Pharmacy.Tehran University of Medical Sciences.Tehran 11519Iran

Objective: Depression affects people living with HIV(PLWH) compliance leading to poor control *** observational studies showed an anti-depression effect of green tea extract(GTE). The therapeutic effect of GTE on depression were investigated in PLWH receiving antiretroviral therapy(ART).Methods: Fifty PLWH on ART with diagnose of mild to moderate of depression, participated in a doubleblind, placebo-controlled trial and underwent 12 weeks of treatment with either 400 mg GTE capsules or placebo twice daily. The Hamilton depression scale of patients was measured before, 6 weeks and 12 weeks after treatment in two groups. The primary outcome measure was performed to evaluate the efficacy of GTE in improving depressive ***: The mean of Hamilton score showed a significant difference between the two groups after 12 weeks(P = 0.035). Repeated measures ANOVA test showed a significant effect for time ? treatment interaction on the Hamilton mean score between the two groups(P = 0.000).Conclusion: It seems the use of GTE capsules in PLWH on ART is safe and could lead to greater and more rapid improvement in depressive symptoms than placebo. Thus it can be considered as an alternative therapy for mild to moderate depression. Further studies with higher sample size and longer followup and comparisons with other antidepressive drugs are warranted.

关键词： depression green tea HIV