Omid Ahmadi - Academia.edu (original) (raw)

Papers by Omid Ahmadi

Frontiers in Emergency Medicine

Objective: Acute kidney injury (AKI) is an independent risk factor in critically ill patients. Th... more Objective: Acute kidney injury (AKI) is an independent risk factor in critically ill patients. This study aimed to evaluate the prevalence of AKI in resuscitated cardiac arrest (CA) patients, its potential risk factors, and outcomes of AKI in cardiac arrest survivors. Methods: A hundred and forty-nine cases of post-CA patients that survived for at least 24 hours, admitted to three hospitals between 2016 and 2020, were studied. AKI was defined by the RIFLE (Risk, Injury, Failure, Loss, and End-stage) criteria. Baseline demographic data, resuscitation variables, the prevalence of AKI, in-hospital and six-month mortality were collected. Logistic regression evaluated the factors associated with AKI occurrence and mortality. Results: AKI occurred in 59 (39.6%) of the patients. Of these, 9 patients (15.3%) required renal replacement therapy (RRT) during their hospital stay. There were 47 (52.2%) in-hospital deaths in patients without AKI and 41 (69.5%) in patients with AKI (P=0.036). Post...

Journal of Research in Medical Sciences, 2021

Background: This study was performed to determine the sensitivity and specificity of ultrasound i... more Background: This study was performed to determine the sensitivity and specificity of ultrasound in the diagnosis of traumatic ankle injury in comparison with magnetic resonance imaging (MRI). Materials and Methods: This cross-sectional study was performed on 31 patients with soft-tissue injury or fracture, referring to the MRI imaging center of Alzahra and Kashani Hospitals in Isfahan from October 2018 to March 2019. After an MRI, an ultrasound of the affected ankle was performed for all patients. Sonography and MRI were performed by two radiologists who were blinded to the results of each other's reports. The sensitivity, specificity, positive predictive value, and negative predictive value of sonography were determined. Results: In this study, 31 patients with ankle trauma were studied. The mean age of the patients was 30.73 ± 10.15 years; 32.3% were male and 67.7% were female. The sensitivity of ultrasound relative to MRI to detect damage to the anterior talofibular ligament (ATFL), posterior talofibular ligament (PTFL), and calcaneofibular ligament (CFL) was 66.67%, 50%, and 100%, respectively, and the corresponding specificity was 92.86%, 93.10%, and 93.10%, respectively. According to Kappa test, the agreement between ultrasound and MRI methods for detecting injury to ATFL (κ = 0.51), PTFL (κ = 0.35), and CFL (κ= 0.63) was statistically significant (P < 0.05). Conclusion: Ultrasound is an appropriate modality for the diagnosis of injuries to CFL and ATFL and has shown acceptable results for PTFL. It could be used as an alternative in cases where access to MRI is not available.

مقدمه: ازدحام در بخش اورژانس به عنوان یکی از موانع اصلی در دریافت مراقبت های درمانی به شمار می رو... more مقدمه: ازدحام در بخش اورژانس به عنوان یکی از موانع اصلی در دریافت مراقبت های درمانی به شمار می رود و می تواند بازتابی از عدم تطابق عرضه و تقاضا در سیستم های بهداشتی درمانی باشد. مطالعه حاضر با هدف ارزیابی ارتباط كیفیت ثبت و انجام مراقبتهای پرستاری در بخش اورژانس با میزان ازدحام طراحی و انجام شده است. روش کار: پژوهش حاضر یك مطالعه مقطعی است که در سال 1391 در مرکز پزشکی آموزشی و درمانی الزهرا شهر اصفهان، ایران انجام گرفته است. جمع آوری اطلاعات توسط یک مشاهده گر آموزش دیده در تمام ساعات بستری بیمار با استفاده از چک لیست مراقبتی استاندارد تهیه شده از کتب پرستاری انجام گرفت. با توجه به آمار تعداد بیماران پذیرش شده به نسبت پرستاران، شیفتهای کم ازدحام و پر ازدحام تفکیک گردیده و نتایج حاصله در دو وضعیت مورد آنالیز آماری و مقایسه قرار گرفت. يافته ها: در مجموع پرونده 170 بیمار از نظر كیفیت ثبت و انجام مراقبت‌های پرستاری در زمان پرازدحام و کم ازدحام بررسی شد. طبق آنالیز آماری انجام گرفته کیفیت ثبت اقدامات پرستاری در زمان پر ازدحام در اورژانس کاهش یافته است (028/0=p). ولی کیفیت انجام مراقبتهای ...

Modern Applied Science, 2016

The goal of the present paper is to analyze the effect of personnel's education and psychological... more The goal of the present paper is to analyze the effect of personnel's education and psychological competence on quality of service. The mediation role of organizational competence in Ministry of the Interior is of descriptive-correlational method. To do that, the standard questionnaire psychological competence by Spriters (1995), personnel education and quality of service by Deher (2015) and organizational commitment by Alen and Mier (1990) were used. The statistical population of the research includes all personnel of Ministry of the Interior which are 1600 subjects. Based on Cochran's formula, 3100 subjects were selected randomly. In order to analyze data the Pearson's correlation test and structural equation of data analysis were used by SPSS and AMOS software. The findings of the research indicate that personnel's education has a positive effect on organizational competence and quality of service (with Alpha level of 0.05). Moreover, the psychological competence is positively affect the quality of service (with Alpha level of 0.05) and organizational commitment affect the quality of service. Finally, it was revealed that the personnel training through organizational commitment affect the quality of service. But, psychological competence does not affect the quality of service through organizational commitment. Moreover, psychological competence does not affect the organizational commitment. The significance levelof the model turned out to be more than the first type error (0.05). This shows that the significant adaption of the estimated model with the present research model. Furthermore, the AGFI and GFI indicators are more than the estimated value (0.9). These indicators show that the model has a capability in estimating the ratio of each factor.

Archives of Academic Emergency Medicine, 2021

Introduction: In recent years, several scoring systems have been developed to assess the severity... more Introduction: In recent years, several scoring systems have been developed to assess the severity of trauma and predict the outcome of trauma patients. This study aimed to compare Rapid Emergency Medicine Score (REMS), Modified Early Warning Score (MEWS), Injury Severity Score (ISS), and Glasgow Coma Scale (GCS) in predicting the in-hospital mortality of trauma patients. Methods: This diagnostic accuracy study was done on adult patients admitted to the emergency department (ED) between June 21, 2019, and September 21, 2020, following multiple trauma. Patients were followed as long as they were hospitalized. The REMS, MEWS, GCS, and ISS were calculated after data gathering and comprehensive assessment of injuries. Receiver operating characteristics (ROC) analysis was performed to examine the prognostic performance of the four different tools. Results: Of the 754 patients, 32 patients (4.2%) died and 722 (95.8%) survived after 24 hours of admission. The mean age of the patients was 38...

Journal of Research in Medical Sciences : The Official Journal of Isfahan University of Medical Sciences, 2021

The confirmed and suspected cases of the 2019 novel coronavirus disease (COVID-19) have increased... more The confirmed and suspected cases of the 2019 novel coronavirus disease (COVID-19) have increased in the entire world. There is still no vaccine or definitive treatment for this virus due to its unknown pathogenesis and proliferation pathways. Optimized supportive care remains the main therapy, and the clinical efficacy for the subsequent agents is still under investigation. Enormous demand for handling the COVID-19 outbreak challenged both the health-care personnel and medical supply system. As outbreaks of COVID-19 develop, prehospital workers, emergency medical services personnel, and other emergency responders are potentially asked to follow specific practice guidelines to mitigate the effects of an escalating pandemic. In this article, we have summarized the current guidance on potential COVID-19 management options. The recent experience with COVID-19 provided lessons on strategy and policymaking that the government and ministry of health should be on the alert and concentrate ...

Ultrasound in the diagnosis of distal radial growth plate injuries in children who have normal ra... more Ultrasound in the diagnosis of distal radial growth plate injuries in children who have normal radiographic studies , Ultrasound in the diagnosis of distal radial growth plate injuries in children who have normal radio... , کتابخانه دیجیتال دانشگاه علوم پزشکی اصفهان

The Ultrasound Journal, 2022

Background In recent years, musculoskeletal ultrasound has increasingly become the common method ... more Background In recent years, musculoskeletal ultrasound has increasingly become the common method for diagnosis for many medical specialties. Therefore, the present study was performed to evaluate the diagnostic value of point-of-care ultrasonography (POCUS) as a primary triage tool in the diagnosis of the acute medial meniscus injury of the knee. Materials and methods The present cross-sectional study was performed on patients with a suspected medial meniscus injury of the knee in the emergency department (ED). After history taking and primary physical examination, radiographic imaging of the knee was done. If there was no fracture in the knee X-ray, the POCUS examination on the knee was carried out. All the patients were asked to refer to an orthopedic clinic 2 weeks after discharge from ED for the Magnetic Resonance Imaging (MRI) evaluation. Finally, the POCUS findings were compared with the MRI findings in diagnosing medial meniscus injury. Results Fifty-five patients with a mean...

Emergency, 2015

Introduction: Nausea and vomiting are the most common complications after minor head trauma that ... more Introduction: Nausea and vomiting are the most common complications after minor head trauma that increases the risk of intracranial pressure rising. Therefore, the present study was aimed to compare the antiemetic effects of metoclopramide and ondansetron in the treatment of post-traumatic nausea and vomiting. Methods: The study was a controlled, randomized, double blind clinical trial, which was conducted in the first 6 months of 2014 in emergency department Al-Zahra and Kashani Hospitals in Isfahan, Iran. The patients with minor head trauma associated with nausea and vomiting were randomly divided into 2 groups: treatment with metoclopramide (10mg/2ml, slow injection) and treatment with ondansetron (4mg/2ml, slow injection). The comparison between the 2 groups was done regarding antiemetic efficacy and side effects using SPSS 21 statistical software. Results: 120 patients with minor head trauma were distributed and studied into two groups of 60 patients (mean age 35.6±14.1 years; ...

Emergency, 2014

Introduction: The increasing use of diagnostic imaging in pediatric medicine has resulted in grow... more Introduction: The increasing use of diagnostic imaging in pediatric medicine has resulted in growing need for procedural sedation and analgesia (PSA) to minimize motion artifacts during procedures. The drug of choice in pediatric PSA was not introduced until now. The aim of the present study was comparison of oral chloral hydrate (OCH) and rectal sodium thiopental (RST) in pediatric PSA. Methods: In the present randomized clinical trial, 2-6 years old pediatrics who referred for performing brain computed tomography scan was enrolled and were randomly divided in to two groups. OCH (50mg/kg) and RST (25mg/kg) were prescribed and a trained nurse recorded the time from drug prescription to receiving the conscious sedation (onset of action), the total period which the patient has the Ramsay score≥4 (duration of action), and adverse effect of agents. Mann-Whitney U test and chi-squared test, and Non-parametric analysis of covariance (ANCOVA) were used for comparisons. Results: One hundred...

Advanced biomedical research, 2018

The present study was designed to evaluate the effectiveness of magnesium sulfate (MgSO) in proce... more The present study was designed to evaluate the effectiveness of magnesium sulfate (MgSO) in procedural sedation and analgesia (PSA) when combined with ketamine in patients with fractures in emergency departments and required short and painful emergency procedures. In this study, 100 patients with fractures and dislocations who were presented to the emergency departments and required PSA for short and painful emergency procedures were randomly allocated to groups of ketamine plus MgSO or ketamine alone. Train of four (TOF) stimulation pattern was assessed using nerve stimulator machine and compared between groups. The mean age of studied patients was 46.9 ± 9.3 years old. 48% were male and 52% were female. No significant differences were noted between groups in demographic variables. The status of TOF, 2 min after the injection of ketamine (1.5 mg/kg), in both groups was similar. After the injection of the second dose of ketamine (1 mg/kg) the status of TOF in four patients in ketami...

Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 2018

Renal colic is a painful medical emergency, needs urgent intervention to reduce pain. Nonsteroida... more Renal colic is a painful medical emergency, needs urgent intervention to reduce pain. Nonsteroidal anti-inflammatory drugs, opioids, and entonox are pain-relieving agents. This study was aimed to compare fentanyl + entonox (nitrous oxide + O) versus fentanyl + oxygen. One hundred and twenty patients with acute renal colic presenting to the emergency department were enrolled. First, 50 μg fentanyl was infused for all patients. Then, patients divided into two groups receiving masks of entonox and oxygen, respectively. Quantitative measurement of pain was performed by visual analog scale, before the intervention, after 3, 5, 10, and 30 min of that. If the pain was not relieved after 30 min, 50 μg fentanyl was infused. If the pain was still continued, ketorolac and ketamine were used. Hospitalization duration and severity of pain at specified times were compared between patients in two groups. The mean (standard deviation) time of hospitalization was 211 (59) and 236 (61) min in fentany...

Advanced Biomedical Research, 2017

Background: According to the lack of adequate studies on comparing the analgesic effect and compl... more Background: According to the lack of adequate studies on comparing the analgesic effect and complications of ketorolac with morphine in long bone fractures, this study aimed to compare the efficacy of ketorolac with morphine in patients referring to the Emergency Department with long bones damage and fracture. Materials and Methods: In this clinical trial study, 88 patients with long bone fracture were selected randomly and divided into two groups. To scale the intensity of pain, visual analog scale (VAS) were used. Intravenous ketorolac and morphine with the loading dose of 10 mg and 5 mg, respectively was administered to a group, followed by 5 mg and 2.5 mg every 5-20 min, if necessary (VAS *4). The pain scores before injection and at 5 min, half an hour and 1-h after the injection were measured and recorded for all patients. Results: The mean age of the ketorolac and morphine groups was 29.1 ± 12.5 and 33.2 ± 11.4, respectively. In the groups, there was 63.6% and 70.5% of male patients respectively. The mean ± SD of pain score before the injection was 7.59 ± 1 and 7.93 ± 1.09 (P = 0.13). One hour after the injection, the mean ± SD of pain in the both groups was 1.41 ± 0.9 and 1.61 ± 1.17 and the mean pain score has no significant difference in the two groups before the injection. Repeated measures ANOVA test also showed that the trend of changes in pain score had no significant difference in both groups (P = 0.08). Conclusion: According to the fewer side effects of ketorolac and effective pain release versus morphine, ketorolac could be suggested to use.

Journal of Research in Medical Sciences, 2015

acceptable agents for sedation of such patients since many years ago. [5,6] However, each of them... more acceptable agents for sedation of such patients since many years ago. [5,6] However, each of them has some special side effects and because of long half-life, they require long-term following. It causes that studies during recent 10 years have been more focused on alternative medicines such as second-generation anti-psychotic drugs and benzodiazepines. [7,8] Although new guidelines recommend second-generation anti-psychotic drugs as the first-line therapy, they are not accessible in many therapeutic centers. In addition, some of these drugs only have oral form which limits their use in restless patients. [6] Midazolam, a solvent benzodiazepine Background: Restless and violent behaviors are common in Emergency Departments (EDs), which need therapeutic interventions in most of the times. The first-generation anti-psychotic drugs are one of the most applicable therapeutic agents in the management of such patients, but their use has some limitations. Some studies suggest midazolam as an alternative medicine. Therefore, this study was performed with the aim of comparison of the efficacy and safety of haloperidol and midazolam in the restless management of referring patients to EDs. Materials and Methods: The present double-blinded trial was done on patients needed sedation and referred to the ED of Alzahra Hospital, Isfahan, Iran, in 2014. The patients were categorized into two random groups of haloperidol (5 mg) and midazolam receivers (2.5 mg for those weighing <50 kg and 5 mg in >50 kg), as intramuscular administration. The time to achieve sedation, need for rescue dose, need to resedation within the first 60 min, and adverse effects of drugs were compared among the groups. Results: Forty-eight patients were entered to the study. The mean age in the haloperidol and midazolam groups was 44.8 ± 4.1 years and 45.5 ± 4.7 years, respectively (P = 0.91). The mean time of sedation in the haloperidol and midazolam groups was 5.6 ± 0.3 min and 5.2 ± 0.1 min, respectively (P = 0.31). The mean time of full consciousness after sedation was 36.2 ± 4.5 min and 38.2 ± 3.4 min in the haloperidol and midazolam groups, respectively (P = 0.72). On average, time to arousal in the midazolam group was 10.33 min more than the haloperidol group, but it was not statistically significant. Conclusion: The results of the present study show that administration of midazolam and haloperidol have similar efficacy in the treatment of restless symptoms with the same recovery time from drug effects for referring patients to the ED. In addition, none of the adverse effects were observed in this study.

$Research paper thumbnail of Comparing low-dose intravenous ketamine-midazolam with intravenous morphine with respect to pain control in patients with closed limb fracture$

Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 2014

We assessed the effects of low-dose IV ketamine-midazolam versus morphine on pain control in pati... more We assessed the effects of low-dose IV ketamine-midazolam versus morphine on pain control in patients with closed limb fracture(s); and also compared the incidence of adverse events (cardio-pulmonary) between two groups. This prospective, single-blind, non-inferiority trial randomized consecutive emergency department (ED) patients aged 18-60 years to two groups: Receiving 300-500 mcg/kg ketamine plus 0.03 mg/kg midazolam, or 0.05-0.1 mg/kg morphine. Visual analogue score (VAS) and adverse events were verified during an interval of 30 minutes. Two hundred and thirty - six patients were selected, among whom 207 were males (87.3%). The average age was 29 ± 2, (range, 18-60 years). The VAS score at T30 (i.e., 30 minutes after initial analgesic dose) was significantly decreased compared with VAS score at T0, in both groups. No statistically significant difference, however, was observed between the two groups (-6.1 ± 1.1 versus -6.2 ± 1.0; P = 0.16). With regard to systolic blood pressure...

Advanced Biomedical Research, 2014

Background: This study was conducted to determine the effect of nurses' workplace on burnout synd... more Background: This study was conducted to determine the effect of nurses' workplace on burnout syndrome among nurses working in Isfahan's Alzahra Hospital as a reference and typical university affiliated hospital, in 2010. Materials and Methods: In this cross-sectional study, 100 nurses were randomly selected among those working in emergency, orthopedic, dialysis wards and intensive care unit (ICU). Required data on determination of occupational burnout rate among the nurses of these wards were collected using Maslach Burnout Inventory (MBI) standard and validated questionnaire. Nurses were selected using simple random sampling. Results: The multivariate ANOVA analysis showed that occupational burnout mean values of nurses working in orthopedic and dialysis wards were significantly less than those of nurses working in emergency ward and ICU (P = 0.01). There was also no significant difference between occupational burnout mean values of nurses working in emergency ward and ICU (P > 0.05). t-test showed that there was a difference between occupational burnout values of men and women, as these values for women were higher than those of men (P = 0.001). Conclusion: Results showed that occupational burnout mean values of nurses working in emergency ward and ICU were significantly more than those of nurses working in orthopedic and dialysis wards.

The American Journal of Emergency Medicine, 2012

The present study aims to assess the influence of ultra-low doses of opioid antagonists on the an... more The present study aims to assess the influence of ultra-low doses of opioid antagonists on the analgesic properties of opioids and their side effects. Methods: In the present randomized, double-blind controlled trial, the influence of the combination of ultra-low-dose naltrexone and morphine on the total opioid requirement and the frequency of the subsequent side effects was compared with that of morphine alone (added with placebo) in patients with trauma in the upper or lower extremities. Results: Although the morphine and naltrexone group required 0.04 mg more opioids during the study period, there was no significant difference between the opioid requirements of the 2 groups. Nausea was less frequently reported in patients receiving morphine and naltrexone. Conclusion: The combination of ultra-low-dose naltrexone and morphine in extremity trauma does not affect the opioid requirements; it, however, lowers the risk of nausea.

Frontiers in Emergency Medicine, 2021

Objective: Healthcare workers (HCWs) are among the highest groups impacted by the COVID-19 pandem... more Objective: Healthcare workers (HCWs) are among the highest groups impacted by the COVID-19 pandemic. This study aimed to analyze professional quality of life (ProQOL) and its association with emotional well-being in HCWs during the pandemic. Methods: This cross-sectional study was conducted on HCWs being in close contact with COVID-19 patients in Iran. The questionnaires assessing ProQOL, emotional well-being, and demographic and occupational characteristics were recruited via email or social media. The ProQOL was used to measure compassion fatigue (CF), burnout (BO) and compassion satisfaction (CS). Results: Among the respondents, 705 HCWs were enrolled, including a higher proportion of physicians 449 (63.7%), females 452 (64.1%), and married 486 (68.9%). The mean of participants’ work experience was 8.41 ± 8.91 years. Almost all of HCWs showed moderate to high levels of CS (98.3%). Also, most of HCWs showed a moderate level of CF (96.3%), and the majority of them (76.6%) had a mod...

Emergency (Tehran, Iran), 2015

Nausea and vomiting are the most common complications after minor head trauma that increases the ... more Nausea and vomiting are the most common complications after minor head trauma that increases the risk of intracranial pressure rising. Therefore, the present study was aimed to compare the antiemetic effects of metoclopramide and ondansetron in the treatment of post-traumatic nausea and vomiting. The study was a controlled, randomized, double blind clinical trial, which was conducted in the first 6 months of 2014 in emergency department Al-Zahra and Kashani Hospitals in Isfahan, Iran. The patients with minor head trauma associated with nausea and vomiting were randomly divided into 2 groups: treatment with metoclopramide (10mg/2ml, slow injection) and treatment with ondansetron (4mg/2ml, slow injection). The comparison between the 2 groups was done regarding antiemetic efficacy and side effects using SPSS 21 statistical software. 120 patients with minor head trauma were distributed and studied into two groups of 60 patients (mean age 35.6±14.1 years; 50.0% male). Administration of b...