Majid Shojaee | Shahid Beheshti university of Medical siencses (original) (raw)

Papers by Majid Shojaee

DOAJ (DOAJ: Directory of Open Access Journals), Dec 1, 2018

Frontiers in emergency medicine, Feb 14, 2022

Objective: As nausea is one of the most common annoying symptoms in isolated head trauma (IHT) an... more Objective: As nausea is one of the most common annoying symptoms in isolated head trauma (IHT) and needs timely management to prevent further adverse outcomes, this study was performed to compare ondansetron and metoclopramide as therapeutic agents in nauseous IHT. Methods: This study was a double-blind clinical trial. Participants were patients visiting the ED with the chief complaint of nauseous IHT event. Group A received 10mg/2ml of metoclopramide and group B 4mg/2ml of ondansetron through slow intravenous (IV) injection. The primary outcome was the severity of nausea 20 minutes after the intervention based on the visual analogue scale (VAS) score. Results: A total of 130 patients participated in the study (65 in each group). The mean age was 30.5±20.5 years, and 73.1% of the participants were male. The decrease in the mean nausea severity scores was statistically significant in both group A (78.3±9.7 before vs. 29.8±16.8 mm after the intervention; P < 0.001) and group B (78.5±11.1 vs. 27.8±13.9 mm; P < 0.001). There was no significant difference between the mean nausea severity scores of groups A and B before the intervention (P = 0.93) or after it (P = 0.65). The decrease in the severity score of nausea was 48.5 mm in group A and 50.6 mm in group B, with no significant difference between the two groups (P = 0.63). Conclusion: Both Ondansetron and metoclopramide significantly reduced the severity of nausea in patients with mild IHT visiting ED but no treatment arm was superior. Both drugs showed good safety profiles.

مجله طب اورژانس ایران, Jul 1, 2015

Iranian journal of emergency medicine, Feb 9, 2016

INTRODUCTION: Considering its high prevalence and cost as well as frequent complications, trauma ... more INTRODUCTION: Considering its high prevalence and cost as well as frequent complications, trauma is one of the major health problems in Iran. Knowing the epidemiologic characteristics of these patients could be helpful in arrangement for decreasing the burden of disease. This study was aimed to evaluate the epidemiology of upper extremity trauma among patients visiting trauma unit of emergency department (ED). METHODS: The present cross-sectional study was done using census method on all patients with upper extremity trauma visiting the ED of Imam Hossein Hospital, Tehran, Iran in 2012. Required data were gathered using a checklist consisting of questions regarding demographic data (age, sex), trauma mechanism, time of trauma, type of trauma, and therapeutic measures taken. Gathered data were statistically analyzed via SPSS version 19.0. RESULTS: 751 patients with the mean age of 27 ± 7.6 years were evaluated. 616 (82%) patients were male and the highest frequency belonged to the age range of 20 - 30 years with 248 (33%) cases. 339 (45.1%) accidents had occurred between 8 AM and 4 PM. Injury caused by motorcycle accidents was the most common mechanism of trauma among those evaluated with 185 (24.6%) cases. 575 (76.6%) cases had an isolated extremity trauma and 176 (23.4%) had multiple trauma that included extremity trauma. The most prevalent injuries that needed surgical intervention were distal radius fracture with 143 (34%) cases, soft tissue injury with 75 (17.8%) cases, and isolated ulna fracture with 46 (10.9%) cases. CONCLUSION: Based on the results of this study, the most common cases of upper extremity trauma occurred in men, age range of 20 - 30 years, spring, and between 8 AM and 4 PM. The most common trauma mechanism was motorcycle accident and distal radius fracture was the most prevalent injury that needed surgical intervention. Language: en

Bangladesh Journal of Pharmacology, Apr 3, 2017

The present study was a double-blind clinical trial to compare the efficiency of hysocine and dia... more The present study was a double-blind clinical trial to compare the efficiency of hysocine and diazepam in vertigo treatment. Eligible patients (n=69) were randomly divided into 2 groups of 5 mg hyoscine and 10 mg diazepam. Severity of vertigo was measured in supine and sitting position, and while turning the head. Vertigo severity was assessed before, and 1 and 2 hours after administration of the drug. Treatment success rate of diazepam in relieving vertigo in different positions varied between 88.9 and 100%, while this rate was 31.2-73.5% in hyoscine treatment group (p<0.01). Prescription of diazepam led to complete relief of vertigo in 40-63% of the patients, while this rate was only 2.6-12.5% in hyoscine treatment group (p<0.001). It is likely that diazepam is a better option than hyoscine for management of true vertigo in patients presenting to the emergency department.

کتواسیدوز دیابتی و سندرم هیپراسمولار هیپرگلیسمیک دو عارضه متابولیکی حاد دیابت ملیتوس کنترل نشده ه... more کتواسیدوز دیابتی و سندرم هیپراسمولار هیپرگلیسمیک دو عارضه متابولیکی حاد دیابت ملیتوس کنترل نشده هستند. کتواسیدوز دیابتی اغلب در بيماران ديابتي نوع 1و سندرم هیپراسمولار هیپرگلیسمیک بیشتر در بيماران ديابتي نوع 2 رخ مي دهد. هیپرگلیسمی، اسیدوز متابولیک و دهیدراسیون نشانه های بالینی بارز کتواسیدوز دیابتی می باشند و در مقابل ویژگی های سندرم هیپراسمولار هیپرگلیسمیک شامل هیپرگلیسمی و دهیدراسیون شدید بدون وجود اسیدوز و اختلالات سطح هوشیاری از خواب آلودگی تا گیجی و تشنج وکوما است. اصلاح دهیدراسیون، کاهش گلوکز خون و برقراری هموستازی الکترولیت ها اصول اساسی درمان هر دو وضعیت می باشند. در مرور حاضر تصمیم بر ارائه تصویری جامع از پاتوفیزیولوژی، تظاهرات کلینیکی، تشخیص و درمان این دو عارضه مهم می باشد.Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS) are 2 acute metabolic crisis of uncontrolled diabetes mellitus. DKA usually occurs in patients with type 1 diabetes and HHS is seen mostly in those with type 2. In DKA, hyperglycemia, metabolic acidosis, and dehydration are the m...

Supplemental material, sj-pdf-1-acr-10.1177_0284185116663045 for Ultrasonography of inferior vena... more Supplemental material, sj-pdf-1-acr-10.1177_0284185116663045 for Ultrasonography of inferior vena cava to determine central venous pressure: a meta-analysis and meta-regression by Mostafa Alavi-Moghaddam, Ali Kabir, Majid Shojaee, Mohammad Manouchehrifar and Mehrdad Moghimi in Acta Radiologica

Frontiers in Emergency Medicine, 2022

Introduction: Quality of life (QOL) of emergency medicine specialists can be effective in provid... more Introduction: Quality of life (QOL) of emergency medicine specialists can be effective in providing services to patients. The aim of the present study was evaluating the lifestyle of emergency medicine practitioners, understanding their problems, and addressing the solutions to enhance and improve their lifestyles, in teaching hospitals in Iran. Method: This descriptive cross-sectional study was conducted on emergency medicine physicians in 10 teaching hospitals of Iran in 2011. Emergency physicians with at least three years of experience who interested in the study, were enrolled in the project. All participants filled out the consent form and QOL questionnaires, then underwent physical examinations and some medical laboratory tests. Categorical variables were reported as percentages, while continuous variables expressed as means and standard deviations. p <0.05 was considered statistically significant. Results: Totally, 100 subjects participated in the study, of whom 48 we...

Iranian journal of emergency medicine, 2015

Introduction: Currently, there is a lack of data on the agreement between the continuous medical ... more Introduction: Currently, there is a lack of data on the agreement between the continuous medical education (CME) programs and the necessary training topics in the field of emergency medicine in Iran. The present study aimed to evaluate the mentioned agreement in CME programs held during 2010-2014, all over the country. Methods: In the present cross-sectional study, the data recorded regarding emergency medicine-related CME programs were extracted from continuous training database of the Ministry of Health. Then, 30 items from the most important topics taught in emergency medicine training were selected by 3 emergency medicine specialists. Subsequently, the agreement of the selected training topics and CME programs was evaluated regarding duration of training, annual changes, and efficiency. Results: During 2010-2014, a total of 10147 hours of CME programs were held in relation to emergency medicine topics in Iran, which were most frequently (1015 hours) related to surgical emergenci...

Introduction: Pain is one of the most common complaints of patients referred to emergency departm... more Introduction: Pain is one of the most common complaints of patients referred to emergency department (ED) and its control is one of the most important responsibilities of the physicians. The present study was designed, aiming to compare the efficiency of intranasal sufentanil and intravenous (IV) morphine sulfate in controlling extremity trauma patients' pain in ED. Methods: In the present clinical trial, extremity trauma cases referred to the ED of Imam Hossein Hospital, Tehran, Iran, from October 2014 to March 2015 were randomly divided into 2 groups treated with intranasal sufentanil (0.3 µg/kg) and IV morphine sulfate (0.1 mg/kg) single-doses. Demographic data and information regarding the quality of pain control such as pain severity before intervention and 15, 30, and 60 minutes after intervention, and probable side effects were gathered using a checklist and compared between the 2 groups. Results: 88 patients with the mean age of 35.5 ± 14.8 years were included in the stu...

DOAJ (DOAJ: Directory of Open Access Journals), Jul 1, 2015

Acalculous cholecystitis, is a rare disease with a high morbidity and mortality, which is develop... more Acalculous cholecystitis, is a rare disease with a high morbidity and mortality, which is developed due to various reasons, including trauma and burn. Its diagnosis is based on clinical suspicion and physical examination. Ultrasonography and computed tomography scan can help in this regard. This report presents a case of post-traumatic acalculous cholecystitis in a 75-year-old patient expressing its method of diagnosis, treatment and outcome.

Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS) are 2 acute metabolic c... more Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic syndrome (HHS) are 2 acute metabolic crisis of uncontrolled diabetes mellitus. DKA usually occurs in patients with type 1 diabetes and HHS is seen mostly in those with type 2. In DKA, hyperglycemia, metabolic acidosis, and dehydration are the most prominent clinical symptoms and HHS is identified by hyperglycemia, severe dehydration without acidosis, and alterations in level of consciousness from sleepiness to confusion, seizure and coma. Treatment for both conditions is based on correction of dehydration and hyperglycemia, and establishing homeostasis of electrolytes. In the present review, we decided to present a comprehensive picture of the pathology and clinical manifestations, diagnosis and treatment of these 2 important conditions.

Advanced Journal of Emergency Medicine, 2017

Introduction: Troponin test is one of the methods for diagnosing acute coronary syndrome, but the... more Introduction: Troponin test is one of the methods for diagnosing acute coronary syndrome, but the overuse and misuse of this test has increased the costs imposed on the health system and the patients. Objective: The present study was conducted to investigate the veracity of troponin test requests for patients presenting to an emergency department with chest pain and examine the effectiveness of training emergency medicine assistants in reducing unnecessary and inappropriate requests in emergency departments. Methods: This clinical audit was conducted in the emergency department of Imam Hossein Hospital, Tehran, Iran, in 2014. Sampling was carried out using the census method and all the cases presenting to the emergency department for whom a troponin test was requested by the emergency medical assistants were included in the research. First, the veracity of the current troponin test requests was assessed; then, training was given to the personnel, and the veracity of the troponin tes...

Journal of Military Medicine, 2019

Background and Aim: Daily care in emergency department may lead to diagnosis of serious condition... more Background and Aim: Daily care in emergency department may lead to diagnosis of serious conditions in patients. A simple and accessible method for daily care of such patients may be beneficial for their diagnosis. The aim of this study was to investigate the effect of ultrasonography on the daily care of patients undergoing mechanical ventilation in the emergency department. Methods: In this cross-sectional study, 57 adult patients under mechanical ventilation in the emergency department of Imam Hossein Hospital, Tehran, Iran were selected for study. Patient demographic and clinical data were recorded in the checklist. The findings of daily sonography were compared with routine care in patients under mechanical ventilation in the emergency department. Results: The mean age of the 57 adult patients included in this study was 65.2±5.5 years. A total of 32 (56.1%) patients were male and 25 (43.9%) were female. The average length of stay was 3.47±1.1 days. The use of ultrasound in daily...

Nigerian Medical Journal, 2015

Background: Rapid and proper diagnosis of sepsis is one of the daily challenges of emergency depa... more Background: Rapid and proper diagnosis of sepsis is one of the daily challenges of emergency department (ED) and intensive care units. The general aim of the present study was to determine the efficacy of measuring procalcitonin levels in the early diagnosis of bacterial resistance to antibiotics administered empirically in patients with sepsis. Materials and Methods: The present cross-sectional study consisted of patients with clinical evidence of sepsis or systemic inflammatory response syndrome (SIRS), referring to the ED of a third-level hospital in Tehran, Iran in 2012. After collection of basic and clinical data of patients, venous blood samples were taken for routine laboratory tests and determination of procalcitonin serum levels at baseline and 6 and 24 hours after administration of the first dose of an empirical antibiotic. The subjects were divided into two groups of discharged and expired and then comparisons were made using t-test, Chi-squared test and Fisher's test. Specificity and sensitivity of procalcitonin were evaluated along with ROC curve. Results: In the present study, 170 patients with sepsis were included. Evaluation of serum levels of procalcitonin 24 hours after administration of antibiotics exhibited the best sensitivity and specificity for each patient's response to antibiotics. Use of the cutoff point of 6.5 mg/mL for procalcitonin can predict the disease outcome with sensitivity and specificity of 67% and 80%, respectively. Conclusion: It is suggested that procalcitonin be used for the diagnosis of sepsis or SIRS resulting from an infectious disease, for follow-up of treatment and for evaluation of response to treatment.

Turkish Journal of Trauma and Emergency Surgery, 2014

BACKGROUND: The Alvarado score is utilized to determine the likelihood of appendicitis based on c... more BACKGROUND: The Alvarado score is utilized to determine the likelihood of appendicitis based on clinical signs, symptoms, and laboratory results. The goal of this study was to determine whether Alvarado scores can be used to aid in the accurate diagnosis of appendicitis. METHODS: Alvarado score evaluations were performed on 300 patients that were referred to or presented to the emergency room with acute abdominal pain. RESULTS: Out of the 300 patients, 85.66% had Alvarado scores of 7 or less and 14.33% had Alvarado scores greater than 7. For patients that had confirmed appendicitis, 25.7% had Alvarado scores of 7 or less, whereas 93% had Alvarado scores greater than 7. The Alvarado scoring system had poor sensitivity at 37%, and the specificity of this scoring system was high at 95%. CONCLUSION: Our findings suggest that patients presenting with abdominal pain and Alvarado scores greater than 7 are more likely to have appendicitis. As such, the Alvarado scoring system may be utilized to better predict whether a patient has appendicitis. An Alvarado score that is positive for appendicitis would consist of a score greater than 7, which suggests that the patient has a 93% chance of having appendicitis. A negative Alvarado score is 7 or lower, suggesting a 26% probability of having appendicitis. In all, the Alvarado scoring system is a good rule-in test, but it does not adequately rule-out appendicitis.

Trauma Monthly, 2013

Background: Many patients are brought to crowded emergency departments (ED) of hospitals every da... more Background: Many patients are brought to crowded emergency departments (ED) of hospitals every day for evaluation of head injuries, headaches, neurologic deficits etc. CT scan of the head is the most common diagnostic measure used to search for pathologies. In many EDs the initial interpretation of images are performed by emergency physicians (EP). Since most decisions are made based on the initial interpretation of the images by emergency physicians and not the radiologists, it is necessary to assess the accuracy of interpretations made by the former group. Objectives: The objective of this study was to compare the findings reported in the interpretation of head CTs by emergency physicians and compare to radiologists (the gold standard). Materials and Methods: This was a prospective cross sectional study conducted from March to May 2009 in a teaching hospital in Tehran, Iran. All non-contrast head CTs obtained during the study period were copied on DVDs and sent separately to a radiologist, 6 emergency medicine (EM) attending physicians and 14 senior EM residents for interpretation. Clinical information pertaining to each patient was also sent with each CT. The radiologist's interpretation was considered as the gold standard and reference for comparison. Data from EM physicians and residents were compared with the reference as well as with each other and statistical analysis was performed using SPSS 18.5. Results: Out of 544 CT scans, EM physicians had 35 false negatives and 53 false positives compared with radiologist's interpretations (P < 0.0001). EM residents had 74 false negatives and 12 false positives compared with radiologist's interpretations (P < 0.0001). Conclusions: Both EPs and ER residents either missed or falsely called a significant number of pathologies in their interpretations. The interpretations of EPs and ER residents were more sensitive and more specific, respectively. These findings revealed the need for increased training time in head CT reading for residents and the necessity of attending continuing medical education workshops for emergency physicians.

Introduction: The present study aimed to evaluate the rate of positive cases in measurement of s... more Introduction: The present study aimed to evaluate the rate of positive cases in measurement of serum troponin level in patients presenting to emergency department (ED) with complaint of chest pain who were dispositioned to coronary care unit (CCU) due to probable acute coronary syndrome. Methods: This cross-sectional study was carried out between September 2014 and September 2015 in ED and CCU of Shahid Modarres Hospital, Tehran, Iran. Using the archives, profiles of patients dispositioned from ED to CCU with diagnosis of acute coronary syndrome were evaluated. No age or sex limitation was imposed in this study. Data were extracted from the profiles and were recorded using a checklist consisting of points considered in history taking and results of troponin tests. Troponin tests were taken on admission, and 3, 6, 12, 18, 24, 36, 48, and 72 hours after that. A serum troponin level higher than 0.6µg/dL was considered positive. Results: 384 patients with the mean age of 62.34 ± 12...

Introduction: Considering its high prevalence and cost as well as frequent complications, trauma... more Introduction: Considering its high prevalence and cost as well as frequent complications, trauma is one of the major health problems in Iran. Knowing the epidemiologic characteristics of these patients could be helpful in arrangement for decreasing the burden of disease. This study was aimed to evaluate the epidemiology of upper extremity trauma among patients visiting trauma unit of emergency department (ED). Methods: The present cross-sectional study was done using census method on all patients with upper extremity trauma visiting the ED of Imam Hossein Hospital, Tehran, Iran in 2012. Required data were gathered using a checklist consisting of questions regarding demographic data (age, sex), trauma mechanism, time of trauma, type of trauma, and therapeutic measures taken. Gathered data were statistically analyzed via SPSS version 19.0. Results: 751 patients with the mean age of 27 ± 7.6 years were evaluated. 616 (82%) patients were male and the highest frequency belonged to t...