Management of Violence and Aggression in Emergency Environment; a Narrative Review of 200 Related Articles

Context: The aim of this study is to reviewing various approaches for dealing with agitated patients in emergency department (ED) including of chemical and physical restraint methods. Evidence acquisition: This review was conducted by searching “Violence,” “Aggression,” and “workplace violence” keywords in these databases: PubMed, Scopus, EmBase, ScienceDirect, Cochrane Database, and Google Scholar. In addition to using keywords for finding the papers, the related article capability was used to find more papers. From the found papers, published papers from 2005 to 2018 were chosen to enter the paper pool for further review. Results: Ultimately, 200 papers were used in this paper to conduct a comprehensive review regarding violence management in ED. The results were categorized as prevention, verbal methods, pharmacological interventions and physical restraint. Conclusion: In this study various methods of chemical and physical restraint methods were reviewed so an emergency medicine physician be aware of various available choices in different clinical situations for agitated patients

Pain Management in the Emergency Department: a Review Article on Options and Methods

Context: The aim of this review is to recognizing different methods of analgesia for emergency medicine physicians (EMPs) allows them to have various pain relief methods to reduce pain and to be able to use it according to the patient’s condition and to improve the quality of their services. Evidence acquisition: In this review article, the search engines and scientific databases of Google Scholar, Science Direct, PubMed, Medline, Scopus, and Cochrane for emergency pain management methods were reviewed. Among the findings, high quality articles were eventually selected from 2000 to 2018, and after reviewing them, we have conducted a comprehensive comparison of the usual methods of pain control in the emergency department (ED).  Results: For better understanding, the results are reported in to separate subheadings including “Parenteral agents” and “Regional blocks”. Non-opioids analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen are commonly used in the treatment of acute pain. However, the relief of acute moderate to severe pain usually requires opioid agents. Considering the side effects of systemic drugs and the restrictions on the use of analgesics, especially opioids, regional blocks of pain as part of a multimodal analgesic strategy can be helpful. Conclusion: This study was designed to investigate and identify the disadvantages and advantages of using each drug to be able to make the right choices in different clinical situations for patients while paying attention to the limitations of the use of these analgesic drugs

The Role of Ultrasonography in Patients Referring to the Emergency Department with Acute Abdominal Pain

Context: Acute abdominal pain is a common clinical problem in emergency and non-emergency cases accounting for 5 to 10% of all referrals to the emergency department. Studies have indicated that these widely differentiated diagnoses are common to these complaints. Considering the high prevalence of this complaint in the patients and the wide range of its differential diagnosis, this review study was designed and evaluated aiming at investigating the causes of acute abdominal pain with a focus on assessing the position of ultrasound as a diagnostic tool in the emergency department. Evidence acquisition: This article was conducted as a narrative review of 106 articles from 2005 through 2019. By comparing them, a comprehensive review of ultrasonographic status was conducted in patients with acute abdominal pain referring to the emergency department. Results: In this review study, we attempted to use the articles of the clinical approach, the required laboratory tests, the disadvantages and advantages of each imaging technique, the differential diagnosis for acute abdominal pain according to the location of the pain, and the position of ultrasound as a diagnostic aid tool. Eventually, the proposed protrusion will be considered in dealing with a patient with acute abdominal pain. Conclusion: Regarding the wide range of causes providing multiple differential diagnosis, as well as the limited time of the health team in the emergency department for diagnostic and therapeutic measures, particularly in time-sensitive clinical conditions, ultrasound offered by emergency medicine specialists as a diagnostic aid is considered to improve the overall diagnosis and treatment of patients, thereby reducing complications

Pain Management in the Emergency Department: a Review Article on Options and Methods

Context: The aim of this review is to recognizing different methods of analgesia for emergency medicine physicians (EMPs) allows them to have various pain relief methods to reduce pain and to be able to use it according to the patient’s condition and to improve the quality of their services. Evidence acquisition: In this review article, the search engines and scientific databases of Google Scholar, Science Direct, PubMed, Medline, Scopus, and Cochrane for emergency pain management methods were reviewed. Among the findings, high quality articles were eventually selected from 2000 to 2018, and after reviewing them, we have conducted a comprehensive comparison of the usual methods of pain control in the emergency department (ED).  Results: For better understanding, the results are reported in to separate subheadings including “Parenteral agents” and “Regional blocks”. Non-opioids analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen are commonly used in the treatment of acute pain. However, the relief of acute moderate to severe pain usually requires opioid agents. Considering the side effects of systemic drugs and the restrictions on the use of analgesics, especially opioids, regional blocks of pain as part of a multimodal analgesic strategy can be helpful. Conclusion: This study was designed to investigate and identify the disadvantages and advantages of using each drug to be able to make the right choices in different clinical situations for patients while paying attention to the limitations of the use of these analgesic drugs

Comparison of Cardiac Arrhythmias between Late Pregnancy and Early Post-partum Periods in Clinically Healthy Iranian Fat-Tailed Sheep

The current study was conducted to find out the prevalence of cardiac arrhythmias in clinically healthy Iranian fat-tailed sheep in two physiological states, i.e., late pregnancy and early post-partum periods. The electrocardiogram (ECG) was recorded from 32 sheep (early post-partum, n=17 and late pregnant, n=15) without any clinical signs of cardiac diseases. Assessment of ECG revealed that 84.3% of sheep had one or two kinds of cardiac arrhythmias. Two types of cardiac arrhythmias which detected in this study were sinus tachycardia and sinus arrhythmia. The proportion of different cardiac arrhythmias between early post-partum and late pregnant sheep, were significantly (P=0.003) different. Sinus tachycardia was the most frequent arrhythmia recorded in both groups. Since none of the sheep with cardiac arrhythmias exhibited any clinical signs of heart disease at the time of ECG recording, the arrhythmias seen in this study could be regarded as physiological ones

Learning Management Systems in Universities of Medical Sciences of Iran and Several Developed Countries

Background & Objective: The core of each WBT system is an online software called learning management system (LMS). The existence of such a system in each university is the minimum requirement for the application and development of WBT methods. The present study aimed to investigate the frequency of LMS usage in Iranian medical universities in comparison with the universities of developed countries. Methods: This descriptive cross-sectional analysis was performed in 2014. The study population consisted of Iranian medical universities and the universities of 4 developed English-speaking countries, including USA, Canada, Australia, and UK. From among the Iranian universities, a total of 52 universities were selected using the census method. Moreover, 58 universities were randomly selected from among 450 well-known universities of developed countries. The data from LMS of Iranian medical universities were collected through visiting university websites, telephone calls, and in some cases, face-to-face interviews. The data were analyzed by descriptive methods. Results: Of the 52 Iranian universities of medical sciences, 33 universities (63.5%) did not have any LMSs for delivery courses in academic degree programs. Of the 19 universities (36.5%) with LMSs, Moodle, ATutor, Docebo, and native-designed LMSs were found in 11, 4, 1, and 3 universities, respectively. In addition, 16 Iranian universities used open source LMSs and 3 used commercial LMSs. All 58 (100%) universities of developed countries used LMSs for delivery courses in their academic degree programs. Blackboard, Moodle, Canvas, Desire2learn, and Sakai were used in 30, 13, 8, 1, and 1 foreign universities, respectively. Moreover, 2 universities were in transition stage and 3 universities used the Mooc system. Conclusion: Iran universities showed a considerable difference from universities in developed countries in terms of frequency of LMS usage. Educational and IT administrators in Iran should fill this gap, especially at high ranking universities. Key Words: Learning management system (LMS), Universities of medical sciences, E-learning, Ira

Metal-Organic Framework Derived Bimetallic Materials for Electrochemical Energy Storage

This is the peer reviewed version of the following article: Metal-Organic Framework Derived Bimetallic Materials for Electrochemical Energy Storage, which has been published in final form at https://doi.org/10.1002/anie.202010093. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.[EN] Supercapacitors (SCs), showing excellent power density, long service life, and high reversibility, have received great attention because of the increasing demand for energy storage devices. To further improve their performance, it is essential to develop advanced electrode materials. One group of materials, porous crystalline solids referred to as metal-organic frameworks (MOFs), have proved to be excellent templates for synthesizing functional materials to be employed in the preparation of electrodes for SCs. In comparison to monometallic MOFs, bimetallic MOFs and their derivatives offer a number of advantages, including tunable electrochemical activity, high charge capacity, and improved electrical conductivity. This review focuses on the use of MOF-derived bimetallic materials in SCs, the origin of the improved performance, and the latest developments in the field. Furthermore, the challenges and perspectives in this research area are discussed.This work was supported by Tarbiat Modares University and College of Engineering, Peking University. Financial support by the Spanish Ministry of Science and Innovation (Severo Ochoa and RTI2018-98237-CO2-1) and Generalitat Valenciana (Prometeo 2017-083) is gratefully acknowledged.Sanati, S.; Abazari, R.; Albero-Sancho, J.; Morsali, A.; García Gómez, H.; Liang, Z.; Zou, R. (2021). Metal-Organic Framework Derived Bimetallic Materials for Electrochemical Energy Storage. Angewandte Chemie International Edition. 60(20):11048-11067. https://doi.org/10.1002/anie.2020100931104811067602

Prediction of Electrofacies Based on Flow Units Using NMR Data and SVM Method: a Case Study in Cheshmeh Khush Field, Southern Iran

The classification of well-log responses into separate flow units for generating local permeability models is often used to predict the spatial distribution of permeability in heterogeneous reservoirs. The present research can be divided into two parts; first, the nuclear magnetic resonance (NMR) log parameters are employed for developing a relationship between relaxation time and reservoir porosity as well as introducing the concept of relaxation group. This concept is then used for the definition of electrofacies in the studied reservoir. A graph-based clustering method, known as multi resolution graph-based clustering (MRGC), was employed to classify and obtain the optimum number of electrofacies. The results show that the samples with similar NMR relaxation characteristics were classified as similar groups. In the second part of the study, the capabilities of nonlinear support vector machine as an intelligent model is employed to predict the electrofacies and permeability distribution in the entire interval of the reservoir, where the NMR log parameters are unavailable. SVM prediction results were compared with laboratory core measurements, and permeability was calculated from stoneley wave analysis to verify the performance of the model. The predicted results are in good agreement with the measured parameters, which proves that SVM is a reliable tool for the identification of electrofacies through the conventional well log data

Immediate Results of Percutaneous Trans-Luminal Mitral Commissurotomy in Pregnant Women with Severe Mitral Stenosis

Background Valvular heart diseases and mainly rheumatic heart diseases complicate about 1% of pregnancies. During pregnancy physiological hemodynamic changes of the circulation are the main cause of mitral stenosis (MS) decompensation. Prior to introduction of percutaneous mitral balloon commissuroplasty (PTMC), surgical comissurotomy was the preferred method of treatment in patients with refractory symptoms. PTMC is an established non-surgical treatment of rheumatic mitral stenosis. The study aimed to assess the safety and efficacy of PTMC in pregnant women with severs mitral stenosis. Material and Method Thirty three consecutive patients undergoing PTMC during pregnancy enrolled in this prospective study. Mitral valve area (MVA), transmitral valve gradient (MVG), and severity of mitral regurgitation (MR) were assessed before and 24 hour after the procedure by transthoracic and transesophageal echocardiography. Mitral valve morphology was evaluated before the procedure using Wilkin's criteria. Patient followed for one month and neonates monitored for weight and height and adverse effect of radiation. Result Mitral valve area increased from 0.83 ± 0.13 cm 2 to 1.38 ± 0.29 cm 2 ( P = 0.007). Mean gradient of mitral valve decreased from 15.5 ± 7.4 mmHg to 2.3 ± 2.3 mmHg ( P = <0.001). Pulmonary artery pressure decreased from 65.24 ± 17.9 to 50.45 ± 15.33 ( P = 0.012). No maternal death, abortion, intrauterine growth restriction was observed and only one stillbirth occurred. Conclusion PTMC in pregnant women has favorable outcome and no harmful effect on children noted

Mitochondrial mutation in Iranian patients with multiple sclerosis, correlation between haplogroups H, A and clinical manifestations

As multiple sclerosis (MS) has long been known to be associated with Leber, hereditary optic neuropathy (LHON), a disease caused by mitochondrial (mtDNA) mutations, in this study we assessed possible involvement of mtDNA point mutation in MS patients. Fifty-two MS patients whose disease was confirmed with revised McDonald criteria and referred to Iranian Center of Neurological Research of Imam Khomeini hospital during 2006–2007 entered the study. Secondary mtDNA mutations, age, gender, clinical disability according to expanded disability status scale (EDSS), course of the disease, and presenting symptoms were the variables investigated in this study. DNA purification was performed by Diatom DNA Extraction Kit. Analysis of data was done by SPSS V11.5. The prevalent mutations with frequency of 19.2% were J, L, and T haplogroups. Haplotype A was more prevalent in patients with younger age of onset (P-value = 0.012) and high proportion of haplogroup H was associated with optic nerve involvement (P-value = 0.015). No motor symptoms were seen in haplogroup H patients. There is no significant relationship between duration of the disease and EDSS in different mutation of mtDNA