Compilation and evaluation of clinical practice guidelines for comprehensive approaches to patients with acute chest pain in the emergency room at Al-Zahra Hospital in Isfahan

Introduction & Aim: This study aimed to develop a standardof clinical guidelines for dealing with patients withacute chest pain in the emergency department at Al-ZahraHospital in Isfahan.Methods: In the first phase, a comprehensive approachand guidelines for patients with unstable angina referredto the emergency department, according to experts fromthe heart and emergency medicine and using valid sourceswas developed. In the second phase, the guidelines ereevaluated in a clinical trial. In this trial, 100 patients wererandomly assigned into intervention and control groups.The waiting time for the first visit, paraclinical measures,appropriate treatment; the physician’s satisfaction withtreatment, the patient’s admission to the emergencyroom, number of visits and treatment outcome; the patient’ssatisfaction from emergency services and treatmentoutcome were compared between two groups.Results: The mean of patients waiting time to receive thefirst visit, paraclinical measures, and appropriate treatmentin the intervention group were significantly lowerthan the control group (P-value<0.05). The mean of physician’ssatisfaction score from the treatment process, patient’sadmission to the emergency room, number of visitsand outcome of treatment in the intervention group wassignificantly higher than the control group (P-value<0.05).The mean patient satisfaction score from the emergencyservices in the intervention group was significantly higherthan the control group (P-value=0.0001).Conclusions: The developed guidelines for dealing withpatients with acute chest pain in the emergency roomsignificantly reduce the patient’s waiting time in receivingcare and improve the satisfaction of the physicians andthe patients

Medical evaluation of ovarian torsion in a 7-year-old child: case report

Ovarian torsion occurs when the ovary is twisted around the supporting tissues. Sometimes the fallopian tube may also twist. This painful condition cuts off blood flow to these organs. Ovarian torsion is a serious medical condition that must be treated immediately. If left untreated, it can lead to ovarian failure. If you have an ovarian cyst that can cause the ovaries to swell, you are more likely to experience ovarian torsion. You may be able to reduce the risk of ovarian torsion by taking hormonal contraceptives or other medications to help reduce the size of the cyst. The longer the diagnosis and treatment process, the greater the risk of ovarian tissue. When torsion occurs, blood flow to the ovaries and possibly the fallopian tube decreases. Decreased blood flow over a long period leads to necrosis (tissue death). If this happens, the doctor will remove the damaged ovary and tissue. The only way to prevent such a complication is to seek immediate treatment. If the ovary is destroyed due to necrosis, pregnancy is possible. Ovarian torsion is not a predictable disease. However, by following the tips emphasized by obstetricians and periodic examinations, ovarian cysts can be detected and treated. In this case, the primary possibility of this disease will be removed from the body. Ovarian torsion is a serious condition that should be treated soon by seeing a doctor. If you feel severe pain in the lower abdomen accompanied by nausea and vomiting, you should immediately go to the emergency room and not seek home treatment