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Showing 6 results for Mehryar

Hamidreza Mehryar, Omid Garkaz, Peyman Atabaki, Shadi Gharibi, Nasser Khalili, Sahar Paryab,
Volume 79, Issue 2 (May 2021)
Abstract

Background: Chest pain is the most common reason for patients to be referred to the emergency department of hospitals. This study was performed to compare the GRACE and TIMI scores in predicting important cardiovascular events in patients.
Methods: This descriptive-analytical study was performed on 862 cardiac patients who were referred to the emergency department of Taleghani Hospital in Urmia in the period of April 1, 2016 to the end of September 2016 by census method. A checklist containing demographic information, medical history and risk factors was used to collect data. After scoring patients, we examined and followed up both groups over the next 30 days and recorded any cardiovascular events such as sudden death, AMI or immediate revascularization. The data were tested using SPSS16 and descriptive statistics tests. T-test and ROC curve were analyzed.
Results: The results showed that in general, out of 862 patients who were studied (50.3%), 433 were female and (49.7%) 429 were male. Most of the patients were under 65 years old 627 (72.7%) and the age range was (17-91). The highest initial diagnosis of nonSTEMI patients was UA with 811 (94.9%) cases. On the other hand, the highest risk factors of patients were HTN 449(52%), CAD 314 (36.425) and DM 22 (25.55). The highest blood pressure was between (100-120) with 328 cases and serum creatinine between (0.6 to 1.3) with 770 cases. MACE after 30 days in GRACE system 17 people (32.69%) were in high risk group and in TIMI 3 people (37.5%) were in high risk group. In MACE evaluation, the specificity of GRACE system (cutoff point=30) was 89.27 vs. 52.24, the specificity of TIMI system (cutoff point=7.3) and the sensitivity of GRACE 93 (cutoff point=10) versus TIMI 85.71 (cutoff point=8.3) is.
Conclusion: The results showed that GRACE was more sensitive and characteristic than TIMI.

Hamidreza Mehryar, Payman Atabaki, Abass Riyahi, Mohammad Reza Amiri Nikpour,
Volume 81, Issue 11 (February 2024)
Abstract

Background: The emergence of thrombolytic drugs has opened new horizons in the treatment of patients with acute ischemic stroke, and this study was conducted with the aim of evaluating the barriers of receiving tissue plasminogen activator in patients with acute ischemic stroke in Imam Khomeini Hospital of Urmia.
Methods: This descriptive-analytical, cross-sectional study was conducted from April 21, 2015 to March 19, 2016 on patients with acute ischemic stroke referred to the emergency department of Imam Khomeini Hospital in Urmia using census sampling method. To collect data, a checklist containing demographic information was used. After collecting the data, it was entered into SPSS 18 and analyzed with the help of descriptive statistics.
Results: In this study, the results showed that out of 100 patients, most of the participants were male (58%)58 and the rest were female, and the average age was 63.71±17.3 years, and 86% were in the age range of 18-80 years, which was the appropriate age to receive or thrombolytics. and the rest were over 80 years old. The fastest visit time was 25 minutes and the latest was 10080 minutes (168 hours). Among these 40 people, only four people (40%) were in the golden time period of thrombolytic drug, i.e. Three hours from the onset of symptoms to the final evaluation. Among the four people who were placed in the golden time, in 50% of the cases there was a history of taking anticoagulants, in 25% a history of head injury, in 50% of the blood sugar less than 50 and finally 1 person (25% of the people placed in the golden time) that is, 1% of all patients were eligible to receive rtPA. About 24% of patients had NIHSS<4 and 2% had NIHSS>25, and the average number obtained was 10.
Conclusion: The most important obstacle in the timely initiation of thrombolytic therapy is the delay in visiting the emergency room. Therefore, public education in order to improve the level of general awareness of the society can be effective in reducing this time delay.

Hamidreza Mehryar, Mohammad Rafiei,
Volume 81, Issue 12 (March 2024)
Abstract

Background: Overcrowding in the emergency department is considered as a problem of the public health system, and the present study was conducted with the aim of evaluating the overcrowding in the emergency department of Imam Khomeini Hospital in Urmia based on the EDWIN index.
Methods: This descriptive-analytical study was carried out cross-sectionally from March 21, 2019 to March 19, 2020, using a simple random sampling method in patients referred to the emergency department of Imam Khomeini Hospital in Urmia. Which was used to collect information from the demographic information checklist and the EDWIN index was calculated. Then the information was entered into SPSS18 software and analyzed with the help of descriptive and analytical statistics.
Results: In this study, the results showed that in terms of the frequency of triage level, 5.4% was level one, 65.6% was level two, 26.3% was level three, 2.7% was level four and there was no disease in level five. In terms of shift, 22.5% visited the hospital in the morning shift, 27.6% in the evening shift and 49.9% in the night shift. The average EDWIN index was 2.7±0.75 on holidays and 5.9±4.6 on non-holiday days. Although emergency room congestion was more on non-holiday days, this difference was not statistically significant (P=0.15). Also, the average of EDWIN in the morning shift was 2.5±2.3, in the evening shift it was 0.71±2.16 and in the night shift it was 9.7±5.8 and even though the average of EDWIN in the night shift was higher than in the evening and night shifts, this difference was not statistically significant (P=0.06).
Conclusion: The results of the present study indicated that on most of the investigated days, the emergency room was evaluated as crowded based on the EDWIN criteria. Also, there is no significant difference between the busyness of the emergency room according to the holiday or working day, as well as the morning, evening and night shift.

Hamidreza Mehryar , Sahil Farakh,
Volume 82, Issue 2 (May 2024)
Abstract

Background: Medicines that are used to prevent and cure disease may affect patients if used incorrectly, and this study was conducted with the aim of evaluating the frequency of drug interactions in patients admitted to the emergency department of Imam Khomeini Hospital in Urmia.
Methods: This study is descriptive-analytical in a cross-sectional way, From March 20, 2020 to September 21, 2020, a census was conducted on patients admitted to the emergency department of Imam Khomeini Hospital in Urmia, who were 1901 people. The data was collected using a checklist that included information (age, sex, type of drug and severity of interference and type of interference). After collecting the data, it was entered into SPSS software, version 18 (IBM SPSS, Armonk, NY, USA) and analyzed with the help of descriptive and analytical statistics.
Results: In this study, the results showed that out of 1901 studied patients, 1101(57.9) were male and the rest were female 801(42.1), And the average age of the patients was 61.67±17.13 years, and 1160(60.9) patients did not have drug interactions and 724(39.01) had drug interactions, and the most common type of drug interaction was the moderate type, which was present in 75.1% of cases; And the final clinical outcome of the patients was 1088(57.2) discharge, 296(15.5) personal consent discharge and 506(26.6) death. Also, the most common drug interactions were serotide/salbutamol, azithromycin/ondansetron, and aspirin/nitroglycerin, respectively. And there was no significant relationship between the occurrence of drug interactions and the gender of patients (P=0.27) and finally, the average age of patients with drug interactions was 17.7±61.2 years and in patients without drug interactions was 16.7±61.9 years. Conclusion: The overall incidence of drug interactions in the studied patients was equal to 39.01, and the most common drug interactions in patients were of moderate and mild type; and there was no statistically significant relationship between the age of the patients and the gender of the patients and the incidence of drug interactions.

 

Hamid Reza Mehryar, Mohammad Reza Hosseini Azar , Afshin Ebrahimi , Omid Garkaz,
Volume 82, Issue 4 (July 2024)
Abstract

Background: Although the respiratory system is the main element involved in the disease of COVID-19, nevertheless, there are reports of the involvement of other organs and their lesser symptoms. This study was conducted with the aim of investigating the frequency of gastrointestinal symptoms in patients with COVID-19.
Methods: This cross-sectional descriptive study was conducted on all patients diagnosed with COVID-19 hospitalized in Imam Khomeini Hospital from April to September 2021 by census method. The data was collected using a checklist that included demographic information. After the data was collected, it was entered into SPSS software, version 18 (IBM SPSS, Armonk, NY, USA) and analyzed with the help of descriptive statistics.
Results: In this study, the results showed that out of 2580 hospitalized patients, 54% were women and 46% were men. And the average age of the patients was 58.67±17.68. The highest frequency of people was in the age range of 40-59 years (925 people). 64% of patients had at least one gastrointestinal symptom, Each of the symptoms had a different prevalence, Anorexia 40% with a preference for men (57%) and the highest frequency in the age range of 40-59 years (430 people), gastrointestinal bleeding 10% with a preference for men (80%), And the highest frequency in the age range of 60-79 years (112 people), abdominal pain 8% with preference for women (65%) with preference for frequency in the age range of 40-59 years (65 people), vomiting 3% with preference for women (51%) with abundance in the age range of 80-99 years (58 people), diarrhea 1.5% with preference in men (51%) with abundance in the age range of 60-79 years (18 people) and constipation in 0.2% with preference Women (67%), all of whom were over 60 years old.
Conclusion: The findings of this study showed that the COVID-19 disease can not only involve the respiratory system but also the digestive system in the course or beginning of the disease.

Babak Choobi Anzali , Leila Tighi, Hamidreza Mehryar ,
Volume 83, Issue 8 (November 2025)
Abstract

Background: Subarachnoid hemorrhage is a life-threatening neurological emergency that requires rapid diagnosis to reduce morbidity and mortality. Acute headache is the most common presenting symptom of Subarachnoid hemorrhage; however, it overlaps with many benign conditions, making early differentiation difficult in emergency departments. Although brain computed tomography is the diagnostic gold standard, readily available laboratory markers may assist clinicians in early risk stratification. Complete blood count (CBC) derived inflammatory indices are inexpensive, rapidly obtainable, and routinely measured in emergency settings. This study aimed to evaluate the diagnostic value of CBC derived indices in distinguishing Subarachnoid hemorrhage from other causes of acute headache.
Methods: This study is a retrospective study conducted on patients who presented with acute headache to the emergency department of the educational and therapeutic hospital affiliated with Urmia University of Medical Sciences. Medical records of patients presenting with acute headache between January 2018 and December 2022 were reviewed. A total of 1,025 patients were included. Demographic data and initial laboratory parameters, including white blood cell count (WBC), neutrophil percentage, lymphocyte percentage, neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR), were collected. Patients were classified into Subarachnoid Hemorrhage and non-Subarachnoid Hemorrhage groups based on brain CT scan findings and complementary diagnostic evaluations when required. Comparative analyses were performed, and the diagnostic performance of CBC derived indices was assessed using Receiver operating characteristic (ROC) curve analysis.
Results: Among the study population, 22 patients (2.1%) were diagnosed with Subarachnoid Hemorrhage. Patients with Subarachnoid Hemorrhage demonstrated significantly higher mean WBC counts and neutrophil percentages, along with significantly lower lymphocyte percentages, compared with non-Subarachnoid Hemorrhage patients (P<0.001). The mean NLR was higher in the Subarachnoid Hemorrhage group (7.23±4.92) than in the non-Subarachnoid Hemorrhage group (3.67±3.51, P<0.001). ROC curve analysis showed that NLR and neutrophil percentage had the highest diagnostic accuracy, each yielding an Area under the curve (AUC) of 0.76, indicating moderate discriminative ability.
Conclusion: CBC derived inflammatory indices, particularly NLR and neutrophil percentage, may serve as useful adjunctive screening tools for early identification of SAH in patients presenting with acute headache. However, these parameters should complement, rather than replace, definitive neuroimaging methods.
 


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