Journal of Acute Disease
Issue 3,2023 Table of Contents
2023(3):89-95.
DOI: 10.4103/2221-6189.379271
Abstract:
Objective: To evaluate morphine's risk-benefit profile in the treatment of acute heart failure.
Methods: Different electronic databases, including PubMed, MEDLINE, Cochrane Library, and Google Scholar, as well as clinicaltrails.gov, were searched for articles published between 2012 and 2022. The risk of bias in the present study was evaluated by employing randomized controlled trials (RCTs) checklist that assesses the effectiveness of new interventions through random assignment of participants to different treatment groups. The two-part tool was used to address the five specific domains such as selection bias, performance bias, detection bias, attrition bias, and selective reporting bias. Evaluation of the quality of diagnostic accuracy studies was conducted using the RevMan software (version 5.4), a quality assessment tool.
Results: A total of 13 studies were included in the present review, in which there were 5 retrospective studies, 3 randomized-control studies, 2 prospective studies, 1 multicenter pharmacodynamics study, 1 multicenter cardiac magnetic resonance imaging study, and 1 open-label, cross-over study. The mortality of acute heart failure patients treated with morphine was higher compared to those without morphine.
Conclusions: Acute heart failure patients who do not receive morphine have a lower mortality rate compared to those who receive morphine. Considering the adverse effects, including mortality associated with morphine, there is a pressing need for further research to explore alternative and effective treatment options in acute heart failure.
Objective: To evaluate morphine's risk-benefit profile in the treatment of acute heart failure.
Methods: Different electronic databases, including PubMed, MEDLINE, Cochrane Library, and Google Scholar, as well as clinicaltrails.gov, were searched for articles published between 2012 and 2022. The risk of bias in the present study was evaluated by employing randomized controlled trials (RCTs) checklist that assesses the effectiveness of new interventions through random assignment of participants to different treatment groups. The two-part tool was used to address the five specific domains such as selection bias, performance bias, detection bias, attrition bias, and selective reporting bias. Evaluation of the quality of diagnostic accuracy studies was conducted using the RevMan software (version 5.4), a quality assessment tool.
Results: A total of 13 studies were included in the present review, in which there were 5 retrospective studies, 3 randomized-control studies, 2 prospective studies, 1 multicenter pharmacodynamics study, 1 multicenter cardiac magnetic resonance imaging study, and 1 open-label, cross-over study. The mortality of acute heart failure patients treated with morphine was higher compared to those without morphine.
Conclusions: Acute heart failure patients who do not receive morphine have a lower mortality rate compared to those who receive morphine. Considering the adverse effects, including mortality associated with morphine, there is a pressing need for further research to explore alternative and effective treatment options in acute heart failure.
2023(3):96-101.
DOI: 10.4103/2221-6189.379276
Abstract:
Objective: To assess the effectiveness of simulation-based learning regarding the management of post-COVID complications in terms of knowledge, clinical decision-making ability, and self-efficacy among nursing students.
Methods: This was a quasi-experimental study conducted among 115 2nd-year nursing students. The participants were selected by a simple random sampling technique. The participants were divided into an experimental (n=56) and a comparison group (n=59) by a random table method. Data were analyzed using descriptive and inferential statistics with SPSS version 20.
Results: There were significant differences in mean post-test knowledge scores (P=0.03) and mean post-test self-efficacy scores (P=0.001) between the experimental and the comparison groups while the difference in mean post-test clinical decision-making ability scores between the two groups was non-significant (P=0.07). A positive correlation was found between knowledge and clinical decision-making ability in pre-test (P=0.03) and in post-test (P<0.001) and a non-significant correlation was found between pre-test knowledge and self-efficacy score (P=0.52) among the experimental group.
Conclusions: Simulation-based learning regarding the management of post-COVID complications is effective among nursing students. Simulation labs should be established in health care settings where simulation training can be provided for updating the knowledge, clinical decision-making ability, and self-efficacy of nursing personnel during program installment and continuous nursing education.
Objective: To assess the effectiveness of simulation-based learning regarding the management of post-COVID complications in terms of knowledge, clinical decision-making ability, and self-efficacy among nursing students.
Methods: This was a quasi-experimental study conducted among 115 2nd-year nursing students. The participants were selected by a simple random sampling technique. The participants were divided into an experimental (n=56) and a comparison group (n=59) by a random table method. Data were analyzed using descriptive and inferential statistics with SPSS version 20.
Results: There were significant differences in mean post-test knowledge scores (P=0.03) and mean post-test self-efficacy scores (P=0.001) between the experimental and the comparison groups while the difference in mean post-test clinical decision-making ability scores between the two groups was non-significant (P=0.07). A positive correlation was found between knowledge and clinical decision-making ability in pre-test (P=0.03) and in post-test (P<0.001) and a non-significant correlation was found between pre-test knowledge and self-efficacy score (P=0.52) among the experimental group.
Conclusions: Simulation-based learning regarding the management of post-COVID complications is effective among nursing students. Simulation labs should be established in health care settings where simulation training can be provided for updating the knowledge, clinical decision-making ability, and self-efficacy of nursing personnel during program installment and continuous nursing education.
2023(3):102-106.
DOI: 10.4103/2221-6189.379272
Abstract:
Objective: To investigate the impact of COVID-19 on the mortality trends and patterns in a tertiary teaching hospital in Raipur, Chhattisgarh, India.
Methods: A hospital-based retrospective study was conducted to analyze the case reports of all deaths from January 2016 to December 2021 in a tertiary teaching hospital in Raipur, Chhattisgarh, India. The socio-demographic profile and the pattern of causes of death were recorded. The deaths were classified according to the 10th revision of the International Classification of Diseases.
Results: A total of 6 128 deaths were registered from 2016 to 2021 and the maximum death number was observed in 2021 (38.2%) followed by 2020 (32.5%) when the country was hit by the COVID-19 pandemic. The highest number of deaths was observed in the age group of 51 to 65 years i.e., 31.1% of the total deaths. In all five years, male deaths were more than female deaths, and more than 50% occurred within three days of hospitalization during the study period.
Conclusions: Even though there is a rise in the death rate due to the sudden hit of COVID-19, the burden of both communicable and non-communicable diseases remains gradually increasing over the five years. There is a need for health awareness in the community about changing lifestyles and their harmful effects on health.
Objective: To investigate the impact of COVID-19 on the mortality trends and patterns in a tertiary teaching hospital in Raipur, Chhattisgarh, India.
Methods: A hospital-based retrospective study was conducted to analyze the case reports of all deaths from January 2016 to December 2021 in a tertiary teaching hospital in Raipur, Chhattisgarh, India. The socio-demographic profile and the pattern of causes of death were recorded. The deaths were classified according to the 10th revision of the International Classification of Diseases.
Results: A total of 6 128 deaths were registered from 2016 to 2021 and the maximum death number was observed in 2021 (38.2%) followed by 2020 (32.5%) when the country was hit by the COVID-19 pandemic. The highest number of deaths was observed in the age group of 51 to 65 years i.e., 31.1% of the total deaths. In all five years, male deaths were more than female deaths, and more than 50% occurred within three days of hospitalization during the study period.
Conclusions: Even though there is a rise in the death rate due to the sudden hit of COVID-19, the burden of both communicable and non-communicable diseases remains gradually increasing over the five years. There is a need for health awareness in the community about changing lifestyles and their harmful effects on health.
2023(3):107-113.
DOI: 10.4103/2221-6189.379274
Abstract:
Objective: To investigate the effect of the first prone position on arterial blood gas analysis and respiratory parameters of acute respiratory distress syndrome (ARDS) patients with and without COVID.
Methods: This study was conducted retrospectively with 22 COVID-ARDS and 22 non-COVID ARDS patients, who were placed in a prone position for at least 16 hours on the first day at the intensive care unit admission, and arterial blood gas analysis was taken in the pre-prone, prone and post-prone periods.
Results: PaO2 were significantly increased in the pre-pronevs. prone comparison in both groups, but the increase in the PaO2/FiO2 ratio was not significant. In comparing the pre-prone vs. post-prone PaO2/FiO2 ratios, there was a significant difference only in the non-COVID ARDS group.
Conclusions: The improved oxygenation provided by prone positioning is more permanent with the “post-prone effect” in non-COVID ARDS patients. This can be attributed to the differences in the pathogenesis of the two ARDS types.
Objective: To investigate the effect of the first prone position on arterial blood gas analysis and respiratory parameters of acute respiratory distress syndrome (ARDS) patients with and without COVID.
Methods: This study was conducted retrospectively with 22 COVID-ARDS and 22 non-COVID ARDS patients, who were placed in a prone position for at least 16 hours on the first day at the intensive care unit admission, and arterial blood gas analysis was taken in the pre-prone, prone and post-prone periods.
Results: PaO2 were significantly increased in the pre-pronevs. prone comparison in both groups, but the increase in the PaO2/FiO2 ratio was not significant. In comparing the pre-prone vs. post-prone PaO2/FiO2 ratios, there was a significant difference only in the non-COVID ARDS group.
Conclusions: The improved oxygenation provided by prone positioning is more permanent with the “post-prone effect” in non-COVID ARDS patients. This can be attributed to the differences in the pathogenesis of the two ARDS types.
2023(3):114-120.
DOI: 10.4103/2221-6189.379275
Abstract:
Objective: To determine the association of the three umbilical cord blood parameters: umbilical cord pH, base deficit, and lactate levels, with neonatal outcomes.
Methods: This prospective observational study was conducted from April 2021 to September 2022 with 100 term and late preterm (>35 weeks) neonates whose umbilical cord blood pH was <7.10, Apgar score was <7 at 1 min, and required positive pressure ventilation. Umbilical cord blood was assessed for pH, base deficit, and blood lactate levels. The neonatal outcomes of neonatal intensive care unit admission, Apgar score at 1 min, and Apgar score at 5 min were assessed.
Results: The mean of umbilical cord blood pH was 7.04±0.07, mean base deficit was (−9.3±3.9) mmol/L, and mean lactate levels were (6.51±2.29) mmol/L. Neonatal intensive care unit (NICU) admission was needed in 78 (78%) neonates. The mean NICU stay length was (2.4±2.2) days ranging from 0 to 12 days with a median of 2 days. Univariate analysis showed no significant difference in cord blood pH (P=0.736) and base deficit (P=0.393) between neonates without NICU admission and neonates who required NICU admission, but lactate level was significantly higher in neonates who required NICU admission (P<0.001). There was no significant difference in cord blood pH (P=0.400) and base deficit (P>0.999) between neonates with Apgar scores 4-7 at 1 min and neonates with Apgar scores <4, but lactate level was significantly higher in neonates with Apgar scores <4 at 1 min (P<0.001).
Conclusions: Umbilical cord blood pH, base deficit, and lactate levels are useful novel markers showing a significant correlation with neonatal intensive care unit admission and adverse neonatal morbidities among hypoxic newborns. Overall, lactate was a better predictor of adverse neonatal outcomes as compared to umbilical cord blood pH and base deficit.
Objective: To determine the association of the three umbilical cord blood parameters: umbilical cord pH, base deficit, and lactate levels, with neonatal outcomes.
Methods: This prospective observational study was conducted from April 2021 to September 2022 with 100 term and late preterm (>35 weeks) neonates whose umbilical cord blood pH was <7.10, Apgar score was <7 at 1 min, and required positive pressure ventilation. Umbilical cord blood was assessed for pH, base deficit, and blood lactate levels. The neonatal outcomes of neonatal intensive care unit admission, Apgar score at 1 min, and Apgar score at 5 min were assessed.
Results: The mean of umbilical cord blood pH was 7.04±0.07, mean base deficit was (−9.3±3.9) mmol/L, and mean lactate levels were (6.51±2.29) mmol/L. Neonatal intensive care unit (NICU) admission was needed in 78 (78%) neonates. The mean NICU stay length was (2.4±2.2) days ranging from 0 to 12 days with a median of 2 days. Univariate analysis showed no significant difference in cord blood pH (P=0.736) and base deficit (P=0.393) between neonates without NICU admission and neonates who required NICU admission, but lactate level was significantly higher in neonates who required NICU admission (P<0.001). There was no significant difference in cord blood pH (P=0.400) and base deficit (P>0.999) between neonates with Apgar scores 4-7 at 1 min and neonates with Apgar scores <4, but lactate level was significantly higher in neonates with Apgar scores <4 at 1 min (P<0.001).
Conclusions: Umbilical cord blood pH, base deficit, and lactate levels are useful novel markers showing a significant correlation with neonatal intensive care unit admission and adverse neonatal morbidities among hypoxic newborns. Overall, lactate was a better predictor of adverse neonatal outcomes as compared to umbilical cord blood pH and base deficit.
2023(3):121-128.
DOI: 10.4103/2221-6189.379277
Abstract:
Objective: To explore the modeling of time series of animal bite occurrence in northwest Iran.
Methods: In this study, we analyzed surveillance time series data for animal bite cases in the northwest Iran province of Iran from 2011 to 2017. We used decomposition methods to explore seasonality and long-term trends and applied the Autoregressive Integrated Moving Average (ARIMA) model to fit a univariate time series of animal bite incidence. The ARIMA modeling process involved selecting the time series, transforming the series, selecting the appropriate model, estimating parameters, and forecasting.
Results: Our results using the Box Jenkins model showed a significant seasonal trend and an overall increase in animal bite incidents during the study period. The best-fitting model for the available data was a seasonal ARIMA model with drift in the form of ARIMA (2,0,0) (1,1,1). This model can be used to forecast the frequency of animal attacks in northwest Iran over the next two years, suggesting that the incidence of animal attacks in the region would continue to increase during this time frame (2018-2019).
Conclusions: Our findings suggest that time series analysis is a useful method for investigating animal bite cases and predicting future occurrences. The existence of a seasonal trend in animal bites can also aid in planning healthcare services during different seasons of the year. Therefore, our study highlights the importance of implementing proactive measures to address the growing issue of animal bites in Iran.
Objective: To explore the modeling of time series of animal bite occurrence in northwest Iran.
Methods: In this study, we analyzed surveillance time series data for animal bite cases in the northwest Iran province of Iran from 2011 to 2017. We used decomposition methods to explore seasonality and long-term trends and applied the Autoregressive Integrated Moving Average (ARIMA) model to fit a univariate time series of animal bite incidence. The ARIMA modeling process involved selecting the time series, transforming the series, selecting the appropriate model, estimating parameters, and forecasting.
Results: Our results using the Box Jenkins model showed a significant seasonal trend and an overall increase in animal bite incidents during the study period. The best-fitting model for the available data was a seasonal ARIMA model with drift in the form of ARIMA (2,0,0) (1,1,1). This model can be used to forecast the frequency of animal attacks in northwest Iran over the next two years, suggesting that the incidence of animal attacks in the region would continue to increase during this time frame (2018-2019).
Conclusions: Our findings suggest that time series analysis is a useful method for investigating animal bite cases and predicting future occurrences. The existence of a seasonal trend in animal bites can also aid in planning healthcare services during different seasons of the year. Therefore, our study highlights the importance of implementing proactive measures to address the growing issue of animal bites in Iran.
2023(3):129-130.
DOI: 10.4103/2221-6189.379278
Abstract:
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