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Background and purpose: Waiting time to receive appropriate services in emergency departments is considered as an important indicator for evaluating hospitals. Triage is the most important and the first stage of patient’s management at the time of arrival to hospital emergency department. This study aimed at determining the length of waiting time to receive treatment and diagnostic services and related factors within 5 level triage system in Imam Khomeini Hospital in Sari. Material and Methods: This cross-sectional study was done in Imam Khomeini Hospital of Sari in December 2012. The subjects included 365 individuals who were selected through Morgan table. Waiting time for receiving treatment and diagnostic services for each patient was calculated by researcher from medical records of the patients and the triage sheet and entered in data collection forms. These forms contained two sections. The first part included demographic data and the second part contained information on the emergency department service delivery. The statistical analysis was performed in SPSS V.16 Results: The mean time of first consultant by physician was 6.4 + 7.2 mins, the mean time to receive the first nursing service was 14.9 + 14.4 mins, and the mean time to determine the patients’ status was 136.6 + 143 mins. There was a significant relation between the working shift and the mean time of first consultant by doctor and determination of the patients’ status. The same relation was also found for triage level. Conclusion: This study indicated a good level of service provided by emergency department of Sari Imam Khomeini Hospital.

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Background and purpose: Every stage in preparation of blood and blood components, storage, transportation, and transfusion involves a specific process which should be continuously supervised. The aim of this study was to compare the knowledge of resident physicians, interns and nurses about transfusion medicine in 2013. Materials and methods: In a descriptive cross-sectional study, 147 individuals were randomly selected from resident physicians, interns and nurses in Imam Khomeini, Boali sina, Zare and Fatemehzahra hospitals in Sari. A questionnaire containing twenty questions was used to assess their knowledge and practice about transfusion medicine. Their scores were classified into three levels (poor, average, and good). Results: The highest score for knowledge was achieved by residents (mean score: 6.2) while nurses had the highest score for practice (mean score: 38.2) which was significantly higher than other groups (P=0.00). Conclusion: This study showed that nurses and medical students including residents and interns require more training about blood transfusion medicine.

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Background and purpose: Aluminum phosphide (AlP) is commonly used in Iran (especially in north) to keep stored rice and cereal grains safe from pests. There are several reports on intentional or accidental poisoning with AlP tablets also referred to as rice tablets. The goal of this research was to study the epidemiological, clinical and laboratory features in patients poisoned with AIP tablets.

Materials and methods: In this cross-sectional study, information was extracted from patients’ records in Qaemshahr Razi Haspital and Sari Imam Khomeini Hospital, 2013-2014. Data including demographic characteristics, number of tablets, methods of intake, time and season of abuse, the time interval between tablet ingestion and hospital admission, vital signs, and laboratory data were recorded in a check list.

Results: Fifty two cases (mean age: 23.4±9.2 years) were investigated including 38 females (73.08%) and 14 males (26.92%). The overall number of poisoned patients was higher in autumn (28.8%) and in evenings (51.9%). Death occurred in 16 cases (5 males and 11 females) and 36 patients survived of whom four (2 males and 2 females) developed complications.

Conclusion: In this study, the number of women poisoned with ALP tablet was dramatically higher compared to that of males. Autumn and evenings were found with highest rates of poisoning.

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Background and purpose: IV opioids and nonsteroidal anti-inflammatory drugs are commonly used to control pain in renal colic. Buprenorphine is a drug that is recently introduced for such cases. The aim of this study was to compare the effect of sublingual buprenorphine and intravenous morphine to control pain in acute renal colic.

Materials and methods: A randomized double-blind, placebo controlled clinical trial was performed in 203 patients with acute renal colic. The samples were divided into two groups to receive either 2 mg sublingual buprenorphine and 5cc IV distilled water (experimental group) or intravenous morphine 0.1 mg/kg and a sublingual placebo (control group). Pain reduction and drug side effects were compared between the two groups. Data analysis was conducted in SPSS ver.22 using repeated measures, Chi-square, and t-test. 

Results: The participants included 79 (38.9%) females and the mean age of the patients in experimental and control groups were 40.50±13.50 and 39.85±13.66, respectively (P=0.73). The mean time required for pain improvement after drug administration was 30.97±19.92 min in experimental group and 34.87±18.59 min in controls (P= 0.19). Significant decrease in pain severity was observed in both groups (P< 0.001) but the type of drug had no significant effect in reducing pain (P= 0.25). Side effects were similar in two groups except for itching that was significantly higher in patients receiving buprenorphine (P= 0.007).

Conclusion: The efficacy of buprenorphine in treatment of renal colic was found to be similar to that of intravenous morphine. Side effects were also similar in two groups except itching that was significantly more prevalent in experimental group.

(Clinical Trials Registry Number: IRCT2015082023696N1)

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Background and purpose: Vertigo is one of the most common principal complaints of patients in emergency departments. Therefore, this study investigated the effect of Diazepam as benzodiazepine and Promethazine in patients with acute peripheral vertigo.

Materials and methods: A double blind randomized clinical trial was done in which 150 patients were randomly divided into two groups (n=75 per group) to receive either 5mg IV injection of Diazepam (group A) or 25mg IV injection of promethazine (group B). The severity of vertigo was scored before treatment and within four hours after receiving the drugs.

Results: Excellent improvements were seen in 71 (94.7%) patients receiving promethazine while good improvements were observed in 13 (17.3%) patients receiving Diazepam. The mean VAS score was 9.69 before the intervention. While the mean scores for VAS1 (30 minutes after treatment), VAS2 (after two hours), and VAS3 (after four hours) were 7.14, 5.06, and 2.45, respectively. The results showed a reduction over time in both groups in VAS score. The Fisher’s exact test showed significant difference in efficacy of promethazine between the two groups. (P<0.001).

Conclusion: According to this result, promethazine improved peripheral vertigo better than Diazepam. So, it could be used in patients with acute peripheral vertigo.