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Background and purpose: Only correct and effective Cardiopulmonary resuscitation (CPR) can increase the survival probability of patients with cardiopulmonary arrest. Therefore, assessing and controlling the CPR performance is of great importance. The aim of this study was to determine the CPR skills and knowledge of medical students in Mazandaran University of Medical Sciences. Materials and methods: Eighty students of medicine in their internship participated in the study. Theoretical knowledge of students on CRP was assessed through a questionnaire. Then all the subjects performed CPR on a resuscitation manikin. To analyze the data t-test and ANOVA were done in SPSS ver.16 Results: None of the participants was completely competent in performing CPR. Among the students 32 (40%) believed emergency medicine courses as the best resource for proper learning of CPR. Thirty eight (47%) participants stated their level of proficiency in CRP as preliminary while the study showed poor theoretical knowledge among 50% of the subjects. Conclusion: This study underscores the necessity of compulsory CPR trainings for all medical students and re-assessment of their CPR skills. Moreover, establishing new strategies for CPR education should be taken into account.

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Background and purpose: Acute Physiology and Chronic Health Evaluation (APACHE II) is a scoring system that describes and predicts the severity of acute illness in patients admitted in intensive care units. Its application is helpful in therapeutic monitoring methods, comparing the effectiveness of treatments and the decision to change the treatment, and comparing the performance and quality of services provided. The aim of this study was to compare the probable mortality rate predicted by APACHE II and the actual mortality rate.

Materials and methods: A prospective cohort study was performed in …….. The patients (over 16 years old) were selected from Emergency Department in Sari Imam Khomeini Hospital with indications for admissions to intensive care unit. The predicted risk of death was calculated for each patient using the APACHE II and compared with the actual rate of death.

Results: In this study, 82 patients enrolled including 54 males (65.9%) and 28 females (34.1%). The APACHE II average score was 19.69± 8.91 and the percentage of mortality rate was 38.43±27.62 while the actual mortality rate was 48%. The accuracy of APACHE II scale in predicting the mortality rate was 63.4%.

Conclusion: The APACHE II scoring system can provide an acceptable estimate of mortality. In calibration of the system it was found with the discontinuity especially in the range of 0.01 to 0.1 and 0.5 to 0.7 scores.

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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.