The Way Residents Treat Patients with Decreased Level of Consciousness in the Emergency Department; a Clinical Audit

Introduction: Arcuate foramen anomaly is an anatomic variation in the first thoracic vertebrae that forms a space for passing of vertebral artery. Considering the role of this bony bridge in migraine development and its effect on prevalence of various types of pain in head, shoulder, and neck areas,...

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Main Authors: Behrouz Hashemi, Roofia Vahedian, Mohammad Mehdi Forouzanfar, Sahar Mirbaha
Format: Article
Language:English
Published: Shahid Beheshti University of Medical Sciences 2019-11-01
Series:طب اورژانس ایران
Subjects:
Online Access:http://journals.sbmu.ac.ir/en-iranjem/article/view/27987
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author Behrouz Hashemi
Roofia Vahedian
Mohammad Mehdi Forouzanfar
Sahar Mirbaha
author_facet Behrouz Hashemi
Roofia Vahedian
Mohammad Mehdi Forouzanfar
Sahar Mirbaha
author_sort Behrouz Hashemi
collection DOAJ
description Introduction: Arcuate foramen anomaly is an anatomic variation in the first thoracic vertebrae that forms a space for passing of vertebral artery. Considering the role of this bony bridge in migraine development and its effect on prevalence of various types of pain in head, shoulder, and neck areas, as well as its importance in screw placement on the lateral mass of atlas, the present study evaluated the prevalence of this anomaly among those presented to the emergency department (ED) of Poursina Hospital, Rasht, Iran. Methods: The present study is a cross-sectional one, carried out on patients over 18 years of age that visited ED of Poursina Hospital, Rasht, Iran, in 2015 and underwent lateral neck radiography using census method. Data of the patients were gathered using their medical profile or by asking them on the phone, and recorded in a pre-designed checklist. Data were analyzed with the aid of SPSS version 24 and chi-square and independent t-test statistical tests. P-values less than 0.05 were considered as significant. Results: 1146 patients with the mean age of 37.95 ± 15.88 years were studied (69.2% male). Mean age was 36.05 ± 15.26 years among men and 14.21 ± 16.44 years among women (p < 0.001). The overall prevalence of arcuate foramen was calculated to be 9.6% [95% confidence interval 7.89 – 11.30; 110 patients (74.5% male)]. This anomaly had a prevalence of 10.34% in men and 7.93% in women (p > 0.05). Conclusion: Based on the results of the present study, the prevalence of arcuate foramen anomaly was estimated to be 9.6% in Guilan province using lateral neck radiography. Its prevalence rate was 10.34% in men and 7.93% in women. Considering this prevalence rate, presence of this anomaly should be considered as a possibility in patients with complaints of head, shoulder, and neck pain.
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spelling doaj.art-92a991df0aa84067b8d9464ab58efee22022-12-22T01:52:10ZengShahid Beheshti University of Medical Sciencesطب اورژانس ایران2383-36452019-11-0161e14e1412875The Way Residents Treat Patients with Decreased Level of Consciousness in the Emergency Department; a Clinical AuditBehrouz Hashemi0Roofia Vahedian1Mohammad Mehdi Forouzanfar2Sahar Mirbaha3Emergency Department, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Emergency Department, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Emergency Department, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Emergency Department, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Introduction: Arcuate foramen anomaly is an anatomic variation in the first thoracic vertebrae that forms a space for passing of vertebral artery. Considering the role of this bony bridge in migraine development and its effect on prevalence of various types of pain in head, shoulder, and neck areas, as well as its importance in screw placement on the lateral mass of atlas, the present study evaluated the prevalence of this anomaly among those presented to the emergency department (ED) of Poursina Hospital, Rasht, Iran. Methods: The present study is a cross-sectional one, carried out on patients over 18 years of age that visited ED of Poursina Hospital, Rasht, Iran, in 2015 and underwent lateral neck radiography using census method. Data of the patients were gathered using their medical profile or by asking them on the phone, and recorded in a pre-designed checklist. Data were analyzed with the aid of SPSS version 24 and chi-square and independent t-test statistical tests. P-values less than 0.05 were considered as significant. Results: 1146 patients with the mean age of 37.95 ± 15.88 years were studied (69.2% male). Mean age was 36.05 ± 15.26 years among men and 14.21 ± 16.44 years among women (p < 0.001). The overall prevalence of arcuate foramen was calculated to be 9.6% [95% confidence interval 7.89 – 11.30; 110 patients (74.5% male)]. This anomaly had a prevalence of 10.34% in men and 7.93% in women (p > 0.05). Conclusion: Based on the results of the present study, the prevalence of arcuate foramen anomaly was estimated to be 9.6% in Guilan province using lateral neck radiography. Its prevalence rate was 10.34% in men and 7.93% in women. Considering this prevalence rate, presence of this anomaly should be considered as a possibility in patients with complaints of head, shoulder, and neck pain.http://journals.sbmu.ac.ir/en-iranjem/article/view/27987consciousness disordersclinical auditpractice guidelineemergency medicineinternship and residency
spellingShingle Behrouz Hashemi
Roofia Vahedian
Mohammad Mehdi Forouzanfar
Sahar Mirbaha
The Way Residents Treat Patients with Decreased Level of Consciousness in the Emergency Department; a Clinical Audit
طب اورژانس ایران
consciousness disorders
clinical audit
practice guideline
emergency medicine
internship and residency
title The Way Residents Treat Patients with Decreased Level of Consciousness in the Emergency Department; a Clinical Audit
title_full The Way Residents Treat Patients with Decreased Level of Consciousness in the Emergency Department; a Clinical Audit
title_fullStr The Way Residents Treat Patients with Decreased Level of Consciousness in the Emergency Department; a Clinical Audit
title_full_unstemmed The Way Residents Treat Patients with Decreased Level of Consciousness in the Emergency Department; a Clinical Audit
title_short The Way Residents Treat Patients with Decreased Level of Consciousness in the Emergency Department; a Clinical Audit
title_sort way residents treat patients with decreased level of consciousness in the emergency department a clinical audit
topic consciousness disorders
clinical audit
practice guideline
emergency medicine
internship and residency
url http://journals.sbmu.ac.ir/en-iranjem/article/view/27987
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