: Since the emergence of ultrasonography, many specialists, including anesthesiologists, have become interested in its practices. Technological innovations in portable ultrasonography devices and their quality enable anesthesiologists to use ultrasonography in various medical conditions and improve their diagnostic and therapeutic interventions. This article clarifies the significance of point-of-care ultra-sonography (POCUS) and highlights the challenges ahead. POCUS can help regional anesthesiologists and pain physicians in vascular access, airway management, focused cardiac ultra-sound (FoCUS), lung ultrasound, gastric ultrasound, focus assessment with sonography in trauma (FAST), regional and neuraxial nerve blocks, and acute and chronic pain management. However, similar to any new clinical method, there are challenges to POCUS, especially in developing countries like Iran. These challenges include the need for more budget allocation for medical equipment and portable devices, developing a comprehensive local curriculum and transparent framework to train residents and postgraduates, creating and/or revising university policies, clinical coordination with healthcare networks, and collaboration with healthcare providers. This article expresses the importance and effectiveness of point-of-care sonography performed by anesthesiologists and pain specialists in Iran and highlights the challenges ahead.

Today, trauma is known to be the third leading cause of death in most countries. Studies have demonstrated below-normal plasma levels of antioxidants in trauma patients. The present study aimed to assess the efficacy of Coenzyme Q10 (CoQ10) on oxidative stress, clinical outcomes and anthropometrical parameters in traumatic mechanical ventilated patients admitted to the intensive care unit. Patients were randomised to receive sublingual CoQ10 (400 mg/d) or placebo for 7 d. Primary and secondary outcomes were measured at the baseline and end of the study. We enrolled forty patients for this trial: twenty in the CoQ10 group and twenty in the placebo group. There was not any significant difference in the baseline variables (P > 0⋅05). At the end of the study, CoQ10 administration caused a considerable reduction in the Malondialdehyde (MDA) and Interleukin 6 (IL-6) concentrations (P < 0⋅001), Glasgow Coma Score (GCS; P = 0⋅02), ICU and hospital length of stay and mechanical ventilation (MV) duration (P < 0⋅001). We found that CoQ10 administration could increase Fat-Free Mass (P < 0⋅001) (FFM; P = 0⋅04), Skeletal Muscle Mass (SMM; P = 0⋅04) and Body Cell Mass (BCM) percent (P = 0⋅03). There was not any significant difference in other factors between the two groups (P > 0⋅05). CoQ10 administration has beneficial effects on patients with traumatic injury and has no side effects. However, since the possibility of the type II error was high, the outcomes on the duration of MV, ICU stay and hospital stay, and GCS may very well be false positives.

Introduction: The aim of the present study was to compare the effectiveness of two teaching models (e-learning and discussion-based learning) on the learning process of emergency department interns in relation to the use of the sedatives. Methods: In this study, 129 interns introduced to the emergency medicine department were included in the study. These interns were randomly divided into two groups, I and II. For both groups, a pre-test based on standard parallel multiple-choice questions (MCQs) was prepared. Then, the electronic software which was prepared was distributed to the first group. For people of group II, six hours of discussion-based training was conducted for 3 consecutive weeks. At the end of the course (after 1 month), a post-test, which was the same questions as the pre-test, was obtained from interns in both groups. Results: At the end of the study, we found a significant improvement in the learning rate of both groups all aspects of the knowledge including: science related to the use of narcotics in sedation (P = 0.01 for e-learning group and P < 0.001 for discussion based group), knowledge related to the use of intravenous anesthetics for sedation(P = 0.025 for e-learning group P < 0.001 for discussion based group), Knowledge related to definition and clinical judgments in sedation and Knowledge related to the use of Neuromuscular blocking agents (NMBAs) for sedation (P < 0.001 for both groups). However, for all the investigated results, the learning rate was significantly better in the discussion-based learning group compared to the e-learning group (P < 0.001). Conclusion According to the results of this study, we found using either e-learning or discussion-based learning methods increase the acquisition of sedation knowledge for emergency department students. However, the discussion-based method have better results on the learning process of the interns.