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Background and Aim:Ideally, the period of patients admitting in the Emergency Department (ED) should not exceed 6 hours. Prolonged of the patients admitting time affects the ED overcrowding, quality of patient care and patient satisfaction. To evaluate the efficacy of new programs and suggest new strategies to reduce the overcrowding in a typical overcrowded ED of general teaching hospital in Tehran city.Materials and Methods:In this descriptive case study, charts of patients held over 24 hours, in Imam Hossein Hospital affiliated to the Shaheed Beheshti Medical University, were reviewed from April 21rd on August 23rd, 2008.Results:Of 15,477 patients, 151 (1%) have been held in the ED over 24 hours. Reasons for this long-stay included:lack of available bed in Intensive Care Unit (ICU) (125 patients), lack of available bed in related wards (18 patients), poor final decision — making by physician (eight patient)Conclusion:Long-term stay of patients in ED of teaching hospital is a major problem. The most frequent cause is a limitation of inpatient beds. The long stay time had not been affected by paraclinic procedures, multispecialities involvement or the lack of obvious diagnosis. The following solution is proposed: (1) creation of a holding unit, (2) active inter-facility transfer and (3) governing admittance of patients who need ICU care to related wards.

BackgroundModest cognitive impairment has been reported in adults with diabetes. Therefore, we aimed to compare memory impairments among two groups of patients with diabetes with different disease durations.This study included 120 patients treated at the diabetes clinic at Imam Khomeini Hospital, Ardebil, Iran, over 14 months (2009–2010). The patients were divided into two groups according to their disease duration as >5 years or <1 year (recently diagnosed). The two groups were approximately matched in terms of age and education. Memory impairments were examined using the Wechsler Memory Scale. Data are presented descriptively, and were compared between groups using multivariate analysis of variance.FindingOverall, there were no significant differences in total scores or individual subscales between the two groups. However, 59% of all patients had below-average scores on the Wechsler memory questionnaire.ConclusionBoth groups reported below-average scores on the Wechsler Memory Scale that were independent of disease duration. The present study agreed with the results of other studies showing impaired memory among patients with diabetes. The current findings require further investigation in longitudinal studies.

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