Objective: The main objective of this study was to determine various characteristics and outcomes of self-harm and suicide in men and women with data obtained from the National Trauma Registry of ...Iran (NTRI). Method: This retrospective multicenter study using data from the NTRI included all patients who went to the emergency department (ED) due to self-harm and suicide, considering the NTRI's specific inclusion criteria, from September 2016 to January 2023. We evaluated patients regarding demographics and clinical characteristics, various outcomes, and factors influencing in-hospital death. Statistical analyses were conducted using the STATA software version 15.0. The chi-square test was used to compare the distribution of variables between men and women. Also, the logistic regression models were applied to assess the predictors of in-hospital death. Results: Self-harm and suicide cases were gathered from eleven geographically diverse hospitals across the country, and our study included 511 men and 347 women out of 50,661 registered trauma cases. Among them, 443 men (86.7%) and 267 women (76.9%) were between 18 and 49 years old (P < 0.001). Single women constituted 130 (37.3%) of the female cases, while single men were 313 (61.6%) of the male cases (P < 0.001). The three most common methods among our patients were poisoning with 234 (45.8%) of men and 245 (70.6%) of women cases, stab/cut with 208 (40.7%) of men and 54 (15.6%) of women cases, and fall with 16 (3.1%) of men and 26 (7.5%) of women cases (P < 0.001). The risk of death in patients with a Glasgow Coma Scale (GCS) score of 3 to 8 was 46.22 (95% CI = 18.66 to 114.45) times more than patients with a GCS score of 13 to 15. Conclusion: Data on self-harm and suicide traumatology were gathered from eleven hospitals in Iran. Our findings indicated differences in the distribution of age and marital status between genders. Moreover, both genders used similar methods for self-harm and suicide, and gender did not affect the outcome.
Purpose
To report the prevalence and the associated factors leading to cataract among the Iranian population living in Gilan Province, Iran.
Methods
This population-based cross-sectional study was ...performed from June to November 2014 on 2,975 residents aged ≥ 50 years old living in urban and rural regions of the Gilan Province in Iran. A representative sample of residents in the province was recruited into the study through door-to-door visiting, and baseline data were collected by questionnaire. All participants were referred to the medical center for comprehensive ophthalmic examination, laboratory tests, and blood pressure measurement.
Results
Among the population, 2,588 (86.99%) subjects were eligible to be included in this study, categorized either into the cataract or the non-cataract group. The mean age of participants was 62.59 ± 8.92 years, and 57.5% were female. Higher prevalence of cataract was found in individuals of older ages (odds ratio (OR) = 1.13; 95% confidence interval (CI) = 1.10 to 1.16;
P
< 0.001) and a history of previous ocular surgery (OR = 5.78; 95% CI = 2.28 to 14.63;
P
< 0.001). At the same time, a lower prevalence of cataract was seen in patients exposed to sunlight for more than 4 h per day (OR = 0.49; 95% CI = 0.32 to 0.73; P = 0.001).
Conclusion
Cataract affects 50.50% of the study population, especially those over 80. The mildest form of cataract, grade zero, is the most common. Surgery for cataract has good outcomes. The risk of cataract is higher for those older or who have had eye surgeries. People not affected by cataract tend to be exposed to more sunlight.
Coronavirus disease 2019 (COVID-19) may lead to acute respiratory disease; cardiovascular, gastrointestinal, and coagulation complications; and even death. One of the major complications is ...cardiovascular disorders, including arrhythmias, myocarditis, pericarditis, and acute coronary artery disease. The aim of this study was to evaluate the frequency of cardiovascular complications and to determine its association with the prognosis of COVID-19 patients. In a prospective analytic study, 137 hospitalized COVID-19 patients were enrolled. During hospitalization, an electrocardiogram (ECG) was performed every other day, and laboratory tests such as cardiac troponin I (cTnI) and creatine kinase-MB (CK-MB) were done 0, 6, and 12 hours after admission. These tests were repeated for patients with chest pain or ECG changes. Patients were categorized into three groups (improved, complicated, and expired patients) and assessed for the rate and type of arrhythmias, cardiac complications, lab tests, and outcomes of treatments. There was no significant relationship among the three groups related to primary arrhythmia and arrhythmias during treatment. The most common arrhythmia during hospitalization and after treatment was ST-T fragment changes. There was a significant age difference between the three groups (P=0.001). There was a significant difference among the three groups for some underlying diseases, including diabetes mellitus (P=0.003) and hyperlipidemia (P=0.004). In our study, different types of arrhythmias had no association with patients’ outcomes but age over 60 years, diabetes mellitus, and hyperlipidemia played an important role in the prognosis of COVID-19 cases.
Introduction: There has been increased interest in the use of Statins in total hip and knee arthroplasty (THA and TKA) patients to improve outcomes and reduce postoperative complications. This study ...was performed to systematically review the evidence on Statin use in total joint arthroplasty, specifically its benefits and complications. Methods: Adhering to the PRISMA guidelines, a systematic review of PubMed, Embase, Scopus, Web of Science, and the Cochrane database was performed to find studies reporting on the effects of Statin use on outcomes of THA and TKA. Two authors independently selected relevant papers to include. Results: A total of 18 papers were included in the final analysis. Most were retrospective studies, with heterogeneous patient selection and outcome measures. The evidence on the risks and benefits of Statin use on outcomes of total joint arthroplasty was very limited and heterogeneous. Studies were focusing on perioperative cardiac outcomes, clinical outcomes and complications, renal, pulmonary, and gastrointestinal outcomes. Due to the heterogeneity of reported data, a formal meta-analysis was not possible. Conclusions: There is some evidence in the literature suggesting that perioperative use of Statins, especially in Statin-naïve patients, may reduce cardiac (e.g. atrial fibrillation) and noncardiac (e.g. delirium) complications, while not increasing the risk of muscle or liver toxicity. The authors also found low levels of evidence that Statin use may reduce the long-term risk for revision surgery and osteolysis.
Purpose: To provide the clinical recommendations for the administration of intravitreal anti-vascular endothelial growth factor (VEGF) drugs especially bavacizumab for ocular vascular diseases ...including diabetic macular edema, neovascular age-related macular degeneration, myopic choroidal neovascularization, retinal vein occlusion and central serous chorioretinopathy.
Methods: Twenty clinical questions were developed by the guideline technical committee. Relevant websites and databases were searched to find out the pertinent clinical practice guidelines to answer the questions. The technical committee provided possible answers (scenarios) according to the available evidences for each question. All scenarios along with their levels of evidence and the supported articles were sent to the experts for external review. If the experts did not agree on any of the scenarios for one particular clinical question, the technical committee reviewed all scenarios and their pertinent evidences and made the necessary decision. After that, the experts were asked to score them again. All confirmed scenarios were gathered as the final recommendations.
Results: All the experts agreed on at least one of the scenarios. The technical committee extracted the agreed scenario for each clinical question as the final recommendation. Finally, 56 recommendations were developed for the procedure of intravitreal anti-VEGF injection and their applications in the management of ocular vascular diseases.
Conclusion: The implementation of this guideline can standardize the management of the common ocular vascular diseases by intravitreal injection of anti-VEGF agents. It can lead to better policy-making and evidence-based clinical decision by ophthalmologists and optimal evidence based eye care for patients.
Objective: To identify the pathogenic gene of Panton-Valentine leukocidin in methicillin-resistant Staphylococcus aureus strain isolated from clinical specimens of burn patients in Shaheed Zare Burn ...Hospital.Methods: A total of 104 samples of Staphylococcus were collected and 78 aureus samples were isolated from Zare Hospital patients from November 2016 to July 2017. All isolates were identified using a standard biochemical and laboratory methodology in accordance with CLSI principles, and disk agar diffusion antibiogram were performed to identify methicillin resistant colonies. Then the presence of the Panton-Valentine leukocidin gene was tested by PCR. Results: Of the methicillin-resistant Staphylococcus aureus samples, 80％ were negative for the Panton-Valentine leukocidin gene, and only 20％ of the samples had Panton-Valentine leukocidin gene. Male and female patients showed no significant difference in the positivity rate of Panton-Valentine leukocidin gene (16.12％ vs. 33.33％) (P=0.25). Besides, there was no significant difference in bacterial resistance or susceptibility to antibiotics between samples with or without the Panton-Valentine leukocidin gene. Conclusions: In recent years, increased resistance has been a serious threat. The resistance or susceptibility of Staphylococcus aureus strains to different antibiotics is different in different geographical locations.
Introduction: The release of storage tanks' contents can lead to consequences such as BLEVE, explosions, fires, etc. Therefore, identifying the causes of content release, determining the scenarios, ...consequences, and possibility of incidents are required to prevent possible accidents. Moreover, the vulnerability and safety ranges should be determined to minimize the losses.
Methods: In this research, the Bowtie method was used to evaluate the risk caused by the pressurized reservoirs. After identifying the risks of process hazards and determining the main, middle, and base events, the fault tree was mapped. Then, the events probability was calculated. In the next step, the event tree was designed to determine different scenarios of events and identify the consequences of each incident. Later, the probability of consequences was calculated. The Bowtie diagram was designed in the next step. Finally, the vulnerability zone was determined for each of the consequences using the PHAST software.
Results: Considering the Bowtie's analysis, a total of 27 events including 21 base events, six mid events were determined. Furthermore, 15 minimal counts along with their event probabilities and importance were identified. In this regard, nine outcomes and scenarios were determined along with their probabilities. The widest human vulnerability zone was related to cloud and steam explosions.
Conclusion: Leakage from the reservoir and connections, overflow, and PRVs are among the important defects of liquefied petroleum gas reservoirs. Considering the high probability of consequences and in order to prevent from the severity and damages of accidents, systems such as cooling system and fire stop system are required in the unit.
This paper describes a rapid and efficient protocol to propagate Anthurium andreanum Linden cultivars Casino and Antadra in presence of IBA, NAA, 2,4-D, KIN and BA through callus induction and ...organogenesis. Segments of lamina and petiole (micro-cuttings or explants) were cultured in MS basal medium with different concentrations of NAA (0.0, 0.01, 0.1, 0.5, 1 and 2 mg/L) and BA (0.0, 0.5, 1, 2 and 3 mg/L) to produce callus. After 65 days, the most callus production was observed in medium containing 0.5 mg/L NAA + 3 mg/L BA in dark conditions. Production of callus in younger explants grown in dark was better than that the older explants grown in light conditions. The development of shoots and plantlets was initiated later from calluses. NAA (0.0, 0.005, 0.01 and 0.02 mg/L), 2,4-D (0.00, 0.05 and 0.1 mg/L), KIN (0.0 and 1.0 mg/L) and BA (0.0 and 1.0 mg/L) were used for shoot proliferation. The best proliferation of shoots per callus (22.83 shoots per cm2 of callus) was observed on medium supplemented with 0.01 mg/L NAA + 1 mg/L BA after 8 weeks in a 16/8 h light and dark cycle under a photoperiod of 50 μmol/m2/s. Callus production and shoot proliferation were better in Antadra cv. than those of Casino. IBA (0.0, 0.5, 1.0 and 2.0 mg/L), NAA (0.0, 0.05, 0.1 and 0.25 mg/L) and KIN (0.0 and 0.2 mg/L) were applied for rooting of proliferated shoots. In root induction media, the largest number of root (11.50 roots per plantlets) was obtained on medium supplemented with 1 mg/L IBA + 0.2 mg/L KIN. Rooting was significantly higher in Casino cv. Regenerated plants were transferred to peat: perlite: sand (1:1:1) after hardening and they showed 96% of survival.
Introduction: Different prophylactic methods are introduced to prevent surgical site Infection. This study was conducted to evaluatesituation of prophylactic antibiotics (PA) usage in an Iranian ...university hospital. Aims: A cross sectional study. Methods: This study obtained data from 1010 patients’ medical files in 2015. These patients were admitted to a university otolaryngology (ENT) and ophthalmology hospital in north of Iran. Data from ordered prophylactic antibiotics considering induction time, type of antibiotic, duration of use, dosage amount and intervals was obtained to compare with international and national guidelines. Data analysis was performed by using Chi-square test at significance level of 95%. Results: 402 (39.8%) patients were male and 608 (60.2%) ones were female. Mean age and standard deviation was 41.8±22.3 years old, and most participants were in 20-39 years of age. Ophthalmic and ENT related procedure was respectively conducted for 41.7% and 58.3% of patients. Septorhinoplasty and phacoemulsification were the commonest procedures. Totally 999 (98.9%) people received prophylactic antibiotics. Intravenous Cefazolin (for ENT procedures) and topical eye drop of Chloramphenicol 0.5% were prescribed mostly. We found poor accommodation between antibiotic use and guidelines for prophylaxis, mostly in case of duration of apply. Conclusion: Ordered prophylactic antibiotics is not as need as prescribed. Also, accommodation between prescription of antibiotics and available scientific guidelines was improper in this study.
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