Pirhossein Kolivand; Peyman Saberian; Fereshte Karimi; Mehdi Raadabadi; Samad Azari; Soheila Rajaie
Volume 12, Issue 2 , April 2024, , Pages 2-7
Abstract
Objective: Trauma-related injuries are the leading cause of death and disability in the active population, withdevastating economic, health, and social consequences for nations. TThis study aimed to assess the economicburden of injuries in Iran.Methods: In this study, the economic impact of trauma in ...
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Objective: Trauma-related injuries are the leading cause of death and disability in the active population, withdevastating economic, health, and social consequences for nations. TThis study aimed to assess the economicburden of injuries in Iran.Methods: In this study, the economic impact of trauma in Iran in 2019 was estimated using a prevalence-basedapproach. The prevalence was estimated based on available statistics in Iran and the GBD website. Directmedical expenditures were calculated using a top-down approach. The cost of lost production due to injuriesand premature death was also estimated using the DALY value. Microsoft Excel 2019 and Stata softwareversion 13.0 were used for the analysis.Results: In Iran, approximately 16,500,000 individuals were estimated to have sustained injuries in a singleyear. The average direct medical expenses for each trauma patient were around $226. Fractures contributedto 39% of the financial impact of trauma. The overall economic burden of trauma in Iran was calculatedto be $10,214,403,423. Approximately 66% of this economic burden was attributed to lost productivity andpremature death resulting from trauma, while direct medical costs made up 34%.Conclusion: The economic burden of trauma in Iran is expected to significantly rise in the future. It maybe necessary to enhance awareness of injury-related mortality and disability, improve therapies, and expandevidence-based interventions to reduce the economic impact of injuries.
Milad Ahmadi Gohari; Ali Akbar Haghdoost; Mehdi Ahmadinejad; Mohammadreza Balooch Hasankhani; Hossein Mirzaei; Yones Jahani
Volume 12, Issue 2 , April 2024, , Pages 73-80
Abstract
Objective: With the COVID-19 outbreak in countries around the world, the countries’ healthcare systemsunderwent an unprecedented shock. This study aimed to examine the resilience of the medical service deliverysystem in providing emergency services during the Covid-19 pandemic.Methods: This study ...
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Objective: With the COVID-19 outbreak in countries around the world, the countries’ healthcare systemsunderwent an unprecedented shock. This study aimed to examine the resilience of the medical service deliverysystem in providing emergency services during the Covid-19 pandemic.Methods: This study was conducted in a reference hospital in Kerman that provided emergency services totrauma patients. It compared service delivery before and after COVID-19, as well as during the COVID-19 peakand non-peak periods. The compared variables were the number of trauma patients admitted to the hospital andthe ICU, the number of patients who died in the hospital due to trauma, and the length of stay in the hospitaland the ICU.Results: The pre- and post-COVID-19 comparisons showed no significant difference in the number of dailyhospital admissions, ICU admissions, and patient deaths. The median length of stay in the ICU was significantlyreduced by almost 2 days during the COVID-19 outbreak. However, the length of stay at the hospital was almostthe same. Furthermore, a comparison of the COVID-19 peaks and non-peak periods indicated no statisticallysignificant difference in the number of admissions in the ICU, hospital and ICU length of stay, and traumainduced mortality.Conclusion: Despite the substantial workload imposed by COVID-19 on hospitals, especially during the peakperiods of the disease, the provision of medical services to emergency trauma patients did not drop significantly,and the quality of services provided to patients was within the acceptable range.
Zahra Mohtasham Amiri; Iraj Barge-Gol; Leila Kouchakinejad‑Eramsadati; Payam Abedian; Helya Jafari-Shakib
Volume 10, Issue 1 , January 2022, , Pages 27-32
Abstract
Objective: To find out factors that influence the use/non-use of pedestrian bridges in Northern Iran. Methods: In this observational study, 4 pedestrian bridges at four different places in Rasht, North of Iran was studied. In addition to demographic data, pedestrians were interviewed for reasons ...
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Objective: To find out factors that influence the use/non-use of pedestrian bridges in Northern Iran. Methods: In this observational study, 4 pedestrian bridges at four different places in Rasht, North of Iran was studied. In addition to demographic data, pedestrians were interviewed for reasons of use/not use the pedestrian bridge. The data analyzed with SPSS software version 18 by non-parametric tests such as Chi Square. Results: From all 499 participants, more than one-third of pedestrians had not used pedestrian bridges. The most reasons for bridges use among respondents were feeling of safety and security (79.2%) and obey the rules (53.6%). The reasons for the non-use of bridges were time saving (63.7%), laziness (48.7%) and inappropriate of the bridge (34.2%). There were no significant differences in age, sex, education level, and road accidents’ history with use of bridge but there was a significant difference between the bridge usage with having a driver’s license, rash-hour time, and the presence of a mechanical elevator (p <0.001). Conclusion: The results of this study show that in order to increase the pedestrian bridges use, it is necessary to pay more attention to make standard facilities such as installing escalators or elevators of these bridges.
Hanieh Ahmadi; Zahra Alizadeh; Samad Karkhah; Mohammad Javad Ghazanfari
Volume 10, Issue 1 , January 2022, , Pages 40-43
Abstract
Ocular trauma is one of the most common causes of acquired blindness in children. The epidemiological parameters associated with ocular trauma vary in different populations, especially in children. The objective of this study was to assess the ocular trauma epidemiology in children less than ...
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Ocular trauma is one of the most common causes of acquired blindness in children. The epidemiological parameters associated with ocular trauma vary in different populations, especially in children. The objective of this study was to assess the ocular trauma epidemiology in children less than 18 years of age. In this crosssectional study, 145 children (under 18 years) with ocular trauma who referred to the emergency department of Bu-Ali-Sina Hospital in Sari, Iran were enrolled from November 2017 to January 2019. Of the participants, 57.9% were men, 70.4% had blunt trauma, 97.2% had a unilateral eye injury, and 54.5% had a right eye injury. The most risk factor for trauma was stationery (51.0%). Almost half of the patients (52.9%) had corneal injuries. The most trauma locations were at home (67.4%). Most patients (95.0%) had normal relative afferent pupillary defects. Blunt (52.6% vs. 47.4%) and penetrating (72.5% vs. 27.5%) traumas was higher in boys than girls (p=0.03). Most frequent part of eye injuries in blunt and penetrating traumas was related to the cornea (P=0.04). It seems that parents should have more supervision on children at home and give adequate education in using of stationery to school-age children by considering the results of present study.
Leili Abedi Gheshlaghi; Hamid sharifi; Mehdi Noroozi; Mohsen Barouni; Homayoun Sadeghi-Bazargani
Volume 9, Issue 4 , October 2021, , Pages 169-177
Abstract
Objective: To investigate the quality of life (QOL) of injured motorcyclists and associated factors in a period of three months after the accident. Methods: In the present study, we were included 190 injured motorcyclists who admitted to two referral specialized hospitals (Emam Reza and Shohada) in Tabriz, ...
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Objective: To investigate the quality of life (QOL) of injured motorcyclists and associated factors in a period of three months after the accident. Methods: In the present study, we were included 190 injured motorcyclists who admitted to two referral specialized hospitals (Emam Reza and Shohada) in Tabriz, between June 2018 and January 2019. All injured motorcyclists were contacted through the telephone one and 171 of them (90%) three months after their accident to complete an EQ-5D-3L questionnaire. The baseline measurements were gathered by using face to face interviews in the hospitals. The QOL score could vary between 1 and 3. The higher score showed a lower QOL. Results: The injured motorcyclist’s QOL score was relatively better in three months after the accident (mean±Standard Deviation (SD): 1.78±0.51) in comparison with their status a month after the accident (2.15±0.65) (p <0.001). The multivariable model showed that individuals with pelvis injuries (Coef: 0.29, (95% CI: 0.16, 0.42), p=0.001) and knee injuries (Coef: 0.26, (95% CI: 0.10, 0.42), p=0.001), experienced a higher QOL score. Also, those whose accident had happened in rainy weather experienced higher QOL score (Coef: 0.33, (95% CI: 0.12, 0.53), p=0.001). The patients who were in an accident with a vehicle were experienced a better QOL than others (Coef: -0.26, (95% CI: -0.43, -0.09), p=0.002). Conclusion: The assessment of three-months post-accident showed that the QOL score of the motorcyclists was reduced. It is recommended that the QOL of patients should be improved in hospital discharge victims.
Hosein Abbasi; Ali Dehghani; Ali Akbar Mohammadi; Tayyeb Ghadimi; Abdolkhalegh Keshavarzi
Volume 9, Issue 4 , October 2021, , Pages 195-200
Abstract
Objective: To investigate the prevalence of chemical burns among the patients admitted to Shiraz burn treatment centers. Methods: It is a descriptive study that was conducted on 62 patients with chemical burns who were admitted between 2008 and 2018. The patients’ records were used in the research ...
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Objective: To investigate the prevalence of chemical burns among the patients admitted to Shiraz burn treatment centers. Methods: It is a descriptive study that was conducted on 62 patients with chemical burns who were admitted between 2008 and 2018. The patients’ records were used in the research using the census sampling process. A questionnaire with questions about age, sex, the extent of the burn, the cause of the burn, duration of hospital stay, level of education, incident location, and clinical outcome was used to collect data (survival-death). The data was analyzed by using descriptive statistical methods. Results: The prevalence of chemical burns was 1% during 2008-2018. Acid and alkali burns were accounted for 93.5% and 6.5% of burns, respectively. 77.4% of patients were male, and 22.6% were female. The mean age of patients was 27 years. The average burn percentage was 16%. 70.6% of patients were illiterate or had primary education. Burns occurred at the workplace and home in 12.9% and 66.1% of cases, respectively. Moreover, Burns occurred due to accident (61%), acid attack (29%), and self-immolation (10%). The average length of hospital stay was 20 days. One patient (1.6%) died from burns. Conclusion: The study’s findings revealed that chemical burns were more common in men than women, and the majority of chemical burns occurred at home. To minimize the occurrence of chemical burns and acid attacks, teaching methods of preventing burns is important at home and work, as well as restricting nonspecialists’ access to chemicals.
Shahla Chaichian; Abolfazl Mehdizadehkashi; Shahla Mirgaloybayat; Neda Hashemi; Farahnaz Farzaneh; Roya Derakhshan; Samaneh Rokhgireh
Volume 9, Issue 3 , July 2021, , Pages 145-150
Abstract
Objective: To evaluate the maternal and fetal outcomes of COVID-19 up to three months after the delivery in pregnant women. Methods: This case series study was conducted on all pregnant women with COVID-19 hospitalized in Hazrat -E- Rasoul Akram Hospital, Tehran, Iran from March 8, 2020 ...
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Objective: To evaluate the maternal and fetal outcomes of COVID-19 up to three months after the delivery in pregnant women. Methods: This case series study was conducted on all pregnant women with COVID-19 hospitalized in Hazrat -E- Rasoul Akram Hospital, Tehran, Iran from March 8, 2020 to December 28, 2020. Data were included maternal age and gestational age (GA) which presenting signs and symptoms were collected at hospital admission. To confirm COVID-19 diagnosis, high-resolution computed tomography (HRCT) or reverse transcription-polymerase chain reaction (RT-PCR) tests were conducted. Both the mothers and the newborns were followed up to three months after delivery. Results: Fourteen pregnant women with the median age of 31.5 were enrolled. HRCT was done in twelve mothers (85.7%), and eleven mothers (78.6%) were evaluated via RT-PCR; four of them (36.36%) were positive. Two mothers (14.28%) were admitted to ICU. The cesarean section (C/S) was done following fetal distress in only three mothers due to their concerns of vertical transmission. Two mothers were admitted to the intensive care unit (ICU), and one of them died of pneumomediastinum. Fortunately, no neonatal death was reported three months after the delivery. Conclusion: COVID-19 affects mothers more in the last trimester of the pregnancy. Although no fetal death was reported in the recent study, physicians should closely monitor pregnant women to reduce the adverse event.
Daem Roshani; Aram Karimian
Volume 9, Issue 1 , January 2021, , Pages 1-8
Abstract
Objective: To assess the preparedness of Iranian hospitals against earthquake.Methods: In this systematic review, a query was carried out on PubMed, Scopus, Web of Sciences, Sid, Irandoc, Google scholar, and Magiran databases for articles published between 2000-2019. Statistical analysis was ...
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Objective: To assess the preparedness of Iranian hospitals against earthquake.Methods: In this systematic review, a query was carried out on PubMed, Scopus, Web of Sciences, Sid, Irandoc, Google scholar, and Magiran databases for articles published between 2000-2019. Statistical analysis was performed using Chi-square and I2 tests at a confidence interval of 95%. Finally, out of 7458 studies, 10 related articles were analyzed.Results: As evidenced by the obtained results, the highest readiness was obtained at 0.709 (95% CI: 0.49-0.88) in “disaster plan”, while the lowest readiness was reported at 0.455 (95% CI: 0.23-0.68) in “structural safety”. The overall earthquake preparedness of these hospitals was calculated at 0.47 (95% CI: 0.37-0.56).Conclusion: The results of the present study pointed to the moderate level of earthquake preparedness in Iranian hospitals. This finding highlights the necessity of a training plan and implementation of a national program in all hospitals of the country to increase earthquake preparedness.
Farshad Faghisolouk; Sanaz Sohrabizadeh; Hamid Soori; Davoud Khorasani-zavareh
Volume 9, Issue 1 , January 2021, , Pages 28-35
Abstract
Objective: To explore the factors affecting unsafe antisocial behaviors of drivers in the context of Iran.Methods: The interviews were conducted from June to November 2019. A number of 19 participants were selected using purposive sampling method. The data were collected using face to face in-depth ...
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Objective: To explore the factors affecting unsafe antisocial behaviors of drivers in the context of Iran.Methods: The interviews were conducted from June to November 2019. A number of 19 participants were selected using purposive sampling method. The data were collected using face to face in-depth semi-structured interviews. Content analysis using Granheim’s approach was applied for data analysis.Results: Seven categories and 14 sub-categories were extracted from the data. The categories included cultural factors, educational and training factors, laws, imitating, substance abuse, awareness and attitude, and psychological problems.Conclusion: Based on the findings, various cultural, legal, educational, individual and psychological factors affect the unsafe antisocial behavior in driving. Seemingly, such behaviors could increase the chance of death or injury caused by road traffic crashes among the road users and affect social welfare of the citizens and road user’s safety.
Hassan Araghizadeh; Mahmoudreza Peyravi; Simintaj Sharififar; Milad Ahmadi Marzaleh
Volume 8, Issue 4 , October 2020, , Pages 218-223
Abstract
Objective: The present study aimed at codifying a native model of civil-military coordination (CIMIC) in natural disasters in Iran. Methods: This manuscript is a part of a larger study. The present cross-sectional study was conducted in 2019 using a two-stage Delphi technique. The factors confirmed by ...
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Objective: The present study aimed at codifying a native model of civil-military coordination (CIMIC) in natural disasters in Iran. Methods: This manuscript is a part of a larger study. The present cross-sectional study was conducted in 2019 using a two-stage Delphi technique. The factors confirmed by the technique were prioritized via a pairwise questionnaire. In doing so, 24 elites and experts in civil-military coordination were presented with the indicators in the course of classic Delphi technique and pairwise comparison. At the end, the nationalized model was finalized by sending the model to ten experts and asking their ideas. Results: The results obtained from the two rounds of Delphi indicated that 36 coordination factors could be classified into three primary classes of staff, stuff, and system. All factors were confirmed by the experts. Considering the weight of each class, “staff” and “stuff” classes were considered to be the highest and lowest priorities, respectively. Conclusion: Application of the coordination factors in the context of military and civil organizations leads to a better response to natural disasters. The organizations in charge of responding to disasters should be obliged to apply this model in the highest organizational commitment level as the final goals of disaster management. The results of the present study can be applied for codification of a comprehensive plan for assessing the civil-military coordination in natural disasters.
Ehsan Sarbazi; Mohamadreza Sarbazi; Saber Ghaffari-fam; Towhid Babazadeh; Sohrab Heidari; Khadijeh Aghakarimi; Ismail Jamal; Ali Sherini; Javad Babaie; Ghader Darghahi
Volume 8, Issue 4 , October 2020, , Pages 236-242
Abstract
Objectives: The aim of the present study was identifying factors associated with h delayed initiation of post-exposure prophylaxis (PEP) among animal bite victims. Methods:This cross-sectional study assessed biting patterns among 3032 cases that were referred to Tabriz Rabies Center. The delay was described ...
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Objectives: The aim of the present study was identifying factors associated with h delayed initiation of post-exposure prophylaxis (PEP) among animal bite victims. Methods:This cross-sectional study assessed biting patterns among 3032 cases that were referred to Tabriz Rabies Center. The delay was described as the initiation of PEP more than 48 hours (h) after possible exposure to the rabies virus. Determinants of delay in initiating PEP were recognizing by a decision tree model. Results: Totally, 8.5% of the victims who were bitten by an animal had a delay of more than 48 h in the initiation of PEP. The relative frequency of delay more than 48 h in females was higher than the males (12.9% compared to 8.5%) (p-value= 0.004). Relative frequency of delay more of 48 h from carnivorous (dog, jackal, fox) was significantly less than others (p -value< 0.001). Of the decision tree, the overall classification accuracy was 89.5%, with 44.1% sensitivity and 92.3% specificity. The identified variables included gender,biting place (rural, urban), and type of animal. Conclusion: Based on the study findings on various variables that affect the delayed initiation of PEP, particularly being female, and rural residents were the major factors associated with a delay in the initiation of PEP for rabies prevention. We found relatively low rates of vaccine completion. Our findings indicate that provider training and patient education are required to ensure the completion of appropriate treatment.
Ali Akbary; Seyed Taghi Heydari; Yaser Sarikhani; Mehrdad Vossoughi; Reza Tabrizi; Maryam Akbari; Najmeh Movahhedian; Arash Mani; Homayoun Sadeghi-Bazargani; Tahereh Ostovar; Kamran Bagheri Lankarani
Volume 8, Issue 3 , July 2020, , Pages 163-168
Abstract
Objective: To investigate the association between attention-deficit/hyperactivity disorder (ADHD) score and driving behaviors among motorcycle drivers in Iran. Methods: This multi-center cross-sectional study was conducted on 1747 motorcyclists in three cities of Iran. We used a random sampling method ...
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Objective: To investigate the association between attention-deficit/hyperactivity disorder (ADHD) score and driving behaviors among motorcycle drivers in Iran. Methods: This multi-center cross-sectional study was conducted on 1747 motorcyclists in three cities of Iran. We used a random sampling method in this study and gathered data using two standard questionnaires. Data were presented using descriptive statistics, also t-test, and ANOVA used for analysis. Results: The mean age of participants was 27.41±8.80 years. ADHD scores of the participants ranged from 0 to 87, with a mean score 31±15.86. All risky driving behaviors (RDBs) were significantly associated with a higher mean of ADHD score. For example, driving with illegal speed (p<0.001), not wearing a crash helmet (p=0.016), driving while exhausting (p<0.001), talking with other passengers (p<0.001), being fined by the police in the past year (p=0.028), and maneuvering while driving (p<0.001) were related to a higher mean of ADHD score. Conclusion: All RDBs were significantly associated with the ADHD score among motorcyclists in Iran. In this regard, health care providers should inform people with ADHD about the negative consequences associated with driving and ADHD. Public health policymakers should consider management of ADHD through a comprehensive approach to improve driving performance and competencies among motorcyclists in order to decrease RDBs and traffic accidents.
Mahmoudreza Peyravi; Ali Asghar Peyvandi; Ali Khodadadi; Milad Ahmadi Marzaleh
Volume 7, Issue 2 , April 2019, , Pages 199-200
Abstract
Dear Editor,Extreme climatic changes have increased the frequency and intensity of natural disasters all over the world imposing disastrous effects on human life and environment[1]. One of the dangerous disasters is flood. Flood may happen due to extreme rain or human-made actions in shores[2]. This ...
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Dear Editor,Extreme climatic changes have increased the frequency and intensity of natural disasters all over the world imposing disastrous effects on human life and environment[1]. One of the dangerous disasters is flood. Flood may happen due to extreme rain or human-made actions in shores[2]. This report has investigated the feature and causes, actions taken, problems faced and lessons learned regarding flood management in Khuzestan province in Iran in January, 2019.
Mohammad Saadati; Saber Azami-aghdash; Mahdiyeh Heydari; Naser Derakhshani; Ramin Rezapour
Volume 7, Issue 1 , January 2019, , Pages 1-8
Abstract
Objective: To perform a systematic review and meta-analysis of self-immolation epidemiology and characteristics in Iran.Methods: This was a systematic review and meta-analysis study. PubMed, Scopus, Web of science and Science Direct were searched for English literature and SID and Magiran for Persian ...
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Objective: To perform a systematic review and meta-analysis of self-immolation epidemiology and characteristics in Iran.Methods: This was a systematic review and meta-analysis study. PubMed, Scopus, Web of science and Science Direct were searched for English literature and SID and Magiran for Persian in the time period of 2000 to 2016. The retrieved studies were screened and reviewed then quality assessed. Random Effect model was applied for meta-analysis. The qualitative data were analyzed by content analysis method.Results: After literature screening, 39 studies included in the analysis. Women were subject to self-immolation more than men. The rate of self-immolation estimated to be 4.5 cases in every 100,000 populations and it was the reason of 16% of hospitalized burns. The average length of hospital stay calculated to be 12.24 (95% CI: 8.85-15.59) days. The total burnt surface area was 65.3% (95% CI: 56.71-73.89). Death due to self-immolation was 62.1%. The major risk factors of self-immolation were having mental health issues, family problems and characteristics and problems in relation/communication with spouses.Conclusion: Despite the low rate of self-immolation in Iran, it comprises one sixth of the hospitalized burns. The mortality rate of self-immolation also is high and this highlights the importance of providing special care. Psychological consultations and mental health screening in the primary health care would help to prevent the self-immolation.
Saeide Aghamohamadi; Katayoun Jahangiri; Amir Kavousi; Ardeshir Sayah Mofazali
Volume 6, Issue 4 , October 2018, , Pages 341-348
Abstract
Objective: To predict the accident mortality trend in next two decades in Iran.Methods: The study population comprised all deaths recorded in the system of registration and classification of causes of death of Ministry of Health and Medical Education of Iran during the years 2006 to 2015. The information ...
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Objective: To predict the accident mortality trend in next two decades in Iran.Methods: The study population comprised all deaths recorded in the system of registration and classification of causes of death of Ministry of Health and Medical Education of Iran during the years 2006 to 2015. The information was collected via death certificate, burial permit, and reporting forms. To forecast the trends of causes-of-death, Lee Carter model was employed in a demographic package 18.1 of R software version 3.3.1.Results: Based on the results, the highest percentage of all causes of death from accidents (in unintentional accidents) goes to transport accidents, and most top intentional accidents belonged to intentional self-harm. The trends of unintentional accidents in the whole population and both sexes have reduced from 2006 to 2035, such that the rate has reduced from 62.2 in 2006 to 12.1 per 100 thousand populations in 2035. It is anticipated that the causes of death due to intentional accidents with the rate of 8.86 in 2006, will be 1.89 (per 100,000 population) in the year 2035.Conclusion: Accident mortalities have a significant role in the deaths of Iranian population; therefore, to reduce the impact of accident mortality on society, a precise approach is needed to monitor the trends as well as preventing measures and increasing the safety standards.
Salman Khazaei; Shahab Rezaeian; Sakineh Mazharmanesh; Mahin Ahmadi-Pishkuhi; Vali Baigi; Zaher Khazaei; Yousef Veisani
Volume 6, Issue 3 , July 2018, , Pages 233-238
Abstract
Objective: To investigate the epidemiological aspects of all-cause injuries in Hamadan province during a 6-year period.Methods: We conducted a cross-sectional study on injured subjects admitted to private or governmental hospitals in Hamadan province during March 2009 to March 2015. The epidemiological ...
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Objective: To investigate the epidemiological aspects of all-cause injuries in Hamadan province during a 6-year period.Methods: We conducted a cross-sectional study on injured subjects admitted to private or governmental hospitals in Hamadan province during March 2009 to March 2015. The epidemiological characteristics were retrieved from a registry-based system including gender, residency, injury mechanism and date of injury occurrence, outcome of hospitalization (full recovery/disability/death).Results: Totally, 135,925 hospitalized injured cases were recorded. The majority of cases were male (72.6%) and were occurred in urban areas (60%), about 40% of patients were in 20-34 years’ age group, and the highest proportion (30.13%) of injuries occurred in summer. Logistic regression showed that the odds of disability vs. recovery was significantly higher in rural areas [Adjusted odds ratio (AOR) =3.42] and the odds of death vs. recovery was higher among male gender (AOR=1.46). In addition, comparing to the 0-4-year age-group, odds of death were significantly higher in middle aged and elderly victims. Conclusion: Our findings showed that middle age groups, male gender and urban area increase the odds of death. Injured males and old age subjects had the highest odds of death and out of residential area injuries were common cause of leading death injuries.
Abbas Rasouli; Seyed Mojtaba Hosseini; Mohammad Karim Bahadori; Ramin Ravangard
Volume 6, Issue 2 , April 2018, , Pages 155-161
Abstract
Objective: To prioritize occupational hazards in a Pharmaceutical Company in Iran using the analytical hierarchy process (AHP).Methods: This was a cross-sectional study conducted in a Pharmaceutical Company in Iran in 2017. All employees working in the administrative, production, installations and facilities, ...
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Objective: To prioritize occupational hazards in a Pharmaceutical Company in Iran using the analytical hierarchy process (AHP).Methods: This was a cross-sectional study conducted in a Pharmaceutical Company in Iran in 2017. All employees working in the administrative, production, installations and facilities, and laboratory units were studied using the consensus method (N=n=130 employees). A data collection form was designed for identifying the hazards using the Nominal Group Technique (NGT) method, as well as a pair-wise questionnaire was used for collecting required data in the quantitative phase. The collected data were analyzed using Expert Choice 10.0 and SPSS 23.0.Results: The results showed that among hazards detected in the studied units, the highest and lowest weights and priorities were, respectively, related to "inhalation of toxic gases" (W=0.253) and “being exposed to radiation” (W=0.022) in the laboratory unit, "skin injuries" (W=0.205) and “bending and straightening for a long time” (W= 0.032) in the production unit, "falling down" (W=0.271) and “standing and sitting for a long time “ (W=0.037) in the installations and facilities unit, and "hand joint failure" (W=0.295) and “working in a low-light environment” (W=0.092) in the administrative unit.Conclusion: The results of the present study showed that there were hazards in all of the studied units. These results indicated a high level of hazards in the pharmaceutical company’s units. Due to the increased medication diversification and increased workload for these companies, paying attention to the preventive and corrective measures in order to reduce the risk of emerging hazards is essential.
Mohamadreza Saatian; Jamal Ahmadpoor; Younes Mohammadi; Ehsan Mazloumi
Volume 6, Issue 1 , January 2018, , Pages 45-53
Abstract
Objective: To determine the epidemiological aspects of patients with traumatic brain injury (TBI) in a regional trauma center.Methods: A cross-sectional study was conducted on patients with TBI during 2013 to 2016 in a single center in Hamedan, central Iran. The distribution and relationships of TBI ...
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Objective: To determine the epidemiological aspects of patients with traumatic brain injury (TBI) in a regional trauma center.Methods: A cross-sectional study was conducted on patients with TBI during 2013 to 2016 in a single center in Hamedan, central Iran. The distribution and relationships of TBI was assessed with gender, age, type of trauma, traumatic cause, exiting status and Length of Hospitalization (LOH). Data were analyzed by Stata V11 statistical software.Results: In general, 9426 patients with TBI were enrolled in analyses. The mean ± SD age of patients was 29.70 (± 21.46) years. Multivariate logistic regression indicated that being male [OR: 1.29; 95% CI (2.92-4.73), P ≤0.001], 41-50 to 71-80 and 90+ years old' age groups (1.32<OR<3.12, 0.029<p≤0.001), having surgery [OR: 5.58; 95% CI (4.89-6.37), p≤0.001], and different types of trauma (p≤0.001) were significantly related to LOH. Moreover, odds ratio of mortality was 1.52 times greater in males than females (p≤0.001). As the age increases, the odds ratio of mortality was also rising. However, having surgery [OR: 3.72; 95% CI (2.92-4.73), p≤0.001], LOH >5 days [OR: 2.01; 95% CI (1.60-2.52), p≤0.001] and different types of trauma were significantly related to mortality.Conclusion: TBI is one of the main causes of mortality and LOH of the young population. By providing preventive measures and a traumatic care system, the burden of trauma can be greatly reduced, the implementation of the trauma care system in Hamedan province is a necessity.
Faranak Sherafati; Enayatollah Homaie-Rad; Abolhassan Afkar; Ramin Gholampoor Sigaroodi; Soheil Sirusbakht
Volume 5, Issue 2 , April 2017, , Pages 116-121
Abstract
Objectives: To investigate the differences in death after receiving emergency services in traffic accidents between urban and rural regions, and decompose factors of the gap in Langerood, Northern Iran.Methods: This cross-sectional study was conducted in Langrood, Northern Iran during a 1-year period ...
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Objectives: To investigate the differences in death after receiving emergency services in traffic accidents between urban and rural regions, and decompose factors of the gap in Langerood, Northern Iran.Methods: This cross-sectional study was conducted in Langrood, Northern Iran during a 1-year period from 2013 to 2014. The hospital data of traffic crashes were used. Data contained those patients who survived at the scene of accident. Injury severity score, time to admission, age, gender, season of crash and type of collision were variables used in this study. Oaxaca decomposition technique was used to show the amount of inequity. In addition, three regression models were used to show the reason of inequity.Results: Overall 1520 patients with road traffic accidents were admitted to our center during the study period. The mean age of the patients was 35.45 ± 17.9 years, and there were 1158 (76.1 %) men among the victims. Motorbike accidents accounted for 869 (57.1%) injuries and 833 (54.8 %) accidents occurred in rural regions. The in-hospital mortality rate was 60 (3.9%). The results of this study showed that 95% of inequity came from factors used in this study and 2.04% disadvantages were for rural crashes. Severity of crash and time to admission had relationship with death, while the effects of time to admission was higher in rural region and severity of the accident had more effect on mortality in urban regions in comparison with rural ones.Conclusion: The high rate of fatal accidents could be decreased by deleting the gap of access to health care services between urban and rural regions. This study suggested that more efforts of health system are needed to reduce the gap.
Marjan Hosseinpour; Abdollah Mohammadian-Hafshejani; Mohammad Esmaeilpour Aghdam; Mahdi Mohammadian; Farzad Maleki
Volume 5, Issue 1 , January 2017, , Pages 47-52
Abstract
Objective: To investigate trend and seasonal pattern of occurrence and mortality of motorcycle accidents in patients referred to hospitals of Isfahan.Methods: This cross-sectional study was carried out using traffic accidents data of Isfahan province, extracted from Ministry of Health (MOH) database ...
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Objective: To investigate trend and seasonal pattern of occurrence and mortality of motorcycle accidents in patients referred to hospitals of Isfahan.Methods: This cross-sectional study was carried out using traffic accidents data of Isfahan province, extracted from Ministry of Health (MOH) database from 2006 to 2010. During the study period, 83648 people injured due to motorcycle traffic accidents were referred to hospitals, all of them entered in the study. Logistic regression model was used to calculate the hospital mortality odds ratio, and Cochrane-Armitage test was used for assessment of linear trend.Results: During the study period, the hospital admission for motorcycle accident was 83,648 and 89.3% (74743) of them were men. Mean age in accidents time was 26.41±14.3 years. The injuries and death sex ratio were 8.4 and 16.9, respectively. Lowest admission rate was during autumn and highest during summer. The injury mortality odds ratio was 1.01 (CI 95% 0.73-1.39) in the Spring, 1.34 (CI95% 1.01-1.79) in summer and 1.17 (CI95% 0.83-1.63). It was also calculated to be 2.51 (CI95% 1.36-4.64) in age group 40-49, 2.39 (CI95% 1.51-5.68) in 50-59 and 4.79 (CI95% 2.49-9.22) in 60-69 years. The mortality odds ratio was 3.53 (CI95% 2.77-4.5) in rural place, 1.33 (CI95% 1.15-1.54) in men, and 2.44 (CI95% 2.09-2.85) in the road out of town and village. In addition, trend of motorcycle accidents mortality was increasing (p<0.001).Conclusion: Motorcycle accidents injuries are more common in men, summer, young age and rural roads. These high risk groups need more attention, care and higher training.
Saber Ghaffari-fam; Ehsan Sarbazi; Amin Daemi; Mohammad Reza Sarbazi; Hossein Ali Nikbakht; Shaker Salarilak
Volume 4, Issue 4 , October 2016, , Pages 223-229
Abstract
Objectives: To determine the epidemiology of injuries of the motorcyclists in road traffic accidents (RTIs) between 2008 and 2014 in East Azarbayejan province of Iran.Methods: A cross-sectional study was performed in East Azerbaijan province in Imam Reza hospital on motorcyclists subjected to injuries ...
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Objectives: To determine the epidemiology of injuries of the motorcyclists in road traffic accidents (RTIs) between 2008 and 2014 in East Azarbayejan province of Iran.Methods: A cross-sectional study was performed in East Azerbaijan province in Imam Reza hospital on motorcyclists subjected to injuries in RTIs between 2008 and 2014. Demographic characteristics (age, sex), duration of hospitalization, final status of injured people after discharge from the hospital, admission ward, number of admissions due to injuries in RTIs, nature of injury, and the clinical services provided to injured people were gathered from hospital information system (HIS). Demographic characteristics (age, sex), duration of hospitalization, final status of injured people after discharge from the hospital, admission ward, number of admissions due to injuries in RTIs, injured site of the body, nature of injury, and the clinical services provided injured people were gathered from HIS. Standardized data collection form was used for uniform handling of the data.Results: Most of the victims (94.4%) were male. The most frequent injuries pertained to the age group of 18-30 with 1676 (51.4%) injuries. Head, abdomen, lower back, lumbar spine, and pelvis, were the most common injured sites, respectively. Reduction of fracture and dislocation and cranial puncture were the most common provided services. The lowest survival time belonged to the age group over 60 years old.Conclusion: Injuries to the head are the most prevalent injuries among motorcyclists in RTIs. So it is suggested that proper interventions be implemented to ensure wearing helmet by motorcyclist and pillion passengers.
Zahra Mohtasham-Amiri; Saeed Dastgiri; Ali Davoudi-kiakalyeh; Ali Imani; Keyvan Mollarahimi
Volume 4, Issue 4 , October 2016, , Pages 230-235
Abstract
Objective: To determine the epidemiological characteristics of the road traffic injuries (RTIs) in Guilan province, northern Iran.Methods: This study was a cross-sectional study which included all of RTIs admitted to medical centers of Guilan province (northern Iran) during 2012. ICD-10 was used as ...
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Objective: To determine the epidemiological characteristics of the road traffic injuries (RTIs) in Guilan province, northern Iran.Methods: This study was a cross-sectional study which included all of RTIs admitted to medical centers of Guilan province (northern Iran) during 2012. ICD-10 was used as diagnostic criteria. Demographic variables also injury circumstance and in hospital variables such as length of stay, time of admission, type of surgery, ICU admission, final outcome and mechanism of injury, anatomical part of injury according to Abbreviated Injury Scale (AIS) classification were derives from records by trained research team. Descriptive data is reported. The predictors of mortality were also determined.Results: The prevalence of road traffic injuries in Guilan province was 31 in 10,000 populations. Of total 7671 accidents, 5976 (77.9%) were men and 1695 (22.1%) were women. Mean age of these victims was 33.3 ± 17.289 years (32.64±16.939 for men, 35.62±18.312 for women). Most of them (32.5%) were 20-29 years old. Motorcycle-car accidents had the highest frequency followed by car-car crashes and car accidents involving pedestrians. Most of the patients (85.9%) were hospitalized and 280 injured died (3.7%). Upper extremities were the most sites of injuries. Male sex, length of hospital stay, multiple injuries and increased age were associated with road traffic accident associated mortality.Conclusion: RTIs cause enormous death and disability in this area and more road traffic preventive programs should be enforcement in these areas to reduce incidences RTI.
Hamid Reza Abbasi; Mitra Amini; Shahram Bolandparvaz; Shahram Paydar; Jameel Ali; Sepideh Sefidbakht
Volume 4, Issue 2 , April 2016, , Pages 75-79
Abstract
Objective: To evaluate the effect of advance trauma life support (ATLS®) training on general surgery residents clinical reasoning skills using the national boards-style objective structured clinical examination (OSCE).Methods: This cross-sectional single-center study was conducted in Shiraz University ...
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Objective: To evaluate the effect of advance trauma life support (ATLS®) training on general surgery residents clinical reasoning skills using the national boards-style objective structured clinical examination (OSCE).Methods: This cross-sectional single-center study was conducted in Shiraz University of Medical Sciences including 51 surgery residents that participated in a mandatory national board style OSCE between May 2014 and May 2015. OSCE scores of two groups of general surgery residents including 23 ATLS® trained and 28 non-ATLS® trained were compared using Mann-Whitney U test. The exam was graded out of 20 points and the passing score was ≥14 including 40% trauma cases.Results: There were 8(15.7%) women and 43(84.3%) men among the participants with mean age of 31.12 ± 2.69 and 33.67 ± 4.39 years in women and men respectively. Overall 7 (87.5%) women and 34 (79.07%) men passed the OSCE. The trauma section OSCE score was significantly higher in the ATLS® trained participants when compared to non-ATLS®(7.79 ± 0.81vs.6.90 ± 1.00; p=0.001). In addition, the total score was also significantly higher in ATLS® trained residents (16.07 ± 1.41 vs. 14.60 ± 1.40; p=0.001). There was no association between gender and ATLS® score (p=0.245) or passing the OSCE (p=0.503).Conclusion: ATLS® training is associated with improved overall OSCE scores of general surgery residents completing the board examinations suggesting a positive transfer of ATLS learned skills to management of simulated surgical patients including trauma cases.
Aliyeh Sargazi; Atefeh Sargazi; Prigil Kumar Nadakkavukaran Jim; HoseinAli Danesh; Forough Sargolzaee Aval; Zohre Kiani; AmirHosein Lashkarinia; Zahra Sepehri
Volume 4, Issue 1 , January 2016, , Pages 43-47
Abstract
Objective: To determine the economic burden of road traffic accidents (RTAs) in patients admitted to a single center in south eastern Iran.Methods: This cross-sectional study was conducted in Amir-Al-Momenin hospital of Zabol affiliated with Zabol University of Medical Sciences during a 12-month period ...
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Objective: To determine the economic burden of road traffic accidents (RTAs) in patients admitted to a single center in south eastern Iran.Methods: This cross-sectional study was conducted in Amir-Al-Momenin hospital of Zabol affiliated with Zabol University of Medical Sciences during a 12-month period from April 2012 to April 2013. All the RTAs patients who were admitted to our emergency department were included. The direct expenses of hospital care were recorded according to their medical charts and the accountant registration information. Data are presented according to different RTAs characteristics.Results: Overall 1155 patients were included in the current study with mean age of 36.7 ± 5.14 years among whom there were 673 (58.3%) men and 482 (41.7%) women. The annual incidence of RTAs were calculated to be 288 per 100,000 population. The RTAs economic burden in our center was 589,448.49 USD which accounted for 10.4% of total hospital expenses during the study period. The money spend on RTAs in our center was 130 times more than gross national income per capita. Cost of each patient in road traffic was 15 times more than cost of an average patient of the hospital in other sections.Conclusion: With considerable high ratio of accidents in Zabol, proper intervention is needed for controlling and preventing RTAs in order to decrease its injuries, impact and the associated economic burden.
Saber Ghaffari-fam; Ehsan Sarbazi; Amin Daemi; Mohamadreza Sarbazi; Lachin Riyazi; Homayoun Sadeghi-Bazargani; Ali Allahyari
Volume 3, Issue 3 , July 2015, , Pages 104-110
Abstract
Objective: To describe the epidemiological and clinical characteristics of fall injuries in East Azerbaijan, Iran.Methods: This cross-sectional study was based on Hospital Information System (HIS) data for patients referred to the Imam Reza Hospital between 2008 and 2013. We recorded the demographic ...
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Objective: To describe the epidemiological and clinical characteristics of fall injuries in East Azerbaijan, Iran.Methods: This cross-sectional study was based on Hospital Information System (HIS) data for patients referred to the Imam Reza Hospital between 2008 and 2013. We recorded the demographic characteristics and epidemiological patterns of patients who were admitted to our center due to fall injuries. To standardize the reports the International Classification of Diseases (ICD), the International Classification of Diseases 9 Clinical Modification (ICD-9-CM)was used. Equally, the hospitalization period and number, admission ward, and the final status of victims after discharge from the hospital were extracted from the HIS.Results: Overall we included a total number of 3397 patients with mean age of 39.2±22.7 years. There were 2501 (73.6%) men among the patients. Long bone fracture (48.1%) and intracranial injury (24.2%) were the most frequent injuries among fall injury victims. Operations on spinal cord and spinal canal structures (12.0%), Operations on nose (11.6%) were the most common operations being performed in these patients. The survival was significantly lower in patients with age more than 60 years when compared to other age groups (p=0.001).The survival rate was significantly lower in age group of >60 years, compared to other age groups (p=0.001).Conclusion: Given the high rate of fall injuries and death among the elderly that increases with age, appropriate measures must be taken to control and prevent injuries while prioritizing the elderly.
