Epidemiological pattern of non-fatal injuries in Iran

To present the incidence rate and distribution of non-fatal injuries in Iran. A one- year study was carried out in all 28 provinces of Iran in 2002-3. Overall, 53,6624 individuals [1,11626 households] from all provinces of the country were randomly selected for the study. In each province about 2000 households in urban and 2000 families in rural areas were included in the study. The guardians or heads of the households were interviewed by using a questionnaire that included information about any accidental injuries taken medical cares within the year prior to the date of data collection and some other demographic information. It is estimated that more than 9.2 million injuries with about 8286 deaths and 74379 hospitalizations occurred in Iran each year. The incidence rate of all types of non-fatal injuries was [444.3 per 100,000]. The top three causes of non-fatal injuries were transport accidents [237 per 100,000], falls [106.2 per 100,000] and struck by thrown, projected of falling object [69.8 per 100,000]. The non-fatal injuries were more common among males than females [8039.6 vs. 2021.7 per 100,000] and nearly equivalent among residence of urban areas compared to those from rural areas [5024.1 vs. 5075.5 per 100,000]. In Iran injuries are one of the main leading causes of diseases and hospital admissions in both rural and urban areas, and this figure for transport accidents is quite high in the world

[Result of retrosigmoid sub-occipital craniectomy in patients with acoustic neurinoma in Shohada hospital [1998-2006]]

Acoustic neurinoma is a benign neoplasm of Schwann cell source that mainly originate from vestibular branch of 8th cranial nerve. In this study we evaluated the result of suboccipital retrosigmoid surgery in patients operated in Shohada hospital from 1998 to 2006. This retrospective study was carried out using the hospital records of patient with suboccipital retrosigmoid operated in Shohada hospital between 1998-2006. The clinical information and outcome of surgery were extracted and then analyzed. A total of 80 patients [42men and 38 women] with mean age 45 +/- 7 years evaluated. The most common clinical presentation was hearing loss. In 93% of patients, the tumor size was greater than 3 cm. The location of the tumor was left side in 25 patients and right side in 50 patients, whereas in 5 patients it was bilateral. All of the patients had been operated with retrosigmoid craniectomy approach and tumor was totally resected in 87% of cases. Regardless of the tumor size, the facial nerve had anatiomically been saved in 76.2% of patients. 6 patients [7%] died and temporary morbidity occured in 34% of patients which has been recovered by medical treatment. 59 patients were had accurately followed up. After 1 year of surgery, the functional condition of facial nerve was: Excellent 73/5%, good 22/5%, fair 6%. We demonstrated that facial nerve was considerably preserved in patients with acoustic neurinoma after operation. In this study, tumors were mainly large. Therefore, it is better to use CT scan and MRI in patients in order to achieve the earlier diagnosis and appropriate treatment

[Study of changes on road traffic injury rates, before and after of four interventions by Iran traffic police]

In Iran there are about 70 deaths per day due to road traffic injuries [RTIs]. Some interventions have been carried out during the past 5 years, however the trend and role of interventions to decrease death and morbidity rates from RTIs has not been evaluated. This study aimed to present the epidemiological pattern of RTIs in Iran during years 2004 to 2007 and comparison of epidemiological measures of RTIs before and 2 years after the four traffic police enforcements and preventive programs. Source of data was 4 year databases from two sources [Traffic Police and Iranian Legal Medicine Organization]. Data were computerized and analyzed. The morbidity and death incidence rates per 10 000 vehicles and per 100.000 population calculated, and odds ratios [ORs] and 95% confidence Interval for ORs were measured for before and 2 years after these national interventional programs. The interventions were obligatory rules for use of seat belt, enforcements of laws and legislations such as some specific road plans in special occasions, educational program campaigns using the national radio and television, and mandatory rules of wearing helmet for motorcyclists taken place nationally by traffic police of Iran. The number of automobiles and all vehicles had 43.1% and 58% increase during the study duration. Two years after the interventional programs there was a decrease rate of deaths from RTIs per 100.000 population [OR= 0.83, 95% CI=0.82-0.85], and per 10.000 vehicles [OR= 0.56, 95% CI= 0.55-0.57] in Iran. There was also a significant decrease for morbidity rate from RTIs per 10.000 vehicles after the interventions [OR= 0.68, 95% CI= 0.67-0.68]. These findings showed the effectiveness of traffic police interventions in Iran on fatal and nonfatal road traffic injuries

[Urinary tract Complications in 94 Patients with spinal dysraphisms]

Congenital neurospinal dysraphism is the most common cause of neurogenic bladder among children. Myelomeningocele, which is the most common type of these lesions, is associated with neurogenic bladder in more than 90 percent of cases. Due to critical consequences of this disorder and high worldwide prevalence of urinary complications in these patients and because of no previous studies in our country, we evaluated patients with various types of spinal dysraphism refered to Labbafinejad and Mofid hospital between 1999 and 2005. In this study which was carried out on existing data, we evaluated 94 patients with various types of spinal dysraphisms. Type of spinal dysraphism, history of pyelonephritis, vesicoureteral reflux, renal damage, urinary incontinence, paraclinic findings, type of treatment and outcome of disease were reviewed in the patients records and these data were entered into a data sheet and reported by descriptive-analytic statistics. Sixty eight patients [72.3%] had at least one episode of pyelonephritis. Hydronephrosis was reported in 34.1% of patients as well as vesicoureteral reflux in 35.1%, renal atrophy in 13.9% and end stage renal failure in 3.2% of them. Among 61 patients aged 4 years or older, 47 [77%] had urinary incontinence. Urodynamic studies were performed in 17% of patients to evaluate lower urinary tract function. Seventy six cases [80.9%] had paraclinic findings in favour of neurogenic bladder, from whom 59.2% had recieved medical treatments [CIC, anticholinergic agents, or both] to improve complications of this disorder; the mean age of these patients was 4.8 +/- 4.4 years at the onset of medical treatments. Cystoplasty was performed in 35.1% of cases. Antireflux surgery was also performed in 9 patients [9.6%]. 7 cases out of them underwent surgery without having any treatment for the underlying cause of reflux; in later follow-up, vesicoureteral reflux had relapsed in 6 cases of these latter group. It seems that urodynamic studies are the most accurate means in evaluation of lower urinary tract function and performing these studies in patients with spinal dysraphisms [in newborn period or early infancy] is necessary for diagnosis of urinary tract dysfunction and planning up the most appropriate management for these patients. Failure to treat the underlying cause of secondary vesicoureteral reflux would significantly jeopardize the success rate of any surgery that might inadvertently be done in an attempt to correct the problem