Does head tilt influence facial appearance more than head turn?

Purpose: To evaluate the frequency of facial asymmetry parameters in patients with head tilt versus those with head turn. Methods: This cross-sectional comparative study was performed on 155 cases, including 58 patients with congenital pure head turn due to Duane retraction syndrome (DRS), 33 patients with congenital pure head tilt due to upshoot in adduction or DRS, and 64 orthotropic subjects as the control group. The facial appearance was evaluated by computerized analysis of digital photographs of patients' faces. Relative facial size (the ratio of the distance between the external canthus and the corner of the lips of both face sides) and facial angle (the angular difference between a line that connects two external canthi and another line that connects the two corners of the lips) measured as quantitative facial parameters. Qualitative parameters were evaluated by the presence of one-sided face, cheek, and nostril compression; and columella deviation. Results: The facial asymmetry frequency in patients with head tilt, head turn, and orthotropic subjects was observed in 32 (97%), 50 (86.2%), and 22 (34.3%), respectively (P < 0.001). In patients with head tilt and head turn, the mean facial angle was 1.78º ± 1.01º and 1.19º ± 0.84º, respectively (P = 0.004) and the mean relative facial size was 1.027 ± 0.018 and 1.018 ± 0.014, respectively (P = 0.018). The frequencies of one-sided nostril compression, cheek compression, face compression, and columella deviation in patients with pure head tilt were found in 19 (58%), 21 (64%), 19 (58%), and 19 (58%) patients, respectively, and in patients with pure head turn the frequencies were observed in 42 (72%), 37 (63%), 27 (47%), and 43 (74%), respectively. All quantitative and qualitative facial asymmetry parameters and facial asymmetry frequencies were significantly higher in head tilt and head turn patients as compared to the control group (P < 0.001). Conclusion: All facial asymmetry parameters in patients with head tilt and head turn were significantly higher than orthotropic subjects. The quantitative parameters such as relative facial size and facial angle were significantly higher in patients with pure head tilt than pure head turn. The results revealed that pure head tilt was associated with a higher prevalence of facial asymmetry than pure head turn.

Students' attitude and sleep pattern during school closure following COVID-19 pandemic quarantine: a web-based survey in south of Iran

BACKGROUND@#School closure is one of the main policies of global health care strategies performed worldwide. Despite all benefits, there might be some threats for younger groups spending their time in quarantine. This study aims to determine the impacts of lockdown and school closure on children's major lifestyle aspects, especially their leisure and sleep pattern during the COVID-19 pandemic.@*METHODS@#For the purpose of this study, an online questionnaire was distributed from 14th to 31st of March 2020 among the schools and students from the first grade to the 12th grade (before university) in Fars province, southern Iran. The questionnaire consisted of five sections which included data regarding the students' general information, activity priorities, adherence to quarantine, attitude toward school closure, and sleep patterns.@*RESULTS@#In our study, 20,697 filled questionnaires were received from the participants with an average age of 13.76 years; 29.7% of them were male, 80.6% were from urban areas, and 83.3% were from public schools. The overall first preference of students during school closure was mobile and computer games (30.1%), followed by studying (26.6%) and watching television (13.8%). Our results demonstrated that the majority of students adhered to social distancing and there was also a significant correlation among education levels and desire for schools to be closed till the end of the semester (P = 0.015). Also, regarding sleep patterns, the majority (53.5%) had above 12 h of sleep throughout the day.@*CONCLUSION@#It seems that lockdown following COVID-19 pandemic has changed various aspects of the students' lifestyle remarkably, especially by increasing screen time and even sleep duration and pattern. We believe that certain strategies should be implemented by the Health and Educational Ministry to control not only the visible side effects of the quarantine period, but also the collateral consequences on their psychological and mental health.

Effects of lavender and Citrus aurantium on pain of conscious intensive care unit patients: A parallel randomized placebo-controlled trial / 中西医结合学报

BACKGROUND@#Conscious patients admitted to intensive care units (ICUs) suffer from pain for various reasons, which can affect their recovery process.@*OBJECTIVE@#The present study compared the effects of aromatherapy with Citrus aurantium and lavender essential oils against placebo for reducing pain in conscious intensive care patients.@*DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS@#This study was a parallel randomized placebo-controlled trial. The ICUs of two educational hospitals in Kerman in Southeastern Iran were the study setting. One hundred and fifty conscious intensive care patients were randomly divided into three groups using a stratified block randomization method. Two groups received aromatherapy with essential oils: one with lavender and the other with C. aurantium; these patients received a 30-minute therapy session using their assigned essential oil on the second day of their intensive care stay. The placebo group used 5 drops of normal saline instead of essential oil during their session.@*MAIN OUTCOME MEASURES@#Patient's pain was assessed using a visual analog scale before the aromatherapy intervention, as well as immediately after and one and three hours after intervention.@*RESULTS@#The mean pain score of the lavender group was 40.01 before the aromatherapy intervention and fell to 39.40, 30.60 and 23.68 immediately after the intervention, and at hour one and three post-intervention, respectively. The mean pain score of the C. aurantium group was 45.48 before the intervention and was reduced to 32.34 at three hours after the intervention. The mean pain of the placebo group decreased from 42.80 before the intervention to 35.20 at three hours after the intervention. Pain scores of all groups decreased during the study (P < 0.001). The mean pain of the lavender group was significantly lower than that of the placebo group at three hours after the intervention.@*CONCLUSION@#The results of this study showed that aromatherapy with lavender essential oil reduced pain in conscious ICU patients. Our data could not justify the use of C. aurantium for reducing pain in this population.@*TRIAL REGISTRATION@#No. IRCT20170116031972N9 (https://en.irct.ir/trial/40827).

Comprehensive Review of Factors Influencing the Use of Telepractice in Stuttering Treatment / 대한의료정보학회지

Objectives@#Stuttering is a speech disorder characterized by the repetition of sounds, syllables, or words; prolongation of sounds; and interruptions in speech. Telepractice allows speech services to be delivered to patients regardless of their location. This review investigated factors influencing the use of telepractice in stuttering treatment. @*Methods@#Articles related to the application of telepractice in stuttering were searched using the Scopus, Web of Science, PubMed, Cochrane, and ProQuest databases without consideration of any time limit. Initially, 79 articles were found and after application of the inclusion and exclusion criteria, 15 articles were selected for the review study. Data were analyzed by using the content analysis method and synthesized narratively. @*Results@#Factors influencing the use of telepractice in stuttering treatment were categorized into individual, technical, clinical, and economic factors. Providing access to healthcare services, maintaining personal privacy, and allowing flexibility in arranging appointments were among individual factors. In terms of the technical factors, technical problems and Internet speed were addressed. Clinical factors were divided into positive and negative outcomes, and economic factors were mainly related to time and cost savings. @*Conclusions@#Although patients may benefit from using telepractice, the widespread adoption of this technology can be hindered by some technical and non-technical factors. Because telepractice can be employed as a complementary method to treat stuttering, more attention should be paid to the required infrastructure and factors that may negatively impact the use of this technology.

Injury surveillance information system: A review of the system requirements / 中华创伤杂志(英文版)

PURPOSE@#An injury surveillance information system (ISIS) collects, analyzes, and distributes data on injuries to promote health care delivery. The present study aimed to review the data elements and functional requirements of this system.@*METHOD@#This study was conducted in 2019. Studies related to injury surveillance system were searched from January 2000 to September 2019 via the databases of PubMed, Web of Knowledge, ScienceDirect, and Scopus. Articles related to the epidemiology of injury, population survey, and letters to the editor were excluded, while the review and research articles related to ISISs were included in the study. Initially 324 articles were identified, and finally 22 studies were selected for review. Having reviewed the articles, the data needed were extracted and the results were synthesized narratively.@*RESULTS@#The results showed that most of the systems reviewed in this study used the minimum data set suggested by the World Health Organization injury surveillance guidelines along with supplementary data. The main functions considered for the system were injury track, data analysis, report, data linkage, electronic monitoring and data dissemination.@*CONCLUSION@#ISISs can help to improve healthcare planning and injury prevention. Since different countries have various technical and organizational infrastructures, it is essential to identify system requirements in different settings.

Integrating Genetic Data into Electronic Health Records: Medical Geneticists' Perspectives / 대한의료정보학회지

OBJECTIVES: Genetic disorders are the main causes of many other diseases. Integrating genetic data into Electronic Health Records (EHRs) can facilitate the management of genetic information and care of patients in clinical practices. The aim of this study was to identify the main requirements for integrating genetic data into the EHR system from the medical geneticists' perspectives. METHODS: The research was completed in 2018 and consisted of two phases. In the first phase, the main requirements for integrating genetic data into the EHR system were identified by reviewing the literature. In the second phase, a 5-point Likert scale questionnaire was developed based on the literature review and the results derived from the first phase. Then, the Delphi method was applied to reach a consensus about the integration requirements. RESULTS: The findings of the first phase showed that data elements, including patients' and healthcare providers' personal data, clinical and genetic data, technical infrastructure, security issues and functional requirements, should be taken into account before data integration. In the second phase, a consensus was reached for most of the items (mean ≥3.75). The items with a mean value of less than 2.5 did not achieve a consensus and were removed from the final list. CONCLUSIONS: The integration of genetic data into the EHRs can provide a ground for increasing accuracy and precision in the diagnosis and treatment of genetic disorders. Such integration requires adequate investments to identify users' requirements as well as technical and non-technical issues.

Mucosal-associated invariant T cells and oral microbiome in persistent apical periodontitis / 国际口腔科学杂志·英文版

Opportunistic bacteria in apical periodontitis (AP) may pose a risk for systemic dissemination. Mucosal-associated invariant T (MAIT) cells are innate-like T cells with a broad and potent antimicrobial activity important for gut mucosal integrity. It was recently shown that MAIT cells are present in the oral mucosal tissue, but the involvement of MAIT cells in AP is unknown. Here, comparison of surgically resected AP and gingival tissues demonstrated that AP tissues express significantly higher levels of Vα7.2-Jα33, Vα7.2-Jα20, Vα7.2-Jα12, Cα and tumour necrosis factor (TNF), interferon (IFN)-γ and interleukin (IL)-17A transcripts, resembling a MAIT cell signature. Moreover, in AP tissues the MR1-restricted MAIT cells positive for MR1-5-OP-RU tetramer staining appeared to be of similar levels as in peripheral blood but consisted mainly of CD4 subset. Unlike gingival tissues, the AP microbiome was quantitatively impacted by factors like fistula and high patient age and had a prominent riboflavin-expressing bacterial feature. When merged in an integrated view, the examined immune and microbiome data in the sparse partial least squares discriminant analysis could identify bacterial relative abundances that negatively correlated with Vα7.2-Jα33, Cα, and IL-17A transcript expressions in AP, implying that MAIT cells could play a role in the local defence at the oral tissue barrier. In conclusion, we describe the presence of MAIT cells at the oral site where translocation of oral microbiota could take place. These findings have implications for understanding the immune sensing of polymicrobial-related oral diseases.

Features and results of conducted studies using a lean management approach in Emergency Department in hospital: a systematic review

Objective: To perform a systematic review of the properties and results of the studies that their approaches are lean management in emergency departments and the factors which influence on their performance

Method: The necessary information in the first stage was collected by searching these keywords: "Lean principles" "Lean Six Sigma", "Lean Process", "Lean thinking", "Lean Methodology", "Toyota Production System lean processing", "lean techniques", "emergency department", "emergency medicine", "emergency room" and "emergency care". And in the next stage the keywords such as "lean management" and "emergency" was collected from SID, Medlib, IranDoc, Google Scholar, MagIran, IranMedex data bases. For extracting the data data-extracting forms was prepared. The information we got from the forms was organized in information-extracting forms and was analyzed manually. The diagrams were drawn in Excel: 2010

Results: Finally, 26 essays have been included. Most of the studies were accomplished in Canada and U.S.A. only in one of the cases, the authors used the control group. Each of these terms, "lean techniques" and "lean principals", with five times repetitions had the highest frequency. The most important team of implementation of lean management included: hospital management team or the manager of Emergency department, physicians, nurses, staffs and external counselors. Generally, 51 indicators were studied which among them the length of stay and the timing had the most frequency. After implementation of lean management, almost all studied indicators have significantly improved. 14 barriers, 14 facilitators and 10 effective factors were recognized in implementing the lean management

Conclusion: According to the studies, responsibility of organization's senior management and his/her supports; increasing the knowledge of the characteristics and dimension of lean among the providers of health service; and decreasing the resistance and consulting with external counselors can have great effect on the success of lean management

The Prevalence and Risk Factors for Diabetic Retinopathy in Shiraz, Southern Iran

Globally, diabetic retinopathy (DR) is one of the leading causes of blindness, that diminishes quality of life. This study aimed to describe the prevalence of DR, and its associated risk factors. This cross-sectional study was carried out among 478 diabetic patients in a referral center in Fars province, Iran. The mean±standard deviation age of the participants was 56.64±12.45 years old and DR prevalence was 32.8%. In multivariable analysis, lower education levels (adjusted odds ratio [aOR], 0.43; 95% confidence interval [CI], 0.24 to 0.76), being overweight (aOR, 1.70; 95% CI, 1.02 to 2.83) or obese (aOR, 1.88; 95% CI, 1.09 to 3.26), diabetes duration of 10 to 20 years (aOR, 2.35; 95% CI, 1.48 to 3.73) and over 20 years (aOR, 5.63; 95% CI, 2.97 to 10.68), receiving insulin (aOR, 1.99; 95% CI, 1.27 to 3.10), and having chronic diseases (aOR, 1.71; 95% CI, 1.02 to 2.85) were significantly associated with DR. In conclusion, longer diabetes duration and obesity or having chronic diseases are strongly associated with DR suggesting that control of these risk factors may reduce both the prevalence and impact of retinopathy in Iran.

Automated Audiometry: A Review of the Implementation and Evaluation Methods / 대한의료정보학회지

OBJECTIVES: Automated audiometry provides an opportunity to do audiometry when there is no direct access to a clinical audiologist. This approach will help to use hearing services and resources efficiently. The purpose of this study was to review studies related to automated audiometry by focusing on the implementation of an audiometer, the use of transducers and evaluation methods. METHODS: This review study was conducted in 2017. The papers related to the design and implementation of automated audiometry were searched in the following databases: Science Direct, Web of Science, PubMed, and Scopus. The time frame for the papers was between January 1, 2010 and August 31, 2017. Initially, 143 papers were found, and after screening, the number of papers was reduced to 16. RESULTS: The findings showed that the implementation methods were categorized into the use of software (7 papers), hardware (3 papers) and smartphones/tablets (6 papers). The used transducers were a variety of earphones and bone vibrators. Different evaluation methods were used to evaluate the accuracy and the reliability of the diagnoses. However, in most studies, no significant difference was found between automated and traditional audiometry. CONCLUSIONS: It seems that automated audiometry produces the same results compared with traditional audiometry. However, the main advantages of this method; namely, saving costs and increased accessibility to hearing services, can lead to a faster diagnosis of hearing impairment, especially in poor areas.

Evaluation of Respiratory Protection Program in Petrochemical Industries: Application of Analytic Hierarchy Process

BACKGROUND: Respiratory protection equipment (RPE) is the last resort to control exposure to workplace air pollutants. A comprehensive respiratory protection program (RPP) ensures that RPE is selected, used, and cared properly. Therefore, RPP must be well integrated into the occupational health and safety requirements. In this study, we evaluated the implementation of RPP in Iranian petrochemical industries to identify the required solutions to improve the current status of respiratory protection. METHODS: This cross-sectional study was conducted among 24 petrochemical industries in Iran. The survey instrument was a checklist extracted from the Occupational Safety and Health Administration respiratory protection standard. An index, Respiratory Protection Program Index (RPPI), was developed and weighted by analytic hierarchy process to determine the compliance rate (CR) of provided respiratory protection measures with the RPP standard. Data analysis was performed using Excel 2010. RESULTS: The most important element of RPP, according to experts, was respiratory hazard evaluation. The average value of RPPI in the petrochemical plants was 49 ± 15%. The highest and lowest of CR among RPP elements were RPE selection and medical evaluation, respectively. CONCLUSION: None of studied petrochemical industries implemented RPP completely. This can lead to employees' overexposure to hazardous workplace air contaminants. Increasing awareness of employees and employers through training is suggested by this study to improve such conditions.

Northern Iranian growth charts for children aged 7–11 years: comparison with international reference curves

Background: Child body mass index [BMI] is an internationally accepted indicator to assess child health status. International BMI reference curves are available but their suitability for Iranian children in not known.

Aims: This study aimed to produce BMI-for-age growth curves for northern Iranian schoolchildren aged 7–11 years and compare them with the World Health Organization [WHO 2006] and Centers for Disease Control and Prevention [CDC 2000] reference curves.

Methods: Stratified multistage cluster sampling was used to select schoolchildren from urban and rural areas of Babol. Height and weight were measured and BMI calculated. Smoothed BMI-for-age growth curves were constructed for both sexes and compared with the WHO and CDC reference curves.

Results: A total of 4 083 children aged 7–11 years were included; 48.8% were boys and 56.7% were urban residents The major significant differences between the Iranian curves in this study and the CDC2000 and WHO 2006 growth charts were in the upper centiles. The 5th centile is close to the 5th centiles of the reference curves.

Conclusions: BMI centiles for 7–11 years schoolchildren in Babol differed significantly from the international growth reference curves. Therefore, local and population-specific BMI curves should be developed to assess physical growth of children.

Comparing the performance of data mining algorithms in predicting Coronary Artery diseases

Introduction: Cardiovascular diseases are the first leading cause of death worldwide. World health organization has estimated that the morality rate due to heart diseases will mount to 23 million cases by 2030. Hence, the use of data mining algorithms will be useful in predicting coronary artery disease. The objective of the present study was to compare the accuracy of the CAD predictions made by ANN and SVM techniques

Methods: The present study was conducted via descriptive-analytical method. The research sample included all CAD patients hospitalized in three hospitals affiliated to AJA University of Medical Sciences from March 2016 to March 2017. Totally, 1324 records with 26 characteristics affecting the disease were extracted and after normalizing, and cleaning of the data, they were entered in SPSS statistics V23.0 and IBM Excel 2013; then, R3.3.2 data mining software was used to format data

Results: SVM model with lower MAPE [112.03] and higher Hosmer-lemeshow statistic [16.71], sensitivity [92.23] and specificity [74.42] yielded better fitness of data and provides more accurate prediction than ANN model. On the other hand, since the area under the ROC curve in SVM algorithm was more than that in ANN, it could be concluded that this model had higher accuracy

Conclusion: According to the results, SVM algorithm presented higher accuracy and better performance than ANN model and showed higher sensitivity and accuracy. It is suggested that in future studies, the results of the present study be compared with the findings resulted from applying other data mining algorithms

Forecasting the number of zoonotic cutaneous leishmaniasis cases in south of Fars province, Iran using seasonal ARIMA time series method

OBJECTIVE@#To predict the trend of cutaneous leishmaniasis and assess the relationship between the disease trend and weather variables in south of Fars province using Seasonal Autoregressive Integrated Moving Average (SARIMA) model.@*METHODS@#The trend of cutaneous leishmaniasis was predicted using Mini tab software and SARIMA model. Besides, information about the disease and weather conditions was collected monthly based on time series design during January 2010 to March 2016. Moreover, various SARIMA models were assessed and the best one was selected. Then, the model's fitness was evaluated based on normality of the residuals' distribution, correspondence between the fitted and real amounts, and calculation of Akaike Information Criteria (AIC) and Bayesian Information Criteria (BIC).@*RESULTS@#The study results indicated that SARIMA model (4,1,4)(0,1,0) in general and SARIMA model (4,1,4)(0,1,1) in below and above 15 years age groups could appropriately predict the disease trend in the study area. Moreover, temperature with a three-month delay (lag3) increased the disease trend, rainfall with a four-month delay (lag4) decreased the disease trend, and rainfall with a nine-month delay (lag9) increased the disease trend.@*CONCLUSIONS@#Based on the results, leishmaniasis follows a descending trend in the study area in case drought condition continues, SARIMA models can suitably measure the disease trend, and the disease follows a seasonal trend.

Forecasting the number of zoonotic cutaneous leishmaniasis cases in south of Fars province, Iran using seasonal ARIMA time series method

Objective To predict the trend of cutaneous leishmaniasis and assess the relationship between the disease trend and weather variables in south of Fars province using Seasonal Autoregressive Integrated Moving Average (SARIMA) model. Methods The trend of cutaneous leishmaniasis was predicted using Mini tab software and SARIMA model. Besides, information about the disease and weather conditions was collected monthly based on time series design during January 2010 to March 2016. Moreover, various SARIMA models were assessed and the best one was selected. Then, the model's fitness was evaluated based on normality of the residuals’ distribution, correspondence between the fitted and real amounts, and calculation of Akaike Information Criteria (AIC) and Bayesian Information Criteria (BIC). Results The study results indicated that SARIMA model (4,1,4)(0,1,0)

Evaluation of the effect of porcelain laminate thickness on degree of conversion of light cure and dual cure resin cements using FTIR

Statement of the Problem: Increasing the thickness of the veneering porcelain may affect the polymerization of resin cements. Incomplete polymerization of resin cements can lead to compromised quality of restoration and decrease the longevity of indirect restorations

Purpose: This study sought to assess the effect of IPS Empress porcelain thickness on the degree of conversion of light-cure and dual-cure resin cements using Fourier transform infrared spectroscopy

Materials and Method: In this experimental study, IPS Empress porcelain discs [A2 shade] with 10mm diameter and 0.5, 1 and 1.5 mm thicknesses were fabricat-ed. Choice2 [Bisco, USA] and Nexus3 [Kerr, USA] resin cements were light cured through the three porcelain thicknesses in two groups of 3 samples using a LED light-curing unit [LEDemetron II; Kerr, USA]. The control group samples were cured individually with no porcelain disc. The degree of conversion of resin ce-ments was determined using FTIR [Bruker; Equinox55, Germany]. The data were analyzed using Dunn's test

Results: The degree of conversion [in percent] beneath the 0.5, 1.5 and 2 mm thicknesses of IPS Empress was 68.67+/-0.88, 71.06+/-0.94 and 72.51+/-0.41 for Choice2 resin cement and 69.60+/-2.12, 69.64+/-1.63 and 69.24+/-2.12 for Nexus3, respectively. Porcelain thickness and type of resin cement had no significant effect on degree of conversion [p>/= 0.05]

Conclusion: It seems that increasing the porcelain thickness by up to 1.5 mm has no adverse effect on degree of conversion of both dual cure and light cure resin cements evaluated in this study

Women's behaviors and views on home food safety in Tehran: a qualitative study

Background and Objectives: The aim of this study was to explore the food safety knowledge and behavior of housewives in the city of Tehran, Iran in 2015

Materials and Methods: In this qualitative study 12 Focus Group Discussions by directed content analysis method [n= 96], were conducted among the women who were responsible for food handling in their households in 10 health centers. Each session was held with 7-10 participants, and their voices were recorded. The final transcripts were read to obtain categories until developing themes by using constant comparison method

Results: Three categories in nine themes were emerged as follows: 1] Personal hygiene and poisoning [Washing hands as priority in personal hygiene]; 2] Food safety, preparation and storage [Inadequate knowledge about proper time for boiling raw milk, Lack of awareness about temperature of refrigerator, Incorrect storage of food in the refrigerator, Storage of unwashed and unpacked eggs, fresh fruits and vegetables in the refrigerator, Thawing frozen raw meat and chicken at room temperature, Incorrect separation and sanitization of cutting boards for fresh vegetables, raw meat, chicken, and Inappropriate washing of fresh leafy vegetables]; and 3] Safety of cooked foods [Improper reheating of leftover foods]

Conclusions: The findings of this study illustrated that there was lack of knowledge about food safety. It was evident that the majority of the participants were not familiar with appropriate practices to prevent cross contamination and food handling. Therefore, home food safety education should be conducted for housewives

Epidemiology and outcome determinants of pedestrian injuries in a level I trauma center in southern Iran; a cross-sectional study

Objective: to epidemiologically assess the accidents and incidents in the injured pedestrians referred to Shahid Rajaee Hospital, Shiraz in order to provide basic preventive strategies and reduce injuries and fatalities caused by traffic accidents in pedestrians

Methods: this cross-sectional study was conducted on 5840 injured pedestrians referred to Shahid Rajaee Hospital, Shiraz from 2009 to 2014. The baseline characteristic including the demographic and clinical information, the mechanism of injury, injury severity score [ISS] and outcome determinants. We also recorded the outcome measures and the mortality. Multivariate logistic regression analysis was performed to investigate the factors related to mortality rate and Length of Stay [LOS] in hospital

Results: in our study, the history of 5840 injured pedestrians was analyzed. The mean age of the patients was 41.3219.21+/- years. Multivariate logistic regression indicated that mortality increased with age. Moreover, the odds of mortality was more in patients with Injury Severity Score [ISS] between 16 and 24 [OR: 12.94, 95% CI [3.78-32.66], p=0.001] and injuries in the head and neck [OR: 7.92, 95% CI [4.18-14.99], p=0.020]. LOS in hospital was also higher in patients with ISS>25 [OR: 16.65, 95%CI [10.68-25.96], p=0.001]

Conclusion: pedestrians have always been one of the most vulnerable road users. Our study indicated that the adverse consequences and mortalities in pedestrians increased with age. Hence, approaches are required to improve primary prevention programs and reduce deaths and injuries due to this major public health problem

[ study of seroprevalence of hepatitis B and hepatitis C and behavioral factors in HIV patients referred to the consultation clinics of Tehran behavioral diseases health center]

Background: The patients who have human immunodeficiency virus, are susceptible to opportunistic infections and tumors due to disease progress and their immune system suppression. Early diagnosis and suitable management of these patients can decrease their mortality and morbidity. Present study was performed for determination of prevalence of viral hepatitis B and C and high risk behavioral among HIV patients

Methods: Present cross sectional study was performed on 481 HIV patients in consultant clinic of behaviors disorders of west Tehran hygiene center at September 2014. Demographic and behavioral data and serum viral hepatitis B and C measurements in participated patients were gathered in the study checklist

Results: Among 481 HIV patients, 331 [68.8%] and 32 [6.6%] patients had hepatitis C and B co-infection and ninety-three patients had only HIV infection. Co-infection of HCV and HBV infection were diagnosed in 25 [51.9%] HIV patients

Conclusion: There were significant association between high risk behaviors with HCV infection and drug abuse, common syringe use with both of HCV and HBV infection among HIV patients

Polymorphisms in the estrogen receptor beta gene and the risk of unexplained recurrent spontaneous abortion

Background: Recurrent Spontaneous Abortion [RSA] is caused by multiple genetic and non-genetic factors. Around 50% of the RSA cases have no known etiology and are considered as Unexplained RSA [URSA]. Estrogens, via binding to their receptors, play an important role in female reproduction. This study aimed to investigate whether single nucleotide polymorphisms [SNPs; +1082G/A, +1730G/A and rs1256030C/T] in the estrogen receptor beta [ESR2] gene are associated with susceptibility to URSA in a population of Iranian women

Methods: In this case-control study, the study groups consisted of 240 subjects with a history of URSA and 102 fertile women as controls. Serum levels of follicle stimulating hormone [FSH], luteinizing hormone [LH], and estradiol [E2] were measured on day 2-3 of menstrual cycle. Two functional SNPs, +1082G/A [a silent mutation in exon 5] and +1730G/A [3' untranslated region of the exon 8], and one intron, rs1256030C/T, in the ESR2 gene were genotyped, using polymerase chain reaction- restriction fragment length polymorphism [PCR-RFLP] analysis

Results: Serum levels of LH were significantly increased in URSA women. No significant differences in distribution of +1082G/A, +1730G/A and rs1256030C/T between URSA and control groups were observed

Conclusion: Our findings suggest that the studied SNPs on ESR2 gene may not be associated with URSA