epidemiological characteristics of motorcyclists associated injuries in road traffics accidents; a hospital-based study

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

Spatial and non-spatial determinants of successful tuberculosis treatment outcomes: an implication of geographical information systems in health policy-making in a developing country

This retrospective study aimed to address whether or to what extent spatial and non-spatial factors with a focus on a healthcare delivery system would influence successful tuberculosis [TB] treatment outcomes in Urmia, Iran. In this cross-sectional study, data of 452 new TB cases were extracted from Urmia TB Management Center during a 5-year period. Using the Geographical Information System [GIS], health centers and study subjects' locations were geocoded on digital maps. To identify the statistically significant geographical clusters, Average Nearest Neighbor [ANN] index was used. Logistic regression analysis was employed to determine the association of spatial and non-spatial variables on the occurrence of adverse treatment outcomes. The spatial clusters of TB cases were concentrated in older, impoverished and outskirts areas. Although there was a tendency toward higher odds of adverse treatment outcomes among urban TB cases, this finding after adjusting for distance from a given TB healthcare center did not reach statistically significant. This article highlights effects of spatial and non-spatial determinants on the TB adverse treatment outcomes, particularly in what way the policies of healthcare services are made. Accordingly, non-spatial determinants in terms of low socio-economic factors need more attention by public health policy makers, and then more focus should be placed on the health delivery system, in particular men's health

Effects of Antibiotic Consumption on Children 2-8 Years of Age Developing Asthma / 한국역학회지

OBJECTIVES: Antibiotic exposure in children is a possible contributor to the increasing asthma prevalence in several countries. The present study aimed to investigate the association between antibiotic exposure and the risk of developing childhood asthma at 2-8 years of age. METHODS: A case-control study was undertaken among children aged 2-8 years old between March and September 2010 in the Urmia district in the northwest of Iran. The cases were doctor-diagnosed asthmatic children based on Global Initiative for Asthma criteria (n=207), and the controls were children without respiratory symptoms (n=400) selected by frequency matching by age and gender. Clinical data including antibiotic exposure was collected by a validated and reliable questionnaire, which was completed by interviewing parents/guardians. RESULTS: Antibiotic consumption during the first year of life increased the odds ratio [OR] of asthma symptoms at 2-8 years of age (crude OR, 2.26; 95% confidence interval [CI], 1.53-3.35; p<0.01), and the strength of association was similar after adjusting for a family history of asthma or atopic disorder, preterm delivery, birth order, and delivery method (adjusted OR, 1.91; 95% CI, 1.27-2.88; p=0.03). CONCLUSIONS: Our study suggests that antibiotic consumption in children was associated with an increased risk of childhood asthma, and an additional confirmative study is needed.

Comparison of three methods in improving bag mask ventilation

Increasedlife expectancy in populations has brought along specific new scenarios in the fields of medicine for the elderly; prevalence of physical complications such as edentulism and patients with dentures is growing. Management of anesthesia and ventilation in this group of patients has turned into a great challenge. Some researchers suggest dentures to be left in place during bag-mask ventilation; yet, no unanimous agreement exists in this regard. In a single blind randomized clinical trial, we studied 300 patients with ASA class I, II [American Society of Anesthesiologists], Mallampati class [I, II] and aged over 55 years in three groups. After induction of anesthesia, in group G dentures were removed and in each buccal space an eight-layer 10x10 cm gauze and an oral airway were placed. In group D, the dentures and an oral airway were left in place. In group C [control], after removing dentures just an appropriate oral airway was placed. Then, each three group underwent bag-mask ventilation. Success of bag-mask ventilation [BMV] was considered as increase in end-tidal carbon dioxide to more than 20 mmHg and back to baseline with fresh gas flow of 3 L/min and adjustable pressure limiting valve pressure of 20 cm H[2]O. Success rates were evaluated between groups. Effective BMV was possible in 91 [91%], 64 [64%] and 41 [41%] patients in groups G, D and C respectively. The differences were statistically significant. Successful BMV rate was significantly higher in female patients in group G compared to group C; 43/44 versus 25/46 individuals, P = 0.0001, odds ratio = 0.03, 95% confidence interval [0.00, 0.22]. Leaving dentures in place in edentulous patients after inducing anesthesia improves bag-mask ventilation. However, placing folded compressed gauze in buccal space leads to more significant improvement in BMV compared to leaving dentures in place

Why do some pregnant women prefer cesarean delivery in first pregnancy?

The increasing number of cesarean section is a great concern in many countries. In Iran cesarean section rate has been steadily rising from 35% in 2000 to 40% in 2005. Preferences for cesarean are often associated with some factors. To investigate factors associated with preference for cesarean delivery, with special emphasis on pregnant women's preferences in first pregnancy in Neyshabur [Northeast of Iran]. In this cross-sectional study, written questionnaires were completed via face to face interview with 797 pregnant women in first pregnancy. Socio-demographic data, preference toward mode of delivery and factors associated with it were assessed by applying questionnaire. Univariate and multivariate analysis were performed to identify the independent variables associated with preference for cesarean delivery. In this study observed that 18.6% of pregnant women preferred caesarean delivery in first pregnancy. The mean age of pregnant women that they preferred cesarean delivery was upper than pregnant women that they preferred vaginal delivery and this difference was statistically significant [p=0.006]. There was a statistically significant relation between preference for cesarean delivery and the following variables: educational level [p<0.001], gestational age [p=0.003] spouse's age of pregnant women [p=0.001], physician's advice [p<0.001], and fear of delivery [p<0.001]. The results of this study show that the majority of pregnant women do not prefer caesarean delivery to vaginal delivery. Nevertheless the preference rate for cesarean delivery exceeded 15% that suggested by WHO and most important factors in pregnant women prefer cesarean deliveries are fear of delivery and physician's advice

Parental risk factors of childhood acute leukemia: a case-control study

Leukemia is the most common cancer in children, accounting for near to half of all childhood cancers. Different risk factors might be effective in the occurrence of this cancer such as parental characteristics. This study was done in West Azarbaijan Province in order to determine the relation between parental characteristics and acute leukemia in children. This matched case-control study was conducted on children less than 15 years affected by acute leukemia from March 20, 2003 to March 20, 2009. Two control groups were selected, one from hospital and the other from the study population. Cases and controls were matched on age and sex. Logistic regression model was used for data analysis. This study was done on 130 patients, 108 [83.1%] were affected by Acute Lymphoblastic Leukemia and 22 [16.9%] by Acute Myeloblastic Leukemia. Seventy two of the patients were male [55.4%] and 58 were female [44.6%]. There was a statistically significant correlation between acute leukemia and variables such as mother's education [OR=4.2, 95% CI: 2.42, 7.34], mother's history of using Oral Contraceptive Pills [OR=1.77, 95% CI: 1.05, 2.82] and parental relationship [OR=2.05, 95% CI: 1.30, 3.23]. It seems that some parental characteristics have an important role in etiology of childhood leukemia