Disability and post-trauma stress in the population over 15 years old in Kashan, Iran: A population-based study / 中华创伤杂志(英文版)

PURPOSE@#One of the consequences of trauma-related injuries is disability. There are more than one billion people with disabilities worldwide. Disability in people reduces their quality of life. The goal of this study was to determine the rate of post-trauma stress and disability related to trauma in the population over 15 years old in Kashan during a solar year of 2018-2019.@*METHODS@#This is a cross-sectional population-based study. A cluster sampling method was used in the city of Kashan, and 3880 persons were interviewed with individuals randomly selected in each household. If a person had trauma during one year ago, the World Health Organization Disability Assessment Schedule 2.0 and Post Trauma Stress Disorder (PTSD) Checklist were applied for further interview. Data were analyzed using Chi-square test or t-test.@*RESULTS@#Among the 3880 participants residing in Kashan, 274 (7.1%) reported a history of traumatic injury during one year ago in 2018-2019. Incidence of all injuries was estimated to be 70.61 (62.60-78.70) per 1000 people. For the trauma population, 213 (77.7%) were male and 75.1% were married. About half of them (50.3%, 138/274) aged 21-39 years. The most common cause of injuries was related to traffic accidents: 140 (51.1%). Of the 274 trauma participants, 47 (17.2%) reported PTSD; 244 (89.1%) had a mild disability, and 30 (10.9%) reported moderate disability.@*CONCLUSION@#One of the main causes of disability in the human community is the traumatic injuries. According to the results of this study, 89.1% of trauma participants have sustained at last mild disability following trauma. These people require follow-up and post-treatment support. It should be noted that psychological complications such as PTSD are as significant as physical symptoms.

National Spinal Cord Injury Registry of Iran (NSCIR-IR) - a critical appraisal of its strengths and weaknesses / 中华创伤杂志(英文版)

The National Spinal Cord Injury Registry of Iran (NSCIR-IR) is a not-for-profit, hospital-based, and prospective observational registry that appraises the quality of care, long-term outcomes and the personal and psychological burden of traumatic spinal cord injury in Iran. Benchmarking validity in every registry includes rigorous attention to data quality. Data quality assurance is essential for any registry to make sure that correct patients are being enrolled and that the data being collected are valid. We reviewed strengths and weaknesses of the NSCIR-IR while considering the methodological guidelines and recommendations for efficient and rational governance of patient registries. In summary, the steering committee, funded and maintained by the Ministry of Health and Medical Education of Iran, the international collaborations, continued staff training, suitable data quality, and the ethical approval are considered to be the strengths of the registry, while limited human and financial resources, poor interoperability with other health systems, and time-consuming processes are among its main weaknesses.

Melatonin pretreated blastocysts along with calcitonin administration improved implantation by upregulation of heparin binding-epidermal growth factor expression in murine endometrium

Objective: implantation failure is an obstacle in assisted reproduction techniques [ART]. Calcitonin is a molecules involved in uterine receptivity and embryo implantation. Melatonin can promote embryo quality and improve implantation. This study examines the effect of pretreatment of blastocysts with melatonin and calcitonin on heparin binding-epidermal growth factor [HB-EGF] expression in murine endometrium

Materials and Methods: in this experimental study, we collected 2-cell embryos from the oviducts of 1.5 day pregnant NMRI mice. Embryos were cultured to the blastocyst in G[TM] medium with or without 10[-9] M melatonin. Pregnant and pseudo-pregnant mice received intraperitoneal [IP] injections of 2 IU calcitonin. After 24 hours, we transferred the cultured blastocysts into the uteri of pseudo-pregnant mice. Two days later, implantation sites were counted and we assessed the levels of HB-EGF mRNA and protein in the uteri of naturally pregnant and pseudo-pregnant mice by quantitative real-time polymerase chain reaction [qRT-PCR] and Western blot. Statistical analysis was performed with one-way ANOVA followed by the Tukey post hoc test. P<0.05 was considered statistically significant

Results: melatonin pretreatment of blastocysts along with calcitonin administration significantly increased HB-EGF mRNA and protein [P<0.001] in the endometrium of pseudo-pregnant mice. Administration of calcitonin in naturally pregnant mice significantly increased HB-EGF mRNA and protein levels [P<0.001]. Compared with the control group [2.6 +/- 0.5], the average number of implantation sites in the melatonin group [4.6 +/- 0.5, P<0.05] and calcitonin group [7 +/- 1, P<0.001] significantly increased. There was a significant increase in implantation sites in the combined melatonin and calcitonin group [8.6 +/- 0.5, P<0.001]. Calcitonin significantly enhanced calcitonin receptor mRNA [P<0.001] and protein [P<0.05] in the uteri of naturally pregnant and pseudo-pregnant mice

Conclusion: melatonin pretreated blastocysts along with calcitonin increased HB-EGF expression in the uteri of pseudopregnant mice. Calcitonin administration upregulated HB-EGF in uteri of naturally pregnant mice

Road traffic deaths in Kashan region, Iran: An eight-year study (2006-2013) / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>The aim of this study was to analyze the trend of road traffic fatalities in Kashan Region, Iran, in a period of eight years.</p><p><b>METHODS</b>Through a cross-sectional study, all road traffic deaths classified under the V01V99 codes according to ICD-10 in Kashan region, central Iran, from March 2006 to March 2013 and population data were collected from the registration system of Kashan University of Medical Sciences. Years of lost life (YLL) and mortality rates were calculated regarding age, gender and year of the accident. Generalized linear model (GLM) with Poisson log-linear link was used to evaluate the effects of the mentioned variables on mortality rate.</p><p><b>RESULTS</b>During the period of the study (8 years), 928 people (767 men) died due to road traffic injuries (RTIs). The total YLL was 20,818. The mortality rate due to RTIs has been declined constantly from 43.1 in March 2006 to 21.1 per 100,000 in March 2013. The highest mortality rate was found in the age group of over 60 years old and the lowest in the age group of 0-14 years old. Both mortality rate and YLL was greater in men than in women. Poisson regression showed that age, gender and year of the accidents had a significant effect on mortality rate (p < 0.001).</p><p><b>CONCLUSION</b>Although there has been a constant decline of mortality rate in Kashan area within the study period, the value remains higher than the mean level of Eastern Mediterranean region and the global average, which is a notable fact for policymakers and authorities.</p>

Return to work after trauma: A survival analysis / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>To evaluate the return to work (RTW) rate, time and predictors among trauma patients using survival analysis.</p><p><b>METHODS</b>This cohort study was conducted with a three-month follow-up on 300 trauma patients hospitalized in Shahid Beheshti Hospital, Kashan, Iran in 2014. The data were collected through conducting interviews and referring to patients' medical records during their hospital stay and follow-up information at one & three months after discharge from hospital. Final analysis was conducted on the data retrieved from 273 patients. Data were analyzed by chi-square test, Mann-Whitney U test and survival analysis method.</p><p><b>RESULTS</b>The rate of RTW at the end of the first and the third follow-up months was respectively 21.6% and 61.2%. Survival analysis showed that the RTW time (Time between admission to first return to work) was significantly longer among patients with illiteracy, drug abuse, hospitalization history in the intensive care unit, low socioeconomic status, non-insurance coverage, longer hospital stay, multiple and severe injuries as well as severe disability.</p><p><b>CONCLUSION</b>Our findings indicated that trauma has profound effects on the rate and time of RTW. Besides disability, many personal and clinical factors can affect the outcome of RTW.</p>

Association between PAPP-A and placental thickness

Background: Measuring of maternal serum pregnancy-associated plasma protein-A [PAPP-A] in first trimester can be a way for early detection of adverse prenatal outcome due to faulty placenta

Objective: The aim was to Determination of association between placental thickness in second trimester with low level of PAPP-A in first trimester

Materials and Methods: In this cohort study, serum PAPP-A of 187 pregnant women was measured in the first trimester of pregnancy. Patients who had PAPP-A /= 0.8 defined as unexposed group. The criteria of placental thickness in ultrasound study was thickness of 4 cm or more than 50% of placental length

Results: Of 187 patients, 87 patients had PAPP-A >0.8 and 93 patients had PAPP-A

Conclusion: Our study showed that serum level of PAPP-A generally was low [4 cm or >50% of placental length]. The first trimester of pregnancy measurement of PAPP-A will be more predictable for healthy placenta

Cervical length versus vaginal PH in the second trimester as preterm birth predictor

To evaluate diagnostic value of vaginal pH and cervical length measurement in the second trimester of pregnancy as a preterm labor [PTL] predictor. During a prospective cohort study 438 uncomplicated singleton pregnant women between 18 and 24 weeks of gestation were assessed regarding vaginal PH and cervical length. Vaginal pH was measured using Ph-indicator strips and cervical length was determined using transvaginal ultrasound. The cut-off values for vaginal PH and cervical length were defined as 5 and <30 mm respectively. Vaginal pH of 5 and above was found in 162/438 women [37%] while cervical length <30 mm was found in 38/438 [8.7%]. The incidence of PTL < 37 weeks was 87/438 [19.9%] while the incidence of early [PTL <34 weeks] was 51/438 [11.6%]. Predictive value of higher vaginal PH was significantly more [31%] than vaginal PH<5 [13%] in predicting PTL. As a result, alkaline vaginal PH significantly increases the odds of preterm labor [OR=3.06]. Shortened cervical length is better predictor of PTL than higher vaginal PH with positive predictive value of 71% and negative predictive value of 85%. Cervical length less than 30 mm nearly 14-fold increases odds of preterm birth [OR=13.9]. Compared to alkaline vaginal PH, shortened cervical length has better value to predict PTL overall. However, regarding early or late PTL, vaginal PH is more accurate to predict late PTL, while cervical length measurement is more appropriate to predict early PTL [<34 weeks]

Prevalence of second-eye cataract surgery and time interval after first-eye surgery in Iran: a clinic-based study

To determine the prevalence of second-eye senile cataract surgery [SECS] as a proportion of all senile cataract surgeries and the trend in the interval between first and second cataract operations in a main referral and academic eye hospital. In this cross-sectional study, a list of patients who underwent senile cataract surgery over four consecutive years [2006-2009] was retrieved from hospital computer-based records as the sampling frame. With a systematic random method, 15% of records were selected [1, 585 out of 10, 517 records]. First- and second-eye operations were performed in 1, 139 [71.9%; 95% confidence interval [CI], 69.5-74.1] and 446 eyes [28.1%; 95% CI, 25.9-30.35], respectively. The proportion of SECS procedures increased from 24.3% in 2006 to 33.4% in 2009 [P- 0.017]. The median [interquartile range] interval between the two operations was 9 [4-24] months, which remained stable during the study period. The SECS rate was 10.4% higher [P - 0.0l] and the time interval was 13 months shorter [P- 0.007] in patients who underwent phacoemulsification than extracapsular cataract extraction. The number of cataract operations in this tertiary eye care setting increased 1.5 fold over the study period. The proportion of second-eye operations also rose from 1/4 to 1/3 during the same time

Socioeconomic status and incidence of traffic accidents in metropolitan Tehran: a population based study

Population based estimates of traffic accidents [TAs] are not readily available for developing countries. This study examined the contribution of socioeconomic status [SES] to the risk of TA among Iranian adult s. A total of 64,200people aged>/=18years were identified from 2008 Urban Health Equity Assessment and Response Tool [Urban HEART] survey. 22,128 households were interviewed to estimate the overall annual incidence, severity and socioeconomic determinants of TAs for males and females in Iranian capital over the preceding year. Wealth index and house value index were constructed for economic measurement. Weighted estimates were computed adjusting for complex survey design. Logistic regression models were used to examine individual and SES measures as potential determinants of TAs in adults. The overall incidence of traffic accident was 17.3[95% CI 16.0, 18.7] per 1000 per year. TA rate in men and women was 22.6[95% CI 20.6, 24.8] and 11.8[95% CI 10.4, 13.2], respectively. The overall TA mortality rate was 26.6[95% CI 13.4, 39.8] per 100,000 person years, which was almost three times higher in men than that for women [40.4 vs. 12.1 per 100,000person years]. Lower economic level was associated with increased incidence and mortality of TA. Association between SES and incidence, and severity and mortality of TA were identified. TAs occur more in lower socioeconomic layers of the society. This should be taken seriously into consideration by policy makers, so that preventive programs aimed at behavioral modifications in the society are promoted to decrease the health and economic burden imposed by TAs