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

Analysis of survival data in thalassemia patients in Shiraz, Iran / 한국역학회지

OBJECTIVES: The survival rate of thalassemia patients has not been conclusively established, and the factors associated with survival remain unclear. This study aimed to determine the survival rate of thalassemia among patients in southern Iran and to identify the factors associated with mortality from thalassemia. METHODS: This retrospective cohort study was conducted based on a retrospective review of the medical records of 911 beta-thalassemia patients in 2014. Data analysis was conducted using the Kaplan-Meier method and Cox regression analysis. RESULTS: Overall, 212 patients (23.3%) died, and 26.8% had thalassemia intermedia. The 20-year, 40-year, and 60-year survival rates were 85%, 63%, and 54%, respectively. Both crude and adjusted analyses found that education, marital status, ferritin levels, and comorbidities were related to mortality. CONCLUSIONS: Sociodemographic and hematological factors were found to be significantly associated with the survival rate of thalassemia. Addressing these factors may help healthcare providers and physicians to provide the best possible care and to improve the survival rate.

[Effect of gelatin sponge and tranexamic acid M.rinses on prevention of bleeding after dental extraction in patients taking warfarin]

Management of postoperative bleeding in patients receiving warafin, has always been one of the most challenges for dentists. Cessation in using warafin 2-3 days before tooth extraction is one of the methods for preventing bleeding in these patients, but it may increase the risk of thromboembolism. The aim of this study was to use localized haemostatic drugs instead including gelatin sponge and tranexamic acid mouthwash. In this clinical trial study, 22 patients who were currently receiving warafin with INR range of 2-4 were selected. For each patient 3 teeth were extracted in several times. After extraction of each tooth, Gelatin sponge, Tranexamic acid 4.8% mouth wash and sterile gauze [without any haemostatic drug] were used. Tendency of bleeding in 66 teeth, 2 and 24 hours after extraction was checked. No suture was used for any patient. Data were analyzed with descriptive statistics [frequency and average] and Chi-square and Fisher's exact tests. Rate of bleeding in three groups were measured: Gelatin sponge: 9.1%, Tranexamic acid 4.8% mouthwash: zero and sterile gauze [without any haemostatic drug]: 27.3%. In patients treated with warafin, interruption in use of warfarin for tooth extraction is not needed. Local haemostasis with tranexamic acid, gelatin sponge, INR