Diurnal temperature range and hospital admission due to cardiovascular and respiratory diseases in Dezful, a city with hot climate and high DTR fluctuation in Iran: an ecological time-series study.

The results of previous studies have indicated the effects of temperature changes on health status. The present study was conducted to investigate the effects of diurnal temperature range (DTR) and hospital admission on cardiovascular and respiratory diseases in Dezful, in Iran. In this ecological time-series study, data related to hospital admissions based on ICD-10, meteorological, and climatological data were gathered over a period of six years from 2014 to 2019. A distributed lag nonlinear model combined with a quasi-Poisson regression was then used to assess the impact of DTR on cardiovascular and respiratory hospital admissions. Potential confounders, including wind speed, air pollution, seasonality, time trend, weekends and holidays, days of week, and humidity were controlled. In extreme low DTRs, the cumulative effects of cardiovascular admissions significantly increased in total, and in warm and cold seasons (Lag0-21, P ≤ 0.05). In addition, in extreme high DTRs, the cumulative effects of cardiovascular significantly decreased in total (Lag0-13 and Lag0-21, P ≤ 0.05), and in warm (Lag0-21, P ≤ 0.05) and cold seasons (Lag0-21, P ≤ 0.05). Moreover, respiratory admissions significantly decreased in total (Lag0-21, P ≤ 0.05) and in warm season (Lag0-21, P ≤ 0.05).Our result indicates that extreme low DTRs could increase the risk of daily cardiovascular admissions, and extreme high DTRs may cause a protective effect on daily respiratory and cardiovascular admissions in some regions with high fluctuations in DTR.

Lessons Learned From a Chlorine Gas Leakage in Dezful City, Iran.

Dezful is the capital of Dezful County, a city in Khuzestan Province, Iran. On August 12, 2017, after a chlorine gas leakage in Dezful, more than 475 people were affected by chlorine gas, and they all suffered from respiratory complications. A lot of problems were encountered in the preparation of the relief forces and organization of the blueprint on how to respond to the incident, such as lack of knowledge on establishment of danger zone, lack of warning system, lack of proper triage and absence of decontamination plans, lack of special chemical safety outfit and respiratory equipment for rescuers, lack of instructions for proper handling, lack of knowledge in dealing with this type of disaster, and inappropriate evacuation skills and failure to cordon off and insure the location of the incident. Although the initial measures to arrest this crisis was performed based on the health system's instructions of the country with regard to all the possible risks, lack of a comprehensive inter-organizational program and prevention plans, lack of control plans, lack of adequate preparation and response to chemical poisoning, lack of foresight, lack of a risk plan, and lack of an intervention plan for these incidents were the reasons for the damages and problems encountered after the crisis.

Cardiovascular and respiratory emergency dispatch due to short-term exposure to ambient PM10 in Dezful, Iran.

Introduction: This study was conducted to determine the relation between exposure to particulate matter less than 10 microns (PM10) caused by dust storms and the risk of cardiovascular, respiratory and traffic accident missions carried out by Emergency Medical Services (EMS). Methods: This was a time-series study conducted in Dezful city, Iran. Daily information on the number of missions by the EMS due to cardiovascular, respiratory and crash problems and data on PM10 were inquired from March 2013 until March 2016. A generalized linear model (GLM) with distributed lag models (DLMs) was used to evaluate the relation between the number of EMS missions and the average daily PM10. The latent effects of PM10 were estimated in single and cumulative lags, up to 14 days. Results: In the adjusted model, for each IQR increase in the average daily PM10 concentration, the risk of EMS missions in the total population in single lags of 2 to 7 days, and the cumulative lags of 0-7 and 0-14 days after exposure had a 0.8, 0.8, 0.8, 0.8, 0.7, 0.6, 6.7 and 1.4% significant increase. Also, for each IQR increase in the daily mean concentration of PM10 in single 1 to 7, and cumulative lags of 0-2, 0-7, and 0-14 days after exposure, respectively, a 2.4, 2.7, 2.8, 2.9, 2.9, 2.7, 2.5, 7.4, 23.5 and 33. 3 % increase was observed in the risk of EMS cardiovascular missions. Conclusion: Increase in daily PM10 concentrations in Dezful is associated with an increase in the risk of EMS missions in lags up to two weeks after exposure.

Triage live lecture versus triage video podcast in pre-hospital students' education.

INTRODUCTION: Triage is the process of determining the priority of patients' treatments based on the severity of their conditions. The aim of the present study was to survey the effect of triage video podcasting on the knowledge and performance of pre-hospital students. METHODS: Sixty pre-hospital students were randomly divided into two groups of a 30-subject control group and a 30-subject intervention group. A pre-test was administered among all students. Afterwards, for the first group, triage education was offered through lectures using PowerPoint, while for the second group, audio and video podcasts tailored for this training program were employed. Right after the training as well as one month later, post-tests were run for both groups, and the results were analysed using an independent t-test and covariance. RESULTS: No significant difference was observed between the effects of both types of education on knowledge and performance, either immediately, or one month after training. DISCUSSION: We suggest that video podcasts are ready to replace traditional teaching methods in triage.

The Methanol Poisoning Outbreaks in Iran 2018.

AIMS: To present epidemiological data, probable causes and lessons learned from the outbreak of methanol poisoning in Iran in September 2018, and relate this to the increasing incidence of methanol poisoning worldwide over recent decades. METHOD: Analysis of all available reliable field information, official news reports and reports from the country's forensic medicine organization and the Ministry of Health. RESULTS: Overall, 768 people in Iran were documented as poisoned from September 7 to October 7 2018 by consuming an informal alcohol containing methanol, of whom 76 died (10.1% fatality rate); 460 subjects attended state hospitals due to acute methanol poisoning of whom 42 (9.13%) died. Those who were hospitalized comprised 177 subjects (38.4%), with 241 subjects (52.3%) seen and discharged. Males comprised 93% of the deaths. About 41% of those poisoned were aged 25-36. Outbreaks were reported in 21 provinces. CONCLUSION: These data indicate a high fatality rate of methanol poisoning in Iran, something seen also in some other countries. Considering that such outbreaks take place more in low-income and Islamic countries due to ignorance and legal constraints, it seems necessary to seek an effective educational model for raising public awareness and a fully native and early warning system in this regard to reduce the damage and enhance readiness to deal with the health effects of such outbreaks.