Standardised mortality ratios in people exposed to sulphur mustard during the Iran-Iraq war: a retrospective study with 39-year follow-up.

OBJECTIVES: Sulphur mustard (SM) is a chemical weapon agent that was extensively used by Iraqi troops during the Iran-Iraq war (1980-1988), resulting in exposure among Iranian military personnel and civilians. However, there is limited and conflicting information about the long-term mortality effects of SM exposure. This study aimed to determine the standardised mortality ratios (SMRs) in individuals exposed to SM gas during the Iran-Iraq war. STUDY DESIGN: This was a retrospective follow-up study. METHODS: Data were obtained from the Veterans and Martyr Affair Foundation of Iran (VMAF) regarding all confirmed individuals who were exposed to SM during the Iran-Iraq war (1980-1988) up to 30 March 2019. The mortality rate, cumulative mortality and SMR with 95 % confidence intervals (CIs) were calculated to assess mortality in chemical warfare survivors (CWS), and results were compared with the general Iranian population. Overall survival was analysed using the Kaplan-Meier curve, and the log-rank test was employed to compare survival probability across different categories. RESULTS: Among the 48,067 confirmed CWS, a total of 4358 (9.1 %) individuals had died by the end of the study period (30 March 2019), with a mean age of 55.5 ± 14.4 years at the time of death. Overall, at the 39-year follow-up, the mortality rate due to all causes of death for people who were exposed to SM was lower than the general Iranian population (SMR: 0.70, 95 % CI: 0.68-0.72). However, cause-specific SMR analysis showed that the mortality rate due to liver cancer (SMR: 1.98, 95 % CI: 1.59-2.45), poisonings (SMR: 1.92, 95 % CI: 1.52-2.38), respiratory disorders (SMR: 1.59, 95 % CI: 1.46-1.73) and multiple myeloma (SMR: 1.72, 95 % CI: 1.06-2.62) were approximately twofold higher in CWS than the general population. CONCLUSIONS: This study provides valuable insights into the mortality effects of SM exposure among the Iranian population affected by the Iran-Iraq war. The results emphasise the importance of continued monitoring and support for individuals exposed to SM, particularly in the context of managing and addressing the heightened risks associated with liver cancer, poisonings, respiratory disorders and multiple myeloma. Further research and interventions may be necessary to mitigate these specific health challenges in the affected population.

Computed tomographic features of coronavirus disease-2019 (COVID-19) pneumonia in three groups of Iranian patients: A single center study.

INTRODUCTION AND OBJECTIVES: The pivotal role of chest computed tomographic (CT) to diagnosis and prognosis coronavirus disease-2019 (COVID-19) is still an open field to be explored. This study was conducted to assess the CT features in confirmed cases with COVID-19. MATERIALS AND METHODS: Retrospectively, initial chest CT data of 363 confirmed cases with COVID-19 were reviewed. All subjects were stratified into three groups based on patients' clinical outcomes; non-critical group (n=194), critical group (n=65), and death group (n=104). The detailed of CT findings were collected from patients' medical records and then evaluated for each group. In addition, multinomial logistic regression was used to analyze risk factors according to CT findings in three groups of patients with COVID-19. RESULTS: Compared with the non-critical group, mixed ground-glass opacities (GGO) and consolidation lesion, pleural effusion lesion, presence of diffuse opacity in cases, more than 2 lobes involved and opacity scores were significantly higher in the critical and death groups (P<0.05). Having more mixed GGO with consolidation, pleural effusion, lack of pure GGO, more diffuse opacity, involvement of more than 2 lobes and high opacity score identified as independent risk factors of critical and death groups. CONCLUSION: CT images of non-critical, critical and death groups with COVID-19 had definite characteristics. CT examination plays a vital role in managing the current COVID-19 outbreak, for early detection of COVID-19 pneumonia. In addition, initial CT findings may be useful to stratify patients, which have a potentially important utility in the current global medical situation.

[Computed tomographic features of coronavirus disease-2019 (COVID-19) pneumonia in three groups of Iranian patients: A single center study]. / Características en tomografía computarizada de la neumonía por coronavirus-2019 (COVID-19) en tres grupos de pacientes iraníes: estudio de un solo centro.

Introduction and Objectives: The pivotal role of chest computed tomographic (CT) to diagnosis and prognosis coronavirus disease-2019 (COVID-19) is still an open field to be explored. This study was conducted to assess the CT features in confirmed cases with COVID-19. Materials and Methods: Retrospectively, initial chest CT data of 363 confirmed cases with COVID-19 were reviewed. All subjects were stratified into three groups based on patients' clinical outcomes; non-critical group (n=194), critical group (n=65), and death group (n=104). The detailed of CT findings were collected from patients' medical records and then evaluated for each group. In addition, multinomial logistic regression was used to analyze risk factors according to CT findings in three groups of patients with COVID-19. Results: Compared with the non-critical group, mixed ground-glass opacities (GGO) and consolidation lesion, pleural effusion lesion, presence of diffuse opacity in cases, more than 2 lobes involved and opacity scores were significantly higher in the critical and death groups (P<0.05). Having more mixed GGO with consolidation, pleural effusion, lack of pure GGO, more diffuse opacity, involvement of more than 2 lobes and high opacity score identified as independent risk factors of critical and death groups. Conclusion: CT images of non-critical, critical and death groups with COVID-19 had definite characteristics. CT examination plays a vital role in managing the current COVID-19 outbreak, for early detection of COVID-19 pneumonia. In addition, initial CT findings may be useful to stratify patients, which have a potentially important utility in the current global medical situation.