Nonfire carbon monoxide-related deaths: a survey in Tehran, Iran (2002-2006).

OBJECTIVE: To depict the epidemiology of deaths due to carbon monoxide (CO) poisoning in Tehran, distinguishing those at greatest risk for acute poisoning resulting in death. METHODS: A retrospective survey was carried out with regularly collected information set in Tehran's Legal Medicine Organization, with a population of 11.1 million. The data included 666 deaths due to CO poisoning from January 2002 through December 2006. The principal consequence measures were age and sex standardized incidence rates for unintentional, suicidal, and undetermined poisonings for legal authorities. RESULTS: The overall rate of unintentional poisonings over the 5-year period was 7.5 per 100,000, with an annual rate of 1.5 per 100,000. The 5-year rates were highest in people aged 25 to 34 years: men, 16.4 per 100,000; women, 7.8 per 100,000. For suicides, the 5-year rate was 0.1 per 100,000; annual rate, 0.02 per 100,000. The suicidal 5-year rates were highest in men aged 35 to 44 years, that is, 0.9 per 100,000; there was no case for women. Unintentional poisonings displayed a powerfully seasonal variation with the highest rates being documented in the months October to March. Over the 5-year period, increasing rates of death from CO poisoning were found annually to be approximately 20%. CONCLUSIONS: In this study, middle-age people, young adults, and elderly people were at the greatest risk for unintentional CO poisoning, and rates were highest in the winter months. Death from suicidal CO poisoning was very rare in this study; on the other hand, unintentional CO poisoning deaths are increasing in Tehran. Health authorities require to consider all populations in any prevention plan.

Epidemiology of drowning in Mazandaran province, north of Iran.

OBJECTIVES: Drowning must be recognized as a major global public health problem with significant opportunities for prevention. METHODS: To examine the incidence and characteristics of drowning in recreational water settings, we analyzed 2002 to 2006 data from the Legal Medicine Organization of Mazandaran province, north of Iran, through a retrospective study. RESULTS: During 2002 to 2006, a total of 1107 persons suffered fatal drowning in Mazandaran province. Mean age was 23.65 +/- 11.47 and M/F ratio was 8.4:1. The most common age groups of drowned victims were 20 to 24 and 15 to 19 years (17.0 and 16.1 per 100,000 population/yr, respectively). Children under the age of 15 years comprised 14.2% of all drowning deaths. Unprotected beaches of the Caspian Sea were the locations with the highest number of drowned victims. Most of drowned victims (65.9%) were travelers from other parts of Iran, especially from Tehran. The manner of death was found as following: 95.5% accidental, 3.6% suicidal, 0.3% homicidal, and 0.6% undetermined. CONCLUSIONS: Mazandaran province has a mean drowning rate 7.6 per 100,000 population-year that is not comparable to the drowning-related mortality in developed countries. Effective prevention of drowning requires programming and policies that address known risk factors.

Does CMV infection increase the incidence of infective endocarditis following kidney transplantation?

BACKGROUND: Infective endocarditis (IE) is a rare but life threatening infection after renal transplantation. In addition, coinfection of CMV and IE has not been reported. Therefore, the current study was initiated to determine whether CMV infection is a risk factor for developing of IE after kidney transplantation. MATERIAL/METHODS: In a retrospectively study, we analyzed the medical records of 3700 kidney recipients at two transplant centers in Iran, between January 2000 and June 2008 for infective endocarditis. RESULTS: During the study, 15 patients with IE hospitalized in our centers were included. The predominant causative microorganisms (60%) were group D non-enterococcal streptococci and enterococci. Patient survival rate in all recipients was 66% at 6 months. Data analysis showed no significant differences in 6 months patient survival from hospitalization between both groups with and without CMV infection (P=0.2). The presentation time of infective endocarditis in recipients with CMV coinfection was more likely to be early when compared to CMV negative coinfection patients (P=0.03). CONCLUSIONS: The present study indicates that CMV infection may lead to predispose to infective endocarditis after kidney transplantation. Rapid diagnosis, effective treatment, and prompt recognition of complications in kidney transplant recipients are essential to good patient outcome.