Shiraz Emedical Journal
Volume:20 Issue: 5, May 2019

Road traffic injuries (RTIs) are one of the main causes of death and disability throughout the world. In this regard, motorcyclists constitute the most vulnerable groups. By investigating the epidemiological characteristics of motorcycle crashes, we can attain valuable information about research priorities. We decided to conduct this study aiming at determining the epidemiological pattern of RTIs among motorcyclists in Shiraz in 2013 - 2016. In this cross-sectional study, we reviewed all information related to motorcycle crashes that took place in Shiraz from January 2013 to December 2016. The injured motorcyclists were classified according to their age, gender, the severity of the injury, injured region, length of hospital stay, hospital-acquired infections, and the outcomes. We also performed a logistic regression analysis to determine the risk factors for fatality in motorcycle crashes. According to our results, from all motorcycle crashes, 13577 (91.5%) were related to men and 1258 (8.5%) to women. Furthermore, most injured motorcyclists were in the 15 - 29-year-old age group. Crashes mostly occurred on weekends and in warm seasons. A hospital stay of more than one month (OR = 4.93, CI: 2.32 - 10.46) and an ISS of 9 - 15 (OR = 7.56, CI: 3.68 - 15.56) were the most effective risk factors for motorcyclist fatality. According to the study, since most motorcycle crashes involved the youth, enforcing stricter laws and cultural developments towards correcting risky behaviors can be very important in reducing the rates of death and disability.

The tendon repairs slowly. Platelets’ alpha granules contain polypeptide growth factors that stimulate proliferation of normal connective tissue cells. The acute phase of inflammation is necessary for healing progress and fibroplasia. Platelet growth factors initiate and accelerate the inflammatory response by the host. This study aimed to investigate if platelet-rich plasma (PRP) helps tendon gap healing. Aseptic surgery was performed on 24 mature guinea pigs in four groups to excise a 7-mm piece of the deep digital flexor (DDF) tendon of the right hind leg. In groups 1 and 2, the two ends of the severed tendon were sutured in the fascia conduit; group 2 received PRP injection into the conduit. In groups 3 and 4, the two ends of the severed tendon were sutured in a silicone tube conduit, and group 4 received PRP injection. After 42 days, the animals were euthanized and tendon samples were collected for further study. The histopathological and stereological data showed that inflammation was far less in PRP-treated groups as they showed more fibroblastic proliferation. The synergistic effects of silicone tube and PRP injection showed the least inflammatory response. The diameter of collagen bundles and their volume were higher in the groups which received PRP in the silicone conduit. The present study found that PRP improved healing of tendon injury and silicone conduit served as good surgical technique with synergistic effect beside PRP.

Mastalgia is the most common symptom of fibrocystic breast changes. It causes concern and fear of breast cancer and has negative effects on quality of life. The study aimed to compare the effectiveness of evening primrose oil (EPO) and vitamin B6 in the pain control of cyclic mastalgia. This triple-blind randomized controlled clinical trial was conducted on 94 patients with mastalgia referring to the breast clinic of Milad hospital, Tehran, Iran. The participants were randomly assigned to three groups: EPO (n = 33), vitamin B6 (n = 31), and placebo (n = 30). The mastalgia severity in the three groups was measured using Visual analogue scale (VAS) before intervention and at the first, second, and third months after the beginning of the intervention using SPSS 18. The results of this study showed that the mean severity of breast pain significantly reduced at the first, second, and third months after the intervention in the EPO (2.61 ± 2.35) and vitamin B6 groups (2.81 ± 1.97) (P < 0.001). However, the mean score of pain severity in the placebo group before and after the intervention did not show a statistically significant difference (5.38 ± 2.28) (P = 0.815). In addition, the difference in the mean score of pain severity between the two groups of EPO and vitamin B6 was not statistically significant (P = 0.999). The results of this study showed that vitamin B6 and EPO have the same therapeutic effects in the treatment of cyclic mastalgia. Because of the low cost and more availability of vitamin B6 compared to EPO, it can be used in the first line of treatment.

This study aimed to assess differences in the quality of voice results of open frontolateral partial laryngectomy with imbrications laryngoplasty and transoral laser microsurgery in T1b glottic carcinoma. In this randomized clinical trial, 20 patients with T1b glottic cancer who were candidates for surgery were randomly (using the blocked randomization method) assigned to schedule for frontolateral partial laryngectomy with imbrications laryngoplasty (n = 7) or transoral laser microsurgery (Va extended cordectomy) (n = 10). The objective and subjective voice results were assessed using voice analysis parameters (jitter, shimmer, harmonics to noise ratio, and maximum phonation time). The Voice Handicap Index (VHI) questionnaire was used with 30 statements consisting of three domains including functional, physical, and emotional aspects of voice disorders. No statistically significant differences were noted between laser surgery and open procedure in objective voice analysis parameters. The voice was significantly disturbed after both procedures but subjective analysis of the voice by the VHI questionnaire showed more statistically significant patients’ satisfaction in the laser group. The mean VHI was 77.29 ± 8.51 after vertical hemilaryngectomy and 65.60 ± 13.08 after laser cordectomy that was significantly lower in the latter procedure (P = 0.042). Despite the imbrications of laryngoplasty in open surgery, no statistically significant differences were noted in objective voice parameters. However, more patients’ satisfaction was noted regarding voice in laser surgery. When considering modality, we need to assess factors such as individual anatomic factors, complete tumor exposure (depth of tumor in anterior commissure), professional needs, quality of life, and cost-effectiveness. With regard to the semi-invasive nature of laser use and more patients’ satisfaction based on the VHI questionnaire, this method is prioritized in comparison with the surgical procedure as vertical hemilaryngectomy.

Decisions on the choice of delivery method are influenced by various factors such as family and social aspects, medical advice, previous delivery experience, and current pregnancy conditions. The present study aimed to determine the frequency of delivery methods and their related factors in pregnant women in Shiraz. This cross-sectional descriptive study was conducted on 3940 pregnant women in Shiraz in 2016. All public hospitals with maternal care units in Shiraz were selected. Stratified sampling method, proportionate to the sample size, was used so that the number of registered pregnant women, during the year before the study, was determined for each center and the subjects were selected by convenience sampling. Data were collected through a checklist and was analyzed performing One-way ANOVA and chi-square test with SPSS 20 at the significance level of 0.05. The mean age of the pregnant women participating in the study was 29 ± 5.7 years. A total of 2003 pregnant women (50.8%) decided to give birth through cesarean section (C-section), 1849 (46.9%) through standard vaginal delivery, and 68 (1.7%) in water. The most prevalent reasons cited by pregnant women were fewer complications in NVD, fewer maternal and obstetric problems in C-section, and comfort of delivery in water. The age of women requesting C-section was significantly higher than those selecting NVD and delivery in water (P < 0.001). The prevalence of elective C-section was substantially higher in urban residents and women with higher education levels (P < 0.001). Physicians’ recommendation was mentioned as the most important reason for elective C-section by pregnant women (70.6%). Multivariable logistic regression showed that the fathers high school education, the age of mother, and living in a suburban area had a significant effect on choosing C/S as a method of delivery by pregnant women. Great inclination of pregnant women and physicians’ recommendation for elective C-section are the problems faced by the healthcare system. It can be minimized by planning and making effective interventions and through changing the attitude and culture of the community and increasing knowledge about the complications of C-section.

Family habits and the lifestyle of parents play an important role in the mental and social health of children. Given the high prevalence of psychiatric disorders in Iran and the lack of information on the factors associated with these disorders, it is necessary to study the relationship between the lifestyle of parents with common psychiatric disorders in children and adolescents. The present analytical cross-sectional study was undertaken from 2016 to 2017. A total of 1,022 children and adolescents aged 6 - 18 in Ilam, Iran, were enrolled in the study. The participants were selected through multi-stage cluster sampling from urban and rural areas of the city. Data on children were collected by using a semi-structured interview with the Kiddie-SADS-Present and Lifetime Version (K-SADS-PL) Questionnaire, and the Life Style Questionnaire (LSQ). Using IBM-SPSS software V. 24, the chi-squared test, Student’s t-test, and multivariable logistic regression model were used to analyze the data. There was a significant association between the mental health of parents with separation anxiety disorder (SAD) (adjusted odds ratio [aOR] = 0.86, P value [P] = 0.01). In addition, significant association was found between physical health (aOR = 1.17, P = 0.04), disease prevention (aOR = 1.22, P = 0.04), spiritual health (aOR = 0.83, P = 0.04), and avoidance of drugs, alcohol, and opiates (aOR = 0.87, P = 0.004) with obsessive-compulsive disorder. Attention deficit hyperactivity disorder with sports and fitness (aOR = 0.82, P = 0.01), social health (aOR = 1.33, P = 0.007), and social phobia with spiritual health (aOR = 0.76, P = 0.04) showed a statistically significant association. This study supports the hypothesis that the lifestyle of parents is an important determinant in the mental health of children.

Emergency departments (EDs) play a crucial role in healthcare systems that are currently inflicted by countless problems. A high level of mismatch between supply and demand in EDs entail crowding and weak performance. To compare the senior early assessment model of care in the ED of main referral medical center in southern Iran. The present study evaluated ED performance measures over a six month period prior to (Sep. 2013 - Feb. 2014) and following (Sep. 2014 - Feb. 2015) the development of the senior early assessment model of care, through the use of retrospective data. All admission records were collected and calculated via Iranian national ED performance measures and further analyzed (α = 0.05). A total of 48 194 patients were visited over a six month period prior to the senior early assessment model of care; in addition, 49,133 patients were analyzed during a six month period after. The percentage of patients disposed within six hours was different before and after the intervention (79.48% vs. 88.05%, P = 0.025). Although the percentage of discharge with personal responsibility and the mean ± SD of duration of triage time were reduced, no statistical significant changes were observed before and after the intervention (P = 0.127, P = 0.132). Moreover, the percentage of unsuccessful CPR was increased, however, it was not significant (P = 0.347). It seems that applying new models of care, such as senior early assessment, can solve ED overcrowding. In the present research, the patients’ disposition within six hours was reduced. On the other hand, no recognizable difference was found as far as reducing unsuccessful CPR, duration of triage time, and discharge with personal responsibility. It is recommended that future studies assess the efficacy of models of care.

Is the h-index an appropriate scientometric criterion? Does it indicate all the research realities and potentials of a researcher? Is it an appropriate indicator for comparing researchers? For several reasons, the h-index cannot be a comprehensive indicator for ranking researchers since it is a confounded criterion far from reality.