ali hadianfar

Identifying factors that influence the length of hospital stay for suspected stroke patients is crucial for optimizing the utilization of hospital resources. This study aimed to determine the factors associated with the length of hospital stay for suspected stroke patients transferred to Qaem Hospital in Mashhad through emergency services using survival analysis.

In this historical cohort study, general information was gathered for all suspected stroke patients who sought emergency services in Mashhad, the largest city in northeast Iran, from March 21, 2018, to March 20, 2019, and were then transferred to the Emergency Department of Qaem Hospital. Pre-hospital emergency data were integrated with hospital records using the mission ID. The primary outcome assessed in the study was the length of hospital stay, with model implementation carried out using the statistical software Stata.

The median hospitalization time until patients' recovery was  seven days. Out of the 578 participants, 386 cases (66.8%) recovered, while the remaining 190 cases (33.2%) were censored (83 individuals had died during the study, and 107 individuals had exited the hospital for other reasons). The average age of patients at the time of hospitalization was 71.13±13.01 years. Statistical analysis employing Log-rank and Breslow tests identified a significant difference in hospitalization duration among patients receiving various levels of care and based on their insurance status. During multivariate analysis, the Cox regression model was considered unsuitable due to some variables not meeting the proportional hazards assumption, leading to the utilization of AFT models. Following the evaluation of AFT models, including Log-normal, Log-logistic, Exponential, and Weibull, the log-normal model emerged as the most suitable choice, exhibiting AIC and BIC values of 1273.909 and 1356.740, respectively. Significant variables influencing length of stay included patient admission priority, insurance status, season, and residency status.

The study suggests that parametric survival models are effective for analyzing lifetime data. Additionally, in light of the significant variables identified, enhancing facility readiness and resource allocation could facilitate more efficient planning and implementation.

Vitiligo is </em>an acquired disease with unknown cause and one of the major challenges in dermatology. The aim of this study was to evaluate the therapeutic efficacy of microneedling in combination with topical liposomal form of 5-fluorouracil (5-FU) 5% in treatment of vitiligo.

This study was performed as a randomized clinical trial on 25 patients with vitiligo referred to the dermatology clinics of Imam Reza and Ghaem hospitals in Mashhad City, Iran. In each patient, three lesions were selected and microneedling with liposomal form of 5-FU 5% and only microneedling were performed on one of them by random allocation. The third lesion was considered as a control without any intervention. This process was done every 2 weeks for 3 months, and the rate of improvement was assessed after 6 months.

68% of lesions (17 persons) treated with microneedling and 5-FU had significant repigmentation, 12% with 25%-50% improvement and 56% with improvement up to 25%. However, response rate of lesions treated with microneedling alone was 32%, 4% with 25%-50% improvement and 28% with improvement up to 25%. Statistical analysis of data with generalized estimating equation (GEE) method showed that in terms of response to treatment, the lesions treated with microneedling and 5-FU had a significant difference with microneedling alone and also with control lesions (P < 0.050).

According to our findings, the combined use of microneedling with topical 5-FU significantly improves resistant vitiligo lesions compared to microneedling method alone.

Clinical trial studies have a special value among a variety of studies. The results of these studies have important applications on human populations, including the study of the effects of drugs and therapies. Given the importance of such studies, it seems necessary to review the quality and evaluation of articles related to this field of research. The issue of critical appraisal has a very important place in biomedical studies; And help researchers evaluate the quality of articles. The aim of this study was to evaluate the clinical trial articles Medical Journal of Mashhad University of Medical Sciences during 1388-1398.

The present study was a descriptive cross-sectional study .In this study, the study population was 173 clinical trial articles that were selected from 741 articles published in the Journal of the Faculty of Medicine of Mashhad University of Medical Sciences during 1388 to the end of 1398. These articles were reviewed using consort checklists in 25 general items by two statistical experts with an agreement of more than 0.91%. Data were analyzed by SPSS software version 23.

In evaluating the articles in this journal, a growing trend was observed in the number of clinical trial articles published in the review. According to the evaluations based on the Consort Checklist, the lowest score assigned to articles was 6 points, which was related to an article in 1394, and the highest was an article in 1397, which received a score of 27 out of 37. The average score of all articles was 13.53 with a standard deviation of 2.82. The statistical methods used and the mention of the term "clinical trial" in the title were the items that received the most and the least amount of attention in the research, respectively.

In general, the attention of the studied clinical trial articles to the observance of the points of the consort statement has been less than acceptable, which eliminates the shortcomings and observes more of the consort items to increase the quality of the articles in Medical Journal of Mashhad University of Medical Sciences.

Randomized controlled clinical trial studies are the most valuable types of studies that their proper design and accurate reporting are of particular importance in medical science. This study was performed with aim to critically evaluate the randomized controlled clinical trial studies in the Iranian Journal of Obstetrics, Gynecology and Infertility.

In this cross-sectional analytic study, the clinical trial articles of the Iranian Journal of Obstetrics, Gynecology and Infertility between 2009 and 2019 were collected and scored based on the latest edition of the Consort Checklist (2010) by three biostatisticians that their training's adequacy was confirmed by measuring the kappa agreement coefficient. The articles were scored, and based on the scores, they were classified into five categories: very poor to excellent. Data were analyzed by SPSS software (version 25) and descriptive statistics.

Out of a total of 1318 articles published during 11 years, 325 were clinical trials, among them only 6 articles (1.85%) were rated as excellent. The lowest and highest scores among the reviewed articles were 14 and 28 (maximum score was 37). The mean and standard deviation of the scores obtained in all articles was calculated as 19.05± 0.34. However, less attention was paid to the two main issues of randomization and blindness in the clinical trials.

Due to the importance of clinical trial studies, it is necessary to pay attention to the articles' quality based on the consort checklist. It is also suggested that authors of such articles pay more attention to the two essential foundations of clinical studies, randomization and blindness, to increase the generalization of the results.

The suicide attempt is one of the crucial public health dilemmas. The present study investigated the epidemiological and geographical pattern of suicide attempts in Mashhad in 2016.

In this cross-sectional study, pre-hospital information of suicide attempts was registered in the disaster and emergency medical management centers (115) of Mashhad, Iran was collected.  Other information was obtained from the medical records department of Imam Reza Hospital as the only reference hospital for trauma and poisoning in Mashhad. Conventional statistical methods were used in the statistical analysis of data. Spatial analysis was used in Arc GIS software to investigate the geographical distribution of suicide attempts.

 A total of 2,785 cases of suicide attempts, 64.7% (1801) of whom were women. The highest frequency of suicide attempts was in the age groups of 15 to 24 (N=799, 39.1%) and 25 to 34 years (N=720, 35.2%). In general, married people (N=1635, 58.7%), high school literacy level (N=821, 29.5%), and homemakers (N=1186, 42.6%) had the highest percentage of suicide attempts. The most common method of suicide was drug poisoning (N=1736 84.9%). The geographical distribution of suicide attempts showed that the highest suicide attempts were reported in the northeastern and suburbs of Mashhad.

The present study results showed that suicide attempts in young age groups and women are very serious. On the other hand, the incidence of suicide attempts was different in all individuals and also separately for men and women in different geographical areas of Mashhad.

Depression is one of the most common mental disorders and it has the third rank of the cause of disability and has been considered to increase the years of life with disability in Iran.

The purpose of this study was to map the geographical distribution and find hot spots of depression and its relation to demographic and socioeconomic factors in Mashhad.

A population-based cross-sectional study was conducted in Mashhad in 2010. In this study, 9704 individuals aged 35 to 65 years old were evaluated using Beck’s depression inventory-II. A generalized linear mixed model with a logit link was fitted for the spatial modeling of depression. R and GIS software was used for spatial analysis and disease mapping, respectively.

The prevalence of depression was different in geographical areas, ranging from 13.29% to 26.67%. The spatial correlation in the prevalence of depression was significant. The fitted spatial model showed that the spatial adjusted associations between gender (P < 0.001), marital status (P < 0.001), socioeconomic status (P < 0.001), and depression were significant.

The significant spatial correlation shows that depression is spatially contagious and it is important to find its hot spots in the population. Thus developing health policy for prevention, early diagnostics, and treatment programs is preferred in these resource-limited areas.

Geospatial distribution analysis is a highly useful tool, especially in the field of health research and health economics. We aimed to study the geospatial distribution of poisoned patients and the risk factors in Mashhad, Iran.

This was a retrospective cross-sectional study of patients treated at the Medical Toxicology Center, Imam Reza Hospital, Mashhad, Iran, which is the only referral center in northeast of Iran, in 2013. Negative binomial and Poisson approach via generalized linear mixed models were performed to investigate the association between socio-demographic characteristics with the number of reported cases of poisoning.

A total of 5064 poisoned patients (52% females) were included. Most of the poisoned patients were within the age group of 20-29 years old (41.4%). Pharmaceutical agents were the most common cause of poisonings (64.6%). The local test of spatial autocorrelation (Moran’s I) confirms that the poisoning had cluster pattern in Mashhad. Number of poisoning events were found to be associated with population density (RR= 1.00011; 95% CI 1.0001-1.00013), and the frequency of people with less than high school education (RR=1.49; 95% CI 1.32-1.68).

The geospatial factors may have impact on the number of acute poisoning events in a city. Some parts of a city may exhibit spatial clustering in poisoning events. Once clusters are found, interventions can be focused to specific geographic locations and would be helpful for healthcare policymakers to focus on prevention programs.