enayatollah homaie rad

Climatic conditions always have a great impact on the quality of driving and consequently the damage, injury and death of traffic accidents, among these conditions, fog due to sudden occurrence and reduced visibility of drivers as dangerous weather conditions need to be investigated and Read more. This study aimed at determining the pattern of accidents in fog and the relationship between driver, road, and accident with injury level in, Guilan from 2014 to 2018.This is a retrospective descriptive-analytical study that investigated all accidents that had occurred in Guilan from 2014 to 2018. All of the data were entered into STATA software. The time-series estimators were used as the multivariate regression model for the presence or absence of any relationship between variables. The likelihood of fatalities in fog decreased with age while it increased when drivers were female (p = 0.001). Most of the accidents in fog condition had occurred in December (p=0.000), February (p=0.001) and November (p=0.012). The number of related injuries at 2 AM (p = 0.032), 3 AM (p = 0.019), and 2 PM (p = 0.02) significantly reduced. Moreover, the rate of mortality at 2 AM (p = 0.005), 9 AM (p = 0.012), 11 AM (p = 0.004), 13 PM (p = 0.008) and 19 PM (p = 0.003) were significantly lower. Due to the fact that the death rate was significantly higher in fog conditions than in other weather conditions, it is necessary to warn and inform the public. Also, in traffic education programs, female drivers and young drivers should be included as the target group of the programs. In addition, preventive interventions should be done mostly in the months of November, January and February and in the cities of Anzali and Rasht.

This systematic review evaluated how different storage times and conditions affect universal adhesives' bond strength and degree of conversion (DC).

A literature search was conducted in PubMed, Scopus, Web of Science, and Google Scholar databases for articles published from January 1st, 2000, until May 15th, 2022. The researchers comprehensively evaluated the articles using a multi-step process to identify articles relevant to the topic of interest. Quality assessment was performed through the ROBDEMAT tool. Due to the high heterogeneity in the preliminary data, performing a meta-analysis was not feasible.

A total of 3169 records were obtained, and after removing duplicates, 2267 remained. Following title and abstract screening, 2253 studies were excluded based on the predetermined exclusion criteria. Of the 14 remaining studies, seven were further excluded due to the use of non-universal adhesives, experimental adhesives, or lack of aging protocols. Ultimately, seven studies were included in this systematic review. All studies focused on bond strength, with only one addressing DC. The Findings showed that aging or different storage conditions generally led to reduced bond strength and DC values in universal adhesives, although exceptions with stable or improved properties were noted.

Adhesives with higher pH and those containing methacrylamides, HEMA-free compositions, or hydrolytically stable monomers showed better durability than others. Strict adherence to storage instructions, lower storage temperatures, and immediate recapping of adhesive bottles after use is recommended to maintain adhesive properties. These findings provide insights for optimizing the long-term performance of universal adhesives in clinical settings.

The impact of health infrastructure on economic growth in the framework of endogenous growth models has been studied in a few research pieces; however, the impact of the Covid-19 pandemic on economic growth in the endogenous growth models has not yet been studied. The present article expands the existing pieces of literature in several ways. First, investigating the impact of the Covid-19 pandemic on economic growth in a steady-state situation. Second, identifying the threshold level of health infrastructure impact on long-term economic growth by considering the Covid-19 pandemic. Third, modeling of population dynamics and the Covid-19 pandemic. Fourth, modeling the level of following the protocols and public awareness of the Covid-19 pandemic and examining their impact on long-term economic growth. The developed model was calibrated using the information of a transition country, Iran. Results show If the health infrastructure is higher than the threshold level of 0.87, the output level will have an upward trend in the presence of the Covid-19 pandemic. Otherwise, the output trend will be downward. The increasing output could lead to the spread of the Covid-19 pandemic even in the long run in the Iranian economy. At a certain level of income, with the improvement of the health infrastructure, the level of Covid-19 pandemic release will decrease.

Providing pre-hospital emergency services is accessible in Iran but costly for the country’s health system. This study calculated the willingness to pay (WTP) for pre-hospital emergency services in Iran. Discrete choice experiment (DCE) was used to measure the population’s WTP for ambulance services focusing on time, price, and quality of services. Four hundred and sixty people in Rasht city, Iran, participated in this online survey. Participants preferred lower transfer fees (β = -0.7, P˂ 0.05), lower time of reaching to the scene (β = -0.061, P˂ 0.05), lower time to arrive to the hospitals (β = -0.038, P ˂ 0.05), Private ambulance (β = -0.151, P ˂ 0.05), and emergency medical services (EMS) technicians (β = 0.209, P ˂ 0.05). Patients’ WTP in selecting EMS services can help policymakers to provide the best services.

Secondary overtriage (SO) is the unnecessary transfer of traumatic patients between facilities, which causes the waste of the resources of the trauma centers and imposes extra costs on patients and caregivers. This study aimed to determine the frequency of secondary overtriage and patient-level, clinical, and hospital factors leading to secondary overtriage.

This cross-sectional study evaluated the data of all trauma patients who were transferred to a high-level trauma center in Guilan between 2016 and 2020. The patients with SO were characterized as those transported to a trauma center with an injury severity score ?15 and discharged alive within 48 hours without undergoing surgical procedure. Secondary overtriage and appropriate transmissions were analyzed using descriptive statistics. Multivariate logistic regression was used to identify the relationship between SO and patient-level, clinical, and hospital factors.

Out of 3342 transferred trauma patients, 3091(92.49%) had the inclusion criteria. The rate of SO was 25.68 % (794). These patients were younger (median 34 versus 36), with 253 women and 541 men. The highest SO belonged to spine injuries (109, 38.2%) (P less than 0.05). In both secondary overtriaged and appropriately triaged patients, the main cause of transmission was the shortage of neurosurgeons (741, 93.3% and 1780, 77.5%) (P less than 0.05). At the patient level, sex (OR 0.632, 95%CI 0.480-0.832) and at the clinical level, injured body region (specifically spine injury (OR 2.233, 95%CI 1.472-3.388), the reason for transfer (OR 2.158, 95%CI 1.185-3.927), injury severity score (OR 0.655, 95%CI 0.0615-0.697) and length of stay (OR 0.368, 95%CI 0.317-0.428) had a significant relationship with secondary overtriage.

About a quarter of transferred traumatic patients were identified as secondary overtriage. Continuous medical education, recruiting trained staff, improving the transfer protocols, extending collaborations between low-level/non-trauma and high-level trauma centers and using telemedicine can provide medical staff with more efficient guidance on transfer decision.

The present study was conducted with the aim of analyzing the spatial distribution of the most accident-prone points of damage, injury and death of heavy vehicle traffic accidents in Guilan province between 2014 and 2018.

In this descriptive- analytical study, all data related to traffic accidents with heavy vehicle referred to the NAJA traffic police in Guilan province were collected and reviewed, and the cases of damages, injuries and deaths of these accidents in these years were calculated and spatial analysis of accident prone points was calculated and analyzed using ARC GIS software.

Most heavy vehicle traffic accidents in Rudbar with 92.6, at 4 am (1.012), in clear air 4227 (72.33%), on main roads 3212 (54.79%) and direct roads and It was related to the conflict with an unknown device 2373 (40.49%).

traffic Accident-prone points in heavy vehicle traffic accidents were identified, with appropriate interventions, accidents should be prevented in these points and the traffic safety of these vehicles should be increased. The traffic transportation organization, in cooperation with the police, should install traffic signs that indicate the speed limit for more awareness of these drivers when traveling on the main roads and direct geometric conditions and monitor the compliance of driving rules by these drivers.

The first contact between emergency patients and medical services is carried out by emergency medical services (EMS). EMS personnel must deliver high-quality and high-speed services. This condition might cause high levels of stress and violence in the patients and their companions.

In this research, we aimed to study the violent acts against pre-hospital EMS personnel in Guilan Province, Iran.

This research was a cross-sectional study. A total of 110 EMS personnel working in Guilan Province in the north of Iran were selected using a random selection method between March and June 2020. A researcher-made questionnaire was used to collect the study data from the EMS personnel. The results were analyzed by the Poisson regression.

A total of 144 questionnaires were sent to the personnel, of these 110 were completed. The mean age of the participants was 34.89±3.65 years and all of them were male. About 61.8% of the samples experienced some kind of physical or verbal violence in the past 3 months. All cases of physical violence were perpetrated by men and half of them were done by close relatives of the patients. A significant relationship was found between the marital status of the EMS personnel and the number of physical violence they experienced (β=2.246, 95% CI; 0.058 to 4.446, P=0.032). In addition, the number of experienced physical violence was higher in those staff who worked at road EMS services compare to city or town EMS services (β=1.519,95% CI; 0.092 to 2.934, P=0.001). According to the EMS personnel, most of the attacks were answered calmly. The personnel revealed that the most important reason for not reporting physical violence was the futility of reports and the lack of guidelines for reporting violence.

The findings of this study confirm that pre-hospital EMS are at high risk of workplace violence in Guilan Province which highly affects their health and well-being. Training EMS personnel and strengthening their communication skills are important factors in reducing violence against emergency services technicians.

 The quantitative studies have shown that cyclists around the world have different attitudes and perceptions of safety needs. Therefore, in this study, we want to examine the experiences of injured cyclists about safety needs in a qualitative study.

 The present study was a qualitative study witha  content analysis method. The study population consisted of male or female cyclists over 18 years of age who were injured in a crash or fall while cycling and one or more of their limbs were injured and hospitalized in Poursina Medical Center. Excel details of these clients were obtained from the registration system ofthe  Guilan Road Trauma Research Center. People with various characteristics in terms of age, sex, education, marriage, sex, occupation, length of hospital stay, etc. were included in the study. The number of participants was twenty. Interviews were conducted by medical students with the cooperation and supervision of supervisors.

 Safety factors from the experiences of injured cyclists included nine categories, which were: orderly cycling, holding training courses, supervising cycling, observing the principles of cycling, being equipped with safety equipment, having the right to an exclusive route , Reviewing exclusive routes, creating a sense of security and creating peace in women cyclists.

 Authorities should try to make the factors that were safe in the experiences of these injured as much as possible to give these users a sense of calm and security, thereby encouraging others to ride a bicycle as a clean vehicle for the environment.

Drowning is the second leading cause of death due to unintentional injury in northern Iran. Unlike other public injuries in Iran such as road traffic injury, only one drowning prevention program has been formally evaluated in this area of the country. The aim of this study is to describe the effect of the challenging program of drowning prevention on the reduction of drowning mortality cases in the north of Iran.

We combined the data of the Iran National Registry of Drowning (INRD) and interviewed stockholders about the drowning prevention program to identify the challenges of drowning prevention in Iran. This type of research was thought to be the most appropriate for looking at events that could involve emotions. To access the opinion and perspective of the resident population in the rural settings of the study area regarding the drowning event, interviews were performed with the local elites including elected representatives, school teachers, religious leaders, and the victim’s families.

Based on drowning data, the registry was carried out by Guilan Road Trauma Research Center as a national center responsible for registering the drowning data through interviewing with lifeguards and health workers by the national focal point of drowning. Several factors have been identified as increasing the likelihood of drowning in northern Iran. The main factors included rip currents in the Caspian Sea, recirculation, buffer,standing waves, and Eddy line in rivers.

This survey demonstrated that a prevention program for drowning can be sustainable when high-quality local drowning data are employed to target and model community-based injury prevention, and evaluate the outcomes. Local governments should install barriers for controlling access to water around rivers and canals and develop training programs on swimming, water safety, and safe rescue skills for the less than 18-year-old population by the Red Crescent Society.

The degree of seriousness of the control areas is low in dealing with those who do not follow wearing helmet legislation. The purpose of this study was to explain the proposed solutions to solve the problem of implementing the wearing helmet legislation from the perspective of control areas and motorcyclists.

This is a retrospective study on the pediatric patients whose ages were between one month to 18 years old; and who were admitted to the medical pediatric in - tensive care unit (PICU) of Namazi Hospital in Shiraz, Iran, from 2019 to 2020 (20 months) for whom a central venous catheter was placed in the subclavian vein through a supraclavicular approach. Then complications such as hemorrhage, arterial perforation, pneumothorax, and failure of this method were recorded and examined by reviewing special forms in the medical record .

The experiences of 20 male participants; 9 people from the control areas, 4 univer - sity faculty members, 3 traffic police, and 4 motorcyclists were registered. The results showed that the solutions for implementing the wearing helmet legislation with four categories names: Hard, correction, support, and soft solutions and14 subclasses and 54 codes were formed .

The use of hard solutions such as the diligence and seriousness of the control areas in implementing the wearing helmet legislation and corrective solutions such as drafting new laws and amending existing laws, supporting solutions such as supporting the police and motorcyclists, and finally soft solutions such as education and cultural creation and the use of mass media are effective in implementing these laws .

 Erb-Duchenne paralysis is the most common form of neonatal brachial plexus palsy. Cesarean section is one of the protective factors in Erb paralysis.

 The data were related to mothers who gave birth by both natural and cesarean section during the study period in Al-Zahra Hospital in Rasht, as well as their infants. The number of cases of Erb paralysis during one-month periods was identified and for the mentioned period, the interrupted time series analysis or ITSA method was calculated and its changes were measured. Other variables including maternal age at delivery, weight of newborns at birth and total number of deliveries by delivery method were extracted and recorded from the maternity and neonatal registry.

 In this study, 7 cases of neonatal paralysis were recorded, which indicates an incidence of 0.17 cases per 1000 births, of which 6 cases were registered after the implementation of the Health Transformation Plan. Considering the confounding variables, the number of cases of Erb paralysis during the period after the implementation of the health system transformation plan has an upward trend compared to before its implementation, which according to P = 0.079, this difference with a 90% confidence interval is significant. have been. Also, deliveries performed by cesarean section have increased from 60.1% before the transformation plan to 64.1% after the transformation plan.

 This study showed that the incidence of Erb paralysis in Al-Zahra Center is lower than other incidence in other studies in other countries. Also, due to its higher incidence in normal deliveries, in addition to reducing the rate of cesarean section to maintain the health of mother and baby, special attention should be paid to increasing the likelihood of some complications following a normal delivery.

Trauma is the first cause of mortality due to non-obstetric causes in pregnant women. There is a limited knowledge on mechanisms of trauma in pregnancy. Therefore, this study was performed with aim to determine the frequency, type and outcomes of trauma in pregnancy period in patients referring to the major trauma center in Guilan.

This retrospective cross-sectional study was conducted using the data registered in triage unit of Poursina Teaching center, Guilan from July 2017 when the Hospital Information System was being implemented for the first time. Using complete enumeration, all mothers with trauma histories until July 2018 (n=138) were entered into the study. They were then interviewed via telephone about the maternal and fetal outcomes after discharge, and 77 mothers answered. Data were analyzed using SPSS software (Version 21).

The mean of maternal age was 29.24±5.25 years and mean gestational age was 20.92±10.12 weeks. The most common mechanism of trauma was falling (35.5%) and then traffic accidents (31.9%), other mechanisms (sharp objects penetrating in the limbs, falling of the object on the person, dog bite, etc.) (21%), violence (10.9%) and self-immolation (0.7%). In terms of frequency, the most reported fetal outcomes were without outcome (87%), preterm birth (7.8%) and abortion (5.2%), respectively; the most common maternal outcomes were reported as uncomplicated (67.5%), bleeding (11.7%), bone fractures (11.7%), uterine contractions and cervical dilatation (9.1%).

The most common type of trauma during pregnancy was falling. Preterm birth and abortion were the fetal outcomes and vaginal bleeding, bone fracture, uterine contraction, and cervical opening were dangerous maternal outcomes which are reported. Future programs should prioritize trauma prevention in pregnancy and follow-up of maternal outcomes after discharge from trauma center.

Stress is an influential factor in mental health; and can lead to psychological disorders. Thus, it has always been a concern for the medical personnel, and particularly dental students. This systematic review aimed to assess the dental environment stress and the related factors in the Iranian dental students.

In this systematic review, an electronic search of the literature was carried out in the Iranian and international databases, and all possible combinations of relevant keywords were searched using the Boolean operators. Data were analyzed using STATA SE 13.1 meta-analysis software. Heterogeneity of the data was evaluated using the I2 statistics, and the correlation between age and level of stress was analyzed by meta-regression. In the Chi-square (X2) heterogeneity test, P-value < 0.05 was considered significant.

A total of 16 eligible articles (3,521 dental students) out of 821 retrieved studies were reviewed in this systematic review. The mean overall stress level of the Iranian dental students was 2.18 (95% CI:1.87-2.49). The maximum (2.21) and minimum (2.10) mean overall stress values of the Iranian dental students were associated with the dental environment stress (DES) questionnaire and the depression, anxiety and stress scale (DASS-21), respectively (P>0.05). Also, the 4th and 5th year dental students had the maximum (2.24) and minimum (2.01) mean overall stress levels, respectively (P>0.05). Gender had no correlation with the stress level (P=0.520).

The mean stress level of the Iranian dental students is moderate to high. Since stress reduction is directly correlated with the promotion of mental health and function, the authorities are required to revise the educational curricula following consultation with the counselors and implement effective programs to minimize the stress level of dental students. Also, achieving efficient communication between dental students and instructors can greatly improve the quality of clinical education.

Animal-vehicle accidents are a growing concern in many parts of the world not only because of its environmental consequences but also because of its economic and social costs. The purpose of this study was to investigate the epidemiology of accidents involving animals in Northern Iran.

In this retrospective cross-sectional study, the data of all animal-vehicle accidents which had occurred during 2014–2018 were obtained from the traffic police database.

According to the regression model, fatalities and injuries associated with animal-vehicle collisions on main roads were significantly lower than those on the secondary and rural roads (P < 0.001). The reports showed a significantly lower number of accidents on wet, slippery than the dry roads (P < 0.001).

This study reports on the high number of accidents involving animals in Guilan which lead to injuries and fatalities of both humans and animals. Importantly, the pattern of such accidents was found to be different from that of motor vehicle collisions, suggesting a model for changing human behavior and reducing accidents that involve animals.

Rib fracture is one of the leading causes of trauma-related deaths globally. The time elapsed to return to work (RTW) following the injury is an important indicator of treatment outcomes. It is subject to the influences of the complications of the injury. The aim of this study was to determine the time of RTW and the associated factors in patients with rib fractures.

This is a retrospective study, in which the sociodemographic variables including age, sex, marital status, residency, and clinical conditions (the type of accident, days of hospitalization, having surgery, Glasgow Coma Scale [GCS], and the number of rib fractures) were obtained from the database. The variables related to RTW were obtained through telephone interviews. We performed a survival analysis to evaluate the time of RTW of 193 victims with rib fractures managed during 2017 and 2018 in Poursina Hospital in Rasht, Iran. We used the Cox regression to determine the factors associated with the time of RTW.

The mean time of RTW was 18.80 ± 11.405 weeks and 97.9% of the victims returned to work. The age of the victims, length of hospitalization, GCS, and type of work were significantly (P < 0.05) associated with the time of RTW.

Improving the interventions for the older adults and for those with long-term hospitalization, and low GCS, as well as strengthening preventive measures for victims with high risk of accidental trauma can effectively increase the rate of RTW.

Diagnosing the status of the posterior ligament complex (PLC) plays an essential role in the management of patients with thoracolumbar fractures. In this study, due to the inefficiency of existing imaging modalities in the accurate detection of PLC damage, we investigated the relevance of some imaging parameters to specific guidelines for rapid PLC injury detection.

Methods and Materials/Patients: 

In this study, 50 patients with and 50 patients without PLC injury were included. MRI, CT scan, and radiographic imaging of the thoracolumbar spine (T12-L1) were evaluated. The thoracolumbar injury classification systems such as Denis, TLICS (Thoracolumbar Injury Classification and Scoring System), and McCormack Load Sharing and radiographic parameters such as Superior Inferior Endplate Angle (SIEA), Body Height (BH), Local Kyphosis (LK), Interspinous Distance (ISD), and Interpedicular Distance (IPD) were investigated in these patients for each imaging method. Statistical analysis was performed using SPSS (Version 21).

The ISD and LK and BHp (Body Height Posterior) were significant predictors of PLC injury. On radiographs, the mean LK with and without PLC damage was 25.67° and 20.92°, respectively (p<0.001). The ISD difference was 6.75 mm in cases with PLC damage and 2.84 mm in cases with an intact PLC (p<0.0001). In CT images, the mean LK was 25.77° in cases with PLC damage and 18.63° in cases with an intact PLC (p<0.037). The ISD difference was 4.14 mm in patients with PLC damage and 2.19 mm in patients without PLC damage (p<0.002). The BHp difference was 9.44 mm in cases with PLC damage and 11.09 mm in cases without PLC damage (p<0.002).

The current study suggests formulating a predictive radiological index to identify PLC injury successfully. These guidelines can be very helpful in emergency room decision-makings, especially when the cost, availability, and time of performing MRI are important concerns in patients with multiple trauma.

The association between gender and time of receiving services(TRS) after traumatic injuries is rarely documented in developing countries. This study aimed to examine gender differences in time between occurring injuries and receiving services in hospital after trauma injuries in northern Iran.

A total of 7085 injured patients were included in this study. Data on sociodemographic and clinical characteristics were extracted from the Guilan province trauma system registry (GTSR) from July 2017 to July 2018. The Oaxaca– Blinder (OB) method was used to explain the gender differences in the TRS after traumatic injuries.

There were significant differences between men and women in marital statues (P < 0.001), education level (P < 0.001), time of injury (P = 0.025), occupation (P < 0.001), type of trauma (P < 0.001), mode of transfer (P < 0.001), mean age (P < 0.001), average distance from hospital (P = 0.052), and average transfer time to the hospital (P < 0.001). We found gender differences in TRS after falling trauma (P = 0.006) when the transfer was performed by emergency medical services(EMSs) and in penetrating trauma (P < 0.001) when the transfer was performed by private vehicles. The difference in the observed characteristics of men and women explained 67% of gender differences in TRS (P = 0.06).

The gender difference in the transfer of injured patients was in favor of men, depending on the socio‑demographic and clinical factors. In OB analysis, the gender differences in falling trauma and transfer by EMS and the gender differences in penetrating trauma and private transmission to the hospital were also confirmed. Steps need to be taken to ensure that services are equally beneficial to both men and women.

The financial burden of cigarette smoking on households’ budget is not well documented in Iran. We aimed to identify the determinants of cigarette consumption and its financial burden among households in Iran. Study design: A cross-sectional study.

A total of 39,864 Iranian’s households from 31 provinces were included in the analysis. Data on sociodemographic and socioeconomic characteristics (age, sex, household size, education level, employment status, income and wealth index), living area, number of cigarettes smoked and cigarette expenditures for households were extracted from the 2016 Household Income and Expenditures Survey (HIES). Tobit model was used to identify the determinants of cigarette smoking frequency and expenditures among Iranian households.

The average number of cigarettes smoked and cigarettes expenditures by all household members was 85.25 cigarettes and US$ 2.64 per month. Living in urban areas, wealth index of households, household income, household size and low educational attainment of household members were positively associated with frequency and expenditures of cigarette smoking. Results also indicated increasing patterns in the number of cigarettes smoked and cigarettes expenditures from east to west of the country. East Azerbaijan, Hamadan, Markazi and Chaharmahal va Bakhtiari provinces had higher cigarette smoking frequency and expenditures in Iran.

Tobacco control interventions in Iran should focus more on households living in urban areas and low-educated households. As the frequency of cigarette smoking was higher in the western region of Iran, comprehensive tobacco control policies should be adopted in western provinces.

 The relationship between weight indices and injuries and mortality in motor vehicle accidents is unknown. Systematic review studies addressing the collection and analysis of the re-lationship in investigations are very limited. The purpose of this systematic review is to determine the relationship between BMI, obesity and overweight with mortality and injuries and their severity and vulnerable organs after the motor vehicle accident.

 The databases (MEDLINE/PUBMED, EMBASE, Web of Science, etc) were searched for relevant abstracts using certain keywords. Of all the articles, similar ones were removed consid-ering different filters. The collected data were entered into the STATA SE v 13.1. The heteroge-neity of the data was analyzed using i2 statistics. In addition, the estimates of the study were done based on the age group (children and adults) and the impact of obesity on different regions of the body.

 A direct relationship was observed between the overall BMI and the degrees of injuries (CI=0.503-1.139), and mortality due to motor vehicle accident (CI=1.267-1.471). A positive re-lationship was found between obesity and AIS+2 (CI=0.653-1.426), and AIS+3 (CI=1.184-1.741), and ISS (CI=1.086-1.589).
Also, a negative relationship between overweight and injuries rates, and a direct relationship between overweight and mortality (CI=0.979-1.167), and injuries with index of AIS+2 (CI=1.178-0.768) and AIS+3 (CI=0.48-2.186) were found.

 The prediction of injury, mortality and severity of injuries in the motor vehicle acci-dent by the variable of obesity and overweight determines the need to design prevention pro-grams for this vulnerable group at all levels.

Head trauma is one of the most important causes of death in trauma centers. In particular, treatment of head injury in the elderly seems more complicated than that of the young and middle aged. This study aimed to identify the outcomes of head trauma due to road traffic accidents (RTAs) in elderly patients.

In a descriptive-analytical study, records of 294 elderly patients with head trauma due to RTA retrieved from health information system were reviewed using a checklist. The outcomes of patients were evaluated using the Glasgow Outcome Scale. Complete recovery and partial disability were considered as favorable outcomes, whereas severe disability, vegetative state, and death were defined as unfavorable outcomes. Descriptive factors and adjusted coefficients were calculated using SPSS software.

Of 294 elderly patients, 77.2% were men. About half of the road accidents had occurred in urban areas (58.8%). Less than half of the injured elderly were pedestrian (44.9%). The mean Glasgow Coma Scale of patients equaled 13.42 ± 3.29. Unfavorable outcomes were observed only in 20.4% of the patients. There were significant differences in head injury severity between the groups with favorable and unfavorable outcomes (P < 0.05). Moreover, intraventricular hemorrhage was significantly associated with the highest prevalence of unfavorable outcome followed by intracranial hemorrhage.

The results of our study mentioned that most of the elderly who had accidents were pedestrian, most of which occurred in the cities. Moderate and severe head injuries in patients had unfavorable clinical outcome.

Dental caries among children is considered as a main public health concern in most of the countries over world and its prevalence is widespread in low-income countries like Iran. The aim of this study was to measure socioeconomic-related inequality in poor decayed, missing, filled (DMF) index and identify the determinants among school children in west of Iran.

A survey was carried out among school children aged 12 to 15 years in Kermanshah City, Iran, in 2018, to collect data on dental caries, demographic characteristics, and socioeconomic status (SES). A total of 1457 students were included in the analysis of this cross-sectional study. Logistic regression analysis examined the association of poor DMF index with the socioeconomic and behavioral determinants. We used the relative index of inequality (RII) and the slope index of inequality (SII) to measure wealth-related inequality in poor DMF index. The Blinder-Oaxaca (BO) decomposition technique was also employed to identify the factors of the difference in poor DMF prevalence between the poorest and the richest groups.

The overall and age-adjusted prevalence of poor DMF index was 36.92% [95% confidence interval (CI): 34.48-39.43] and 37.32% (95% CI: 34.64-40.08), respectively. The SII and RII indicated that the poor DMF index was mainly prevalent among poorer children. The absolute gap (%) in the incidence of poor DMF index between children from the richest and the poorest groups was 22.50. The BO results showed that the most important factors affecting the difference in poor DMF index were mother’s education (18.23%), being girl (6.12%), and visit to dentist (2.93%).

There was a significant pro-rich distribution of poor DMF index among school children in the capital of Kermanshah Province. Interventions aimed at increasing mother’s education and good oral health behavior among poorer children could contribute to decline of the difference in poor DMF index between the highest and the lowest SES groups.

Self-medication is the use of drugs which have not been prescribed by health professionals. It is considered an important issue especially in developing countries because of side effects of irrational use of drugs and economic burden of disease. This study aim to analyze the prevalence of self-medication in Iran by provinces and socio economic and demographic factors that affect it. Data of Iranian household income and expenditures survey (HEIS) in 2016 (source Iranian Statistical Center) was used in this study. Multilevel mixed effect regression was used to find relation between explanatory variables and self-medication ratio. STATA SE v 14 was used to perform the analysis. the results of this study showed that income (coefficient = - 0.00286) and socioeconomic status had negative significant relationship with self-medication ratio, while self-medication ratio was higher in some provinces like Ardebil, Sistan va Baluchistan and Ilam and it was lower in some provinces like Khuzestan and Kurdistan. The prevalence of self-medication among Iranian people was relatively high and this ratio varies in provinces. In addition to promote population awareness about undesirable effects of the irrational drug consumption, developing strategies for drug consumption by improving prescribing pattern, OTC drugs and also increasing inspection of pharmacies is needed.

Statins are among useful drug to prevent hyperlipidemia and subsequent cardiovascular diseases. Having an equal access to these drugs are very important for health policy makers. Provincial data of statin supply for Iran in 2013 were used in this study. Concentration index, GINI coefficient, concentration curve and Lorenz curve were calculated to show the level of inequality in access of statins. The percentage of population more than 65 years old was used as the need index. A panel data regression was used to estimate the contributing factors of inequality. GINI index was 0.297 for lovastatin, 0.322 for atorvastatin and 0.526 for simvastatin. GINI index for overall statin use was 0.303. Concentration index was not significant for atorvastatin and simvastatin while it was 0.160 for lovastatin. The coefficient of income was -1.75 for lovastatin, 1.04 for atorvastatin and -1.117 for simvastatin. The regression model showed that household income was independently contributed to decrease in Lovastatin (B = -1.752) and Simvastatin (B = -1.118) and increase in Atorvastatin (B = 1.04) access. Higher percentage of people with academic education, the number of physician, and price of drug were another significant predictors of statin access. The inequality for access in Simvastatin was greater than other statins. Household income and price of drug were among important contributors of statin access. For increasing access to statins it is suggested to increase the coverage of health insurance.

High‑cost sharing in physician care may result in worse health outcomes and financial burdens for individuals, and it reduces needed health‑care utilization. Hence, this study examines the impact of cost sharing on utilization of Physician care. In the present study, multistage sampling (n = 1610) was done to collect general physician utilization and quality of life. Count data model was used to analyze the effect of cost sharing and other factor on the ratio of referring to the general physician. Negative binomial regression was employed to analyze the utilization model. People who have high‑cost sharing had used general physician services much less, so that ratio of incidence among them was 0.18 less than individuals with low‑cost sharing (P < 0.05). Gender and age variables showed a significant effect on the demand for the general physician visit (P < 0.05). A low cost‑sharing policy would remove the clinically and financial threat from the patient decision‑making so as to provide them with access to needed care

Studies have shown that the number of road fatalities has been decreasing in developed regions and increasing in less and middle developed regions. Iran has one of the highest road fatalities in the world. Controlling road fatalities is vital for less and middle developed countries like Iran.
The aim of this study was to find factors affecting road fatalities in Iran using macro provincial data.
Panel data of provinces of Iran between 2008 and 2012 were used for this study. Panel data Poisson estimator was used for estimating the model. Hausman test and Breusch-pagan test were used for finding between pooled or panel and fixed or random effects.
No significant relationships were found regarding the percentage of emergency sites and percentage of cars with road fatalities. Increase in the percentage of motorcycles, rain, highways and freeways increased the risk of road fatalities. The effect of highways in road fatalities was higher than freeways. Increase in the percentage of traffic police sites and people living in urban regions decreased the risk of accident fatalities.
The government, ministry of health and policy makers must develop strategies for controling high levels of road fatalities in Iran.