جستجوی مقالات مرتبط با کلیدواژه « incidence » در نشریات گروه « پزشکی »

Dengue fever is a potentially life-threatening tropical disease that causes an acute febrile illness that can range from asymptomatic disease to potentially life-threatening disease, which may lead to hemorrhagic shock and death in the most severe cases.

Pulmonary embolism (PE) is a life-threatening condition or complication that continues to pose a significant risk of morbidity and mortality.  This study aims to identify the perioperative risk factors associated with PE and to examine its prevalence and consequences in patients who have undergone major surgery.   This cross-sectional analytical study reviewed the medical records of 30 consecutive patients admitted to the general surgery ward who developed in-hospital PE. The study aimed to extract risk factors, including demographic and clinical features, such as body mass index (BMI), smoking history, hospitalization history, hypertension, cardiovascular complications, history of oral contraception pill (OCP) usage, diabetes, history of cancer, trauma, intensive care unit (ICU) hospitalization, and the type of surgery.  Among all PE patients, 19.7% had a normal BMI, and tobacco use was reported in 50% of these patients. Only 16.7% of PE patients had a history of OCP usage. Pulmonary and breast cancer were reported in 56.6% and 6.7% of PE patients, respectively. The most common comorbidities among PE patients were hypertension (23.3%), followed by cardiovascular issues (16.7%) and diabetes mellitus (6.7%). The majority of PE patients had ICU hospitalization (93.3%). Forty percent of PE patients experienced trauma, with 15% having hip with limb fractures, 13% experiencing chest trauma, and 12% having abdominal visceral trauma. Almost 30% of the PE patients who were admitted for general surgery and developed in-hospital PE died before discharge.  PE is one of the most common adverse events after surgery, despite the use of thromboprophylaxis. The major risk factors in patients with postoperative PE were found to be old age, smoking history, trauma, and cardiovascular problems.

Major β-Thalassemia is the most prevalent singlegene disorder in Iran. Over 2 million beta-thalassemia carriersand more than 25,000 patients have been identified nationwide. This study aimed to evaluate the Major β-Thalassemia (MBT) screening surveillance system in the Jiroft district, southeast Iran.

This descriptive study was conducted using the census method and was based on the information recorded in the files of all major thalassemia births (born between 2011 and 2021) in the health centers of Jiroft University of Medical Sciences. A formula was used to calculate the program’s incidence, expected incidence, and success rate. Stata version 14 and Excel software were utilized to analyze the data, and the qualitative data are presented as numerical values and percentages.

During the study periods, 91 patients with betathalassemia Major were born in the population covered by Jiroft University of Medical Sciences. By performing prenatal diagnosis tests in the first weeks of pregnancy and obtaining parental consent for legal abortion, the birth of 422 sick children was prevented. The 11-year incidence of beta-thalassemia major was 5.32 per 10,000, and the expected incidence (if no prevention program was implemented) was 30 per 10,000 live births. The mean success rate of the Major β-Thalassemia surveillance system during the study period was 82.26%, which reached 95.45% in 2021.

The i mplementation of efficient, e ffective h ealth policies influenced by the native culture of the region has resulted in the thalassemia prevention program in Jiroft City being completely effective. The implementation success rate of this program has exceeded 95%. Modeling and adapting these preventive policies can assist in implementing thalassemia prevention programs in other parts of the country and developing countries.

There is still disagreement about the prevalence and incidence of dysphagia in Parkinson’s Disease (PD). Since the prevalence of dysphagia has been reported very differently in the related literature, it is imperative to estimate pooled prevalence in PD patients. Thus, we conducted a systematic review and meta-analysis to estimate the pooled prevalence of dysphagia in PD overall and separately for each assessment method (subjective and objective). 

These databases were searched: ScopusPubMed Web of Science ,and Google Scholar, January 1990 to October 2021. A random-effects model was used to pool the prevalence rates reported in the included studies by the Comprehensive Meta-Analysis (CMA( software .All designs of the studies were included. 

Thirty-nine articles entered the current meta-analysis. The global estimation of the overall prevalence of dysphagia in PD patients was 50.4% )95%CI:42.2-58.6) in all the 39 studies, which proved statistically heterogeneous (p<0.001). Moreover, the pooled prevalence by the subjective (30 studies) and objective (19 studies) methods of assessment were estimated to be 39.5 and 68.8%, respectively. There was also a significant relationship between the prevalence of dysphagia and age of Parkinson’s patients )r=0.44, p=0.011) and also between the prevalence of dysphagia and the duration of PD (r=0.55, p=0.006). 

Based on the results, one in two patients with PD has dysphagia. This is proven that dysphagia is common in PD. The prevalence of objective dysphagia and subjective dysphasia were very different. It suggests that all Parkinson’s patients should be evaluated for swallowing disorders regularly with objective tools.

Brucellosis, a zoonotic disease, poses a significant health and economic challenge in many parts of the world, including Mediterranean and Middle Eastern countries. This study aimed to investigate the risk factors and recurrence of brucellosis, focusing on demographic variables such as age, gender, occupation, place of residence, and the spatiotemporal pattern of the population.

The study design was cross-sectional.The authors enrolled all Brucella cases registered in the infectious disease surveillance system of Fars province from 2014 to 2018 in the study. They performed a multivariate analysis of the disease risk factors using a Poisson regression model and a multivariate analysis of the risk factors associated with brucellosis recurrence using a logistic regression model.

The incidence of brucellosis in Fars province exhibited a decreasing trend. The findings revealed that the sex ratio of patients who consumed unpasteurized dairy products, the mean age of patients per month, and the proportion of people living in rural areas relative to the total number of patients with brucellosis were significantly associated with the risk of brucellosis. Moreover, the probability of disease recurrence was higher in colder seasons compared to spring.

A higher ratio of lightweight livestock to heavyweight livestock was identified as a risk factor for brucellosis, indicating the more significant role of lightweight livestock in the incidence of brucellosis in Fars province. Therefore, controlling the disease in lightweight livestock is of paramount importance, and the vaccination of these livestock should be more strictly monitored and implemented.

Brucellosis is one of the common diseases between humans and animals. We aimed to assess the annual incidence rate, the geographical distribution of Malta fever using GIS and its time trend.

This was an ecology study carried out in exploratory mixed design. The study population was the individuals with brucellosis in Iran during the years2009-2018. Data analysis has been done using Joinpoint regression analysis and GIS at a significant level of α = 0.05.

The average annual incidence rate of the disease rate was 19.91 per one hundred thousand people. The trend of the changes in the incidence between 2009 and 2018 has increased and the Annual Average Per-cent Change increased by 4.6%. However, a joinpoint was observed in 2014 and the incidence has changed sig-nificantly at this point in time, so that the annual incidence of the disease has increased more strongly between 2009 and 2014 (APC=17.1%) and then from 2014 to 2018, the incidence of the disease has decrease (APC=-9.2%). The spatial distribution showed that the western and northwestern provinces have high incidence rate, but the northern and southern provinces have low incidence rate.

The incidence of brucellosis in Iran is higher than in developed countries and similar to develop-ing countries. Ten-year trend of disease incidence increased slightly, but it has decreased in recent years. It is necessary to improve the surveillance system and increase facilities for prevention and treatment in the high-risk areas including the west and northwest of Iran. 

Exposure to ionizing radiation, especially during childhood, is a well-established risk factor for thyroid cancer. Following the 1986 Chernobyl nuclear power plant accident the total number of cases of thyroid cancer registered between 1991 and 2015 in males and females who were less than 18 years old exceeded 19,000 (in Belarus and Ukraine, and in the most contaminated oblasts of the Russian Federation). However, as indicated by the United Nations Scientific Committee on the Effects of Atomic Radiation the fraction of the incidence of thyroid cancer attributable to radiation exposure among the non-evacuated residents of the contaminated regions of Belarus, Ukraine and Russia is of the order of 0.25. Apparently, the increased registration of thyroid neoplasms in the parts of these countries is a classical ‘screening effect’, i.e., massive diagnostic examinations of the risk-aware populations performed with modern eqipment resulting in detection of many occult neoplasms (incidentalomas). Moreover, one type of thyroid cancer previously called ‘encapsulated follicular variant of papillary thyroid carcinoma’ is non-invasive and instead of ‘carcinoma’ should now be recognized as ‘noninvasive follicular thyroid neoplasm with papillary-like nuclear features.’ Other potential causes of overdiagnosing of thyroid tumors include increase of the spontaneous incidence rate of this disease with age, iodine deficiency among children from Belarus, Russia and Ukraine, and/or consumption by these children of drinking water containing high levels of nitrates that likely coincides with the carcinogenic effect of radiation on the thyroid gland.

The month of "Ramadan" is a remarkable instance of strong influences of culture and religion in Iranian people's behaviors and habits. Studies have reported different results in the rate of incidence, hospitalizations, time pattern and risk factors affecting stroke during fasting. This study was conducted with the aim of determining the incidence and factors related to stroke in the month before, during and after fasting in Yasuj, Iran.  This retrospective cross-sectional study was conducted on stroke patients referred to Yasuj hospitals, Iran from January 2018 to December 2020 (Shaban, Ramadan and Shawwal 1443 AH). Complete medical records of 40 stroke patients with inpatient records were used. Stroke cases were separated by month, based on age, gender and other risk factors, as well as the time of incidence of stroke. Data were analyzed using SPSS v.28 software. According to the findings of this study, 23 patients (57.5%) were male and 17 patients (42.5%) were female. The number of hospitalized patients with stroke in the months of Shaban, Ramadan and Shawwal were 12, 12 and 13 respectively. No significant correlation was observed in terms of the incidence of stroke during the month of Ramadan and other two months. In addition, there was no any significant difference between different months in terms of the studied variables (stroke history, cardiovascular diseases, hypertension, hyperlipidemia, and smoking).  This study indicated that fasting in Ramadan does not increase the incidence of stroke. Proper medical advice can significantly prevent strokes during Ramadan.

Since December 2019, COVID-19 spread worldwide. Patients with COVID-19 are at high hazard for dysphagia. This study investigates the incidence of dysphagia in COVID-19 patients admitted to the intensive care unit (ICU) and identifies predictors of dysphagia in COVID-19 patients.

This prospective study analyzed 100 COVID-19 patients admitted to the ICU of Firoozgar Hospital in Tehran City, Iran. The demographic and clinical features of the eligible patients were collected. Dysphagia and cognition were evaluated according to the Persian version of functional oral intake (FOIS-P) status and the Rancho Los Amigos scale (RLAS). The qualitative variables are described in frequency and percentages and the quantitative variables are illustrated by Mean±SD. Also, univariate and multivariate cox regression was performed to predict possible relations between demographic and clinical variables with dysphagia.

A total of 100 COVID-19 patients (43.3±13.3 years, 55% were men) who were admitted to the ICUs were appraised by speech and language pathologists. Meanwhile, 70% of the subjects had at least one comorbidity, with the most common ones being diabetes, hypertension, and obesity. Also, 74% of patients were on invasive mechanical ventilation (60% through endotracheal tube and 40% through tracheostomy). In addition, 57% of patients presented dysphagia. Age (odd ratio (OR)=1.127; 95% confidence interval (CI), 1.019%, 1.247%; P=0.02) and level of consciousness (OR=0.393; 95% CI, 0.178%, 0.868%; P=0.021) were predictors of dysphagia. 

Dysphagia was prevalent among COVID-19 patients predicted by age and level of consciousness. Early evaluation of suspected patients is required for timely and efficient interventions to avoid further problematic issues and progress their quality of life.

The rate of re-revision total knee arthroplasty (TKA) ranges between 4% and 10%, depending on the cause of the procedure. Periprosthetic joint infection (PJI) and periprosthetic fracture are the main causes of re-revision TKA. The likelihood of implant survival of re-revision TKA diminishes with each subsequent revision, with PJI being the main cause of multiple revisions. Acute early asep tic revision TKA (within 90 days of surgery) involves a high risk of re-revision at 2 years and a high risk of subsequent PJI. The use of antibiotic-loaded cement is associated with lower risk of re-revision. Patients younger than 50 years experiencing aseptic revision TKA have a 1 in 3 risk of re-revision. Patients revised for instability or having prior TKA revisions have the highest risk of re -revision at 10 years. Patients younger than 55 years experiencing revision TKA have a 5 -year revision-free survival of 80%. Level of evidence: III

 While there has been extensive research on colorectal cancer (CRC) incidence and its associated factors in Iran, a significant gap exists in studies predicting its future trends. Our study aimed to thoroughly report CRC incidence across Iran from 2014 to 2017, by sex, age, and geographical regions, and provide a projection for 2025.

 This retrospective study utilized data from the Iranian National Population-based Cancer Registry (INPCR). Patients with the International Classification of Diseases for Oncology, 3rd Edition (ICD-O-3) codes C18 to C21 were included. The age-standardized incidence rate (ASR), was calculated per 100000 individuals annually, and crude incidence rates were retrieved for various demographic groups and years.

 Between 2014 and 2017, a total of 43580 new CRC cases (55.96% males) were registered. Men exhibited an ASR of 134.45, while women’s ASR was 94.85. The highest ASRs were observed in Tehran, Qom, and Ilam (18.99, 18.26, and 18.06, respectively). Incidence rates surpassed 20 after age 50 for both genders, reaching their peak within the 80–84 age group. Adenocarcinoma was the most frequent histological type of CRC in nearly all provinces. Case numbers and ASRs are projected to continuously rise until 2025, with a predominance of male cases.

 The anticipated increase in CRC incidence in Iran emphasizes the need for additional studies to better identify risk factors. Furthermore, implementing screening programs is recommended for individuals at a higher risk of CRC, including men, the elderly population, and those residing in regions with a notable prevalence of CRC.

This study investigated the influence of age, gender and geographical region on the incidence of four types of injuries among pedestrians, cyclists, motorcyclists and motor vehicle drivers in Iran. The geographical correlation between the different provinces of the country was also examined.

The present study aimed to investigate 4 common type of road traffic injuries by provinces in Iran.

The data was taken from the Global Burden of Disease (GBD) study. The data were analyzed in terms of age group, gender and type of injury in different provinces, and the effect of geographical region on the incidence of RTIs were investigated through a multilevel analysis. Provinces were included in the model as random intercepts, and Moran's I test was used to examine geographic correlation and identify hot spots and cold spots. A significance level of 5% was used for all tests.

Elderly people were the main victims of pedestrian accidents, and young people were most frequently injured in cycling accidents. On the other hand, adults were the most frequently injured age group in motor vehicle accidents. Men were injured more often than women in all four types of injury. Although the injuries were not related to the province where the accident occurred, the geographical distribution of injuries caused by cyclists showed a geographical correlation, with Sistan and Baluchistan (southeast) and Tehran (the capital) being the areas with the highest and lowest risk of these types of injuries, respectively.

According to the results of this study, the causes of different types of road traffic injuries are very different for different age groups, genders and geographical areas. Therefore, different plans should be developed for each type of injury in order to prevent road traffic accidents.

Context: 

Liver transplant recipients are highly susceptible to infections, including those affecting the central nervous system (CNS), due to their compromised immune systems and underlying chronic comorbidities.

 Despite recent advancements in diagnostic and treatment modalities, post-transplant fungal infections continue to affect these patients. CNS fungal infections following liver transplantation pose a significant challenge in the diagnostic and therapeutic management of transplant recipients. Timely diagnosis and treatment are crucial because these infections are often identified late, leading to substantial morbidity and mortality in this patient population.

 This mini-review aims to explore the incidence of CNS fungal infections in liver transplant recipients, the key opportunistic pathogens involved, the associated risk factors, various clinical presentations, and the importance of preventive measures.

Thalassemia is the most common heritable disorder globally, characterized by the synthesis of low atypical hemoglobin and erythrocytes destruction. There are inadequate data about the epidemiology and other thalassemia traits in Iraq. This study was conducted to inspect the thalassemia epidemiology in Babylon, Iraq.

This single-center retrospective study involved 306 thalassemic patients. Patients were recruited from those recorded at ‘’Babylon Hereditary Blood Disorders Center’’. Information related to demographic characteristics, age at first diagnosis, socio-economic status, family history, place of residence, frequency of blood transfusions, chelation therapy and serum ferritin measurement were collected and analyzed.

The mean age of the studied patients was 2.3-17.9 years, which included 185 males and 121 females. 75% of the patients had thalassemia major, 12% had thalassemia intermedia, and 0.3% suffered minor thalassemia. 3.3% had thalassemia with G6PD deficiency, 2% had sickle thalassemia, 1.3% had alpha thalassemia, and 4.6% had beta-thalassemia. The patients received regular blood transfusions about once or twice monthly in the majority of the cases (85.6%). The mean serum ferritin concentrations were high (2976.9 μg/L). The growth in the males was affected more than in females (p=0.05). Most of the patients were from rural areas and 2/3rd of the thalassemia patients had a family history of thalassemia and a high rate of parental consanguineous marriage (p=0.001). The majority of the patients had one or more complications of thalassemia. All the children under 10 years of age included in the study revealed stunted growth significantly.

According to the results of this study, the management of thalassemia necessitates early diagnosis of irregular transfusion programs, and associated comorbidities, besides prompt actions. Comprehensive premarital screening, paternal counseling programs, and ongoing regulation can all aid in bringing down prevalence to far lower levels.

 COVID-19 infection may adversely affect pregnancy outcomes. We aimed to assess the incidence rate of the COVID-19 virus and its effect on maternaland neonatal outcomes.

 This was a cohort study in which a number of health-care centers in Tehran province were randomly selected, and all pregnant women referring to these centers were screened for COVID-19 from April 2020 to July 2020. Out of 15520 pregnant women, 263 individuals infected with COVID-19, who were followed until delivery. To collect the data, a demographic and obstetric characteristics questionnaire and a maternal and neonatal outcome checklist were used. Data analysis was done by SPSS version 22 using the Chi-square test, independent t-test, and logistic regression model.

 The incidence of COVID-19 among participants was 17 per 1000 (95% CI: 15-19). Women with a higher BMI (OR = 1.198, CI =1.003-1.431, P = 0.047) and lower blood oxygen level (OR= 0.886, CI: 0.808-.970, P=.009) were more likely to have adverse pregnancy outcomes. Preterm labor (18.3%) was the most common outcome of pregnancy, followed by stillbirth (0.8%), ICU admission (3.0%), maternal mortality (1.1%), need to mechanical ventilation (1.5%) and preeclampsia 1(0.38). Regarding neonatal outcomes, neonatal COVID-19 was seen in 1.9% of cases, NICU admission in 15.2%. Neonatal mortality without COVID-19 in 2.3%.  The majority of neonates with complications were male (29.1% vs. 21.5%, (P= 0.002).

 Pregnant women had a lower COVID-19 incidence rate than the general population, but when infected, they were at risk for poor maternal and neonatal outcomes.

Ventilator‑associated pneumonia (VAP) is one of the most common nosocomial infections. The role of probiotics in preventing VAP is still questionable. This study aimed at evaluating the effect of synbiotic FamiLact 2plus on the prevention of VAP in patients admitted to the intensive care unit (ICU).

A total of 80 mechanically ventilated patients were included and divided into two groups of 40. Group 1 received FamiLact 2plus, and group 2 received placebo. The outcome variables were compared, including the incidence of VAP, the time interval between the onset of ventilation and VAP, the duration of mechanical ventilation, and the length of stay in the ICU.

VAP is documented in four patients (10%) in group 1 and 11 patients (27.5%) in group 2 (P = 0.045). The length of stay in the ICU in group 1 was significantly shorter than in group 2, and the time interval between the start of intubation and the onset of VAP in group 1 was longer than in the placebo group. During the intervention, 15 patients in group 1 (37.5%) and 26 patients in group 2 (65%) developed diarrhea, which was a significant difference (P = 0.02).

Synbiotic is associated with a reduction in the incidence of VAP as well as a reduction in ICU stay and delayed VAP.

Each year, an estimated 15 million pre-term births occur worldwide, with the incidence of pre-term labor on the rise globally. Complications arising from pre-term labor are a leading cause of mortality among children under the age of 5. Despite this, there has been limited research on the trend of pre-term labor in Iran.

This study aimed to assess the trend of pre-term labor and identify influencing factors on pre-term labor in Arak city, Iran, from 2005 to 2019.

We analyzed a total of 89 307 live birth cases in Arak city from 2005 to 2019. The trend of pre-term labor over this study period was evaluated using statistical analysis software packages, specifically SPSS version 25. Linear trend analyses, as well as univariate and multivariate logistic regression analyses, were performed for statistical analysis.

Themeanpercentage of pre-term labor incidence during the first, second, and third 5-year periods was 8.9%, 10.3%, and 12.1%, respectively. Multivariate logistic regression analysis showed an increasing trend in pre-term labor incidence, even after adjusting for confounding factors (P < 0.001).

The observed increasing trend in pre-term labor incidence indicates the necessity for a comprehensive preventive strategy. This strategy should focus on identifying high-risk pregnancies and implementing effective interventions. The increasing incidence of pre-term labor in Arak city highlights the necessity for preventive measures to reduce the burden of this condition.