ATTRIBUTION OF MENTAL DISORDERS IN SUICIDE OCCURRENCE

The present study aimed to determine attribution of mental disorders in suicide occurrence. By a cross-sectional study, all suicide records (n = 5188), between 1993 and 2009 in Ilam province, were investigated. Multiple logistic regression analysis was adopted. Totally, 27.5 of the suicides occurred due to mental disorders. This was significantly higher in males (29.3), individuals born in 1996(44) and 1990s (30.3), those aged 30 years and above (33.2) and suicide attempters (28.3), respectively and separately. The risk of suicide due to mental disorders was observed for females (OR = 0.85, CI = 0.74-0.97), those born in 1994 (OR = 2.82, CI = 1.27-6.24), completed suicides (OR = 0.81, CI = 0.68-0.97) and the age group 25 to 29 years old (OR = 0.82, CI = 0.66-1.01). Suicide due to mental disorders was higher among males compared to females, the rate of which was directly proportional to attempted suicide and age. It is therefore recommended that health educations be seriously carried on targeted groups

Health outcomes attributed to PM10 due to dust storms in Ilam city, in Iran from 2012 to 2013

Background and Aim: In recent years, increasing dust storms originating from the Iran's neighbors in the west have led to social, economic, and health concerns. The aim of this study was to assess the acute health effects of dust and estimate the mortality rate associated with cardiovascular and pulmonary disorders, attributed to dust particles in Ilam city, by using WHO protocols. Material and Methods: In this study, concentrations of PM10, PM2.5, and PM1 were measured from March 2012 to Feb 2013. The measurement was performed using the Grimm aerosol spectrometer model 1.108. Air Quality Health Impact Assessment software (Air Q 2.2.3) was used for quantification of health outcomes attributed to PM10 in Ilam, Iran. Results: Using the model, the number of cumulative excess mortality, mortality due to cardiovascular and pulmonary diseases, and all admitted patients due to cardiovascular and pulmonary diseases attributed to PM10 in Ilam were 69.2, 42.5, 12.3, 80.3 and 208.7 cases respectively. The additional cases of disorders attributed to PM10 showed an increasing trend with concentrations of more than 100 µg/m3. This trend was more severe with concentrations of more than 200 µg/m3. Conclusion: The estimated rates of health outcomes attributed to PM10 associated with dust storms necessitate urgent regional measures to bring the problem of harmful particles under control. In addition, personal care and training are of great importance. © 2015, Kurdistan University of Medical Sciences. All rights reserved

Iranian Dietary Patterns and Risk of Colorectal Cancer

Background: Role of diet on colorectal cancer (CRC) has been considered in terms of single foods and nutrients, but less frequently in terms of dietary patterns in Iran. The objective of this study was to determine the association between Iranian dietary patterns and CRC. Methods: This case-control study was conducted in four hospitals in Tabriz City of Iran including 414 participants aged 35-75 years: 207 cases with CRC confirmed by pathology and colonoscopy findings were selected and 207 controls free of neoplastic conditions and diet-related chronic diseases (from the same hospital at the same period for the cases). Dietary data were assessed using a 123-item semi-quantitative food frequency questionnaire. Two dietary patterns were found by using of Principal Component Analysis (PCA) method;"Healthy pattern" and "Iranian pattern". Multivariate logistic regression analysis was used to estimate adjusted odds ratios (OR) for relationship between dietary patterns and colorectal cancer. Results: After adjusting for confounding factors, the Iranian dietary pattern was significantly associated with an increased odds of colorectal cancer (OR=1.46; 95 Confidenec Interval (CI)=1.05-2.19) while a reduced odds of colorectal cancer was observed with the Healthy dietary pattern (OR=0.18; 95 CI=0.091-0.47). Conclusion: Iranian dietary pattern (IDP) seems to increase the odds of colorectal cancer and protective effect of Healthy dietary pattern

Prevalence of high-level gentamicin-resistant Enterococcus faecalis and Enterococcus faecium in an Iranian hospital

This study was designed to determine the molecular characteristics and antimicrobial resistance of enterococcal strains isolated from patients admitted to an Iranian Hospital. Enterococcal strains were isolated from the burn patients. All strains were screened for genes encoding resistance to aminoglycoside aac(6')-Ie-aph(2'')-Ia, aph (3'), ant (4'), resistance to vancomycin (vanA, vanB), resistance to tetracycline (tetK, tetL, tetM, tetO), and resistance to erythromycin (ermA, ermB, ermC) by PCR and multiplex PCR-based methods. Genetic diversity was evaluated via Random Amplified Polymorphic DNA (RAPD)-PCR. All enterococcal isolates showed complete sensitivity to vancomycin with MIC � 0.5μg/ml. Resistance to gentamicin, tetracycline, erythromycin, ciprofloxacin or quinopristin-dalfopristin was detected, whilst more than 96.2% of isolates were high-level gentamicinresistant (HLGR) and multiple drug resistant. The most prevalent aminoglycoside resistance gene was aac(6')-Ie-aph(2'')-Ia, that was found in 96.2% (26/27) of the isolates. The most prevalent tetracycline resistance genes were tetM, found in 85.1% (23/27) followed by tetL and tetO found in 7.4% (2/27) of the isolates. The ermA and ermB genes were detected in 33.3% (9/27) and 44.4% (12/27) of the isolates respectively. RAPD-PCR analysis yielded 17 distinct profiles among 27 investigated isolates. One cluster of isolates shared the same RAPD pattern, while 16 isolates had unique RAPD pattern. Our study showed that during the examination time period one RAPD genotype was the common type and was disseminated among patients in the burn unit. Interestingly, most of these strains had an identical or very similar antibiotic and gene resistance pattern

Application of lidocaine spray for tracheal intubation in neonates - A clinical trial study

Background: Tracheal intubation is extremely distressing, painful, and may influence heart rate and blood pressure. Sedatives, analgesics, and muscle relaxants are not commonly used for intubation in neonates. Objectives: This study aimed to evaluate the effects of lidocaine spray as a non-intravenous drug before neonatal intubation on blood pressure, heart rate, oxygen saturation and time of intubation. Patients and Methods: In a randomized, controlled study each neonate was randomly assigned to one of the two study groups by staffs who were not involved in the infant's care. The allocation concealment was kept in an opaque sealed envelope, and the investigators, the patient care team, and the assessors were blinded to the treatment allocation. The selected setting was NICU unit of a teaching hospital in Ilam city, Iran and participants were 60 neonates with indication of tracheal intubation with gestational age >30 weeks. Patients in the treatment group received lidocaine spray and the placebo group received spray of normal saline prior to intubation. Main outcome measurements were the mean rates of blood pressure, heart rate, oxygen saturation, intubation time and lidocaine side effects were measured before and after intubation. Results: Totally 60 newborns including 31 boys and 29 girls were entered into the study (drug group n = 30; placebo group n = 30). Boy/girl ratio in treatment and placebo groups were 1.3 and 0.88, respectively. Mean age ± SD of participants was 34.1 ± 24.8 hours (treatment: 35.3 ± 25.7; placebo: 32.9 ± 24.3; P < 0.0001). Mean weight ± SD of neonates was 2012.5 ± 969 g. Application of lidocaine spray caused a significant reduction of mean intubation time among treatment group compared with placebo group (treatment: 15.03 ± 2.2 seconds; placebo: 18.3 ± 2.3 seconds; P < 0.0001). Mean blood pressure, heart rate and oxygen saturation rate, among neonates in treatment group was reduced after intubation compared with their relevant figures before intubation; however, their differences were not statistically significant except for mean oxygen saturation rate that was reduced significantly in placebo group. No side effects were observed during study. Conclusions: Though the current study revealed some promising results in the application of lidocaine spray during neonatal intubation without any considerable side effects; however, the current investigation could only be considered as a pilot study for further attempts in different locations with higher sample sizes and in different situations. © 2015, Growth & Development Research Center

MASH Test No. 3-10 of a Non-Proprietary, High-Tension, Cable Median Barrier for Use in 6H:1V V-Ditch (Test No. MWP-9)

The Midwest Pooled Fund Program has been developing a prototype design for a non-proprietary, high-tension, cable median barrier for use in a 6H:1V median V-ditch. This system incorporates four evenly spaced cables, Midwest Weak Posts (MWPs) spaced at 8 to 16 ft (2.4 to 4.9 m) intervals, and a bolted, tabbed bracket to attach the cables to each post. Full-scale crash testing was needed to evaluate the barrier’s safety performance. According to the Manual for Assessing Safety Hardware 2016 (MASH) testing matrix for cable barriers installed within a 6H:1V median V-ditch, a series of eight full-scale crash tests are required to evaluate the safety performance of a system. Several previous tests have failed due to the posts penetrating into the occupant compartment. In order to mitigate the floor pan tearing, a modified MWP was designed. Test no. MWP-9 was conducted on the modified barrier system, consisting of MWPs with 3⁄4-in. (19-mm) diameter weakening holes at the ground line. Additionally, a two-part cap with a single retainer bolt was added to the top of the posts. The cap shielded the free edges of the MWPs during the post-to-vehicle contact. This test was conducted according to MASH 2016 test designation no. 3-10 and utilized an 1100C small car impacting the barrier on level terrain. The vehicle was contained by the system. The two-piece cap mitigated the floor pan tearing. However, one cable (cable no. 3) snagged on the cap retainer bolt and caused two cables (cable nos. 3 and 4) to become interlocked with the left-side A-pillar on the impact side of the vehicle, which resulted in excessive A-pillar crush. Therefore, test no. MWP-9 was deemed unacceptable. However, the two-part cap demonstrated that a closed-section post should be capable of mitigating floor pan tearing

Distribution of the most prevalent spa types among clinical isolates of methicillin-resistant and -susceptible Staphylococcus aureus around the world: A review

Background: Staphylococcus aureus, a leading cause of community-acquired and nosocomial infections, remains a major health problem worldwide. Molecular typing methods, such as spa typing, are vital for the control and, when typing can be made more timely, prevention of S. aureus spread around healthcare settings. The current study aims to review the literature to report the most common clinical spa types around the world, which is important for epidemiological surveys and nosocomial infection control policies. Methods: A search via PubMed, Google Scholar, Web of Science, Embase, the Cochrane library, and Scopus was conducted for original articles reporting the most prevalent spa types among S. aureus isolates. The search terms were "Staphylococcus aureus, spa typing." Results: The most prevalent spa types were t032, t008 and t002 in Europe; t037 and t002 in Asia; t008, t002, and t242 in America; t037, t084, and t064 in Africa; and t020 in Australia. In Europe, all the isolates related to spa type t032 were MRSA. In addition, spa type t037 in Africa and t037and t437 in Australia also consisted exclusively of MRSA isolates. Given the fact that more than 95 of the papers we studied originated in the past decade there was no option to study the dynamics of regional clone emergence. Conclusion: This review documents the presence of the most prevalent spa types in countries, continents and worldwide and shows big local differences in clonal distribution. © 2018 Asadollahi, Farahani, Mirzaii, Khoramrooz, van Belkum, Asadollahi, Dadashi and Darban-Sarokhalil

Phenotypic and genotypic characteristics of tetracycline resistant Acinetobacter baumannii isolates from nosocomial infections at Tehran hospitals

Objective(s): To date, the most important genes responsible for tetracycline resistance among Acinetobacter baumannii isolates have been identified as tet A and tet B. This study was carried out to determine the rate of resistance to tetracycline and related antibiotics, and mechanisms of resistance. Materials and Methods: During the years 2010 and 2011, a total of 100 A. baumannii isolates were recovered from patients in different hospitals of Tehran, Iran. Antimicrobial susceptibility to tetracycline, minocycline, doxicycline and tigecycline was evaluated by E-test. Polymerase chain reaction (PCR) of the tet A and tet B genes was performed using specific primers, after which the isolates were subjected to Repetitive Extragenic Palindromic-PCR (PCR) to identify the major genotypes. Results: Of all isolates, 89 were resistant to tetracycline (MIC50 = 32 mu g/ml, MIC90 = 512 mu g/ml). Minocycline with the resistant rate of 35 (MIC50 = 16 mu g/ml, MIC90 = 32 mu g/ml) and doxicycline with the resistant rate of 25 (MIC50 = 16 mu g/ml, MIC90= 32 mu g/ml) have a good activity against A. baumannii isolates. All isolates were sensitive to tigecycline. Frequencies of tet B and tet A genes and coexistence of tet A and tet B among the isolates resistant to tetracycline, were 87.6, 2.2 and 1.1, respectively. Distribution of REP-types among A. baumannii isolates was types A (40), B (30), C (10), D (5) and E (5). Conclusion: It seems that tet A and tet B genes play an important role in the induction of resistance towards tetracyclines used in this study. It is suggested that further studies focus on other antimicrobial drugs and combinations in order to achieve a successful therapy against multi drug resistance (MDR) A. baumannii strains in Iran

Phase II Evaluation of Floor Pan Tearing for Cable Barrier Systems

The objective of this research effort was to mitigate the potential for floor pan tearing and penetration into the occupant compartment by modifying the posts utilized in a prototype cable barrier system. A series of dynamic component tests were conducted on the modified Midwest Weak Post (MWP). A bogie vehicle was equipped with a simulated floor pan designed to replicate the height, thickness, and strength of the floor pan of a Kia Rio. Two methods of post modification were investigated, including edge protection on the top of the MWP as well as weakening of the MWP at the ground line. Two methods of edge protection were tested, including a 31⁄2-in. x 21⁄2-in. x 3/16-in. (89-mm x 64-mm x 5-mm) thick steel tube cap and 21⁄8-in. x 13⁄8-in. x 7-gauge (54-mm x 35-mm x 5-mm) bent steel plates. Weakening of the MWPs was accomplished through two 3⁄4-in. (19-mm) diameter holes drilled through the weak-axis of the posts at the ground line. Both methods of edge protection showed potential for mitigating the propensity for floor pan tearing. In all but one test, the posts caused creasing on the simulated floor pan. In one test, test no. MWPFP-23, the edge protector connection bolt sheared and allowed the posts’ free edges to contact and tear the simulated floor pan, which would not be expected in full-scale crash testing with the 1100C vehicle. The bogie testing of MWPs with 3⁄4-in. (19-mm) diameter weakening holes with steel plate edge protectors mounted at the top of the posts resulted in only minor creasing on the simulated floor pan. Thus, a combination of weakening holes and edge protectors using steel bent plates at top of the MWP was recommended for further evaluation through full-scale vehicle crash testing