Placenta previa after prior abortion: a meta-analysis

There is controversy regarding the role of prior abortion on placenta previa in subsequent pregnancies. We conducted an updated, comprehensive meta-analysis of placenta previa after prior abortion. The search was conducted from PubMed, Web of Science and Scopus databases from the database inception to January 31, 2017. The heterogeneity across studies was evaluated by Q-test and I2 statistical test. Publication bias was assessed by Begg's test and Egger's test. Results of odds ratio (OR) estimates with their corresponding 95% confidence intervals (CI) were pooled using random-effects modeling. The literature search included 872 articles up until January 2017 with 2,134,529 participants. Based on OR estimates obtained from case-control and cohort studies, we found a significant association between prior spontaneous abortions and placenta previa (1.77; 95% CI: 1.60, 1.94) and between prior induced abortions and placenta previa (1.36; 95% CI: 1.02, 1.69). The meta-analysis study herein showed that prior abortion is a risk factor for placenta previa.</jats:p

Predictors of mortality among hemodialysis patients in Hamadan Province using random survival forests

Background: Hemodialysis patients are at the high risk for morbidity and mortality. The aim of this study was to find out the predictors of mortality and survival in hemodialysis patients in Hamadan province. Methods: The numbers of 785 patients during the entire 11 years were enrolled into this historical cohort study. Data were gathered by a checklist of hospital records. The survival time was the time between start of Hemodialysis treatment to patients death as the end point. Random survival forests (RSF) method was used to identify main predictors of survival among the patients. Results: The median survival time was 613 days. The number of 376 death was occurred. The three most important predictors of survival were hemoglobin, CRP and albumin. RSF method predicted survival better than the conventional Cox-proportional hazards model (out-of-bag C-index of 0.808 for RSF vs. 0.727 for Cox model). Conclusions: We found that higher levels of CRP, low serum albumin and low serum hemoglobin were the top three most important predictors of survival for HD patients

Angiogenic factors and the risk of preeclampsia: A systematic review and meta-analysis

Background:&nbsp;The etiological nature of preeclampsia is heterogeneous. The use of biomarkers indices in early pregnancy helps to have appropriate stratification of pregnancies into high- and low risk for the purpose of choosing timely interventions. Objective:&nbsp;The aim of this systematic review was to determine the pathogenic role of&nbsp;soluble soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) inthe prediction of preeclampsia in women. Materials and Methods:&nbsp;We performed a systematic search of the international databases including PubMed, Scopus, and Web of Science until August 2017. The&nbsp;quality of included studies was assessed using the Newcastle-Ottawa Scale. The&nbsp;primary outcome in this review was preeclampsia. The statistical heterogeneity was&nbsp;assessed using the X2 test and quantified by I2. Pooled effects size was obtained by&nbsp;random effects model. Subgroup&nbsp; analyses were also carried out. Results:&nbsp;Totally, 284 records were identified in the initial search and 15 records were&nbsp;finally included in the meta-analysis. The pooled odds ratios (ORs) for the association&nbsp;between the high level of sFlt-1 and low level of PlGF and subsequent development&nbsp;of preeclampsia among women were 5.20 (95% CI: 1.24–9.16) and 2.53 (95% CI: 1.33–3.75), respectively. The mean difference for sFlt-1 and PlGF in women with preeclampsia&nbsp;compared to controls was 1.15 (95% CI: 0.43–1.86) and –0.94 (95% CI: –1.37–0.52),respectively. Conclusion:&nbsp;According to the results from this meta-analysis, increased levels of sFlt-1&nbsp;and reduced levels of PlGF predict the subsequent development of preeclampsia. Key words: Angiogenic factors, Preeclampsia, sFLT-1, PlGF

Epidemiologic characteristics of injuries among 1-5 year-old children in Hamadan Province: Analysis of 4523 hospitalized children over a 6-year period

Background: Unintentional injuries are one of the major causes of death in Iranian children. Information on epidemiological pattern of injury among one-to 5-year-old children is limited in Hamadan. The aim of this study was to clarify the person, space and time pattern of injury among 1-5 year-old children in Hamadan Province. Methods: All registered incidence cases of injury among 1-5 year-old children in Hamadan Province from March 2009 to March 2015 were included in this cross-sectional study. We analyzed the data on county, gender, age category, type of injury, season and outcome of injury. Temporal trend was explored using time series regression with accounting autocorrelation, seasonality, and short-term variation. Results: This study included 4523 injury cases. During the studied period, urban residents and boys had a higher number of injuries. Motor vehicle-related injuries were the most common type of injury. A seasonality pattern was found so that most of the cases were occurred in summer months. The lowest and highest incidence rate ratios (IRRs) were occurred in January 2011 (IRR = 0.61 with 95 confidence interval CI: 0.31, 1.18) and May 2014 and August 2013 (IRR = 6.78 with 95% CI: 4.38, 10.51), respectively. Conclusion: In Hamadan Province, childhood injury has a variation in person, place, and time pattern, as some groups such as boys and urban residents among 1-5 year-old children are at a higher risk for the incidence of injury. Therefore, it is recommended that health service managers and health policymakers devote more healthcare and resources to the high-risk groups

Assessment of the Community Periodontal Index of Treatment Needs (CPITN) in Pregnant Women Referring to the Health Centers in Arak, Iran

Objectives: The periodontal disease during pregnancy is considered to be significant because not only does it affect the tissues supporting the teeth, but also it is connected with systemic conditions such as adverse pregnancy outcomes. The present study aimed at assessing periodontal disease in pregnant women and other relevant demographic factors. Materials and methods: This is a cross-sectional, descriptive-analytical study that was conducted among 275 pregnant women visiting the health centers in Arak, Iran, in 2021. Cluster random sampling method was used to select the samples. The demographic information was gathered and periodontal statues was examined using the Community Periodontal Index of Treatment Needs (CPITN). The data were analyzed by SPSS18 software, using logistic regression. Results: According to the results, 55.4% of the pregnant women had periodontal disease (CPI&gt;0). Bleeding on probing (BOP), dental calculus, and periodontal pocket depth (PPD) between 4 and 5 mm were observed of 17.5%, 36.4%, 5.1% of women, respectively. No periodontal pocket deeper than 6mm was observed. Brushing frequency was the main predictor for gingival health, and the women with under diploma education (OR: 2.26, 95% CI: 1.14-4.48) and having one or more children were (OR: 1.40, 95% CI: 1.02-1.94) more likely to have periodontal disease than women with academic education or having no children. Conclusion: According to the findings, pregnant women were not in good health condition in terms of periodontal disease. Considering the demographic and behavioral differences, designing the health promotion programs during pregnancy is recommended

Pattern of trauma related to falling from walnut tree as an occupational injury: A cross-sectional study in the west of Iran

Background: Evidence regarding the epidemiological characteristics and the mechanisms of trauma related to falling from walnut tree are limited in Iran. Therefore, this study was conducted to investigate the pattern of trauma related to falling from walnut tree as an occupational injury in Tuyserkan in the west of Iran in 2017. Materials and Methods: In this cross-sectional study, all the patients admitted in Vali-Asr Hospital for injuries caused by falling from walnut trees during the harvest for walnuts (from September to October 2017) were reviewed. The data were collected by a checklist including the demographic and clinical characteristics of the patients obtained from the hospital records. Data were analyzed using descriptive and analytical statistics by the STATA software version 12. Results: During the study, a total of 52 injured cases were registered in Vali-Asr Hospital. All patients were male, and 71.2 of them were rural dwellers. Falls were more concentrated in Friday (27) and peaked in mid-days (19.2 of cases). Branch breaking was the common cause of falling in 30 (57.7) injured cases. Nearly 70 (n = 36) of the cases were transferred to the trauma center by the emergency services. Among injured patients, 4 patients (7.7) died. Overweight patients had a 7.75-fold higher chance of death or handicap compared to underweight patients (P = 0.09). Conclusion: Most of the cases were young men from rural areas who were economically important groups. High air temperature in mid-day time is in related to increase in the probability of falling; thus, it should be advised not to work at this time. A considerable proportion of injured patients were carried by family members to the hospital. Therefore, the general awareness that an injured person must be transferred to the hospital by the emergency medical services for the reduction of the severity of trauma is necessary

Etiology and outcome of burns in Hamadan, Iran: A registry-based study

Background: Burn prevention strategies are most effective when they are based on knowledge of etiological patterns of burn injuries and considering the geographical variations and socioeconomic differences in burn epidemiology. In this regard, this study aimed to investigate the etiology and outcome of burns in Hamadan, Iran. Materials and Methods: This registry-based, cross-sectional study was conducted on 798 burn patients admitted to the Besat Hospital from March 2013 to February 2018. The medical records of all the patients were extracted from hospital information system. Results: In males, the most common cause of burn was gas explosion (41.4), whereas in females, the most common cause was hot liquids (37.1). In below 5 years and 6-15 years age group, burning with hot liquids was the common cause of burn, whereas in other age groups, gas explosion was the common cause of burn. In the present study, 6.9 of the patients died because of their burns. With increasing age, the odds of death increases, so that patients between 30 and 59 years had 2.2 fold (P = 0.02) and patients 60 years had 3.5 fold (P = 0.006) higher odds of death compared to patients aged Conclusion: Findings of the present study show that males and people aged 26-40 years and children 0-5 years were at a greater risk of burns. Furthermore, this study shows that self-immolation with a high rate of case fatality should be considered as a mental health challenge, and it is necessary to design preventive strategies to reduce it

Effectiveness of sodium bicarbonate and zinc chloride mouthwashes in the treatment of oral mucositis and quality of life in patients with cancer under chemotherapy

Aim: The purpose of the study is to evaluate the effectiveness of sodium bicarbonate and zinc chloride mouthwashes on oral mucositis and quality of life in patients undergoing chemotherapy. Design: The present study was a randomized controlled trial study. Methods: One hundred forty‐four patients with a cancer diagnosis were randomly assigned into three groups: sodium bicarbonate mouthwash (n = 48), zinc chloride mouthwash (n = 48) and placebo group (n = 48). The severity of mucositis and quality of life were examined blindly at the baseline and 3‐week follow‐up. Results: The grade of oral mucositis decreased at the end of the third weeks in the sodium bicarbonate and zinc chloride groups rather than the placebo group (p &lt; .001). The severity of oral mucositis in the sodium bicarbonate and zinc chloride groups decreased from end of the first week until third week (p &lt; .001). In addition, there was significant difference in the severity of oral mucositis among the groups at the end of the second (p = .014) and the third weeks (p &lt; .001). Also, there was a statistically significant difference in quality of life scores between the sodium bicarbonate and zinc chloride mouthwash with the placebo group (p &lt; .001). Conclusion: Zinc chloride and sodium bicarbonate mouthwashes were effective in treating and reducing the severity of oral mucositis, and subsequently improving quality of life in patients with cancer under chemotherapy. Therefore, we can recommend zinc chloride and sodium bicarbonate at the beginning of chemotherapy to improve oral health and promoting quality of life in these patients

Injury as a Threat To Health, Experiences of Falling From Trees in Farmers: A Qualitative Study

Background: Falling is a significant cause of occupational injuries and fatalities among farmers, and falling from trees is one of the most common causes of injury resulting in a high number of visits to health centers. Despite this, there is limited evidence on the factors associated with falling from walnut trees. Therefore, this study aimed to identify the factors that contribute to falling from walnut trees from the perspective of farmers and farmworkers.Methods: This qualitative study was conducted using conventional content analysis. Data were collected through semi-structured interviews with 20 farmers and farmworkers who had experienced falling from walnut trees as recorded in the National Accidents Record Program from September to October 2017 in Tuyserkan county, Iran. Participants were selected through purposive sampling. Moreover, data rigor was ensured through participant and external checks. All interviews were recorded and analyzed using content analysis methods.Results: Data analysis led to the extraction of six themes, including psychological factors, physical factors, behavioral and habitual factors, economic factors, factors related to walnut trees, and atmospheric agents, along with 18 subthemes for behavioral, human, and environmental factors.Conclusion: The findings of this study suggest that with appropriate interventions and training, farmers and farmworkers can be guided and assisted so as to prevent the occurrence of falling from walnut trees. In addition to educational interventions, health promotion measures such as providing safety equipment and insurance coverage can be essential in reducing injuries