Epidemiology of Poisoning in Northeast of Iran (2004-2013)

Background: Poisoning is a major concern, especially in developing countries. We aimed to focus on poisoning trends based on registry data for the recent 10 years.Methods: This cross-sectional study was performed on registry database of Imam Reza Hospital in Mashhad, Iran. All cases of toxic exposure or poisoning during 2004 to 2013 were included (49189 patients). Data from two national censuses were used for calculating rates. SPSS 11.5 was used for data analysis. P<0.05 was considered statistically significant.Results: There were 49189 admissions during the 10-year period with a mean age of 26.21±14.97 years out of which 50.3% were female. The prevalence rate had increased three times in women and four times in men. Pharmaceutical toxins (63.5%) had the highest proportional mortality ratio, which mostly occurred in winters. The mean age of admission began to decline again in recent years.Conclusion: Analyzing data on secular trends can always enlighten the healthcare decision makers for real health problems. Designing the proper population-based interventions can be one of the many uses of these findings

Can brain natriuretic peptide predict cardiovascular complications in severe preeclampsia? A case-control study

Background: Preeclampsia is one of the most common pregnancy complications, which is one of the major causes of fetal and maternal mortality. Objective: To compare the serum Brain Natriuretic Peptide (BNP) level in patients with severe preeclampsia and normal pregnancy and investigate associated cardiovascular complications. Materials and Methods: This case-control study was performed on 94 women with a singleton pregnancy (severe preeclampsia and normal pregnancy) at Imam Reza Hospital in Mashhad, Iran. The venous blood samples were collected to evaluate the serum BNP level. All patients were subjected to echocardiography performed by a single cardiologist. Results: The mean pro-BNP levels were 480.36 ± 754.52 and 67.46 ± 106.24 pg/dL in the severe preeclampsia and normal pregnancy patients, respectively (p < 0.001). However, adjusted BNP for maternal and gestational age was not different in the two groups (ANCOVA, p = 0.69). Furthermore, the two study groups showed no significant difference in terms of the cardiac parameters, including ejection fraction (EF), left ventricle end-diastolic and -systolic diameters (LVEDD and LVESD, respectively), tricuspid annular plane systolic excursion (TAPSE), and ratio of the early transmitral flow velocity to the early diastolic tissue velocity (E/Em). However, the serum BNP level showed a significant correlation with EF (r = -0.39, p = 0.008), TAPSE (r = -0.47, p = 0.001), and E/Em ratio (r = 0.48, p = 0.001) in patients with severe preeclampsia. Conclusion: It seems that BNP can be used as a predictor for some of the main cardiac functional indices (i.e., E/Em, EF, and TAPSE) in severe preeclampsia patients. Key words: Brain natriuretic peptide, Echocardiography, Stroke volume, Preeclampsia, Pregnancy

Comparing APACHE II, APACHE IV, SAPS II, and SOFA Predictive Power in Poisoned Patients Admitted to the Intensive Care Unit

Background: This study aimed to assess the performance of the Acute Physiology and Chronic Health Evaluation (APACHE) II, APACHE IV, Simplified Acute Physiologic Score (SAPS) II, and Sequential Organ Failure Assessment (SOFA) scores in predicting mortality rate in poisoning patients admitted to an intensive care unit (ICU).Methods: This cross-sectional study was performed on all admitted patients in the poisoning ICU of Imam Reza Hospital, Mashhad City, Iran. All patients were evaluated for three consecutive days since admission time and then every two days until discharge from ICU or death. The scoring systems mentioned above were calculated and analyzed by MedCalc statistical software version 18.9.1 and SPSS version 16.Results: Overall, 150 patients were studied, out of whom 67% (101) were male. Their mean±SD age was 41.6±18.9 years. In their whole hospitalization period, APACHE II (79.5%), SAPS II (78.7%), APACHE IV (78.4%), and SOFA (72.9%) were the most precise measures. On the first day of admission APACHE II (77.4%), on the second day, APACHE II (83.1%), on the third day, APACHE II (90.7%), and on the fifth day, SOFA (81.6%) were the most precise measures.Conclusion: All four systems have acceptable discriminatory power for poisoned patients. However, it seems that APACHE II can be used for mortality prediction, especially in the early days of admission.

Work‐related respiratory symptoms and pulmonary function tests in northeast iranian (the city of Mashhad) carpenters

OBJECTIVE: To assess the respiratory symptoms and pulmonary function of carpenters from the city of Mashhad (northeast Iran). METHODS: The frequency of respiratory symptoms was retrospectively estimated in a sample of 66 carpenters in the city of Mashhad in northeast Iran using a questionnaire including questions on work-related respiratory symptoms in the past year, allergy, type of irritant chemicals that induce respiratory symptoms, smoking habits, and working periods as a carpenter. PFT values were also measured in all participants, and the age and smoking habits matched those of a sample of men from the general population as a control group. RESULTS: Thirty-five carpenters (53%) reported work-related respiratory symptoms. Cough (34.4%) and sputum (33.3%) were the most common symptoms, and only 15.15% of carpenters reported wheezing during work. All respiratory symptoms were higher in carpenters than in controls, which was statistically significant for cough and sputum (p<0.001 in both cases). Most allergic symptoms were also significantly greater among the carpenters than in the control group (p<0.05 for both itchy eyes and sneezing). Most respiratory and allergic symptoms in the carpenters increased during work compared to rest period which was statistically significant only for cough (p<0.05). PFT values were significantly lower in the carpenters than in control subjects (p<0.05 to p<0.001). CONCLUSIONS: Carpentry work was associated with a high frequency of respiratory symptoms, particularly after exposure to irritating chemicals during work. PFT values were also significantly reduced among carpenters compared to controls

The future of medical students; perspectives and expectations: a cross-sectional study in Mashhad University of Medical Sciences

Background: Health decision makers should be able to predict attitudes of medical students and factors influencing their tendency to allocate enough resources and university vacancy. These attitudes may not be always congruent with the actual and prominent health needs of society. The purpose of this study was to delineate medical students’ career prospects and general expectations. Methods: This cross-sectional study was conducted on 200 medical students who were selected through a multi-stage sampling method from all educational stages (basic science, physiopathology, clinical clerkship, internship) studying at Mashhad University of Medical Sciences in 2016-2017. The first five priorities for work after graduation and first five priorities for residency were studied and the Priority-Percentage Index (PPI), which considers the percentage and a reverse scoring for the priority of selecting an item, was calculated. Results: Principally, “pursuing one of the medical specialities” was the most desired career choice (3.73 PPI) followed by “employment in private practice” (2.08 PPI) regardless of gender, native status, and stage of education. Although the most preferred specialities were ophthalmology (1.99 PPI), cardiology (1.66 PPI) and radiology (1.44 PPI), the trend of interest varied by educational stage. Conclusion: Income and reputation have a significant influence on medical students’ attitude toward specialities. Therefore, it is crucial that policy-makers note preferences in specialities and consider the society’s demand in the field of healthcare

3D Printed Models for Teaching Orbital Anatomy, Anomalies and Fractures

Purpose: The aim of this study was to determine the efficacy of using 3D printing models in the learning process of orbital anatomy and pathology by ophthalmology residents. Methods: A quasi-experimental study was performed with 24 residents of ophthalmology at Mashhad University of Medical Sciences. Each stratum was randomized into two groups. The educational booklets were distributed, and various forms of orbital 3D models were printed from orbital computed tomography (CT) scans. Knowledge enhancement on the topics was measured by comparing pretest and posttest scores. Results: Thirteen residents who were trained using traditional methods were deemed the control group; while 11 residents who were trained using the 3D printed models were classed as the intervention group. The control group was younger than the intervention group (P = 0.047). The results showed that there was a statistically significant difference in the total posttest scores between the two groups. Based on the repeated measures of the analysis of variance (ANOVA), score variables were significant between the two groups (P = 0.008). Interestingly, the use of the 3D educational model was more effective and statistically significant with the year one residents as compared to the year two residents (P = 0.002). Conclusion: This study is the first one in Iran quantifying the effects of learning using 3D printed models in medical education. In fact, 3D modeling training is seemingly effective in teaching ophthalmic residents. As residents have never encountered such technology before, their experience using 3D models proved to be satisfactory and had a surprising positive effect on the learning process through visual training

Relationship between household food insecurity and food and nutrition literacy among children of 9-12 years of age: a cross-sectional study in a city of Iran

Objective: The aim of this study was to assess the relationship between household food insecurity (HFI) with food and nutrition literacy (FNLIT) in a sample of Iranian children. This cross sectional study was performed on 315 children aged 9 to 12 years recruited from the primary schools throughout Mashhad, Iran. The Household Food Insecurity Access Scale (HFIAS) was used to assess the HFI. Also, overall FNLIT score and its sub-categories were evaluated using a validated 40-item questionnaire. Results: The prevalence of HFI in the total sample was about 56. Also, almost 14 of students had a low FNLIT score. Food insecure children had significantly lower levels of FNLT and some subscales including nutrition knowledge, food choice literacy, and food label literacy than the food-secure subjects, moreover, they had a higher likelihood of having low FNLIT score (OR = 2.89, CI 1.03-8.09; p = 0.04). In conclusion, there is a negative association between HFI and FNLIT in children. Further studies to confirm this finding are needed. © 2020 The Author(s)

Prevalence of Smoking in the Outskirts of Mashhad, Iran

Background:Globally, smoking is one of the main causes of morbidity and mortality. It is also an important social determinant of health and the largest contributor to health inequalities. While several prevalence studies are conducted on special groups such as physicians, less such studies have been focused on deprived areas (areas with lacking adequate food, shelter, education, etc). The aim of this study is to evaluate the prevalence of smoking in the outskirts of Mashhad, Iran. Methods:This analytical cross-sectional study was performed on 500 residents of sub-urban areas of Mashhad, Iran. Subjects were included and were interviewed using a multi-stage random sampling method.   Results:Composition of subjects, 40% (200) were male. Mean age was 35±11 years. Twenty-four percent (117) of subjects were smokers (18% women and 33% of men). Hookah was used twice as much as cigarettes (18% vs. 9%, respectively). Smoking was most prevalent between 25 and 34 years old for both genders. More than 75% of smokers had low grade education. Conclusion:Smoking is of high prevalence in suburban areas of Mashhad. Target oriented interventions are needed to effectively lower this major health risk factor