Suicide Mortality Risk in Kermanshah Province, Iran: A County-level Spatial Analysis

Background: Kermanshah province has one of the highest suicide rates in Iran. The aim of this study is to explore spatial variations in the relative risk of suicide across the counties of Kermanshah province. Methods: This is an applied ecological study in which county-level counts of suicide deaths recorded by the forensic medicine organization of Kermanshah province during the period March 21, 2006 to March 20, 2013 have been used. Following a Bayesian approach, Besag, York and Mollie's (BYM) model was fitted to the number of suicide deaths of males, females and all persons to make inference about the relative risk of suicide across the counties of the province. Results: Over the study period and based on 95% credible intervals, Kangavar, Harsin and Sonqor counties had significantly lower relative risks of suicide for both males and females, Slas-Babajani, Paveh, Javanrud and Ravansar counties had significantly lower relative risks of suicide only for males and Kermanshah county had a significantly higher relative risk of suicide only for males. The relative risk of suicide for the other counties were not significantly different from the province’s overall risk neither for males nor females. Conclusion: The counties of Kermanshah province can be classified into four categories by the level of relative risk of suicide: low relative risk for both males and females, low relative risk only for males, high relative risk only for males and average relative risk. Findings from this study could be used to specify priority counties for suicide prevention initiatives

Analgesic Effects of Ketamine Nebulizer vs. Intravenous Morphine in Limb Trauma Patients in Pre-Hospital Emergency Setting; A Randomized Double-Blinded Clinical Trial

Background: Limb trauma is one the main causes of emergency room (ER) referrals and patients often complain of pain from the very moment of arrival. Objective: We decided to compare the analgesic effect of ketamine nebulizer with intravenous (IV) morphine in trauma patients referred to ER. Methods: In this clinical trial study trauma patients referred to ER of Alzahra and Kashani hospitals in Isfahan, Iran were selected. All trauma patients older than 18 years with limb pain who had a pain score ≥ 7 based on visual analogue scale (VAS) criteria were included. During pre-hospital management, patients were divided into two groups of receiving ketamine nebulizer with a dose of 1.6 mg/kg and receiving IV morphine with a dose of 0.1 mg/kg. Pain score, vital signs and complications were recorded 5 and 15 minutes after receiving the first dose of drug and also at the time of arrival to ER. Results: Finally, the records of 391 patients were analysed. There was no significant difference between the two groups in terms of pain intensity, vital signs before intervention, the first 5 and 15 minutes after and the time of arrival in ER (P>0.05). But the changing of VAS scores in different times was significant in both groups (P<0.001). There was a significant difference between the two groups in complications including nausea and vomiting (P<0.001), and also delirium (P=0.010). Conclusion: Using ketamine nebulizer can produce similar analgesic effects as IV morphine in trauma patients referred to ER

Urmia Lake desiccation and the signs of local climate changes

The water crisis is one of the important issues in the Middle East countries. Many lakes are ‎drying up and/or facing critical situations, exerting tremendous impacts on the socio-economics ‎of their region. Lake Urmia, in northwestern Iran, currently is facing critical situations and is on ‎the brink of total ‎shrinkage and environmental disaster. This paper investigates the roots of crises ‎through trend ‎analysis of hydrologic variables and shows the impact of the lake desiccation on ‎altering the ‎local climate. The results indicate an increase in temperature, a decrease in lake ‎inflow, and ‎limited significant trends in precipitation. They also indicate that increasing ‎agricultural water ‎consumption is the main cause of the current crisis of Lake Urmia. Further ‎investigation reveals a ‎significant change in the local climate as a consequence of Urmia Lake ‎water shrinkage. This change occurs in the dominant wind direction where before its desiccation ‎the lake was acting as a cooling medium. This phenomenon vanished after the desiccation of the ‎lake causing a sharp increase in the temperature of the affected areas. ‎

Association between Neonatal Phototherapy and Cancer during Childhood

Background: Phototherapy is the most effective and commonly used treatment for neonatal jaundice, which reduces the need to exchange transfusion. Today, phototherapy is widely used even in unnecessary cases; however, clinicians who use phototherapy should be aware of the possible adverse effects of this treatment to avoid unnecessary use of it. Therefore, this study aimed to evaluate the relationship between neonatal phototherapy and childhood cancer.Methods: This case-control study assessed 500 children up to 14 years of age with every kind of cancer that referred to Children's Medical Center, Tehran, Iran, during 2015-18. Moreover, 500 children without cancer referring to a General Clinic of Children's Medical Center, Tehran, Iran were included in this study as the control group. History of phototherapy and its duration evaluated in these two groups. Furthermore, demographic characteristics, including maternal age during pregnancy, birth weight, gender, smoking by father, type of cancer, age at cancer detection, and history of cancer in relatives were recorded in this study.Results: The results of a single-variable logistic regression showed that neonatal phototherapy without any other variables was not significantly correlated with childhood cancer. However, phototherapy will increase the risk of cancer by 55% when it is accompanied by the male gender, maternal age >35 years during pregnancy, and smoking by father.Conclusion: The potential risk of developing cancer with neonatal phototherapy should be considered versus its benefits in reducing the bilirubin

Antifungal effects of various extracts from three Artemisia species against dermatophytosis fungal agents

Background and Aims: Dermatophytosis is one of the most important superficial infections in humans and animals worldwide. Artemisia species, as rich resources of natural products, have a high potential to treat many human diseases. The present study was conducted to investigate the antifungal effects of various extracts from three Artemisia species against dermatophyte fungi. Materials and Methods: For in vitro study, aerial parts of Artemisia aucheri, Artemisia turcomanica, and Artemisia kopetdaghensis were extracted using five different solvents: petroleum ether, dichloromethane, ethyl acetate, ethanol, and hydro ethanol (50%), and were screened for their anti-dermatophytic effects against Epidermophyton floccosum, Trichophyton rubrum, Trichophyton verrucosum, and Microsporum canis. Afterward, the minimum inhibitory concentration (MIC) assay was performed according to the agar dilution method. The most active extracts were subjected to preliminary phytochemical studies. Results: In the first screening of the extracts (concentration of 2 mg/ml), E. flucosum with no growth in the culture medium containing 13 extracts out of 15 was the most sensitive, and T. rubrum with no growth in 7 extracts from 15, including petroleum ether extracts obtained from A. aucheri, dichloromethane, ethylacetate and hydroethanolic extract obtained from A. turcomanica treatment; petroleum ether, ethylacetate and hydroethanolic obtained from A. kopetdaghensis treatment showed the highest resistance to the extracts. In the MIC results, the tested fungi were sensitive to all or some of the concentrations (ranging from 61.9 to 1981.1μg/ml). The lowest MIC value (61.9 μg/ml) was recorded for petroleum ether extract derived from A. turcomanica against E. floccosum. The preliminary phytochemical research results showed the presence of terpenoids and sterols in these extracts. Conclusion: Some lipophilic components of the various extracts, especially petroleum ether extracts from A. aucheri, A. turcomanica, and A. kopetdaghensis, have in vitro anti-dermatophytic effects

Prevalence of Helicobacter felis and Helicobacter heilmannii and Co-infection With Helicobacter pylori in Gastric Biopsy Specimens in Endoscopy Ward of Shahid Beheshti Hospital, Hamadan City, Iran

Background: Helicobacter pylori (H. pylori) has various strains associated with human infections. H. pylori, H. heilmannii, and H. felis are the most common strains in humans. H. pylori is associated with several human diseases such as chronic gastritis, peptic ulcer, mucous membrane lymphoma, and gastric adenocarcinoma. This study aimed to determine the prevalence rates of H. felis and H. heilmannii and the effect of co-infection with H. pylori in gastric biopsy specimens of patients. Methods: Totally, 80 gastric biopsy specimens were taken by a physician from the patients referred to Shahid Beheshti Hospital, Hamadan City, Iran. PCR test was used to confirm the presence of H. pylori in samples that had positive rapid urease tests. Moreover, the ureB gene and ureA and ureB genes were used for H. heilmannii and H. felis, respectively.Results: Of the study patients, 61.5% were females, and 38.5% were males with a mean age of 37.8 years. Of 80 biopsies, 50% were H. pylori-positive, 53.8% were H. heilmannii-positive, but no H. felis was identified in any sample. Results indicate that smoking, having a history of gastrointestinal diseases, and taking certain medications can be risk factors for H. pylori. Conclusion: Any agent contributing to gastric mucosal damage can enhance the susceptibility to bacterial contamination. Overall, the results indicate a low probability of interactions between H. pylori, H. heilmannii, and H. felis