Head Trauma Patients Presented To Emergency Department; an Epidemiologic Study

مقدمه: صدمات تروماتیک مغزی یکی از مهمترین علل مرگ و میر و معلولیت هستند. با در نظر گرفتن تناقضات متعدد جهت ترخیص بیماران با ضربه به سر به خصوص صدمات تروماتیک مغزی خفیف، این مطالعه با هدف بررسی اپیدمیولوژیک صدمات تروماتیک مغزی طراحی شده است. روش کار: در این مطالعه مقطعی گذشته نگر، بیماران با ترومای منحصر سر، بدون فاکتورهای مخدوش کننده و همه آنها که تحت سی تی اسکن سر قرار گرفتند، با نمونه گیری در دسترس وارد این مطالعه شدند. اطلاعات دموگرافیک و تشخیص نهایی این بیماران از پرونده های بالینی استخراج و مورد تحلیل آماری با استفاده از نرم افزار SPSS 21 و تست های آماری متناسب قرار گرفت. يافته ها: 786 بیمار با میانگین سنی 8/16 ± 24 سال (دامنه: 75-5/0) مورد بررسی قرار گرفتند (8/67 درصد مرد). 42 بیمار (3/5 درصد) سی تی اسکن مغز غیرطبیعی داشتند و بستری شدند. از بین این 42 بیمار، 7 نفر (7/16 درصد بیماران بستری، 3/3 درصد بیماران کم خطر و 9/0 درصد کل بیماران) در دسته ی کم خطر از جهت احتمال وجود ضایعه مغزی قرار داشتند. 12 نفر (5/1 درصد) از بیماران به عمل جراحی احتیاج داشتند که از این میان 2 نفر (9/0 درصد) از بیمارانی بوده اند که جزو دسته کم خطر طبقه بندی شده بودند. استفراغ در بیماران با اسکن غیرطبیعی (2/45 درصد)  به طور معنی داری بیشتر از بیماران با اسکن طبیعی (6/19 درصد) بود (p = 0/001 ). در سایر علائم اختلاف معنی داری بین دو گروه مشاهده نشد. نتيجه گيری: با توجه به یافته های این مطالعه، می توان نتیجه گرفت که با تصمیم گیری بر اساس علائم بالینی صرف احتمال خطا در مدیریت حدود 3/3 درصد بیماران مبتلا به ترومای سر وجود دارد. همچنین حدود 9/0 درصد از بیمارانی که در دسته کم خطر طبقه بندی شدند در نهایت به .عمل جراحی احتیاج پیدا کردندIntroduction: Traumatic brain injuries are among the most important causes of mortality and disability. Since there is a lot of controversy regarding discharge of head trauma patients, especially those with mild traumatic brain injuries, this study was designed aiming to evaluate traumatic brain injuries from an epidemiologic point of view. Methods: In this retrospective cross-sectional study, patients with isolated head trauma, and all those who underwent computed tomography (CT) were included using convenience sampling. Demographic data and final diagnosis of the patients were extracted from their medical profile, and were analyzed using SPSS 21 and appropriate statistical tests. Results: 786 patients with the mean age of 24 ± 16.8 years (range: 0.5 – 75) were evaluated (67.8% male). 42 patients (5.3%) had abnormal CT scan and were hospitalized. 7 of them (16.7% of hospitalized, 3.3% of low-risk, and 0.9% of all patients) were in the group categorized as low-risk regarding probability of brain injuries. 12 (1.5%) participants needed surgery, 2 of which (0.9%) were initially categorized as low-risk. Vomiting was significantly more in patients with abnormal CT scan (45.2%) compared to those who had normal CT scan (19.6%) (p = 0.0001). No significant difference was detected between the 2 groups in other symptoms. Conclusion: The results of this study indicate that by making decisions based on clinical findings alone, there is a probability of about 3.3% error in management of head trauma patients. In addition, 0.9% of the patients initially categorized as low-risk, needed surgical intervention in the end.

Spatiotemporal clustering of suicide attempt in Kermanshah, West-Iran

BackgroundA suicide attempt is a major societal problem because it imposes high costs on societies worldwide. This paper analyses the spatiotemporal clustering of suicide attempt in Kermanshah, Iran from 2006–14.MethodsThis study draws on 18,333 individuals (7,234 males and 11,097 females) who attempted suicide across the Kermanshah province. Data was collected from the records of individuals registered in hospitals across the Kermanshah province between 2006 and 2014. Mean Center, Standard Deviational Ellipse (SDE), Moran’s I and Kernel Density Estimation (KDE) in Arc/GIS10.6 software were used for the analysis of the spatial distribution of suicide attempt, while the chi-squared test in SPSS was used to examine the different demographic variables between groups within/outside spatial clusters of suicide.ResultsThe results show that a total of 18,331 suicide attempts (39.46% male and 60.53% female) were reported between 2006 and 2014 in the Kermanshah province. The spatial pattern of suicide attempts was clustered in 16 clusters (6 high clusters and 10 low clusters) and statistically significant differences were found within and outside the hotspots of suicide attempts. Most hot spots were formed in and around cities. Younger people were at a greater risk. The rate of suicide attempts reduced in illiterate people and increased in people with university degrees. Unmarried people were associated with a higher risk of suicide attempt than was married status for both males and females.ConclusionThe results of this study could help public health practitioners and policymakers in Iran prioritize resources and target efforts for suicide attempt prevention

Feeding indices and enzymatic activities of carob moth Ectomyelois ceratoniae (Zeller) (Lepidoptera: pyrallidae) on two commercial pistachio cultivars and an artificial diet

Feeding indices and enzymatic activities of Ectomyelois ceratoniae (Zeller) were studied in a growth chamber under controlled conditions (29 ± 2 °C, relative humidity of 70 ± 5% and a photoperiod of 16:8 (L:D) hours) on two commercial Pistachio cultivars (Akbari and Kalequchi) and an artificial diet. Feeding indices of E. ceratoniae larvae differed significantly on three hosts (P < 0.05). The relative consumption rate was calculated to be 5.36 ± 0.009, 11.10 ± 1.49 and 10.631 ± 0.599 (mg/mg/day) on artificial diet, Akbari and Kalequchi cultivars, respectively. Carob moth larvae reared on Akbari cultivar showed the highest efficiency of conversion of digested food (ECD) (5.64 ± 0.43). The highest amount of efficiency of conversion of ingested food (ECI) was obtained on artificial diet but approximate digestibility (AD) was the lowest on this diet. The highest enzymatic activities of alpha-amylase, general proteases and lipase were observed in the midgut of larvae reared on artificial diet. Total protein and lipid value were highest in larvae that were reared on artificial diet

A Pattern of Competency - Oriented Compensation System of Employees

The purpose of this research is to propose a competency-Compensation Assessment System Through Succession Planning. Having reviewed the research literature as well as experts' opinions, the primary model was proposed and then, the final research model was presented using the experts' opinions. The study was carried out via mixed methods research. The statistical population included the experts and academic specialists in the field of human resources and senior managers of Bank Saderat Iran in the qualitative section and experts and managers at various levels of Bank Saderat in the quantitative section. Non-judgmental purposive sampling and random stratified sampling were employed in the qualitative and quantitative sections respectively. In the qualitative section, 17 persons participated in the interview and in the quantitative section, 400 persons participated as the research sample. Tools of data collection were interview and researcher self-made questionnaire. Reliability of the questionnaire was calculated equal to 0.93 and its validity was approved. The results of the survey in the qualitative section illustrate that there are 25 components for competency-oriented compensation system in five dimensions including competency, foresight, flexibility, justice, and comprehensiveness. In the quantitative section, the findings showed that competency has the highest effect on employees' competency-oriented compensation. Likewise, among the secondary components in the subset of competency dimension, "absorption, retaining and development of organization's talents" has the highest effect on employees' competency-oriented compensation system. T-statistic of this component is equal to 11.82 and its path coefficient is equal to 0.8

Clinical, laboratory, and chest CT features of severe versus non-severe pediatric patients with COVID-19 infection among different age groups

Abstract Background This study was performed with the intention of comparing the clinical, laboratory, and chest computed tomography (CT) findings between severe and non-severe patients as well as between different age groups composed of pediatric patients with confirmed COVID-19. Method This study was carried out on a total of 53 confirmed COVID-19 pediatric patients who were hospitalized in Namazi and Ali Asghar Hospitals, Shiraz, Iran. The patients were divided into two severe (n = 27) and non-severe (n = 28) groups as well as into other three groups in terms of their age: aged less than two years, aged 3–12 years and 13–17 years. It should be noted that CT scans, laboratory, and clinical features were taken from all patients at the admission time. Abnormal chest CT in COVID-19 pneumonia was found to show one of the following findings: ground-glass opacities (GGO), bilateral involvement, peripheral and diffuse distribution. Result Fever (79.2%) and dry cough (75.5%) were the most common clinical symptoms. Severe COVID-19 patients showed lymphocytosis, while the non-severe ones did not (P = 0.03). C-reactive protein (CRP) was shown to be significantly lower in patients aged less than two years than those aged 3–12 and 13–17 years (P = 0.01). It was shown also that O2 saturation experienced a significant increase as did patients’ age (P = 0.01). Severe patients had significantly higher CT abnormalities than non-severe patients (48.0% compared to 17.9%, respectively) (P = 0.02). Conclusion Lymphocytosis and abnormal CT findings are among the factors most associated with COVID-19 severity. It was, moreover, showed that the severity of COVID-19, O2 saturation, and respiratory distress were improved as the age of confirmed COVID-19 pediatric patients increased