Characteristics of dermatophytoses among children in an area south of Tehran, Iran

The aim of this study was to determine the prevalence and etiological agents of dermatophytoses, and also their distribution according to age, gender, and body site among children in an area south of Tehran. A total of 382 children aged �16 years suspected to have dermatophytic lesions were examined over a period of 3 years (1999-2001). The incidence rate of dermatophytoses was 6.6 per 100 000 person-years. Trichophyton violaceum was the most frequent isolate (28.3) followed by Microsporum canis (15.1), Epidermophyton floccosum (15.1), T. rubrum (13.2), T. mentagrophytes (11.3), M. gypseum (7.5), and T. verrucosum (5.7). Tinea capitis (39.6) was the most common type of infection, followed by tinea corporis (30.2), tinea faciei (18.9), and tinea manuum (7.5)

Epidemiology of suicide by burns in the province of Isfahan, Iran

The aim of the study was to determine epidemiologic features and factors associated with suicidal behaviors by burns requiring hospitalization in the province of Isfahan, Iran. A prospective population-based study of all suicidal behaviors by burns requiring hospitalization was conducted in the province of Isfahan, Iran, from March 21, 2005 to March 20, 2006. Data were obtained from patients, family members, and/or friends through interviews during the course of hospitalization. A total of 89 patients ages 13 to 62 years with suicidal behaviors by burns were identified during the study period, representing an overall incidence rate of 2.9 per 100,000 persons-year (P-Y; 95 confidence interval 2.3-3.5 per 100,000 P-Y). Females (4.7 per 100,000 P-Y) had a higher rate of suicidal behavior by burns than males (1.2 per 100,000 P-Y; P < .001). The age-specific rate of suicidal behavior by burns peaked at age group 20 to 29 years (6.3 per 100,000 P-Y). Among the population aged 15 to 29 years, married women had a higher rate of suicidal behavior by burns (9.3 per 100,000 P-Y) than single women (6.6 per 100,000 P-Y). The highest rate of suicidal behavior by burns was found among the unemployed population (17.7 per 100,000 P-Y). The most frequent precipitating factor for suicidal behavior was a quarrel with a family member, relative, and/or friend (61.8). Depression and anxiety disorders were the most frequent psychiatric comorbidities associated with suicidal behaviors. Mortality rate caused by suicidal behavior by burns was 1.4 per 100,000 P-Y. A high rate of suicidal behavior among young and mostly married women in the province of Isfahan is a tragedy and great concern. Social, cultural, and economical factors may contribute to suicidal behavior in Isfahan, and they need to be addressed through education, support, and commitment. Findings of this study can be used for implementation of a preventive program(s) to reduce the incidence of suicide among high risk groups. © 2007 The American Burn Association

Rupture of Splenic Artery Aneurysm With Portal Hypertension During Pregnancy: A Case Report

Background: Spontaneous rupture of a splenic artery aneurysm (SAA) during pregnancy is a rare event with catastrophic consequences. This report presents a case of SAA associated with portal hypertension that ruptured during pregnancy with maternal survival. Case: A 27-year-old primigravid woman at 31 weeks of gestation presented to the Emergency Department at Pars Hospital in Tehran, Iran with sudden onset of severe abdominal pain. She was in obvious distress with blood pressure of 90/50 mm Hg and a pulse rate of 110 beats per minute. Abdominal ultrasound confirmed free fluid in the peritoneal cavity. The patient was immediately transferred to the operating room. An infant delivered by Caesarean section died shortly thereafter. There was no evidence of placental abruption, but about 2 L of blood was noted in the abdominal cavity. A ruptured SAA was found. Proximal ligation of the splenic artery was performed followed by splenectomy. The patient did well and was discharged on the eighth postoperative day. Conclusion: This case illustrates the need to consider ruptured SAA as part of differential diagnosis of hemoperitoneum in pregnant women. Immediate surgical intervention is needed to ensure survival of mother and fetus. © 2006 Society of Obstetricians and Gynaecologists of Canada

Impact of hybrid heat transfer enhancement techniques in shell and tube heat exchanger design

Despite the advantages of shell and tube heat exchangers, one of their major problems is low thermal efficiency. This problem can be improved by using heat transfer enhancement techniques such as adding nanoparticles to the hot or cold fluids, and/or using tube inserts as turbulators on tube side as well as changing baffles to a helical or twisted profile on the shell side. Although all of these techniques increase the thermal efficiency; however, engineers still need a quantitative approach to assess the impact of these technologies on the shell and tube heat exchangers. This study attempts to provide a combination of such techniques to increase the impact of these improvements quantitatively. For this purpose, at first stage the thermal and hydraulic characteristics of pure fluid, Al₂O₃/water nanofluid in a plain tube equipped with and without twisted tape turbulator is evaluated based on a developed rapid design algorithm. Therefore, the impact of using enhanced techniques either in form of individual or in hybrid format and the increase of nanoparticle concentration in base fluid have been studied. The results show that using turbulators individually and in hybrid format with nanofluid can be effected on design parameters of a typical heat exchanger by reducing the required heat transfer area up to 10 %

Persistence of health inequalities in childhood injury in the UK: a population-based cohort study of children under 5

BACKGROUND: Injury is a significant cause of childhood death and can result in substantial long-term disability. Injuries are more common in children from socio-economically deprived families, contributing to health inequalities between the most and least affluent. However, little is known about how the relationship between injuries and deprivation has changed over time in the UK. METHODS: We conducted a cohort study of all children under 5 registered in one of 495 UK general practices that contributed medical data to The Health Improvement Network database between 1990–2009. We estimated the incidence of fractures, burns and poisonings by age, sex, socio-economic group and calendar period and adjusted incidence rate ratios (IRR) comparing the least and most socio-economically deprived areas over time. Estimates of the UK annual burden of injuries and the excess burden attributable to deprivation were derived from incidence rates. RESULTS: The cohort of 979,383 children experienced 20,804 fractures, 15,880 burns and 10,155 poisonings, equating to an incidence of 75.8/10,000 person-years (95% confidence interval 74.8–76.9) for fractures, 57.9 (57.0–58.9) for burns and 37.3 (35.6–38.0) for poisonings. Incidence rates decreased over time for burns and poisonings and increased for fractures (p<0.001 test for trend for each injury). They were significantly higher in more deprived households (IRR test for trend p<0.001 for each injury type) and these gradients persisted over time. We estimate that 865 fractures, 3,763 burns and 3,043 poisonings could be prevented each year in the UK if incidence rates could be reduced to those of the most affluent areas. CONCLUSIONS: The incidence of burns and poisonings declined between 1990 and 2009 but increased for fractures. Despite these changes, strong socio-economic inequalities persisted resulting in an estimated 9,000 additional medically-attended injuries per year in under-5s

Suicide attempts and related factors in patients admitted to a general hospital: a ten-year cross-sectional study (1997-2007)

[Abstract] Background: Suicide and suicide attempts represent a severe problem for public health services. The aim of this study is to determine the socio-demographic and psychopathological variables associated with suicide attempts in the population admitted to a General Hospital. Methods: An observational-descriptive study of patients admitted to the A Coruña University Hospital (Spain) during the period 1997-2007, assessed by the Consultation and Liaison Psychiatric Unit. We include n = 5,234 admissions from 4,509 patients. Among these admissions, n = 361 (6.9%) were subsequent to a suicide attempt. Admissions arising from a suicide attempt were compared with admissions occurring due to other reasons.Multivariate generalised estimating equation logistic regression models were used to examine factors associated with suicide attempts. Results: Adjusting by age, gender, educational level, cohabitation status, being employed or unemployed, the psychiatric diagnosis at the time of the interview and the information on previous suicide attempts, we found that the variables associated with the risk of a suicide attempt were: age, psychiatric diagnosis and previous suicide attempts. The risk of suicide attempts decreases with age (OR = 0.969). Psychiatric diagnosis was associated with a higher risk of suicide attempts, with the highest risk being found for Mood or Affective Disorders (OR = 7.49), followed by Personality Disorders (OR = 7.31), and Schizophrenia and Other Psychotic Disorders (OR = 5.03).The strongest single predictive factor for suicide attempts was a prior history of attempts (OR = 23.63). Conclusions: Age, psychopathological diagnosis and previous suicide attempts are determinants of suicide attempts