Lessons Learned From Trauma Injuries in Arbaeen 2019 in Ilam Province, Iran

Arbaeen is the largest peaceful religious gatherings on Earth. In this event, millions of people go to the holy city of Karbala in Iraq.  Annually, about 20 million pilgrims attend Arbaeen ceremony, including about three million foreigners, that most of whom are Iranians. Ilam province is located near Iran’s western border with Iraq. Every year, many Iranian pilgrims enter Iraq through Ilam borders for the Arbaeen ceremony, which lasts two weeks before and after Arbaeen day. Pilgrims after the religious rituals enter to their home

CROWDWORK PLATFORMS: JUXTAPOSING CENTRALIZED AND DECENTRALIZED GOVERNANCE

Crowdwork is a novel form of digitally mediated work arrangement that is managed and organized through online labor platforms. This paper focuses on the governance of platforms that facilitate creative work—that is, complex work tasks that require high-level skill and creative workers. Crowdwork platform governance faces numerous challenges as a result of technology mediation, scalable and distributed workers, and temporary work arrangements. Creative crowdwork platforms, such as Topcoder, typically require additional governance structures to manage complex tasks. However, we know relatively little about creative crowdwork platform governance, as most existing studies focus on routine work platforms, such as Amazon Mechanical Turk. Accordingly, this paper explores how incumbent and insurgent creative crowdwork platforms are governed under centralized and decentralized modes. We conducted a comparative case study based on the analysis of two different cases: Topcoder, a successful commercial platform with a largely centralized governance structure, and CanYa, an emerging innovative platform based on blockchain technology with more decentralized governance. We identified and classified different governance elements related to work control and work coordination. In addition, we explored the characteristics of creative crowdwork platform governance with different degrees of centralization. Keywords: Crowdwork Governance, Creative Crowdwork, Centralized Platforms, Decentralized Platforms, Blockchain, Tokenomics

Thrombotic Thrombocytopenic Purpura Following Honeybee Envenomation: A Case Report

Background: Thrombotic Thrombocytopenic Purpura (TTP) is a rare and life-threatening disorder characterized by severe thrombocytopenia, microangiopathic hemolytic anemia, fever, renal dysfunction, and neurological deficient. TTP leads to the formation of blood clots in small blood vessels throughout the body. TTP is associated with many risk factors such as pregnancy, HIV, cancer, lupus, and infections. Recently there have been few published case reports of bee sting associated TTP.Methods: A 67-year-old man from a rural area of the Southwest Province of Iran, Ilam, was referred to the academic general hospital because of fever, chills, sweating, vomiting and dizziness following the honeybee sting on his body. Results: this study showed that,multiple co-morbidities including CVD and diabetes, along with coagulation abnormalities after honeybee stings, seriously exacerbated patient hemodynamic status.Conclusion: TTP, as a major complication due to the toxic reaction of a large number of bee stings with underlying diseases in patients, should be given more attention

Menorrhagia in Women After the Administration of Novel Oral Anticoagulants, Like Rivaroxaban: A Case Report

Background: The Novel Oral Anticoagulants (NOACs), despite numerous benefits, such as the ease of use and less drug involvement, provide extensive adverse effects. One of the most significant, but rare side effects of them in women is severe and dangerous bleedingCase presentation: In this study, we reported a case of severe vaginal bleeding (manometric hemorrhage) in a woman receiving rivaroxaban to prevent pulmonary thrombosis.Conclusion: The oral anticoagulant rivaroxaban could present a rare adverse effect on women

Induced Abortion by Vaginal Use of Aluminum Phosphide in a 44-Year-Old Woman: A Case Report

Aluminum phosphide (AlP) is an efficient and toxic pesticide that is easily available in many Asian countries such as Iran. Many cases of unintentional or suicidal use of AlP have been reported in these countries, and these statistics are rising rapidly. We aim to present a case of abortion induced by vaginal use of AlP. We report a 44-year-old gravid woman who self-administered one-quarter of a 3-g AlP tablet intravaginally. Ultrasound at 6 hours post-admission showed no fetal movement or heart motion. Intravaginal administration of AlP can lead to fetal death and abortion. There is concern about the spread of vaginal use of these agents in pregnant women, as the number of illegal abortions is increasing

میزان رضایتمندی گیرندگان خدمت از مراکز مدیریت حوادث و فوریت های پزشکی شهرهای یزد و بیرجند؛ یک مطالعه مقطعی

Introduction: The satisfaction rate of patients is a valuable tool for evaluating the quality of providing health care and gives important data regarding the expectations of patients and the degree to which they are being met. Considering the importance emergency medical service (EMS) centers in providing proper care, this study was carried out aiming to evaluate the satisfaction rate of those receiving services from EMS centers of Yazd and Birjand. Methods: The present cross-sectional study was carried out on 150 of EMS recipients registered on the list of EMS centers of Yazd and Birjand in 2012. Systematic sampling was used and required data were gathered using the standard questionnaire of satisfaction for EMS center recipients that consisted of 2 parts; demographic data and 16 questions regarding satisfaction of recipients. Data were analyzed using SPSS 18 and descriptive tests. Results: 150 participants were studied (56.7% male). The most common reason for calling was trauma due to motor vehicle accidents (32%) in Yazd and weakness and nervous system diseases (18%) in Birjand. 10% of the participants in Yazd province had low satisfaction, 39% had intermediate, and 51% had high satisfaction. In Birjand satisfaction rate was intermediate in 16% and high in 84% of those studied in Birjand. The highest satisfaction rate in Yazd was regarding cooperation of emergencies center with the patient and their manners in facing them. The lowest satisfaction rate belonged to following the condition of the patient until the arrival of ambulance and the waiting time for ambulance arrival. In Birjand, the lowest satisfaction rate belonged to the quality and existence of equipment in the emergency team. Conclusion: The results of the present study showed that satisfaction level of EMS recipients in Yazd and Birjand was intermediate. The lowest satisfaction rate belonged to following the condition of the patient until the arrival of ambulance and the waiting time for ambulance arrival in Yazd, and the quality of equipment in Birjand. مقدمه: میزان رضايتمندي بيماران ابزار سنجش مهمي براي ارزیابی كيفيت ارائه خدمات بهداشتي درماني است و اطلاعات مهمي راجع به انتظارات بيماران و ميزان برآورده شدن آنها فراهم مي كند. با توجه به اهمیت و جایگاه مهم مراکز مدیریت حوادث و فوریت های پزشکی و ارائه موثر خدمات از سوی آنها، این مطالعه با هدف بررسی میزان رضایتمندی گیرندگان خدمات از مرکز مدیریت حوادث و فوریت های پزشکی در شهرستان های یزد و بیرجند انجام پذیرفته است. روش کار: مطالعه مقطعی حاضر در سال 1391 بر روی 150 نفر از گیرندگان خدمت موجود در لیست مرکز مدیریت حوادث و فوریت های پزشکی شهر های بیرجند و یزد انجام پذیرفت. نمونه گیری به صورت سیستماتیک و اطلاعات مورد نیاز توسط پرسشنامه استاندارد رضایتمندی گیرندگان خدمات از مرکز مدیریت حوادث و فوریت های پزشکی که شامل دو قسمت؛ مشخصات دموگرافیک و 16 سؤال مربوط به رضایتمندی گیرندگان خدمت بود، جمع آوری گردید. داده ها با استفاده از نرم افزار SPSS 18 و آزمون های توصیفی مورد تجزیه و تحلیل قرار گرفتند. يافته ها: 150 نفر مورد مطالعه قرار گرفتند (7/56 درصد مرد). شایعترین دلیل برقراری تماس در شهر یزد، ترومای ناشی از تصادفات رانندگی (32درصد) و در شهر بیرجند ضعف و بیحالی و بیماری عصبی (18درصد) بود. 10 درصد از پاسخگویان در استان یزد رضایتمندی کم، 39 درصد رضایتمندی متوسط و 51 درصد رضایتمندی مطلوبی داشتند. به همین ترتیب 16 درصد از پاسخگویان در شهر بیرجند رضایتمندی متوسط و 84 درصد رضایتمندی مطلوب داشتند. بالاترین میزان رضایتمندی در استان یزد از همکاری مرکز فوریت ها با بیمار و رفتار پرسنل با بیمار بود. همچنین کمترین میزان رضایتمندی نیز متعلق به پیگیری وضعیت بیمار تا رسیدن آمبولانس و زمان انتظار بیمار تا رسیدن آمبولانس بود. در شهر بیرجند نیز کمترین میزان رضایتمندی مربوط به کیفیت امکانات و تجهیزات تیم اورژانس بود. نتيجه گيری: نتایج حاصل از این مطالعه نشان داد که میزان رضایتمندی گیرندگان خدمات از مراکز مدیریت حوادث و فوریت های پزشکی، در شهر یزد و بیرجند در سطح متوسطی بوده است. کمترین میزان رضایتمندی از خدمات مرکز مدیریت حوادث و فوریت های پزشکی در شهر یزد مربوط به حیطه پیگیری وضعیت بیمار تا رسیدن اورژانس و نیز زمان انتظار بیمار تا رسیدن آمبولانس و در شهر بیرجند مربوط به کیفیت امکانات و تجهیزات بود

Evaluation of the Prevalence of Congenital Heart Diseases in neonates of Ilam province of Iran, in 2019-2020

Background: Congenital heart diseases (CHDs) can cause death and severe disorders in the developmental process of children and, in most cases, are associated with other congenital defects. The current study investigates the prevalence of such defects among infants born in 2019 and 2020.Materials and Methods: This analytical cross-sectional study was conducted in Ilam province on 91 referred neonates, with the possibility of heart diseases, who were diagnosed with CHDs. Demographic, clinical, and definitive diagnoses of cardiologists were recorded and analyzed in these infants, followed by a 6-month follow-up. Data were analyzed using SPSS software with descriptive statistics, Chi-square test, and correlation coefficients.Results: A total of 91 infants out of 16,064 newborns were diagnosed with CHDs, and the prevalence of heart diseases was 5.9 in every 1000 live births. The most frequent defects were ventricular septal defects (VSDs) and PDA, with prevalence rates of 59.3% and 14.2%, respectively. Among 54 VSDs, mus VSD (n = 39) was the most common form of this disorder.Conclusion: The incidence of CHDs in Ilam province was lower than the global average, which may be attributed to the easier access of several cities to the health centers of the bordering provinces. The highlighted results of this study were the frequency of VSDs and the high rates of muscular VSD compared to membranous VSD

Predicting number of traumas using the seasonal time series model

Background: Road accidents and casualties resulted are among the current challenges of human societies, which have imposed a high cost on the economies of countries. Objectives: Prediction of accidents caused by driving incidents helps planners achieve a suitable model to reduce the occurrence of traumas resulted from the driving accidents. Materials and Methods: In this study, a seasonal time series model was used for predicting the number of road accident traumas. Data related to the patients referring to Imam Khomeini Hospital in Ilam Province were evaluated from March 2012 to June 2017. Results: The results showed that during November and October in 2015 and 2016, we had the highest number of accidents due to high traffic during New Year's Vacation, summer trips, and religious pilgrimages including the Arbaeen. Moreover, the results depicted that the seasonal Arima model was effective in predicting the number of traumas due to accidents. Furthermore, forecasting the model showed an ascending trend in the number of accidents in the following 3 years. Conclusion: The number of accident traumas in the forthcoming months can be predicted through time series models. Of course, these models can be used by managers as appropriate tools for traffic analysis. Furthermore, the increasing trend in the number of traumas indicates that serious consideration for planning and managing such events seems necessary for the administrators in the near future

A comparison of difficulties in emotional regulations of patients with mild traumatic brain injury and normal controls

Background: Many individuals with traumatic brain injury experience difficulties with social behavior, some of which are attributed to difficulties in regulation of emotions. Objectives: The aim of this study was to compare the difficulties in emotional regulations of patients with mild traumatic brain injury (MTBI) and normal controls. Patients and Methods: In this cohort study, 72 patients with MTBI and 72 normal controls with similar gender were selected. Difficulties in Emotion Regulation Scale (DERS) and Positive and Negative Affect Schedule (PANAS) questionnaires were completed for both the study groups at the beginning of the study and 6 months later. The data were analyzed using multiple linear regression, Chi-square, and paired t-test. Results: The results showed that there was a significant difference between MTBI patients and normal controls in all subscales 6 months after MTBI, and in the total score of DERS, except for the nonaccepted scale and PANAS (P = 0.001), in which no significant difference was observed. In addition, the results of multivariate regression showed that trauma (β = 0.493), age (β = 0.196), familial history of mental disorders (β = 0.185), and financial status could predict emotional regulation (β = 0.148). Conclusions: It seems that mild traumatic brain injuries may be the cause of problems in social behaviors