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Background: Childhood and adolescent injuries are among the most significant health system hazards, especially in developing countries including Iran. In this report, we evaluated the main characteristics of all cases of pediatric injury-related mortality in Shiraz in a 5 -year -period. Methods: This cross -sectional study comprised all injury-related deaths in children and adolescents up to 18 years of age, from September 2011 to September 2016 in Shiraz, Iran. The required information about demographic factors including age, sex, cause of death, the manner and location of death and time period between injury and death was collected for all the cases.

Purpose An analysis and identification of the hidden relationships between effective factors in the mortality rate caused by road accidents in Fars Province of Iran to prevent and reduce traffic accidents in the future. Methods This cross-sectional study was conducted to integrate all the pervious researches performed on mortality rate of road traffic accidents in Fars Province from March 21, 2013 to March 20, 2017. In order to reveal the relationships between the factors affecting mortality rates of road traffic accidents, the data regarding road traffic accidents extracted from resources such as Legal Medicine Organization, Traffic Police, Accident & Emergency Department, as well as Department of Roads and Urban Development of Fars Province, then cleaned and the applicable attributes embedded in the data all aggregated for further analysis. It should be noted that the data not related to Fars Province were deleted, the data analyzed, converted and the aggregation between various attributes identified. The aggregation between these different attributes as well as the FP-growth algorithm and two indexes of support and confidence calculated and interesting and effective rules extracted. In the end, several accident-provoking factors, the degree of consecutive and interdependence of each one in road accidents identified and introduced. The statistical analysis was conducted by using Rapid Miner software. Results Of the 6216 people dead due to road traffic accidents, 4865 (79.02%) were male and 1292 (20.98%) were female, 59 of them have no clear gender. The largest portion of people died of road traffic accidents belonged to married and self-employed men who collided with motorcycles in autumn. Moreover, young individuals (aged 19–40 years) with secondary educational level who died of accidents in summer at 12:00 a.m. and then 5:00 p.m. in outer city main roads of Kazerun-Shiraz, then Darab-Shiraz, Fasa-Darab and in within-city main streets had the highest mortality rates. Among women, the middle-aged group (aged 41–65 years) followed by young-aged group (aged 19–40 years) with elementary educational level and then illiterate accounted for the highest mortality rate of road traffic accidents. The automobiles involved in accidents included Pride, Peugeot 405, Peykan pickup, Samand, Peugeot Pars, other vehicles and motorcycles. Conclusion The high mortality rate of illiterate and low-literate in various age groups indicates that educational level plays a crucial role as a factor in road accidents, requiring related organizations such as Traffic Police and Ministry of Education to take necessary measures and policies.

Objective:The aim of study was to conduct a time-based analysis to utilize the obtained knowledge for forecasting the trend of accidents in the future.Methods:The present study, which was conducted as a cross-sectional research, investigated deaths from traffic accidents in Fars Province during a five-year period from 2013 to 2018. The pseudo-regression model of Spline was used to predict the increase in mortality rate by 2021. Results:The forecasted values indicated a decline in deaths from traffic accidents by 2021. A total of 8020 records of accidents leading to death were included in the study. The mean mortality rate from traffic accidents in the province was approximately estimated to be 33.7 per 100,000 populations. More than half of the people who died (52.36%) were in a car, 25.57% were motorcycle riders, and 19.93% were pedestrians. The highest rate of deaths was observed in the age group of 16 to 25 years old (21.5%). The data indicated a reduction in the rate of death among car riders and pedestrians and an increase in the number of deaths among motorcycle riders. The trend of deaths occurred outside the city had been increasing while the trend of deaths occurred inside the city had been decreasing. Conclusion:The present regulations are only able to reduce a small number of deaths each year. In order to achieve a downward trend in mortality with a steeper pace, it is necessary to design and implement more intelligent standards, not merely the stricter ones.

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The aim of this study was to evaluate the death proportion and death risk of COVID-19 hospitalized patients over time and in different surges of COVID-19. This multi-center observational study was conducted from March 21, 2021 to October 3, 2021 which included the alpha and delta SARS-CoV-2 surges occurred in April and August in Tehran, respectively. The risk of COVID-19 death was compared in different months of admission. A total of 270,624 patients with COVID-19, of whom 6.9% died, were admitted to hospitals in Tehran province. Compared to patients admitted in March, a higher risk of COVID-19 death was observed among patients admitted to the hospital in July (HR 1.28; 95% CI 1.17, 1.40), August (HR 1.40; 95% CI 1.28, 1.52), September (HR 1.37; 95% CI 1.25, 1.50) and October (HR 4.63; 95% CI 2.77, 7.74). The ICU death proportion was 36.8% (95% CI: 35.5, 38.1) in alpha surge and increased significantly to 39.8 (95% CI 38.6, 41.1) in delta surge. The risk of COVID-19 death was significantly higher in delta surge compared to alpha surge (HR 1.22; 95% CI 1.17, 1.27). Delta surge was associated with a higher risk of death compared to alpha surge. High number of hospitalizations, a shortage of hospital beds, ICU spaces and medical supplies, poor nutritional status of hospitalized patients, and lack of the intensivist physicians or specialized nurses in the ICU were factors that contributed to the high mortality rate in the delta surge in Iran.

Background Transgender people are at serious risk for HIV infection and other sexually transmitted infections (STIs), they are four times more likely to experience HIV infection than the general population. The aim of this study was to assess sexual behaviors and vulnerability of transgender women to STIs including HIV. Method A cross-sectional study was conducted using convenient sampling from August 2019 to March 2020 in Iran at “Support center for Iranian transgender” and “Shiraz Forensic Medicine” where transgender individuals refer to follow the steps of gender affirmation. 127 transgender women participated in this study. A researcher-made questionnaire was applied for evaluating sexual behaviors, STIs and HIV. Results The mean age of participants and their age of sexual debut were 27.6 and 16.9, respectively. 92.1% of participants were single with experience of sex and 59.3% had one sex partner in the last 2 years. 96.9% of the participants were heterosexual with 67.2% reporting experiencing orgasm in at least 50% of their sexual intercourse. However, 42.5% reported sexual pain and the same percentage reported low or very low sexual satisfaction. About half of the participants used condoms occasionally during sex (48.7%) and the most important reason for not using condoms in most cases was not having a condom (37.9%). Some of participants had little knowledge of the symptoms (33.9%) and complications (44.1%) of STIs. Although 87.4% and 72.4% of participants had never been tested for a STI and HIV, 1.6% were HIV positive and 18.1% had a history of STIs. Also, 26% of people had undergone vaginoplasty and a significant association was observed between vaginoplasty with sexual satisfaction (p < 0. 01(. Conclusion Some of transgender women in this study were involved in high-risk sexual behaviors while unaware of the signs and symptoms of STIs. Also, despite reaching orgasm in most of their sexual relationships, they had little sexual satisfaction that could probably be related to body dissatisfaction, and lack of vaginoplasty in the majority of them. The need for gender affirming surgeries and psychiatric interventions affecting body satisfaction was identified in this group.