No abstract

ObjectiveThe WHO estimates the global incidence of death by drowning to be about 300 000 cases per year. The objective of this study was to estimate the trend in mortality due to drowning in all provinces of Iran in all age groups and both genders from 1990 to 2015.Study designThe National and Subnational Burden of Diseases (NASBOD) project is a comprehensive project in Iran. It is based on the Global Burden of Disease study and includes novel methods to estimate the burden of diseases in Iran.MethodsThis study used the results of the mortality rate due to drowning as part of NASBOD and investigated the causes behind the mortality rates. The data set recorded mortality rates by 19 age groups and two genders with the corresponding subnational pattern during the time period from 1990 to 2015.ResultsThe drowning mortality rate decreased in Iran from 1990 to 2015. From 1990 to 2015, the annual percentage change for males and females was −5.28% and −10.73%, respectively. There were 56 184 male and 21 589 female fatalities during the study period. The highest number of deaths was seen in 1993 with 4459, and the lowest number of fatalities was observed in 2015 with 903 deaths.ConclusionOur data showed a decline in drowning mortality in Iran from 1990 to 2015, but the rates and declines varied by province. Our findings are of great importance to health officials and authorities in order to further reduce the burden of drowning.

Interpersonal violence (IPV) is a major public health concern with a significant impact on physical and mental health. This study was designed to evaluate age–sex-specific IPV mortality trends and the assault mechanisms (firearm, sharp objects, and other means), at national and provincial levels, in Iran. We used the Iranian Death Registration System (DRS) and the population and housing censuses in this analysis. Spatio-temporal and Gaussian Process Regression methods were used to adjust for inconsistencies at the provincial level and to integrate data from various sources. After assessing their validity, all records were reclassified according to the International Classification of Diseases, 10th Revision (ICD-10). All ICD-10 codes were then mapped to Global Burden of Disease (GBD) 2013 coding. More than 700 individuals died due to IPV in 1990 and more than twice this number in 2015. The IPV mortality age-standardized rate, per 100,000, increased from 1.62 (95% Uncertainty Interval [UI] = [0.96, 2.75]) in 1990 to 1.81 [1.15, 2.89] in 2015. Among females, the age-standardized mortality rate at national level per 100,000 due to IPV was 1.27 [0.66, 2.43] in 1990 and decreased to 1.08 [0.60, 1.96] in 2015. Among males, the age-standardized mortality rate was 1.96 [1.25, 3.09] in 1990 rising to 2.54 [1.70, 3.82] in 2015. Data from provinces revealed that during the period of our study, Hormozgan province had the largest increase of IPV among females, and Fars province had the largest increase of IPV among males. Conversely, the largest decrease was detected in West Azarbaijan and Qom provinces in females and males, respectively. This study showed a wide variation in the incidence and trends of IPV in Iran by age, sex, and location. The study has provided valuable information to reduce the burden of IPV in Iran and a means to monitor future progress through repeated analyses of the trends.

Study Design: Scoping review. Objectives: To identify a practical and reproducible approach to organize Quality of Care Indicators (QoCI) in individuals with traumatic spinal cord injury (TSCI). Methods: A comprehensive literature review was conducted in the Cochrane Central Register of Controlled Trials (CENTRAL) (Date: May 2018), MEDLINE (1946 to May 2018), and EMBASE (1974 to May 2018). Two independent reviewers screened 6092 records and included 262 full texts, among which 60 studies were included for qualitative analysis. We included studies, with no language restriction, containing at least 1 quality of care indicator for individuals with traumatic spinal cord injury. Each potential indicator was evaluated in an online, focused group discussion to define its categorization (healthcare system structure, medical process, and individuals with Traumatic Spinal Cord Injury related outcomes), definition, survey options, and scale. Results: A total of 87 indicators were identified from 60 studies screened using our eligibility criteria. We defined each indicator. Out of 87 indicators, 37 appraised the healthcare system structure, 30 evaluated medical processes, and 20 included individuals with TSCI related outcomes. The healthcare system structure included the impact of the cost of hospitalization and rehabilitation, as well as staff and patient perception of treatment. The medical processes included targeting physical activities for improvement of health-related outcomes and complications. Changes in motor score, functional independence, and readmission rates were reported as individuals with TSCI-related outcomes indicators. Conclusion: Indicators of quality of care in the management of individuals with TSCI are important for health policy strategists to standardize healthcare assessment, for clinicians to improve care, and for data collection efforts including registries.

No abstract

H syndrome is a complex multi-organ disorder with autosomal recessive inheritance. The skin manifestations include early onset hyperpigmentation and hypertrichosis, followed by skin induration often diagnosed as scleromyxedema and morphea. There

Background: We reviewed the literatures focusing on trichogram and comparing it with other newly introduced trichologic diagnostic methods (to be specific trichoscopy). Methods: This is a narrative review. We searched PubMed, Scopus, EMBASE and the Web of Science for most relevant and English publications using the terms ‘trichogram’ or ‘phototrichogram’ or ‘trichoscan’ or ‘unit area trichogram’ or ‘trichoscopy’.The results were then screened by two independent reviewers and discrepancies was reviewed by another author. The text and data related to these terms were then selected out of each included study and discussed with all authors for inclusion in this study. Results: There are many hair disorders with diagnostic clues of trichogram such as Alopecia areata, Androgenic alopecia, Anagen effluvium, Telogen effluvium, Trichotillomania, Pemghigus, Psoriasis, and Loose anagen syndrome. Trichoscopy have become a widely used non-invasive practical diagnostic tool for evaluation of many immune-mediated or non-immune mediated dermatologic disorders with involvement of hair. Trichoscopy is also commonly used for following up and evaluating the therapeutic responses in affected hair-bearing area. Conclusion: Trichogram is a valuable diagnostic method for complicated hair disorders butthe trend is toward less aggressive and more sensitive informative methods like trichoscopy and trichoscan. Key words: Trichogram, Trichoscopy, Phototrichogram, Trichoscan, Unit Area Trichogram, Dermatoscopy, Dermoscopy, Hair, Alopecia, Scalp, Diagnoses

Study Design Systematic Reviews. Objectives To investigate predictors of surgical outcomes for mild Degenerative Cervical Myelopathy (DCM) by reviewing all related studies conducted at this point. Methods An electronic search was carried out in PubMed, EMBASE, Scopus, and Web of Science until June 23, 2021. Full-text articles reporting surgical outcome predictors of mild DCM cases were eligible. We included studies with mild DCM which was defined as a modified Japanese Orthopaedic Association score of 15 to 17 or a Japanese Orthopaedic Association score of 13 to 16. Independent reviewers screened all the records, and discrepancies between the reviewers were solved in a session with the senior author. For risk of bias assessment, RoB 2 tool was used for randomized clinical trials and ROBINS-I for non-randomized studies. Results After screening 6 087 manuscripts, only 8 studies met the inclusion criteria. Lower pre-operative mJOA scores and quality-of-life measurement scores were reported by multiple studies to predict better surgical outcomes compared to other groups. High-intensity pre-operative T2 magnetic resonance imaging (MRI) was also reported to predict poor outcomes. Neck pain before intervention resulted in improved patient-reported outcomes. Two studies also reported motor symptoms prior to surgery as outcome predictors. Conclusion Lower quality of life before surgery, neck pain, lower pre-operative mJOA scores, motor symptoms before surgery, female gender, gastrointestinal comorbidities, surgical procedure and surgeon’s experience with specific techniques, and high signal intensity of cord in T2 MRI were the surgical outcome predictors reported in the literature. Lower Quality of Life (QoL) score and neck prior to surgery were reported as predictors of the more improved outcome, but high cord signal intensity in T2 MRI was reported as an unfavorable outcome predictor.