OBJECTIVES: Rates of attempted deliberate self-poisoning (DSP) are subject to undercounting, underreporting, and denial of the suicide attempt. In this study, we estimated the rate of underreported DSP, which is the most common method of attempted suicide in Iran. METHODS: We estimated the rate and number of unaccounted individuals who attempted DSP in western Iran in 2015 using a truncated count model. In this method, the number of people who attempted DSP but were not referred to any health care centers, n0, was calculated through integrating hospital and forensic data. The crude and age-adjusted rates of attempted DSP were estimated directly using the average population size of the city of Kermanshah and the World Health Organization (WHO) world standard population with and without accounting for underreporting. The Monte Carlo method was used to determine the confidence level. RESULTS: The recorded number of people who attempted DSP was estimated by different methods to be in the range of 46.6 to 53.2% of the actual number of individuals who attempted DSP. The rate of underreported cases was higher among women than men and decreased as age increased. The rate of underreported cases decreased as the potency and intensity of toxic factors increased. The highest underreporting rates of 69.9, 51.2, and 21.5% were observed when oil and detergents (International Classification of Diseases, 10th revision [ICD-10] code: X66), medications (ICD-10 code: X60-X64), and agricultural toxins (ICD-10 codes: X68, X69) were used for poisoning, respectively. Crude rates, with and without accounting for underreporting, were estimated by the mixture method as 167.5 per 100,000 persons and 331.7 per 100,000 persons, respectively, which decreased to 129.8 per 100,000 persons and 253.1 per 100,000 persons after adjusting for age on the basis of the WHO world standard population. CONCLUSIONS: Nearly half of individuals who attempted DSP were not referred to a hospital for treatment or denied the suicide attempt for political or sociocultural reasons. Individuals with no access to counseling services are at a higher risk for repeated suicide attempts and fatal suicides.
Classification ; Counseling ; Delivery of Health Care ; Denial (Psychology) ; Detergents ; Female ; Humans ; Iran* ; Male ; Methods ; Monte Carlo Method ; Poisoning ; Population Density ; Suicide ; Suicide, Attempted ; World Health Organization

OBJECTIVES: Rates of attempted deliberate self-poisoning (DSP) are subject to undercounting, underreporting, and denial of the suicide attempt. In this study, we estimated the rate of underreported DSP, which is the most common method of attempted suicide in Iran.METHODS: We estimated the rate and number of unaccounted individuals who attempted DSP in western Iran in 2015 using a truncated count model. In this method, the number of people who attempted DSP but were not referred to any health care centers, n0, was calculated through integrating hospital and forensic data. The crude and age-adjusted rates of attempted DSP were estimated directly using the average population size of the city of Kermanshah and the World Health Organization (WHO) world standard population with and without accounting for underreporting. The Monte Carlo method was used to determine the confidence level.RESULTS: The recorded number of people who attempted DSP was estimated by different methods to be in the range of 46.6 to 53.2% of the actual number of individuals who attempted DSP. The rate of underreported cases was higher among women than men and decreased as age increased. The rate of underreported cases decreased as the potency and intensity of toxic factors increased. The highest underreporting rates of 69.9, 51.2, and 21.5% were observed when oil and detergents (International Classification of Diseases, 10th revision [ICD-10] code: X66), medications (ICD-10 code: X60-X64), and agricultural toxins (ICD-10 codes: X68, X69) were used for poisoning, respectively. Crude rates, with and without accounting for underreporting, were estimated by the mixture method as 167.5 per 100,000 persons and 331.7 per 100,000 persons, respectively, which decreased to 129.8 per 100,000 persons and 253.1 per 100,000 persons after adjusting for age on the basis of the WHO world standard population.CONCLUSIONS: Nearly half of individuals who attempted DSP were not referred to a hospital for treatment or denied the suicide attempt for political or sociocultural reasons. Individuals with no access to counseling services are at a higher risk for repeated suicide attempts and fatal suicides.
Classification ; Counseling ; Delivery of Health Care ; Denial (Psychology) ; Detergents ; Female ; Humans ; Iran ; Male ; Methods ; Monte Carlo Method ; Poisoning ; Population Density ; Suicide ; Suicide, Attempted ; World Health Organization

Background: One of the important actions for enhancing human reliability in any industry is assessing human error probability (HEP). The HEART technique is a robust tool for calculating HEP in various industries. The traditional HEART has some weaknesses due to expert judgment. For these reasons, a hybrid model is presented in this study to integrate HEART with Best-Worst Method.Materials MethodIn this study, the blasting process in an iron ore mine was investigated as a case study. The proposed HEART-BWM was used to increase the sensitivity of APOA calculation. Then the HEP was calculated using conventional HEART formula. A consistency ratio was calculated using BWM. Finally, for verification of the HEART-BWM, HEP calculation was done by traditional HEART and HEART-BWM. Results: In the view of determined HEPs, the results showed that the mean of HEP in the blasting of the iron ore process was 2.57E-01. Checking the full blast of all the holes after the blasting sub-task was the most dangerous task due to the highest HEP value, and it was found 9.646E-01. On the other side, obtaining a permit to receive and transport materials was the most reliable task, and the HEP was 8.54E-04. Conclusion The results showed a good consistency for the proposed technique. Comparing the two techniques confirmed that the BWM makes the traditional HEART faster and more reliable by performing the basic comparisons.

Background: The interest in ultrasonography (US) and magnetic resonance imaging (MRI) assessment of the patients with carpal tunnel syndrome (CTS) is growing. This paper aimed to find the correlation of postoperative changes in these modalities’ parameters with clinical outcomes. Methods: Boston CTS questionnaire-symptom severity (BQ-SS), Boston CTS questionnaire-functional status (BQ-FS), and visual analog scale (VAS) questionnaires (for pain, paresthesia, and grip weakness assessment) were used to evaluate clinical outcomes. Various imaging parameters of the median nerve and carpal tunnel were evaluated using US and MRI at two levels of the hook of the hamate (distal) and the pisiform (proximal) once preoperatively and then 3 months postoperatively. Corresponding US and MRI parameter measures were compared, and correlational analysis was performed between alteration of imaging findings and changes in clinical parameters postoperatively. Results: Patients’ functional status (BQ-FS score) was positively correlated with the nerve width both in US and MRI at the proximal level (r = 0.457 and r = 0.453, respectively) and also with the MRI nerve circumference at the distal level (r = –0.482). Correlation between paresthesia and the nerve width was notable in MRI at the distal hook of the hamate level (r = –0.403). Grip weakness VAS score was correlated with the nerve width-to-height ratio (WHR) in US at the distal level (r = 0.432). Conclusions Changes in US and MRI parameters of the median nerve width, circumference, and WHR were associated with clinical changes in patients with CTS after surgery.

Background: Sleep has confirmed physical, psychological, and behavioral benefits, and disruptions can result in disturbances in these states. Moreover, it can be linked bidirectionally with susceptibility to and the subsequent status of brain tumors. The current study examined mood disorders and sleep quality before and after surgery for hemangioblastoma brain tumors. Methods: Thirty-two patients diagnosed with hemangioblastoma brain tumors between 2017and 2023 underwent surgical treatment. The Karnofsky Performance Status and ECOG performance status scales, the Brunel Mood Scale, the Morningness-Eveningness Questionnaire, and the MiniSleep Questionnaire were employed to assess the patients. Results: The findings indicate that after surgery, sleep quality and mood disorders, including tension, vigor, and depression, did not exhibit significant differences in these patients (p>0.05). However, tension, vigor, depression, and sleep quality did have a significant impact on their functional status post-surgery (p<0.05). Conclusion Depression is the significant mood factor in patients with brain tumors that impact their functional status. In this context, it is recommended that psychological therapies be considered for them, alongside conducting more comprehensive and in-depth studies on psychological disorders in patients with brain tumors.

The gold standard method for diagnosis of tuberculosis is the isolation of Mycobacterium tuberculosis through culture, but there is a probability of cross-contamination in simultaneous cultures of samples causing false-positives. This can result in delayed treatment of the underlying disease and drug side effects. In this paper, we reviewed studies on falsepositive cultures of M. tuberculosis . Rate of occurrence, effective factors, and extent of false-positives were analyzed. Ways to identify and reduce the false-positives and management of them are critical for all laboratories. In most cases, falsepositive is occurring in cases with only one positive culture but negative direct smear. The three most crucial factors in this regard are inappropriate technician function, contamination of reagents, and aerosol production. Thus, to reduce false-positives, good laboratory practice, as well as use of whole-genome sequencing or genotyping of all positive culture samples with a robust, extra pure method and rapid response, are essential for minimizing the rate of false-positives. Indeed, molecular approaches and epidemiological surveillance can provide a valuable tool besides culture to identify possible false positives.

Objectives: This study investigated preventive behaviors toward coronavirus disease 2019 (COVID-19) and related factors in a Kurdish Iranian sample. Methods: This online survey was conducted among the population aged 18 and above in Kermanshah Province, in western Iran, in April 2020. Samples were invited and recruited through social media. Data were collected using a questionnaire consisting of 4 sections (questions on demographic variables, risk perception, risk communication, and COVID-19 preventive behaviors) and analyzed using Stata ver. 8. Results: The Pearson correlation test showed that risk communication was significantly correlated with COVID-19 preventive behaviors (r = 0.320, p < 0.01). In the final model, where the explanatory power increased with the entry of the risk communication variable, the variables explained a total of 14% of variance in COVID-19 preventive behaviors. Sex (β = −0.482), risk perception (β = 0.047), and risk communication (β = 0.662) were significant determinants. Conclusion Risk communication and risk perception related to COVID-19, as well as being a woman, were determinants of COVID-19 preventive behaviors.

Objective To update current situation of the cutaneous leishmaniasis (CL) in Kazerun County, southwest of Iran and to analyse the epidemiological aspects of the disease during 2005–2015. Methods Data on CL were obtained from the Health Center of Kazerun County, and then were analysed and mapped using SPSS and Arc GIS 10.3. Results A total of 700 cases of CL were recorded during the study period with an overall decreasing trend from 2005 to 2015. More than 60% of the patients were inhabitants of rural areas and males were infected more than females. Although there was not a significant difference between gender, job categories, residence and CL infection (P > 0.05), age groups were significantly different (P < 0.05). But there was no significant correlation between monthly cases of the disease with average temperature (P > 0.05). Most of the acute lesions were found to be present on the hand, leg and face, respectively. The average CL incidence in the study area was calculated as 24.9/100 000 population. A hot spot for the disease was found in southern part of the area (P < 0.05). Conclusions This study revealed that CL is present in Kazerun country. Thus, effective monitoring and sustained surveillance system is crucial in counteracting the disease, and if possible, to eliminate it.