Objective:To evaluate the effect of Heracleum persicum L. against gentamicin-induced nephrotoxicity in rats. Methods:Thirty-six Wistar rats were divided into 6 groups including control (normal saline), gentamicin (80 mg/kg/d for 10 d), Heracleum persicum (750 mg/kg/d), and gentamicin (10 d) + Heracleum persicum extract at three different doses (250, 500, and 750 mg/kg/d for 40 d). Urine creatinine, urea, protein, and albumin levels were determined. In addition, serum urea, creatinine, sodium, potassium, cytokines (TNF-α, IL-1β, IL-6, and IL-10), glutathione peroxidase activity, total antioxidant capacity, kidney malondialdehyde, stereological parameters, and expressions of apoptosis-related genes (p53, Bax, Bcl-2, and caspase-3) were measured. The LD50 of Heracleum persicum extract was determined based on Lorke's method. Histopathological evaluation was also performed. Results:In addition to decreased urine protein and albumin, and increased creatinine and urea, co-treatment with gentamicin and Heracleum persicum significantly reduced levels of creatinine and urea, and increased sodium and potassium in serum. Heracleum persicum treatment also improved stereological parameters and serum inflammatory cytokines. There was a significant increase in serum glutathione peroxidase activity and total antioxidant capacity as well as a reduction in malondialdehyde level. Furthermore, treatment with Heracleum persicum extracts downregulated p53, caspase-3, and Bax and upregulated Bcl-2 expressions. In histopathological evaluation, Heracleum persicum extracts showed protection against gentamicin-induced renal damages. Conclusions:Heracleum persicum exhibits protective effects against gentamicin-induced structural and functional renal impairments.

OBJECTIVETo analyze the data of patients with spinal cord injury (SCI) induced by road traffic crashes in southeastern Iran for better understanding the pattern of these injuries and therefore for better designing health system planning.

METHODSIn this historical cohort study, the patients who had been transferred to Level I trauma center in southeastern Iran due to road traffic accidents with radiographic documented SCI were evaluated.

RESULTSAmong 64 patients with SCI, 38 patients (59.4%, 36 males and 2 females, aged 27.42 years+/-9.44 years on average) were injured by road traffic accidents. Car and motorcycle accidents were responsible for 26 cases (68.4%) and 12 cases (31.6%), respectively. And 31 patients (81.6%) had complete SCI. Conus medularis (T12-L2) was the most affected level.

CONCLUSIONSResults are discussed in terms of preventive measures, specifically those concerning the use of restraint and helmet and driving behavior. This study should be extended nationally to gain a larger case series so that the SCI risk of particular vehicle configurations, considering other crash factors, can be more precisely quantified and the characteristics for low occurrence of SCI can be more precisely identified.

Accidents, Traffic ; statistics & numerical data ; Adolescent ; Adult ; Equipment Design ; Head Protective Devices ; Humans ; Iran ; epidemiology ; Middle Aged ; Seat Belts ; Spinal Cord Injuries ; epidemiology ; prevention & control ; surgery

OBJECTIVETo compare fatalities and injuries in road traffic crashes (RTC) in Iran with other countries.

METHODSData were obtained from national health sources of Iran. These data included population number, registered motor-vehicles number, number of RTCs and consequent fatalities and injuries from 1997 to 2006.

RESULTSRTC fatality and injury rates increased from 1997 to 2005, but decreased in 2006. The overall men/women ratio in the RTC fatalities was 4.2:1. High RTC fatality rate of 39 per 100 000 population in Iran was almost the same as some other developing countries. In Iran, RTC fatalities in recent years were almost twice as much as the highest rate among the European countries.

CONCLUSIONSThis investigation shows that in spite of reduction of RTC fatality in Iran in 2006, it is still one of the highest in the world. Moreover, this paper describes the state of RTC-related parameters in a developing country in comparison with the developed countries.

Accidents, Traffic ; statistics & numerical data ; Developed Countries ; Developing Countries ; Female ; Humans ; Iran ; epidemiology ; Male ; Wounds and Injuries ; epidemiology ; mortality

Purpose::Upper extremity injuries (UEIs) and lower extremity injuries (LEIs) constitute a considerable component of traumas. However, their epidemiologic differences and short-term in-hospital outcomes are not fully elucidated. This study aims to compare such discrepancies in a large-scale study.Methods::In this retrospective study, all patients with UEIs and/or LEIs hospitalized from 24th July 2016 to 16th May 2020 in Sina Hospital, Tehran, Iran, and registered at the National Trauma Registry of Iran were enrolled in the study. Relevant demographic and clinical characteristics were extracted from the National Trauma Registry of Iran database. Patients were grouped into either UEI or LEI. For those with concomitant UEIs and LEIs, the more severe one based on the abbreviated injury scale was defined as the principal diagnosis. In addition, cases with the abbreviated injury scale > 3 for both UEI and LEI or concomitant injuries to body areas other than the limbs were excluded. Independent samples t-test, Mann-Whitney U test, Chi-square test, quintile regression models, and logistic regression models with "margins" command were used for statistical analyses, as indicated. Results::In this research, 3170 eligible cases were identified. For the LEI group, there was a much higher proportion of male patients (86.7% vs. 82.0%) and higher mean age (years, 42.9 vs. 35.3) compared to the UEI group (both p < 0.001). Patients with an injury severity score (ISS) of 9 -15 were outnumbered in the LEI group (22.9% vs. 1.6%, p < 0.001), while the proportion of those with an ISS < 9 was higher in the UEI group (98.1% vs. 76.8%, p < 0.001). The multiple logistic regression model showed a statistically significant association between intensive care unit (ICU) admission and ISS (odds ratio ( OR)=4.01 for ISS 9 -15 vs. ISS < 9, 95% confidence interval ( CI)): 3.01 -5.35; OR =17.65 for ISS ≥ 16 vs. ISS < 9, 95% CI: 4.03 -77.27), age ( OR =1.02, 95% CI: 1.01 -1.03), cause of injury ( OR =0.27 for blunt trauma vs. road traffic crash, 95% CI: 0.08 -0.90; OR =0.49 for cut/stab injuries vs. road traffic crash, 95% CI: 0.28 -0.84) and body region ( OR=1.65 for lower extremity, 95% CI: 1.19 -2.29). Having adjusted for other covariates, the odds of ICU admission in patients with LEIs was 1.65 times the odds in patients with UEIs. Conclusions::Patients with LEIs were older and suffered from more severe injuries. In addition, the age-and ISS-adjusted ICU admission and length of hospital stay were significantly higher in LEI patients. The chance of ICU admission was associated with age, cause of injury, ISS, and body region. The findings of this study can aid in the meticulous selection of ICU-candidate patients. In addition, the role of factors other than ISS and age in ICU admission and prolongation of hospitalization should be addressed by prospective studies.

Purpose::The purpose of the National Spinal Cord Injury Registry of Iran (NSCIR-IR) is to create an infrastructure to assess the quality of care for spine trauma and in this study, we aim to investigate whether the NSCIR-IR successfully provides necessary post-discharge follow-up data for these patients.Methods::An observational prospective study was conducted from April 11, 2021 to April 22, 2022 in 8 centers enrolled in NSCIR-IR, respectively Arak, Rasht, Urmia, Shahroud, Yazd, Kashan, Tabriz, and Tehran. Patients were classified into 3 groups based on their need for care resources, respectively: (1) non-spinal cord injury (SCI) patients without surgery (group 1), (2) non-SCI patients with surgery (group 2), and (3) SCI patients (group 3). The assessment tool was a self-designed questionnaire to evaluate the care quality in 3 phases: pre-hospital, in-hospital, and post-hospital. The data from the first 2 phases were collected through the registry. The post-hospital data were collected by conducting follow-up assessments. Telephone follow-ups were conducted for groups 1 and 2 (non-SCI patients), while group 3 (SCI patients) had a face-to-face visit. This study took place during the COVID-19 pandemic. Data on age and time interval from injury to follow-up were expressed as mean ± standard deviation (SD) and response rate and follow-up loss as a percentage.Results::Altogether 1538 telephone follow-up records related to 1292 patients were registered in the NSCIR-IR. Of the total calls, 918 (71.05%) were related to successful follow-ups, but 38 cases died and thus were excluded from data analysis. In the end, post-hospital data from 880 patients alive were gathered. The success rate of follow-ups by telephone for groups 1 and 2 was 73.38% and 67.05% respectively, compared to 66.67% by face-to-face visits for group 3, which was very hard during the COVID-19 pandemic. The data completion rate after discharge ranged from 48% - 100%, 22% - 100% and 29% - 100% for groups 1 - 3.Conclusions::To improve patient accessibility, NSCIR-IR should take measures during data gathering to increase the accuracy of registered contact information. Regarding the loss to follow-ups of SCI patients, NSCIR-IR should find strategies for remote assessment or motivate them to participate in follow-ups through, for example, providing transportation facilities or financial support.

Objective: To analyze and review the overall seroprevalence rate of Toxoplasma gondii (. T. gondii) infection in cattle from Iran. Methods: In the current study, data collection (published and unpublished papers, abstracts of national scientific congresses and dissertations) using particular terms was carried out systematically on the following electronic databases like PubMed, Google Scholar, Ebsco, Science Direct, Scopus, Magiran, Irandoc, IranMedex and SID (Scientific Information Database). Results: A total of 22 studies since 1983 to 2012 reporting the seroprevalence of toxoplasmosis in cattle from different regions of Iran met our eligibility criteria. The pooled proportion of toxoplasmosis, using random effect model, among cattle in Iran from over the 30-year period was estimated 18.1% (95% CI: 9.9% to 28.2%). Conclusions: This study firstly establishes a crude seroprevalence rate of Toxoplasma infection in cattle which can lead us to understand the condition of cattle toxoplasmosis, which have to take into accounted for an appropriate and effective prevention and controls. Secondly, it compares and discusses elaborately the role of risk factors including sex, age and breed in the epidemiology of the disease. Thus, it determines gaps and drawbacks in the prior studies which are greatly useful to design more accurate investigations in the future.

PURPOSETo accurately assess the mechanism, type and severity of injury in Iranian multiple trauma patients of a trauma center.

METHODSPatients with multiple traumas referring to the emergency department of Hasheminejad University Hospital in Mashhad, Iran, entered this cross sectional study from March 2013 to December 2013. All the patients with injury severity score (ISS) > 9 were included in this study. Data analysis was performed by SPSS software (Version 11.5) and P values less than 0.05 were considered as significant differences.

RESULTSAmong the 6306 hospitalized trauma patients during this period, 148 had ISS>9. The male female ratio was 80%. The mean age of the patients was (33.5 ± 19.3) years. And 71% of the patients were younger than 44 years old. There were 19 (13%) deaths from which 68.5% were older than 44 years old. The mean transfer time from the injury scene to hospital was (55 ± 26) minutes. The most frequent mechanisms of injury were motorcycle crashes and falling from height, which together included 66.2% of all the injuries. A total of 84% of hospital deaths occurred after the first 24 h of hospitalization. Head and neck were the most common body injured areas with a prevalence of 111 cases (75%).

CONCLUSIONMotorcycle crashes have high frequency in Iran. Since most victims are young males, injury prevention strategies should be considered to reduce the burden of injuries.

Accidents, Traffic ; statistics & numerical data ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Cross-Sectional Studies ; Female ; Hospital Mortality ; Humans ; Infant ; Injury Severity Score ; Male ; Middle Aged ; Multiple Trauma ; epidemiology ; mortality ; Trauma Centers ; Young Adult

The National Spinal Cord Injury Registry of Iran (NSCIR-IR) is a not-for-profit, hospital-based, and prospective observational registry that appraises the quality of care, long-term outcomes and the personal and psychological burden of traumatic spinal cord injury in Iran. Benchmarking validity in every registry includes rigorous attention to data quality. Data quality assurance is essential for any registry to make sure that correct patients are being enrolled and that the data being collected are valid. We reviewed strengths and weaknesses of the NSCIR-IR while considering the methodological guidelines and recommendations for efficient and rational governance of patient registries. In summary, the steering committee, funded and maintained by the Ministry of Health and Medical Education of Iran, the international collaborations, continued staff training, suitable data quality, and the ethical approval are considered to be the strengths of the registry, while limited human and financial resources, poor interoperability with other health systems, and time-consuming processes are among its main weaknesses.