1.Excess Deaths During the COVID-19 Pandemic in Southern Iran: Estimating the Absolute Count and Relative Risk Using Ecological Data
Mohammadreza ZAKERI ; Alireza MIRAHMADIZADEH ; Habibollah AZARBAKHSH ; Seyed Sina DEHGHANI ; Maryam JANFADA ; Mohammad Javad MORADIAN ; Leila MOFTAKHAR ; Mehdi SHARAFI ; Alireza HEIRAN
Journal of Preventive Medicine and Public Health 2024;57(2):120-127
Objectives:
The coronavirus disease 2019 (COVID-19) pandemic led to increased mortality rates. To assess this impact, this ecological study aimed to estimate the excess death counts in southern Iran.
Methods:
The study obtained weekly death counts by linking the National Death Registry and Medical Care Monitoring Center repositories. The P-score was initially estimated using a simple method that involved calculating the difference between the observed and expected death counts. The interrupted time series analysis was then used to calculate the mean relative risk (RR) of death during the first year of the pandemic.
Results:
Our study found that there were 5571 excess deaths from all causes (P-score=33.29%) during the first year of the COVID-19 pandemic, with 48.03% of these deaths directly related to COVID-19. The pandemic was found to increase the risk of death from all causes (RR, 1.26; 95% confidence interval [CI], 1.19 to 1.33), as well as in specific age groups such as those aged 35-49 (RR, 1.21; 95% CI, 1.12 to 1.32), 50-64 (RR, 1.38; 95% CI, 1.28 to 1.49), and ≥65 (RR, 1.29; 95% CI, 1.12 to 1.32) years old. Furthermore, there was an increased risk of death from cardiovascular diseases (RR, 1.17; 95% CI, 1.11 to 1.22).
Conclusions
There was a 26% increase in the death count in southern Iran during the COVID-19 pandemic. More than half of these excess deaths were not directly related to COVID-19, but rather other causes, with cardiovascular diseases being a major contributor.
2.Half-Saline Versus Normal-Saline as Irrigation Solutions in Burr Hole Craniostomy to Treat Chronic Subdural Hematomata: A Randomized Clinical Trial
Mehdi MAHMOODKHANI ; Mohammad SHARAFI ; Arman SOURANI ; Donya Sheibani TEHRANI
Korean Journal of Neurotrauma 2022;18(2):221-229
Objective:
This study aimed to evaluate the efficacy and safety of half-saline (HS) serum as an irrigation solution in chronic subdural hematoma (CSDH) surgery using the burr hole craniostomy (BHC) technique.
Methods:
This randomized clinical trial was conducted in university hospital referral centers from 2020 to 2021. Sixty-three patients with CSDH eligible for BHC were primarily enrolled. Two patients were excluded because of concurrent stroke. Sixty-one patients were randomly allocated into case (HS=30) and control (normal-saline [NS]=31) groups. HS was used to irrigate the hematoma in the case group and NS was used in the control group. The patients were followed-up. Clinical variables including demographic and medical findings, postoperative computed tomography findings, postoperative complications, hospitalization period, recurrence rate, and functional status measured by the Barthel type B index were recorded.
Results:
Forty-six of 61 patients were male (75.4%), and the patients’ mean age was 65.4±16.9 years, with equal distribution between the 2 groups. Postoperative effusion and postoperative hospital stay duration were significantly lower in the HS group than in the NS group (p=0.002 and 0.033, respectively). The postoperative recurrence within 3 months in both groups was approximately equal (6.6%). In terms of functional outcomes and postoperative complications, HS showed similar results to those of NS.
Conclusion
HS as an irrigation fluid in BHC effectively reduced postoperative effusion and hospital stay duration without considerable complications.
3.Socioeconomic Inequalities in the Oral Health of People Aged 15-40 Years in Kurdistan, Iran in 2015: A Cross-sectional Study.
Ghobad MORADI ; Ardavan MOINAFSHAR ; Hemen ADABI ; Mona SHARAFI ; Farideh MOSTAFAVI ; Amjad Mohamadi BOLBANABAD
Journal of Preventive Medicine and Public Health 2017;50(5):303-310
OBJECTIVES: The aim of this study was to evaluate socioeconomic inequalities in the prevalence of dental caries among an urban population. METHODS: This study was conducted among 2000 people 15-40 years of age living in Kurdistan, Iran in 2015. Using a questionnaire, data were collected by 4 trained dental students. The dependent variable was the decayed, missing, and filled teeth (DMF) index. Using principal component analysis, the socioeconomic status (SES) of families was determined based on their household assets. Inequality was measured using the concentration index; in addition, the Oaxaca analytical method was used to determine the contribution of various determinants to the observed inequality. RESULTS: The concentration index for poor scores on the DMF index was -0.32 (95% confidence interval [CI], -0.40 to -0.36); thus, poor DMF indices had a greater concentration in groups with a low SES (p<0.001). Decomposition analysis showed that the mean prevalence of a poor DMF index was 43.7% (95% CI, 40.4 to 46.9%) in the least privileged group and 14.4% (95% CI, 9.5 to 9.2%) in the most privileged group. It was found that 85.8% of the gap observed between these groups was due to differences in sex, parents' education, and the district of residence. A poor DMF index was less prevalent among people with higher SES than among those with lower SES (odds ratio, 0.31; 95% CI, 0.19 to 0.52). CONCLUSIONS: An alarming degree of SES inequality in oral health status was found in the studied community. Hence, it is suggested that inequalities in oral health status be reduced via adopting appropriate policies such as the delivery of oral health services to poorer groups and covering such services in insurance programs.
Cross-Sectional Studies*
;
Dental Caries
;
DMF Index
;
Education
;
Family Characteristics
;
Health Equity
;
Humans
;
Insurance
;
Iran*
;
Methods
;
Oral Health*
;
Prevalence
;
Principal Component Analysis
;
Social Class
;
Socioeconomic Factors*
;
Students, Dental
;
Urban Population
4.Prevalence of latent tuberculosis infection among tuberculosis laboratory workers in Iran.
Mahshid NASEHI ; Abdolrazagh HASHEMI-SHAHRAKI ; Amin DOOSTI-IRANI ; Saeed SHARAFI ; Ehsan MOSTAFAVI
Epidemiology and Health 2017;39(1):e2017002-
OBJECTIVES: The risk of transmission of Mycobacterium tuberculosis from patients to health care workers (HCWs) is a neglected problem in many countries, including Iran. The aim of this study was to estimate the prevalence of latent tuberculosis (TB) infection (LTBI) among TB laboratory staff in Iran, and to elucidate the risk factors associated with LTBI. METHODS: All TB laboratory staff (689 individuals) employed in the TB laboratories of 50 Iranian universities of medical sciences and a random sample consisting of 317 low-risk HCWs were included in this cross-sectional study. Participants with tuberculin skin test indurations of 10 mm or more were considered to have an LTBI. RESULTS: The prevalence of LTBI among TB laboratory staff and low-risk HCWs was 24.83% (95% confidence interval [CI], 21.31 to 27.74%) and 14.82% (95% CI, 11.31 to 19.20%), respectively. No active TB cases were found in either group. After adjusting for potential confounders, TB laboratory staff were more likely to have an LTBI than low-risk HCWs (prevalence odds ratio, 2.06; 95% CI, 1.35 to 3.17). CONCLUSIONS: This study showed that LTBI are an occupational health problem among TB laboratory staff in Iran. This study reinforces the need to design and implement simple, effective, and affordable TB infection control programs in TB laboratories in Iran.
Cross-Sectional Studies
;
Delivery of Health Care
;
Health Personnel
;
Humans
;
Infection Control
;
Iran*
;
Latent Tuberculosis*
;
Mycobacterium tuberculosis
;
Occupational Health
;
Odds Ratio
;
Prevalence*
;
Risk Factors
;
Skin Tests
;
Tuberculin
;
Tuberculin Test
;
Tuberculosis*
5.Prevalence of latent tuberculosis infection among tuberculosis laboratory workers in Iran
Mahshid NASEHI ; Abdolrazagh HASHEMI-SHAHRAKI ; Amin DOOSTI-IRANI ; Saeed SHARAFI ; Ehsan MOSTAFAVI
Epidemiology and Health 2017;39(1):2017002-
OBJECTIVES: The risk of transmission of Mycobacterium tuberculosis from patients to health care workers (HCWs) is a neglected problem in many countries, including Iran. The aim of this study was to estimate the prevalence of latent tuberculosis (TB) infection (LTBI) among TB laboratory staff in Iran, and to elucidate the risk factors associated with LTBI.METHODS: All TB laboratory staff (689 individuals) employed in the TB laboratories of 50 Iranian universities of medical sciences and a random sample consisting of 317 low-risk HCWs were included in this cross-sectional study. Participants with tuberculin skin test indurations of 10 mm or more were considered to have an LTBI.RESULTS: The prevalence of LTBI among TB laboratory staff and low-risk HCWs was 24.83% (95% confidence interval [CI], 21.31 to 27.74%) and 14.82% (95% CI, 11.31 to 19.20%), respectively. No active TB cases were found in either group. After adjusting for potential confounders, TB laboratory staff were more likely to have an LTBI than low-risk HCWs (prevalence odds ratio, 2.06; 95% CI, 1.35 to 3.17).CONCLUSIONS: This study showed that LTBI are an occupational health problem among TB laboratory staff in Iran. This study reinforces the need to design and implement simple, effective, and affordable TB infection control programs in TB laboratories in Iran.
Cross-Sectional Studies
;
Delivery of Health Care
;
Health Personnel
;
Humans
;
Infection Control
;
Iran
;
Latent Tuberculosis
;
Mycobacterium tuberculosis
;
Occupational Health
;
Odds Ratio
;
Prevalence
;
Risk Factors
;
Skin Tests
;
Tuberculin
;
Tuberculin Test
;
Tuberculosis
6. Forecasting the number of zoonotic cutaneous leishmaniasis cases in south of Fars province, Iran using seasonal ARIMA time series method
Mehdi SHARAFI ; Haleh GHAEM ; Hamid Reza TABATABAEE ; Hossein FARAMARZI
Asian Pacific Journal of Tropical Medicine 2017;10(1):79-86
Objective To predict the trend of cutaneous leishmaniasis and assess the relationship between the disease trend and weather variables in south of Fars province using Seasonal Autoregressive Integrated Moving Average (SARIMA) model. Methods The trend of cutaneous leishmaniasis was predicted using Mini tab software and SARIMA model. Besides, information about the disease and weather conditions was collected monthly based on time series design during January 2010 to March 2016. Moreover, various SARIMA models were assessed and the best one was selected. Then, the model's fitness was evaluated based on normality of the residuals’ distribution, correspondence between the fitted and real amounts, and calculation of Akaike Information Criteria (AIC) and Bayesian Information Criteria (BIC). Results The study results indicated that SARIMA model (4,1,4)(0,1,0)
7.Comparison of the tuberculin skin test and the QuantiFERON-TB Gold test in detecting latent tuberculosis in health care workers in Iran.
Ehsan MOSTAFAVI ; Mahshid NASEHI ; Abdolrazagh HASHEMI SHAHRAKI ; Saber ESMAEILI ; Ebrahim GHADERI ; Saeed SHARAFI ; Amin DOOSTI-IRANI
Epidemiology and Health 2016;38(1):e2016032-
OBJECTIVES: The tuberculin skin test (TST) and the QuantiFERON-TB Gold test (QFT) are used to identify latent tuberculosis infections (LTBIs). The aim of this study was to determine the agreement between these two tests among health care workers in Iran. METHODS: This cross-sectional study included 177 tuberculosis (TB) laboratory staff and 67 non-TB staff. TST indurations of 10 mm or more were considered positive. The Student's t-test and the chi-square test were used to compare the mean score and proportion of variables between the TB laboratory staff and the non-TB laboratory staff. Kappa statistics were used to evaluate the agreement between these tests, and logistic regression was used to assess the risk factors associated with positive results for each test. RESULTS: The prevalence of LTBIs according to both the QFT and the TST was 17% (95% confidence interval [CI], 12% to 21%) and 16% (95% CI, 11% to 21%), respectively. The agreement between the QFT and the TST was 77.46%, with a kappa of 0.19 (95% CI, 0.04 to 0.34). CONCLUSIONS: Although the prevalence of LTBI based on the QFT and the TST was not significantly different, the kappa statistic was low between these two tests for the detection of LTBIs.
Cross-Sectional Studies
;
Delivery of Health Care*
;
Iran*
;
Latent Tuberculosis*
;
Logistic Models
;
Prevalence
;
Risk Factors
;
Skin Tests*
;
Skin*
;
Tuberculin*
;
Tuberculosis
8.Phytochemistry, pharmacology, and therapeutic uses of black seed (Nigella sativa).
Wesam KOOTI ; Zahra HASANZADEH-NOOHI ; Naim SHARAFI-AHVAZI ; Majid ASADI-SAMANI ; Damoon ASHTARY-LARKY
Chinese Journal of Natural Medicines (English Ed.) 2016;14(10):732-745
Black seed (Nigella sativa) is an annual flowering plant from Ranunculaceae family, native to southwest Asia. This plant has many food and medicinal uses. The use of its seeds and oil is common for treatment of many diseases, including rheumatoid arthritis, asthma, inflammatory diseases, diabetes and digestive diseases. The purpose of this study was to provide a comprehensive review on the scientific reports that have been published about N. sativa. The facts and statistics presented in this review article were gathered from the journals accessible in creditable databases such as Science Direct, Medline, PubMed, Scopus, EBSCO, EMBASE, SID and IranMedex. The keywords searched in Persian and English books on medicinal plants and traditional medicine, as well as the above reputable databases were "Black seed", "Nigella sativa", "therapeutic effect", and "medicinal plant". The results showed that N. sativa has many biological effects such as anti-inflammatory, anti-hyperlipidemic, anti-microbial, anti-cancer, anti-oxidant, anti-diabetic, anti-hypertensive, and wound healing activities. It also has effects on reproductive, digestive, immune and central nervous systems, such as anticonvulsant and analgesic activities. In summary, it can be used as a valuable plant for production of new drugs for treatment of many diseases.
Animals
;
Drug Therapy
;
Humans
;
Molecular Structure
;
Nigella sativa
;
chemistry
;
Plant Extracts
;
chemistry
;
therapeutic use
;
Seeds
;
chemistry
9.Analysis of survival data in thalassemia patients in Shiraz, Iran.
Abdolreza RAJAEEFARD ; Mahmoud HAJIPOUR ; Hamid Reza TABATABAEE ; Jafar HASSANZADEH ; Shahab REZAEIAN ; Zahra MORADI ; Mehdi SHARAFI ; Mohsen SHAFIEE ; Ali SEMATI ; Sanaz SAFAEI ; Maryam SOLTANI
Epidemiology and Health 2015;37(1):e2015031-
OBJECTIVES: The survival rate of thalassemia patients has not been conclusively established, and the factors associated with survival remain unclear. This study aimed to determine the survival rate of thalassemia among patients in southern Iran and to identify the factors associated with mortality from thalassemia. METHODS: This retrospective cohort study was conducted based on a retrospective review of the medical records of 911 beta-thalassemia patients in 2014. Data analysis was conducted using the Kaplan-Meier method and Cox regression analysis. RESULTS: Overall, 212 patients (23.3%) died, and 26.8% had thalassemia intermedia. The 20-year, 40-year, and 60-year survival rates were 85%, 63%, and 54%, respectively. Both crude and adjusted analyses found that education, marital status, ferritin levels, and comorbidities were related to mortality. CONCLUSIONS: Sociodemographic and hematological factors were found to be significantly associated with the survival rate of thalassemia. Addressing these factors may help healthcare providers and physicians to provide the best possible care and to improve the survival rate.
beta-Thalassemia
;
Cohort Studies
;
Comorbidity
;
Education
;
Ferritins
;
Health Personnel
;
Humans
;
Iran*
;
Kaplan-Meier Estimate
;
Marital Status
;
Medical Records
;
Mortality
;
Retrospective Studies
;
Statistics as Topic
;
Survival Rate
;
Thalassemia*
10.Evaluation of the accuracy of linear and angular measurements on panoramic radiographs taken at different positions.
Sima NIKNESHAN ; Mohamad SHARAFI ; Naghmeh EMADI
Imaging Science in Dentistry 2013;43(3):191-196
PURPOSE: This study assessed the accuracy of linear and angular measurements on panoramic radiographs taken at different positions in vitro. MATERIALS AND METHODS: Two acrylic models were fabricated from a cast with normal occlusion. Straight and 75degrees mesially and lingually angulated pins were placed, and standardized panoramic radiographs were taken at standard position, at an 8degrees downward tilt of the occlusal plane compared to the standard position, at an 8degrees upward tilt of the anterior occlusal plane, and at a 10degrees downward tilt of the right and left sides of the model. On the radiographs, the length of the pins above (crown) and below (root) the occlusal plane, total pin length, crown-to-root ratio, and angulation of pins relative to the occlusal plane were calculated. The data were subjected to repeated measures ANOVA and LSD multiple comparisons tests. RESULTS: Significant differences were noted between the radiographic measurements and true values in different positions on both models with linear (P<0.001) and those with angulated pins (P<0.005). No statistically significant differences were observed between the angular measurements and baselines of the natural head posture at different positions for the linear and angulated pins. CONCLUSION: Angular measurements on panoramic radiographs were sufficiently accurate and changes in the position of the occlusal plane equal to or less than 10degrees had no significant effect on them. Some variations could exist in the pin positioning (head positioning), and they were tolerable while taking panoramic radiographs. Linear measurements showed the least errors in the standard position and 8degrees upward tilt of the anterior part of the occlusal plane compared to other positions.
Dental Occlusion
;
Dimensional Measurement Accuracy
;
Head
;
Lysergic Acid Diethylamide
;
Posture
;
Radiography, Panoramic

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