Reduced White Matter Fiber Density in Patients with Multiple Sclerosis.

Introduction: Improved understanding of multiple sclerosis (MS) symptomatology, disease mechanisms, and clinical effectiveness can be achieved by investigating microstructural damage. The aim was to gain deeper insights into changes in white matter (WM) tracts in MS patients. Methods: Diffusion magnetic resonance imaging-based tractography was utilized to segment WM tracts into regions of interest for further quantitative analysis. However, tractography is susceptible to false-positive findings, reducing its specificity and clinical feasibility. To address these limitations, the Convex Optimization Modeling for Microstructure Informed Tractography (COMMIT) technique was used. COMMIT was used to derive measures of intracellular compartment (IC) and isotropic compartments from multishell diffusion data of 40 healthy controls (HCs) and 40 MS patients. Results: The analysis revealed a widespread pattern of significantly decreased IC values in MS patients compared with HCs across 61,581 voxels (pFWE < 0.05, threshold-free cluster enhancement [TFCE] corrected). Similar WM structures studied using the fractional anisotropy (FA) value also showed a reduction in FA among MS patients compared with HCs across 57,304 voxels (pFWE < 0.05, TFCE corrected). Out of the 61,581 voxels exhibiting lower IC, a substantial overlap of 47,251 voxels (76.72%) also demonstrated lower FA in MS patients compared with HCs. Discussion: The data suggested that lower IC values contributed to the explanation of FA reductions. In addition, IC showed promising potential for evaluating microstructural abnormalities in WM in MS, potentially being more sensitive than the frequently used FA value.

Symmetry differences of structural connectivity in multiple sclerosis and healthy state.

Focal and diffuse cerebral damages occur in Multiple Sclerosis (MS) that promotes profound shifts in local and global structural connectivity parameters, mainly derived from diffusion tensor imaging. Most of the reconstruction analyses have applied conventional tracking algorithms largely based on the controversial streamline count. For a more credible explanation of the diffusion MRI signal, we used convex optimization modeling for the microstructure-informed tractography2 (COMMIT2) framework. All multi-shell diffusion data from 40 healthy controls (HCs) and 40 relapsing-remitting MS (RRMS) patients were transformed into COMMIT2-weighted matrices based on the Schefer-200 parcels atlas (7 networks) and 14 bilateral subcortical regions. The success of the classification process between MS and healthy state was efficiently predicted by the left DMN-related structures and visual network-associated pathways. Additionally, the lesion volume and age of onset were remarkably correlated with the components of the left DMN. Using complementary approaches such as global metrics revealed differences in WM microstructural integrity between MS and HCs (efficiency, strength). Our findings demonstrated that the cutting-edge diffusion MRI biomarkers could hold the potential for interpreting brain abnormalities in a more distinctive way.

Epidemiological, clinical, and economic burden of myocardial infarction patients in Iran during the COVID-19 pandemic.

Background: To define changes in AMI case rates, patient demographics, cardiovascular comorbidities, treatment approaches, in-hospital outcomes, and the economic burden of COVID-19 during the pandemic. Methods: We conducted a multicenter, observational survey with selected hospitals from three medical universities in Tehran city. A data collection tool consisting of three parts. The first part included socio-demographic information, and the second part included clinical information, major complications, and in-hospital mortality. Finally, the third part was related to the direct medical costs generated by AMI in COVID-19 and non-COVID-19 patients. The study cohort comprised 4,560 hospitalizations for AMI (2,935 for STEMI [64%] and 1,625 for NSTEMI [36%]). Results: Of those hospitalized for AMI, 1,864 (76.6 %) and 1,659 (78 %) were male before the COVID-19 outbreak and during the COVID-19 era, respectively. The length of stay (LOS), was significantly lower during the COVID-19 pandemic era (4.27 ± 3.63 vs 5.24 ± 5.17, p = 0.00). Results showed that there were no significant differences in terms of patient risk factors across periods. A total of 2,126 AMIs were registered during the COVID-19 era, with a 12.65 % reduction (95 % CI 1.5-25.1) compared with the equivalent time in 2019 (P = 0.179). The risk of in-hospital mortality rate for AMI patients increased from 4.9 % in 2019 to 7.0 % in the COVID-19 era (OR = 1.42; 95 % CI 1.11-1.82; P = 0.004). Major complications were registered in 9.7 % of cases in 2020, which is higher than the rate of 6.6 % reported in 2019 (OR = 1.46, 95 % CI 1.11-1.82; P = 0.000). Total costs in hospitalized AMI-COVID patients averaged $188 more than in AMI patients (P = 0.020). Conclusion: This cross-sectional study found important changes in AMI hospitalization rates, worse outcomes, and higher costs during the COVID-19 periods. Future studies are recommended to examine the long-term outcomes of hospitalized AMI patients during the COVID-19 era.

A comparative study of interagency communications and information exchange in disaster response among selected countries.

BACKGROUND: Effective communications and secure information exchange platforms during disasters and emergencies are among the significant factors in inclusive disaster management and can radically contribute to better preparedness, efficient and timely responsiveness, and, finally, maximal reduction of damages and fatalities. The present study was to compare communications and information exchange among disaster response organizations in selected countries. MATERIALS AND METHOD: This applied research, carried out in 2022, was a qualitative descriptive-comparative study pursuing a content analysis approach. Australia, Turkey, India, America, Japan, and Iran constituted the statistical population of the study. The sampling was based on the countries' disaster histories and response experiences. The note-taking tool was used to extract and collect data during the review of texts, documents, and articles, and the qualitative content analysis method was employed for data analysis. RESULTS: The outcomes of the descriptive-comparative analysis fell into four main comparative axes of the selected countries, including comparing reference, authority, and coordinator organizations in the response phase, comparing planning records and histories in disaster and emergency management comparing the contribution or non-contribution of government, military institutions, and non-governmental organizations to disaster and emergency management, the commonalities of the selected countries' disaster and emergency management and dependence on government. CONCLUSION: The results revealed that all selected countries depended on the government in managing disasters and emergencies, and the four communication platforms, i.e., landline telephone, mobile phone, radio communications systems, and couriers, were the common communication and information acquisition sources.

Cost-Effectiveness of Remote Cardiac Monitoring With the CardioMEMS Heart Failure System: A Systematic Review.

Background: Heart Failure (HF) imposes a relevant burden and a considerable health concern, with high prevalence and mortality rates. This study was conducted to assess the cost-effectiveness of remote cardiac monitoring with the CardioMEMS Heart Failure System. Methods: In the present systematic review, several scholarly databases were searched and updated from inception up to September 20, 2022. The objective of the present review was formulated according to the patient/population, intervention, comparison and outcomes format. Mortality rate, hospitalization rate, quality-adjusted life year (QALY), total costs, and the incremental cost-effectiveness ratio regarding the use of the CardioMEMS System were the key outcomes of the present study. The quality of included studies was assessed using the Consolidated Health Economic Evaluation Reporting Standards 2022 (CHEERS) checklist. Results: Finally, 5 articles were retained and analyzed in the present systematic review. All studies employed the Markov and decision tree models. Results show that the CardioMEMS system reduced mortality and hospitalization rate and created a higher QALY. In all selected countries the CardioMEMS method is a more expensive method than the standard of care (SoC), with the highest cost in the United States (US) ($201,437) and the lowest cost in the United Kingdom ($25,963), respectively. the highest willingness to pay in the US and the lowest in Italy ($100,000 and $33,000 per QALY), respectively. Results showed that the most cost per QALY for the CardioMEMS system was in the US and the lowest was in the Netherlands ($46,622 and $26,615 per QALY), respectively. Conclusion: In all selected countries, CardioMEMS is a cost-effective method for monitoring and managing pulmonary artery pressures in HF patients. Strategies such as CardioMEMS, which decrease the rate of hospitalization, are likely to be only more cost-effective in the future.

Cost-effectiveness Analysis of Air Emergency Versus Ground Emergency Medical Services Regarding the Patient's Transportation and Treatment in Selected Hospital.

Background: The prehospital emergency system is the first initiator of medical care as an alternative to hospitals and health care services that helps patients and injured people in critical situations and accidents. This study aimed to evaluate the cost-effectiveness of air ambulance versus ground ambulance regarding the patient's transportation and treatment. Methods: In this cost-effectiveness analysis study, 300 patients who were transferred to the Shohadaye HaftomTir hospital by air ambulance and 300 patients transferred by ground ambulance during the study period were selected in 2021-2022. This study examined the costs from the society's perspective. After drawing the decision tree model in TreeAge software, the incremental cost-effectiveness ratio was calculated; and to evaluate the strength of the analysis results, one-way and two-way sensitivity analyses were done on all costs and consequence parameters. Results: The effectiveness rate in the ground ambulance group and in the air ambulance group was 0.42591 and 0.5566, respectively, and the total cost of transportation and treatment by ambulance in these patients was $412.88 and for patients transported and treated by air ambulance was $11898.05. Therefore, air ambulance costs more and is more effective than ground ambulance, and the amount of incremental cost and effectiveness of air ambulance compared with ground ambulance was $11485.17 and 0.130773 units, respectively. The incremental cost-effectiveness ratio (ICER) of the 2 strategies was 87825.28, and the cost-effectiveness threshold was $7200. To determine the strength of the study results, one-way and two-way sensitivity analyses were done and the results of the cost-effectiveness analysis was not changed. Conclusion: Our study showed that ground ambulance is more cost-effective than air ambulance and the most important reason is that the total cost of air ambulance is 26 times more than ground ambulance, however, it is more effective than ground ambulance.

Clients' Satisfaction with Services Provided by Ambulances and Motor Ambulances of Tehran Emergency Medical Services: A Cross-sectional Study.

Background: To improve the quality of services provided by emergency medical services (EMS), a correct understanding of the current situation and analysis of possible problems is required. The purpose of this study was to investigate the level of clients' satisfaction regarding the missions performed by ambulances and motor ambulances (motorlances) of the Tehran EMS center, and also identify the factors affecting their satisfaction. Methods: This cross-sectional study was conducted for 1 month in Tehran, Iran. All clients in the age range of 18 to 87 years who were approached by Tehran EMS motorlances or ambulances were eligible. Those with wrong registered phone numbers, uninformed callers (passers, coworkers), and those who were not willing to participate in the study were excluded. A valid and reliable researcher-made questionnaire was used to assess the clients' satisfaction. Missions were surveyed routinely, 1 to 2 days following their performance. The questionnaires were filled out by the investigators via a telephone call to the patients or the patients' siblings. The collected data were statistically analyzed using IBM SPSS Statistics 24.0. An independent t test and 1-way analysis of variance were used to compare the mean satisfaction score between the groups. Other tests, such as the Pearson correlation coefficient, were also used to examine the relationship between quantitative variables. P<0.05 were considered statistically significant. Results: In total, the data of 1100 missions were analyzed. The age range of the patients was between 1 and 100 years and their mean age was 52.1 ± 19.2 years, and the mean age of interviewees was 44.4 ± 13.4 years (18-87 years); of all the interviewees, 610 (55.5%) were women. The overall satisfaction of people with the Tehran EMS was rated as "very satisfied" in 78.5% of the cases; However, 11.2% of the participants had moderate and low satisfaction. We found that overall satisfaction was related to dependence on the health group (p≤0.001), educational status (p=0.006), economic status (p=0.002), sent vehicle (p=0.040), and diagnosis (p<0.001). Conclusion: Almost 80% of the participants were highly satisfied with the services provided by Tehran EMS motorlances/ambulances, according to this study. Those with a higher educational level, higher socioeconomic class, accurate diagnosis, proper sent car, and health dependency showed a higher level of happiness than the others.

The association between micronutrients and the SARS-CoV-2-specific antibodies in convalescent patients.

BACKGROUND: Various micronutrients play key roles in the immune responses to viral infection, antibody synthesis, and susceptibility to infection. This study aimed to investigate the role of micronutrients on the immune responses following SARS-CoV-2 infection. METHODS: To evaluate humoral immunity following SARS-CoV-2 infection, the levels of SARS-CoV-2-specific IgM and IgG, as well as the concentrations of different micronutrients, were determined in 36 convalescent COVID-19 patients 60 days after infection. Furthermore, the correlation between biochemical and hematological parameters, clinical features, and the changes in adiposity with SARS-CoV-2 antibodies was evaluated. RESULTS: Serum IgM and IgG antibodies were detected in 38.8% and 83.3% of recovered patients after 60 days of COVID-19 infection, respectively. The values of SARS-CoV-2-specific IgG were negatively correlated with the number of the platelet. Moreover, the values of SARS-CoV-2-specific IgM were positively correlated with LDH and the vitamin B12 concentration. Furthermore, a gender-specific association of SARS-CoV-2-specific IgG and IgM with vitamins D as well as with B9 and zinc was observed. A significant negative correlation was observed between the values of IgG with vitamin D in male participants and a positive correlation was detected between IgG values and B9 in female participants. Moreover, IgM levels with serum zinc values in females were negatively correlated. CONCLUSION: Our study suggests the potential role of micronutrients in gender-specific humoral immunity following SARS-CoV-2 infection. Further studies are required with a greater sample of subjects to substantiate the validity and robustness of our findings.

Perform the Regulatory Process: A National Approach for Evaluation of the Pre-Hospital Emergency Information System in I.R. Iran.

Evaluation of Emergency Medical Services Management Information System (EMSIS) makes it possible to assess the extent to which the objectives of supporting of healthcare delivery services. This paper presents an overview of the regulatory process in prehospital EMS electronic data registration and provides a minimum data set for the purpose of developing such a care system on a national scale. It further offers an evaluation framework for such systems.

Risk Assessment of COVID-19 in the Iranian Health System.

OBJECTIVE: The outbreak of coronavirus disease 2019 (COVID-19) has exerted unprecedented pressure on healthcare systems throughout the world. This study was designed to develop a national health emergency management program based on risk assessment for COVID-19. METHODS: Mixed-methods research was used. Based on recommendations of the national epidemiology committee, 2 risk scenarios were used as basic scenarios for risk assessment. Two rounds of Focus Group Discussions (FGDs) were conducted between January and May 2020 with 30 representatives of the health system. The data were collected, analyzed, and integrated by the research team. RESULTS: In the risk matrix, "contamination of environment and individuals" and "burnout of medical staff" occupied the red zone (intolerable risk). "Defects in screening and admissions," "process disruption in medical care and rehabilitation," "increased mental disorders," "social dissatisfaction," "the decline in healthcare services," and "loss of medical staff" were identified as the orange zone (significant risk) of the matrix. CONCLUSIONS: The avoidance of environmental and individual contamination and healthcare worker burnout are the priorities in Iran. Attention to intersectoral cooperation, the involvement of non-governmental organizations and private center capacities, integration of information health systems, and developing evidence-based protocols are other measures that can improve the health system's capacity in the response COVID-19.

Cost-Effectiveness of Sacubitril/Valsartan Compared with Enalapril in Patients with Heart Failure with Reduced Ejection Fraction: A Systematic Review.

Background: To assess the cost-effectiveness of sacubitril/valsartan compared with enalapril in patients with heart failure with reduced ejection (HFrEF). Methods: A systematic literature search was conducted searching in major electronic databases from inception to January 1, 2021. All relevant full economic evaluation studies of sacubitril/valsartan versus enalapril for the treatment of patients with HFrEF were identified using ad hoc search strategies. Mortality, hospital admissions, quality-adjusted life years (QALYs), life-years (LYQs), annual drug costs, total lifetime costs, and incremental cost-effectiveness ratio (ICER) were considered as the outcomes. The quality of the included studies was assessed using the CHEERS checklist. This study was conducted and reported in accordance with the "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" (PRISMA) guidelines. Results: The initial search yielded a pool of 1026 articles, of which 703 unique articles were screened, 65 full-text articles were assessed for eligibility and 15 studies finally included in the qualitative synthesis. Studies show that sacubitril/valsartan reduces mortality and hospitalization rate. The mean of death risk ratio and hospitalization were computed at 0.843 and 0.844, respectively. Sacubitril/valsartan produced higher annual and total lifetime costs. The lowest and highest lifetime costs for sacubitril/valsartan were found in Thailand ($4,756) and Germany ($118,815), respectively. The lowest ICER was reported in Thailand ($4857/QALY) and the highest in the USA ($143,891/QALY). Conclusion: Sacubitril/valsartan is associated with better outcomes and may be cost-effective compared to enalapril for the management of HFrEF. However, in developing countries such as Thailand, sacubitril-valsartan costs must be reduced to yield an ICER below the threshold.

Hospital Preparedness Challenges in Biological Disasters: A Qualitative Study.

OBJECTIVE: Identification of hospital preparedness challenges against biological events such as coronavirus disease 2019 (COVID-19) is essential to improve dynamics, quality, and business continuity confidence in the health system. Accordingly, the purpose of the present study is to evaluate the challenges of hospital preparedness in biological events. METHODS: This study used a qualitative method using content analysis in which 20 health-care managers and experts who are experienced in biological events were selected through purposeful sampling. The data collection was done through semi-structured interviews, which continued until data saturation. The data were analyzed using qualitative content analysis as well as the Landman and Graneheim Approach. RESULTS: Six main concepts (training and practice, resource management, safety and health, patient management, risk communication, and laboratory and surveillance) and 14 subconcepts were extracted on hospital preparedness challenges in biological events through analyzing interviews. CONCLUSIONS: The present study indicated that the health system of the country faces many challenges in response to biological events and threats. Moreover, study participants indicated that Iranian hospitals were not prepared for biological events. It is recommended to design preparedness plans of hospitals based on preparedness standards for biological events. In addition, comprehensive measures are required to enhance their capacity to respond to biological emergencies.

Exposure to sulfur mustard increases the risk for mortality in patients with COVID-19 infection: A cohort study.

OBJECTIVE: This study aims to assess the prognosis of inpatients with COVID-19 infection who have a history of sulfur mustard exposure. METHODS: We started a cohort study in October 2020 and ended in May 2021 on inpatients with COVID-19 infection who had been admitted to university healthcare centers. The analytic sample included 960 inpatients having COVID-19 infection (192 with; and 768 without sulfur mustard exposure). The exposed patients were male war veterans, and the unexposed patients were male individually age-matched people. All patients had a positive RT-PCR test and a positive chest CT for COVID-19. The outcome was death within 28 days of admission, and the predictors were clinical features recorded at patients' bedsides. RESULTS: There was a significantly higher prevalence for asthma (p = 0.026) and pulmonary disease other than asthma (p < 0.001) in patients with the exposure. Sulfur mustard exposure was associated with increased risk for mortality of COVID-19 [hazard ratio (95% CI) = 1.92 (1.14,3.24), p = 0.013]. Early intubation signified a poor prognosis [hazard = 7.34 (4.65,11.58), p < 0.001]. However, individuals with higher PaO2 [hazard = 0.97 (0.95,0.98), p < 0.001], or people undergoing O2 therapy early upon admission [hazard = 0.58 (0.38,0.89), p = 0.011] showed lower risks for mortality. Individuals with asthma were at higher risk for mortality [hazard = 3.76 (1.69,8.36), p = 0.001]. CONCLUSION: Individuals with COVID-19 infection and sulfur mustard exposure should be considered high-risk patients and that, healthcare settings should be ready to provide critical care for them, including O2 therapy. They are more likely to have asthma or other pulmonary diseases.

Risk Assessment of Arbaeen Mass Gathering in the Covid-19 Pandemic.

Introduction: Arbaeen is a religious ceremony held annually with the participation of a large number of pilgrims. During the pandemic of Covid-19, a mass gathering of Arbaeen pilgrims can strengthen the transmission of this disease and put more pressure on the health care system of countries. The aim of the study is to evaluate the risk of Arbaeen ceremony in the Covid-19 pandemic in 2021. Materials and methods: A mixed method was performed to perform the study using qualitative and quantitative methods. A national risk assessment tool was used that consisted of hazard identification and assessment, scenario development, exposure assessment, vulnerability assessment and risk estimation. The national risk assessment tool was completed through a focused group discussion and the opinions of 20 representatives of the health system and the level of risks were estimated. Data were collected, analyzed, and integrated by the research team. Results: Based on the results of risk matrix analysis, factors such as the increase in the number of new cases of COVID-19, the probability of exposure to a new variant of COVID-19, the probability of arrival of a new variant of COVID-19 to the country, the probability of increasing referrals to healthcare facilities (score 16), the probability of getting respiratory diseases, and the environmental contamination (score 12) occupied the red area of the matrix and were found to have the highest risk (unbearable risk), that needs immediate action. Conclusion: Preparing for a mass gathering such as Arbaeen is very important in order to reduce the risk of communicable disease, and the first step in improving preparedness is risk assessment and its continuity in the various stages of the ceremony. Therefore, policy makers and planners of such events should conduct risk assessments with the participation of local and national public health authorities regularly.

Toward an Agile System: Iranian Information System for Covid-19-Affected Patients Data Collection from Iranian Hospitals.

COVID-19's rapid spreads has caused a global pandemic. On 19th February 2020, Iran reported its first confirmed cases of infections in Qom City and the number of diagnosed cases and the death toll rose exponentially in March [1-3]. Managing the disease, which is considered a pandemic according to the World Health Organization (WHO) [4], requires definite approaches differing according to various factors in each country, which may also lead to (in)effective dealing with the disease. In addition, using international data and information, and WHO advice, especially in the crisis and therapeutic procedures, is one of the best crisis management strategies [5]. For every plan by governances, the first step is collecting information on epidemic distribution for the purpose of isolating provinces and cities at a national scale. Thus, Ministry of Health and Medical Education of Iran (MOHME) attempted to collect the minimum required data on the infection-affected patients based on medical records and epidemiological factors, such as demographic data (gender, age and national code), exposure history (close contact with the infected, suspect patients or even having traveled) and signs and symptoms (fever, cough, shortness or difficulties in breathing, fatigue, anorexia, hemoptysis, sputum production, dyspnea, Myalgia, Pharyngalgia, nausea, vomiting, Diarrhea, Headache, Abdominal pain, Dizziness, etc.). Therefore, to ensure accuracy and validity, and to speed up data collection in an area, Information Technology (IT) tools were required [6]. In this regard, developing an information system with a simple format and user-friendly interface in the shortest possible time was the aim. This study presents the local information system developed in March 2020, which has been registering hospitalized Covide-19-affected patients in Iranian hospitals up till now. In other words, this paper introduces features and procedures of one of the national systems as a health registry that includes clinical information on admitted Covid-19 patients in Iranian hospitals from admission to discharge or death. This system is supported by MOHME, and along with outpatient Point of Care Information Systems (POCS), feeds the national and international pandemic reports and decisions.

Worldwide disaster loss and damage databases: A systematic review.

Nowadays, disaster databases have become a valuable tool for disaster risk management and health promotion and serve various purposes. The purpose of this study is to provide a systematic review of disaster databases in the world and to identify the objectives, information sources, criteria, and variables of disaster data registration in the world's reputable databases. To conduct review, all English-language articles published without a time limit until the end of September 2020 were extracted from the databases of Web of Science, PubMed, Scopus, Cochrane Library, Science Direct, Google Scholar, and Embase. Necessary information in the papers including study time, type of disasters, related databases, dimensions and indicators of global and regional databases were extracted by using a researcher-made questionnaire. A total of 22 studies have been reviewed to identify the dimensions and indicators of disaster databases worldwide. The main focus was on global and regional databases, mostly used at the level of scientific societies and disaster experts. After explanation, researchers highlighted each of the disaster databases, along with the main differences available among the existing databases. Some databases have well-defined data collection methods. Their knowledge is high quality and they can be used to create and improve a disaster database at other levels. Disaster database limitations include risk bias, time bias, accounting bias, threshold bias, and geographical bias. To support the right decisions to reduce disaster risk, it is necessary to complement existing global, regional, and national databases. Countries need to take action to set up national databases.

Epilepsy lifetime prevalence in Iran: a large population- based national survey.

Epilepsy has garnered increased public health focus because patients who suffer from epilepsy experience pronounced and persistent health and socioeconomic disparities despite treatment and care advances. The epidemiology of epilepsy is diverse in different countries and regions. This nationwide population-based cross-sectional study was conducted to determine the life time prevalence and health related factors of epilepsy for the first time in Iran through a two-phase door-to-door survey method. In phase I, a screening for epilepsy was performed on 68,035 people. Then in phase II, after the neurological evaluation of participants and reviewing medical records, 1130 subjects with epilepsy was confirmed. The life time prevalence of epilepsy was achieved to be 16.6 per 1000 people (95% CI 15.4-17.8) with the average age onset 19.1 ± 21.1 (active prevalence 9.5 per 1000 people). Focal seizure (59.3%), generalized epilepsy (38%) and unknown types of epilepsy (2.7%) were detected among participants. The overall life time prevalence of febrile convulsion was 4.1 per 1000 people. The frequency of attacks per year and per month were 3.0 ± 1.6 and 0.5 ± 0.1, respectively. Age-specific life time prevalence was highest among the age group of 15-19 years old [32.7 per 1000 persons (95% CI 29.1-36.8)] and it was higher in male (53.8%) than female (46.2%) participants. Our results showed that the life time prevalence of epilepsy in Iran is higher than worldwide average.

Criteria and components of the emergency and disaster database in Iran: A content analysis study.

BACKGROUND: Nowadays, emergencies and disasters are considered one of the biggest problems in human life. To reduce the risk of emergencies and disasters, governments must develop strategies and policies using evidence-based methods. Disaster databases are the main source and tool for storing and managing a wide range of data in this field. This study was conducted with the aim of exploring the necessary criteria and components of the emergency and disasters database in Iran. MARTIALS AND METHODS: This qualitative study was performed using content analysis in which 18 managers and experts with experience in registering, documenting, or responding to emergencies and disasters were selected through purposive sampling. Data collection was done using semi-structured interviews that continued until saturation. Data were analyzed by means of qualitative content analysis recommended by Landman and Graneheim. RESULTS: In total, three main concepts concerning the necessary criteria and components of the database of natural and artificial emergencies and disasters in Iran were explored. The main concepts include information resources, information evaluation, and information management. Subconcepts include data collection, information transfer, access to information, information validation, disaster leveling, information registering, information storage and retrieval, information analysis, and information dissemination. CONCLUSION: The experience of the participants showed that there are many challenges in the field of monitoring and gathering information about injuries and damages caused by emergencies and disasters in the country. The knowledge obtained from this study can be used to create and develop a database of emergencies and disasters in Iran. It will also provide insights for healthcare policymakers and managers in future planning areas to more effectively address identified challenges in preventing and responding to disasters at both regional and national levels.