Development and validation of burnout factors questionnaire in the operating room nurses.

Nurses may experience burnout more than other professions. Occupational burnout is a serious concern considering the importance of nurses' jobs in patient care. This study was carried out with the aim of designing and validating the questionnaire of burnout factors in the operating room nurses. Mixed method study was done in two qualitative and quantitative phases in 2022 on Iranian operating room nurses. In the first stage, the concept of operating room nurses' burnout was explained using interviews and literature review, and items were generated. In the second stage, the face validity, content and construct validity of the questionnaire was examined with 342 operating room nurses, and also the reliability of the questionnaire was tested using internal consistency (Cronbach's alpha) and stability (test-retest). After conducting the interview and literature review, 65 questions were extracted. Based on face validity, 4 items were modified. After content validity, 40 items remained. In construct validity, after exploratory factor analysis, 34 items with 5 dimensions were extracted. These dimensions included Organizational, Individual, Interpersonal, Occupational Nature and Managerial factors. Cronbach's alpha and intra-class correlation coefficient were equal to 0.937 and 0.946, respectively. The designed tool based on understanding the concept of burnout in operating room nurses has appropriate and acceptable validity and reliability. Therefore, it can be used to measure burnout in operating room nurses.

Does a 30-minute introductory visit to the operating room reduce patients' anxiety before elective surgery? a prospective controlled observational study.

BACKGROUND: Patients scheduled for elective surgery typically suffer from preoperative anxiety related to the unknown environment and unclear expectations. We hypothesized that a virtual or in-person introductory visit to the operating room one day before surgery may decrease the extent of preoperative anxiety by familiarizing patients and their families with the operating room environment. So, this study aimed to evaluate the impact of operating room visits, conducted both in-person and virtual reality, on patients' preoperative anxiety. METHODS: This prospеctivе controllеd obsеrvational study еxaminеd patiеnts who wеrе candidatеs for gеnеral surgеry in a tеaching hospital in Iran. All patiеnts agеd bеtwееn 18-60 yеars, who wеrе undеrgoing gеnеral surgеry bеtwееn April and Sеptеmbеr 2022 and had prеopеrativе anxiеty basеd on thе Spiеlbеrgеr quеstionnairе, wеrе sеlеctеd. Patients who had emergency surgery or were taking anti-anxiety drugs were excluded from the study. Patiеnts wеrе thеn randomly assignеd to thе in-pеrson visit, virtual rеality visit, and control groups. In thе in-pеrson group, individuals visitеd thе opеrating room for 30 minutеs on thе day bеforе surgеry. In contrast, in thе virtual rеality group, visits wеrе conductеd via a 'livе' virtual vidеo tour of thе opеrating room for thе samе duration on thе day bеforе surgеry. The control group received routine care such as prе-surgеry hospitalization and mеdication. All participants completed the Spielberger questionnaire before the intervention (the day before surgery) and again two hours before surgery. Data were analyzed using variance analysis, t-tests, and Chi-square tests in SPSS 22 software. RESULTS: Wе idеntifiеd 105 patiеnts undеrgoing gеnеral surgеry who wеrе dividеd into thrее groups of 35 pеoplе еach. Thе rеsults showеd that, bеforе thе intеrvеntion, thеrе wеrе no statistically significant diffеrеncеs among thе thrее groups in tеrms of dеmographic data and prеopеrativе anxiеty (p > 0.05). Aftеr thе intеrvеntion, thе mеan scorеs of prеopеrativе anxiеty in thе in-pеrson visit, virtual rеality visit, and control groups wеrе 52.82 ± 4.51, 54.48 ± 5.04, and 53.42 ± 4.62, rеspеctivеly, with no significant statistical diffеrеncе (p = 0.33). Furthermore, there was no significant difference in preoperative anxiety scores before and after the intervention in the in-person visit (p = 0.13), virtual reality visit (p = 0.10), and control (p = 0.33) groups. CONCLUSION: A 30-minute visit to familiarize patients with the operating room environment, equipment, and staff, whether conducted in-person or virtually, does not significantly affect patients' preoperative anxiety or reduce their anxiety levels.

Lessons from Self-Assessment of Post-Rhinoplasty Complaints; Analysis of 192 Candidates of Secondary Rhinoplasty.

Background: Rhinoplasty as the most common aesthetic surgical operations aims to correct deformities of the different structures of the nose with each case its own challenges. We aimed to highlight the importance of self-assessment for rhino surgeons. Methods: This retrospective descriptive study was done on 192 patients in Ordibehesht Hospital, Isfahan, Iran from April 2017 to Jun 2021. candidate for secondary rhinoplasty, with mandatory aesthetic and optional functional purposes, having previously undergone rhinoplasty with the same or another surgeon. Patients with initial rhinoplasty by the first author were assigned to group 1 (n=102) and the patients who were operated by the other surgeons were in the group 2 (n=90). Data were collected using an author made checklist divided into three parts: overall demographic questions, questions about the patients' aesthetic and functional complaints and objective evaluation by the surgeon. Results: The most frequent reported complaints led to their current rhinoplasty were about the nasal tip with 161 cases (83.9%), upper nasal part with 98 cases (51%) and mid-nose (middle nose) with 81 cases (42.2%). Besides, respiratory problem was observed in 58 patients (30.2%). Surgeon's skill was significantly associated with occurrence of these two complaints; so that these two complaints were more common in group2 than group1 (P value <0.05). Conclusion: Such assessments resulted to improve the surgical outcomes due to finding the more prevalent problems in own patients than the other surgeons' patients and determining the reasons that leads to change the techniques with regard to the researches and consulting with the colleagues.

The use of medicinal plants in the prevention of COVID-19 using the Health Belief Model: A survey based on the Iranian population.

BACKGROUND: Because of the spread of coronavirus disease 2019 (COVID-19), the preventive measures have increased, such as focusing on the use of medicinal plants in most communities, including Iran. The purpose of this study was to identify the knowledge, attitude, and performance of individuals toward the use of medicinal plants and to identify the predictors of the use of medicinal plants in the prevention of COVID-19. MATERIALS AND METHODS: This descriptive-analytical study (February-April 2021) was performed on 3840 Iranian men and women aged 20-70 years selected as a multi-stage cluster study. At the first stage, all provinces were divided into five regions: North, South, East, West, and Center. In the second stage, a provincial center and a city were randomly selected from each region (North: Sari, Babol; South: Bushehr, Bandar Genaveh; East: Mashhad, Sabzevar; West: Hamedan, Toisarkan; Center: Yazd, Ardakan). Data were collected by a researcher-made scale based on the Health Belief Model (HBM). Data analysis was performed applying Pearson correlation coefficient, logistic regression, and linear regression. RESULTS: The results showed that people have relatively high knowledge and positive attitude toward the use of medicinal plants in prevention of COVID-19. The most important reason for positive attitude was the perceived benefits with the mean of 75.06%. Also, half of the people had poor performance. Correlation coefficient showed that the use of medicinal plants with perceived sensitivity (p = 0.000, r = 0.3), perceived benefits (p = 0.012, r = 0.126), perceived barriers (p = 0.000, r = 0.179), and perceived self-efficacy (p = 0.000, r = 0.305) had a significant correlation. The strongest correlation between perceived self-efficacy was observed with the use of herbs in prevention of COVID-19. The HBM constructs can predict 26% of the variance for the use of medicinal plants in the prevention of COVID-19, among which perceived self-efficacy (ß = 0.230) was the most powerful predictor. CONCLUSION: Based on the results, the predictive role of self-efficacy constructs for the use of medicinal plants in prevention of COVID-19 has been confirmed according to the HBM. Therefore, methods of increasing self-efficacy such as training programs and providing appropriate intervention models can be used not only as promoters of using medicinal plants in prevention of COVID-19 but also for improving people's performance in the proper use of medicinal plants.

1D spatially chirped periodic structures: managing their spatial spectrum and investigating their near-field diffraction.

This work introduces a class of 1D spatial-frequency-modulated structures with transmittance T(x), in which the period changes along the x axis so that the corresponding spatial frequency f(x) sinusoidally alternates between two values. It is shown that T(x) generally is an almost-periodic function and has an impulsive spatial spectrum. However, we find the condition under which T(x) is a periodic function and its spatial spectrum form a lattice of impulses. When the periodicity condition is fulfilled, we call these structures as 1D spatially chirped periodic structures. These structures are characterized by two natural numbers, named as n c and n a v , and a real parameter named as frequency modulation strength (FMS). As an important special case, we define a 1D spatially chirped amplitude sinusoidal grating (SCASG) based on the transmission function of a conventional amplitude sinusoidal grating, in which the phase of conventional amplitude sinusoidal grating is replaced by desired chirped phase. Then the spatial spectrum of a 1D SCASG is investigated in detail, and it is shown that the spatial spectrum can be managed by changing the value of FMS. In other words, the grating's spectrum can be manipulated by adjusting the value of FMS. This feature might find applications in optical sharing of the incident power among different diffraction orders. Moreover, near-field diffraction from 1D SCASGs is studied by using the so-called angular (spatial) spectrum method, and Talbot distances for these gratings are determined and verified experimentally. It is shown that the intensity profiles at quartet- and octant-Talbot distances strongly depend on the values of the parameters n c and n a v . In comparison with the conventional gratings, we see some new and interesting aspects in the diffraction from 1D SCASGs. For instance, unlike the conventional gratings, in some propagation distances, the diffraction patterns possess sharp and smooth intensity bars at which the intensity is several times of the incident light beam's intensity. It is shown that the maximum intensity of these bright bars over the diffraction patterns depends on the characteristic parameters of the grating, including n c , n a v , and FMS of the grating. These intensity bars might find applications for trapping and aggregation of particles along straight lines.

Comparative Study of the Incidence of Port Site Infection in Disposable Ports and Reprocessed Disposable Ports in Laparoscopic Cholecystectomy.

INTRODUCTION: Port site infection (PSI) is a rare complication of laparoscopic surgery that can reduce the benefits of this minimally invasive surgery and increase postoperative complications. As a variety of disposable ports (single-use ports) and reprocessed ports are used in laparoscopic surgeries, this study was conducted to compare the incidence of PSI in disposable ports and reprocessed disposable ports in laparoscopic cholecystectomy (LC). MATERIALS AND METHODS: In this prospective cohort study, 473 patients were studied. Two hundred fifteen and two hundred fifty eight were in the disposable port group and reprocessed disposable port group, respectively. The demographic characteristics and incidence of superficial and deep infection were evaluated using the researcher-made checklist of infection assessment standards at intervals of 3 to 5 and 5 to 14 days following LC using call and physical examination on day 14. Data analysis was performed using descriptive statistics and statistical tests in SPSS software. RESULTS: The incidence of PSI, 3 to 5 and 5 to 14 days after surgery in the reprocessed disposable port group was significantly higher than that in the disposable ports group. In both groups, all PSI accrued in the epigastric port area (where the gallbladder was removed) ( P < 0.05). CONCLUSION: On the basis of the results, our study suggests using disposable ports instead, and in the case of using reprocessed disposable ports in LC, upgrading of disinfection and sterilization techniques is necessary.

The safety of a novel single-drape cover for sterile back tables in the operating room compared to the standard two-drape method: an experimental study.

BACKGROUND: Covering the prepared sterile back tables (PSBTs) during periods of nonuse and during active surgeries may decrease contamination of sterile surgical instruments that have direct contact to surgical wound. The Association of periOperative Registered Nurses (AORN) declared that an easy method for covering and removing the drape will ultimately be most effective (e.g. standard two-drape method). Hence, this study was designed to test the hypothesis that using a novel single-drape cover had more efficiency and safety in decreasing airborne bacteria-carrying particles (ABCPs) settling on the PSBTs during static and dynamic periods than the standard two-drape method. METHODS: This experimental study was conducted with using 918 agar plates to detect contamination of the PSBTs with ABCPs on two conditions (static and dynamic) at an academic medical center in Kashan, Iran, from September 25, 2021, to January 20, 2022. The contamination of PSBTs was evaluated by 6 agar settle plates (n = 918 in total) on each PSBT in static and dynamic operating room (OR) conditions. At each time-point, this set-up was repeated on two occasions else during data collection, establishing 81 PSBTs in total. Tested groups included the PSBTs covered with the standard two-drape method, the novel single-drape cover, or no cover. The plates were collected after 15, 30, 45, 60, 120, 180, 240 min and 24 h. The primary outcome measured was comparison of mean bioburden of ABCPs settling on covered PSBTs on two conditions by using agar settle plates. The secondary outcomes measured were to determine the role of covering in decreasing contamination of PSBTs and the estimation of time-dependent surgical instrument contamination in the uncovered PSBTs on two conditions by using agar settle plates. RESULTS: Covering the PSBTs during static and dynamic OR conditions lead to a significantly decreased bioburden of ABCPs on them (P < 0.05). No differences were seen between the standard two-drape method and the novel single-drape cover (P > 0.05). CONCLUSIONS: We found that there is no preference for using the novel single-drape cover than the standard two-drape method. Our results showed a significant decrease in bioburden of ABCPs on the PSBTs when those were covered during static and dynamic OR conditions, indicating the efficiency for covering the PSBTs during periods of nonuse and during active surgery.

Evaluation of Lateral Crura Divergence Angle of Iranian Candidates for Primary Rhinoplasty.

BACKGROUND: Cephalic malposition of the lower lateral cartilages is a common nasal anatomic variation. Knowing the range of lateral crura (LC) divergence angle in Iranian population can help Middle East plastic surgeons. This study aimed to determine LC divergence angle of candidates for primary rhinoplasty in Iranian population. METHODS: This cross-sectional study was conducted on 256 candidates for primary rhinoplasty from November 2017 through May 2018. Two sides of LC divergence angle were measured intraoperatively by a researcher-made device. RESULTS: Totally, 211 female and 45 male patients with the mean age of 29.9±6.51 years were recruited. The mean LC divergence angle was 35.86±4.74° (between 20-50°). The mean LC divergence angle was 35.11° and 36.02° in male and females, respectively. There was no significant difference between males and females. In addition, there was no significant correlation between LC divergence angle and age. LC divergence angle had normal distribution and about 68% of the LC divergence angle were within one standard deviation of the mean (i.e. 32 to 40 degree). CONCLUSION: In 16% of studied people, the divergence angle of the lateral crus of the lower lateral cartilage was lower than 32° and was considered as malposition.

Sensory and Affective Dimensions of Pain and Anxiety Like Behaviors Are Altered in an Animal Model of Pain Empathy.

Objective: Pain is a unique and subjective experience that has a prominent function in animals' survival. Observation of pain in others leads to alterations in pain sensation and affection, termed "Empathy for pain". The present study aimed to evaluate the effect of empathy on sensory and affective dimensions of pain and its effect on anxiety-like behaviors. Method : In this study, male Wistar rats were used. Two cage mates were selected, one of which underwent administration of a noxious stimuli for 10 days and the other observed the conspecific in pain. Hot plate, tail flick, and conditioned place aversion were used to evaluate sensory and affective dimensions of pain, respectively. Anxiety-like behavior was assayed using elevated plus maze paradigm and time spent in open and close arms and number of entrance into each arm was recorded as the anxiety indicator within a 5-minute framework. Results: Rats observing the cage mate in pain had a lower threshold to noxious stimuli in comparison to controls. They also had an increased aversion from painful stimuli, demonstrating heightened affective response to pain. Anxiety-like behavior was also enhanced in the observers. Conclusion: Results of this study demonstrate that both sensory and affective dimensions of pain are altered following observation of pain in a conspecific. Further studies evaluating the underlying mechanisms are encouraged to elucidate the role of different neurotransmitters in this phenomenon.

Effect of Incise Drape on Contamination Rate of Surgical Wound during Surgical Procedures of Lumbar Spine.

BACKGROUND: The aim of this study was to investigate the effect of the incise drape (ID) on surgical wound bacterial contamination during lumbar spine surgical procedures in treatment group (with ID) and control group (without ID). MATERIALS AND METHODS: The present study was conducted on 88 patients who were a candidate for lumbar spine surgery. The patients were randomly assigned to one of the two groups, treatment and control. The ID was only used in the treatment group. The surgical wound sampling for bacterial culture was done in two steps, immediately after surgical incision (IASI) and immediately prior to the surgical wound closure (IPSWC). The samples were then sent to the laboratory. RESULTS: The mean total bacterial count of the surgical wound in the stage IASI was not significantly different between treatment and control groups (0.09 vs. 0.02, P = 0.31). However, this means in the stage IPSWC in treatment group was significantly more than the control group (18.6 vs. 0.41, P = 0.04). The frequency distribution of Staphylococcus aureus (25% vs. 3%, P = 0.02) and Staphylococcus epidermidis (36.4% vs. 9.1%, P = 0.002) was significantly higher in the treatment group compared with control group in the stage IPSWC. CONCLUSION: The results suggest that the use of ID is unable to reduce surgical wound bacterial contamination in clean lumbar spine surgery. Therefore, based on the results obtained in our study, the application of ID is not recommended as an essential action for the prevention of surgical wound contamination.

Does Plastic Incise Drape Prevent Recolonization of Endogenous Skin Flora during Lumbar Spine Procedures?

BACKGROUND: The aim of this study was to compare the PID with bare skin (without PID) regarding bacterial recolonization and bacterial regrowth of the adjacent skin of surgical incision in lumbar spine surgery patients. METHODS: This quasi-experimental study was conducted from February to May 2018 on 88 patients who were candidate for lumbar spine surgery. Patients were assigned to one of two groups, treatment (with PID) and control (without PID). Skin sampling (adjacent of surgical incision) for bacterial culture was done in two steps, immediately after surgical skin prep (IASSP) and immediately after surgical wound closure (IASWC) by researcher. Finally, samples were sent to the laboratory. RESULTS: The mean total bacterial count of patient's skin in stage IASSP was not significantly different between treatment and control groups (0.34 vs 0.27, P = 0.68). However, mean total bacterial count in stage IASWC in treatment group was significantly higher than control group (2.2 vs 0.93, P = 0.03). The frequency distribution of S. aureus (P = 0.04) and S. epidermidis (P = 0.02) was significantly higher in treatment group compared with control group in stage IASWC. CONCLUSIONS: The results showed that using PID is unable to reduce recolonization and regrowth of bacteria on patients' skin adjacent to surgical wound in clean lumbar spine surgeries. However, making a definite decision about using or not using of PID requires further studies.

Evidence of Altered Trigeminal Nociception in an Animal Model of Fibromyalgia.

Objective: Fibromyalgia (FM) is a debilitating chronic condition that significantly affects quality of life. A strong association has been demonstrated between FM and chronic pain in the trigeminal region in clinical studies. This study was performed to evaluate the response to acute and chronic noxious stimuli applied to the facial region. Methods: Adult male Wistar rats (250-270 g, N = 10 for each group) were used in the current study. A subchronic swim stress model was used as the animal model of FM. Anxiety-like behaviors and response to acute and chronic noxious stimuli were assayed using the elevated plus maze, eye wiping test, and orofacial formalin test, respectively. Balance and motor function were evaluated using rotarod and wire grip tests. Results: An increased anxiety-like behavior was observed in swim stress rats in comparison with control and sham subjects. Response to acute and chronic noxious stimuli in the trigeminal region was increased in the stressed rats. Motor and balance function were not altered following stress. Conclusions: Results of the current study demonstrated a hyperalgesic state in the trigeminal region in a possible animal model of FM. This study provides a reliable animal model for further research on the possible mechanisms of orofacial pain in FM.

Effect of chronic stress on capsaicin-induced dental nociception in a model of pulpitis in rats.

OBJECTIVE: Chronic stress can alter nociceptive sensitivity. However, the effect of stress exposure on dental nociception has been less addressed. Therefore, the present study investigated the effects of chronic exposures to some social and psychological stresses on pulpal nociceptive responses. DESIGN: The stress groups were constructed as follows: forced swimming (n=6), restraint (n=6), and mild (n=10) and severe (n=15) crowding stresses. Rats were subjected to stress for 1h per day for a week. At the end of the stress session, pulp irritation was induced by intradental application of capsaicin (100µg). There were another capsaicin or capsaicin plus stress training groups that received articaine 5min before the administration of capsaicin. Nociceptive responses were recorded for 40min. The time (ins) of continuous shaking of the lower jaw and excessive grooming and rubbing of the mouth near the procedure site was measured as nociceptive behaviors. Data was analyzed using one-way analysis of variance (ANOVA) followed by post hoc Tukey's test. RESULTS: Significant nociceptive responses were evoked by the administration of capsaicin. Exposures to forced swimming (p<0.01), restraint (p<0.001), and both mild and severe crowding stresses (p<0.05) exaggerated capsaicin-induced nociceptive reaction. There was, however, no significant difference in nociceptive reaction time between the different stress groups. Articaine buccal infiltration attenuated nociceptive time in capsaicin and capsaicin plus stress training groups (p<0.001). CONCLUSIONS: The current data support the association between chronic stress exposures and nociceptive behavior following intradental capsaicin administration.

Effect of Multimedia Self-Care Education on Quality of Life in Burn Patients.

BACKGROUND: Burn injuries can have adverse effects on quality of life of patients and can disturb their physiological, psychological, social and spiritual well-being. This study aimed to investigate the effect of multimedia self-care program on quality of life in burn patients. METHODS: This Randomized controlled clinical trial was conducted from November 2015 to December 2016. The samples were hospitalized burn patients with 10% to 45% of 1st, 2nd and 3rd degree burns of total body surface area (TBSA). The patients were randomly allocated into experimental (n=50) and control (n=50) groups. Both groups received the routine in-person self-care trainings of the hospital and then the experimental group received self-care compact disks. The quality of life questionnaire in both groups were completed before intervention and after 3-months and statistically analyzed. RESULTS: Accordingly, the changes in quality of life and the dimensions between both groups after 3 month of intervention were significant. The changes in quality of life in experiment group was significantly greater than control group for physical, psychological and social variables. CONCLUSION: According to the findings, using multimedia self-care programs can improve burn patient's quality of life, so it is recommended for nurses and hospital staffs of burn injury wards to use multimedia self-care programs as a complementary therapy measure.

Modern concepts of transport in multiple trauma: a narrative review.

Multiple variables can influence triage decision in multiple trauma. Recognition of priorities and selection of the destination can be successfully achieved by field triage and individualized clinical judgment. This narrative review summarizes the new options and protocols for transport of injured subjects. There are four levels of emergency medical providers including first responders and three levels of emergency medical technicians. Two distinct accepted protocols for transport are known as scoop and run and treat and then transfer. The former provides minimum lifesaving treatment at the scene of accident followed by transferring the patient(s) as soon as possible, and the latter mainly emphasizes the need for complete stabilization as a prerequisite for safe transport. The destination and mode of transport are selected according to clinical capabilities of the receiving hospital, transfer time from the scene to the facility, patient's medical condition, accessibility of the scene, and weather. Two common methods of transfer are ground transport, including various type of ambulances, and air medical transport, i.e. helicopter and airplane.

Factors associated with nonbenzodiazepine antiepileptic drug intoxication: analysis of 9,809 registered cases of drug poisoning.

PURPOSE: Antiepileptic drug (AED) intoxications are common due in part to wide clinical application and availability. Because AEDs usually depress central nervous system function, overdosing may be potentially life-threatening or lead to a range of adverse outcomes. The aim of this study was to identify risk factors for nonbenzodiazepine AED (NBAED) intoxication. METHODS: In this cross-sectional study, all consecutive adult and adolescent (>12 years old) poisoned patients who presented to the Loghman-Hakim Poison Hospital (LHPH) during a 6-month period were evaluated. Patients with NBAED intoxication were identified and compared to a control group of those other pharmaceutical intoxications. The risk factors for AED intoxication were identified using univariate analyses and multivariate modeling. RESULTS: Among 9,809 cases of pharmaceutical agent overdose, there were 474 cases (4.8%) with NBAED intoxication. Mean age of the subjects was 24.5 +/- 8.9 years. The most frequent NBAED was carbamazepine (n = 117), followed by phenobarbital (n = 77) and sodium valproate (n = 51). The most frequent motivation was intentional intoxication (95.3%). Multivariate analysis revealed that presence of medical disorders, a history of psychological events, and loneliness were associated with AED intoxication, whereas educational level had a protective effect. There was no association between previous history of parasuicide, sex, age, occupation status, and AED intoxication. DISCUSSION: In conclusion, this study showed that the majority of AED intoxications are due to deliberate self poisoning. The presence of psychological events, medical disorders, and loneliness are risk factors for AED intoxication, whereas higher education level has a protective effect.

Prevalence of spinal cord injury in Tehran, Iran.

BACKGROUND/OBJECTIVE: To determine the prevalence of traumatic spinal cord injury (SCI) in Tehran, Iran. METHODS: A population-based study was performed. In a random cluster sampling, 100 addresses were selected as the starting point of the survey for each cluster consisting of 25 households. To expand the geographic dimension of each cluster, the interviewers skipped 3 of 4 houses in gathering data for each study unit. Each person with traumatic SCI was evaluated initially by a nurse and then by a neurosurgeon by physical examination and spinal imaging at the hospital or at home. RESULTS: Ninety-seven percent of all surveyed agreed to participate in the study (2425 households, or 9006 persons). Four cases of SCI were identified. The point prevalence of SCI was 4.4 [95% CI = 1.2-11.4] per 10,000 people. Over the 5-year period from january 2003 through January 2008, the reported incidence rate of SCI was 2.2 (95% CI = 0.27-8.00) per 10,000 people. CONCLUSIONS: In this, the first published population-based study from Iran, the prevalence of traumatic SCI in Tehran ranged from 1.2 to 11.4 per 10,000 people. More research is required to determine the patterns and causes of SCI. Development of a nationwide SCI registry or surveillance system is fundamental to an understanding of the epidemiology, and hence the prevention, of this costly health problem.

Rising incidence of adenocarcinoma of the esophagus in Kerman, Iran.

BACKGROUND: The fall in the incidence of esophageal squamous cell cancer and noncardia gastric cancers in western countries parallels a concomitant rise in the incidence of gastric cardia cancer and distal adenocarcinoma of the esophagus. We aimed to investigate the incidence trend of different gastric and esophageal cancers in Kerman, southeast Iran. METHODS: The information of all newly diagnosed patients with gastric and esophageal cancers were collected actively from all histopathology departments around the Kerman Province during 1991 - 2002 retrospectively. RESULTS: The annual age standardized incidence risks of esophageal and gastric cancers in Kerman were 1.9 and 6.9 per 100,000 populations. In average, the risks of gastric and esophageal squamous cell cancers were more or less constant, while the risk of adenocarcinoma of the esophagus increased around 11% annually. CONCLUSION: The risks of upper gastrointestinal cancers in Kerman Province were quite lower than the average risks in the whole country. The rising incidence of adenocarcinoma of the esophagus in Kerman parallels its temporal pattern in western countries.