Higher education does not protect against firework-related injuries: a review of the economic burden and the risk factors of firework-related injuries in the capital of Iran.

OBJECTIVE: To examine the incidence and risk factors of firework-related injuries during the Last Wednesday Eve Festival in Tehran, Iran, with a focus on the association of socio-economic status and educational level with the use of fireworks and the incidence of firework-related injury. STUDY DESIGN: Cross-sectional household survey. METHODS: Using a random cluster sampling approach, a household survey was conducted in Greater Tehran in April 2008. During a structured interview with an adult member of the household, questions were asked about the use of fireworks and any firework-related injuries sustained by household members during the preceding festival. Data were gathered on expenditure on fireworks, medical treatment of firework-related injuries, length of hospital stay for the treatment of these injuries, and damage to personal property by fireworks. RESULTS: The survey included 2456 households in Greater Tehran. At least one member of 18% of these households had used fireworks during the Last Wednesday Eve Festival in 2008. The overall incidence of firework-related injuries was 100 per 100,000 population (95% confidence interval 37-163). The use of fireworks was less common among parents and more common among male children. Individuals who used fireworks were younger than non-users. Younger age and use of fireworks were associated with firework-related injuries (P < 0.05). The mean household expenditure on fireworks was US$1.62. Among the households that had bought fireworks, the mean expenditure was US$9.40 (standard deviation US$16.34). Thirty-two households (1.3%) reported damage to personal property due to fireworks during the festival costing US$3.30-167.20. The regional price of housing in the study area was correlated with the educational level of the head of the household. Higher educational level of the head of the household was associated with participation in firework activities by household members, expenditure on fireworks, and the amount of financial loss due to fireworks (all P < 0.05). CONCLUSION: Fireworks are associated with serious injuries, and impose a non-trivial financial burden on families. While personal use of fireworks was an independent risk factor for firework-related injuries, higher socio-economic status of the household and higher educational level of the head of the household were not protective factors.

The epidemiology of tick-borne relapsing fever in Iran during 1997-2006.

BACKGROUND: Tick-borne relapsing fever is an acute febrile and endemic disease in Iran. For many reasons, the incidence of disease is on decrease, however tick-borne relapsing fever is still a health issue in the rural areas for travelers. This study was carried out during 1997-2006 to investigate the tick-borne relapsing fever in Iran. METHODS: Based on a cross-sectional, retrospective and descriptive study in all the provinces, the residents in the endemic areas who were febrile and suspicious to tick-borne relapsing fever were enrolled in the study. Tick-borne relapsing fever is a notifiable disease in Iran and the national communicable disease surveillance data were used through questionnaires. The infectivity of Ornithodoros species to Borrelia also was studied in two highly endemic areas including Hamadan and Qazvin provinces. RESULTS: During 1997-2006, a total of 1415 cases have been reported from the entire country. The highest prevalence was observed in year 2002 with the incidence rate of 0.41/100,000 population. Ardabil province is the first ranked infected area (625 out of 1415), followed by Hamadan, Zanjan, Kurdestan and Qazvin provinces sequentially. The disease is recorded during the whole year but its peak occurs during summer and autumn. There have been 87.6% of the cases recorded from June to November. Forty five percent of the infected cases were male and one third of the patients were under 5 years of age. Fifty four percent of the patients comprise the children under 10 years. Ninety two percent of the cases were living in rural areas where their dwellings were close to animal shelters. They were involved mainly with farming and animal husbandry activities. All the febrile patients with confirmed spirochetes in their blood samples were treated according to a national guideline for tick-borne relapsing fever treatment. Only 7% of the patients were hospitalized and 0.8% of them exhibited the Jarisch-Herxheimer reaction. The study of infectivity of Ornithodoros species to Borrelia revealed that Ornithodoros tholozani was infected with Borrelia persica and Ornithodoros erraticus with Borrelia microti. CONCLUSION: Travelers to the rural areas with high prevalence of the disease should be made aware of the risk of tick-borne relapsing fever and use of appropriate control measures. Communicable disease surveillance including tick-borne relapsing fever should be pursued as well.

Detection of Wheat Stem Rust (Puccinia graminis f. sp. tritici) Race TTKSK (Ug99) in Iran.

In 2007, new reports of stem rust caused by Puccinia graminis Pers. f. sp. tritici Eriks. in Lorestan and Hamadan provinces of Iran were considered unusual because stem rust had not been recorded previously in the Hamadan area where winter habit wheat cultivars are grown. Detailed investigations in these areas showed significant levels of stem rust in experimental plots and occasionally in farmers' fields, some that showed moderate to high levels of infection. Race analysis of four stem rust samples collected from Borujerd, Hamadan, and Poldokhtar (southwest) and Kelardasht (north) in 2007 was conducted using a modified North American Pgt differential set representing the resistance genes Sr5, 6, 7b, 8a, 9a, 9b, 9d, 9e, 9g, 10, 11, 17, 21, 24, 30, 31, 36, 38, Tmp, and McN, commercial cultivars, and genotypes known to carry the 1B.1R translocation. A race collected from Borujerd in 1997 was also included for comparison. Tests were carried out under standard controlled conditions (1,2). Two isolates from samples collected from Borujerd and Hamadan in 2007 showed high infection types (ITs 33+ to 4) on differential lines carrying resistance genes Sr5, 6, 7b, 8a, 9a, 9b, 9d, 9e, 9g, 10, 11, 17, 21, 30, 31, 38, and McN, and low ITs of ;C1= to 2=, ;C to ;N1=, and 2+ on lines carrying Sr24, Sr36, and SrTmp, respectively. On the basis of the high/low ITs on the 20 differentials in the modified Pgt differential set of North America, the two isolates of Pgt collected from Borujerd and Hamadan in 2007 were identified as race TTKSK. The two isolates from samples collected from Poldokhtar and Kelardasht in 2007 and the isolate collected from Borujerd in 1997 were identified as races TRFSC, TTJQC, and RRHSC, respectively. Race TTKSK identified in the current study produced high ITs of 3+ to 4 on the wheat genotypes Line E*4/Kavkaz, Fed.*4/Kavkaz, Clement, and Mildress and commercial cultivars Falat (Seri 82), Shiroodi (CIMMYT name Attila and Indian name PBW343), Atrak (Kauz), and MV17, all carrying the 1BL.1RS translocation and further confirming virulence for Sr31. The spread of Ug99 to Kenya (1999 to 2002), Ethiopia (2003), and Yemen (2006) suggests progressive migration from Uganda, following the pattern believed to have occurred for the spread of wheat stripe rust pathogen from East Africa in 1986 to India in 1998 (3). Our results are consistent with the TTKSK race identified in Iran migrating from the new African population. Seedling evaluation of Iranian wheat cultivars and advanced lines to isolates of TTKSK from Iran confirmed full susceptibility. These results reinforce the serious threat of race TTKSK to wheat production in Iran. In conclusion, the occurrence of race TTKSK in Iran, the susceptibility of Iranian wheat cultivars to this race, the presence of environmental conditions conducive to disease epidemics in different parts of the country, and the occurrence of the alternate host barberry in many of the mountainous areas of Iran, indicate a new and serious threat to wheat production in Iran and a potentially serious threat to neighboring countries. References: (1) Y. Jin et al. Plant Dis. 91:1096, 2007. (2) Z. A. Pretorius et al. Plant Dis. 84:203, 2000. (3) R. P. Singh et al. CAB Rev. 1 (No. 054), 2006.

Nephrotoxicity by dicloxacillin and gentamicin in 163 patients with intertrochanteric hip fractures.

Of 163 patients with intertrochanteric hip fractures 87 received 2 g dicloxacillin and 240 mg of gentamicin preoperatively, and 76 patients had no antibiotic prophylaxis. Preoperative antibiotic prophylaxis was not shown to have any significant effect on wound infections. However, 16 reversible and 1 irreversible cases of kidney toxicity were found among patients receiving antibiotic prophylaxis, whereas there were only four cases of reversible kidney damage among the patients not receiving antibiotics.