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Saadat S.,Tehran University of Medical Sciences | Javadi M.,Janbazan Medical and Engineering Research Center | Divshali B.S.,Tehran University of Medical Sciences | Tavakoli A.H.,Tehran University of Medical Sciences | And 4 more authors.
BMC Public Health | Year: 2010

Background. Spinal cord-injured (SCI) patients experience poor health-related quality of life (HRQOL) and they usually report lower HRQOL than the general population or population subgroups in Iran and elsewhere. The aim of this study was to compare HRQOL between veterans and non-veterans with SCI in Iran. Methods. This was a cross-sectional study. HRQOL was measured using the 36-item Short Form Health Survey (SF-36). Thirty-nine male veterans and 63 non-veteran males with SCI were included in the study. Regression analyses were applied to determine the variables affecting physical and mental health-related quality of life among the patients. Results. The male veterans had a lower HRQOL than the non-veterans with SCI. The differences were significant for all measures except for physical and social functioning. The greatest difference was observed for bodily pain (P = 0.001). The regression analysis results indicated that a longer time since injury was associated (P = 0.01) with better physical health-related quality of life (PCS), while being a veteran (P < 0.001) and having a spinal lesion in the cervical region (P = 0.001) were associated with poorer PCS. Older age (P < 0.001) and higher education (P = 0.01) were associated with better mental health-related quality of life (MCS), while being a veteran and having a spinal lesion in the cervical region (P = 0.02) were associated with poorer MCS. Conclusion. The study findings showed that veterans with SCI experienced lower HRQOL than their non-veteran counterparts. A qualitative study is recommended to evaluate why HRQOL was lower in veterans than in non-veterans with SCI although veterans had higher incomes as a result of their pensions and increased access to equipment, and medications. To improve quality of life in both veterans and non-veterans with spinal cord injuries, policy changes or implementation of new interventions may be essential so that veterans could receive additional support (e.g. counseling, recreation therapy, vocational therapy, etc.) and non-veterans could meet their basic needs. © 2010 Saadat et al.

Jafarinasab M.-R.,University of Tehran | Zarei-Ghanavati S.,Mashhad University of Medical Sciences | Karimian F.,University of Tehran | Soroush M.-R.,Janbazan Medical and Engineering Research Center | Javadi M.-A.,University of Tehran
Cornea | Year: 2010

Purpose: To evaluate in vivo confocal microscopic features of the cornea in chronic and delayed mustard gas keratopathy (MGK). DESIGN:: Comparative cross-sectional study. Participants and controls: Twenty-two eyes of 22 consecutive patients with MGK and 28 eyes of 28 normal unoperated subjects were enrolled. Methods: All subjects underwent corneal confocal scanning, and the findings were compared between the 2 groups. Main outcome measures: Qualitative (layer thickness measurement and cell count) and quantitative (nerve and deposit evaluation) findings of corneal confocal scanning. Results: All subjects with MGK and normal subjects were males, with no significant difference in mean age between the 2 groups. Mean central corneal thickness, mean epithelial thickness, mean cell density of basal epithelia, keratocyte density at 3 stromal layers, and endothelial cell density in the MGK group were significantly lower than those in the control group. Loss of keratocytes was predominantly observed in the anterior to middle stroma. In vivo confocal microscopy revealed lack of a subbasal nerve plexus, presence of intrastromal hyperreflective microdots, prominent thickened midstromal nerves, enlarged bizarre-looking keratocytes, amyloid degeneration, lipid keratopathy, posterior stromal folds, and endothelial cell pleomorphism and polymegathism. Conclusion: Corneal thinning, significant loss of keratocytes together with pleomorphic residual keratocytes, thickened midstromal nerve, stromal microdots, amyloid degeneration, and lipid keratopathy were remarkable findings observed in our cases. Although all the corneal layers were affected significantly by mustard gas, the anterior to middle parts of the cornea were more involved than the posterior parts. © 2010 by Lippincott Williams and Wilkins.

Roshan R.,Shahed University | Rahnama P.,Shahed University | Ghazanfari Z.,Ilam University | Montazeri A.,Iranian Institute for Health science Research | And 5 more authors.
Health and Quality of Life Outcomes | Year: 2013

Background: Sulfur mustard (SM) is an alkylating agent that induces short and long term toxicity on various organs. The aim of this study was to assess the long-term psychological symptoms among samples of exposed to sulfur mustard gas compared with unexposed civilians 20 years after exposure.Methods: This historical cohort study was conducted on 495 civilians of Sardasht and Rabat in two age matched groups, including 367 sulfur mustard exposed participants from Sardasht and 128 unexposed subjects from Rabat. Psychological symptoms was assessed using the Symptom Check List-90 Revised (SCL-90-R) including measures of somatization, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism providing three global distress indices namely: Global Severity Index (GSI), Positive Symptom Total (PST) and Positive Symptom Distress Index (PSDI). Comparison was made between exposed and unexposed civilians.Results: There were significant differences in somatization (P = 0.002), obsessive-compulsive (P = 0.031), depression (P = 0.007), anxiety (P = 0.042), and hostility (P = 0.002), between the exposed and unexposed groups. In addition there were significant differences between two groups concerning the GSI (P = 0.045) and the PSDI (P < 0.001). The differences between two groups in other subscales were not significant.Conclusions: The findings from this study showed that civilians who exposed to sulfur mustard gas were suffering from a number of psychological symptoms even 20 years after exposure. Providing mental health services and more resource allocation for this community are highly recommended. © 2013 Roshan et al.; licensee BioMed Central Ltd.

Khaji A.,Tehran University of Medical Sciences | Fallahdoost S.,Organization of Ground Force Devotees Holy Defense Research Center | Soroush M.R.,Janbazan Medical and Engineering Research Center
Chinese Journal of Traumatology - English Edition | Year: 2010

Objective: To determine the nature and extent of Iranian casualties by ballistic missile attacks during the eight years of the Iraq-Iran war. Methods: The data collected about Iraqi missile strikes on Iranian cities included the following: date and time, number and type of missiles, cities targeted, and injuries and deaths resulting from impacts of missiles in civilian areas. The data were extracted from a database that was constructed by the army staff headquarters based on daily reports of Iranian army units during the war. Results: Over a period of eight years (1980-1988), Iraqi army fired 533 ballistic missiles at Iranian territories. From those, 414 missiles (77.7%) landed on Iranian cities. The impacts of these missiles caused the deaths of 2 312 civilians and injured 11 625 others. Three types of ballistic missiles were used: FROG-7, Scud, and Al-Hussein (a modified version of the Scud missile). Twenty-seven cities in Iran were struck by Iraqi ballistic missiles. The highest mortalities from ballistic missiles were in Dezful and Tehran. Iraqi missile attacks continued for 90 months (2 748 days). Conclusion: Our results point to the necessity of investigating the psychological consequences of Iraqi ballistic missile attacks among survivors in 27 Iranian cities during the eight years of the Iraq-Iran war.

Javadi M.,Janbazan Medical and Engineering Research Center | Hafezi-nejad N.,Tehran University of Medical Sciences | Vaccaro A.R.,Thomas Jefferson University | Vafa R.-M.,Tehran University of Medical Sciences | Vafa R.-M.,University of Tehran
Advances in Clinical and Experimental Medicine | Year: 2014

Background. Spinal cord injury [SCI] occurring in military veterans is a disabling and highly morbid event. Often the victims are young active males who sustain these injuries during military conflict and suffer from the complications of the SCI for the rest of their lives. Objectives. The aim of the study is to report the epidemiology of Iranian SCI veterans and their health related quality of life, medical complications and patient associated outcomes. Material and Methods. A cohort of 1984 patients was examined to investigate the epidemiology of Iranian SCI veterans of the Iraq-Iran War (1980-1988); 1803 out of the total number of SCI records were included. Health monitoring was carried out through scheduled monthly visits by general physicians, followed by interviews with specialists from March 20, 2007, to March 19, 2010. Additional follow-up was conducted by telephone survey. Results. In all, 174 patients (8.77%) had incomplete injury and the rest had complete injury, the most frequent level of injury was the thoracic level (1256 patients - 63.30%). Pressure ulcers were the most frequent complication (up to 14.7% annual prevalence), followed by reactions to severe stress and adjustment disorders (up to 13.6%) and diabetes (up to 10.1%). In the telephone surveys, kidney and/or urologic disorders were the most frequent reported complaints (21.6%). A total of 101 out of the 1984 SCI veterans died between 2000 and 2010 (∼0.5% per year). Conclusions. In veterans with spinal cord injury, pressure area ulcers (ICD10:L89), reactions to severe stress and adjustment disorders (ICD10:F43), diabetes mellitus (ICD10:E10-E14) and kidney and/or urologic disorders are common and should be addressed aggressively in healthcare planning and management programs for patients with spinal cord injuries. © Copyright by Wroclaw Medical University.

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