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Background Suicide is a significant public health problem caused by the interaction between demographic, socio-economic, and cultural factors. According to the World Health Organization, about 804,000 fatal suicides and several times this number of suicide attempts occurred worldwide in 2017. Evidence suggests that the incidence of suicide varies among Iran provinces. It is essential to know these differences to allocate resources and adopt the right policies.Methods We used data recorded by the Ministry of Health and the National Forensic Medicine Organization during the study years to provide information about the rate of suicide attempts in the provinces of Iran. To accurately calculate the under-reporting of suicide attempts according to the frequency of successful suicide, we used TSsmooth methods in STATA 14 software. We ran Exponential, Moving Average, and H Winter models and the best model was chosen according to the lowest root mean square error.Results There were 30,137 successful suicide attempts and 349342 unsuccessful suicide attempts during the eight-year study period. Around 18,684 suicides resulted in the death of males, and 11,453 were females. Among the unsuccessful suicide attempts, 237,552 cases were males, and 111,790 were females. The incidence rate of eight years of successful suicide based on age in the age group (15–25 years) was higher than in other groups.Conclusion Considering the current situation in Iran, it is suggested that interventional measures be designed to reduce the incidence of suicide attempts, especially in the age group of 15–49 years, and to conduct pilot studies in provinces with relatively higher incidence rates than other provinces of the country.

Background Critical limb ischemia (CLI) is associated with increased risk of tissue loss, leading to significant morbidity and mortality. Therapeutic angiogenesis using cell-based treatments, notably mesenchymal stem cells (MSCs), is essential for enhancing blood flow to ischemic areas in subjects suffering from CLI. The objective of this study was to evaluate the feasibility of using placenta-derived mesenchymal stem cells (P-MSCs) in patients with CLI. Methods This phase I dose-escalation study investigated P-MSCs in nine CLI patients who were enrolled into each of the two dosage groups (20 × 106 and 60 × 106 cells), delivered intramuscularly twice, two months apart. The incidence of treatment-related adverse events was the primary endpoint. The decrease in inflammatory cytokines, improvement in the ankle-brachial pressure index (ABI), maximum walking distance, vascular collateralization, alleviation of rest pain, healing of ulceration, and avoidance of major amputation in the target leg were the efficacy outcomes. Results All dosages of P-MSCs, including the highest tested dose of 60 × 106 cells, were well tolerated. During the 6-month follow-up period, there was a statistically significant decrease in IL-1 and IFN-γ serum levels following P-MSC treatment. The blood lymphocyte profile of participants with CLI did not significantly differ, suggesting that the injection of allogeneic cells did not cause T-cell proliferation in vivo. We found clinically substantial improvement in rest pain, ulcer healing, and maximum walking distance after P-MSC implantation. In patients with CLI, we performed minor amputations rather than major amputations. Angiography was unable to demonstrate new small vessels formation significantly. Conclusion The observations from this phase I clinical study indicate that intramuscular administration of P-MSCs is considered safe and well tolerated and may dramatically improve physical performance and minimize inflammatory conditions in patients with CLI. Trial registration: IRCT, IRCT20210221050446N1. Registered May 09, 2021.

Background: Traffic accidents are one of the most common causes of mortality and physical disabilities, endangering the lives of many people all over the world annually and are among the top public health problems worldwide. In the present study, we aimed to investigate the trend of mortality rate due to traffic accidents in the provinces of Iran.Methods: In this cross-sectional study, all the deaths caused by traffic accidents in Iran during 2006-2018 were investigated. Using the population of the country by age, sex, and provinces of the country, the mortality rate was calculated and the trend of 13-year changes was studied. The negative binomial regression was used to analyze the linear or nonlinear trend of reduction in mortality rate during the study years. Microsoft Excel 2016 and Stata version 14 software were used to analyze the data.Results: During the study period, 259995 traffic accidents deaths occurred in Iran, of which 78.6% were men and 21.4% were women. The mean age of the deceased was 37.6 ± 20.7 years (37.4 ± 20 years in men and 38.6 ± 23 years in women). The number of the deaths in these years has decreased from 27,567 in 2006 to 17,183 in 2018 and the mortality rate has dropped from 39 per 100,000 in 2006 to 21 per 100,000 in 2018.Conclusion: Despite the decreasing trend in the mortality rate of traffic accidents in Iran during the study years, this trend was different across the provinces. Therefore, it seems necessary to design epidemiological studies to be conducted in different area and provinces of a country, to better and more accurately determine the factors affecting the occurrence of these deaths.

Background: Patients admitted to intensive care units (ICUs) are particularly susceptible to hospital-acquired infections (HAIs) and the HAIs are higher in the ICUs than other wards of the hospital. This study aimed at investigating factors associated with ICU-acquired infections incidence in Iran. Methods: In this multi-center study, Iranian nosocomial infections surveillance (INIS) and hospital statistics and information system (AVAB) were used to collect data on patients with HAIs in 2018. The data was expanded based on 12 months of the year (13,632 records in terms of "hospital-ward-month") and then, the last observation carried forward method was used to replace the missing data. The generalized negative binomial regression with “patient-days” as an offset variable was used to identify the factors affecting ICU-acquired infections incidence.Results: The median age of patients was 57.5 (IQR=55.09) years. Of the 22.92%, 5.76%, 13.62%, 43.41%, and 14.29% of patients were in NICU, PICU, internal ICU, general ICU, and surgical ICU, respectively. Only 13.73% of hospitals were in efficient zone (zone III). Based on multivariable regression, the number of death (IRR=1.02), the number of infections due to the device (catheters and ventilators) (IRR=1.1), ward type (PICU (IRR=1.58), internal ICU (IRR=1.63), general ICU (IRR=1.53) and surgical ICU (IRR=1.47)), hospital's expertise, hospital's accreditation, bed occupancy rate indicator (IRR=1.17 for moderate conditions) were associated with an increase of ICU-acquired infections incidence. Infection due to ventilator, infection due to catheter, and the number of surgery in hospitals reduced 5%, 7%, and 1% incidence of infections, respectively. Conclusions: Based on the results, the most common ICU-acquired infections were VAE and UTI. Therefore due to the high sensitivity of intensive care units, full hygiene should be taught to the medical staff, especially the ICU wards. Ventilators and catheters should be used in special circumstances and minimum duration.