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Introduction: Medical complaints are always the most challenging items in the scope of practice and have great difficulties for both the physician and the patient. Due to the need for comprehensive data for health planning of Guilan province And the importance of this research as factors in occupational safety and health practitioners, patients, re search in this area is necessary. Objective: Determining factors in a complaint to the Medical Council of Doctors in Gilan Province in the years 2005 to 2010 Materials an d Methods: In this cross-sectional study of 425 case s related to medical malpractice law suits stemming from the Medical Council of Guilan during the years 1385 to 1390 was carried out. Thus the plaintiffs checklist includes information such as age, sex, date of complaint, the complaint doctors information such as gender, field of practice, location of practice, Work Experience and the first instance and appeal preparation was completed. The data were entered into a statistical software SPSS18 and were analyzed using descriptive statistics. Results: Dentists had the most claims, followed by orthopedic surgeons, General Practitioners, General Surgeons and Gynecologists. Physicians were found innocent and guilty in 354 cases (83.3%) and 67 cases (15.7%) of cases, respectively. Al so, patients quit their claims in 4 case s. The most common cause s of complaints mentioned by patients, were medical error, complications of treatments and then, financial is sue s. Most cause s of proposing a claim were malpractice, treatment complications and financial is sue s. Conclusion: The data showed that most of the claims recorded were unfounded and consequently, respective physicians were not guilty. Therefore, knowledge of the patient' s physician, the patient is familiar with the methods of treatment and possible side effects and reduce the financial relationship between the physician and patient compliance in many case s can be prevented by a patient complaint. [ABSTRACT FROM AUTHOR]

Introduction: Promoting the quality of services in hospital emergency departments can lead to greater patient satisfaction, reduced complaints and improved health quality. To this end, understanding the strengths and weaknesses of the current status of hospital emergency departments can help improve the quality of services in the future. Objective: To evaluate the quality of health care of emergency centers of Rasht in 2013 Materials and Methods: This study was a descriptive and analytical one, carried out in 7 teaching, training centers including Razi hospital emergency departments, Poursina, Dr. Heshmat, Alzahra, Amiralmomenin, Shafa and Velayat in Rasht province. Data were collected using a questionnaire consisting of two parts with 77 questions; first part having 13 questions related to the in-charge information and the second part consisting of 64 questions related to structure, process and the function of emergency department. Data analysis software was SPSS18 using descriptive and inferential indicators. Hospitals with more than 90 percentage points for the process, structure and function were considered favorable, 71-90% were relatively favorable, 50-70% were at middle level and less than 50% were considered as weak. Results: Average number of active beds in the emergency department of the hospitals was 19.8. As shown, 85.72% of the investigated emergency departments were relatively favorable and 14.28% were favorable. Regarding distribution of human resources, Dr. Heshmat training and medical center with 88%, in environment and facilities area, Velayat training and medical center with 99.5%, in management affairs Poursina, Razi, Velayat and Dr. Heshmat with 94.54 percentage, in emergency department rules, Razi training and medical center with 96.3 percentage were in better situation. Average gained point in the field of educational process of training and medical centers in Rasht was 66.28%. Conclusion: Structure and function of the investigated training and medical centers of Rasht in terms of human resources, environment and facilities, managing and emergency department rules were relatively favorable and favorable and in the field of educational processes were at average level. Therefore, given the nature of emergency departments, it seems that paying more attentions to standardization, and particularly empowering of human resources are necessary. Continuous education of the physicians and nurses could be very helpful, too. Conflict of interest: non declared [ABSTRACT FROM AUTHOR]

Background and Aims: Health policymakers face challenges in designing compulsory plan packages for medical students to encourage them to work in disadvantaged regions. Using a discrete choice experiment, this study assessed the preferences of medical students for selecting the compulsory service plan packages in Guilan Province, Iran., Methods: In total, 374 medical students responded to a survey inquiring about salary, distance from their residency city, availability of welfare amenities, work difficulty, the developmental status of their workplace, contract duration, and preference for urban or rural work settings., Results: The study revealed that students favor a compulsory service package that provides higher salaries and shorter contract duration. They also show a preference for working within their home province over other factors. For the opportunity to serve in their city of residence, they would forgo an average of US$77.93 per month., Conclusion: While financial incentives were the primary consideration for medical students when choosing compulsory service packages, a range of nonfinancial factors significantly influenced their decisions as well., Competing Interests: The authors declare no conflict of interest., (© 2024 The Author(s). Health Science Reports published by Wiley Periodicals LLC.)

Cancer is one of the most serious leading causes of death in the world. Many eclectic factors are involved in cancer progression including genetic and epigenetic alongside environmental ones. In this account, the performance and fluctuations of microRNAs are significant in cancer diagnosis and treatment, particularly as diagnostic biomarkers in oncology. So, microRNAs manage and control the gene expression after transcription by mRNA degradation, or also they can inhibit their translation. Conspicuously, these molecular structures take part in controlling the cellular, physiological and pathological functions, which many of them can accomplish as tumor inhibitors or oncogenes. Relatively, Oxidative stress is defined as the inequality between the creation of reactive oxygen species (ROS) and the body's ability to detoxify the reactive mediators or repair the resulting injury. ROS and microRNAs have been recognized as main cancer promoters and possible treatment targets. Importantly, genotoxicity has been established as the primary reason for many diseases as well as several malignancies. The procedures have no obvious link with mutagenicity and influence the organization, accuracy of the information, or fragmentation of DNA. Conclusively, mutations in these patterns can lead to carcinogenesis. In this review article, we report the impressive and practical roles of microRNAs, oxidative stress, and genotoxicity in the pathobiology of cancer development in conjunction with their importance as reliable cancer biomarkers and their association with circulating miRNA, exosomes and exosomal miRNAs, RNA remodeling, DNA methylation, and other molecular elements in oncology., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

Background: Reliable estimation of prevalence is important for monitoring and evaluation of COVID-19 prevention programmes among at-risk populations., Aims: We compared the capture-recapture method with a seroprevalence survey for accurate estimation of the prevalence of COVID-19 during a 1-year period in Guilan Province, northern Islamic Republic of Iran., Methods: We used the capture-recapture method to estimate the prevalence of COVID-19. Records from the primary care registry system and the Medical Care Monitoring Center were compared, using 4 matching approaches based on combinations of the following variables: name, age, gender, date of death, positive or negative cases, and alive or dead cases., Results: The estimated prevalence of COVID-19 in the study population from the beginning of the pandemic in February 2020 until the end of January 2021 was 16.2-19.8%, depending on the matching approach used, which was lower than in previous studies., Conclusion: The capture-recapture method may provide better accuracy than seroprevalence surveys in measuring the prevalence of COVID-19. This method may also reduce the bias in the estimation of prevalence and correct the misconception of policymakers about seroprevalence survey results., (Copyright © Authors 2023; Licensee: World Health Organization. EMHJ is an open access journal. This paper is available under the Creative Commons Attribution Non-Commercial ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo).)

Objective: Burn trauma is a life-threatening incident that may be accompanied by several risk factors that increase morbidity and mortality. Drug abuse is one of the lifestyle dangers on the rise globally and can have an impact on the outcomes of burn injuries. This study aimed to evaluate the effect of drug abuse on the clinical outcomes of adult burn patients who were admitted to a burn center in the North of Iran., Methods: This retrospective cross-sectional study included adult burn patients who were referred to Velayat Hospital, between March 1, 2021, and March 20, 2022. The hospital information system (HIS) was used to select patients with a history of drug use and then were compared with burn victims who had never used drugs before. In both groups, demographic information, the cause of the burn, the comorbid diseases, total body surface area, length of stay, and outcomes were collected and recorded for both groups., Results: This study included 114 inpatients, 90 of whom (78.95%) were men. The mean age of the patients was 43±15 years. The mean length of hospitalization in the drug-user group was significantly higher than in the non-drug abuse group ( p =0.004). The drug abuse group had significantly higher rates of comorbid diseases ( p =0.021), inhalation injury ( p <0.001), mortality ( p =0.002), and pneumonia ( p <0.001). However, there were no statistically significant differences in the Infection and Sir's rates ( p =0.583) between the groups., Conclusion: Drug abuse is a risk factor in adult burn patients, which can affect the length of stay and burn-related morbidities., Competing Interests: None of the authors has any personal or financial conflicts of interest.

Background: Aluminum phosphide (ALP) poisoning is considered one of the health care issues in Iran, which is associated with the mortality outcome of patients., Introduction: According to the ALP poisoning that commonly results in death, we aimed to evaluate the prevalence of ALP pill poisoning by employing register-based research., Methods: In this descriptive cross-sectional study, all selected patients diagnosed and confirmed with ALP poisoning by a specialist and referred to the poisoning ward from the beginning of April 2016 to the end of October 2017 were enrolled, and data were registered in the Disease Registration System by a technical expert for daily follow-up during hospitalization., Results: Approximately 12.4% of patients had neurological problems, with the majority having paresis (68.3%). Self-poisoning with the purpose of suicide was documented for 96.2% of cases, with the most common cause being family problems (54.1%). In 97.3% of cases, the method of contact with the toxic substance was oral. Hypotension, cardiac, and respiratory complications were observed in 25.2%, 30.8%, and 25% of the patients, respectively. The most gastrointestinal symptoms were nausea and vomiting (86.7%)., Conclusion: The results indicate that the rate of ALP pill poisoning is relatively high. Suicide is the most important cause of ALP poisoning, which is more common in men under 40 years of age., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Child abuse related to witchcraft and exorcism phenomena is not limited to specific cultures, religious beliefs, races and geographic areas and it can be seen in all periods of human culture and civilization. Despite the widespread consequences of harm, due to the limited reports and announced statistics, the scope of the problem in comparison to other forms of child abuse seems minor. The legal and judicial services are often unaware of these cases and it is not highlighted in police and social service databases as a significant factor in child abuse. In spite of global programs on children's peace and activities of child rights committee of United Nations, this type of hidden child abuse continues. In this study, we have discussed seven cases of child abuse related to these phenomena and address the psychological dimensions of the injury by The Revised Children's Anxiety and Depression Scale and Subscales (RCADS) that showed clinically significant anxiety and depression. In addition, we have tried to look at the historical background, risk factors, extent of damage and challenges in the reporting field. Children are the future makers of the world, and any type of child abuse has adverse effects on their growth, physical and mental health. To confront this issue, strengthening partnerships between child protection institutions and multimodal approaches in collaboration with local, national and international organizations also imposing strict punishment on the people who played a role in this action should be pursued more seriously., Competing Interests: Declaration of competing interest We are pleased to submit an article entitled “Hidden Aspects of Child Abuse” in the Journal of Forensic and Legal Medicine. All authors declare that we have no conflicts of interest. Thank you for your consideration., (Copyright © 2022 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)

A methanol poisoning outbreak occurred in Iran during the initial months of coronavirus disease 2019 (COVID-19) pandemic. We aimed to evaluate the epidemiology of the outbreak in terms of hospitalizations and deaths. A cross-sectional linkage study was conducted based on the hospitalization data collected from thirteen referral toxicology centers throughout Iran as well as mortality data obtained from the Iranian Legal Medicine Organization (LMO). Patient data were extracted for all cases aged > 19 years with toxic alcohol poisoning during the study period from February until June 2020. A total of 795 patients were hospitalized due to methanol poisoning, of whom 84 died. Median [interquartile ratio; IQR] age was 32 [26, 40] years (range 19-91 years). Patients had generally ingested alcohol for recreational motives (653, 82.1%) while 3.1% (n = 25) had consumed alcohol-based hand sanitizers to prevent or cure COVID-19 infection. Age was significantly lower in survivors than in non-survivors (P < 0.001) and in patients without sequelae vs. with sequelae (P = 0.026). Twenty non-survivors presented with a Glasgow Coma Scale (GCS) score > 8, six of whom were completely alert on presentation to the emergency departments. The time from alcohol ingestion to hospital admission was not significantly different between provinces. In East Azerbaijan province, where hemodialysis was started within on average 60 min of admission, the rate of sequelae was 11.4% (compared to 19.6% average of other provinces)-equivalent to a reduction of the odds of sequelae by 2.1 times [95% CI 1.2, 3.7; p = 0.009]. Older patients were more prone to fatal outcome and sequelae, including visual disturbances. Early arrival at the hospital can facilitate timely diagnosis and treatment and may reduce long-term morbidity from methanol poisoning. Our data thus suggest the importance of raising public awareness of the risks and early symptoms of methanol intoxication., (© 2022. The Author(s).)

Background: Anthracosis is caused by several factors and is a risk factor for cancer and tuberculosis. This study investigated the prevalence of anthracosis and the associated factors in autopsy specimens from the Guilan Office of the Iranian Legal Medicine Organization., Materials and Methods: This retrospective study examined the medical records of autopsy specimens (>18 years) in the Guilan Office of the Iranian Legal Medicine Organization in 2019 for pulmonary anthracosis. Data were extracted from the autopsy findings, and demographic characteristics, occupational information, tuberculosis or pulmonary cancer history, and anthracosis were recorded in a checklist. SPSS version 16 was used to analyze the collected data., Results: The study included 190 autopsy specimens with a 32.1% anthracosis prevalence. Forty-five (23.7%) subjects had anthracofibrosis. Individuals with agricultural carriers or who worked in tobacco fields had the highest prevalence of anthracosis. The frequency of pulmonary cancer and tuberculosis was significantly higher in the specimens with anthracosis (anthracosis group) than in the non-anthracosis group (P<0.05). The use of traditional cooking and heating methods, as well as exposure to carbon and smoke in the workplace, were significantly higher in the anthracosis group than in the non-anthracosis group (P<0.05)., Conclusion: The results of the current study revealed that occupational exposure, tuberculosis, pulmonary cancer, and traditional indoor cooking and heating methods were all associated with anthracosis., (Copyright© 2022 National Research Institute of Tuberculosis and Lung Disease.)

Background: Identifying the non-survived patients' characteristics compared to survived subjects and introducing the critical risk factors of COVID-19 mortality would help enhance patients' prognosis and treatment., Methods: In the current case-control study, medical records of 103 non-survived COVID-19 patients (cases) and 147 sex-matched survivors (controls) who admitted to Razi University Hospital in Rasht, Guilan, Northern Iran from April 21 to August 21, 2020, were explored. Data on demographic, anthropometric, clinical, and laboratory assessment was extracted from the electronic medical records. To estimate the association between variables of interest and mortality odds due to COVID-19 logistic regression was carried out., Results: The patients who died (mean age = 62.87 years) were older than the discharged patients (57.33 years; P value = 0.009). According to the results of multivariable regression adjusted for potential confounders, elevated BMI (OR = 2.49; 95% CI = 1.15-5.41), higher CRP levels (OR = 2.28; 95% CI = 1.08-4.78), increased FBS levels (OR = 2.88; 95% CI = 1.35-6.17), higher levels of total cholestrol (OR = 2.55; 95% CI = 1.19-5.45) and LDL (OR = 2.27; 95% CI = 1.07-4.79), elevated triglyceride (OR = 5.14; 95% CI = 2.28-11.56), and raised levels of D-dimer (OR = 5.68; 95% CI = 2.22-14.49) were identified as independent risk factors of COVID-19 mortality. No significant association was detected regarding HDL level, QTc interval or heart size, and COVID-19 fatality odds., Conclusion: The present findings demonstrated that obesity, higher levels of CRP, blood sugar, D-dimer, and lipid markers were likely to be predictive factors of COVID-19-related mortality odds., (© 2021. Royal Academy of Medicine in Ireland.)

Cancer stem cells (CSCs) are responsible for carcinogenesis and tumorigenesis and are involved in drug and radiation resistance, metastasis, tumor relapse and initiation. Remarkably, they have other abilities such as inheritance of self-renewal and de-differentiation. Hence, targeting CSCs is considered a potential anti-cancer therapeutic strategy. Recent advances in the identification of biomarkers to recognize CSCs and the development of new techniques to evaluate tumorigenic and carcinogenic roles of CSCs are instrumental to this approach. Elucidation of signaling pathways that regulate CSCs colony progression and drug resistance are critical in establishing effective targeted therapies. CSCs play a central key role in immunomodulation, immune evasion and effector immunity, which alters immune system balancing. These include mTOR, SHH, NOTCH and Wnt/β-catering in cancer progression. In this review article, we discuss the importance of these CSCs pathways in cancer therapy., (Copyright © 2020 Elsevier B.V. All rights reserved.)

The objective of study was to evaluate the prevalence of malnutrition and associated factors in cardiac patients in the north of Iran. This cross-sectional study was done on 430 cardiac patients, who were admitted to the only heart hospital in the north of Iran. The malnutrition status was assessed based on "Malnutrition Universal Screening Tool" (MUST). The data was analyzed using SPSS software. The mean age of patients was 63.5 ± 12.67 years. The commonest cause of hospitalization was acute coronary syndrome. 31.4% patients had history of admission in the past 12 months. The prevalence of malnutrition was 14%, 7.7%, and 6.3% had medium and high risk of malnutrition, respectively. Patients with history of one time admission were 2.7 times more likely to be malnourished. The odds ratio for more than one time of hospital admission was 3.54. Malnutrition is likely to be present when the cardiac patients are admitted to hospital in Gilan province, in northern Iran.

Objective: To determine the status of pre-hospital emergency care and its associated factors in traumatic patients., Methods: In across-sectional study, 577 traumatic patients who were transferred to Poursina hospital by EMS (Emergency Medical Services) personnel were selected by simple random sampling method. Pre-hospital emergency services were observed. Then the mean of taken measures scores for each domain was determined in percent and evaluated in terms of associated factors (age, working experience of staff and number of missions per day) and compared using Spearman's test., Results: Out of 577 patients, 454 were men (78.7%) and 123 women (21.3%). Their mean age was 35.1 years old. Accident (82.7%) was the most common mechanism of injury. Most vehicles involved in the accident were light -weight cars (48.5%) and motorcycles (32.2%). A significant relationship was found between age, general domain (p=0.039) and hemodynamic (p=0.019) as well as between work experience and general domain (p=0.018)., Conclusion: Given that pre-hospital emergency services provided in most of the domains are relatively far from world standard, results of this research can provide information for managers to improve strategic planning on care and medical services, appropriation of budget, knowledge of personnel and necessary equipment., Competing Interests: None declared.

A 51-year-old man committed suicide by swallowing the contents of a fire extinguisher. A few hours after his suicide attempt, he was referred to the medical center for poisoning. At the time of admission, the patient was conscious with stable vital signs. The patient complained of burning lips and mouth, mentioning diarrhea. Initial treatments included gastric lavage with activated charcoal, while paraclinical measures were requested. The patient had undergone hypernatremia (Na: 152 mEq/l) and metabolic alkalosis. Treatment focused on the adjustment of sodium level and alkalosis. On the first day of hospitalization, the patient experienced recurrent episodes of tonic-clonic seizure along with the loss of consciousness. On the third day of hospitalization, the patient developed respiratory arrest followed by cardiac arrest and death.