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Introduction: Disability is an unavoidable fact which has been existed as a social phenomenon in communities from the past until now. There are different reasons for the emergence of this phenomenon which can be identified and prevented, thereby lowering the incident rate of disability in communities. This descriptive-analytical study aimed at investigating the causes of disability among adolescents under 14 years of age in Ilam, Iran. Materials & Methods: This study included 694 participants (336 males and 270 females) who were selected using a census sampling method. The data were collected through a researcher-made questioner, and subsequently, they were analyzed using descriptive (i.e., Frequency and Frequency percent) and inferential statistics (i.e., the Chi-square test). Findings: The results showed that consanguineous marriage, congenital factors, literacy, and gender correlated significantly with disability (P

Background Persons with disabilities can have physical, mental, intellectual, or sensory impairments which can hinder their social participation. Despite Sustainable Development Goals call for “universal access to sexual and reproductive health (SRH)”, women with disabilities (WwDs) continue to experience barriers to access SRH services in Nepal. This study evaluated factors affecting the utilization of SRH services among WwDs in Ilam district, Nepal. Methods A mixed-method study with 384 WwDs of reproductive age was conducted in Ilam district, eastern Nepal. Quantitative data were collected using a structured questionnaire. Relationships between utilization of SRH services and associated factors were explored using multivariate logistic regression analysis. Qualitative data were collected from focus groups with female community health volunteers and interviews with WwDs, health workers and local political leaders. They were audio-recorded, translated and transcribed into English and were thematically analyzed. Results Among 384 respondents (31% physical; 7% vision,16% hearing, 7% voice&speech,12% mental/psychosocial, 9% intellectual, 18% multiple disabilities), only 15% of them had ever utilized any SRH services. No requirement (57%) and unaware of SRH services (24%) were the major reasons for not utilizing SRH services. A majority (81%) of them reported that the nearest health facility was not disability-inclusive (73%), specifically referring to the inaccessible road (48%). Multivariate analysis showed that being married (AOR = 121.7, 95% CI: 12.206–1214.338), having perceived need for SRH services (AOR = 5.5; 95% CI: 1.419–21.357) and perceived susceptibility to SRH related disease/condition (AOR = 6.0; 95% CI:1.978–18.370) were positively associated with the utilization of SRH services. Qualitative findings revealed that illiteracy, poor socioeconomic status, and lack of information hindered the utilization of SRH services. WwDs faced socioeconomic (lack of empowerment, lack of family support), structural (distant health facility, inaccessible-infrastructure), and attitudinal (stigmatization, bad behaviour of health care providers, perception that SRH is needed only for married) barriers to access SRH services. Conclusions Utilization of SRH services among WwDs was very low in Ilam district, Nepal. The findings of this study warrant a need to promote awareness-raising programs to WwDs and their family members, sensitization programs to health service providers, and ensure the provision of disability-inclusive SRH services in all health facilities.

Introduction: Supply chain management in healthcare sector is of utmost importance due to its effect on individuals’ health status compared to other industries. In the current world economic situation wherein logical thinking should be based on lifetime costs of products ,as well as supply chain sources and processes, it is essential to have an agile supply chain to have a socio-environmental performance creating competitive advantage. Materials & Methods: This study was a survey with a correlational design considering its methodology and purpose. The statistical population of this study included the staff of public hospitals in Ilam province, Iran; of which, 340 individuals were selected as the participants based on Krejcie and Morgan’s sample size determination table. Moreover, the SPSS Statistics Software and LISREL Software were used to analyze the data in this study. Findings: The statistic of the Kaiser-Mayer-Olkin (KMO) index was equal to 0.844 implying sampling adequacy. Moreover, all the factors affecting supply chain agility had a normal distribution and the test statistic was larger than 1.96 for all the factors, suggesting their relationship with supply chain agility. The positive correlation between supply chain agility and competitive advantage was further confirmed based on the research findings.Additionally,the value of the goodness of fit index (GFI=0.96) showed the fit of the model and the test statistic of the model (T=9.60) revealed the significant impact of supply chain agility on creating the competitive advantage. Discussion & Conclusions: The results of the present study demonstrated that the seven dimensions of computer-based technologies, flexibility, relationships with suppliers, use of modern technologies, collaborative partnerships, sensitivity to market, and responsiveness of demands had effects on supply chain agility in hospitals. Moreover, public hospitals in Ilam Province were endowed with competitive advantage in three dimensions of durability and permanence, retention, and opportunities; however, they lacked competitive advantage in the dimension of individuals’ unique capabilities.

Introduction: Technological advancements and increased production of cars and motorcycles have led to the increased incidence of traumas all around the world. Injuries and fractures occur due to different etiologic factors such as motor vehicle accidents, quarrels, and fall accidents. The purpose of this study was to evaluate the frequency of fractures in computed tomography (CT) scans in Emergency Department of Imam Khomeini Hospital in Ilam, Iran, in 2014. Materials & Methods: In this cross-sectional retrospective study, we evaluated the medical records of all trauma patients who were admitted to Imam Khomeini Hospital in Ilam during 2014. Information from patients' medical records and CT scan radiographs were recorded in a checklist. After removing duplicate data, 710 patients were evaluated. Findings: In this study, 52% (75% male and 25% female) of the fracture cases due to motor vehicle accidents were aged 18-26 years. The most frequent etiologic factor was accident (62.9%) and the most frequent trauma type was hand and foot trauma in males (39.1%) and females (38.4%), followed by head and neck trauma in males (32.7%) and females (22.1%). Most of the fractures had occurred in the first half of 2014, and the mortality rate due to fracture was 1.3%. Discussion & Conclusions: This study showed that the most frequent etiologic factor of trauma is motor vehicle accident similar to other developing countries. Therefore, providing education in this area and increasing the safety of transport systems are essential.

Introduction: Skin cancer, the melanoma type of which causes high mortality, is the most common malignancy in Iran and all over the world. UV is the most important cause of the incidence of this disease. This study evaluates the frequency of different types of cancer and their trajectory in Ilam province from 2012 to 2011. Materials and Methods: This analytical–descriptive study covered and evaluated all skin cancer patients who were registered in Ilam Province Cancer Registry during 20002 to 2011. Required information of each individual patient, such as age, sex, residence, pathological type of skin cancer, the location of the incidence of the disorder, and the year, was collected and studied. Findings: Out of total 347 cases, 240 cases (69.2%) were diagnosed with basal cell carcinoma (BCC), 63 cases (18.2%) with squamous cell carcinoma (SCC), 16 cases (4.6%) with malignant melanoma (MM), 8 cases (2.3%) with metastatic cancer, and 20 cases (37.7%) with other skin cancers. Mean age of patients was 62/42 ± 16/11 years, and the majority of them (37.7%) were men and lived in the city. Face was the most common place of the incidence of this disease (81.6%) and hand was the least common one (1.7%). The rate of incidence of cancer has experienced considerable growth in men and a slight decrease in the case of women between 2002 and 2011 in Ilam. Conclusion: According to the results of this study, the rate of skin cancer has increased among men during the studied period; thus, necessary measures are required to prevent and reduce the incidence of this disease, especially in people who are exposed to the sun's ultraviolet rays because of their jobs.

Long- term exposure to street dust because of the potential toxicity of heavy metals can cause harmful effects on the human's health by inhalation, ingestion and dermal contact. In this study, 25 dust samples were collected from the sidewalks of the main streets of Ilam and analyzed by inductively coupled spectroscopy (ICP- OES) method. The mean concentration of the studied metals was: Pb (58.80), Zn (213.24), Cu (63.12), Cr (45.84), Cd (0.37), Ni (43.73) V (30.92) and As (5.00) (mg / kg). Based on the average value of the potential ecological risk (Er), the heavy metals of Pb, Zn, Cu, Cr, Ni and V had a low ecological risk and Cd showed a moderate one. The highest non- carcinogenic risk (HQ) in children and adults was related to As through ingestion and Cr through the dermal contact pathway; on the other hand, the lowest amount was due to the Cd via the inhalation. Cumulative non- carcinogenic hazard (HI) of all heavy metals in the street dust have been found to be higher for children rather than adults. In both age groups, Cr and Pb had the highest and lowest risk of carcinogenicity (RI), respectively. The obtained results, therefore, indicate that the main source of heavy metals in the study area is anthropogenic sources such as traffic, industrial facilities and fossil fuels burning.

Introduction: Premenstrual syndromes are among the disorders associated with reproductive age that includes physical, cognitive, emotional, and behavioral signs during the luteal phase that occurs periodically from 7 to 14 days before menstruation. These signs are not present at the begining of menstruation or during the first few days of bleeding. The aim of this study was to investigate the frequency of premenstrual syndromes in high school girls of Ilam during the year 2015. Materials & Methods: This descriptive-analytic study has been performed on 266 single girl- students aged from 15 to 18 years, with the average age of 16.34, considered to have regular and natural menstruation cycles (with gaps of 21 to 35 days between each two menstruations lasting for 3 to 7 days). To assess the frequency of premenstrual syndromes, the prospective questionnaires (Premenstrual Symptoms Screening Tool: PSST) was used for two consecutive cycles. In this research, statistical tests such as Chi-square, Variance analysis, and Logistic regression were applied to analyze the data. Findings: Based on our results, the frequency of medium or sever premenstrual syndromes was 36.84% and the frequency of premenstrual dysphoric disorder was 11.65%. According to logistic regression model, severe bleeding multiplies chances of the individuals suffering from dysphoric disorder by 5.1 times, while pain multiplies chances of the girls suffering from premenstrual syndrome about 4.1. There was a significant relation between the mild and severe premenstrual syndrome with pain, (P less-than 0.001), and also between premenstrual dysphoric disorder and volume of bleeding (P less-than 0.01). Investigating the mean for the 19 signs, the highest averages stood for fatigue, possession of physical signs, trouble or lack of concentration, reduction in interest of participation in normal routines, and anger; while the lowest average stood for over eating. Discussion & Conclusion: Our research concluded that prevalence of such syndromes among Ilami's high school girl-students was relatively high. Considering the negative effects of these syndromes on physical condition as well as psychological, emotional, and social wellbeing of teenagers, and the significance of this period from the educational point of view, more investigations and interventional moves are recommended to manage these signs.

Introduction: Theory of mind is one of the most important aspects of cognitive faculty. The theory of mind is impaired in individuals who suffer from mental disorders like autistic children. The ‘autistic-like’ behaviors also have been reported in the congenitally blind children. This study was conducted to examine the presence or absence of theory of mind and its function in congenitally blind children. Materials and methods: A number of 20 individuals containing 10 bilingual congenitally blind children from Baghcheban elementary school of Ilam city as a case group and 10 sighted ones as a control group were selected. Three kinds of false belief cognitive tests appropriate for the congenitally blind children were designed. The collected data were analyzed using one sample Kolmogorov–Smirnov test, independent t-test along with Levenn test and one-way and two-way Analysis of Variance. Results: Considering the performance of congenitally blind children in false belief tasks, the blindness just had effect on the story narration task (P0.05). Conclusion: The findings showed only the story narration task was affected by blindness, because this task was more dependent on visual sense. Therefore, blindness results in delay in evolution of theory of mind. To fix this delay, the congenitally blind children should be exposed to further tactile and olfactory inputs.

Background: Diabetes mellitus is the most common metabolic disease around the world. The present study aims at studying hemoglobin A1C (HbA1C) and vitamin D serum levels in diabetic patients. Materials and Methods: A descriptive study was conducted on 102 diabetic patients presenting to the diabetic clinic of a tertiary care hospital in West of Iran in 2016 (Shahid Mostafa Khomeini Hospital of Ilam city). The data collected were inserted into the SPSS-20 software, and it was then analyzed by using the relevant statistical tests. For describing the quantitative variables, mean and standard deviation were used. Moreover, for describing the qualitative variables, number and percentage were applied. The mean serum levels of HbA1C and vitamin D were compared for different variables using the Chi-square and ANOVA. Results: There is a positive and statistically significant relationship between the HbA1C and fasting blood sugar (FBS). Moreover, there is a statistically significant relationship between the serum level of vitamin D with smoking and body mass index (BMI). There is also an inverse linear relationship between vitamin D with HbA1C, FBS, BMI, and disease duration. The relationship between HbA1C with FBS and disease duration is a linear direct one. Their relationship between HbA1C and BMI is an inverse linear one, yet not significant. Conclusion: Given the role of this vitamin in secretion and the effect of insulin, it seems useful to monitor the serum level of vitamin D in a diabetic patient and prescribe its supplements if necessary.

Background: The presence of heavy metals in water resources above threshold levels can be toxic and carcinogenic for consumers. This study determined the concentrations of heavy metals in the drinking water distribution network and resources of the city of Ilam in Iran. Methods: In this cross-sectional study from 6 sources of water supply and also, different parts of the water supply system of Ilam city, samples were collected based on standard sampling methods. The samples were tested with a BRAIC atomic absorption spectrophotometer. The data was analyzed using nonparametric Mann-Whitney test. Results: The concentration of zinc in all water sources of the city of Ilam was higher than WHO guidelines and Iranian standard 1053. Contamination by cobalt, arsenic and lead from Ilam dam, Pich-e Ashoori well and Haft Cheshmeh well was higher than national and international standards. The amount of cobalt and mercury at Ilam dam was significantly different from the levels at other sources (P < 0.05). Conclusion: The use of pesticides in the agricultural sector, contamination of water by human waste and aged and worn water pipes are the likely sources of the increased concentrations of heavy metals, especially lead and arsenic. Because there is a cumulative effect from these metals, appropriate measures are necessary by the relevant agencies to address this problem.

Background: Seasonality in suicide has been investigated from the early 19th century to explore the productive environmental variables. Seasonality studies can provide information on prevention and interventions in suicide. In this study, we examined seasonality in suicide and aimed to explore the differences in seasonality between rural and urban areas, mental disorders, and genders. Methods: In this cross-sectional study, overall identified suicide cases in Ilam province from 21 March 2010 and 11 December 2014 were identified, using systematic registration suicide data (SRSD). Two methods were used separately to analyze seasonality (Chisquare, Edwards' T). Seasonal effect (peak/ trough seasons) and (deaths/ attempts suicide) was explored by ratio statistics. The null hypothesis was that the completed suicides in each method group were evenly distributed over a year. Results: Significant seasonality was observed in suicide during the study period, with one peak in the spring and one in the winter. Our results showed that suicide seasonality following mental disorders was statistically significant with a peak in the spring, regardless of other factors such as gender and age. When all non- mental suicides are taken into account, the seasonality remains statistically significant, but the peak season is shifted to autumn. Conclusion: Investigating suicide in Ilam revealed a significant seasonality for both rural and urban areas, which was greater in the urban part. A significant seasonality in suicide was observed in attempters with mental disorders. In suicide attempters with mental disorders, findings showed two peaks in the spring and the autumn.

Introduction: Escherichia coli (E.coli) as a main cause of both nosocomial and community-acquired infections in humans have a relative potential to develop resistance. Nowadays, most infections caused by ESBL-producing E.coli (ESBLEC) had mostly been described as nosocomial acquired or nursing home related. In this study, we employed E-test assay to detect antibiotic resistance of E.coli strains and determine MIC of antibiotics. Materials and methods: Thirty E.coli strains gathered from Imam Khomeini hospital of Ilam, and cultured on TSB and bacterial suspension prepared by 0.5 µF concentration for E-test. Mueller Hinton agar and E-test strips of Amikacin, Cefepime, Ceftazidime, Ceftriaxone, Gentamicin, Meropenem, Nitrofurantoin, Piperacillin/Tazobactam, Tetracycline, Ticarcillin/ Clavulanic acid, Tobramycin, Trimethoprim were used Results: Resistance to Ceftriaxone, Tobramycin, Gentamicin, Ticarcillin/ Clavulanic, Amikacin were 19.8%, 26.4%, 23.3%, 62.7%, 70.3%, respectively. Conclusion: the results indicated, E.coli strains in this study were high sensitivity to Meropenem ,Nitrofuratoin, Ciprofloxacin , Ceftazidime, Cefepime.

Background and Objectives: As the elderly population increases, aging diseases are also increasing. Nutritional status is the major determinants in the prevention of chronic diseases of old age. The aim of this study was to determine nutritional behaviors of the elderly in Ilam city, Iran. Materials and Methods: In this cross-sectional study, a total of 200 subjects aged over 60 years with a mean age of 61.15 ± 2.37 years were enrolled. Data were collected using a researcher-made questionnaire in two parts including demographic characteristics and nutritional behaviors. Data were analyzed using Pearson correlation, t-test and one-way ANOVA with the SPSS 19 statistical software. Results: The mean ± SD for the subjects’ nutritional behaviors was 32.59±5.46 from 10 to 40 obtainable scores. The results showed that there was no significant difference between nutritional behaviors regarding gender, educational level and job status (P> 0.05). However, there was a significant positive correlation between subjects’ age and nutritional behaviors (r= 0.215, P = 0.002). Also, the consumption of fruits and vegetables, grains, meats and dairy products was inadequate. Conclusions: The results of this study indicated inadequate intake of important food groups in the elderly, including fruits and vegetables, whole grains and dairy. So, planning for improving nutritional behaviors of the elderly by officials and health experts is suggested.

Background: Dust storm is one of the most important natural sources of air pollution in the Middle East that has caused a major concern in recent years. The aim of this study was to evaluate the respiratory tract function of people living in Ilam city (Iran) during dust storm. Methods: A sample size of 250 people was selected and the cluster sampling was randomly used from 13 health centers in Ilam city. Pulmonary function test (PFT) was determined via a standard spirometry apparatus. Vital capacity (VC), Forced Vital capacity (FVC), FVC in first second (FEV 1 ), FEV 1 /VC, FEV 1 /FVC, peek expiratory flow (PEF), forced expiratory flow (FEF 25-75% ), forced expiratory flow (FEF 25–75% ), forced expiratory flow (FEF 75–85% ), forced mid flow time (FMFT) and maximum voluntary ventilation (MVV) were measured. Results: Mean values of respiratory capacities measured in all participants excluding FEV 1 /VC and FMFT were less than predicted mean values by ECCS reference. 21.6% of the population suffered from obstructive lesions. This value among males (24.1%) was more than females (19.6%). This could be related to more exposure (outdoor jobs) of males with dust storms. Conclusion: The results also showed a negative significant relationship between duration of inhabitance in Ilam city and all respiratory capacities. Further studies are needed for confident confirmation of whether reduction of respiratory capacities among Ilamian people is only related to dust storms.

Background and objectives Health care staffs, all over the world, usually face harsh behavior. Violence in forms of verbal assault and physical action is experienced especially by hospital nurses; however, such violent behaviors are usually not reported, for some reasons. The aim of current study was to identify the workplace violence against nursing staff at educational hospitals of Ilam city (western Iran) in 2012. Materials and methods A descriptive study was carried out during July to August 2012 at three educational hospitals of Ilam city. Data collection was done from 106 randomly selected nurses through a questionnaire on types of violence, their sources, and ways to cope with them. Data analysis was carried out through descriptive statistics & Chi-square test. Results Totally, 43.84% of the participants had experienced and reported the violence, while the remaining 56.16%, despite being subjected to violence, did not report it. Out of all the studied people, 64.94% believed that reporting violence to officials would be useless. Considering the gender, 43% were male with reported violence rate of 53.57%, while the 57% population of females were reported a lower rate of 42.18% violence. Conclusion and recommendation Since most the violent actions have not been reported, it is suggested to develop proper organizational infrastructures, educational programs on reporting such violent behaviors as well as their management. Furthermore, it is recommended to plan more comprehensive educational programs for patients and the community to reduce such undesired aggressive actions against the nurses and other staff at hospitals.

Objective To measure the activities of cholinesterase enzyme among farmers who used the selected insecticides for the purpose of preventing the growth of agricultural pests on their farms. Methods A total of 21 people used diazinon to spray their agricultural lands and 13 people also used sevin to spray theirs in western part of Iran. Lovi Bond method was used for the measurement of cholinesterase activity. Results Results revealed that the enzyme level before spraying with diazinon was 100.0% among 3 workers and 87.5% in 18 of them. This level decreased to 75.0% among 13 workers and 67.5% in 5 workers. The number of workers that had headache, pale, dizziness with headache, nausea, diarrhea with cramps and stomachache were 5, 9, 5, 3, 4 and 7 respectively. These symptoms decreased after 72 h. Out of 13 workers who sprayed with sevin, the enzyme level before spraying was normal (100.0%) among 5 workers and 87.5% in 8 workers. After spraying, the enzyme level was 87.5% in 5 workers, 75.0% in 5 workers and 67.5% in 3 workers. Conclusions These workers were in danger of chemical poisoning. Measurement of pre-cholinesterase and post-cholinesterase exposures is recommended in order to compare the values after pesticide application.

One of the most common problems in the medical world is the resistance of cancer cells to anti-tumor drugs, so finding new anticancer agents with minimal side effect is essential. This study aims at identifying medicinal plants in to the southern region of Ilam province in west Iran, which are traditionally used in the treatment of cancer by herbal practitioners. This study was conducted in the southern district of Ilam province, Iran. The study was conducted from August 2013 to October 2014 by using questionnaire and interview from herbal practitioners. The collected data were analyzed through relative frequency of citation index (RFC). In this study, 36 herbal practitioners were interviewed. A sum of 21 medicinal plants used in variety of cancers from16 families were identified for the Southern District of Ilam. Asteraceae was the dominant plant family, and the most used organ was aerial parts (44). Dermal cancer was the most treated cancer by herbal practitioners in the region with different herbs. Lawsonia inermis and Satureja khuzistanica were the most cited species for anticancer use. On comparison with the literature it was revealed that 61.9 plants are not scientifically validated against any type of cancer. New therapeutic remedies were reported for the first time and a number of similar effects of the reported plants were found in other studies. As a result of the present study we recommend the plants documented in the present study, which are not pharmacologically assessed, for further pharmacological studies. © M. Bahmani et al., 2017.

Background Suicide by aggressive physical methods such as firearms, hanging, and jumping is well known; however, different factors may influence a person while selecting a particular method. The aim of this study was to investigate the epidemiological factors involved in the selection and use of different physical methods for suicide over a long-term period in Ilam province, Iran. Methods The present study was conducted retrospectively between 1993 and 2013 using recorded data from a comprehensive system for registration of suicide attempts in Ilam University of Medical Sciences. The epidemiological characteristics included person, time and place variables, and the outcomes of the suicide attempts. The chi square, univariate and multivariate logistic regression models were used for data analysis. Results Totally, 1516 suicide attempts were evaluated (the annual incidence rate: 19/100,000 individuals). The most commonly used suicide method in females (88.4%) and males (38.9%) was self-immolation. Furthermore, the annual incidence rate among males and females was within the age group of 15–24 years (24.6 and 47.8/100,000 individuals). The risk of death by suicide in the age group of 55–64 years was 2.93 compared with the age group of 10–14 years (OR = 2.93; 95% CI = 0.64–13.54, P = 0.168). Conclusion This study revealed that self-immolation was the most selected physical method of suicide and had the highest incidence rate, and inflicted the survivors with severe physical and mental complications. In order to reduce the use of physical methods, especially self-immolation, life skills training becomes more important than ever.

As the field of high-precision applications based on carriers continues to expand, the development of low-cost, small, modular receivers and their application in diverse scenarios and situations with complex data quality has increased the requirements of carrier-phase data preprocessing. A new geometry-based cycle slip detection and repair method based on Global Position System (GPS) + BeiDou Navigation Satellite System (BDS) is proposed. The method uses a Time-differenced Carrier Phase (TDCP) model, which eliminates the Inner-System Bias (ISB) between GPS and BDS, and it is conducive to the effective combination of GPS and BDS. It avoids the interference of the noise of the pseudo-range with cycle slip detection, while the cycle slips are preserved as integers. This method does not limit the receiver frequency number, and it is applicable to single-frequency data. The process is divided into two steps to detect and repair cycle slip. The first step is cycle slip detection, using the Improved Local Analysis Method (ILAM) to find satellites that have cycle slips; The second step is to repair the cycle slips, including estimating the float solution of changes in ambiguities at the satellites that have cycle slips with the least squares method and the integer solution of the cycle slips by rounding. In the process of rounding, in addition to the success probability, a decimal test is carried out to validate the result. Finally, experiments with filed test data are carried out to prove the effectiveness of this method. The results show that the detectable cycle slips number with GPS + BDS is much greater than that with GPS. The method can also detect the non-integer outliers while fixing the cycle slip. The maximum decimal bias in repair is less than that with GPS. It implies that this method takes full advantages of multi-system.

Background: Staphylococcus aureus is known to be responsible for nosocomial infections, and the typing method was useful in managing the reservoir of bacteria. The main aim of this study was to determine the prevalence of S. aureus in the nares and hands of nurses working in Imam Khomeini hospital, Ilam, Iran, as well as to determine the clonal relatedness, antimicrobial susceptibility profiles, different virulence, and resistance determinants among these isolates. The evolution of mupirocin activity in the eradication of methicillin-resistant S. aureus (MRSA) and methicillin-susceptible S. aureus (MSSA) colonization in the nares of the healthcare workers in Ilam, Iran, was also determined in this study.Materials and Methods: In this cross-sectional study, 80 nurses, auxiliary nurses, and service workers from Imam Khomeini Hospital were enrolled. MRSA, antibiotic susceptibility, and virulence determinants were evaluated. Then, the isolates were subjected to pulsed field gel electrophoresis (PFGE) and Staphylococcal cassette chromosome mec typing. Results: Our results demonstrated that 23% of isolates were MRSA. PFGE results demonstrated that pulsotypes A (3 out of 30; 10%) and J (3 out of 30; 10%), pulsotypes E (2 out of 30; 6.7%), M (2 out of 30; 6.7%), P(2 out of 30; 6.7%), and V (2 out of 30; 6.7%) were the most predominant pulsotypes, respectively. Conclusion: We cannot give conclusive suggestions about the correlation between nasal carriage and infections, but we suggest the monitoring of all healthcare workers annually, decontamination of their noses by using mupirocin and other antistaphylococcal agents, and also the washing of their hands at least every 2 h.

Background Suicide is an important social tragic phenomenon which occurs by different tools or methods in different communities. Considering deliberate poisoning as a common and important method in Ilam province for suicide, the present study was launched to epidemiologically assess committing suicide in Ilam province, Iran, based on intentional poisoning. Methods By a retrospective study, all the recorded data associated with intentional poisoning suicide in Ilam Province during 1993–2013 were analyzed. All the demographic variables and the suicides’ outcomes were analyzed using the Chi-Square test, and the univariate and multivariate logistic regression models. Results Totally, 6794 cases of suicide (annual incidence rate of 87.28/ 100, 000) associated with poisoning were evaluated. The incidence rate of suicide attempts was 84.63/ 100, 000 (94.51 in female and 74.98 in male) and the incidence rate of completed suicide was 2.17/ 100, 000 (1.94 in female and 2.40 in male). Also, the highest rates of attempted and completed suicide (annual incidence rate of 172.42 and 4.14, respectively) were attributed to the age group of 15–24 year. Conclusion Females had a greater tendency to commit suicide by poisoning, and the lower level of education, the age group of 15–24 years and single individuals were more associated with suicide using poisonings. The incidence of attempted suicide in females and completed suicide in males was higher in this method. Considering the high rate of suicide by poisoning, further attention and supervision on the sale and reserve of drugs and poisons is necessary. Meanwhile, it seems that due to momentary emotions during the pubertal stage, the risk of committing suicide is increased especially among unemployed individuals; therefore, performing an extensive psychotherapy intervention is needed in the societies with younger populations.

Introduction: In Iran, cancer is the third reason of the death and every year 500,000 new cases were detected, and 14% of all death is related to cancer. The most common system that is affected by cancer (after the skin) is gastrointestinal (GI) system. The purpose of the study is evaluation of the 7 years incidence (2002-2008) of the GI cancers in Ilam province in the west of Iran. Materials and Methods: In this retrospective cross-sectional study, total 307 record health related to the patients affected by the gastro-intestinal system cancer were evaluated after referring to the pathologic centers of the Ilam province and neighboring provinces. Patient's data were recorded from their file based on the standard questionnaire. Result: The mean age ± standard deviation of participants was 63.8+1.5. More than half of participants study was men (58.3%). The prevalence of the esophagus, stomach, small intestine and colorectal cancers was significantly higher in the men than the women (unlike liver cancer) (p

ObjectivesAflatoxins as a highly toxic group of mycotoxins are present in the environment and foodstuff. These have been reported to cause serious health problems in humans. Since aflatoxin M1 (AFM1) is excreted into breast milk, investigating the exposure of infants to AFM1 is of special concern.MethodsIn the present study, breast milk samples were collected from 85 lactating mothers in Ilam province, Iran, and the levels of AFM1 were analyzed using the enzyme-linked immunosorbent assay-based technique. AFM1 was detected in breast milk of all lactating women. The mean contamination level was 5.91 ± 2.031 ng/L, ranging from 2 ng/L to 10 ng/L.ResultsMultiple regression analysis indicated no significant associations of consumption of milk and dairy products, meat, fish, legumes, grain products, fruits, and nuts with the concentration of AFM1 in breast milk. Furthermore, no significant association was observed between AFM1 concentration and anthropometric data of infants.ConclusionIn western parts of Iran, lactating mothers and their infants could be at risk of aflatoxin B1 and AFM1 exposure, respectively. Therefore, in Iran, the evaluation of AFM1 in human breast milk as a biomarker for postnatal exposure of infants to this carcinogen requires more attention in different regions and various seasons.

Introduction: Many studies have shown that the prevalence of celiac disease (CD) is increasing in the patients with irritable bowel syndrome (IBS), but the present evidences are controversy and all of the researches don’t suggest evaluation of the patients with IBS for the CD. Materials and Methods: In the cross-sectional study, 1000 patients that affected by IBS with the predominant feature of diarrhea who referred to the gastroenterology clinic were evaluated during 2009-2012 years. Blood samples were taken from the patients for ELISA of IgA tissue transglutaminase (TTG) Ab. Then biopsy was taken from the second part of duodenum of all of patients by endoscopy and the sample was referred to pathologist for histopathology evaluation in order to confirm diagnosis. Results: About half of the patients with IBS were women (50.3%) and the mean age ± Standard deviation of the men and women was 29.59±11.41 and 28.42±11.73, respectively. The mean titer of TTG IgA Ab in the women and men affected by IBS was 5.25±17.77 and 7.22±25.4, respectively. Seventy six cases (7.6%) that affected by IBS had high serum level of Ab titer (TTG IgA.Ab≥10) that including 41 women and 35 men. In the patients with high serum level of Ab titer, 57 cases (75%) were affected by celiac disease (based on histopathology report). Therefore, the prevalence of CD was 5.7% among patients with IBS. Conclusion: In the current study the incidence of CD was evaluated 5.7 cases per each 100 people with IBS. It’s suggested that all of the patients with diarrhea predominant IBS and high serum level of TTG IgA Ab must be examined for evaluation of CD.

Background: There are few diverse studies that have reported the case fatality rates of different methods of suicide, none of them are originated from developing countries. The aim of the present article is to report the case fatality rates of different methods of suicide in Ilam province of Iran. Materials and Methods: Data on 611 cases of suicide and 1807 cases of deliberate self harm (DSH) that were recorded in a comprehensive registry during 1995 through 2002 were analyzed for both genders together and for males and females, separately. Findings: For both genders together, the two most fatal methods were hanging (75.4%) and self-immolation (68.3%); for males, hanging (76.3%) and self-immolation (64.7%); and for females, firearms (75%) and hanging (73.7%), respectively. The least fatal methods for both genders together and for females and males separately were drug ingestion and cutting. Conclusion: The results of present study, which for the first time has reported the case fatality rates of suicide methods in a developing world, would not only help to better plan the local suicide prevention strategies and clinical assessment of suicidal cases but to shed light on overall understanding of this mysterious human phenomenon.

Background Impaired fasting glycaemia (IFG) has been defined as the fasting plasma glucose level between 6.1 (110 mgl/dl) and 6.9 mmol/l (125 mgl/dl). Control of hyperglycaemia during acute illness among diabetic and non-diabetic patients has been associated with improved outcome. The aim of this study was to investigate the prevalence of and factors related to hyperglycaemia, IFG and diabetes in west of Iran. Methods This project was performed by a cross-sectional method in Ilam province including 2158 people ≥ 25 years old. From the list of all rural and urban health centers of each county, several were randomly selected. For each selected health centre, families numbered 1–20 completed questionnaire forms for all the members aging ≥ 25 years. FBS was measured for all the participants by standard method. All the demographic and laboratory results were analysed using SPSS 16. Descriptive and regression analysis were used for statistical analysis appropriately. Results A total of 2158 people were evaluated in this study, among which 72 % were female with a mean age of 45.5 ± 14 years. 40 % of participants were from urban regions and the mean height, weight, FBS and waist size of the participants were respectively as follows: 164 ± 8.9 cm, 68.4 ± 12.3 kg, 5.7 ± 2.8 mmol/l (102.6 ± 49.9 mg/dl) and 82.3 ± 14.3 cm. The prevalence of IFG, diabetes and hyperglycaemia among participants were 7.8 %, 11.8 % and 19.6 %, respectively and participants from urban area showed a significantly higher prevalence of hyperglycaemia compared to rural regions (P Conclusion The most effective factors associated with IFG and diabetes were family history of diabetes, age, hypertension, marital status, place of life and smoking, respectively. The prevalence of IFG, diabetes and hyperglycemia among the population living in Ilam province, west of Iran, were 7.8, 11.8 and 19.6 % respectively which were directly increased with age.