Background: Elderly people are in need of several Drugs due to physiological changes and multiple chronic diseases. Studies have shown that anticholinergic Drugs can cause cognitive impairment, reduced physical activity, and increased mortality in elderly population. Paying attention to the anticholinergic medication use in older adults can prevent the occurrence of adverse events and increase the quality of health care. This study was conducted to quantify exposure to anticholinergic medicines in older people in Amirkola. Methods: This study is a part of the comprehensive cohort project that was being conducted from 2011 on the case patients of 60 years and above that referred to the Amirkola Health Center. A total of 1532 individuals were included, of whom 54. 9% were men. The Drug information was obtained by observing the patient’, s prescription and self-report questionnaires and collected data were analyzed by SPSS software. Exposure to anticholinergic medications was measured using the Drug burden index-anticholinergic (DBI-Ach) and the anticholinergic Drug scale (ADS). Results: Among the 1532 elderly people with an average age of 69. 21 years, 29% had DBI>0 and 36. 3% had ADS>0. Also, there was a significant correlation between DBI and ADS (R=0. 758). In addition, there is a significant relationship between sex variable with DBI and ADS (P=0. 0001). So, women in comparison with men had higher values of DBI and ADS. Conclusion: The findings of this study indicate that anticholinergic exposure is relatively high especially in older women, which posed special precautions to avoid inappropriate prescribing in the elderly.

Background and Objective: Fixed Drug eruption (FDE) is one kind of Drug rashes that is characterized by re-appearance of the lesions on the same sites after re-exposure to the causative Drug. This study was performed to evaluate the epidemiologic characteristics of FDE. Materials and Methods: This descriptive study was done on a series of 100FDE cases, whom were admitted at the outpatient dermatology clinic of Hazrat-e-Rasoul Hospital over a six-year period. The primary diagnosis of FDE was suggested according to clinical findings including a remaining hyperpigmentation at the site of healed skin lesion(s). Oral challenge test with a single low dose administration of the suspected Drug was used to confinn the diagnosis. Recurrence of the lesion(s) at the same body area(s) was considered as positive result. Results: Most commonly causative agents were co-trimoxazole and codein, which were found in 88% and 3% FDE cases; respectively. The most common site of involvement was penile glans in 57.7% of male patients and trunk in 48.3% of females. In one patient, reaction to multiple Drugs including co-trimoxazole, codein and tetracycline was observed and after re-challenge with each Drug, re-appearance of the skin lesion at the same site was evident. Several patients reported concomitant acetaminophen intake, but there was no reaction to that Drug. Conclusion: Co-trimoxazole is the most common cause of FDE.      

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Background and Objective: According to the International Labor Organization (ILO), occupational accidents cause the greatest human hardship and economic compensation. The economic costs of accidents are not only borne by the victims but also by the relevant companies and the government. This study aimed to estimate the burden of occupational accidents in Kashan, Iran. Materials and Methods: This cross-sectional study was conducted on the working population of Kashan, Iran. In order to collect data, all information related to occupational accidents registered in the Department of Labor, Cooperation, and Social Affairs of Kashan was used. The burden of occupational accidents was assessed using the method by the World Health Organization. Moreover, Excel software was utilized to estimate the number of years lost due to early death and disability, and the overall years of life lost regarding social values. Results: The results showed that 407 accidents occurred during the study period. Furthermore, the total number of DALY (Disability Adjusted Life Years) cases in the present study was 523. 138 years, out of which 308 (58%) years are related to YLL (Years of Life Lost) and the remaining 138/218 years are related to YLD (Years Lived with Disability). Conclusion: Given the high number of years of life lost due to disability caused by occupational accidents, this study highlights the importance of providing occupational health services in industries to protect human resources against occupational accidents.

Background: Prostate cancer (PC) ranks as the second most commonly diagnosed neoplasia and the fifth cause of death in men with cancer, with an increasing trend in incidence. Methods: All accessible data sources from the 2019 Global burden of Disease study were used to estimate the prevalence, mortality and disability-adjusted life years (DALY) and burden prostate cancer in Asia from 1990 to 2019. We estimated all-cause and cause-specific mortality, years of life lost (YLLs), years lived with disability (YLDs) and DALYs. All estimates were presented as counts and age-standardized rates per 100 , 000 population, with uncertainty intervals (UIs). Concentration index analysis and Concentration Curve were used to determine the relationship between Prostate cancer burden and human development index. Results: The results showed that the percentage of changes in the incidence in 19902019 was positive in all countries of the Asian continent except for Afghanistan and Kyrgyzstan. The results of the concentration index showed that the incidence and mortality of prostate cancer is more concentrated in countries with a high HDI level. Examining the DALY, YLL and YLD index also showed the value of concentration index, which shows that DALY, YLL and YLD of prostate cancer are more concentrated in countries with high HDI level. Conclusion: Given that burden of prostate cancer are increasing in most Asian countries and are mostly concentrated in the HDI drawers, obtaining accurate estimates in these countries to prepare for the potential change in public health burden due to this disease which is very important.

Background: Tuberculosis (TB) remains a significant global health crisis, regaining its status as the leading cause of death in 2023. Quantifying its economic burden is essential for crafting effective public health strategies. This study aimed to estimate the economic burden of TB in Iran. Study Design: This study employed a cross-sectional design. Methods: A prevalence-based approach was used to estimate the economic burden of TB in Iran, accounting for cost variations across TB types and cost categories. Costs were categorized as direct medical, direct non-medical, and indirect, and were calculated for suspected TB patients as well as for those with Drug-sensitive TB, multiDrug-resistant TB, and extensively Drug-resistant TB. Data were extracted from various sources, including the National Tuberculosis Registration System, national TB diagnosis and treatment guidelines in Iran, official medical service tariffs, and previous studies. Results: Of 210, 544 individuals screened, 7, 221 were diagnosed with TB, of whom 81. 0% had pulmonary TB and 19. 0% had extrapulmonary TB. Drug-sensitive TB accounted for 99. 4% of cases, multiDrug-resistant TB 0. 6%, and extensively Drug-resistant TB 0. 0%. Diagnostic costs represented 48. 0% of the total economic burden (approximately Int’l$4. 71 million), while postdiagnosis costs totaled Int’l$5. 15 million. Overall, economic burden, including all diagnostic and treatment expenses, amounted to approximately Int’l$9. 86 million. Conclusion: This study underscores the significant economic burden of TB in Iran, encompassing both pre-diagnosis and post-diagnosis expenses, with direct medical costs representing the largest component. Effective healthcare strategies and comprehensive public health approaches are crucial to reducing these costs and improving patient outcomes.

Background and objectives: Carpal Tunnel Syndrome (CTS) is the most common mononeuropathy encountered in clinical practice. Conventional electro diagnosis studies have been useful in the diagnosis of this condition. The Terminal Latency index (TLI) is a derived neurophysiological value that adjusts the Distal motor Latency (DL) for the terminal distance and motor nerve Conduction Velocity (CV).Several studies have suggested utility of the median TLI for diagnosis of CTS.The goal of this study is to evaluate prospectively the sensitivity of the median TLI in the diagnosis of CTS and compare it with other electrodiagnosis techniques.Material and Methods: This study was done on 111 patients as CTS group & 62 healthy subject as control group. In all groups five selected tests of electrodiagnosis were done and all of them were compared with TLI sensitivity.Results: The mean TLI was 0.3±0.05 in the CTS group and 0.42±0.03 in the control group. The sensitivity of TLI was 73% The TLI wasn't statistically better than the other tests, but in three cases from the CTS group, the TLI was the only abnormal test.The 7 and 14 cm method had meaningful sensitivity in contrary to other tests.Conclusion: The sensitivity of TLI has no meaningful difference with other routine electro diagnostic tests in diagnosis of CTS.The median TLI is a useful but not more sensitive electrodiagnostic test for CTS.

Introduction: Three methods of OCRA index, Strain index (SI), and ACGIH HAL have been proposed for the assessment of risk factors of upper limb musculoskeletal disorders. Investigating the correlation and consistency of these three methods are of prominence importance in the workplaces. Thus, this study aimed to determine the correlations of the results of the above mentioned methods. Materials and Methods: In this cross-sectional study, a total of 150 tasks were studied in four industries. For each task, a video taping of a full working cycle was prepared and evaluated according to the instructions of each method. The level of risk exposure to musculoskeletal disorders was analyzed with correlation and Kappa agreement coefficient tests using SPSS (version 16) and R software packages.Results: The correlation between the results of risk assessments of OCRA and SI methods for right and left hands were acceptable and equal to 0.751 and 0.726, respectively (p<0.001). Meanwhile, the coefficients of agreement between OCRA and HAL methods for left and right hands were 0.526 and 0.595, respectively.Conclusion: These findings partly confirmed the agreement between the methods of risk assessment. The origin of this partial agreement can be the number and type of variables and their impacts on the final score of the methods.