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Alharbi RJ, Al-Jafar R, Chowdhury S, Rahman MA, Almuwallad A, Alshibani A, Lewis V. Impact of easing COVID-19 lockdown restrictions on traumatic injuries in Riyadh, Saudi Arabia: one-year experience at a major trauma centre. BMC Public Health 2023; 23:22. [PMID: 36600205 PMCID: PMC9812537 DOI: 10.1186/s12889-023-14981-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 01/03/2023] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Lockdown restrictions due to the COVID-19 pandemic have reduced the number of injuries recorded. However, little is known about the impact of easing COVID-19 lockdown restrictions on the nature and outcome of injuries. This study aims to compare injury patterns prior to and after the easing of COVID-19 lockdown restrictions in Saudi Arabia. METHOD Data were collected retrospectively from the Saudi TraumA Registry for the period between March 25, 2019, and June 21, 2021. These data corresponded to three periods: March 2019-February 2020 (pre-restrictions, period 1), March 2020-June 2020 (lockdown, period 2), and July 2020-June 2021 (post easing of restrictions, period 3). Data related to patients' demographics, mechanism and severity of injury, and in-hospital mortality were collected and analysed. RESULTS A total of 5,147 traumatic injury patients were included in the analysis (pre-restrictions n = 2593; lockdown n = 218; post easing of lockdown restrictions n = 2336). An increase in trauma cases (by 7.6%) was seen in the 30-44 age group after easing restrictions (n = 648 vs. 762, p < 0.01). Motor vehicle crashes (MVC) were the leading cause of injury, followed by falls in all the three periods. MVC-related injuries decreased by 3.1% (n = 1068 vs. 890, p = 0.03) and pedestrian-related injuries decreased by 2.7% (n = 227 vs. 143, p < 0.01); however, burn injuries increased by 2.2% (n = 134 vs. 174, p < 0.01) and violence-related injuries increased by 0.9% (n = 45 vs. 60, p = 0.05) post easing of lockdown restrictions. We observed an increase in in-hospital mortality during the period of 12 months after easing of lockdown restrictions-4.9% (114/2336) compared to 12 months of pre-lockdown period-4.3% (113/2593). CONCLUSION This is one of the first studies to document trauma trends over a one-year period after easing lockdown restrictions. MVC continues to be the leading cause of injuries despite a slight decrease; overall injury cases rebounded towards pre-lockdown levels in Saudi Arabia. Injury prevention needs robust legislation with respect to road safety measures and law enforcement that can decrease the burden of traumatic injuries.
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Affiliation(s)
- Rayan Jafnan Alharbi
- grid.411831.e0000 0004 0398 1027Department of Emergency Medical Service, College of Applied Medical Sciences, Jazan University, 45142, Al Maarefah Rd, Jazan, Saudi Arabia
| | - Rami Al-Jafar
- grid.7445.20000 0001 2113 8111Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK ,Department of Data Services, Lean Business Services, Riyadh, Saudi Arabia
| | - Sharfuddin Chowdhury
- grid.415998.80000 0004 0445 6726Trauma Center, King Saud Medical City, Riyadh, Saudi Arabia
| | - Muhammad Aziz Rahman
- grid.1040.50000 0001 1091 4859School of Health, Federation University Australia, Berwick, VIC Australia
| | - Ateeq Almuwallad
- grid.411831.e0000 0004 0398 1027Department of Emergency Medical Service, College of Applied Medical Sciences, Jazan University, 45142, Al Maarefah Rd, Jazan, Saudi Arabia ,grid.4868.20000 0001 2171 1133Centre for Trauma Science, Blizard Institute Queen Mary University, London, UK
| | - Abdullah Alshibani
- grid.412149.b0000 0004 0608 0662Department of Emergency Medical Services, College of Applied Medical Sciences, King Saud bin, Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia ,grid.452607.20000 0004 0580 0891King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Virginia Lewis
- grid.1018.80000 0001 2342 0938Australia Institute for Primary Care and Ageing (AIPCA), La Trobe University, Melbourne, VIC Australia
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Al Mutari M, Alasmari B, Aldosari L, Alluhaidan R, Aljohani R, Hijazi SO, Othman F. Epidemiology and factors associated with all-terrain vehicle accidents in children: A retrospective cross-sectional study of a trauma registry in Saudi Arabia. Int J Crit Illn Inj Sci 2021; 11:191-197. [PMID: 35070907 PMCID: PMC8725812 DOI: 10.4103/ijciis.ijciis_156_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 01/22/2021] [Accepted: 02/17/2021] [Indexed: 11/17/2022] Open
Abstract
Background: All-terrain vehicle (ATV) accidents have a substantial impact on the pediatric population in Saudi Arabia; however, few local studies are available. An in-depth study of this issue and adequate implementation of regulations are required to prevent additional casualties. The aim of this study was to describe the epidemiology of ATV injuries in the pediatric population and the outcomes associated with the injuries. Methods: We conducted a retrospective chart review at a Level 1 trauma center in Riyadh. All patients, aged ≤14 years and admitted due to an ATV accident, from 2004 to 2018 were included in this study. Demographic information, hospital course, and injury outcomes were extracted from the King Abdulaziz Medical City trauma registry. Each medical record was reviewed for short-term complications and the mechanism of injury. The primary outcome measure was the type of injury associated with ATV accidents; the secondary outcomes were injury site and mechanism of injury, and the association between the impact of injury and the clinical and demographic variable. Results: In total, 165 patients were involved in ATV accidents and met our inclusion criteria. The mean age was 8 ± 4 years, and 79% (131/165) were boys. Over 50% (84/165) of the sample had lower limb injuries. The majority of patients had fracture injuries (37%, 61/165), followed by amputations (30%, 50/165). Of the amputation group, the majority (86%, 43/50) was from 1 to 5 years compared to the no amputation group (P < 0.001). For the amputation group, 67% (33/50) had a limb trapped in the chain of the vehicle as to the mechanism of injury. Conclusion: The majority of patients had lower-extremity injuries, specifically fractured (37%) or amputated (30%) with children from age 1–5 years having a significantly higher proportion of hospital admission compared to the rest of the study population. Despite the existing legislation for ATV use in children, they are not enforced. The finding of this study recommends urgent implementation of these regulations for both ATV retailers and users and promotes public awareness about the severity of such injuries.
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Affiliation(s)
- Mohammed Al Mutari
- Department of Pediatric Emergency, King Abdullah Specialist Children Hospital, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Bushra Alasmari
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Lama Aldosari
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Rahaf Alluhaidan
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Reham Aljohani
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Shahd Omar Hijazi
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Fatmah Othman
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,Department of Research, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Alghnam S, Alkelya M, Aldahnim M, Aljerian N, Albabtain I, Alsayari A, Da'ar OB, Alsheikh K, Alghamdi A. Healthcare costs of road injuries in Saudi Arabia: A quantile regression analysis. ACCIDENT; ANALYSIS AND PREVENTION 2021; 159:106266. [PMID: 34225170 DOI: 10.1016/j.aap.2021.106266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 05/09/2021] [Accepted: 06/16/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Road traffic injuries (RTIs) are the second leading cause of death in Saudi Arabia. Their economic burden is significant but poorly quantified, as limited literature exists locally. We aim to estimate the impact of RTIs on healthcare costs. METHODS We included all patients from the hospital's trauma registry for the year 2017 (n = 381). Due to the availability of data, the analysis focused only on direct medical costs incurred during the hospitalization period. We computed the components of hospitalization costs and evaluated the association between patient and RTI characteristics and total hospitalization costs (the average and median) using quantile and log-linear regression techniques respectively. RESULTS Patients were relatively young with an average age of 31 years (SD ± 14.6). Overall, patients treated for RTIs cost the hospital around 77,657 Saudi Riyal (SAR) on average. Pedestrian injuries incurred the highest costs. Motor vehicle injuries accounted for the highest procedure-related costs (SAR 19,537). The quantile regressions results suggest that Glasgow coma scale (GCS), admission to intensive care unit (ICU), and hospital length of stay were significantly associated with an increase in hospitalization cost. Hospital home disposition was however, associated with a decrease in cost. One additional day of stay in the hospital increases total hospitalization cost by SAR 3,508. Additionally, the log-linear showed injury severity score (ISS < 16) was associated with a 20% decrease in the geometric mean of the hospitalization costs (p < 0.001). CONCLUSIONS This study underlines the economic burden of RTIs in addition to their impact on population health. The findings may be used to inform policymakers, researchers, and the public about the increasing burden of traffic crashes in the Kingdom. Public health interventions are warranted to reduce the severity and frequency of RTIs in order to improve traffic safety and reduce associated healthcare costs.
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Affiliation(s)
- Suliman Alghnam
- Population Health Department, King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences (KSUHS), Riyadh, Saudi Arabia.
| | - Mohamed Alkelya
- The Center for Health Research Studies (CHRS), Saudi Health Council, Riyadh, Saudi Arabia.
| | - Mahdya Aldahnim
- Respiratory Care Department, Specialized Medical Center Hospital, Riyadh, Saudi Arabia
| | | | - Ibrahim Albabtain
- Department of Surgery, King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
| | - Alaa Alsayari
- The Center for Health Research Studies (CHRS), Saudi Health Council, Riyadh, Saudi Arabia.
| | - Omar B Da'ar
- College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
| | - Khalid Alsheikh
- Department of Orthopedics, King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
| | - Ali Alghamdi
- National Center for Road Safety, Riyadh, Saudi Arabia.
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Liu JC, Ismael AA, Zaidi A, Sha'ban BW, Almutawa SE, Chatha AA, Abuzeyad FH, Jaafar RI, Alghanem SA, Qassim GA, Kumar N, Corbally M. Epidemiology of pediatric trauma in the Kingdom of Bahrain: a national pediatric trauma registry pilot study. Inj Epidemiol 2021; 8:42. [PMID: 34225802 PMCID: PMC8256499 DOI: 10.1186/s40621-021-00336-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 05/12/2021] [Indexed: 11/30/2022] Open
Abstract
Background A pediatric trauma registry for the Kingdom of Bahrain would be a novel public health tool for the Bahraini health system. The aim of this study was to explore the epidemiology of pediatric trauma at the national level by describing the distribution of pediatric injury in the Kingdom, and quantifying the burden of injury shouldered by the study population. Methods This multicenter observational cross-sectional study was conducted in Bahrain using data from the Pediatric Trauma Registry (PTR), which was a short-term paper-based prospective trauma registry that collected data over a three-month period in 2018. PTR was based in the pediatric emergency departments (ED) of the three national referral hospitals in the Kingdom. By simultaneously collecting data from all three trauma hospitals in the country, it was assumed that during the data collection period all major pediatric trauma patients in the country would be captured by the study, and that the data collected would provide national estimates of trauma. Inclusion criteria for the study was any individual under the age of 14, that arrived at the ED seeking care for intentional and unintentional injuries. Results A total of 1328 patients were included in the study. Sixty-nine percent of patients were treated and discharged from the ED, 30.5% were admitted to the hospital, admitted for surgery, or seen by a specialist, and 0.5% were declared deceased. The percentage of patients documented as unrestrained during Motor Vehicle Collisions (MVC) was 92.3%, and amongst those involved in MVC, 12% were ejected from the cabin of the vehicle. Conclusions There are significant implications that this study holds for policy implementation and practice surrounding injury prevention in the Kingdom of Bahrain. Low seatbelt utilization and the high proportion of ejection amongst MVC victims warrant immediate public health policy implementation, including enforcement of seat belt laws, strengthening of the traffic court system, and awareness campaigns for MVC prevention. Additionally, pediatric drowning prevention programs centered on constant adult supervision, pool isolation fencing, personal flotation devices, and swimming education should be created to address the mortality attributable to drowning in this study.
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Affiliation(s)
- Jay C Liu
- Royal College of Surgeons in Ireland - Bahrain, Busaiteen, Bahrain.
| | - Aieshah A Ismael
- Royal College of Surgeons in Ireland - Bahrain, Busaiteen, Bahrain
| | - Ayesha Zaidi
- Royal College of Surgeons in Ireland - Bahrain, Busaiteen, Bahrain
| | - Ban W Sha'ban
- Royal College of Surgeons in Ireland - Bahrain, Busaiteen, Bahrain
| | | | | | | | | | | | - Ghada Al Qassim
- Bahrain Defence Force - Royal Medical Services, Riffa, Bahrain
| | - Nitya Kumar
- Royal College of Surgeons in Ireland - Bahrain, Busaiteen, Bahrain
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Hashemi Nazari S, Shojaei S, Mahdavi S, Mirtorabi S, Forouzesh M. Descriptive epidemiology of road traffic mortality caused by heavy vehicles in Iran in 2018. ARCHIVES OF TRAUMA RESEARCH 2021. [DOI: 10.4103/atr.atr_103_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Alharbi RJ, Lewis V, Mosley I, Miller C. Current trauma care system in Saudi Arabia: A scoping literature review. ACCIDENT; ANALYSIS AND PREVENTION 2020; 144:105653. [PMID: 32629227 DOI: 10.1016/j.aap.2020.105653] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 05/04/2020] [Accepted: 06/14/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Trauma is one of the leading causes of death worldwide with millions of people dying each year, particularly in low or middle-income countries. This paper describes and evaluates the current trauma system (TS) in Saudi Arabia (SA). METHODS A scoping literature review was performed, incorporating an extensive search of Medline and Embase databases for refereed literature, as well as a search of grey literature to locate unpublished articles or reports in English or Arabic. All publications were assessed against the World Health Organization (WHO) Trauma System Maturity Index (TSMI) and American College of Surgeon's (ACS) criteria. RESULTS Despite local injury prevention efforts, Motor Vehicle Crashes (MVC) remain the primary cause of injuries in SA. Prehospital trauma care in SA aligns with level III care as described in the WHO TSMI classification system, based on the presence of formal emergency medical services and universal access to care. With respect to the ACS classification, no clear written guidelines, either for field triage or trauma destination protocols such as trauma bypass, were identified in prehospital trauma care. The role of secondary and tertiary facilities in treating trauma patients is unclear, with no clear referral linkages, suggesting a level I to III grading of SA's trauma care facilities. Currently, there is no national or regional electronic trauma registry, no quality assurance program, and active involvement in research projects related to injuries is limited. CONCLUSION The current SA TS has strengths but there are key features missing in comparison to other systems globally. As MVCs remain a leading cause of death/ disability, efforts to reduce the prevalence and impact of MVC burden in SA through development of a stronger national TS are warranted.
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Affiliation(s)
- Rayan Jafnan Alharbi
- Alfred Health Clinical School, La Trobe University, Prahran, Victoria, Australia; Department of Emergency Medical Service, Jazan University, Jazan, Saudi Arabia.
| | - Virginia Lewis
- Australian Institute for Primary Care and Ageing, School of Nursing & Midwifery, La Trobe University, Bundoora, Victoria, Australia
| | - Ian Mosley
- School of Nursing & Midwifery, La Trobe University, Bundoora, Victoria, Australia
| | - Charne Miller
- Alfred Health Clinical School, La Trobe University, Prahran, Victoria, Australia
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Almarwani SM, Hijazi LO, Alamer MA, Alnwaiser JM, Aldakheel RA, Alsheikh K, Albabtain I, Alghnam S. The association between family cohesion and disability following blunt trauma: findings from a level-I trauma center in Saudi Arabia. Inj Epidemiol 2020; 7:40. [PMID: 32772920 PMCID: PMC7416389 DOI: 10.1186/s40621-020-00271-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 06/23/2020] [Indexed: 01/29/2023] Open
Abstract
Background Injuries pose a significant burden on population health of Saudi Arabia. Even in nonfatal injuries, the burden varies from temporary to permanent disabilities. Health outcomes following injuries can vary, and predictors of recovery from disability are not well understood. In the Kingdom, family values and cohesion can differ from other countries due to several factors, including religious beliefs and cultural traditions. Learning about predictors of injury recovery can improve prevention as well as planning for rehabilitation programs. Therefore, the study aims to evaluate the association between family cohesion and recovery following blunt injuries. Methods This prospective study included 249 patients who were hospitalized for at least 1 day following blunt trauma in King Abdulaziz Medical City, Riyadh. Adult patients were interviewed twice: initially during admission, and a second interview via the phone 3 months after discharge. Baseline information included: demographics, injury characteristics, the five dimensions EQ-5D and family support scale. The follow-up interview captured only EQ-5D. Suboptimal family cohesion was defined as any issue with the relationship with parents, spouse, or siblings. Any disability was defined as a reported limitation in one or more domains of the EQ-5D scale. Logistic regression was used to assess the association between family cohesion and recovery at 3 months. Results Of the overall sample, 169 (67.8%) responded to the second interview, and three patients passed away. About 95.2% of patients reported disabilities at baseline, while 88.1% continued to report disabilities after 3 months. Forty patients (16.1%) reported suboptimal family cohesion. Of these patients, 37(94.87%) were in pain, 33(82.5%) reported problems with usual activities, 32(80%) faced problems with self-care, 32 (80%) patients had difficulty in mobility, and 23(57.5%) were depressed. Multivariable regression suggested that patients with suboptimal family cohesion were less likely to recover from disabilities. Conclusion The prevalence of any disability 3 months after discharge is striking. This study suggests that health outcomes after blunt trauma are affected by the strength of the patient’s family cohesion. More research is needed to identify effective ways through which the provision of social support can reduce short term disability after trauma.
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Affiliation(s)
- Sarah Mohammed Almarwani
- King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard-Health Affairs (NGHA), Riyadh, Saudi Arabia
| | - Leen Omar Hijazi
- King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard-Health Affairs (NGHA), Riyadh, Saudi Arabia
| | - Modhi Abdullah Alamer
- King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard-Health Affairs (NGHA), Riyadh, Saudi Arabia
| | - Jury Muhanad Alnwaiser
- King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard-Health Affairs (NGHA), Riyadh, Saudi Arabia
| | - Reem Abdullah Aldakheel
- King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard-Health Affairs (NGHA), Riyadh, Saudi Arabia
| | - Khalid Alsheikh
- Department of Orthopedics, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.,College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ibrahim Albabtain
- Department of Surgery-Hospital-NGHA, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Suliman Alghnam
- Population Health Section- King Abdullah International Medical Research Centre (KAIMRC), King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, 11426, Saudi Arabia.
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Gorge J, Alsufyani L, Almefreh G, Aljuhani S, Almutairi L, Al Babtain I, Othman F. The age and gender distribution of patients admitted following nonfatal road traffic accidents in Riyadh: A cross-sectional study. Int J Crit Illn Inj Sci 2020; 10:76-80. [PMID: 32904484 PMCID: PMC7456288 DOI: 10.4103/ijciis.ijciis_16_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 12/14/2019] [Accepted: 03/13/2020] [Indexed: 02/04/2023] Open
Abstract
Introduction Road traffic accidents (RTAs) are the leading cause of mortality and disability nationally and globally. There is a need to identify the age and gender distribution of individuals involved in nonfatal RTAs. Methods This was a cross-section study using electronic trauma registry data from King Abdulaziz Medical City. We included all trauma registry patients older than 14 years, who were involved in a nonfatal RTA from 2015 to 2017. The data collected included patient demographic information (age and gender), injury mechanism, injury type, and severity. Results In total, 1314 patients were included in the analysis. The majority of the sample (88%) was male, with a median age of 25 (interquartile range: 21-35) years. A higher proportion of the male group had severe injury scores. Gender was equally distributed in terms of head-and-neck injuries. The majority (66%) of the sample was admitted in a ward. The female group had a higher proportion (17%) of chest injuries. In terms of age, the 65-year and older group had more severe injuries to the head, neck, and chest. Conclusions The findings of this study provide updated evidence regarding the age group most frequently involved in nonfatal RTAs. The evidence from this study supports the urgent need for developing prevention programs such as early awareness and education for young drivers and passengers of both genders.
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Affiliation(s)
- Jobby Gorge
- Department of Occupational Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Lena Alsufyani
- Department of Occupational Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Ghezlan Almefreh
- Department of Occupational Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Shahad Aljuhani
- Department of Occupational Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Layla Almutairi
- Department of Occupational Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.,King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Ibrahim Al Babtain
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,Department of Surgery, King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Fatmah Othman
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.,Department of Research, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Yamamoto R, Kurihara T, Sasaki J. A novel scoring system to predict the requirement for surgical intervention in victims of motor vehicle crashes: Development and validation using independent cohorts. PLoS One 2019; 14:e0226282. [PMID: 31821375 PMCID: PMC6903719 DOI: 10.1371/journal.pone.0226282] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 11/24/2019] [Indexed: 11/29/2022] Open
Abstract
Background Given that there are still considerable number of facilities which lack surgical specialists round the clock across the world, the ability to estimate the requirement for emergency surgery in victims of motor vehicle crashes (MVCs) can ensure appropriate resource allocation. In this study, a surgical intervention in victims of MVC (SIM) score was developed and validated, using independent patient cohorts. Methods We retrospectively identified MVC victims in a nationwide trauma registry (2004–2016). Adults ≥ 15 years who presented with palpable pulse were included. Patients with missing data on the type/date of surgery were excluded. Patient were allocated to development or validation cohorts based on the date of injury. After missing values were imputed, predictors of the need for emergency thoracotomy and/or laparotomy were identified with multivariate logistic regression, and scores were then assigned using odds ratios. The SIM score was validated with area under the receiver operating characteristic curve (AUROC) and calibration plots of SIM score-derived probability and observed rates of emergency surgery. Results We assigned 13,328 and 12,348 patients to the development and validation cohorts, respectively. Age, motor vehicle collision and vital signs on hospital arrival were identified as independent predictors for emergency thoracotomy and/or laparotomy, and SIM score was developed as 0–9 scales. The score has a good discriminatory power (AUROC = 0.79; 95% confidence interval = 0.77–0.81), and both estimated and observed rates of emergency surgery increased stepwise from 1% at a score ≤ 1 to almost 40% at a score ≥ 8 with linear calibration plots. Conclusions The SIM score was developed and validated to accurately estimate the need for emergent thoracotomy and/or laparotomy in MVC victims.
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Affiliation(s)
- Ryo Yamamoto
- Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Shinjuku, Tokyo, Japan
- * E-mail:
| | - Tomohiro Kurihara
- Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Junichi Sasaki
- Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Shinjuku, Tokyo, Japan
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10
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Alharbi R, Miller C, Lewis V. Protocol for a feasibility exploratory multicentre study of factors influencing trauma patients' outcomes of traffic crashes in Saudi Arabia. BMJ Open 2019; 9:e032046. [PMID: 31594903 PMCID: PMC6797312 DOI: 10.1136/bmjopen-2019-032046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Road traffic injury is a leading cause of death for people of all ages. The burden of road traffic injuries is well established in developed countries. However, there has been limited investigation of the incidence and burden of road traffic injury in low/middle-income countries. With a proportionally high number of road users, there is a need to explore the factors in prehospital and hospital care in Saudi Arabia (SA) that are associated with mortality for adult trauma patients following road traffic crashes (RTCs). This paper outlines the method for the planned research. METHODS AND ANALYSIS A feasibility exploratory multicentre study will be conducted at three purposefully selected hospitals with different trauma care resources in differing geographic locations of SA. The study sample will include all adult trauma patients who are involved in RTCs in SA and have been admitted to a study site in a 3-month period from May to July 2019. Data regarding the characteristics of the crashes and prehospital health care factors will be extracted from hospital databases where it is available. Information will be collected from patients or carers and hospital records in the two sites that do not have a registry. Patient status at 30 days post-injury, particularly mortality, will be assessed through hospital records. The relative contribution of a range of factors to predicting mortality will be explored using logistic regression analysis. ETHICS AND DISSEMINATION This study was approved by the Institutional Review Board Committee at King Saud Medical City (H-01-R-053), the General Department of Research and Studies at the Ministry of Health in SA (1440-1249939) and (1440-1398648), and the La Trobe University Human Research Ethics Committee (HEC19095). The results will be reported in a thesis and in peer-reviewed journal articles and conference presentations.
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Affiliation(s)
- Rayan Alharbi
- Australian Institute for Primary Care and Ageing, School of Nursing & Midwifery, La Trobe University, Bundoora, Victoria, Australia
- Department of Emergency Medical Service, Jazan University, Jazan, Saudi Arabia
| | - Charne Miller
- La Trobe Alfred Health Clinical School, La Trobe University, Prahran, Victoria, Australia
| | - Virginia Lewis
- Australian Institute for Primary Care and Ageing, School of Nursing & Midwifery, La Trobe University, Bundoora, Victoria, Australia
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11
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Alghnam S, Alsulaim HA, BinMuneif YA, Al-Zamil A, Alahmari A, Alshafi A, Alsaif A, Albabtain I. Injuries following motorcycle crashes at a level-1 trauma center in Riyadh. Ann Saudi Med 2019; 39:185-191. [PMID: 31215223 PMCID: PMC6832331 DOI: 10.5144/0256-4947.2019.185] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 04/02/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Motor vehicle crashes are the third leading cause of death in Saudi Arabia. Motorcycle riders, in particular, are considered more vulnerable than occupants, yet there are no previous studies that have examined the epidemiology of their injuries and outcomes in the country. Better understanding is needed to inform policymakers and guide future prevention programs. OBJECTIVE Describe patterns of injury among conscious and unconscious patients injured in motorcycle crashes. DESIGN Retrospective chart review. SETTINGS Level 1 trauma center in Riyadh. PATIENTS AND METHODS This retrospective study included all patients involved in motorcycle crashes who were admitted between 2001 and 2017. Medical records were reviewed, and data about injury characteristics, outcomes and healthcare utilization were ascertained. MAIN OUTCOME MEASURES Injury site and mortality rate. SAMPLE SIZE AND CHARACTERISTICS 572 patients included 488 males (85.3%) and 232 <18 years of age (40.5%), mean (SD) age 21.1 (11.6) years. RESULTS About 3% of patients died either before or after admission. Extremity injuries (356, 62.2%) were most common followed by head injuries (229, 40%). Fifty-six (9%) suffered amputation, mostly to a lower limb. CONCLUSION This study underscores the significant burden of motorcycle-related injuries on population health of Saudi Arabia. The number of amputations due to motorcycle injuries is striking. Therefore, we need to increase enforcement of safety measures during recreational use of motorcycles and to raise awareness about the dangers of motorcycle crashes to improve traffic safety and ultimately population health. LIMITATIONS The study was conducted at a single hospital which may affect the generalizability of the data to the Saudi population. CONFLICT OF INTEREST None.
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Affiliation(s)
- Suliman Alghnam
- From the Department of Population Helath, King Abdullah International Research Center, Riyadh, Saudi Arabia
| | - Hatim A. Alsulaim
- From the Department of Surgery, Unaizah College of Medicine, Qassim University, Qassim, Saudi Arabia
| | | | - Abdulmohsen Al-Zamil
- From the College of Medicine, Imam Muhammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Abdullah Alahmari
- From the College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Abdullah Alshafi
- From the College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Ahmad Alsaif
- From the College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ibrahim Albabtain
- From the Department of Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia
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12
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Khobrani A, Patel NH, George RL, McNinch NL, Ahmed RA. Pediatric Trauma Boot Camp: A Simulation Curriculum and Pilot Study. Emerg Med Int 2018; 2018:7982315. [PMID: 29535873 PMCID: PMC5817262 DOI: 10.1155/2018/7982315] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 10/16/2017] [Accepted: 11/16/2017] [Indexed: 11/17/2022] Open
Abstract
Trauma is a leading cause of morbidity and mortality in infants and children worldwide. Trauma education is one of the most commonly reported deficiencies in pediatric emergency medicine (PEM) training. In this study, we describe the creation of a pediatric trauma boot camp in which trainees' basic knowledge, level of confidence, teamwork, and communication skills are assessed. The primary goal of this pilot study was to create a simulation-based pediatric trauma curriculum for PEM fellows and emergency medicine residents utilizing Kern's curricular conceptual framework. This was a pilot, prospective, single cohort, exploratory, observational study utilizing survey methodology and a convenience sample. The curriculum consisted of a two-day experience that included confidence surveys, a cognitive multiple-choice questionnaire, and formative and summative simulation scenarios. At the conclusion of this intensive simulation-based trauma boot camp participants reported increased confidence and demonstrated significant improvement in the basic knowledge and performance of the management of pediatric trauma cases in a simulated environment.
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Affiliation(s)
- Ahmad Khobrani
- Department of Pediatric Emergency Medicine, King Faisal Medical City Southern Regions, Ministry of Health, Abha, Saudi Arabia
- Summa Health System, Akron, OH, USA
| | - Nirali H. Patel
- Department of Pediatric Emergency Medicine, Akron Children's Hospital, Akron, OH, USA
| | - Richard L. George
- Division of Trauma, Department of Surgery, Summa Health, Akron, OH, USA
- Northeast Ohio Medical University, Akron, OH, USA
| | - Neil L. McNinch
- Rebecca D. Considine Research Institute, Akron Children's Hospital, Akron, OH, USA
| | - Rami A. Ahmed
- Northeast Ohio Medical University, Akron, OH, USA
- Department of Medical Education, Summa Health, Akron, OH, USA
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13
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Aljerian N, Alhaidar S, Alothman A, AlJohi W, Albaqami FA, Alghnam SA. Association between the mode of transport and in-hospital medical complications in trauma patients: findings from a level-I trauma center in Saudi Arabia. Ann Saudi Med 2018; 38:8-14. [PMID: 29419523 PMCID: PMC6074188 DOI: 10.5144/0256-4947.2018.8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND In Saudi Arabia, injury is the leading cause of death. Even if nonfatal, the impact of injuries on population health is enormous, as thousands of young patients suffer permanent disabilities every year. Unlike in developed countries, private transportation (PT) is a common means to transport trauma patients. Outcome differences between patients transported via PT relative to emergency medical services (EMS) has not been previously explored. OBJECTIVES To evaluate the association between transportation mode and in-hospital complications among trauma patients. DESIGN Retrospective. SETTING Tertiary care center. PATIENTS AND METHODS The study included all patients (>=16 years), who were admitted following trauma. MAIN OUTCOME MEASURES The main outcome in the study was the occurrence of any medical complications including stroke, sepsis, myocardial infarction, pulmonary embolism, pneumonia, renal failure, acute respiratory distress syndrome, and cardiac arrest. RESULTS The 493 patients were relatively young (over two-thirds of the sample were 45 years old or younger) and over half the population sustained injuries due traffic crashes. More than half (58%) of patients arrived via private transportation. Regression analyses revealed that in-hospital complications following injuries were significantly lower among those who arrived via PT. However, after incorporating propensity score matching, we found no difference in hospital complications (OR=0.55, 95% CI 0.25-1.17). CONCLUSION Multiple factors may influence this unexpected finding, such as distance to health care set.tings, the belief that PT is faster or lack of knowledge of the EMS contact number. Further efforts are needed to raise awareness of the importance of using EMS to transport trauma patients to hospitals. Prevention programs to reduce traffic crashes may facilitate reduction in traumatic injuries and associated complications. LIMITATIONS Retrospective and conducted in one center only.
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Affiliation(s)
| | | | | | | | | | - Suliman Abdullah Alghnam
- Dr. Suliman Abdulah Alghnam Population Health, King Abdullah International Research Center, PO Box 22490, Riyadh 11426, Saudi Arabia T: +966-539468887, , ORCID: http://orcid.org/0000-0001-5817-0481
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14
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Vakili M, Mirzaei M, Pirdehghan A, Sadeghian M, Jafarizadeh M, Alimi M, Naderian S, Aghakoochak A. The Burden of Road Traffic Injuries in Yazd Province - Iran. Bull Emerg Trauma 2016; 4:216-222. [PMID: 27878127 PMCID: PMC5118574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2016] [Revised: 09/12/2016] [Accepted: 09/29/2016] [Indexed: 06/06/2023] Open
Abstract
OBJECTIVES To estimate the Disabled-adjusted Life Years (DALYs) of Road Traffic Accidents in patients referred to hospitals in Yazd Province, central Iran. METHODS This cross-sectional study was conducted in Yazd province during 2010. To calculate the Years of Life Lost (YLL) due to premature death and to calculate the incidence of non-fatal injuries and Years Lost due to Disability (YLD), the data were collected from Yazd death registration system and hospital records. The causes of death and nature of non-fatal injuries were classified using International Classification of Diseases (ICD-10). We estimated Disability Adjusted Life Years (DALYs) on the guidelines of the Global Burden of Disease Study (discount rate: 0.03, age weight: 0.04, constant age weight correction factor: 0.165). Age and sex composition was taken from the National Statistical Center for the year 2010. RESULTS During 2009, 483 deaths were caused by traffic accidents in Yazd Province, 382 (79.09%) of which were males, and 101 (20.91%) were females. The mortality rates for males and females were 70.98 and 20.15 in 100,000, respectively. The years of life lost due to premature deaths were 15.84/1000 in men and 4.75/1,000 in women. Total YLLs caused by traffic accidents were 10,908 years. The injuries caused by traffic accidents were calculated as 15.21 and 3.73/1,000 in males and females, respectively. The total YLDs was calculated 1.51/1,000. The total burden of Road Traffic Injuries in Yazd province was 12478 years (DALYs), 87.41% of which was due to premature death, and 12.59% was related to disability. Also, 78.32% was lost in males. The age specific peak of burden was in 15-29 year. CONCLUSION This study showed that traffic accidents in Yazd impose a high burden. It seems that it is one of the health sector priorities. It is recommended to revise laws on use of motorcycles, especially on helmet use for motorcyclists, enforce strict laws in residential areas, and review social determinant affecting the incidence of such accidents.
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Affiliation(s)
- Mahmood Vakili
- Department of Community Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohsen Mirzaei
- Department of Community Medicine, School of Medicine, Monitoring of Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Azar Pirdehghan
- Department of Community Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohamadreza Sadeghian
- Health Center of Yazd Province, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Majid Jafarizadeh
- Health Center of Yazd Province, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mojtaba Alimi
- Department of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Shadi Naderian
- MSc Student in Epidemiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Arezoo Aghakoochak
- Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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15
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Mirzaei M, Mirzadeh M, Shogaei Far H, Mirzaei M. Trends in Road Traffic Deaths in Yazd, Iran, 2004 - 2010. ARCHIVES OF TRAUMA RESEARCH 2016; 5:e29266. [PMID: 27679788 PMCID: PMC5035672 DOI: 10.5812/atr.29266] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Revised: 12/23/2015] [Accepted: 12/27/2015] [Indexed: 11/16/2022]
Abstract
Background Road traffic deaths are a considerable public health problem and a major source of lost financial and human resources. Most mortality occurs in low- and middle-income countries. Objectives This study aimed to measure road traffic fatality rates and years of lost life, and also to depict a view of trends in road traffic deaths from 2004 to 2010 in Yazd city, a province in central Iran. Materials and Methods This retrospective case study analyzed road traffic deaths that were classified under the V01 - V99 codes of the ICD-10 in Yazd province from March 2004 to March 2010, using data that were collected from the death registration system of the Yazd province health center. Cases were classified according to age, sex, time of year, and residence (urban vs. rural). Years of lost life and road fatality rate per 100,000 people were calculated. Data were analyzed using chi-square test and ANOVA with SPSS 16. Results During the seven-year period of this study, 3,028 people in Yazd province died due to road traffic accidents (9.1% of total deaths in the province). Most deaths occurred among people aged 20-24 (15%), men (82.7%), and urban residents (82.6%). Total years of lost life (YLL) were 73,875 (60,337 and 13,489 in men and women, respectively). The road traffic fatality rate per 100,000 was 47.6 in 2004 and 37.6 in 2010. In the study period, the rate of traffic fatalities decreased for men (from 77.9 to 68.5) but this is not the case for women (from 14.8 to 19.2). Road traffic deaths peaked every summer. Conclusions Despite the overall reduction trend, the road traffic fatality rate in Yazd province is still alarmingly high compared to national and global data. In addition, the female population shows increasing death rates. These findings can serve as a basis for health care professionals and policymakers to conduct preventive measures, especially during summer, and plan specifically for reducing fatalities in the female population.
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Affiliation(s)
- Mohsen Mirzaei
- Department of Community Medicine, Health Monitoring Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran
| | - Mahboobahsadat Mirzadeh
- Department of Internal Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran
| | - Hossein Shogaei Far
- Health Center of Yazd Province, Shahid Sadoughi University of Medical Sciences, Yazd, IR Iran
| | - Mojtaba Mirzaei
- Tehran University of Medical Sciences and Health Services, Tehran, IR Iran
- Corresponding author: Mojtaba Mirzaei, Tehran University of Medical Sciences and Health Services, Tehran, IR Iran, Tel/Fax:+989132595430. E-mail:
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