Background: Frostbite, the most common cold injury, occurs in mountaineers, a major group at risk, more often than in the general population. Objectives: To describe the incidence of frostbite and the situations associated with it in mountaineering, emphasising factors that can be modified to decrease its frequency and severity. Methods: In this cross sectional, questionnaire based study, 637 mountaineers were asked if they had suffered any frostbite injuries during the preceding two years and to provide the personal and circumstantial details. Results: The mean incidence was 366/1000 population per year. Grade 1 injury (83.0%) and hands (26.4%) and feet (24.1%) involvement were most common. There was a significant relation between lack of proper equipment (odds ratio 14.3) or guide (p,0.001) and the injury. Inappropriate clothing, lack or incorrect use of equipment, and lack of knowledge of how to deal with cold and severe weather were claimed to be the main reasons for the injury. Conclusions: In high altitude and winter expeditions, mountaineers should wear appropriate clothing, have the necessary equipment such as quality boots and mittens, use a competent guide, and have training on how to tackle cold weather. They should also avoid wet clothing, windy terrains, and should never remain in the same position for long periods to reduce the risk of cold injuries.

Medical students are subject to stress from sources related to medical training in addition to personal problems, resulting in significant mental distress. This study evaluates the scope of the problem in Tehran medical schools and sheds light on some of its associations. Students (604) of medicine from four medical schools in the city of Tehran responded to the Persian version of 28-item General Health Questionnaire (GHQ-28) in conjunction with a data collection sheet asking about age, sex, marital status, current training level, living place, grade point average in previous semester, and perceptions of their financial status. Of 602 students, 40.7% had mental distress (45.7% of female and 36.7% of male students). Distress was associated with being a woman (female to male odds ratio: 1.55) and very poor financial status (OR: 18.0).

Overall, our findings indicate that virtual patients are strong tools in enhancing history-taking skills of students, but they do not affect other areas of competence significantly. Educators are recommended to be sceptical about enthusiastic reports on various computer applications and avoid falling into false expectations of their implementation.