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Traumatic spinal cord injury (TSCI) is a condition with suffering of neural structures from acute trauma with short-term or permanent sensory and motor problems. This study was conducted with the aim of determining the prevalence of TSCI in Tehran with emphasis on demographic characteristics of patients and to evaluate the effect of computed tomography (CT) in determining fracture type and severity grade of injury among TSCI patients. In a cross-sectional study, all TSCI and spinal fracture patients ( = 520) who referred to the main trauma center in Tehran, Iran, in 2013 and 2014 were selected. Radiography and CT scan were prepared and reported blindedly by two radiologists. Majority of the patients was 21-30 years male, married and their most common occupation was car driver. A significant difference was observed between gender and etiology ( = 0.001). The main etiology was traffic accident followed by falling from height. While the most common location of injury for males was thoracic vertebrae followed by lumbar vertebrae; for females it was lumbar followed by thoracic. Majority of patients had ASIA (American Spinal Injury Association) impairment scale of E (normal), followed by B (sensory incomplete). Most of the cases were hospitalized less than one week. Age of the patient and duration of hospitalization had a significant association ( = 0.015). The results showed that in traumatic spinal cord events, traffic accident and falling from height are the main etiologies; hence, authorities in Iranian health system could consider preventive policies to decline the load and TSCI effects in hospitals and population.

Background and aims: The aim of the present study was to investigate the main causes of traumatic spinal cord injury (TSCI), along with the relationship between SCI patients’ demographic characteristics and related treatments. Methods: In general, 608 patients suffering from TSCI and referring to Ayatollah Kashani hospital, Shahrekord in 2016-2017 were enrolled in this cross-sectional study. Patients’ demographic characteristics, level of injury, the severity of the injury, injury cause, and duration of hospitalization (DOH) were obtained according to their files and medical records. Several months after discharge, the patients were examined by a neurosurgeon, and the treatment outcome was recorded in specific checklists. Results: The mean age of the injured individuals was 34.2±16.9 years and the majority of the injured (70.2%) were males. ASIA grades E and D were also reported in 50.3% and 25% of the injured at admission, respectively. Further, grade E injury was observed in 77.1% of the injured at discharge. Medicinal, non-surgical, and surgical treatments were used for 53.8%, 25.8%, and 20.4% of patients, respectively. The levels of injury, treatment strategy, and clinical outcomes were significantly different based on the ASIA grades at admission (P<0.001, for all items). There was a significant difference among DOH (day) in terms of the level of injury, ASIA grades during admission, treatment strategy, and treatment outcomes in different individuals (P<0.001, for all items). Conclusion: Regarding the relationship between the treatment strategy, the ASIA grade, and the outcome of the treatment, it seems necessary to perform surgical or rehabilitative interventions for each person in accordance with demographic characteristics.

Background Few reports have addressed the clinical and laboratory features of patients with coronavirus disease-2019 (COVID-19) in mountainous areas, especially in Iran. Objectives To report the clinical and laboratory data and manifestations predicting mortality of patients with COVID-19 in the west of Iran. Methods We conducted a retrospective cohort study of 286 patients hospitalized with COVID-19 between 25 February 2020 and 12 May 2020 to describe their clinical symptoms and laboratory test findings when they were admitted at the Hajar Hospital affiliated with the Shahrekord University of Medical Sciences, and a multivariable analysis of factors that predict their disease severity and mortality. Results After hospital admission, 18 patients died and 268 were discharged. Older age [odds ratio (OR) = 1.02, 95% confidence interval (CI) = 1.01–1.04, P = 0.001], presence of underlying diseases (OR = 1.86, 95% CI = 1.01–3.45, P = 0.04), elevated hematocrit (OR = 1.08, 95% CI = 1.03–1.13, P = 0.002), and increase in red blood cell distribution width (RDW) coefficient of variation (OR = 1.18, 95% CI = 1.02–1.36, P = 0.02) were significantly associated with disease severity. Older age (OR = 1.00, 95% CI = 1.00–1.07, P = 0.03), hypocalcemia (OR = 0.20, 95% CI = 0.09–0.58, P = 0.002), hypophosphatemia (OR = 0.50, 95% CI = 0.26–1.02, P = 0.04), and increase in platelet-larger cell ratio (P-LCR; OR = 1.10, 95% CI = 1.00–1.15, P = 0.04) were significantly associated with mortality. The areas under the receiver operating characteristic curves were as follows: calcium 0.759; lactate dehydrogenase (LDH) 0.731; phosphorus 0.725; bilirubin 0.689; C-reactive protein 0.679; and RDW – standard deviation (RDW-SD) 0.624. Conclusions Those who did not survive tended to be elderly and had a greater incidence of comorbidities. Elevated LDH, decreased levels of calcium and phosphorus, and anemia at diagnosis were associated with greater risk of death for these Iranian patients hospitalized with COVID-19. Regular assessment of these markers would help to manage patients with COVID-19.