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OBJECTIVE: The purpose of this study was to evaluate Silymarine effects on prognosis of patients with severe and moderate traumatic brain injury. STUDY DESIGN: This double blind, placebo-controlled clinical trial. SETTING: Valiasr hospital hospital in Arak, Iran. SUBJECTS AND METHODS: Research was performed among patients between 15 and 65 years of age with severe moderate (Glasgow Coma Scale score 9 to 12) and moderate (GCS 3 to 8) traumatic brain injury (TBI). Patients were divided into two groups (Each group: 40 patients). Patients assigned to the control groupwere receiving all standard treatments. Patients in case groups were administered 140 mg of silymarin every 8 hours for 7 days. We Checked the Glasgow Outcome Scale (GOS), GCS, age, gender, location, mechanism of trauma, site of accident and the incidence time of accident to arrival at emergency unite. Statistical analysis was conducted using SPSS (SPSS version 18; Chicago, IL). RESULTS: Our findings suggested that there was no a significant difference between intervention group and control in terms of parameters as GOS, GCS, age, gender, location, mechanism of trauma, and site of accident and the incidence time of accident to arrival at emergency unite (P > .05). Brain CT in two groups showed a significant difference (P = .002), where in the silymarin group there were more normal cases when comparing with control group. CONCLUSIONS: Silymarin did not reveal a significant effect for improving prognosis of patients with moderate and severe TBI.
Subject(s)
Antioxidants/therapeutic use , Brain Injuries, Traumatic/drug therapy , Brain/diagnostic imaging , Protective Agents/therapeutic use , Silymarin/therapeutic use , Adolescent , Adult , Aged , Brain Injuries, Traumatic/diagnostic imaging , Double-Blind Method , Humans , Iran , Middle Aged , Prognosis , Severity of Illness Index , Tomography, X-Ray Computed , Treatment Outcome , Young AdultABSTRACT
BACKGROUND: According to the side effects of the usual treatment of burns, in improving the patients' prognosis, there is a need to introduce faster and more effective adjuvant therapies to treat wounds, thus to improve the prognosis of patients. The aim of this study was to investigate the effect of adjuvant treatment with oral silymarin on wound healing process caused by second degree-burns among the patients admitted to Valiasr Hospital of Arak. METHODS: This randomized, double-blind clinical trial study was carried out on 80 patients with second-degree burns covering 20 to 30 percent of the body with flame. Patients were randomized into 2 groups with an equal number: The intervention group (treated daily with oral 140-mg silymarin) and control (under the administration of placebo). Patients were treated for 8 weeks and at the end of weeks 1, 2, 3 and 4 according to the degree of wound healing (grade 1, 2 and 3) were followed during 2016-2017. RESULTS: Changes in degrees of burn wound healing in both the intervention and placebo groups during the 4 weeks of treatment, significantly improved grade 3 completely. Based on the results, the complete remission in all four follow-up stages was significantly higher in silymarin group than the placebo group: Week 1 (intervention: 9 (22.5%), control: 0 (0%), (p=0.011), week 2 (intervention group: 18 (45%), placebo: 7 (17.5%), (p=0.000), week 3 (intervention: 24 (60%), placebo: 11 ( 27.5%), (p=0.051); week 4 (intervention: 27 (67.5%), control: 19 (47.5%), (p=0.003). CONCLUSIONS: According to our results, the 4-week adjuvant treatment with oral silymarin resulted in the full and faster wound recovery in patients with second degree-burn. So, it is recommended to use adjuvant treatments to obtain effective results.
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Background: Methamphetamine cannot be detected through conventional urine screening tests or other analytical methods in methamphetamine abusers who have not used the drug for some time. In some instances, detection of methamphetamine in fingernails can be a good alternative. We aimed to determine the sensitivity and specificity of the one-step methamphetamine test strip used in the detection of methamphetamine in urine in the detection of methamphetamine in fingernails. Methods: We took 72 fingernail samples, including 60 samples from methamphetamine abusers and 12 samples as controls from their relatives who had no history of methamphetamine use. The liquid-liquid extraction method was used on fingernail samples, and the resultant solution was tested with one-step methamphetamine test strip. We analysed participants' demographics including age, gender, duration of methamphetamine abuse and strip test results. Results: The mean (SD) age of the participants was 25 (4.33) years. The mean (SD) duration of methamphetamine abuse was 10 (4.5) months. Of the 72 participants, 61 (84.7%) had positive and 11 (15.3%) had negative strip test results. All 60 methamphetamine abusers had positive test results. A positive or negative history of methamphetamine abuse was taken as the gold standard. The sensitivity and specificity of the test was 100% and 91.6%, respectively. Conclusion: Performing liquid-liquid extraction on fingernails and using the strip test for detection of methamphetamine is a simple, inexpensive, rapid and accessible method, and its high sensitivity and specificity make it appropriate for screening. This method may be preferred over other urine and blood methamphetamine detection methods when the patient has not used the drug for a few days.
Subject(s)
Amphetamine-Related Disorders/diagnosis , Liquid-Liquid Extraction/methods , Methamphetamine/analysis , Nails/chemistry , Substance Abuse Detection/methods , Adult , Amphetamine-Related Disorders/etiology , Feasibility Studies , Female , Humans , Liquid-Liquid Extraction/instrumentation , Male , Methamphetamine/adverse effects , Sensitivity and Specificity , Substance Abuse Detection/instrumentation , Time Factors , Young AdultABSTRACT
A large number of dead bodies are referred to forensic autopsy halls for medicolegal examination. They can be a source of transmission of infectious diseases through direct contact or autopsy tools. The main aim of this study was to estimate the virus infection rates in the dead bodies. One thousand consecutive dead bodies that had been referred to autopsy hall of Legal Medicine Bureau of Tehran, Iran, during 2016, were included. The blood samples were analyzed in the laboratory for detection of HBs Ag, HBs Ab, HIV Ab, and HCV Ab, after providing informed consent from legal next of kin of the dead bodies. The general characteristics of the dead bodies were also collected by a checklist. Forty-seven cases of HIV seropositivity, 80 cases of HBs Ag seropositivity, and 97 cases for HCV Ab seropositivity were found. Among them, 27 cases of HIV, 40 cases of anti-HBC positive, and 94 cases of RIBA testing positive for HCV were proved through confirmatory tests. In other words, 2.6% of the dead bodies were infected with HIV, 3.8% with HBV, and 9% with HCV. The total infection rate was 15.5%. This is a worrying risk for pathologist and autopsy technicians.
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The present study aimed to evaluate the effectiveness of morphine and meperidine (pethidine) as pain relief in opioid-dependent patients with acute pain. A total of 122 opioid-dependent patients with acute pain were included in the study. Their pain severity was assessed, using visual analog scale (VAS) scores ranging from 0 to 10. The patients randomly received intravenous morphine (up to 0.15 mg/kg) or meperidine (up to 1.5 mg/kg) for pain control by patient control analgesia (PCA) pump. The clinical opioid withdrawal scale (COWS) was employed for the assessment of withdrawal symptoms. The pain relief and the emergence of withdrawal symptoms were measured at 15, 30, and 60 minutes after drug administration. The patients who received morphine reported a better pain control compared to those who received meperidine (mean ± standard deviation [SD] VAS scores 4.11±1.90 vs 5.85±2.08 at the end of the study; P<0.001). On the other hand, the patients who received meperidine indicated prominent withdrawal symptoms (mean ± SD COWS scores 4.80±2.18 vs. 1.98±0.82 at the end of the study; P<0.001). Our findings revealed that morphine can be recommended in acute pain management of opioid-dependent patients. In addition, emergency physicians should ask their patients about any drug dependence before selecting the appropriate drug for their acute pain management.
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BACKGROUND: Acute and chronic pain is prevalent in patients with opioid dependence. Lack of knowledge concerning the complex relationship between pain, opioid use, and withdrawal syndrome can account for the barriers encountered for pain management. This study was designed to evaluate the efficacy of sublingual (SL) buprenorphine for post-operative analgesia, compared with intravenous (IV) morphine. METHODS: A total of 68 patients, aged 20-60 years were randomly selected from whom had been underwent laparotomy due to acute abdomen in a University Teaching Hospital in Arak, Iran, and were also opioid (opium or heroin) abuser according to their history. After end of the surgery and patients' arousal, the patients were evaluated for abdominal pain and withdrawal syndrome by visual analog scale (VAS) and clinical opioid withdrawal score (COWS), respectively 1, 6, and 24 h after the surgery. They received either morphine 5 mg IV or buprenorphine 2 mg SL, 1 h after end of the surgery, and then every 6 h for 24 h. FINDINGS: VAS was 4.47 ± 0.73 and 2.67 ± 0.53 at h 6 and 24 in buprenorphine group, respectively. The corresponding score was 5.88 ± 0.69 and 4.59 ± 0.74 in morphine group. At the same time, patients in buprenorphine experienced less severe withdrawal syndrome. CONCLUSION: The present study confirmed the efficacy of SL buprenorphine as a non-invasive, but effective method for management of post-operative pain in opioid dependent patients. Result of this study showed that physicians can rely on SL buprenorphine for post-operative analgesia.
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INTRODUCTION: The changes in concentration of trace elements have effects on many organ systems, including the immune system. There have been conflicting reports on serum trace element levels in heroin users. This study was carried out to compare serum trace element concentrations in opium, heroin, and methamphetamine users. METHODS: The study was done on 90 chronically illegal drug users (n = 30 per group) and 30 controls of the similar sex and age range (from 20 to 40 years). The control group was healthy subjects with no lifetime history of substance abuse or dependence. All of the substance users were selected from among those who had a history of substance use, for a minimum of 1 year. Serum zinc (Zn), copper (Cu), iron (Fe), and magnesium (Mg) were measured spectrophotometrically using chemistry analyzer. RESULTS: Serum Fe concentration was decreased in heroin (P = 0.026) and methamphetamine (P = 0.0001) users compared with healthy subjects, whereas serum Cu was higher in opium, heroin, and methamphetamine users (P < 0.01). Copper was negatively and significantly correlated with Fe in all groups (P < 0.05). There was no statistically significant difference between drug users and healthy subjects in serum concentrations of Zn and Mg. CONCLUSIONS: This study showed decreased in serum concentration of iron and increase in serum copper in drug users when compared with controls.
Subject(s)
Copper/blood , Iron/blood , Magnesium/blood , Substance-Related Disorders/blood , Trace Elements/blood , Zinc/blood , Adult , Case-Control Studies , Drug Users , Humans , Iran , Male , Young AdultABSTRACT
BACKGROUND AND AIMS: Currently, there is no widely accepted evidence-based pharmacotherapy regime for the treatment of psychostimulant dependence. Yet, different pharmacological approaches have been tried in the treatment of MA addiction. The present study was conducted to compare efficiency of methylphenidate which is relatively easily accessible in our country, with resperidone for this purpose. METHODS: Eighty-six patients with MA dependence according to criteria defined by DSM IV-TR were divided into two groups. Patients in group R were given oral resperidone 1 mg daily for 1 week; then 2 mg daily in a divided dose for 3 weeks. Patients in group M were given oral methylphenidate 10 mg daily for 2 weeks, 7.5 mg daily for 1 week, then 5 mg daily for 1 week. They were evaluated for drug craving, psychological, neurologic and somatic symptoms at the start and end of the study. FINDINGS: Both drugs were useful for lowering drug craving in patients; however resperidone was more effective (6.31 ± 8.31 vs.19.6 ± 12.45 cravings per week, respectively). The effects of resperidone were more notable in lowering frequency and intensity of psychiatric, neurologic, cardiac and somatic symptoms of the patients after discontinuation of MA abuse; however methylphenidate was effective too; though with a lower potency. CONCLUSION: The present study confirmed that both methylphenidate and resperidone can successfully be used for treatment of MA dependence, in order to reduce drug craving and psychological, neurologic, and somatic problems in patients. However, the efficacy of methylphenidate was estimated to be less than that of resperidone for this purpose.
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BACKGROUND AND AIMS: Methamphetamine abuse results in numerous adverse health effects. Formation of free radicals may be a contributing factor. Methamphetamine has produced free radicals in animal studies. Present study was conducted to evaluate status of oxidative stress and lipid peroxidation among chronic methamphetamine users. METHODS: Ninety six individuals were selected randomly from methamphetamine abusers who had referred to rehabilitation and treatment center for drug abuse and their closed relatives, after providing informed consent. Blood samples were taken from each of the studied individuals. Ferric reducing ability of plasma (FRAP) assay and serum level of MDA (malondialdehyde) were used to assess the total anti-oxidant power and status of lipid peroxidation of the body, respectively. The results were analyzed by SPSS software version 16.0. Differences among groups were determined by T-test. FINDINGS: Total anti-oxidant powers of plasma were 0.31±0.04 micromoles/liter and 0.46±0.05 micromoles/liter in methamphetamine abusers and control groups respectively. The difference was statistically significant (p-value=0.04). Levels of MDA were 4.38±5.05 micromoles/liter and 1.72±2.04 micromoles/liter in methamphetamine abusers and control group. The difference was statistically significant (p-value=0.01). CONCLUSION: results of present study suggest that prolonged use of methamphetamine exerts oxidative stress on the body and enhances lipid peroxidation. The event may contribute to emergence of adverse effects of acute and prolonged use of methamphetamine; such as loss of attention, psychomotor dysfunction, and cognitive deficits. It is recommended that antioxidants were included in drug regimens prescribed for methamphetamine abusers who referred to physicians to seek medical care for any reason.
Subject(s)
Amphetamine-Related Disorders/blood , Central Nervous System Stimulants/adverse effects , Lipid Peroxidation/drug effects , Methamphetamine/adverse effects , Oxidative Stress/drug effects , Adolescent , Adult , Amphetamine-Related Disorders/rehabilitation , Antioxidants/analysis , Biomarkers/blood , Case-Control Studies , Humans , Male , Malondialdehyde/blood , Middle Aged , Time Factors , Young AdultABSTRACT
BACKGROUND: No pharmacologic agents have been approved for the treatment of non-alcoholic steatohepatitis (NASH) that is common in our region. The present study was designed to evaluate the efficacy of silymarin, a known herbal drug, in the treatment of NASH. METHODS: This clinical-trial study was conducted on 64 patients with NASH who were randomly divided as case group (33) and control group (31). Abdominal sonography and persistent elevation in levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) more than 1.2 times of the upper normal limit within the last six months were selected as inclusion criteria. They were advised to take low-fat, low carbohydrate diet, do regular sport activity to lose weight up to 4 Kg. Patients in the case group received 210 mg/day silymarin orally for 8 weeks and those in the control group received placebo. After 8 weeks, the patients were reevaluated and their AST and ALT levels were measured. This study was registered in the Iranian Registry of Clinical Trial (www.irct.ir) with registration number ID: IRCT201202159018N1. RESULTS: The mean age of patients in case and control groups was 43.6±8.3 and 39.4±10.5 years, respectively. Their BMI were 27.4±1.7 and 27.5±1.9, respectively. Their weights were also 79±9.2 and 76.9±9.5 kg, respectively. Serum concentrations of ALT were 91.3±21.3 and 38.4±11.8 in case group before and after the study respectively, whiles the figures were 84.6±23.3 and 52.3±29 in the control group (P=0.026). The same trend was seen for AST (P=0.038). CONCLUSION: The patients who had taken silymarin experienced more notable fall in hepatic enzymes.
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BACKGROUND: Tincture of opium (TOP) is currently used for maintenance therapy in treatment of opioids addiction. It contains ethanol. The present study was conducted to assess the increase in blood alcohol concentration (BAC) in its users; a process which may interfere with breath-alcohol test performed by law enforcement or traffic police. METHODS: A total of 143 individuals were selected randomly from drug users who had been referred to an addiction treatment clinic. They were asked to undergo breath-alcohol test 15, 30, 45, and 60 min after taking their daily dosage of TOP. The resulting figures were statistically analyzed by t-test and chi-square test using SPSS for Windows. FINDINGS: The calculated blood ethanol concentration rose to 26.33 ± 14.34, 29.15 ± 6.70, and 33.03 ± 8.46 in persons taking 20, 25, and 30 ml TOP respectively, 5 min after their drug ingestion. The figures turned into zero after 15 min. CONCLUSION: Users of TOP should be reassured about its alcoholic content. Its alcoholic content cannot produce equilibrium disturbance or notable BAC. However, it is recommended that users of TOP are observed in addiction treatment centers for 15 min after taking their drug to reach a higher degree of certainty about any effect of alcoholic content of TOP.
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A relationship between the expression of inflammation markers, oxidative stress and opium use has not been clearly established. This study was done to determine serum high-sensitivity C-reactive protein (hs-CRP), quantity of C3 and C4 complement factors, immunoglobulins, nitric oxide (NO) and total antioxidant capacity (TAC) in opium smokers and non-drug-using control participants. The present study was done on 44 male opium smokers and 44 controls of the same sex and age (20-40 years). The control group was healthy individuals with no lifetime history of drug abuse or dependence. All of the opium abusers were selected from those who had a history of opium use, for at least one year, with a daily opium dosage not less than 2g. Addicts known to abuse alcohol or other drugs were excluded. Serum hs-CRP concentration was measured using ELISA method and serum C3, C4 and immunoglobulins concentration were determined by Single Radial Immunodiffusion (SRID) method. NO production was estimated through Griess reaction and TAC was assessed by Ferric Reducing/Antioxidant Power (FRAP) test. Serum hs-CRP, complement factors (C3 and C4) and FRAP levels were significantly higher in the opium smokers (8.93 ± 1.93; 138.47 ± 13.39; 68.79 ± 7.02 and 972.75 ± 11.55, respectively) relative to the control group (0.72 ± 0.09; 93.36 ± 8.73; 33.08 ± 7.39 and 761.95 ± 18.61, respectively). These results permit us to conclude that opium smokers indeed present with a low to moderate grade inflammation, which is defined by an increase in acute phase proteins.
Subject(s)
Biomarkers/blood , Inflammation/chemically induced , Inflammation/immunology , Opium/adverse effects , Oxidative Stress/immunology , Adult , Antioxidants/metabolism , C-Reactive Protein/metabolism , Complement C3/metabolism , Complement C4/metabolism , Humans , Immunoglobulins/blood , Inflammation/blood , Male , Nitric Oxide/blood , Substance-Related Disorders , Young AdultABSTRACT
OBJECTIVES: There are few studies with conflicting results on the effects of in vivo administration of opioids on immune function. The aim of this study was to evaluate the serum levels of interferon (IFN)-γ, interleukin (IL)-4, IL-10, IL-17, and hs-C-reactive protein (hs-CRP) in opium smokers. METHODS: The study was conducted between 44 male opium addicts and 44 controls aged 20 to 40 years. The control group was healthy individuals with no lifetime history of substance abuse. All the opium abusers were selected from those who had a history of use of opium, as a regular habit, at least for 1 year, with a daily opium dosage of not less than 2 g. Addicts known to abuse alcohol or other drugs were excluded. Serum samples were collected from all participants and tested for the cytokine and hs-CRP levels by ELISA (enzyme-linked immunosorbent assay) method. Statistical analysis was performed using the Student t test. RESULTS: The mean serum levels of IFN-γ, IL-10, and IL-17 in the opium addicts were significantly higher than those observed in the control group. The mean concentration of serum IL-4 in opium addicts did not differ from that in the control group. Systemic IL-10 levels correlated positively and significantly with CRP in opium addicts. CONCLUSIONS: Long-term, daily use of opium is associated with higher Th1 (IFN-γ), Tr1 (IL-10), and Th17 (IL-17) cytokines concentration in serum. Interferon-γ and IL-17 are involved in inducing and mediating proinflammatory responses. Our data suggest that an immunoregulatory response is occurring with the upregulation of IL-10.
Subject(s)
C-Reactive Protein/metabolism , Cytokines/blood , Immune System/drug effects , Opioid-Related Disorders , Opium/adverse effects , Adult , C-Reactive Protein/analysis , Case-Control Studies , Cross-Sectional Studies , Diagnostic and Statistical Manual of Mental Disorders , Enzyme-Linked Immunosorbent Assay , Humans , Immune System/metabolism , Iran , Male , Opioid-Related Disorders/diagnosis , Opioid-Related Disorders/immunology , Substance Abuse Detection/methods , TimeABSTRACT
BACKGROUND: Withdrawal syndrome may influence patient's motivation for participation in addiction treatment programs. Management of the symptoms can improve the success rate of addiction treatment programs. In the present study, we have evaluated the efficiency of an herbal product as adjunct therapy for alleviation of withdrawal syndrome in opium abuse. METHODS: In the present clinical trial, 81 patients were assigned into case and control groups. The control group was treated with methadone and placebo for 4 weeks. The case group was treated with methadone and powdered dried leaves of Rosmarinus officinalis for the same interval. Occurrence of withdrawal syndrome was compared between groups on days 3, 7, and 14 after beginning of the treatment, and the possible signs and symptoms of withdrawal syndrome were checked. The clinical opioid withdrawal scale (COWS) was used for evaluation of withdrawal syndrome in the patients. FINDINGS: Patients in the case group experienced less severe withdrawal syndrome compared to those in the control group; chiefly bone pain, perspiration, and insomnia. CONCLUSION: The present study showed that rosemary can be used as an optional extra drug for treatment of withdrawal syndrome during treatment programs for opium addiction and possibly addiction to other opioids.
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BACKGROUND: Hanging is a common method of suicide in many countries, and it has a higher success rate than other commonly employed modes of attempted suicide, such as self-poisoning. STUDY OBJECTIVES: The aim of this study was to determine the epidemiology and characteristics of near-hanging patients admitted to the main referral hospital in Arak, Iran. METHODS: All patients with the diagnosis of hanging admitted between January 2000 and 2009 were included in the study. Data regarding demographics, radiographic studies, injuries, Glasgow Coma Scale score (GCS) on arrival, and outcomes, were examined. RESULTS: During the 9-year study period, 43 cases of near hanging were identified. All patients were male, with a mean age of 24.2 years (range: 12-38 years). The median GCS at presentation was 6 (range: 3-12), and 83.8% of patients had a GCS of 8 or less. Cervical spine fracture of C2 was observed in two cases (4%). The imaging studies revealed that 62.7% of patients had an abnormal brain computed tomography scan, with brain edema being the most common finding (n=16, 37.2%), followed by subdural hematoma (n=10, 23.3%). Ophthalmologic examination demonstrated retinal bleeding in 24 patients (55.8%). There were four inpatient deaths among the study group, and 39 patients survived to discharge, yielding a mortality rate of 9.3%. Findings on presentation associated with subsequent mortality included a systolic blood pressure<90 mm Hg, GCS<5, retinal bleeding, and pulmonary edema. CONCLUSION: Mortality among patients who present alive to the hospital after near hanging is low, including those with a low GCS on arrival. Ophthalmoscopic examination, as well as radiological examination of the brain and cervical spine, should be performed in cases of near hanging.
Subject(s)
Suicide, Attempted/statistics & numerical data , Adolescent , Adult , Blood Pressure , Brain Edema/diagnostic imaging , Brain Edema/etiology , Cervical Vertebrae/diagnostic imaging , Cervical Vertebrae/injuries , Child , Glasgow Coma Scale , Hematoma, Subdural/diagnostic imaging , Hematoma, Subdural/etiology , Humans , Iran/epidemiology , Male , Prognosis , Pulmonary Edema/etiology , Radiography , Retinal Hemorrhage/etiology , Spinal Fractures/diagnostic imaging , Spinal Fractures/etiology , Survival Rate , Young AdultABSTRACT
BACKGROUND: Given the paucity of data on possible testis changes in opioid dependents, we sought to compare the testis volumes between a group of opium dependents and a group of healthy controls. OBJECTIVE: Comparison of testis volume between opium dependents and healthy controls. MATERIALS AND METHODS: This case-control study recruited 100 men with opium dependency (cases) and 100 healthy men (controls) in Iran, in 2008. A checklist containing questions about age, height, weight, daily amount of cigarette use, and duration of cigarette use for all the participants as well as daily amount of opium use (grams) and duration of opium use (years) for the case group was completed. Additionally, the dimensions of each testis were measured by a single person using calipers, and the mean of the left and right testes volume was compared between these two groups. RESULTS: The mean of the testis volumes in the case group was significantly lower than that of the case group (11.2±2.2 and 25.1±2.7cm³, p<0.001). The results of the ANCOVA test showed that even after the omission of the cigarette smoking effect (p=0.454), the testis volume remained lower in the opium dependents (R(2)=0.884, p<0.001). In the case group, there were significant reverse correlations between testis volume and age (r=-0.404, p<0.001), daily amount of opium use (r=-0/207, p=0.039) and duration of opium use (r=-0.421, p<0.001). CONCLUSION: We found that the testis volume in the male opium dependents was lower than that of the healthy controls. We would recommend that future studies into the impact of drugs on the testis dimensions pay heed to possible histological changes in the testes owing to opium dependency.
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BACKGROUND: Naloxone, as a low-priced and available drug, may be useful in improvement of signs and symptoms of benzodiazepines intoxication. The aim of this study was assessment of its effect on benzodiazepines poisoning. METHODS: In this clinical-trial study, patients with typical signs and symptoms of benzodiazepines poisoning, who were referred to a poisoning center in Tehran in 2008, were selected. After recording of patients' characteristics, supportive treatment was initiated and patients were randomly assigned to the case group with intravenous (IV) injection of two 0.4 mg naloxone ampules or to the control group. Their signs and symptoms were evaluated again 0.5 hour later. Each of diazepam, clonazepam and alperazolam drug group had 30 patients and lorazepam drug group had 26 patients, half of which patients in each drug group received naloxone. RESULTS: Most of the participants were female and the mean age was 28 years. There were no significant differences between case and control groups in age, sex, time of drug consumption, tablet counts, signs and symptoms and level of consciousness at the admission time in each drug types. After naloxone injection in case groups, all signs and symptoms significantly improved in all drug types in comparison to control groups except nystagmus. In addition, level of consciousness significantly improved in case groups in all drug types except lorazepam. CONCLUSION: Findings of the study showed that naloxone is effective in management of benzodiazepines poisoning. However, future clinical trials with greater sample size are recommended.
Subject(s)
Benzodiazepines/toxicity , Hypnotics and Sedatives/toxicity , Naloxone/therapeutic use , Narcotic Antagonists/therapeutic use , Poisoning/drug therapy , Adult , Benzodiazepines/antagonists & inhibitors , Female , Humans , Hypnotics and Sedatives/antagonists & inhibitors , Male , Poison Control Centers , Poisoning/etiology , Poisoning/physiopathology , Treatment Outcome , Unconsciousness/chemically induced , Unconsciousness/drug therapyABSTRACT
Rapid diagnosis of major beta thalassemia along with certain preventive measures is of utmost significance. The present study aims to compare the fingerprints in Major beta thalassemic patients (67) and in their parents (76 with minor thalassemia) with the normal fingerprints of control group (144). A forensic medical examiner determined fingerprint types of arch, loop, whorl and other types. Like normal individuals, loop fingerprint pattern was found to be the most common fingerprint type among thalassemic patients. However, the number of whorl fingerprints in all fingers in thalassemic patients was greater than that of normal individuals and the number of loop fingerprints was smaller (p < 0.05). Arch type fingerprint pattern was less frequent in major thalassemic patients compared to minor thalassemic ones (p < 0.05). The findings show that the number of whorl fingerprint patterns in thalassemic patients was greater than that of normal individuals, while the number of loop fingerprint patterns being smaller and the frequency of arch fingerprint pattern in patients with major thalassemia was lower than that of minor thalassemic patients. Therefore, one may choose fingerprint pattern as a simple, affordable and appropriate screening method to help detect the afflicted patients and prevent severe cases of thalassemia.