survey on substance abuse related deaths referred to Tehran's legal medicine organization during 2007 and 2008

Doubtlessly one of the major problems in Iran is drug abuse or substance abuse. The transmission of HIV/AIDS has made the problem so complicated that has created an urgent need for a campaign against this awful phenomenon. The objective of this study-that was carried out through the cross-sectional methods considering the situation of the addict death and the related factors. The target population consists of the corpses of the addicts referred to the Legal Medicine Organization of Tehran during 2007 and 2008. The cadavers were examined in the preliminary stage. The blood, urine and the contents of the gall-bladder, stomach and viscera were collected and sent to the toxicology laboratory to examine and find narcotics metabolites and other drugs. The samples of the brain, heart, lungs, liver and kidneys were sent to the pathology laboratories. All of the extracted data were recorded and analyzed using SPSS software. It was diagnosed that 248 cases [79.7%] out of the total 311 in this study, died of substance abuse. Totally 300 cases were reported as male addicts [96.5%]. The oldest and youngest addicts were 49 and 17 respectively. The most frequent drugs used were heroin and combination of heroin and opium. No meaningful difference was observed between the death cause of different groups of drug abusers. It seems that the increase in the population of the substance users is the main cause of frequency changes of the addicts' deaths

Predicting the risk of preterm laborby second trimester measurement of maternal alpha-fetoprotein levels and a risk factor scoring system

Preterm labor [delivery after 20 weeks and before 37 weeks of gestation] is the leading cause of prenatal mortality in developed countries. Many women who have preterm labor have abnormally high plasma levels of a-fetoprotein in early pregnancy.This study was designed to evaluate the ability of this biochemical test and a clinical risk factor scoring system to prospectively discriminate pregnancies at high risk for preterm delivery. In nested case control study six-hundred women were studied prospectively from the early second trimester until delivery. There were sixty women in the study group [those with preterm delivery] and sixty women in the control group [those with term delivery]. A plasma level sample was collected during the second trimester, between 17 and 30 week's gestation. Then a-fetoprotein was determined in both groups.The mean AFP level was 196.75 +/- 151.48 IU/mL in the study group and85.98 +/- 55.90 IU/mL in the control group, both of which were statistically significant [p<0.001']. The mean infants age was 33.11 +/- 3.40 weeks in the study group and 38.83 +/- 0.86 weeks in the control group [p<0.001] and mean of birth weight was 1988 +/- 672.33 gr in the study group and 3241.50 +/- 405.98 gr in the control group [p<0.001]. The risk factor scoring system was >10 in 17% of women in the study group and in 8% of women in the control group. The sensitivity, specificity, PPV and NPV of this test was 78%, 65%, 69.10 and 75% respectively. The accuracy of the test, LR+ and LR- were 71%, 2.24 and 0.333 respectively.The combination of measurement of maternal serum AFP in the second trimester associated with a risk factor scoring system provides a more accurate indicator of the risk of preterm delivery and therefore may be of use in targeting prevention strategies