Adverse drug reactions in an Iranian department of adult infectious diseases

This study aimed to assess the frequency and severity of adverse drug reactions [ADRs] [WHO definition] in hospitalized adult patients in an infectious diseases referral ward in Tehran. Of 281 patients evaluated over 6 months, a total of 170 suspected ADRs were reported among 101 patients [35.9%]. The most commonly affected organ system was gastrointestinal [47.5%], and the most common class of drugs responsible was anti-infectives [93.1%]. ADRs were high among HIV-positive patients [82.9%], mainly due to anti-tuberculosis drugs. Attention to appropriate prescription of drugs is required with more careful clinical and laboratory monitoring of patients

Therapeutic response to folinic acid in methanol poisoning epidemic in Shiraz

Methanol poisoning may result to death and permanent complications, sporadic cases of methanol poisoning are fairly rare and the largest experience are generally gained from managing methanol intoxication epidemics. The main metabolite of methanol is acid formic that is the prime metabolite responsible for toxic effects of methanol and since folate dependent systems are responsible for the oxidation of formic acid to CO2 and water. It is believed that administration of folic acid enhances the metabolism of formate. Though therapeutic effects of folic or folinic acid has never been fully tested in clinical trails in human. Our objective was to evaluate therapeutic effect of folinic acid in methanol poisoned persons. In recent methanol poisoning epidemic due to "bootleg" Liquor consumption in Shiraz at 2004, Sixty-two patients have hospitalized. Folinic acid was administered to 19 patients and therapeutic effect of folinic acid was studied. There was no significant difference between two groups of patients and number of decreased visual acuity, renal function, hospital stays and needs to bicarbonate therapy and hemodialysis. The only effect was decreasing acidosis in folate treated patients. Regardless of prior animal studies and case reports, with attention to our study limitation we didn't found significant protective effect of folinic acid infusion among methanol poisoning patients. The only effect was decreasing acidosis in folate received patients. Further studies in optimal situation is needed for definite judgment

Nutritional assessment of GI cancer patients at admission and seven days after major intraabdominal surgery

Pre-existing malnutrition has been reported to affect a high percentage of cancer patients. Various methods are being used to assess nutritional status in hospitalized patients. The aim of this study was to apply two different nutritional assessment techniques to determine the prevalence of malnutrition in GI cancer patients and to assess their nutritional status, at admission and seven days after surgery. For this purpose, the nutritional status of fifty one patients who underwent major intraabdominal surgery was assessed. The Subjective Global Assessment [SGA], Nutritional Risk Index [NRI], anthropometric measurements, serum albumin, prealbumin, lymphocyte count and hematocrit were used to assess nutritional status of the patients. At the time of admission, based on the SGA and NRI, 70.6% and 74.5% of the patients were malnourished respectively. Both anthropometric and laboratory data, including weight, body mass index, mid arm circumference, triceps skin fold, mid arm muscle circumference, albumin, prealbumin, hematocrit and lymphocyte decreased significantly seven days after surgery [p<0.01]. The malnutrition rates increased significantly to 98% with both the SGA and NRI, seven days after surgery [p<0.01]. From the findings of this study it is concluded that there was a high prevalence of malnutrition in GI cancer patients and in almost all patients, nutritional status deteriorated seven days after surgery. Both methods proved useful for detection of the prevalence and development of malnutrition. Based on these results it is suggested that nutritional care after surgery should be improved by providing enough calories via enteral and/or parenteral route

[Comparing epidemiological methods in detecting drug safety signal in IRAN]

To compare three different methods of signal detection applied to the Adverse Drug Reactions registered in the Iranian Pharmacovigilance database from 1998 to 2005. All Adverse Drug Reactions [ADRs] reported to Iranian Pharmacovigilance Center from March 1998 through January 2005, were included in the analysis. The data were analyzed based on three different signal detection methods including Reporting Odds Ratios [PRRs], Bayesian Propagation Neural Network [BCPNN] and Reporting Odds Ratios [RORs]. Signals detected by each method were categorized based on the number of reports per drug-adverse event combination, severity of the event and labeled or unlabeled ADRs. The methods applied to signal detection were then compared in recognizing different types of adverse events. A total of 6353 cases of ADR reports, describing 11130 reactions, were reported to Iranian Pharmacovigilance Center [IPC] during the study period. The dataset involved 4975 drug-event combinations, which were assessed for detecting signals. The counts of drug-event combinations was 1, 2 and 3 or more for 3470, 727 and 779 combinations, respectively. There were 500 drug items responsible for 468 reaction terms in the database. According to PRR and 95 Confidence Interval, there were 2838, 872 and 488 drug-event combinations known as a signal for the pairs with the reporting frequency of >/=1,>/=2 and >/=3 reports, respectively. The signals detected with the criteria of PRR>/=2, [CHI]2>/=4 were 2930, 872 and 480 for the pairs with the same reporting frequencies. Estimates of RORs and the 95% Confidence Interval showed that 2722, 862 and 481 drug-event combinations were detected to be signal for the pairs with the reporting frequency of >/=1, >/=2 and >/=3 reports, respectively, while measuring IC and IC-2SD detected 1120, 378 and 235 cases for the same reporting frequencies. There were 234 signals detected by all three methods. Despite the similarities between data mining methodologies for signal detection, there are differences in the numbers of signals detected by each method. The study findings suggest that quantitative signal detection methods should be added to the routine Pharmacovigilance activities in Iran and the trends for quantitative measures over time should be monitored

relation between breast feeding and breast cancer

Second to the cardiovascular disease, cancer is the main cause of death in Iran. In this study some of the risk factors of breast cancer; especially the ones related to breastfeeding have been assessed. The study was a retrospective study of 100 women with breast cancer. The most important risk factors in breast cancer were number of children, age of mother on the first pregnancy. The result showed that the increase of breast cancer was related to women who stopped breastfeeding before age 24 months. Breastfeeding for more than 12 months will reduce the incidence of breast cancer by 25%. In general there was a reverse relationship between duration of breastfeeding and risk of cancer in premonopausal, but not in postmenopausal women