ABSTRACT
Objectives: This study aimed to evaluate cardiovascular complications among patients who abuse amphetamines
Methods: This cross-sectional study took place between April 2014 and April 2015 among 3,870 patients referred to the Toxicology Emergency Department of Baharlou Hospital, Tehran University of Medical Sciences, Tehran, Iran. Those with clinical signs of drug abuse and positive urine screening tests were included in the study, while cases of chronic abuse were excluded. Cardiac complications were evaluated via electrocardiography [ECG] and transthoracic echocardiography
Results: A total of 230 patients [5.9%] had a history of acute amphetamine abuse and positive urine tests. Of these, 32 patients [13.9%] were <20 years old and 196 [85.2%] were male. In total, 119 [51.7%] used amphetamine and methamphetamine compounds while 111 [48.3%] used amphetamines with morphine or benzodiazepines. The most common ECG finding was sinus tachycardia [43.0%], followed by sinus tachycardia plus a prolonged QT interval [34.3%]. Mean creatine kinase-MB and troponin I levels were 35.9 +/- 4.3 U/mL and 0.6 +/- 0.2 ng/mL, respectively. A total of 60 patients [26.1%] were admitted to the Intensive Care Unit. The majority [83.3%] of these patients had normal echocardiography results. The mean aortic root diameter [ARD] was 27.2 +/- 2.8 mm. Abnormalities related to the ARD were found in 10 patients [16.7%], three of whom subsequently died
Conclusion: According to these findings, cardiac complications were common among Iranian patients who abuse amphetamines, although the majority of patients had normal echocardiography and ECG findings
ABSTRACT
Sulfur mustard gas is one of the chemical warfare gases that roughly about 45000 soldiers continue to suffer long-lasting consequences of exposure during the Iran-Iraq war between 1980 and 1988. According to the common pulmonary lesions due to this gas exposure, we studied gross and microscopic pulmonary lesions in cadavers and also assessed the main causes of mortality caused by mustard gas exposure. A case-series study was performed on hospital record files of 100 cadavers that were exposed with documented sulfur mustard gas during the Iran-Iraq war from 1979 to 1988 and autopsied in legal medicine organization In Tehran between 2005 and 2007 and gross and microscopic pathological findings of autopsied organs such as hematological, pulmonary, hepatic, and renal changes were evaluated. All cases were male with the mean age of 43 years. The time interval between the gas exposure and death was almost 20 years. The most frequent pulmonary complication was chronic bronchitis in 81% of autopsied cadavers. Other pulmonary findings were progressive pulmonary fibrosis [9%], pulmonary infections and tuberculosis [29%], malignant cellular infiltration [4%], and aspergilloma [1%]. According to the chronic progressive lesions caused by mustard gas exposure such as pulmonary lesions and also its high mortality rate, suitable programming for protection of the gas exposed persons and prohibiting chemical warfare are recommended
Subject(s)
Humans , Male , Lung Injury , Lung/drug effects , CadaverABSTRACT
In Iran before 2003 and approval of therapeutic abortion law in parliament there was severe restriction in abortion permissions and at that time, after presenting "The Guidelines for Therapeutic Abortion" by legal medicine organization of Iran [from now on known as LMO] presented in 2003 and finally, Islamic consultative assembly voted to approve the indications determined by LMO in 2005. In this study all cases referred to the clinical examination department of legal medicine organization in Tehran central region to get therapeutic abortion permission during one year before approval of therapeutic abortion law [first study from June 1999 to the end of May 2000] and after that [second study from early October 2006 to the end of September 2007], who could get this permission were considered accurately. Information needed to perform this study collected via completion of pre-designated forms and analyzed with SPSS software and the results compared in these two groups. In the second study in 85.36% of cases, fetal disorders and in 14.63%, maternal diseases and in the first study just 126 permission were issued, with 17% fetal disorders [major Thalassemia was the only considered case at that time] and 83% maternal indications were the reason to issue permission for abortion. In the second study the major fetal and maternal indications were: anencephaly and cardiovascular problems. The 2nd study shows that in 202 cases [35.19%], abortion permission was issued after confirmation of three specialists [cases which were forecasted in the Predetermined Abortion Indications List]. This study shows that in spite of all efforts made so far to present legal approaches for abortion, it is not still time to stop working on the issue and perhaps some other diseases should be added to the mentioned list in future; but this would definitely needs joint cooperation of different authorities, governmental and judicial organization