tentative component analysis of Norjizak: a new abused drug in Iran

Norjizak is a new drug abused in the past few years in Iran with symptoms and complications distinct from other common forms of drug and characterized by higher rate of mortality. The present study aims to analyze the chemical components of this substance. Five samples were obtained from abusers referring from different areas of Tehran to a treatment clinic. All samples were 2ml vials with yellowish fluid. Thin Layer Chromatography [TLC] was performed first to analyze the samples semi-quantitatively and the quantitative levels of components were then explored using high-performance liquid chromatography [HPLC]. TLC revealed steroid [in form of betamethasone], heroin, codeine, morphine and thebaine in all five samples. Four samples contained acetaminophen and two samples contained caffeine. None of them contained amphetamine, benzodiazepine, tricyclic antidepressant, aspirin, barbiturates, tramadol and buprenorphine. HPLC revealed that heroin, codeine, morphine and thebaine constituted the narcotic foundation in all samples. In addition, the heroin to acetylcodeine ratio was significantly lower in three samples, which indicates their higher toxicity. The results of the present study on the chemical components of Norjizak showed that this substance is an opiate one similar to heroin and the heroin-based crack prevalent in Iran which contains betamethasone

Component analysis of iranian crack ; a newly abused narcotic substance in Iran

Iranian crack is a new form of narcotic substance that has found widespread prevalence in Iran in the past years. crack only nominally resembles crack cocaine as it is widely different in its clinical signs. Thus the present study aims to quantify the chemical combination of this drug. The samples included 18 specimen of crack collected from different zones of Tehran, Iran. All specimens were in the form of inodorous cream solid powdery substance. TLC and HPLC methods were used to perform semi-quantitative and quantitative analysis of the components, respectively. The TLC analysis showed no cocaine compound in the specimens while they all revealed to contain heroin, codeine, morphine and caffeine. All but two specimens contained thebaine. None of the specimens contained amphetamine, benzodiazepines, tricyclic antidepressants, aspirin, barbiturates, tramadol and buprenorphine. Acetaminophen was found in four specimens. HPLC revealed heroin to be the foundation substance in all specimens and most of them contained a significant amount of acetylcodeine. The present analysis of the chemical combination of crack showed that this substance is a heroin-based narcotic which is basically different from the cocaine-based crack used in Western countries. Studies like the present one at different time points, especially when abnormal clinical signs are detected, can reveal the chemical combination of the target substance and contribute to the clinical management of its acute or chronic poisoning

effect of opium dependency on testis volume: a case-control study

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. Comparison of testis volume between opium dependents and healthy controls. 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. 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 +/- 2.7cm[3], 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]. 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

Marital adjustment in patients on long-term hemodialysis. A case-control study

This study was conducted to compare marital adjustment between patients on long-term hemodialysis and healthy controls and to determine whether the psychological symptoms correlate with marital adjustment in these patients. In a case-control study, 40 patients on long-term hemodialysis and 40 healthy participants were compared for the quality of marital relationship. The Revised Dyadic Adjustment Scale was used for interviews of marital relationship, which includes total marital adjustment and its subscales of marital consensus, affection expression, marital satisfaction, and marital cohesion. Symptoms of anxiety and depression and the Ifudu comorbidity scale were also assessed in the patients group. Marital consensus, affection expression, marital satisfaction, marital cohesion, and the overall marital relationship were significantly poorer in the patients on hemodialysis than in the controls. Also, symptoms of anxiety were more severe among the patients on hemodialysis in comparison with that in the controls. However, this was not the case for symptoms of depression. In the patients on hemodialysis, the severity of anxiety slightly correlated reversely with the total marital relationship score and marital satisfaction subscale. Depression correlated reversely with total marital adjustment, affection expression, marital satisfaction, and marital cohesion. Finally, some marital relationship subscales showed poorer results in men on dialysis, younger patients, and those with higher educational levels. Marital adjustment in patients on hemodialysis, which is linked with depressive symptoms and anxiety, is poorer compared to the healthy controls. This finding shows the necessity of an appropriate family approach for patients on long-term dialysis

Urogenital history in veterans exposed to high-dose sulfur mustard a preliminary study of self-reported data

To date, little information exists regarding urogenital disease in those who have been exposed to sulfur mustard [SM]. We report the self-reported history of urologic conditions and findings on physical examination in a group of male veterans 19 to 26 years after exposed to high-dose sulfur mustard. Data on urologic health conditions of a nationwide health survey were used in this study. This survey included all 289 Iranian male veterans who had been exposed to high doses of SM between 1983 and 1989. Demographic data, exposure-related data, health status, and also self-reported lifetime history of urologic tract infections, pyelonephritis, urinary calculi, kidney failure, and urogenital neoplasms were specifically concerned. The mean age of the veterans was 45.0 +/- 7.5 years [range, 30 to 75 years]. An interval of 19 to 26 years had passed from exposure to SM. Fifty veterans [17.3%] had a positive history of urinary calculi, 25 [8.7%] had recurrent urinary tract infections, 5 [1.7%] had BPH, and 2 [0.7%] had kidney failure. None of them had experienced urogenital malignancies. Neither recurrent urinary tract infections nor urinary calculi were significantly associated with age, medications and their doses, or SM-reduced late complications in other organs. This study adds the prevalence of self-reported urologic conditions to our limited knowledge on SM-exposed veterans' health condition, without finding any link neither to demographic, nor to the severity of health complications related to SM exposure

Evaluation of the severity of depression and anxiety in hepatitis B and hepatitis C patients: a case control study

Although several studies have reported the poor mental health of patients with chronic viral hepatitis, few reports exists over the correlation of mental health and virus type. Current study was conducted to compare the severity of anxiety and depression in chronic hepatitis C, B and healthy subjects. This case control study was conducted in Tehran Hepatitis Center [THC] in 2006. Group I [chronic hepatitis C, n=14], group II [chronic hepatitis B, n=65] and group III [healthy subjects, n=65] were matched for age, sex and educational level and were compared by means of the severity of anxiety and depression measured by Hospital Anxiety Depression Scale [HADS]. The correlation between clinical or para-clinical findings of the patients with viral hepatitis and severity of anxiety and depression was also assessed. Group I in comparison to other groups reported a higher anxiety [9.57 +/- 3.86 vs. 7.45 +/- 4.52 vs. 4.81 +/- 4.80, p=0.001] and depression [6.43 +/- 3.76 vs. 5.23 +/- 3.74 vs. 4.76 +/- 4.40, p=0.05]. Anxiety and depression score were also both correlated with total serum bilirubin level, but were not correlated with other para-clinical findings. However the patients who had received interferon reported higher depressive symptoms but the difference did not reach statistically significant level. According to the higher severity of anxiety and depression in the case of chronic HCV infection in comparison to HBV infection or healthy subjects and the importance of mental health issues in viral hepatitis, we recommend a more close mental health observation in patients affected with HCV infection. Psychiatrist and psychologist visits and consultations can help in this approach

[Prehospital emergency service for internal medicine problems in pediatrics; causes, time indices and outcomes]

Although pediatric pre-hospital emergency medical services [EMS] are a main challenge of health care systems, few data exists over it. Current study of ambulance calls for medical causes relating to children in Tehran was conducted with the following aims: 1] assessment of the frequency of causes of EMS call, 2] assessment of time indices of service providing by EMS, and 3] to assess the correlation between outcomes and time indices. In this retrospective study, all calls to Tehran EMS system [Dial 115] for medical causes of children=<15 years old in Tehran between December 2005 and May 2006 were extracted. Demographic variables, accident type, patient outcome before hospital arrival, and ambulance time indices [response time, scene time, total run time, total run time hospital, transport time, round trip time] were registered. 1052 [15.5%] calls were for children. From these, 717 [68%] were due to problems of medic problems. The most frequent problem was epilepsy [26.8%], unconsciousness [18.1%] and respiratory disorders [15.2%]. 12 [5. 6%] subjects died before ambulance arrival, but no one died between scene and hospital arrival. Mean [SD] delay time, response time and scene time were 3.8 +/- 1.8, 15.1 +/- 6.9, and 23.5 +/- 10.9, respectively. The pre-hospital mortality was not correlated with any of the time intervals. One of six ambulance calls in Tehran is related to pediatric patients, most of them with a medical cause. Epilepsy, unconsciousness and respiratory disorders as the most frequent causes for EMS calls for medical problems highlights the need for planning for training of the EMS personnel with these problems. There is still a need for further improvement in time intervals of EMS services, which may be possible by proper management and equipping by more ambulances