Opium use in a rural area of the Islamic Republic of Iran

Because of its geographic proximity to the major drug production centres, there is easy access to narcotic drugs in the Islamic Republic of Iran despite efforts by governmental and nongovernmental organizations. Using a structured questionnaire as a basis for conversation, local health workers interviewed 310 residents of a rural area in Babol province about opium use. The self-reported rate of opium use, adjusted due to a bias in the sex ratio of the sample, was 8.9%. All the 42 opium users reported opium use at least 2-3 times per week in the previous 3 months. Opium was smoked by 95.2% and taken orally by 4.8%; there was no injecting use. There was no reported use of other substances, including alcohol. There was a statistically significant relationship between opium use and male sex, unemployment and cigarette smoking

[ effect of intravenous atropine on prevention of spinal anesthesia-induced hemodynamic alterations in young patients]

Background: we investigated the effect of intravenous [IV] atropine injection before spinal anesthesia [SA] on prevention of hemodynamic alterations in young patients

Materials and Methods: we randomized 217 patients in two groups. All individuals received 10 ml/kg IV infusion of Ringer lactate solution.Control group [103 patients] received placebo injection while case group [114 patients] were premedicated with 10 [micro]/kg IV atropine in a blinded trial

Results: the systolic and diastolic blood pressure and heart rate decreased significantly in control group compared to the rise of these hemodynamic variables in case group. There was a significant decrease in the incidence of hypotension and discomfort during sitting position SA comparing control and case groups [46.6% vs. 0%; p<0.001]. No cardiac or nervous complication was recorded in patients while rescue therapy for hypotension was needed in control group

Conclusion: we concluded that pretreatment with atropine in patients undergoing sitting position SA could lower the incidence of complications while adequate screening is performed

[ 8 - year old boy with chest pain]

Background: Broad Beta disease is one of the genetically disorders in lipoprotein that cause aggregation of lipoprotein in plasma and Incidence risk of Ischemic heart disease among these patients is high

Case Presentation: An eight year old boy was admitted to the hospital because of an abrupt onset chest pain, faint and ST depression in inferior leads. He has been well one day earlier, when an exertional chest pain developed. Laboratory values obtained before admission showed hypercholesterolemia, and physical exam showed mild supravalvular aortic stenosis. ECG: ST depression in inferior leads. TT Echo: Mild supravalvular aortic stenosis. Angiography: Three vessel disease. Lab: Only hypercholesterolemia. [Cholesterol upper than 400 mg/100]. Treatment: CABG, Three graft

Conclusion: There are few data regarding the preoperative risk in patients with hypercholesterolemia. In patients with familial hypercholesterolemia, there is a high incidence of premature Coronary Artery Disease. These patients are also at risk for both valvular and supravalvular aortic stenosis as well as atherosclerosis of the carotid and femoral arteries. There is a higher than expected incidence of proximal lesions in the coronery and in the left main artery in patients with familial hypercholesterolemia

[Evaluation effect of acute normovolemic Hemodilution [ANH] on hemostasis in coronary artery bypass surgery [CABG] under cardiopulmonary bypass with thromboelastography [TEG] analyzer]

Recognizing that allogenic transfusion is best avoided in all patients, we implemented a policy of transfusion avoidance in coronary artery bypass graft surgery with use of acute normovolemic hemodilution [ANH] technique. ANH is a blood conserving technique and a form of pre-operative autologous donation [PAD].Blood stored at the bedside at room temperature [up to 6 hrs.] ANH technique preserves factors and coagulation of stored blood and also has several advantages in physiologic aspect. Thrombelastogrphy is a noninvaive diagnostic instrument designed to monitor and analyze the coagulation state of a blood sample in order to assist in assessment of patient clinical haemostatic condition. A prospective, randomized, clinical trial conducted in 130 patients scheduled surgery with CPB, that divided to two 65 persons, A [ANH] and B [non-ANH] group. Patients underwent ANH with avg. of 500 ml whole blood removed after induction of anesthesia and hemodilution was replaced with crystalloid solution. Hemoglobin, platelets, TEG analysis and homodynamic changes pre and post operation, amount of blood transfusion during surgery and in ICU checked in both groups. This study shows that amount of Hb, pit, in ANH group was greater than B group. Changes in components of R, K, ANGLE, MA in ANH group were statistically significant, that show greater preservation of coagulation factors, platelets,[actors, platelets, [amount and function] and fibrinogen in ANH group. Changes in homodynamic postoperatively were less in ANH group. performance of ANH in CABG is effective in reduce in blood transfusion and post operation bleeding

[Pattern of firearm related injuries: results of a multi-center study]

Firearm-related injuries pose a serious public health problem in many countries, such as the United States and South Africa. The aim of this study was to report the pattern of firearm injuries using data collected by the national trauma project. The national trauma project has been conducted by Trauma and Surgery Research Center of Sina Hospital in 8 cities of Iran [Tehran, Shiraz, Tabriz, Ahvaz, Kermanshah, Mashhad, Babol and Qom] and it includes information of 16753 trauma patients. Overall, 104 patients [0.6%] were identified as having sustained a firearm injury. They were 94 [90.4%] males and 10 [9.6%] females, with a mean age of 28.2 +/- 10.3 [range, 15 to 60 years]. The age group of 21-30 years comprised 49.5% of our patients. Extremity injury was the most common type of injury [47.9%]. Eight patients [7.6%] died resulting from the severity of injuries, with head injury as the main cause of death in 4 of them [50%]. Most patients [73.3%] sustained injuries in an assault. More restricted rights toward keeping and using firearms seem to be necessary. Awareness of physicians of firearm related injuries and their treatment is essential for the appropriate management of patients and reduction of hospital mortality in victims. On the other hand, attempts should be made to build an especial system for monitoring firearm-related injuries in Iran

[Assessment of different methods to remove organic inhibitors in order to create a sensitive method for direct surveillance of enteroviral infectious diseases in sewage specimens]

Enteroviruses in sewage are considered among the most sensitive indicators for virus circulation in society. These are mainly detected by sensitive cell cultures, however, since it is time consuming, molecular direct methods have also been considered as sensitive techniques. This study accomplished to assess different methods of removing organic inhibitors of sewage in order to detect Enteroviruses with RT-PCR. For this cross sectional study, 63 sewage specimens of Tehran were prepared with Grab sample method and concentrated with Pellet and Two-Phase methods and cultured in RD and Hep-2 cells. Then, with 12 different methods, removing organic inhibitors in sewage with RT-PCR method was assessed. Of investigated methods, we succeeded to isolate all of expected viruses only with the use of ICC-RT-PCR method. With respect to 0.01 TCID50 sensitivity of ICC-RT-PCR method, further studies are strongly recommended in order to confirm the utility of this method as one of the most sensitive methods of detecting Enteroviruses