RESUMO
BACKGROUND: It has been almost three decades since tramadol was introduced to the market as a centrally acting analgesic. It is claimed to have weak opioid properties and a low dependence potential in opioid-addicted patients. This study was designed to investigate the suspicion of potential tramadol abuse among patients visiting pharmacies in Babol, one of the major cities in northern Iran. METHODS: Under supervision by pharmacists, a questionnaire designed to monitor drug abuse was filled out for every patient who requested tramadol from Babol's pharmacies during 6 months (Aug. 2007 till Feb. 2008). The data obtained were used to derive descriptive statistics and to make a comparison with results from other countries. RESULTS: Of 162 patients (or someone on their behalf) who had sought tramadol from a pharmacy, 92 (56%) patients did not have a prescription. At least 103 (64%) patients reported criteria for addiction (ie, for feeling of psychological well being, unable to cease taking the drug, more than two weeks of tramadol use). In total, 145 (89%) patients were aged younger than 30 years, and 90 (55%) patients were aged younger than 18 years. More than 63% of patients reported a history of addiction or drug abuse. Most of the patients with no prescription (88%) had abuse/addiction criteria. CONCLUSION: Patients who request tramadol from pharmacies in Babol seem to have a high potential for drug abuse, in particular those who do not have prescriptions. The high prevalence of people under 18 years of age seeking tramadol could be a worldwide trend. We recommend further governmental support for pharmacies to deal with tramadol abusers in northern Iran.
RESUMO
The aim of the present study was to examine the effects of a course of aerobic exercise on pulmonary function and tolerance of activity in asthmatic patients. Among the asthmatic patients, 36 patients (M= 16, F= 20) were chosen after clinical examinations, pulmonary function test, skin prick test (SPT) for aeroallergen and a six minute walk test (6MWT) on their own free will. A patient was said to have Exercise Induced Asthma (EIA) when he/she fulfilled the following criteria; (1) FEV1 less than 80%, (2) 12% increase or more in FEV1 or PEF after short-acting ss2 agonist prescription and (3) 15% decrease in FEV1 or PEF after 6MWT with 70% or 80% of maximum heart rate. The patients were randomly put into two groups of case (M=8, F=10, Mean age=27) and control (M=8, F=10, Mean age=29). Case group participated in eight-week aerobic exercise plan, while control group had no plan of exercise. Pulmonary function tests were done before and after the course of exercise. There were significant changes in FEV1, FVC, PEF, FEF25-75%, MVV, RF and 6MWT between asthmatic patients of the two groups (P less than or equal to 0.05), but FEV1/FVC showed no significant change. Mean of changes in FEV1, FVC, PEF, FEF25-75%, MVV, RF and 6MWT were -25.56, -17.19, 32.09, -27.93, -22.18, 5.63 and -307.5 in case group respectively while they were 6.2, 4.67, 1.96, 6.65, 15.56,-2.87 and 18.78 in the control group. This study shows that aerobic exercises in asthmatic patients lead to an improvement in pulmonary functions. Aerobic exercise rehabilitation can be a complement to medical treatment of asthma.
