Showing papers by "Shahid Beheshti University of Medical Sciences and Health Services published in 1997"

A retrospective study of poisoning in Tehran.

Abstract: Objective: To examine the causes and majority of poisoning in Tehran. Methods: The 7000 poisoning cases referred to Loghman-Hakim Hospital in Tehran over six months in 1994 were evaluated retrospectively. Results: The overall female to male ratio was 1.8:1. Most poisoning occurred in the age range 2-6 y for children and 21-40 y for adults. Oral ingestion was the most common route of intoxication. In children, boys had a higher frequency of poisoning than girls. Most cases of children were referred to the hospital between 8 am and 8 pm. In adults referred to the hospital, there was little diurnal variation in poisoning presentations. In adults, drugs were the most common cause of intoxication (60.2%). Of these, benzodiazepines (24.5%) were the most frequent, followed by antidepressants (20.5%) and analgesics (18%). Pesticide and opiate intoxications were also commonly observed. In children, after drugs (32.1%), hydrocarbons were the most frequent cause of poisoning (19.2%). Pesticide poisonings wer...

The reform of medical education in Iran.

Abstract: In order to investigate the path of medical education in Iran, indicators of medical education were searched from 1970 to 1994. There have been rises in the number of educational institutions from 10 to 46; student admissions in programmes of medical sciences from 1387 to 18,141; medical student admissions from 632 to 3630; teaching staff from 1573 to 7979; and teaching-bed to student ratio from 1.05 to 2.08. The numbers of students in clinical specialty and MS degrees have increased, and various programmes in clinical sub-specialty and PhD degrees have been initiated. The quality of medical education has improved with increasing field and ambulatory care training, with more emphasis on teaching preventive medicine and a significant rise in the research activities. Most qualitative and quantitative progress has been achieved following the establishment of a joint Ministry of Health and Medical Education in 1985. The results of this review demonstrate the success of Iran in upgrading medical education by the unification of health services and medical education in one ministry.

Reconstruction and rehabilitation of short-range, high-velocity gunshot injury to the lower face: a case report

Abstract: War injuries can range from the most minor to the devastating and life-threatening. Multidisciplinary care is required for successful management of survivors. In the acute phase, care may involve emergency surgeons, anaesthetists, neurosurgeons, ophthalmic surgeons, vascular surgeons and ENT specialists in addition to the oral and maxillofacial surgeon. Afterwards, definitive treatment of facial hard and soft tissue gunshot injuries depends ultimately on the abilities and skills of the oral and maxillofacial surgeon and his appreciation of such injuries. The timing and sequence of the surgical procedures used for reconstruction and rehabilitation of maxillofacial gunshot injuries are crucial to a successful outcome and aesthetic result. If incorrect, they may lead indefinitely to infection, graft rejection, wound dehiscence with consequent multiple revisional operations and complications which will prolong hospital stay, and increase treatment costs and morbidity in these patients. In this article, we describe the treatment protocol for reconstruction and rehabilitation of a typical case of devastating gunshot injury to the lower face and propose a staged sequence of surgical treatment based on an 8-year experience gained in treating war casualties during the Iraq-Iran war (1980-1988).

Essential oil of salvia hydrangea dc. ec benth

Abstract: The composition of the essential oil of Salvia hydrangea DC. ex Benth. was analyzed by GC and GC/MS. The major constituents were spathulenol (23.1%), 1,8-cineole (12.3%), α-pinene (10.04%) and β-caryophyllene (99%).

Surgical management of cataract and posterior chamber intraocular lens implantation in Fuchs' heterochromic iridocyclitis.

Abstract: Background: To determine the inflammatory course and level of visual rehabilitation after cataract extraction and posterior chamber lens implantation in patients withFuchs‘ heterochromic iridocyclitis complicated by cataract. Methods: In a clinical trial, 32 eyes (visual acuity of 20/160 or worse) of 30 patients underwent extracapsular cataract extraction (19 eyes) or lensectomy(13 eyes) accompanied by posterior chamber intraocular lens implantation. Indirect ophthalmoscopy was performed intraoperatively prior to intraocular lens implantation and the extent of vitreous haze was assessed. If vitreous haziness was 3+ or more, core vitrectomy (two eyes) or three-port pars plana deep vitrectomy (four eyes) was performed. Results: After an average follow up of14.4 months (6 to 24 months), there was no statistically significant increase in cell and flare in the anterior chamber and vitreous or in keratic precipitates compared with the preoperative status of the eyes. However, 12%of the eyes developed synechiae (anterior and/or posterior) in comparison to preoperative condition (p< 0.05). Eighty-seven percent of the eyes gained visual acuity of 20/40 or better (P < 0.005). Using the logistic regression model, a higher level of preoperative inflammation was associated with reduced likelihood of gaining visual acuity of 20/25 or more (OR = 0.25, 95%CI 0.049, 1.255). The complications of surgery were synechiae, 12%; opaque posterior capsule, 12%; vitreous loss, 3%; chronic glaucoma, 3%; and retinal detachment,3%. Conclusions: Implantation of a posterior chamber intraocular lens can be well tolerated in patients with Fuchs‘ heterochromic iridocyclitis. Vitrectomy, whenever indicated in addition to cataract extraction, improves visual rehabilitation.

Opposite influences of different adrenoceptors on baclofen-induced antinociception in mice

Abstract: In the present study, the effects of adrenoceptor agonists and antagonists on baclofen-induced antinociception was investigated. Intraperitoneal administration of different doses of baclofen (2.5, 5 and 10 mg/kg) induced antinociception in the tail-flick test. The response was dose-dependent. The alpha 2-adrenoceptor agonist, clonidine, increased, while the alpha 1-adrenoceptor agonist, phenylephrine, decreased the baclofen response. In reserpine-treated animals, alpha 2-adrenoceptor, clonidine, induced antinociception and increased that of baclofen. Yohambine and propranolol but not prazosin decreased the baclofen effect. Although phenoxybenzamine itself induced antinociception it did not alter the baclofen response significantly. Reserpine treatment decreased the response induced by single administration of baclofen or phenoxybenzamine and that induced by a combination of baclofen with either phenoxybenzamine or prazosin. It may be concluded that alpha 2-adrenoceptor stimulation increases, while alpha 1-adrenoceptor activation decreases the baclofen-induced antinociception, and aminergic mechanism(s) may have a positive influence on baclofen response.

Evaluation of natural occurrence of fusarium mycotoxins in wheat fields of northern iran

Abstract: During 1996, 35 samples of fresh harvested wheat from the Northern Iran (Gonbad & Gorgan regions) were collected. The mycotoxins including nivalenol, deoxynivalenol, fusarenone-x, diacetoxyscirpenol, ueosolaniol, T-2 toxin, HT-2 toxin, and zearalenone were simultaneously detected. Wheat samples were extracted with aqueous methanol and purified by a 2-step chromatographic procedure using Amberlite XAD-4 and Florisil columns. Mycotoxins were detected by thin layer chromatography and quantitated by gas-liquid chromatography with flame ionization detector. The data revealed that 34, 27, and 35 out of 35 wheat samples were positive for nivalenol, neosolaniol, and zearalenone with average levels being 577.6, 476.2, and 3464.3 ppm, respectively. Deoxynivalenol, fusarenone-x, diacetoxyscirpenol, HT-2 toxin, and T-2 toxin were not detected in any of wheat samples.

Efficacy of flumazenil in the management of benzodiazepine overdose

Abstract: Benzodiazepine overdose is the most commonly encountered drug overdose in Iran. It has been reported by many authors that flumazenil possesses highly specific antagonistic activity on central benzodiazepine receptors. We conducted a prospective study on 150 patients brought to the toxicology emergency ward in Loghman-Hakim hospital with benzodiazepine overdose to assess the efficacy of flumazenil to counteract benzodiazepine overdose. Upon arrival, patients were examined thoroughly and their Glasgow coma scale was recorded. Afterwards flumazenil was administered in sufficient dosage, between 0.25-0.50 mg. The most commonly consumed benzodiazepine was diazepam (50%). One hundred and thirty patients responded positively to flumazenil, characterized by improved response to painful stimuli, and decreased amnesia. Twenty percent of the patients (26 cases) had an increased respiratory rate after flumazenil administration. In 86 patients, consciousness improved after 5 minutes, in 36 patients after 10 minutes and in 8 patients after 15 minutes. In 48 patients the psychomotor performance improved 5 minutes after antidote administration, while in 15 patients psychomotor performance improved after 30 minutes. Some patients developed resedation after flumazenil administration. In 25 patients resedation occurred after 15 minutes, in 59 patients after 30 minutes, and 34 patients showed this phenomenon after 45 minutes. Despite this last finding, we concluded that flumazenil effectively and rapidly antagonizes the central effects of benzodiazepines. It is also a valuable diagnostic agent with no serious side effects.

An Assessment of Possible Protective Roles of Morphine and Naloxone on the Acute Toxicity of T-2 Toxin

Abstract: The efficacy of naloxone and morphine on acute toxicity of T-2 toxin, a potent cytotoxic trichothecene mycotoxin, was investigated. In this study, mice received naloxone (4 or 8 mg/kg, sc) or morphine (5 or 15 mg/kg, sc) 24, 18, 1 hr before and 6 hr after ip injection of 2 or 1.8 mg/kg of T-2 toxin, respectively. In addition, naloxone (8 mg/kg, sc) were administered at 13, 7, 1 hr before, and 5 hr after T-2 toxin administration (1.8 mg/kg, ip). The acute lethal toxicity and change in body and organ weights (including liver, spleen, and kidneys) were evaluated. The acute lethal toxicity of T-2 toxin was reduced by administration of the first regimen of naloxone (8 mg/kg, sc). It also caused a protective effect against T-2 toxin-induced weight changes. On the other hand, morphine increased T-2 toxin-induced lethality (although not statistically significant). It could be concluded that opioid agonists may exacerbate the lethal toxicity of T-2 toxin-induced shock and opioid antagonists such as naloxone could antagonize this shock.

A New Synthesis of Alpha-Hydroxycarboxylates and 2-Hydroxybenzoates

Abstract: A new synthesis of a-hydroxycarboxylates and 2-hydroxybenzoates based on the reaction of acetonides of a-hydroxycarboxylic acids and 2-hydroxybenzoic acid with sodium alkoxides in the corresponding alcohols as solvent is described. In general, decreasing the steric hindrance of the reactants and increasing the boiling points of alcohols increased the yields and decreased the required time for the reactions.

Primary malignant pericardial mesothelioma

Abstract: Primary malignant neoplasms of the pericardium are rare and are predomi­ nantly mesotheliomas, followed by benign localized fibrous mesothelioma, ma­ lignant fibrosarcoma, angiosarcoma and benign and malignant teratomas. 1 This article concerns an atypical presentation of this malignant tumor with symptoms and signs of pericardial effusion. This unusual feature was complete encasement of the heart by this tumor, without pericardial effusion.

Possible Roles of Diphenhydramine, Triazolam, Diltiazem, and Ketotifen in Protection Against T-2 Toxin Toxicity

Abstract: The efficacy of diphenhydramine, triazolam, diltiazem, and ketotifen on the acute toxicity of T-2 toxin, a potent cytotoxic trichothecene mycotoxin, was investigated. Mice were received triazolam (20 or 40 mg/kg, sc), diltiazem (5 mg/kg, sc), or diphenhydramine (50 mg/kg, sc) 24, 18, 1 hr before and 6 hr after injection of T-2 toxin (1.8 mg/kg, ip). In other experiments, mice were either administered ketotifen (70 mg/kg, sc) 13, 7, 1 hr before and 5 hr after T-2 toxin (1.8 mg/kg, ip) or ketotifen (40 or 70 mg/kg, ip) 4 hr before T-2 toxin (1.8 mg/kg, ip). The acute lethal toxicity and change in body and organ weights (including liver, spleen, and kidneys) were evaluated. Among these drugs, only diphenhydramine prolonged the survival times. When mice received ketotifen (70 mg/kg, sc) 13, 7, 1 hr before and 5 hr after T-2 toxin (1.8 mg/kg, ip), it caused a protective effect against T-2 toxin-induced splenomegally and weight change. Triazolam (20 or 40 mg/kg, sc) also produced a protective effect against T-2 toxin-induced weight change. It is concluded that antihistamines might have some protective effects against acute T-2 toxin toxicity..