bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of a Detraining After Resistance Training on the Histochemical Expression of Potassium Channels and Mitochondrial Biogenesis of Heart Tissue in Male Rats
Authors:   Department of Exercise Physiology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran., Ahmadi Fatemeh , Siahkouhian Marefat ,   Department of Exercise Physiology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran., Mirdar Shadmehr ,   Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Mazandaran, Babolsar, Iran., Tapak Leily ,   Department of Biostatistics, Noncommunicable Diseases Research Center, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
Published: July 2021

Aims: Detraining may affect cardiovascular adaptations. The present study aimed to investigate the effect of a detraining period followed by resistance training on immunohistochemical expression of ATP-sensitive potassium channels and mitochondrial biogenesis of heart tissue in male rats. Methods & Materials: The present study was experimental. Thirty male Wistar rats were randomly divided into four groups (control, control-detraining, resistance training, and resistance-detraining training). The control group was sacrificed at the beginning of the study, and the control-detraining group did not exercise for 11 weeks. The resistance training group performed eight weeks of training. The resistance-detraining group did not train for three weeks after training. One-way analysis of variance and Tukey’s post hoc test were used for statistical analysis. Findings: The expression of KIR6.2, SUR2a, PGC1α, and TFAM in the heart tissue of the control-detraining group was significantly lower than those in the resistance training group (P=0.001). Also, they were significantly higher in the resistance training group compared to those in the resistance-detraining group (P=0.001). PGC1α expression in the resistance-detraining group was higher than in the control-detraining group (P=0.001). Conclusion: Resistance training increases PGC1α and TFAM in the heart tissue of rats by increasing the expression of KIR6.2 and SUR2a. But lack of exercise reduces the expression of potassium channels and factors that increase mitochondrial biogenesis.
The Effect of Interval Training and Consuming Fenugreek Seed Extract on FGF-21 and VEGF Gene Expression in Patients With Coronary Artery Diseases
Authors:   Department of Sport Physiology, Ayatollah Amoli Branch, Islamic Azad University, Amol, Iran., Roohbakhsh Ebad , Barari Alireza ,   Department of Sport Physiology, Ayatollah Amoli Branch, Islamic Azad University, Amol, Iran., Abbaszadeh Hajar ,   Department of Sport Physiology, Sari Branch, Islamic Azad University, Sari, Iran.
Published: July 2021

Aims: A high-fat diet, smoking, and a sedentary lifestyle are the major causes of Coronary Artery Disease (CAD). This study aimed to explore the effect of interval training and the consumption of fenugreek seed extract on FGF-21 and VEGF gene expression among patients with CAD. Methods & Materials: The present quasi-experimental study was conducted on a sample of 32 male patients with CAD, aged between 55 and 65 years. They were randomly divided into four groups: control, training only, fenugreek only, and training + fenugreek. The training program consisted of eight weeks of interval running, three sessions per week with an intensity of 55% and 65% of heart rate reserve, with a gradually increasing intensity. Subjects consumed 10 mg/kg of fenugreek extract daily. Real-time PCR was used to measure the expression of FGF-21 and VEGF genes. Findings: The results showed that the mean expression ratios of FGF-21 in training only, fenugreek only, and training + fenugreek groups were significantly higher than the control group (P<0.0001). The fenugreek + training group had a greater significant increase (P<0.0001) more than the training + fenugreek group. Moreover, the mean Coefficient of Variation (CV) of VEGF gene expression was significantly increased more than that in the training group (P<0.0001), fenugreek group (P=0.0004), and the training + fenugreek group (P<0.0001), compared to the control group. The fenugreek + training group had a greater and more significant increase than the training only (P=0.0181) and the fenugreek only groups (P<0.0495). Conclusion: The results showed that a combination of interval training and consumption of fenugreek seed extract increased the CV of FGF-21 and VEGF gene expression and thus, have beneficial effects on the angiogenesis pathway in patients with CADs
The Effectiveness of Mindfulness-based Group Therapy on Perceived Stress, Emotional Cognitive Regulation, and Self-care Behaviors in Patients With Hypertension
Authors:   Department of Psychology, Faculty of Psychology, UAE Branch, Islamic Azad University, Dubai, United Arab Emirates., Sabetfar Nima , Meschi Farahnaz ,   Department of Psychology, Faculty of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran., Hosseinzade Taghvaei Marjan ,   Department of Psychology, Faculty of Psychology, Karaj Branch, Islamic Azad University, Karaj, Iran.
Published: July 2021

Aims: Patients with high blood pressure usually experience high levels of stress that affect their emotion regulation and self-care behaviors. The current study aimed to examine the cognitive-minded group therapy on perceived stress, emotional, cognitive regulation, and self-care behaviors in patients with hypertension. Methods & Materials: The study has a quasi-experimental design with a pre-test, post-test, follow-up, and a control group. The study population was all people with hypertension referred to medical centers in Kish Island, Iran, in 2010 (March to June). The research sample consisted of 32 qualified candidates who were selected using the purposive sampling method. Then they were randomly assigned to the experimental and control groups. Perceived stress, emotional and cognitive regulation, and self-care questionnaires of patients with hypertension were used to collect information in the pre-test, post-test, and follow-up stages. The experimental group underwent mindfulness-based group therapy, but the control group did not receive any intervention. The obtained data were analyzed with repeated measures analysis of variance in SPSS v. 22. The significance level of the tests was considered 0.05. Findings: The results showed a significant difference between the experimental and control groups in the mean scores of positive stress (P=0.001), negative stress (P=0.001), positive emotion (P=0.001), negative emotion (P=0.001), medication regimen (P=0.003), diet (P=0.011), and disease management (P=0.026) in the post-test and follow-up. But there was no significant difference between the mean scores of food labels (P=0.195). Conclusion: The effectiveness of mindfulness-based group therapy on reducing stress and negative emotion and improving self-care of patients with hypertension suggests that in addition to the physical components of chronic diseases, the psychological components of patients be considered to prevent recurrence diseases and increase adherence to treatment in them.
Endocrine-Disrupting Chemicals Role in Drug Abuser: A Review Study
Authors:   Department of Pathology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia., Arfianti Wiraagni Idha , Mustafa Ali Mohd Mustafa ,   Shimadzu‐UM Center for Xenobiotics Studies (SUCXeS), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia., Abdul Rashid Rusdi ,   Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia., Erwandi Bin Mohamad Haron Didi ,   Shimadzu‐UM Center for Xenobiotics Studies (SUCXeS), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Published: July 2021

Endocrine-disrupting Chemicals (EDCs) are exogenous chemicals that influence many aspects of natural hormone actions. Bisphenol is used in the industry, for increasing the thickness and durability of materials in certain plastics and resins. Paraben is used as preservatives in many pharmaceuticals, cosmetics, and some food products. EDCs can increase estrogen levels inside the body, and estrogen itself can increase the monoamine effect (dopamine, serotonin), neuronal excitability, neuropeptide transmitter mechanism, and drug metabolism. In drug abusers, this effect can develop greater craving behavior, addiction, and relapse.
Factors Affecting Tramadol-Associated Seizure
Authors:   Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran., Zaare Nahandi Maryam , Abbaszadeh Sayna ,   Department of Obstetrics and Gynecology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran., Mansouri Mostafa ,   Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran., Elahifard Haniyeh ,   Student Research Committee, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran., Banagozar Mohammadi Ali ,   Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Published: July 2021

Background: Tramadol is a widely prescribed analgesic and due to its opioid-like effects, the potential for abuse of tramadol is noticeable. Besides, the complications of tramadol abuse have become a public health concern. This study aimed to investigate the affecting factors on the seizure, as one of the most common complications of tramadol consumption. Methods: A total number of 64 patients from 315 patients who were referred to Sina Hospital, Tabriz, Iran because of tramadol toxicity were included in this 9 months cross-sectional retrospective study. Results: There were 52 males and 12 females in the study. The seizure happened in 53.1% of the subjects and the Mean±SD time between tramadol consumption and seizure was 5.9±7.36 hours. There was no significant association between seizure and sex, age, the dose of tramadol, and previous tramadol consumption history. A significant association was seen between the dose of tramadol and the time of seizure. Conclusion: Seizure that happens due to tramadol overdose is not dependent on sex, age, and previous history of tramadol consumption. As the dose of tramadol is higher, the seizure happens later. More research is needed to understand why the seizure occurs later in higher doses.
Guillain-Barre Syndrome Due to Tramadol
Authors:   Department of Internal Medicine, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran., Banagozar Mohammadi Ali , Ostadi Ali ,   Department of Internal Medicine, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran., Paeezi Maryam ,   Department of Forensic Medicine and Toxicology, Loghman Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran., Mostafazadeh Babak ,   Toxicological Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Published: July 2021

Tramadol is a powerful prescription medication used for pain relief of varying intensities. Tramadol was initially produced in Germany to alleviate postsurgical and chronic pains. We describe a case of a 22-year-old male with no past medical history who took tramadol for the second time and then had a tonic-clonic seizure episode that worsened the weakness of his inferior limbs and followed by loss of consciousness. According to physical examination, clinical and paraclinical tests, he was diagnosed with Guillain-Barre syndrome. After treatment with intravenous immunoglobulin, he was improved and discharged 9 days after treatment. He was recommended to continue physiotherapy. The relation between tramadol using and Guillain-Barre syndrome development is unknown but it can be due to reactive oxygen species generation.
Brain Death According to the Sunni Jurisprudence
Authors:   Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran., Abbasi Mahmood , Amini Jahandar ,   Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran., Mahmoodian Nazli ,   Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Published: July 2021

Background: Brain death is a new medical term that appeared in the second half of the 20th century. Some research about it has already conducted in law, but no academic research in this field from the Sunni jurisprudents point of view. Methods: Because this is a theoretical study in theology, our primary research method is library research. Results: There are different opinions about brain death in Sunni jurisprudence, which can be divided into three groups of supporters, opponents, and neutrals. Some jurisprudents do not recognize brain death due to their respect for the human soul. According to principles such as asceticism and the observance of the custom of the universe, the death of patients with brain death is not certain, and subsequently, it is not allowed to separate assist devices from the patient and the perception of their members. However, the second group, considering the lack of human life and according to the theory of medical commission, which is the same convention, brain death is considered to be a definite death, so it is allowed to separate the assist devices from the patient and the withdrawal of its members. The neutrals consider brain death as one of the examples of definitive death, but for some jurisprudential rulings, legal rights are not considered in the death sentence. Conclusion: The brain death is the complete cessation of the activities of the brain, including the brain stem and cortex. By diagnosis and announcing the brain death, the patient is considered as a dead body regardless of lungs and heart function even with the help of a resuscitator. It seems the reasons of the supporters of brain death are favorable. So the resuscitator should be separated from the patient with brain death.
Risperidone-Induced Erythema Multiforme Minor: A Case Report
Authors:   Student Research Committee, School of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran., Negintaj Sina , Bidaki Reza ,   Department of Psychiatry, Research Center of Addiction  and  Behavioral Sciences, School of Medicine, Shahid Sadoughi University of  Medical Sci-ences and Health Services, Yazd, Iran., Zare Kamali Javad ,   Student Research Committee, School of Pharmacy, Shahid Sadoughi University of Medical Sciences, Yazd, Iran., Saghafi Fatemeh ,   Department of Clinical Pharmacy, School of Pharmacy and Pharmaceutical Sciences Research Center, Shahid Sadoughi University of Medical Sci-ences, Yazd, Iran., Naseri Bafrouie Maryam ,   Department of Psychiatry, School of Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran., Tabaei Zadeh Nilofar ,   Department of Psychiatry, School of Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran., Azadi Hossein ,   Department of Psychiatry, School of Medicine, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.
Published: July 2021

Erythema Multiforme (EM) is a hypersensitivity reaction that can be triggered by an infection or particular medications. Erythema multiforme minor (EM minor) represents localized skin lesions with minimal or no mucosal involvement. Only a few case of EM associated with risperidone are found in the scientific literature. In this case report, the administration of the risperidone resulted in the rapid appearance of skin lesions. Erythematous lesions were recovered upon discontinuation of the drug and no new skin lesion was observed. A 52-year-old male patient was admitted to the psychiatry hospital because of developing schizophrenic symptoms. At the time of admission, risperidone was added to her previous drug regimen. Two weeks later, the patient returned with a complaint of progressively increasing rashes over his body. The patient was diagnosed with EM minor. The prescribed risperidone was discontinued due to its side-effect profile and the patient’s drug regimen was changed entirely to the olanzapine, haloperidol, and topical clobetasol. At one month follow up visit, his skin lesions were satisfactorily controlled.
Attitudes of Patients and Their Families Towards Medical Privacy and Competence of Bearer or Receiver of Bad News
Authors:   Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran., Zaare Nahand Maryam , Asghari Jafarabadi Mohammad ,   Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran., Haghighatjou Mehrnoosh ,   Medical Toxicology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran., Ashrafrezaei Kosar ,   Department of Pathology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran., Shakeri Saeedabad Marziyeh ,   Sina Educational Research and Treatment Center, Department of Pathology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran., Banagozar Mohammadi Ahad ,   Department of Iranian Traditional Medicine, School of Traditional Medicine, Tabriz University of Medical Sciences, Tabriz, Iran., Banagozar Mohammadi Ali ,   Sina Educational Research and Treatment Center, Department of Internal Medicine, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Published: July 2021

Background: Based on the patients’ and relatives’ views on the level of preservation of privacy rights of individuals, we propose a way to reduce problems and disagreements about the competence of the provider and recipient of bad news. Methods: In the current cross-sectional study, the participants were recruited from the main northwest hospital of Iran. It was also conducted to study the scope of medical privacy and competence of bearers or receivers of bad news. After the literature review, two questionnaires were designed and administered. They contained items pertinent to the scope of medical privacy and competence of bearers and receivers of bad news. Each item of the original questionnaire was scored on a 5-point Likert scale. Results: The model quality and significance level were obtained using KMO and Bartlett tests. The results (patient’s attitudes questionnaire: KMO=0729 and P<0.05 in the Bartlett test; family attitudes questionnaire: KMO=0.764 and P<0.05 in the Bartlett test) confirmed the model efficiency. According to the results from factor variance and their cumulative rate, the predictive power of the model was obtained as 62.019%, based on the overall factor variance rate. The majority of patients wanted to be informed about their disease conditions. They also considered bad news to be medical privacy and disagreed that their medical information should be opened up with others without permission. Conclusion: To preserve medical privacy, it is recommended that a system be designed that allows patients at the admission to the medical center to enlist their eligible family members to whom medical information can be delivered.
The Effects of Quetiapine on Craving and Withdrawal Symptoms in Methamphetamine Abuse: A Randomized, Double-Blind, Placebo-Controlled Trial
Authors:   Department of Addiction Studies, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran., Javdan Najme Sadat , Ghaderi Amir ,   Department of Addiction Studies, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran., Banafshe Hamid Reza ,   Department of Addiction Studies, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran.
Published: July 2021

Background: Patients with Methamphetamine Abuse (MA) are susceptible to many complications like craving, and withdrawal symptoms. These trials were designed to evaluate the effect of quetiapine administration on craving and withdrawal symptoms in MA abuse. Methods: This trial was conducted on 60 people with MA abuse to receive either 100 mg quetiapine (n=30), or placebo (n=30) every day for 2 months. The Desire for Drug Questionnaire (DDQ) and Amphetamine Withdrawal Questionnaire (AWQ) scores were evaluated at baseline and after 2 months’ intervention. For data analysis, t test, and the Chi-square test were applied in SPSS v. 18. Results: Quetiapine significantly decreased DDQ (P=0.002) and AWQ symptoms (P=0.001) compared to the placebo. Furthermore, there was a significant difference among groups in terms of the frequency of negative urine tests (P<0.001). Conclusion: This trial showed that administration of quetiapine supplements for 2 months in individuals with MA abuse had beneficial effects on craving and withdrawal syndrome.
The Epidemiology of Human Mortality in West Azerbaijan Province, Iran, 2016
Authors:   Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran., Farivarnia Flora , Entezarmahdi Rasool ,   Department of Biostatistics and Epidemiology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran., Delirrad Mohammad ,   Department of Forensic Medicine and Toxicology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran.
Published: July 2021

Background: This article presents the most recent mortality data in West Azerbaijan Province (WAP) of Iran in 2016 based on selected characteristics, including age, sex, state of residence, and cause of death. Methods: After the local Ethics Committee approval, we obtained the data for this systematic database study from the local health registration office. The causes of death are processed following the International Classification of Diseases, tenth revision (ICD-10). The vital statistics were refined from the yearbooks of the National Organization for Civil Registration. Results: In 2016, a total of 14688 deaths were registered in the Health Death Registration System (HDRS) and 14622 in the Civil Death Registration System (CDRS) of WAP (~4% of Iran’s mortality). The Crude Mortality Rate (CMR) was 4.30 per 1000, showing an increase of 7.5% from the 2011 rate. Of the deceased, 56.9% were males, and 60% were attributed to urban areas. On average, men died 4 years earlier than women (61.2 vs 65.3 years, respectively). The major causes of death in 2016 remained the same as in 2011. Conclusion: The pattern of human mortality in WAP is comparatively consistent with the other regions of Iran except for the higher rate of neoplasms (19.6% compared to 10.7% of the country average) and the lower ratio of certain infectious and parasitic diseases (1% compared to 3.8% of the national average). There was a significant difference in registering the state of residence between HDRS and CDRS, which is highly recommended for further investigation in future studies.
Severe Accidental Organophosphorus Poisoning in Two Children
Authors:   Student Research Committee, Zabol University of Medical Sciences, Zabol, Iran., Aminisefat Alireza , Saravani Khadijeh ,   Department of Medical, Assistant Professor of Forensic Medicine and Toxicology, Zabol University of Medical Sciences, Zabol, Iran., Saravani Mahdieh ,   Department of Pediatric, Children and Adolescent Health Research center, Zahedan University of Medical Sciences, Khash, Iran.
Published: July 2021

Background: Organophosphorus (OP) compounds have intense anticholinesterase activity and are commonly used as insecticides and pesticides. OP poisoning is a global health problem and poses a threat to human health. Case Report: Here we report two sisters, aged 3 and 4 years, who had inadvertently eaten agricultural pesticides. These patients had a decreased level of consciousness, nausea, and vomiting. We do not have pralidoxime in this center and the adjacent center, so we used atropine as the primary drug in treating these patients. However, after 4 days, the 3-year-old patient felt a weakness in upper and lower limb movements. Conclusion: In the treatment of OP poisoning, it is necessary to pay special attention to delayed complications such as intermediate syndrome.
Scorpion Stings in Tehran Province, Iran: A Seven-Year Hospital-Based Study
Authors:   Department  of  Clinical  Toxicology,  School  of  Medicine,  Toxicological  Research  Center,  Excellence  Center  of  Clinical  Toxicology,  Loghman  Hakim  Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran., Rahimi Mitra , Shadnia Shahin ,   Department  of  Clinical  Toxicology,  School  of  Medicine,  Toxicological  Research  Center,  Excellence  Center  of  Clinical  Toxicology,  Loghman  Hakim  Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran., Mirzaei Nasab Reza ,   Department  of  Clinical  Toxicology,  School  of  Medicine,  Toxicological  Research  Center,  Excellence  Center  of  Clinical  Toxicology,  Loghman  Hakim  Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran., Soltaninejad Kambiz ,   Department of Forensic Toxicology, Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran.
Published: July 2021

Background: Scorpion sting is an important public health problem in Iran. This study aimed to describe the demographics, clinical and laboratory findings of the scorpion stings victims in Tehran Province. Methods: This cross-sectional retrospective study evaluated demographic characteristics, clinical presentations, laboratory findings, treatments, and disposition of scorpion sting patients in Tehran Province, Iran, during 7 years (2012-2018). Results: A total of 199 cases of scorpion sting cases with a mean (SD) age of 30 (18.7) years were studied. The majority of patients were males (62.8%). The most affected age group was 20-30 years (31.1%). The majority of victims (45.7%) were residents in the southern districts of Tehran. The yellow scorpions (33.2%) were responsible for a larger number of envenomations. Most of the stings have been occurred in summer (68.8%). Also, the most affected limbs were hands and legs (94.4%). Most patients (58.8%) had localized manifestations, and the common systemic clinical presentations were hypotension (41.7%) and hypertension (17.1%). Also, the common laboratory findings increased blood urea nitrogen (48.7%), hyperglycemia (20.1%), and anemia (15.1%). The polyvalent anti-scorpion serum had been administered for 33.2% of victims. All patients had been recovered and were discharged in good condition without any complications. There was no fatality report. Conclusion: The demographic characteristics of scorpion sting in Tehran Province are similar to those previously reported from other Iran provinces. It seems that the incidence and clinical severity of scorpionism in Tehran are lower than those compared to other tropical and sub-tropical zones in Iran.
Nicotine Dependence Severity and Revised Reinforcement Sensitivity Theory: Assessing the Mediating Role of Risky Decision Making Using Path Analysis
Authors:   Department of Addiction Studies, School of Medical, Kashan University of Medical Sciences, Kashan, Iran., Cheraghi Kiomars , Rasouli-Azad Morad ,   Department of Education and Psychology, College of Education, University of Raparin, Kurdistan Region, Iraq., Banafshe Hamid Reza ,   Department of Addiction Studies, School of Medical, Kashan University of Medical Sciences, Kashan, Iran., Yoonessi Ali ,   Department of Neuroscience, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran., Ghaderi Amir ,   Department of Addiction Studies, School of Medical, Kashan University of Medical Sciences, Kashan, Iran., Omidi Abdollah ,   Department of Clinical Psychology, School of Medicine, Kashan University of Medical Science, Kashan, Iran.
Published: July 2021

Background: Gray’s revised Reinforcement Sensitivity Theory (r-RST) is a neuropsychological explanation of personality that has been broadly used in substance use disorders. Although the Behavioral Approach System (BAS) is strongly related to nicotine dependence, findings in Behavioral Inhibition System (BIS) are controversial and there is little information about the role of the Fight/Flight/Freeze System (FFFS) in nicotine dependence. The purpose of the present study was to evaluate the mediating role of Risky Decision Making (RDM) in this relationship to clarify the controversy and fill the gap. Methods: The final sample of this correlation study comprised of 347 university students (age, Mean±SD 23.2±6.7) who completed two self-report measures, including the Fagerstrom Test For Nicotine Dependence (FTND), Jackson-5 questionnaire of r-RST, and a computerized Iowa Gambling Task (IGT) to measure RDM. Pearson correlation and a path analysis framework were used to determine the simple, direct, and indirect effects of r-RST systems on nicotine dependence severity through RDM. Results: Using Amos, path analyses demonstrated significant direct and indirect effects of BAS and FFFS/BIS on tobacco use. Also, the relationship between BAS/FFFS/BIS and tobacco use was shown to be mediated by RDM. Conclusion: It was demonstrated that the relationship among BAS /FFFS/BIS and tobacco use can be partly explained using maladaptive RDM strategies, suggesting that decreasing reliance on decision-making in risky situations, while increasing the use of decision-making skills educations in risky situations, and increasing the use of alternative sensation and fun seeking by smoking and emotion regulation and mindfulness-based therapies
Successful Management of an Aluminum Phosphide Poisoned Patient Following Ventricular Tachycardia
Authors:   Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran., Hallaj Shahin , Banagozar Mohammadi Ali ,   Department of Internal Medicine, Sina Educational, Research and Treatment Center, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran., Ghorbani Anahita ,   Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran., Ostadi Ali ,   Department of Internal Medicine, Sina Educational, Research and Treatment Center, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran., Zaare Nahandi Maryam ,   Department of Internal Medicine, Sina Educational, Research and Treatment Center, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Published: July 2021

Aluminum Phosphide (ALP) poisoning is regarded as fatal; however, it is commonly used in developing countries. In some countries, such as India and Iran, it is still being used to protect grain against pests at home. As yet, no known antidote is reported to be effective against ALP poisoning. ALP acts through blockage of cell respiration, alteration of cell permeability, and induction of oxidative stress. Some factors can worsen the prognosis of its intoxication, which include hyperglycemia on admission, ingestion of fresh tablets, cardiac abnormality, especially Ventricular Tachycardia (VT), severe metabolic acidosis, cardiogenic shock and other types of shocks, electrolyte disturbances, end-organ damage, and a need for mechanical ventilation. ALP kills its victims by induction of multi-organ failure. In this study, we controlled the patient’s VT using MgSO4, electric shock, amiodarone, and lidocaine. We also encountered the cardiogenic shock using norepinephrine, High-Dose Insulin (HDI), antioxidants, sodium bicarbonate, and normal saline. Moreover, myocardial ischemia, recurrent VTs, and adverse cardiac effects were protected via tight control of magnesium and other electrolytes.
Suicidal Ideation in Patients With Gender Identity Disorder in Western Iran From March 2019 to March 2020
Authors:   Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran., Alizadeh Mohajer Mehdi , Adibi Amir ,   Department of Child and Adolescent Psychiatry, Ilam University of Medical Sciences, Ilam, Iran., Mozafari Ali Ashraf ,   Department of Epidemiology, School of Public Health, Ilam University of Medical Sciences, Ilam, Iran, Sahebi Ali ,   Clinical Research Development Unit, Shahid Mustafa Khomeini Hospital, Ilam University of Medical Sciences, Ilam, Iran, Bakhtiyari Amin ,   Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran.
Published: July 2021

Background: In recent years, the number of patients with gender identity disorder (GID) has rapidly increased. These people are at risk of adverse life events that influence their health and wellbeing. Research studies have also shown a significant rate of suicide in these individuals. This study aims to determine the prevalence of suicidal ideation in patients with GID referred to Legal Medicine Office in Ilam Province. Methods: In study sample comprised 21 patients without psychiatric comorbidity visited the Legal Medicine Office in Ilam Province for confirmation of transsexuals from March 2019 to March 2020. GID disorder was diagnosed through a GIDYQ (A-A) questionnaire and clinical interview. The Beck scale for suicide ideation was used to clarify and measure the intensity of attitudes, behaviors, and planning for a suicide attempt. Results: In 21 patients with GID, the average score for suicide ideation was 11.6. The average age of patients was 19 years, and all of them were single. In this sample, 19.1% had low risks, 71.5% high risks, 9.5% had very high-risk suicide ideation. Linear regression analysis showed that higher education and higher age were risk factors for suicide ideation in patients with GID. Conclusion: The high rate of suicidal ideation in patients with gender identity disorder makes it essential to pay attention to their mental health. It should be noted that suicidal thoughts can be a basis for suicide attempts.
Sepsis Criteria and Revision in Toxicological Intensive Care Unit
Authors:   Toxicological Research Center, Department of Toxicology & Pharmacology, Loghman-Hakim Hospital, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Talaie Haleh , Nazari Maryam ,   Toxicological Research Center, Department of Toxicology & Pharmacology, Loghman-Hakim Hospital, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Emami Habib ,   Tobacco Prevention and Control Research Center, National Research Institute of Tuberculosis and Lung Disease, Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Published: July 2021

Background: Sepsis is one of the significant causes of mortality in hospitalized patients. This cross-sectional study was performed to determine the frequency of positive blood culture and assess sepsis criteria based on Third International Consensus Definitions (related to Sequential Organ Failure Assessment score) and clinical and paraclinical findings (i.e., on-admission leukocytosis, increased lactate level, and fever) in poisoned patients admitted to the Toxicological Intensive Care Unit (TICU). Methods: Medical records of a total of 2000 poisoned patients admitted to the TICU of Loghman Hakim Hospital from 2016 to 2018 were assessed. Among them, 189 cases (9.45%) with suspected sepsis were considered eligible to be enrolled in the study. Results: Of 189 cases, 146 (77.24%) had possible signs and symptoms of sepsis as well as SOFA score higher than two with positive blood culture in 81 cases (55%). The Mean±SD serum level of lactate was 25.97±16.32 on admission. The most common pathogen detected in blood culture was coagulase-negative Staphylococci in 35 (24.0%) out of 146 cases. Glasgow Coma Scale (GCS) less than 12, age older than 50 years, and bilirubin more than 1.2 mg/dL were found as independent predictors of sepsis on multivariate analysis. Conclusion: Based on our findings, it is proposed that the sepsis definition should not be restricted to the guidelines. The patients’ poisoning background and presence of many confounding factors, including poisoning-induced on-admission increased lactate levels, leukocytosis, and disturbed arterial blood gas provide a critical decision-making situation to confirm sepsis according to guidelines.
Efficacy of Lofexidine in the Outpatient Management of Tramadol Withdrawal Syndrome
Authors:   Department of Forensic Medicine and Clinical Toxicology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran., Majidi Mohammad , Nekoueifard Solmaz ,   Urmia Health Center, Urmia University of Medical Sciences, Urmia, Iran.
Published: July 2021

Tramadol is recognized as an opioid with non-opiate properties. It has a low affinity for opioid receptors and prevents reabsorption of norepinephrine and serotonin at synapses. It also increases the level of Gamma Aminobutyric Acid (GABA) in the central nervous system [1, 2]. Tramadol is an analgesic for patients suffering from moderate to severe pain [1]. In addition, previous studies have shown that tramadol abuse and suicidal attempts have increased in Iran [3, 4].
The Epidemiological Status of Carbon Monoxide Poisoning in East Azerbaijan Province (Iran) in 2016-2018
Authors:   Emergency Medicine Department, Sina Medical Research and Training Hospital, Tabriz University of Medical Sciences, Tabriz, Iran., Rahmani Farzad , Ostadi Ali ,   Emergency Medicine Department, Sina Medical Research and Training Hospital, Tabriz University of Medical Sciences, Tabriz, Iran., Daneshvar Sepideh ,   Emergency Medicine Department, Sina Medical Research and Training Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
Published: July 2021

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Occupational Exposure to Paving Asphalt Fumes, Impact on Liver and Kidney Function Test Parameters
Authors:   Department of Toxicology and Pharmacology, Faculty of Pharmacy, Pharmaceutical Sciences Branch, Islamic Azad University, Tehran, Iran., Noroozi Mahdieh , Akhgari Maryam ,   Department of Forensic Toxicology, Legal Medicine Research Center, Iranian Legal Medicine Organization, Tehran, Iran., Abdollahi Alireza ,   Department of Pathology, Imam Khomeini Teaching Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Published: July 2021

Background: Asphalt is a mixture of aliphatic and aromatic hydrocarbons. It also contains different kinds of heavy metals. Hot mix asphalt emits hazardous volatile substances. Asphalt is used in many industries, causing serious adverse health effects for workers. Therefore, investigation of the health status of workers is of crucial importance. The present study aimed to assess the impact of asphalt vapor on hepatic and renal function tests parameters and the clinical parameters in road paving workers compared to healthy subjects. Methods: In a cross-sectional study, 41 road asphalt paving workers and 120 healthy non-exposed subjects were selected. The serum enzymes of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), total bilirubin, triglyceride, urea, and creatinine levels were assessed using diagnostic kits. A medical practitioner examined all subjects for any possible medical condition. Results: Liver and kidney function test parameters were significantly higher in road asphalt paving workers compared to their healthy counterparts (P<0.05 for all parameters). About 63% of workers exposed to asphalt fumes for more than 10 years showed cardiac, pulmonary, and metabolic complications. Conclusion: Significant elevations in liver and kidney function test parameters suggest that exposure to asphalt fumes is associated with hepatic and renal dysfunction in asphalt-exposed workers.
Comparison of Short-term Outcome of Thoracoscopic-Laparoscopic Esophagectomy Versus Transhiatal Esophagectomy for Resectable Esophageal Cancer
Authors:   Department General Surgery, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran., Asvadi Kermani Touraj , Rasihashemi Seyed Ziaeddin ,   Department Thoracic Surgery, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran., Hoseinpour Feyzi  , Hoseinpour Feyzi Moein ,   Department General Surgery, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran., Mousavai Toomatari Seyed Ehsan ,   Department General Surgery, Imam Reza Hospital, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
Published: July 2021

Background: Esophagectomy is performed in all patients with resectable esophageal cancer. Transthoracic-Laparoscopic Esophagectomy (TLE) is a minimally invasive method and considered to be the most appropriate method. In this study, we aim to evaluate and compare the perioperative outcome, and 1-year overall survival of TLE and Transhiatal Esophagectomy (THE) approaches. Methods: In this retrospective study, we reviewed the medical records of 108 patients with esophageal cancer undergoing TLE (n=44) or THE (n=64) between 2015 and 2018. The patients were followed for one year. The intraoperative and postoperative findings, as well as 1-year overall-survival, were compared between the two groups. Results: TLE compared to THE had a longer surgery duration (278.63±33.28 vs 223.28±33.99 min, P=0.001), a higher number of dissected lymph nodes (15.06±2.95 vs 10.21±2.58, P=0.001), less blood loss (345.45±178.76 vs 585.15±294.75 mL, P<0.001), and need for transfusion (20.5% vs 45.3%, P=0.006) during surgery as well as lower ICU stay (2.59±0.77 vs 3.90±0.83 days, P<0.001) and ward stay (8.77±0.96 vs 11.42±1.71 days, P<0.001). THE had somewhat higher complication than TLE, but with no significant differences. Conclusion: TLE had a similar rate of complication to THE approach, but with lower blood loss and lower ICU and hospital stay, it is a more appropriate method for esophagectomy.
Ten Years of Experience in Treating Patients With Digoxin Toxicity Without Using Digoxin Fab Antibody
Authors:   Department of Clinical Toxicology, Isfahan Clinical Toxicology Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran., Gheshlaghi Farzad , Wong Anselm ,   Victorian Poisons Information Center and Austin Toxicology Service, Austin Hospital, School of Clinical Sciences, Monash University, Victo-ria, Heidelberg, Australia., Dorooshi Gholamali ,   Department of Clinical Toxicology, School of Medicine, Clinical Toxicology Research Center, Khorshid Hospital, Isfahan University of Medi-cal Sciences, Isfahan, Iran., Meamar Rokhsareh ,   Department of Clinical Toxicology, School of Medicine, Clinical Toxicology Research Center, Khorshid Hospital, Isfahan University of Medi-cal Sciences, Isfahan, Iran., Tabesh Faezeh ,   Department of Cardiology, School of Medicine, Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Khorshid Hospi-tal, Isfahan University of Medical Sciences, Isfahan, Iran., Aminsafaei Hajar ,   Department of Clinical Toxicology, Isfahan Clinical Toxicology Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran., Zoofaghari Shafeajafar ,   Department of Clinical Toxicology, Isfahan Clinical Toxicology Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran., Eizadi-Mood Nastaran ,   Department of Clinical Toxicology, Isfahan Clinical Toxicology Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Published: July 2021

Background: Digoxin is extensively prescribed for cardiac diseases, so its chronic or acute toxicity commonly occur. Although digoxin specific antibodies (anti-digoxin Fab) are recommended to be used in patients with cardiac symptoms of digoxin toxicity, there is ongoing controversy about the effectiveness and dose of anti-digoxin Fab. Because our department lacks access to anti-digoxin Fab and the high cost of the antidote, we evaluated 10 years of experience in treating patients with digoxin toxicity without using digoxin Fab antibodies considering outcomes. Methods: A retrospective study was performed in Khorshid Hospital, affiliated with Isfahan University of Medical Sciences, from October 2008 to September 2018. Patients with acute or chronic digoxin toxicity were included in the study. The patients’ data were gathered and analyzed according to their medical documents. Results: Out of 150 cases with digoxin toxicity, 38% (n=57) were acute and 62% (n=93) were chronic. About 64.7% (n=97) were female. The most common non-cardiac manifestations of toxicity were gastrointestinal (67.3%, n=101) and neurological symptoms (52.7%, n=79). Bradyarrhythmia (80.5%, n=33) was the most cardiac manifestation in patients with acute (15.8% n=9) and chronic (25.8%, n=24) toxicity. A total of 144 (96%) cases fully recovered with supportive care, and 6 patients (4%) died. None of the cases received anti-digoxin Fab. Conclusion: The majority of presentations with acute or chronic toxicity recovered with supportive measures without using anti-digoxin Fab.
Complications of Central Venous Catheter Insertion in Patients Undergoing Hemodialysis in Iran: A Systematic Review and Meta-analysis
Authors:   Department of Surgery, School of Medicine, Ilam University of Medical Science, Ilam, Iran., Karimian Mohamad , Afsharloo Somayeh ,   Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran., Okhli Atieh ,   Department of Nursing, Gonbad Kavoos Branch, Islamic Azad University, Gonbad Kavoos, Iran., Gholami Ali ,   Department of Anesthesiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran., Tarjoman Asma ,   Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran., Borji Milad ,   Department of Nursing, Faculty of Nursing and Midwifery, Ilam University of Medical Science, Ilam, Iran., Mahdikhani Somayeh ,   Department of Public Health and Infectious Diseases, School of Medicine, Sapienza University of Roma, Italy.
Published: July 2021

Background: Regarding the prevalence of chronic renal disease and CVC (central venous catheterization) complications, this systematic review and meta-analysis was performed to determine the prevalence of CVC complications in Iran. Methods: In this systematic review and meta-analysis, based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocol, all Iran and international databases from 2000 to 2019 were investigated using keywords of fever during or after dialysis, redness of the catheter insertion site, swelling, tenderness (touch sensitivity), infection, thrombosis, inadequate catheter (catheter malfunction), hemothorax, and pus outflow (pus drainage). The search was conducted by two members of the research team (MB, AT). In case of any disagreement between them, the quality of the investigation was examined by the third person (AB). In the present study, we analyzed data using comprehensive meta-analysis software. Results: According to this study’s findings, 12 articles with a total sample of 1395 patients were included in the systematic review and meta-analysis. Our findings were as follows: the prevalence of hemodialysis infection was 26.6% (95%CI: 16.2%–40.6%) (I2=95.5, P<0.001, Q=236.66), the prevalence of thrombosis was 18.3% (95%CI: 11.2%-28.6%), and the prevalence of inadequate catheter (catheter malfunction) was 16.1% (95%CI: 9.2%-26.7%). Conclusion: The prevalence of CVC complications was significant in hemodialysis patients. Therefore, appropriate interventions should be provided to reduce these complications.