Epidemiological Profile of Snakebite in Iran, 2009-2010 Based on Information of Ministry of Health and Medical Education

Background: Snake bite is one of the significant health problems in the tropical and subtropical regions. It is a common medical emergency in Iran. The current study was conducted to characterize related risk factors for snake bite accidents.Methods: This research was a descriptive retrospective study. Data were collected by gathering snake bite records of 42 Medical Sciences Universities in Iran from March 2009 to March 2010. Information included: age and sex of the victims, region of incident, site of bite and outcome.Results: The results showed that the majority of snake bite patients were male (66.1%). The age distribution of patients indicated that the greatest rate of snake bites occurred among the 25-34 years old. Of 5172 snake bite, 2851 (54.7%) observed on lower limbs, 12019 (38.9%) on upper limbs and 303(5.8%) on head and Trunk and 20 (0.3%) unknown site. The average incidence of snake bite  was estimated 6.9 Per 100,000, however, the highest and the lowest affected cases were observed in Semnan province (with incidence of 111.6 per 100000 individuals) and Rafsanjan, Sabzevar cities  (with incidence of 0 per 100000), respectively. The mortality and recovery rates of cases with and without anti venom, was evaluated (0.12%, 99.88%) and (0.4%, 99.6%) respectively.Conclusion: The high incidence of snake bites in some of provinces of Iran suggests the necessity of preventive programs for minimizing the incidence

Pathological Findings of Tramadol on Liver Tissue in the Cadaver Referred to Legal Medicine Organization of Tehran 2008-2013

Background: Tramadol is a synthetic opioid used to control chronic pain and pain after surgery. However, many cases of poisoning and dangerous side effects have been reported. In order to discover the causes of death in forensic medicine is usually examine tissue samples taken from the body, although the results of toxicology tests generally give us more information, but identifying the pathological effects of Tramadol on the internal organs, especially the livers can be very helpful.Methods: In this cross-sectional study, information on the history, the autopsy report and toxicology testing of patients who died due to poisoning Tramadol were studied. In this study, all of the information already provided by the use of particular forms collected and then analyzed using computer software SPSS.Results: A total of 49 cadavers were examined in this study. There were 39 dead (80%) of men and 10 of (20%) women. Most common age groups in the study were 24 to 34 years old (41%), 15 to 24 years old (39%), were reported. There were significant difference between liver microscopic spread among different ages, history of Tramadol, positive and negative toxicology tests stomach contents, urine, blood, tissue and vitreous. Most common pathological changes were in liver, degenerative changes and inflammatory cell infiltration in patients who under 35 years old.Conclusion: In this study, the majority of patients had acute poisoning with Tramadol, it can be concluded that the majority of changes in tissue obtained was as a result of acute Tramadol, respectively incidence of atelectasis and edema and alveolar bleeding in the liver were most pathological findings. In reviewing toxicology, Tramadol are also present in the stomach contents, urine, gall bladder, liver and blood were positive, the result of stomach contents will be most helpful for us

Role of Diffusion-Weighted MRI (DWI-MRI) in the Diagnosis of Brain Complications caused by Heroin Substance Abuse

Background: Magnetic resonance imaging (MRI) offers higher diagnostic accuracy for brain lesions caused by heroin abuse compared to compute tomography (CT) scan. These lesions have a low signal on T1-weighted (T1W) images and a high signal on T2-weighted (T2W) and fluid-attenuated inversion recovery (FLAIR) images. This study aimed to evaluate the role of diffusion-weighted MRI (DWI-MRI) in heroin addicts.Methods: This cross-sectional study was conducted on 20 patients with heroin addiction (vapor inhalation/injection) referring to Imam Reza Hospital of Mashhad, Iran. Patients in whom heroin abuse was only cause of consciousness, loss and neurological symptoms were enrolled in this study. Demographic data of the patients were recorded, including MRI, FLAIR, T1W and T2W images. In addition, DWI of axial and sagittal sections of the brain was performed in the following sequences.Results: In this study, mean age of patients was 40.15±7.673 years, and 95% of patients were male. The most common mode of heroin use was inhalation, and mean duration of addiction was 5.48±3.393 years. Mean daily intake of heroin was 13.4±15.30 grams, and mean duration of heroin abuse was 10.3 and 4.6 years in patients with and without MRI changes, respectively. A significant correlation was observed between MRI changes and duration of heroin use (r=0.721) (p=0.001). In addition, a significant correlation was observed between MRI changes and daily intake of heroin (p=0.006).Conclusion: According to the results of this study, brain lesions caused by heroin abuse have a low signal on T1W images and a high signal on T2W and FLAIR images. Therefore, it could be concluded that heroin intake has significant effects on the brain of users

Pesticide Consumption in Greenhouses; a Case Study of Kashan Region

Aims: In regard to increasing greenhouse area in Iran followed by increased use of pesticides and contaminated crops, this study aimed to determine the frequency and types of consumed pesticides in Kashan region, Iran, greenhouses. Instrument & Methods: In this descriptive study in 2011-2012, samples was entered by census method. At the first step, a list of greenhouses was obtained from agricultural organization, 39 active greenhouses were detected, thereafter the questionnaires have been completed in detail by direct interview; obtained data were analyzed in SPSS 23 by descriptive statistics. Findings: 87.1 of greenhouses used chemical methods for controlling pest and diseases of products and 43.5 used non-chemical methods. The most frequent used chemical pesticides were Deltamethrin (37.9) and Permethrin (28.3) as pyrethroid insecticides, Diazinon (23.1) as an organophosphate insecticide and Carbendazim (23.2) as a fungicides. Conclusion: 87.1 of the greenhouses’ owners of Kashan region, Iran, use chemical pesticide for pest control

Feasibility and safety of clipless and sutureless laparoscopic adrenalectomy: A 7-year single center experience

Purpose: Laparoscopic adrenalectomy (LAD) is considered the gold standard surgical method for resecting adrenal tumors. To date, only few small studies have investigated the safety of clipless laparoscopic adrenalectomy in which the adrenal vessels were controlled by the LigaSure system or bipolar coagulation. The aim of the present study was to evaluate the safety and feasibility of sutureless and clipless laparoscopic adrenalectomy operations performed in our center. Materials and Methods: All patients with functional adrenal tumors, nonfunctional adrenal tumors larger than 5 cm and secondary adrenal metastases from the kidneys, lungs or breasts who had underwent an LAD procedure between 2012 to 2019 were included in our study. In all of the cases, complete coagulation of adrenal veins was achieved through bipolar cautery and no vascular staplers, clips or other energy sources were used for controlling the adrenal vessels whatsoever. Outcomes of interest included operation time, length of hospital stay, changes of serum hemoglobin level, and occurrence of major complications. Results: Of a total 251 patients, unilateral right and left-side adrenalectomy was performed in 168 and 67 cases, respectively, and 16 cases had underwent bilateral adrenal resection. The mean age (SD) of patients was 40.7 (13.6) years old at the time of operation and the mean size (SD) of the adrenal lesions was 5.2 (3.1) cm as measured by the greatest diameter. Histological examination showed that the most common pathology of the resected adrenal glands was pheochromocytoma (n=78). None of the laparoscopic operations required a conversion to open surgery. Also, major bleeding or other serious complications did not occur in any of the cases either intraoperatively or postoperatively. Conclusion: Clipless and sutureless laparoscopic adrenalectomy seems to be feasible and safe for removing adrenal tumors. Moreover, bipolar cautery is associated with an acceptable outcome for vessel closure. © 2019 Urology and Nephrology Research Centre