Drug Interactions in Iranian Veterans With Chronic Spinal Cord Injury - A Descriptive Study

Background: Veterans with chronic spinal cord injury usually have various comorbidities. They are, therefore, visited by different doctors and use different medications. It is necessary to monitor the health of these veterans. One of the important issues in this regard is the attention to drug interactions. The purpose of this study was to investigate the drugs used and their interactions.Methods: This descriptive study of the cross-sectional studies was carried out retrospectively in 2015 under the Shefa Neuroscience Research Center’s supervision, examining the medical records of veterans with spinal cord injury participating in the health screening program at Khatam Alanbiya hospital in Tehran. Demographic data, comorbidities, used drugs, and the level of involvement collected. According to the FDA, drug interactions among the drugs used for each patient has evaluated and classified into three severe, moderate, and weak groups. SPSS v. 21 analyzed data.Results: The study population consisted of 404 men, ranging in age from 41 to 74, with a mean of 51.6 ± 6.4 years. One hundred forty-two of them (35.1%) had a complete injury, and 262 veterans (64.8%) had an incomplete injury. Only 17 veterans (4.2%) had no drug interactions. The number of drug interactions varied from 1 to 38, with an average of 5.9 ± 12.8 interactions per patient. The total number of interactions was 2856, of which 32.5% were weak, 55.3% moderate, and 12.2% severe, with a 95% confidence interval. Among the severe drug interactions in the study, the highest number belonged to the antidepressant drugs.Conclusion: This study highlights the necessity of developing a strategy for investigating and preventing drug interactions in veterans with chronic spinal cord injury. It has recommended that physicians pay more attention to other medications used by the patient and prescribe as little as possible of the drug and the drug with the least number of interactions

Usporedba dijagnostičke točnosti izravnog ispitivanja i shematske procjene lokalizacije kronične boli

None of the previous studies localized pain in comparison with graphic scheme. Our aim was to investigate the validity of direct questioning about the main pain localization in comparison with schematic evaluation. In this cross-sectional study, 331 patients, mean age 49.4±10.72 years, localized their main pain site anatomically with manikin and by direct questioning. Two methods were employed to localize pain: direct questioning and schematic evaluation (manikin). Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and odds ratio (OR) were used to compare these two methods. Study patients answered in both methods. The sensitivity and PPV were mostly in a weak range, while accuracy, specificity and NPV were mostly in good range. Kappa index was in the marginal reproducibility range. Pain in the left part of the body had a higher OR (OR=9). PLR for pain in the right part of the body was 28.03. NLR for all questions was located in the small and rarely important change probability group. Negative answer in direct questioning was more reliable than a positive one. Pain localization in the left side of the body was more reliable.Dosad nisu objavljene studije u kojima bi se lokalizacija boli uspoređivala s grafičkim prikazom. Cilj našega istraživanja bio je ispitati vrijednost izravnog ispitivanja o glavnom bolnom dijelu tijela u usporedbi s procjenom na shematskom prikazu. Ova križna studija uključila je 331 bolesnika srednje dobi 49,4±10,72 godina; bolesnici su pokazali glavno bolno mjesto na shematskom antomskom modelu ljudskog tijela i opisali ga izravnim ispitivanjem. Dakle, dvije metode su primi-jenjene za lokaliziranje boli: izravno ispitivanje i shematski anatomski model ljudskog tijela. Osjetljivost, specifičnost, točnost, pozitivna prediktivna vrijednost (PPV), negativna prediktivna vrijednost (NPV), pozitivni omjer vjerojatnosti (PLR), negativni omjer vjerojatnosti (NLR) i omjer izgleda (OR) primijenjeni su u usporedbi dviju metoda. Bolesnici su svoje odgovore dali pomoću obiju metoda. Osjetljivost i PPV uglavnom su bili u nižem rasponu, dok su točnost, specifičnost i NPV bili u dobrom rasponu. Indeks kappa bio je u graničnom rasponu reproducibilnosti. Bol u lijevom dijelu tijela pokazala je viši OR (OR=9). PLR za bol u desnom dijelu tijela bio je 28,03. NLR za sva pitanja bio je u skupini manje i rijetko važne promjene vjerojatnosti. Negativni odgovor kod izravnog ispitivanja bio je pouzdaniji od pozitivnog odgovora. Lokalizacija boli na lijevoj strani tijela bila je pouzdanija

A review on the animal models of seizure: review article

Nowadays, there are various animal models of acute and chronic seizures. Some chemical and electrical models such as seizure induced by pentylenetetrazol injection and maximum electric shock has been developed over of six decades and different kinds of chemical, electrical and genetic models have been admitted up to now. Among chemical models of seizure induction penicillin, bicuculline, tetanus toxin, pentylenetetrazol, pilocarpine and kainic acid are the more common chemoconvulsants to induce acute and chronic seizures. Numerous mechanisms involved in different models lead to develop different types of seizures. This variety leads to be confused beginner researchers which model should be carried in a research hypothesis. This study was aimed to illustrate how choose the most proper animal model for a hypothesis as well as different animal models of seizure and epilepsy. Penicillin and bicuculine are most proper models to induce focal seizures. In addition, pilocarpine and kainic acid are able to develop temporal lobe seizures. Pentylenetetrazol and tetanus toxin could develop acute and chronic generalized and tonic-clonic seizures. Furthermore, maximum electric shock has been well known as a proper model for acute seizures induction. Electrical kindling of amygdala could develop repetitive temporal lobe seizures. Hypoxia model of seizure is more used for screening of anti-epileptic drugs, long-term consequences, and epileptogenesis mechanisms. Also, hyperthermic (febrile) models of seizure are reliable for studying epileptogenesis mechanisms and cognitive consequences. Genetic models such as recurrent simultaneous (such as GAERS, WAG/Rij) and reflex seizures (such as GEPR) are more valid in some studies, including absence and audiogenic seizures. WAG/Rij rats have been known as the most valid animal model for absence epilepsy. It should be noted that the animal model is a simple expression of a complex system and it covers only a part of what happens in humans’ body. The most important use of animal models of seizure is developing and finding more effective and new anti-epileptic drugs. Therefore, proper selection of the animal model between numerous animal models of seizure induction is crucial to design an equitable hypothesis. The evidences reviewed in this study made beginner researchers potent to choose the best model

Comparing Diagnostic Accuracy of Direct Questioning Versus Schematic Evaluation of Chronic Pain Localization

None of the previous studies localized pain in comparison with graphic scheme. Our aim was to investigate the validity of direct questioning about the main pain localization in comparison with schematic evaluation. In this cross-sectional study, 331 patients, mean age 49.4±10.72 years, localized their main pain site anatomically with manikin and by direct questioning. Two methods were employed to localize pain: direct questioning and schematic evaluation (manikin). Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), negative likelihood ratio (NLR) and odds ratio (OR) were used to compare these two methods. Study patients answered in both methods. The sensitivity and PPV were mostly in a weak range, while accuracy, specificity and NPV were mostly in good range. Kappa index was in the marginal reproducibility range. Pain in the left part of the body had a higher OR (OR=9). PLR for pain in the right part of the body was 28.03. NLR for all questions was located in the small and rarely important change probability group. Negative answer in direct questioning was more reliable than a positive one. Pain localization in the left side of the body was more reliable