Status of Airway Reactivity among Small Airway Diseases with Regular Users Substance Abuse of Inhaling Opium; Preliminary Results of a Survey of Indirect Provocation Test

Background:Opium is an oldest recreational abuse substance with dependency.  Small airway diseases (SAD) were established within opium user’s population.  Bronchial hyper-responsiveness (BHR) reflects airway reactivity and inflammation. Opium can induce airway inflammation and following airway reactivity.The objective of the study assessed status of BHR among SAD with regular inhaled opium users. It performed with hypertonic normal saline provocation challenge test.Methods: Target population enrolled among SAD with inhaled regular opium users. In the next step, standard hypertonic normal saline provocation test carried out on the sample study.Results:A total of 46 subjects followed the study. The mean age±SD was 50.1±1.2 years, with median 48 years. 91% of those were male. A positive result of BHR was distributed more frequently in thechronic obstructive pulmonary disease(COPD) with the asthma phenotype.  In addition, it was more market in the youngest and advanced age classes equally.Conclusion:hypertonic normal saline provocation test result was quite noticeable between regular inhaled opium users. BHR was detected more frequently in COPD with asthma phenotype, COPD, chronic bronchitis, and bronchial asthma disease, respectively. The outcome indirectly revealedthat there was a relation between airway inflammation and opium inhalation in population. It may be reflected an added effect on the predisposing risk factors of induced airway inflammation and hyperreactivity of airway in target populations

A Review of Applicability of Banning (Hajre) in Jurisprudence from the Perspective of Forensic Medicine

The topic of ward is among the important topics in jurisprudence and Forensic Medicine. Banning literally means prohibiting. The term of prohibition means preventing someone from being involved in financial or non-financial affairs and is called being banned. A person is banned from all affairs such as an unlettered person or some of the affairs such as a dying person. Banning has two forms; it sometimes is in the interests of the one banned from and his/her rights and sometimes for the benefit and the right of others. The objective of this brief article is an evaluation of extent banning applicability in Forensic Medicine topics and its relation with concepts and logics of the Islamic law

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely