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