Comparison of Activated Charcoal and Industrial Charcoal in Prevention of GI Absorption of Diazepam

BBackground: GI decontamination is required frequently in management of intoxicated patients. Activated charcoal is used for this purpose normally. Is it possible that powdered industrial charcoal is used as a substitute? Present study was conducted to determine efficiency of industrial charcoal in prevention of absorption of diazepam, compared to activated charcoal. Method: 30 Sprague–dawley rats were randomly divided into 3 equal groups. 20 mg/kg diazepam was given orally to all 3 groups. No GI decontamination was performed for the control group. Activated and industrial charcoal (1 g/kg dissolved in 10 ml of water) was administered for other two groups. The urinary concentration of diazepam was used for evaluation of level of the drug absorption in the animals. Results: The mean urine concentration of diazepam was considerably lower in groups taking charcoal, compared control group. However the concentration in the group taking activated charcoal was lower than the concentration in the group taking industrial charcoal. Conclusion: Results of present study suggest that industrial charcoal can be used as a substitute for activated charcoal, though with a little lower efficacy for absorption of drugs and toxins

Novel molecular targets in gastric adenocarcinoma.

Gastric adenocarcinoma (GAC) is the third leading cause of cancer-related death worldwide. A high mortality rate and resistance to treatment protocols due to a heterogeneous molecular pathogenesis has made discovering the key etiologic molecular alterations of the utmost importance. The remarkable role played by epigenetic modifications in repressing or activating many cancer-related genes and forming new epigenetic signatures can affect cancer initiation and progression. Hence, targeting the key epigenetic drivers could potentially attenuate cancer progression. MLLs, ARID1A and EZH2 are among the major epigenetic players that are frequently mutated in GACs. In this paper, we have proposed the existence of a network between these proteins that, together with PCAF and KDM6A, control the 3D chromatin structure and regulate the expression of tumor suppressor genes (TSGs) and oncogenes in GAC. Therefore, we suggest that manipulating the expression of EZH2, PCAF, and KDM6A or their downstream targets may reduce the cancerous phenotype in GAC

Adjuvant effect of oral Silymarin on patients’ wound healing process caused by thermal injuries

Background: According to the side effects of the usual treatment of burns, in improving the patients’ prognosis, there is a need to introduce faster and more effective adjuvant therapies to treat wounds, thus to improve the prognosis of patients. The aim of this study was to investigate the effect of adjuvant treatment with oral silymarin on wound healing process caused by second degree-burns among the patients admitted to Valiasr Hospital of Arak. Methods: This randomized, double-blind clinical trial study was carried out on 80 patients with second-degree burns covering 20 to 30 percent of the body with flame. Patients were randomized into 2 groups with an equal number: The intervention group (treated daily with oral 140-mg silymarin) and control (under the administration of placebo). Patients were treated for 8 weeks and at the end of weeks 1, 2, 3 and 4 according to the degree of wound healing (grade 1, 2 and 3) were followed during 2016-2017. Results: Changes in degrees of burn wound healing in both the intervention and placebo groups during the 4 weeks of treatment, significantly improved grade 3 completely. Based on the results, the complete remission in all four follow-up stages was significantly higher in silymarin group than the placebo group: Week 1 (intervention: 9 (22.5%), control: 0 (0%), (p=0.011), week 2 (intervention group: 18 (45%), placebo: 7 (17.5%), (p=0.000), week 3 (intervention: 24 (60%), placebo: 11 ( 27.5%), (p=0.051); week 4 (intervention: 27 (67.5%), control: 19 (47.5%), (p=0.003). Conclusions: According to our results, the 4-week adjuvant treatment with oral silymarin resulted in the full and faster wound recovery in patients with second degree-burn. So, it is recommended to use adjuvant treatments to obtain effective results

Does Ingestion of Tincture of Opium Notably Raise Blood Alcohol Concentration?‎

Background: Tincture of opium (TOP) is currently used for maintenance therapy in treatment of opioids addiction. It contains ethanol. The present study was conducted to assess the increase in blood alcohol concentration (BAC) in its users; a process which may interfere with breath-alcohol test performed by law enforcement or traffic police. Methods: A total of 143 individuals were selected randomly from drug users who had been referred to an addiction treatment clinic. They were asked to undergo breath-alcohol test 15, 30, 45, and 60 min after taking their daily dosage of TOP. The resulting figures were statistically analyzed by t-test and chi-square test using SPSS for Windows. Findings: The calculated blood ethanol concentration rose to 26.33 ± 14.34, 29.15 ± 6.70, and 33.03 ± 8.46 in persons taking 20, 25, and 30 ml TOP respectively, 5 min after their drug ingestion. The figures turned into zero after 15 min. Conclusion: Users of TOP should be reassured about its alcoholic content. Its alcoholic content cannot produce equilibrium disturbance or notable BAC. However, it is recommended that users of TOP are observed in addiction treatment centers for 15 min after taking their drug to reach a higher degree of certainty about any effect of alcoholic content of TOP

Post-operative Analgesia in Opioid Dependent Patients: Comparison of ‎Intravenous Morphine and Sublingual Buprenorphine

Background: Acute and chronic pain is prevalent in patients with opioid dependence. Lack of knowledge concerning the complex relationship between pain, opioid use, and withdrawal syndrome can account for the barriers encountered for pain management. This study was designed to evaluate the efficacy of sublingual (SL) buprenorphine for post-operative analgesia, compared with intravenous (IV) morphine. Methods: A total of 68 patients, aged 20-60 years were randomly selected from whom had been underwent laparotomy due to acute abdomen in a University Teaching Hospital in Arak, Iran, and were also opioid (opium or heroin) abuser according to their history. After end of the surgery and patients’ arousal, the patients were evaluated for abdominal pain and withdrawal syndrome by visual analog scale (VAS) and clinical opioid withdrawal score (COWS), respectively 1, 6, and 24 h after the surgery. They received either morphine 5 mg IV or buprenorphine 2 mg SL, 1 h after end of the surgery, and then every 6 h for 24 h. Findings: VAS was 4.47 ± 0.73 and 2.67 ± 0.53 at h 6 and 24 in buprenorphine group, respectively. The corresponding score was 5.88 ± 0.69 and 4.59 ± 0.74 in morphine group. At the same time, patients in buprenorphine experienced less severe withdrawal syndrome. Conclusion: The present study confirmed the efficacy of SL buprenorphine as a non-invasive, but effective method for management of post-operative pain in opioid dependent patients. Result of this study showed that physicians can rely on SL buprenorphine for post-operative analgesia

Beneficial Effects of Rosmarinus Officinalis for Treatment of Opium Withdrawal Syndrome during Addiction Treatment Programs: A Clinical Trial

Background: Withdrawal syndrome may influence patient's motivation for participation in addiction treatment programs. Management of the symptoms can improve the success rate of addiction treatment programs. In the present study, we have evaluated the efficiency of an herbal product as adjunct therapy for alleviation of withdrawal syndrome in opium abuse. Methods: In the present clinical trial, 81 patients were assigned into case and control groups. The control group was treated with methadone and placebo for 4 weeks. The case group was treated with methadone and powdered dried leaves of Rosmarinus officinalis for the same interval. Occurrence of withdrawal syndrome was compared between groups on days 3, 7, and 14 after beginning of the treatment, and the possible signs and symptoms of withdrawal syndrome were checked. The clinical opioid withdrawal scale (COWS) was used for evaluation of withdrawal syndrome in the patients. Findings: Patients in the case group experienced less severe withdrawal syndrome compared to those in the control group; chiefly bone pain, perspiration, and insomnia. Conclusion: The present study showed that rosemary can be used as an optional extra drug for treatment of withdrawal syndrome during treatment programs for opium addiction and possibly addiction to other opioids. Keywords: Withdrawal syndrome, Rosmarinus officinalis, Opium, Addictio

Prevalence of HCV, HBV, and HIV Seropositivity among Cadavers Referred to Autopsy Hall of Legal Medicine Bureau of Tehran, Iran

A large number of dead bodies are referred to forensic autopsy halls for medicolegal examination. They can be a source of transmission of infectious diseases through direct contact or autopsy tools. The main aim of this study was to estimate the virus infection rates in the dead bodies. One thousand consecutive dead bodies that had been referred to autopsy hall of Legal Medicine Bureau of Tehran, Iran, during 2016, were included. The blood samples were analyzed in the laboratory for detection of HBs Ag, HBs Ab, HIV Ab, and HCV Ab, after providing informed consent from legal next of kin of the dead bodies. The general characteristics of the dead bodies were also collected by a checklist. Forty-seven cases of HIV seropositivity, 80 cases of HBs Ag seropositivity, and 97 cases for HCV Ab seropositivity were found. Among them, 27 cases of HIV, 40 cases of anti-HBC positive, and 94 cases of RIBA testing positive for HCV were proved through confirmatory tests. In other words, 2.6% of the dead bodies were infected with HIV, 3.8% with HBV, and 9% with HCV. The total infection rate was 15.5%. This is a worrying risk for pathologist and autopsy technicians

Prevention of lung complications following paraquat poisoning by silymarin, n-acetyl cysteine and hydrocortisone: An experimental study

Background: Paraquat poisoning results in multi-organ failure, primarily pulmonary fibrosis, acute renal failure, and hepatic impairment. The present study was designed to evaluate three treatment regimens, such as N-Acetyl cysteine (NAC), silymarin and hydrocortisone in the prevention of lung fibrosis after ingestion of toxic doses of paraquat in rats. Methods: Male Sprague-Dawley rats (N=20) were randomly divided into four groups of five each. The drugs and paraquat were given to the rats orally. All rat groups received one oral dose of paraquat (10 mg/kg) once daily for 1 week. The first group received a daily oral dose of silymarin (600 mg/kg) for 2 weeks. The second group received a daily oral dose of NAC (500 mg/kg) for 2 weeks. The third group was given daily oral doses of NAC (500 mg/kg) and hydrocortisone (50 mg/kg) for 2 weeks. The fourth group (controls) received no drugs other than paraquat. The experiment continued for 4 weeks. After the experiment, autopsy was performed on all rats and the lungs were examined histopathologically. Results: The results of histopathology examinations for peribronchial inflammation in the groups were shown that NAC plus hydrocortisone and silymarin had notable effects in the prevention of lung inflammation. Septal widening in the lungs was also observed in group three less than that in the other groups. Conclusion: Based on the results, silymarin, NAC and hydrocortisone may be used as a palliative treatment in paraquat poisoning specifically aimed at preventing the acute and chronic lung injuries as the worst complication of the poisoning

Does Ingestion of Tincture of Opium Notably Raise Blood Alcohol Concentration?

Abstract Background: Tincture of opium (TOP) is currently used for maintenance therapy in treatment of opioids addiction. It contains ethanol. The present study was conducted to assess the increase in blood alcohol concentration (BAC) in its users; a process which may interfere with breath-alcohol test performed by law enforcement or traffic police. Methods: A total of 143 individuals were selected randomly from drug users who had been referred to an addiction treatment clinic. They were asked to undergo breath-alcohol test 15, 30, 45, and 60 min after taking their daily dosage of TOP. The resulting figures were statistically analyzed by t-test and chi-square test using SPSS for Windows. Findings: The calculated blood ethanol concentration rose to 26.33 ± 14.34, 29.15 ± 6.70, and 33.03 ± 8.46 in persons taking 20, 25, and 30 ml TOP respectively, 5 min after their drug ingestion. The figures turned into zero after 15 min. Conclusion: Users of TOP should be reassured about its alcoholic content. Its alcoholic content cannot produce equilibrium disturbance or notable BAC. However, it is recommended that users of TOP are observed in addiction treatment centers for 15 min after taking their drug to reach a higher degree of certainty about any effect of alcoholic content of TOP. Keywords: Addiction, Treatment, Tincture of opium, Ethano