esmaeil farzaneh

Poisoning is one of the common causes of hospital emergency department referrals, especially in adolescents and young people; therefore, knowing the pattern of poisoning will be helpful in identifying risk factors and early detection of poisoning. The aim of this study was to investigate the epidemiology of acute poisoning in adults referred to Imam Khomeini Hospital in Ardabil from 2017 to 2020.

In this descriptive-analytical and retrospective study, 755 cases related to poisoned patients referred to Imam Khomeini Hospital in Ardabil from 2017 to 2020 were reviewed. The extracted data include ward, gender, age, marital status, place of residence, general status, cause of poisoning, and time of referral, were recorded on the checklist. Obtained Data were analyzed by Chi-square test and SPSS25 software.

The results showed that drug poisoning, opium (opium and its derivatives) and pesticides were the first to third ranks of the most poisoning agents. Most of the poisoned patients were men, married, in the age group of 21 to 30 and living in urban areas. Most of the poisonings were intentional and 33 deaths (4.4%) happened due to poisonings. The cause of poisoning had a significant relationship with age, sex, marital status, place of poisoning (p<0.05) but had no significant relationship with the general condition and time of patients' referral.

Acute poisoning is a major health problem in Ardabil province. The results show that the three agents of drug poisoning, opium and pesticides are the main means of poisoning in adults. Most cases of poisoning occurred in young and adult groups and were in the age range of 21 to 30 years. Poisonings occurred in people aged 31 to 40 were more due to amphetamine. Poisoning with aluminum phosphide tablets had increased compared to before. Consumption of aluminum phosphide is one of the problems of today's societies and it was one of the main causes of death in this research, so it is better to provide necessary measures for management and training for its correct use. Also, by limiting the use of these agents and replacing other methods and techniques, poisoning with these agents can be reduced.

Poisoning with acute opioids and stimulant is the most common causes of emergency visits, and its early detection and treatment is of utmost importance. The present study aimed to evaluate the frequency of opioid and stimulant use in poisoned cases. This cross-sectional descriptive study was conducted on 255 cases with acute opioids and stimulant poisoning. Out of all patients, 7(2.7%) patients died due to severe complications. Moreover, 72.2% of patients were male, and the majority of cases (86.87%) were urban residents. The leading cause of poisoning was suicide (65.1%), and 34.9% of patients had accidental poisoning. The mean age of patients was 36.26 years. Tramadol, methadone, and opium with 29.4%, 23.9%, and 23.5% were the most used opioids for poisoning, respectively.As evidenced by the obtained results, tramadol poisoning is the most common poisoning in patients referring to hospital emergence. Nevertheless, tramadol use and availability need to be prevented and controlled; moreover, the awareness of health system providers should be raised about the care of these patients.

Aluminum phosphide or rice tablet is one of the most common pesticides and insecticides used in agriculture to protect crops, cereals, and rice. Recently, this substance has been increasingly used as a method for committing suicide among people in society. This study aimed to evaluate the clinical symptoms and para-clinical findings of deceased patients due to Aluminum phosphide poisoning in Ardabil province, Iran. This descriptive cross-sectional study was conducted on 97 hospitalized patients who died due to Aluminum phosphide poisoning in Ardabil province, Iran, from 2009 to 2017. The data were collected using a checklist and then analyzed in SPSS software (version 19) through descriptive and analytical statistics The mean age of all patients was 34.3±15.8 years, and the majority of the cases (77.3%) were female. The most important symptoms were nausea and vomiting in males (92%) and females (100%). Moreover, the patients had a mean recovery time of 5.89 h. Of all the deceased patients, 22 and 75 cases took two and one tablets, respectively. Furthermore, 92.7% of the patients had taken the rice tablets orally. The amount of Glasgow Coma Scale (P=0.001), systolic blood pressure (P=0.001), PH (P=0.001), heart rate (P=0.001), respiratory rate (P=0.001), bicarbonate (P=0.001) and white blood cell (P=0.009) in died patients in more than 24 hour significantly difference with died patients in less than 24 hour. The females obtained a significantly lower systolic blood pressure (P=0.01) and lower pH (p=0.045), but the higher partial pressure of oxygen (P=0.01), compared to males. The results of this study showed that the frequency of deaths due to rice pill poisoning was much higher in males than females; moreover, this value was higher in middle-aged groups, compared to other age groups.

The study of effect four diets formulated containing vegetable oils including canola and corn oils and their mixture, in three replications each, was carried out to feed N. diversicolor during two months. At the end of the experiments, growth performance in each treatment included total biomass, L3 length, specific growth rate (SGR), body weight increase (BWI), and survival rate were measured. Biochemical composition including total protein, total fat and fatty acid profile of diets and worms body carcass were analyzed. The results showed that there was no significant difference in the growth performance of worm from diets containing different oils with control treatment (worms fed from diet of without oil). The results indicate that the fat in the diet has no effect on the growth of the worms, but the presence of these vegetable oils in carcass composition was important. The results of this study showed that all saturated and unsaturated fatty acids in the diet, except of the control treatment in the N. diversicolor, were higher than their dietary. In the present study, N. diversicolor, fed from diet containing of canola oil, had the highest ⍵-3 fatty acids. The highest EPA level and ratio of ⍵-3/⍵-6 in the worms fed canola oil were higher than formulated diet containing canola oil. Totally, treatment 1, including diets containing canola oil, was more suitable for increasing the growth perfoermance and unsaturated fatty acids of worm than other treatments.

Considering the importance of organizational learning and its impact on health accreditation, the present study investigates the level of learning and its relationship with accreditation and its promotion strategies in medical sciences universities as the core of the health sector.
In this descriptive-analytic study, data was gathered from 176 nurses working in four teaching hospitals in Ardabil. The standard organizational learning questionnaire and the accreditation rating checklist (second generation) were used as well. Data were analyzed by ANOVA, SPSS22, follow-up tests and correlation coefficient.
The results showed that there was no significant difference in the total score of accreditation between teaching hospitals (P-value = 0.320, F = 1.178), but there was a significant difference in organizational learning (P-value > 0.001, F = 146.9) due to the very low rating of one of the centers. The results also showed a positive, significant and strong relationship between the organizational learning score and the total score of accreditation in 4 teaching hospitals in Ardabil (r = 0.319, P-value Based on the results there is a positive and significant relationship between the organizational learning and the accreditation scores. By increasing personnel organizational learning, the accreditation score has also significantly increased. Therefore, with proper policy on organizational learning, educational centers can have a higher level of accreditation in order to provide decent services

Lead poisoning usually occurs in occupational situations, however, there are sometimes non-occupational toxicities and opium-related lead poisoning has been reported recently. Neuropathy due to lead poisoning can also occur.
Case Report: In this study, a 43 year old man with a history of oral opium use with the complaint of progressive muscle weakness was reported. Muscle forces in the upper and lower limbs were 0/5 and 1/5, respectively. Serum lead level was 88.8 μg/dl. Electrodiagnostic studies were indicative of subacute moderate to severe axonal motor polyneuropathy. Following the treatment, the muscle force was improved and lead level was decreased.
Motor neuropathy due to lead poisoning is a rare but possible complication. Due to the increased incidence of opium related lead toxicity in Ardabil, Iran, we recommend to consider lead poisoning as one of the possible differential diagnosis of peripheral neuropathy to initiate early and proper treatment.

One of the newest non-occupational sources of lead contamination is drug addiction, which has recently been addressed as a major source of lead poisoning in some countries. The present study aimed to investigate the blood lead level (BLL) of asymptomatic opium addicts.

This case-control study was conducted during a one-year period to compare BLL of three groups consisting of opium addicts, patients under methadone maintenance therapy (MMT), and healthy individuals.

99 participants with the mean age of 55.43§12.83 years were studied in three groups of 33 cases (53.5% male). The mean lead level in opium addicts, MMT and control groups were 80.30 § 6.03 ¹g/L, 67.94 § 4.42 ¹g/L, and 57.30§4.77 ¹g/L, respectively (p=0.008). There was no significant difference in BLL betweenMMT and healthy individuals (p=0.433) and also between opiumaddicts andMMT individuals (p=0.271).Oral opiumabusers had significantly higher lead levels (p = 0.036). There was a significant correlation between BLL and duration of drug abuse in opium addict cases (r=0.398, p=0.022). The odds ratio of having BLL ¸ 100 in oral opium users was 2.1 (95% CI: 0.92 - 4.61; p = 0.43).

Based on the result of present study, when compared to healthy individuals, opium addicts, especially those who took substance orally had significantly higher levels of blood lead, and their odds of having BLL ¸ 100 was two times. Therefore, screening for BLL in opium addicts, particularly those with non-specific complaints, could be useful.

Aluminum phosphide poisoning is common in our region. It can cause severe metabolic acidosis and persistent hypotension, which lead to cardiogenic shock and subsequently mortality. Oliguric or anuric acute kidney injury is seen in almost all patients with aluminum phosphide poisoning. Renal replacement therapies are recommended in these patients to improve metabolic acidosis and increase the rate of survival. We report 2 cases of severe acute aluminum phosphide poisoning treated successfully with peritoneal dialysis.

Every day, people with addiction cause heavy economic and cultural damage to society. In some circumstances, opioids are used as a tool for suicide, which is often seen in youth. The aim of this study was to investigate the clinical signs of toxicity associated with opium in patients referred to Ardabil city hospital.
This is a cross-sectional study that has been done on opium toxicity patients referred to Ardabil Sabalan hospital from 2014-15. Patients’ information such as individual characteristics (age, gender, living location, job and marital status), drug type, poisoning cause, poisoning season, history of physical and mental illness, and clinical symptoms were obtained from patients and then analyzed using statistical methods in SPSS.16 software.
180 hospitalized patients were entered in the study. 75 persons (42%) used Tramadol, the most commonly used drug in opium intoxication. Most patients (80.6%) were male and in the age group 20-30 years (37.8%). 155 patients (86.1%) lived in this city, and the most patients (55 cases, 35.5%) had a primary education level. 39% of cases were seen in spring, the most common season for referring intoxications. Of all patients, 160 (88.9%) consciously took the drug (by choice).
Results showed that poisoning by Tramadol was the most common form of opium intoxication in patients. Opium intoxication can be prevented by decreasing the arbitrary use of drugs and also increasing the awareness level of personnel about care of these patients, and raising awareness to all people in society about opium and drug toxicity.

The novel conductive nanocomposite and composite from polyaniline (PANI) were prepared. The composites were synthesized by in situ oxidative chemical polymerization of aniline on silica- and nanosilica-supported sulfuric acid. The reaction was carried out in a mortar and ammonium persulfate was used as oxidant under solvent-free condition at room temperature. Structure, size and morphology of the synthesized nanocomposite and composite were determined by Fourier transform infrared (FTIR) spectroscopy, ultraviolet-visible (UV-Vis) spectroscopy, scanning electron microscopy (SEM), transmission electron microscopy (TEM) and atomic force microscopy (AFM). Conductivity was measured by four-probe technique and revealed that the samples not only had the conductivity in the range of conductive polymers (~ 0.4 S/cm) but also they showed high conductivity as composites and blends of polyaniline reported by others. Synthesis of composites (nanocomposites) and formation of polarons were confirmed by FTIR and UV-Vis. SEM images showed that silica particles were thoroughly coated by PANI and all were amorphous. According to the TEM and AFM images, particle size in composite and nanocomposite was in the range of 1-5 μm and 35-49 nm, respectively. Furthermore, the surface morphology, shape and dimensions of particles obtained by AFM strongly supported the SEM and TEM observations related to polymer deposition on the silica particles. The key benefits of the approach used in this research are the preparation of novel conductive composite and nanocomposites with the polaron structure under green chemistry condition of dopant solid acids including silica- and nanosilica-supported sulfuric acid.

The aim of current study was comparison the maximal fat oxidation and the exercise intensity elicit maximal fat oxidation (Fatmax) between trained and untrained girls. 10 healthy untrained (exercising 55% VO2max (P

Poisoning is a common cause of hospital emergency visits in many countries. Incidence of poisoning is different based on cultural and economic characteristics. The aim of this study was to investigate the epidemiology of poisoning in pediatrics. This cross sectional study was performed on 336 patients under 13 years of age referring to Bu-Ali hospital during five years (2007-2011). Variables such as age, sex, residency place, hospitalized duration, cause of the poisoning, clinical signs, treatment and outcome were obtained by a checklist. Collected data analyzed by statistical methods in SPSS v16. Among the subjects, 197 patients (58.6%) were male. The average age of the children was 4.1 years and the most common age range was 1 to 4 years with (210 patients, 62.5%). The mean duration of hospitalization of children was 1.7 day (SD= 0.2), 77.7 % of the children were living in the city and the summer was accounted as a common season in which the patients referred to the hospital (32.7 %). The most used materials were drugs with 60.71% and in 86.6% of patients the cause of poisoning was accidental. Results showed that the most common cause of poisoning among children are drugs and methadone was the most commonly abused substance. It requires that parents should be trained about keeping their children away from drugs somewhere.

Bronchial carcinoid tumor comprises 1 to 3% of lung neoplasms. The common age of onset is mainly post-puberty although atypical carcinoid tumors occur atages 44 to 55. Carcinoid tumors cause two groups of symptoms in patients: symptoms due to obstruction and symptoms due to the production and release of active neuropeptides. Histologically, carcinoid tumors are categorized into two groups of typical and atypical while in terms of location of lesion, they are grouped into central and peripheral types. Differentiation between malignant and benign carcinoid tumors is based on presence or absence of metastasis.Bronchoscopy and endobronchial biopsy are the best diagnostic measures in these patients. Serologic evaluation and assessment of active metabolites in case of liver metastasis also help the diagnosis. Surgical resection is the treatment of choice for this condition.This report discusses a patient with carcinoid tumor who was receiving bronchodilator treatment for a couple of months because of chronic cough with possible diagnosis of asthma and had received several courses of antibiotic therapy with possible diagnosis of lung infection until he eventually developed bronchiectasis in the right lower lobe. In patients with chronic pulmonary symptoms especially with localized bronchiectasis, diagnostic bronchoscopy must be included in the diagnostic work-up to rule out intrabronchial lesions.

Aluminum phosphide poisoning (ALPP) still has no efficient and approved antidote. Supportive care and hemodynamic monitoring are the only choices of treatment. We proposed a new lavage formulation in addition to evaluation of its efficacy and defining the impact of clinical characteristics of patients on their prognosis. During eight months period of time, 120 patients were enrolled to the study and randomly received two different gastric lavage protocols. Our new lavage protocol had positive impact on patient's survival and the P-value in comparison with the classic gastric lavage method was close to significant level (P=0.054). On hospital arrival indication for intubation-ventilation as well as sense of thirst, sore throat and absence of nausea indicate worse outcome. Using our novel approach, indication for intubation-ventilation as well as sense of thirst, sore throat and absence of nausea can be considered as applicable prognostic factors in survival of ALPP patients. Further studies are required to set this approach as preferred treatment.