zahra khalighi

Aluminum Phosphide (ALP) is an effective, cheap, and highly toxic pesticide. ALP poisoning can have destructive effects on the human body, such as the heart, lungs, gastrointestinal tract, kidneys, and central nervous system, although all organs can be involved. We describe a 53-year-old Iranian Kurdish man with Hemolytic Uremic Syndrome (HUS) and Acute Kidney Injury (AKI). Supportive treatments such as hemodialysis and plasmapheresis were performed. After 23 days of hospitalization, the patient fully recovered and was discharged. Thrombotic microangiopathy such as HUS should be considered in patients with ALP toxicity that has a genetic defect in complement proteins. Combined use of hemodialysis and plasmapheresis improve outcomes in these patients.

Methadone poisoning intentionally or accidentally leads to a high rate of treatment burden and cost and deaths. The evaluation of the factors affecting the severity of poisoning can reduce recovery time, costs, and potential risks.

This study aimed to investigate the effect of intravenous vitamin C (ascorbic acid) administration on serum level and urinary excretion of methadone.

In this single-blind study, 54 patients who were diagnosed with methadone poisoning were divided into three groups. The two intervention groups received different doses of vitamin C, including 12 and 24 g, and the control group received normal saline. The serummethadone level and urine pH weremeasured at the time of arrival and 24 hours after admission. The data were analyzed using repeated measure analysis of variance (ANOVA) in STATA version 12.

In this study, 18 patients were placed in each group. The three groups were not significantly different in basic variables, such as age, gender, and methadone dosage. Between and within-group comparison showed a significant decrease in the serum methadone levels over time after adjusting age, gender and methadone dosage (P < 0.05). Post-hoc analyses revealed a significant difference in methadone reduction between 12 g of vitamin C and control groups (P = 0.04), and there was no significant difference between the control and 24 g of vitamin C groups (P > 0.05). However, between and within-group comparisons showed no significant difference between the three groups in terms of urine pH (P > 0.05). In addition, interaction was observed between intervention and time on serum methadone levels (P < 0.001) and urine pH (P = 0.04) variables.

Consuming 12 g of vitamin C further reduced the serum methadone level in patients with methadone poisoning. There was no effect on methadone urinary excretion in patients.

In order to measure the plasma levels of Losartan and Bosentan, a sensitive Reverse Phase-High Performance Liquid Chromatography (RP-HPLC) technique was developed.

To compare bioavailability, the Area Under the Curve (AUC), peak plasma concentration (Cmax), and time to Cmax (Tmax) were employed. The standard curve (150-2400 ng/ml) was linear (R2=0.999), relative errors were between 2.4 to 10.05% and the coefficient of variation (CV%) ranged from 1.52 to 10.88. A single dosage (test and reference) was used for the in vivo investigation, which involved 16 healthy individuals.

The AUC0-48, AUC0-, Cmax, and Tmax of the test and reference had no statistically significant differences. The Cmax and 95% confidence intervals of the ratio of Cmax of the two formulations were 0.93-0.96 and 97.6-135%, respectively.

Therefore, it was established that generic Bosentan was equivalent to Bosentan from Actelion and that both medications could be regarded as equally effective in clinical settings. The blood level of Bosentan could be measured using this straightforward procedure in all hospital laboratories.

The aim of the present study is to identify, report and compare native medicinal plants that are used for treatment of depression, anxiety and stress, anorexia, insomnia and headache and migraine in the Ilam city, Ilam province, Iran.

A standard questionnaire was used to obtain information regarding traditional therapeutic uses of plants that are effective on common psychiatric disorders, such as depression, anxiety and stress, anorexia, insomnia, headache and migraine. Data collection instruments included a questionnaire and interview. The study population also included 37 perfumers. First, a complete list of the perfumers of Ilam city was extracted from the Food and Drug Vice-Chancellor of Ilam University of Medical Sciences. The questionnaires included questions on the personal information of perfumers and a list that contains the no names of native plants, but included their used organs, usage, and traditional therapeutic effect. The results showed that twenty-two plant families are effective in treating common psychiatric disorders.

Fabaceae plant family with 7 plants and Lamiaceae plant family with 5 plants were the most effective plant families used for the treatment of common psychiatric disorders. Also, the most plant organs used for the treatment of the above disorders included aerial parts (38%), leaves (14%), fruits (14%), flowering branches (14%), and seeds (12%).

Native medicinal plants of Ilam city are traditionally used to treat common psychiatric diseases and can be used as natural and effective treatments of disorders such as depression, anxiety and stress, anorexia, insomnia, headache and migraine.

Domestic violence against men has several dysfunctional consequences that affect not only the individual and the family, but also the middle and upper levels of society. The aim of this study was to study domestic violence against men under sociological explanation. This was a descriptive-explanatory study in which data were collected from married women between 18 and 65 years old in Mashhad in 1398 with a sample size of 394 people by multi-stage cluster sampling. Spss and Amos softwares were used to analyze the data.The results showed that the overall average of domestic violence against men in a range of 0 to 100 was 18.16, and in general, 75.4% of men were slightly abused, 21.3% were moderately abused and 3.3% were severely abused. Also, among the dimensions of violence, the highest amount belonged to the psychological dimension (Mean: 21/09). Among the independent variables, experience of violence, observation of violence, feeling of injustice and life satisfaction had a significant effect (P <0.01) on domestic violence against men, which the most impact belonged to the experience of violence (Beta = 0.50, P <0.01). Social variables played an important role in facilitating violent behavior against men, which necessitates educational needs through school, media and family

Aluminum phosphide is known in our country as Phostoxin tablet. Human contact with Phostoxin tablet can have severe and fatal consequences. The present study aimed to evaluate and compare the group of patients dying due to Phostoxin tablet poisoning with the group that survived despite taking Phostoxin tablet.

This descriptive-analytical and cross-sectional study was performed on all patients poisoned with Phostoxin tablet in 2018 and 2019. The sampling method was a full census. According to the purpose of the study, T-test, Mann-Whitney, and Chi-square tests were employed in SPSS software version 24 and Graph pad prism version 8.

This study included 35 poisoned individuals with a mean age of  (16-82) years. The highest frequency was in the age group of 20-40 years (82.9%) and 21 women (60%) and 14 men (40%). There was a statistically significant relationship between mortality rate with drug use, length of hospital stay, blood pressure, number of breaths, level of consciousness, abdominal pain (P<0.05). Meanwhile, the mean level of ALT and AST liver enzymes and blood pressure in the two groups of dead and rescued were significantly different (P<0.05).

Phostoxin Tablet poisoning is a common cause of poisoning in Iran that has a high mortality rate. This is a serious health problem in communities where Phostoxin tablet is used. Consequently, you must go to the hospital immediately after contact with Phostoxin.

Aluminum phosphide is known in our country as Phostoxin tablet. Human contact with Phostoxin tablet can have severe and fatal consequences. The present study aimed to evaluate and compare the group of patients dying due to Phostoxin tablet poisoning with the group that survived despite taking Phostoxin tablet.

This descriptive-analytical and cross-sectional study was performed on all patients poisoned with Phostoxin tablet in 2018 and 2019. The sampling method was a full census. According to the purpose of the study, T-test, Mann-Whitney, and Chi-square tests were employed in SPSS software version 24 and Graph pad prism version 8.

This study included 35 poisoned individuals with a mean age of  (16-82) years. The highest frequency was in the age group of 20-40 years (82.9%) and 21 women (60%) and 14 men (40%). There was a statistically significant relationship between mortality rate with drug use, length of hospital stay, blood pressure, number of breaths, level of consciousness, abdominal pain (P<0.05). Meanwhile, the mean level of ALT and AST liver enzymes and blood pressure in the two groups of dead and rescued were significantly different (P<0.05).

Phostoxin Tablet poisoning is a common cause of poisoning in Iran that has a high mortality rate. This is a serious health problem in communities where Phostoxin tablet is used. Consequently, you must go to the hospital immediately after contact with Phostoxin.

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease characterized by synovitis, inflammation, and joint destruction that if not well controlled can destroy cartilage, bone, ligaments and tendons, and in some cases cause disability. The aim of this study was to evaluate the possible role of the ratio of neutrophil-lymphocyte (NLR) as an inflammatory marker in determining the severity of RA (Disease Activity Score 28 [DAS28]).

Fifty patients with RA attending the rheumatology clinic in Ilam Shahid Mostafa Khomeini Hospital, Iran, were examined for disease activity using physical and laboratory tests. NLR and disease severity were determined based on DAS28.

The disease activity, including remission and mild/moderate were seen in 34% (DAS28<2.6) and 66% (DAS28 2.6), respectively. The patients were 86% women and 14% men. Mean ages of patients with mild/moderate and remission RA were 51.30 and 36.82 years, respectively. The mean NLR was 1.80 in patients with remission RA and 1.93 in those with mild/moderate RA and no significant relationship was found in NLR between these two groups (P=0.99). There was a significant relationship between DAS28 and erythrocyte sedimentation rate (ESR) (P=0.02), and a weak relationship between DAS28 and age, gender, and medication (P≥0.1).

According to the results, perhaps ESR rather than NLR could be a prognostic factor for determining disease activity levels in RA patients with DAS28 <3.2.

Context: 

Acetylcysteine is an effective treatment for acetaminophen poisoning. The preparation and dose calculation of acetylcysteine is associated with medical errors. The prevalence of this error is 34% globally.

Case report:

 A 15-year-old girl took an overdose of acetaminophen in a suicide attempt. Acetylcysteine intravenous was ordered. Due to the medication error by the nurse, she received a 10-fold overdose of intravenous acetylcysteine in both initial loading dose and maintenance dose, at first day. On the second day, the patient showed abdominal pain, nausea, vomiting, and elevated liver enzymes. Her hemoglobin, hematocrit, and platelet quickly decreased. Subsequently, she developed oliguria, anuria, and rising serum creatinine levels. The patient was diagnosed with uremic hemolytic syndrome. She underwent hemodialysis and was treated with plasmapheresis, blood transfusions, and platelets.

 The effects of acetaminophen poisoning and acetylcysteine overdose may be much more severe and have a greater impact on patient survival than each poisoning alone. Timely and accurate treatment measures can help prevent long-term side effects.

Thrombotic Thrombocytopenic Purpura (TTP) is a rare and life-threatening disorder characterized by severe thrombocytopenia, microangiopathic hemolytic anemia, fever, renal dysfunction, and neurological deficient. TTP leads to the formation of blood clots in small blood vessels throughout the body. TTP is associated with many risk factors such as pregnancy, HIV, cancer, lupus, and infections. Recently there have been few published case reports of bee sting associated TTP.

A 67-year-old man from a rural area of the Southwest Province of Iran, Ilam, was referred to the academic general hospital because of fever, chills, sweating, vomiting and dizziness following the honeybee sting on his body.

this study showed that,multiple co-morbidities including CVD and diabetes, along with coagulation abnormalities after honeybee stings, seriously exacerbated patient hemodynamic status.

TTP, as a major complication due to the toxic reaction of a large number of bee stings with underlying diseases in patients, should be given more attention.

The association between anemia and postpartum depression (PPD) has been reported to be controversial in different studies. Therefore, this study aimed to provide a comprehensive assessment of anemia and PPD. This review study was conducted according to the MOOSE protocol and results have been reported according to the PRISMA guideline. We searched epidemiologic studies published until January 2018 in nine English databases including Scopus, PubMed/Medline, Science Direct, Embase, Web of Science, CINAHL, Cochrane Library, EBSCO and Google Scholar using English MeSH keywords. The heterogeneity of the studies was assessed using the Cochran’s Q test and I2 index. Data were analyzed using a random effects model and comprehensive meta-analysis (CMA) software version 2. In the 10 studies, the association between postpartum anemia and PPD was significant (heterogeneity test: P<0.001, I2=74.62%), and RR=1.887 (95%CI: 1.255-2.838, P=0.002). In 8 studies, anemia during pregnancy significantly increased the risk of postpartum depression (heterogeneity test: P=0.116, I2=36.422%), RR=1.240 (1.001-1.536, P=0.048). The subgroup analysis of postpartum anemia and PPD was not significant for the variables of quality of studies, study design, and the period of evaluating depression and anemia. The subgroup analysis of anemia during pregnancy and PPD was not significant for the period of evaluating depression. Publication bias did not affect the results of the studies. Meta-analysis results showed anemia during pregnancy and after pregnancy that significantly increased the risk of postpartum depression. Therefore, prevention, identification and treatment of anemia in pregnant women seem necessary.

Hearing disorders are reported in thalassemia patients treated with deferoxamine. This study aimed to assess hearing loss in Iranian thalassemia major patients treated with deferoxamine.
This review article was designed based on PRISMA guidelines. To review the literature, two researchers studied national and international databases including Iranmedex, Magiran, Medlib, SID, Scopus, PubMed, Science Direct, Web of Science and Google Scholar without time limit until May 2017. Cochran's Q test and I2 index were used to assess the heterogeneity of the studies. The data were analyzed using Comprehensive Meta-Analysis software version 2 and p A total of 17 articles involving 1,835 Iranian thalassemia major patients treated with deferoxamine were included in the meta-analysis. The overall prevalence of hearing loss was estimated 27.3% (95% confidence intervals (CI): 19-37.6). The prevalence of sensorineural, conductive and mixed hearing loss was estimated 10.6% (95% CI: 5.7-18.8), 14.6% (95% CI: 10.5-20.6) and 9.1% (95% CI: 5.6-14.6), respectively. No significant differences were noted regarding the relationship hearing loss and mean serum ferritin (P=0.29) and average daily deferoxamine (P=0.30). Meta-regression model showed an increased significance in the prevalence of hearing loss based on the year of studies (p There is a high prevalence of hearing loss in Iranian thalassemia major patients treated with deferoxamine. Therefore, periodic hearing assessments and regular check-ups after the initiation of chelation therapy are necessary.

Previous studies have reported endothelial dysfunction and inflammatory cytokine in heart failure patients (HF)..
The purpose of this study was to determine the effects of creatine monohydrate and exercise on inflammatory and endothelial dysfunction markers among HF patients..
Patients and One hundred patients were prospectively randomized into two groups: Intervention group which received 5 grams/day creatine monohydrate and exercised for 8 weeks; and control group which did not receive any interventions. Interleukine-6 (IL-6), high sensitivity C reactive protein (hs-CRP), P-selectin, intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule 1 (VCAM-1) were measured at the start and end of the study for both groups..
In total, 100 patients including 50 controls and 50 intervention group (54% male, mean EF of 34.2 ± 10.5% and 52% male, mean EF of 35.6 ± 12.7%, respectively) were analyzed. The serum levels of hs-CRP and IL-6 increased at the end of the study in the control group compared to the baseline, (7.5 ± 1.5 mg/L vs. 6.9 ± 1.3 mg/L, P 0.05)..
Combination of creatine monohydrate and exercise attenuated inflammation and endothelial dysfunction markers among heart failure patients..