Problems In Iran Research Articles

Epidemiology of illicit drug use disorders in Iran: prevalence, correlates, comorbidity and service utilization results from the Iranian Mental Health Survey.

Drug abuse is a significant social and public health problem in Iran. The present study aimed to provide prevalence estimates and information on correlates of illicit drug use disorder and opioid dependence, as well as service use for these disorders in Iran. This report is based on the Iranian household Mental Health Survey (IranMHS) conducted in 2011. A three-stage probability sampling was employed. Face-to-face interviews by trained psychologists were carried out with a nationally representative sample of 7841 individuals (3366 men and 4475 women) aged 15-64 years. The Composite International Diagnostic Interview and questionnaires for socio-demographic correlates and service use. The prevalence of 12-month use disorders for any illicit drug according to DSM-IV and DSM-5 criteria were 2.09% [95% confidence interval (CI) = 1.70-2.47%] and 2.44% (95% CI = 2.03-2.85%), respectively. Opioid use disorders, and opium in particular, were the most common use disorder. The odds of drug use disorders were greater in men than in women, in previously married participants than in currently or never married participants, and in participants with lower socio-economic status than in those with higher socio-economic status (all P-values <0.05). Approximately half of those with drug use disorders and 40% with opioid dependence had a 12-month unmet need for treatment. Self-help groups were the most common type of service used, followed by obtaining medication from pharmacies directly and outpatient treatment services. Opioid use disorders are the most common type of drug use disorders in Iran, setting Iran apart from many other countries. Patterns of service use suggest a large unmet need for drug use disorder treatment in Iran.

The Impact of Gender Differences on Healthy Lifestyle and its Subscales Among Patients With Coronary Artery Disease

Background: Coronary artery disease (CAD) is one of the major causes of death and disability all over the world. The increasing prevalence of CAD as well as its high economic cost makes it a serious health problem in Iran. Objectives: The study aimed to evaluate the impact of gender differences on healthy lifestyle measures among patients with CAD. Patients and Methods: In this descriptive cross-sectional study, 412 patients with CAD (239 men and 173 women) were selected between February 2014 and May 2015. Data were collected by demographic characteristic forms and a healthy lifestyle questionnaire. The data were analyzed using SPSS software with appropriate statistical tests. Results: There was no significant difference in age, blood pressure, and cholesterol between the two genders (P = 0.573, P = 0.092, P = 0.438). Men were more educated than women (P = 0.000), and had higher levels of low-density lipoprotein and high-density lipoprotein (P = 0.000). The mean of healthy lifestyle scores was 19.2 ± 4.2 for the men and 18.8 ± 3.2 for the women. Overall, there was no significant difference between two genders in healthy lifestyle scores (P = 0.342). However, among the healthy lifestyle subscales, women had healthier nutrition (P = 0.000) and were less inclined to smoke and drink than men (P = 0.000). Men had more physical activity (P = 0.000), more health responsibility (P = 0.000), and more health-based purchases (P = 0.000). There was no significant difference between the two genders in stress management (P = 0.272). Conclusions: The results indicated that the patients’ lifestyles were unhealthy overall. However, tendency towards healthy behaviors was different between men and women. Therefore, it is important and necessary to emphasize gender differences in prevention and health promotion programs.

Proposing a Novel Adaptive Learning Management System: An Application of Behavior Mining &amp; Intelligent Agents

AbstractNowadays, the internet has become one of the main resources for distance education, learning or training purposes. Various learning management systems (LMSs) have been designed for providing various services to learners in all parts of the world. Each of these LMSs has some similarities or differences with others regarding to capabilities or services. One of the main problems in Iran is teaching foreign languages to people with different genders, experiences, jobs, educational levels, etc. People need to learn English for different purposes, but unfortunatly, all the learning matrials are similar for all the learners without considering their capabilities, age, actual usage, etc. This paper attempts to design a personalized LMS for teaching foreign language to people whose native language is not English. Our experimental results indicated that the proposed LMS is useful for teaching conversation or grammar of foreign languages such as English language even to illiterate people or those with low ed...

Trends in Incidence of Common Cancers in Iran.

Cancer is a major public health problem in Iran. The aim of this study was to evaluate trends in incidence of ten common cancers in Iran, based on the national cancer registry reports from 2004 to 2009. This epidemiological study was carried out based on existing age-standardized estimate cancer data from the national report on cancer registry/Ministry of Health in Iran. The obtained data were analyzed by test for linear trend and P ≥ 0.05 was taken as the significant level. Totals of 41,169 and 32,898 cases of cancer were registered in men and females, respectively, during these years. Overall age-standard incidence rates (ASRs) per 100,000 population according to primary site weres 125.6 and 113.4 in males and females, respectively. Between 2004 and 2009, the ten most common cancers (excluding skin cancer) were stomach (16.2), bladder (12.6), prostate (11), colon-rectum (10.14), hematopoeitic system (7.1), lung (6.1), esophagus (6.4), brain (3.2), lymph node (3.8) and larynx (3.4) in males; and in females were breast (27.4), colon-rectum (9.3), stomach (7.6), esophagus (6.4), hematopoeitic system (4.9), thyroid (3.9), ovary (3.6), corpus uteri (2.9), bladder (3.2) and lung (2.6). Moreover, results showed that skin cancer was estimated as the most common cancer in both sexes. The lowest and the highest incidence in females and males were reported respectively in 2004 and 2009. Over this period, the incidence of cancer in both sexes has been significantly increasing (p<0.01). Like other less developed and epidemiologically transitioning countries, the trend of age-standardized incidence rate of cancer in Iran is rising. Due to the increasing trends, the future burden of cancer in the Iran is going to be acute with the expected increases in aging populations. Determining and controlling potential risk factors of cancer should hopefully lead to decrease in its burden.

Review of Stroke: The 2nd International and the 8th National Iranian Stroke Congress : Shiraz, Iran

Dear reader,&#x0D; Stroke is a major health problem in Iran as other developing countries. Meanwhile, epidemiological characteristics of stroke in Iranian population are different with other countries. Both  population-based and hospital-based studies showed that  incidence and mortality of stroke in Iran is higher than most western countries [1,2]. Higher rates of patients with young-adult stroke in Iranian population are a prominent feature too [3]. In the same time, prevalence of cerebral venous sinus thrombosis is higher than western populations [4] but the frequency of the intracranial stenosis is more or less same as Europeans [5]. The high prevalence of atherosclerotic disease in Iran can be attributed to social and economic factors, including increased life span, changes in dietary habits and an increasingly sedentary lifestyle [6]. In the light of these changes, Iranian health policymakers should consider concerted primary and secondary preventive measures to reduce the impact of this increasingly problematic public health issue.&#x0D; Iranians who have had a stroke consider their social, financial and rehabilitative support to be inadequate. Moreover, awareness of the manifestations of stroke is poor in the Iranian general population [7]. Consequently, the clinical status of stroke patients by the time they are transferred to the referral center may be worse than it could have been. There is an urgent need for Iranian hospitals to develop better measures to manage acute stroke patients.&#x0D; The second international Iranian stroke congress was held from 23-25 September 2015 in Shiraz, Iran. This Conference was a joint effort of the Clinical Neurology Research Center of Shiraz University of Medical Sciences and Iranian Stroke Association.&#x0D; Here we presented  some selected reviews from outstanding platforms of this congress. Ghandehari presented the epidemiology of stroke in Iran [8]. Safari et al presented a comprehensive review about immunology of stroke [9]. Abolhasani-Foroughi and Nazeri  summarized the role of Computed topography scan for diagnosis and treatment planning of stroke patients [10].&#x0D; Lotfi discussed about pearls and pitfalls of color doppler sonography of cervical arteries [11]. We also have three reviews about clinical and radiologic aspects of cerebral venous sinus thrombosis [12-14]. Two reviews focused on importance of rehabilitation in new stroke era [15,16].&#x0D; Â

Review of Stroke: The 2nd International and the 8th National Iranian Stroke Congress : Shiraz, Iran

Dear reader,Stroke is a major health problem in Iran as other developing countries. Meanwhile, epidemiological characteristics of stroke in Iranian population are different with other countries. Both population-based and hospital-based studies showed that incidence and mortality of stroke in Iran is higher than most western countries [1,2]. Higher rates of patients with young-adult stroke in Iranian population are a prominent feature too [3]. In the same time, prevalence of cerebral venous sinus thrombosis is higher than western populations [4] but the frequency of the intracranial stenosis is more or less same as Europeans [5]. The high prevalence of atherosclerotic disease in Iran can be attributed to social and economic factors, including increased life span, changes in dietary habits and an increasingly sedentary lifestyle [6]. In the light of these changes, Iranian health policymakers should consider concerted primary and secondary preventive measures to reduce the impact of this increasingly problematic public health issue.Iranians who have had a stroke consider their social, financial and rehabilitative support to be inadequate. Moreover, awareness of the manifestations of stroke is poor in the Iranian general population [7]. Consequently, the clinical status of stroke patients by the time they are transferred to the referral center may be worse than it could have been. There is an urgent need for Iranian hospitals to develop better measures to manage acute stroke patients.The second international Iranian stroke congress was held from 23-25 September 2015 in Shiraz, Iran. This Conference was a joint effort of the Clinical Neurology Research Center of Shiraz University of Medical Sciences and Iranian Stroke Association.Here we presented some selected reviews from outstanding platforms of this congress. Ghandehari presented the epidemiology of stroke in Iran [8]. Safari et al presented a comprehensive review about immunology of stroke [9]. Abolhasani-Foroughi and Nazeri summarized the role of Computed topography scan for diagnosis and treatment planning of stroke patients [10].Lotfi discussed about pearls and pitfalls of color doppler sonography of cervical arteries [11]. We also have three reviews about clinical and radiologic aspects of cerebral venous sinus thrombosis [12-14]. Two reviews focused on importance of rehabilitation in new stroke era [15,16].

A Systematic Review on the Prevalence of Overweight and Obesity, in Iranian Children and Adolescents.

ContextObesity has now become a common health problem worldwide. To gain insight into the epidemiology of the problem in Iran, we systematically reviewed all available studies on the prevalence of overweight and obesity in the Iranian pediatric population.Evidence AcquisitionWe systematically searched PubMed, ISI, SCOPUS, as well as Iranmedex, Irandoc, and Scientific Information Database (SID) databases.All studies on mean and standard deviation or percentile categories of BMI, WC, WHR, or WHtR or prevalence of obesity/overweight in Iranian child and adolescence, were performed from January 1990 to the end of December 2013. Refining processes were conducted by two independent reviewers. Quality assessment and data extraction followed based on validated form. As, these data were heterogeneous, meta-analysis was not performed.ResultsFrom 3253 records, through three refining steps, 129 articles were found related to our study. In Iran, national studies are limited and nearly there is no comprehensive study for sub-national trends. Different age and sex groups had large variations in the prevalence of obesity and overweight (from 1% up to 16.1% and from 4.4% up to 42.3% respectively for obesity and overweight). ConclusionsRelated data are very scattered or limited to some specific subgroups in some living areas. For comparing, aggregating, and imputing the information we need more modern practical statistical methods.

Isolation and identification of cutaneous leishmaniasis species by PCR-RFLP in Ilam province, the west of Iran.

Cutaneous leishmaniasis (CL) is one of the most common parasitic diseases and public health problems in Iran. CL is endemic in most parts of Ilam province, in the west of Iran. The distance from the center of country, the great number of divers rural areas, and lack of specialists and laboratory facilities have been the major causes of Leishmania species remaining unknown in this region. Polymerase chain reaction followed by restriction fragment length polymorphism was performed to identify the Leishmania species in 61 patients with cutaneous lesions. Eventually L. major was confirmed as the cause of cutaneous leishmaniasis in Ilam province, the west of Iran.

Central Nervous System Hydatid Disease

Objectives: Hydatid diseases are both a medical and an economic problem in Iran, especially in the rural areas. The aim of this study was to analyze brain involvement in this disease, the related problems, the causes, and its diagnostic and therapeutic aspects. Materials and Methods: Medical records of 99 patients with cerebral hydatid disease treated between 1977 and 2013 in Qaem hospital were retrospectively reviewed. Clinical presentations, radiologic examinations, treatment modalities, and outcomes of the patients were analyzed. Results: Ninety-nine patients with hydatid disease of neuraxis underwent 149 operations. Of the 99 patients, 68 cases had primary cerebral hydatid cysts, 18 cases had unusual hydatid cysts of neuraxis (orbit: 3; spinal cord: 3; cerebellum: 3; cranial epidural: 1; bilateral hemispheric: 8), and 13 cases had >1 operations because of having multiple cysts. All patients were treated surgically. Complications related to surgery were observed in 4 patients. There were no recurrences or residual cysts among the patients. Conclusions: Hydatid disease should be considered in the differential diagnosis of intracranial space-occupying lesions in developing countries where there are still lots of rural areas and the quality of life is not good. Early diagnosis of cerebral hydatid cysts may prevent serious life-threatening complications of this disease. Outcome is favorable when the cyst is completely removed without rupture.

Characteristics of Co-Dependence Among Wives of Persons with Substance Use Disorder in Iran

Substance use disorder is known to adversely affect both the user as well as his or her family members. A consequence of chemical dependence on family members is co-dependence. Co-dependence is associated with an excessive focus on the needs and behaviors of the person with substance use disorder. Most studies in the field of drug-related problems in Iran have focused on the substance user, while few studies have been carried out on the family members. A qualitative case study approach was employed to explore characteristics of co-dependence among wives of persons with substance use disorder in Iran where substance use disorder is a notable social harm. Purposive snowball sampling technique was used to identify 11 Iranian wives of individuals with substance use disorder. The data were collected through in-depth, face-to-face interviews, non-participation observation, and document analysis. Data were analyzed using the constant comparative method. The analysis yielded five main characteristics of co-dependence among wives of persons with substance use disorder, namely: Denial, enabling behavior, low self-worth, enmeshed self, and weak spiritual relationship with God. The findings showed that except for a weak spiritual relationship with God, most of the characteristics of co-dependence among the participants were similar to the traits of co-dependents found in previous studies conducted outside Iran.

The Effect of Consanguineous Marriage on Mental Health among the Students of the Shahrekord University of Medical Sciences

In Iran, after unintentional accidents, mental health problems are the second leading burden of disease. Consanguineous marriage is very common in Iran and the association between parental consanguinity and mental health is an important issue that has not yet been studied sufficiently in Iran. To investigate the effect of consanguinity and the degree of relationship on different levels of mental health. In this cross-sectional study, conducted in the Shahrekord University of Medical Sciences, two groups of students were enrolled. The first group consisted of 156 students that had consanguineous parent (case group) and the second group was 156 students whose parents had non-blood relationship (control group). The students were evaluated using General Health Questionnaire (GHQ-28). Statistical analysis was conducted by Pearson's correlation coefficient, independent t-test and the one-way analysis of variance. Odd ratio was used to estimate the relative risk. Over 30% of the individuals were suffering from mental health problems. The most and least common mental health problems in both groups were social dysfunction (54.5% in the case group and the control group 50%) and depression (15.4% in the case group and 17.3% in the control group), respectively. No statistically significant difference was observed in the frequency of overall mental health and its subscales between student with non-consanguineous parent (control group) and the students that had consanguineous parent (case group) (p>0.05) and the status of mental health was not significantly different among student with different degree of kinship (p>0.05). The study revealed that social dysfunction was very common among the study students and also there were no relationship between parental consanguineous marriage and mental health. Parental consanguinity and genetic factors may not be the major causes of high prevalence of mental health problems in Iran and the effects of the environmental factors on these problems may be greater than those of the inherited ones.

Prevalence and Antibiotic Susceptibility of Shigella Species Isolated From Pediatric Patients in Tehran

Background: Dysentery accounts for a significant proportion of morbidity and mortality cases, especially in children with diarrhea in developing countries. Shigellosis remains a public health problem in Iran. Objectives: The objectives of this study were to investigate the presence and the frequency of Shigella spp. among children younger than 10 years with diarrhea and to determine the antimicrobial resistance patterns of these isolates in Tehran, Iran. Patients and Methods: This cross-sectional study was conducted in two pediatric hospitals in Tehran, from October, 2013 to October, 2014. Nine hundred and thirty-eight (n = 938) stool samples were collected (one stool per patient) from children less than 10 years of age. The stools were primarily cultured on MacConkey agar and xylose lysine deoxycholate (XLD). (Selenite-F broth is also used as an enrichment medium for the isolation of Shigella spp.) All of the isolates were confirmed as Shigella species by biochemical and serological tests. Molecular confirmation of Shigella isolates was determined by polymerase chain reaction (PCR) using specific primers for the ipaH gene. The antibiotic susceptibility of the Shigella isolates was tested using the Kirby-Bauer disc-diffusion method. Results: Amongst 938 stool samples, 36 were Shigella spp. S. sonnei (61.1%, n = 22), which was the most common, followed by S. flexneri (27.8%, n = 10), S. boydii (8.3%, n = 3), and S. dysenteriae (2.8%, n = 1). Furthermore, most Shigella isolates showed resistance to amoxicillin (83.3%), tetracycline (61.1%), and co-trimoxazole (83.3%). No resistance was found against ciprofloxacin and imipenem. This study showed that S. sonnei is currently the predominant species in Tehran, Iran. Conclusions: Because resistance to antibiotics changes constantly, Shigella strains should be under surveillance in order to monitor local susceptibility and subsequently formulate policies for the use of antimicrobial drugs.

Adaptive meta-modeling-based simulation optimization in basin-scale optimum water allocation: a comparative analysis of meta-models

Incorporating river basin simulation models in heuristic optimization algorithms can help modelers address complex, basin-scale water resource problems. We have developed a hybrid optimization-simulation model by linking a stretching particle swarm optimization (SPSO) algorithm and the MODSIM river basin decision support system (DSS), and have used the SPSO-MODSIM model to optimize water allocation at basin scale. Due to high computational cost of the SPSO-MODSIM model, we have, subsequently, used four meta-model types of artificial neural networks (ANN), support vector machines (SVM), kriging and polynomial response functions, replacing the MODSIM DSS, in an adaptively learning meta-modeling approach. The performances of the meta-models are first compared in two Ackley and Dejong benchmark functions optimization problems, and the meta-models are then evaluated by solving the Atrak river basin water allocation optimization problem in Iran. The results demonstrate that independent of the meta-model type, the sequentially space-filling meta-modeling approach can improve the performance of meta-models in the course of optimization by adaptively locating the promising regions of the search space where more samples need to be generated. However, the ANN and SVM meta-models perform better than others in saving the number of costly, original objective function evaluations.

Iranian EFL Teachers’ Challenges with the New ELT Program after the Reform: From Dream to Reality

There is no doubt concerning the interdependence of educational progress with human development, socio-economic growth, greater opportunities, welfare, and political stability. Hence,for further development and growth of education,transformations and reforms in curriculum are required to reflect the latest changes in theories and praxis of the modern world (Fterniati, 2006). In Iran, due to the inadequacy of the preceding ELT education policies in developing students’ communicative skills and capabilities, a reform occurred in the ELT program as new communicative based textbooks entitled as “English for School Series” and CLT pedagogywere introduced into the context of public schools. However, implementation of the innovative curriculum was associated with different feedback from English teachers. This qualitative study is, indeed, an attempt to explore concerns, problems, and constraints that EFL teachers experienced through the revolutionary reform of the ELT education. Thus, based on stratified purposive sampling, the researchers selected 35male and female teachers of English at grades one and two of junior high schools from both urban and rural regions of Tehran, Shiraz, and Yazd, Iran.The researchers usedtranscription and codification of data gathered through semi-structured interview to find the emergent themes concerning teachers’ challenges and problems in Iran. The findings also indicated that if the new English language reform and policy turn out to be successful at the national level, the government is necessarily required to take actions towards elimination of the potential impediments which block the materialization of the new curriculum.

Analysis of the Environmental Challenges of Rural Areas in Guilan Province with Emphasis on Solid Waste (Case Study: Bandar Anzali, Rasht and Roudbar)

Analysis of the Environmental Challenges of Rural Areas in Guilan Province with Emphasis on Solid Waste (Case Study: Bandar Anzali, Rasht and Roudbar)

Assessment of Knowledge, Attitude and Practice toward Vectors Control Programs among Managers of the Schools in Neka, Iran

Background and purpose: Vector-borne diseases such as Malaria and Leishmaniasis are still a public health problem in Iran. One of the effective ways to prevent of these diseases is to improve the vector control program. We carried out this study for assessment managers of school knowledge, attitude and practice regarding vector c ontrol programs. Materials and Methods: A cross-sectional study was conducted during October to September 2008 in Neka County, Iran. The participants were 18 managers of school that were selected randomly sampling. The data were collected through a questionnaire that was comprised four sections. All statistical analyses were performed u sing SPSS software . Results: The finding showed that only 34% of participants ha d a positive attitude toward the vector control program. Furthermore, 55.6% of parti cipants were agreed with chemical vector control method. Conclusion: The knowledge of participants was rather good abou t vector control. Since, Community education is a key factor to improve vector control program, we suggest strengthening the vector control education program at different levels of the community. [Nikookar SH, Pashaeei T, Nikzad D, Moosa-Kazemi SH, *Davari B. Assessment of Knowledge, Attitude and Practice toward Vectors Control Programs among Managers of the Schools in Neka, Iran . Iran J Health Sci 2015; 3(3): 58-62] http://jhs.mazums.ac.ir

Effect of Al-Anon attendance on family function and quality of life in women in Mashhad, Iran

Background: Al-Anon self-help group is the sole source of assistance for families whose members suffer from alcohol abuse problems in Iran. Objectives: To assess the effects of Al-Anon meeting attendance on family function and quality of life of women living with husbands with alcohol use disorders. Methods: The study was conducted among two groups of women first time participants in Al-Anon (n = 40) and participants who had attended Al-Anon for at least six months (n = 40) in Mashhad, Iran. Participants were administered the Quality of Life Short Form (QOL SF-36) and Family Assessment Device (FAD). Results: There was a significant group difference in the QOL SF-36 total as well as in the sub-scores of role limitations due to physical problems, role limitations due to emotional problems, vitality, pain, and social functioning sub-scores. No significant group differences were observed in FAD sub-scores, except for the subscale of problem solving. Conclusion: These findings suggest Al-Anon, when other structured therapeutic interventions are not available, may be of particular benefit for quality of life issues in women attendees.

Incidence Trend and Epidemiology of Common Cancers in the Center of Iran.

Introduction:Cancer is a major public health problem in Iran and many other parts of the world. The cancer incidence is different in various countries and in country provinces. Geographical differences in the cancer incidence lead to be important to conduct an epidemiological study of the disease. This study aimed to investigate cancer epidemiology and trend in the province of Qom, located in center of Iran.Method:This is an analytical cross-sectional study carried out based on re-analysis cancer registry report and the disease management center of health ministry from 2004 to 2008 in the province of Qom. To describe incidence time trends, we carried out join point regression analysis using the software Join point Regression Program, Version 4.1.1.1.Results:There were 3,029 registered cases of cancer during 5 years studied. Sex ratio was 1.32 (male to female). Considering the frequency and mean standardized incidence, the most common cancer in women were breast, skin, colorectal, stomach, and esophagus, respectively while in men the most common cancers included skin, stomach, colorectal, bladder, and prostate, respectively. There was an increasing and significant trend, according to the annual percentage change (APC) equal to 8.08% (CI: 5.1-11.1) for all site cancer in women.Conclusion:The incidence trend of all cancers was increasing in this area. Hence, planning for identifying risk factors and performing programs for dealing with the disease are essential.

Prevalence of Tramadol Consumption in First Seizure Patients; a One-Year Cross-sectional Study.

Previous studies have shown that there is a probability of seizure even with therapeutic doses of tramadol. Yet, no accurate data exist regarding this problem in Iran. Therefore, the present study aimed to evaluate the prevalence of tramadol consumption in patients with first seizure referred to the emergency department (ED). In the present retrospective one-year cross-sectional study, all patients who were referred to the ED of Poursina Hospital, Rasht, Iran, with the complaint of first seizure were evaluated. Demographic data and data regarding history of tramadol consumption, duration, total dose, last dose, and time passed from the last dose of consumption were recorded and analyzed regarding the study questions using SPSS 20. 383 (68.9%) out of the 556 patients referred to the ED, were experiencing their first seizure (mean age 26.43 ± 6.48 years; 70.5% male). 84 (21.9%) patients had recently used tramadol. History of seizure in the family of tramadol consumers was significantly lower (3.6% compared to 11%; p = 0.036). Mean total tramadol consumption dose in the last 24 hours was 140.17 ± 73.53 mg (range: 50-300 mg). Duration of tramadol consumption was less than 10 days in 84.5% (df: 2; χ(2) = 96.1; p < 0.001). In addition, 62 (73.8%) patients had seizure within 6 hours of consumption (df: 3; χ(2) = 29.5; p < 0.001). Results of the present study showed that 21.9% of the patients with first seizure had a history of tramadol consumption. Seizure following tramadol consumption is more prevalent in the initial 10 days and within 6 hours of consumption. In addition, it seems that lower doses of tramadol may also induce seizure.

Cyanide poisoning related deaths, a four-year experience and review of the literature

Cyanide has been used as a poison for thousands of years. Symptoms of cyanide poisoning begin quickly and death occurs within minutes. In this study, we review 52 cyanide poisoning cases in Tehran, Iran, over a four-year interval, from 30 December 2009 to 1 January 2014. Toxicological analysis and post-mortem findings are discussed. Colour test (Prussian Blue) was used for screening for cyanide with confirmation using the voltammetry method. The youngest decedent was a 2-month old girl. Men constituted 76.9% (40) of the total 52 victims. Peak age prevalence of cases was seen in age groups 21–40 years (32 cases, i.e. 61.5%). Methadone and opioid alkaloids were the most common drugs detected in biological samples in this study. A suicide attempt was the main cause of poisoning in 33 cases. The results showed that cyanide-poisoning-related deaths are among the most public health problems in Iran. Restricted access to cyanide and stricter buying and selling controls may reduce intentional self-poisoning with this dangerous substance.