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Background: The prevalence of smoking is much higher in prisoners than it is in the general population. Prisoners who smoke cause many health problems for themselves and other prisoners. Therefore, we should help them stop smoking. Objective: To compare the effects of motivational interviewing-based (MI-based) treatment and its combination with nicotine replacement therapy (NRT) on smoking cessation in prisoners at Mashhad Central Prison. Methods: The study was designed as a double-blind, randomized, controlled clinical trial, and it began in February 2013 and ended in February 2014. Two hundred and thirteen prisoners met the inclusion criteria and were enrolled in the study. They were divided randomly into three groups, i.e., MI-based treatment, MI with NRT, and the control group, which didn't receive any therapy. The outcome measures were reported after intervention and at a 90-day follow-up, and changes in the CO levels in expired air and nicotine dependency were measured. Results: The average age of the subjects was 37.59 ± 8.76, and their mean duration of imprisonment was 3.3 ± 1.90 years. They smoked an average of 21.84 ± 8.72 cigarettes per day. Analysis of the concentration of CO in expired air in the pre-test, post-test, and at the follow-up for the three groups showed that the variations in the mean CO concentrations in the MI group and the MI with NRT group at the pre-test and at the post-test were statistically significant (p < 0.001), but no significant changes occurred between the post-test and the follow-up (p > 0.050). In addition, the results indicated that CO concentration in expired air in the MI with NRT group was statistically significant, with better efficacy of smoking cessation, compared with control group and the MI group after the follow-up (p = 0.02). Conclusions: Motivational interviewing combined with NRT for smoking cessation is more effective than MI alone, and it resulted in a significant decrease in the CO concentration in expired air at the 90-day follow-up. [ABSTRACT FROM AUTHOR]

Background: The Persian Gulf is a suitable habitat for various types of marine species. This study was conducted with the aim of determining the epidemiology and clinical findings of injuries inflicted by marine creatures in the Persian Gulf, south Iran. Methods: In this retrospective cross-sectional study, medical records of patients with diagnosis of marine animal exposures treated at 6 referral clinics in Bushehr province, south Iran, during 2009-2014 were studied. Results: Ninety-eight patients were studied whose mean (SD, Min - Max) age was 23.6 (7.0, 14-57) years. The majority of patients (91, 92.9%) were men. Scorpionfish stings were the most common cause of injuries (56.1%) followed by jellyfish stings (22.4%), stingray stings (13.3%) and sea urchin stings (8.2%). In most cases (60.2%), the location of injury was on lower limbs. The most common symptom was pain. Marked local swelling was detected in 69.1% of scorpionfish stings and 100% of stingray stings. Itching and hives were seen in 100% and 36.3% of jellyfish stung patients. Gastrointestinal manifestations were the most common systemic effects. Muscle cramps and transient local paralysis were reported in 38.7 % and 23 % of stingray patients, respectively. Serious systemic effects were rare except for symptomatic hypotension in a scorpionfish sting patient and syncope in a stingray sting patient. The vast majority of patients (93.9%) recovered without notable sequels. Secondary dermal infections were only observed in 1 stingray inflicted victim and 4 sea urchin stung victim. No death occurred. Conclusion: Scorpionfish attacks are the common cause of marine animal exposures in south Iran and should be taken seriously. Men at young ages are the victims of this environmental and occupational hazard. [ABSTRACT FROM AUTHOR]

Copyright of Future of Medical Education Journal is the property of Mashhad University of Medical Science and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Few methods have been introduced to assess the level of consciousness in critically-ill patients. This study was designed to evaluate how the Alert\Verbal\Painful\Unresponsive (AVPU) responsive scale corresponds with the Glasgow Coma Scale (GCS) and Richmond Agitation-Sedation Scale (RASS) scores in drug-poisoned patients and to devise an augmented AVPU scale. Methods: In this prospective study, patients with diagnosis of acute drug poisoning were included and their level of consciousness was assessed using GCS, RASS and AVPU scales. Results: Overall, 165 poisoned patients (59% female) were studied. According to AVPU scale, 123 patients (74.5%) were graded as "alert", 26 patients (15.8%) as "responsive to verbal stimulation", 10 patients (6.1%) as "responsive to painful stimulation", and 6 patients as "unresponsive" (3.6%). AVPU grades of "alert", "responsive to verbal stimulation", "responsive to painful stimulation" and "unresponsive" corresponded with median [IQR] GCS scores of 15 [15-15], 13 [12-13], 8 [7-10] and 6 [5-6], and median [IQR] RASS scores of -1 [-1 - +1], -2 [-3 - -1], -3 [-4 - -1], -5 [-5 - -5], respectively. By taking the median of RASS scores corresponding with each AVPU grade, an augmented AVPU scale for the assessment of consciousness was devised. The first proposed version of AVPU plus includes 14 qualitative grades of consciousness. By application of this scale, clinicians can evaluate both the alertness/attentiveness and arousal/excitability of poisoned and critical patients. Conclusion: The AVPU plus is a new scale designed for more detailed assessment of neurologic status of poisoned and critical patients. The prognostic-ability, reliability and validity of the scale should be investigated in future studies. [ABSTRACT FROM AUTHOR]

Background: In Asia Pacific (AP) region, the exact picture of the alcohol use problems has remained relatively obscure. In this study, the profile of alcohol consumption and alcohol related disorders in AP countries are presented. Methods: Official statistics on average alcohol consumption (alcohol per capita consumption, APC), alcohol related health variables, income group and alcohol policy of countries geographically related to Asia and Oceania continents were extracted from the 20 14 edition of World Health Organization report on global status of alcohol and health. Results: The data of 57 AP countries were analyzed. Two-third of the countries did not establish comprehensive national monitoring systems (NMSs). Median of total APC in people aged 15 years and older was 2.4 (1-4.6) L during 2003 to 2005, while this indicator was 2.8 (1-5.5) L during 2008 to 2010 which accounts for about 0.4 L (in median) increase in consumption. In 13 countries which were mostly located in South-east Asia and the Pacific region, APC was higher than average global consumption. Comparing the countries with and without total ban policy, the countries with total ban policy had significantly lower APC (P = 0.003), higher rate of abstainers (P = 0.002) and lower rate of alcohol related disorders (P < 0.001). Higher APC and higher rates of alcohol related disorders were observed in higher income countries. Conclusion: Alcohol consumption in AP region is comparatively lower than global average. However, the status of some countries in Southeast Asia and Pacific region is alarming and needs serious attention. Moreover, establishment of comprehensive NMSs, proper data registry and holistic harm reduction and rehabilitation programs for users should receive meaningful governmental and public support. [ABSTRACT FROM AUTHOR]

Background: Rhabdomyolysis is a clinical and biochemical syndrome, which is observed in some patients with acute chemical and/ or pharmaceutical poisonings. We aimed to investigate rhabdomyolysis in patients with acute poisonings due to different chemicals, natural toxins or drug overdose. Materials and Methods: Following approval of the University medical research committee and obtaining informed consents from the patients or their relatives, all patients with acute poisonings who were treated between March 2009 and February 2010 in the Toxicologic Ward of Imam Reza Hospital and had serum creatine phosphokinase (CPK) above 975IU/L (as a definition for rhabdomyolysis) were studied. Results: Of 3555 hospitalized poisoned patients, 114 patients had rhabdomyolysis with CPK of 5996 ± 892 IU/L (mean ± standard error). The most common intoxication to induce the rhabdomyolysis was opioid overdose (28%). Acute renal failure (ARF) was diagnosed in 11 (8.7%) patients. There was a linear correlation between CPK and creatinine (P < 0.001), which in turn had a significant correlation with death (P < 0.05). Conclusion: Patients with acute poisoning were at risk of rhabdomyolysis. Acute opioid poisoning was the most common cause of toxic rhabdomyolysis in the intoxicated patients, and ARF was the main complication. [ABSTRACT FROM AUTHOR]

Background: Morning reports (MRs) are commonly used as an efficient technique in Medical Education. This study was intended to assess the developmental process following Iranian definable standards in the Internal Medicine Department, Imam Reza General Hospital, Mashhad, Iran. Methods: Following an initial one-month assessment through direct observation of morning reports held in Imam Reza Hospital Internal Medicine Department, workshops were run for 6 weeks aiming at rectifying the flaws and reforming the trends practiced contrary to current standards. Checklists were filled by the attending researcher, subsequent to which feedback was given regarding possible flaws and/or challenges to the attending physicians. Reforms as well as alteration s were urged to improve the status quo, which were eventually accepted and implemented by the Head of Department. Reassessment was conducted six weeks afterwards, using checklists having been prepared in advance. An equal number of MR Sessions (n=25) was evaluated prior to and following the Reform Scheme. Results: Significant differences can be seen in the level of participation by nephrologists, infectious disease specialists and clinical pharmacologists after the scheme (P<0.001). Better arrangements were made between the coordinator and the resident in charge prior to the MR session, mainly via short text messages (44%). This encompassed the case selection, number of cases to be presented and the chief objective behind these presentations. Of the total of 65 patients presented, 50 (77%) were complicated ones whereas common disorders only reported in 6% of the cases. Presentations became growingly shorter in case of the first cases (P=0.022) while second and third ones took as much time as prior to the Reformation Scheme. There could be seen no considerable improvement in the accuracy of the final diagnoses yet punctuality was reported to have improved significantly as morning reports routinely and regularly commenced at 8 a.m. following alterations(P=0.025). A significant rise in the number of cases presented and discussed in every meeting (p=0.006). Conclusions: Training and feedback seem to have improved the quality of morning reports in different respects, especially when augmented by applying national as well as international standards used in this and other studies. [ABSTRACT FROM AUTHOR]

Evaluation of scientists working in a specific area of science is necessary, as they may strive for same limited resources, grants and academic promotions. One of the most common and accepted methods of assessing the performance and impact of a scientist is calculating the number of citations for their publications. However, such method suffer from certain shortcomings. It has become more and more obvious that evaluation of scientists should be qualitative in addition to quantitative. Moreover, the evaluation process should be pragmatic and reflective of the priorities of an institution, a country or an intended population. In this context, a scoring scale called "360-degree researcher evaluation score" is proposed in this paper. Accordingly, scientists are evaluated in 5 independent domains including (I) science development, (II) economic impact, (III) policy impact, (IV) societal impact and (V) stewardship of research. This scale is designed for evaluation of impacts resulted from research activities and thus it excludes the educational programs done by a scientist. In general, it seems necessary that the evaluation process of a scientist's impact moves from only scintometric indices to a combination of quantitative and qualitative indices. [ABSTRACT FROM AUTHOR]

Objective: Cultural factors may influence health. Street drugs (SDs) and traditional medicines are commonly used in Iran. Opium has been recommended for pain relief and diarrhea in Iranian traditional medicine. This study seeks to explain the potential knowledge, attitude and practice of students towards the therapeutic effects of SDs. It further seeks to hypothesize cultural and ethnic related SDs use. Methods: A construct validated questionnaire was piloted and used. Over 800 students of Mashhad University of Medical Sciences, Iran were invited to participate in this study ranging in age from 16 to 52 years and included 520 females and 289 males, respectively. Results: Knowledge of potential therapeutic use of SDs, declared by 73%, was significantly associated with attitude (odds ratio (CI 95%) 1.62 (1.11, 2.37) and the recommendation of use to others (1.79 (1.08, 2.97)). Conclusion: Growing use of SDs is, at least in part, influenced by being marketed as medications. Drug abuse could be culturally or ethnically oriented. [ABSTRACT FROM AUTHOR]

Background: Running standard journal clubs is one of the important goals of postgraduate education. Students should update their knowledge and learn critical appraisal skill. This study aimed to compare quality of journal clubs in Mashhad Dental School in order to improve educational and appraisal structure of journal clubs. Methods: This quasi-experimental study was conducted on journal clubs of Mashhad dental school. Journal clubs were evaluated and compared using a valid and reliable (r= 0.74) checklist before and after an educational workshop. Data were analyzed using SPSS: 11.5 by paired T-Test (CI= 95 %) Results: There was a significant difference before and after intervention in terms of educational structure, however no critical appraisal was conducted. Conclusion: As to the results, it is recommended to refresh faculty members and postgraduate students in terms of educational and appraisal structure of journal clubs. It seems teaching critical appraisal is more important. [ABSTRACT FROM AUTHOR]

Background: In recent decades, the science of toxicology in Asia Pacific (AP) region has been expanding. In this study, the productivity of the science of toxicology in the timeframe of the years 1996 to 2013 in AP region was evaluated and was compared with Northern America (NA) region. Methods: The SCImago portal was accessed to obtain the scientific indicators of toxicology science. The subject category of "toxicology" was used. In the SCImago portal, the AP region is divided into three sub-regions, Asiatic (AS), Pacific (PA) and Middle East (ME). To standardize the results, number of documents and citations of AP sub-regions in each time point were divided by their corresponding information from NA region. Results: In 1996, 3674 toxicology documents were published from NA region while in the same time 1308 documents were published from AS, 130 from PA and 144 from ME. These figures increased to 3985, 3893, 354 and 788 in the year 2013. While the total number of publications per year remained relatively stable in NA region over this 18-year period, this figure increased for AS and PA regions by about 3 times and for ME by about 5 times. The number of citations in the field of toxicology in AS, ME and PA regions, however, is still far behind NA. The percentage of toxicology documents that were produced through international collaboration in PA region was considerably higher than NA, AS and ME regions. Conclusion: The productivity of toxicology science in AP region has been increased over the past 18 years, though the level of citations is low compared to NA countries. International collaborations should be seriously considered and strengthen in AP countries. [ABSTRACT FROM AUTHOR]

Background: Carbon monoxide (CO) poisoning may lead to hypoxic/anoxic injury and eventually ischemic encephalopathy. Magnetic resonance imaging (MRI) has a well-recognized role in assessment of the severity of brain damage caused by CO poisoning. In this study, we aimed to present and analyze the structural abnormalities in the brain MRI and especially in diffusion weighted MRI (DWI) images in a series of patients with acute CO poisoning. Methods: This cross-sectional observational study was performed on patients with moderate to severe CO poisoning admitted to Mashhad Medical Toxicology Center of Imam Reza Hospital, Mashhad, Iran, during autumn and winter 2013. After stabilization, patients underwent brain MRI. T1 weighted, T2 weighted and FLAIR images in sagittal, axial and coronal sections, and DWI in axial sections were performed for each patient. Results: Eighteen patients (77.8% men) were enrolled in this study with median age of 29.5 years. Eleven patients (61.1%) had abnormal MRI signals and in 7 cases no abnormality or nonspecific abnormalities were detected. The most common involved region in brain MRI was white matter (38.9%) followed by globus pallidus (33.3%). Patients with signal abnormality in brain MRI had significantly longer duration of exposure to CO compared to those without signal changes (10.6 ± 6.2 h vs. 3.4 ± 2.8 h, P = 0.011). Nine patients had restricted diffusion in DWI. Patients with restricted diffusion in DWI had also longer duration of exposure to CO compared to patients with normal DWI (12.1 ± 5.5 h vs. 3.5 ± 2.9 h, P = 0.001). Conclusion: The white matter and globus pallidus were the most common affected regions in brain following acute CO poisoning. Signal abnormalities and restricted diffusion in MRI were correlated with duration of exposure to CO but not with the carboxyhemoglobin levels. [ABSTRACT FROM AUTHOR]

Background: In order to describe the patients and evaluate the effectiveness of treatments for widow spider envenomation, investigators require a reliable assessment tool. In this paper, the development of a clinical index for measuring the widow spider bite severity, Latrodectus Envenomation Severity Score (LESS), is described. Methods: According to the valid methods for index development, a Delphi group process was applied. A panel of 13 experienced medical toxicologists and physician experts in treatment of black widow spider bites was assembled in December 2013. The participants were asked to score clinical manifestations of Latrodectus envenomation based on their importance on the severity and patients' prognosis. Hence, an initial draft of the severity index was developed and in the second phase of study, the draft was discussed in a focus group of experts to finally comment on each variable and vote about the final scores. Results: The proposed version of LESS comprises of 34 clinical items categorized in 8 organ systems. The index includes definition of each clinical variable to help users of the index how to ascertain or rule out the clinical finding. The maximum theoretical score according to LESS is 87. Acute renal failure, myocarditis, pulmonary edema and ileus received the highest scores in this index . Conclusion: The LESS is a new assessment tool that is designed to more objectively evaluate the severity and progression of envenomation in victims of widow spider bite. The prognostic-ability, reliability and sensitivity to change of the index should be investigated in future studies. [ABSTRACT FROM AUTHOR]

Background: One of the medical team's responsibilities is to teach the methods of rescue and aid necessary for casualties who have been injured in disasters. They must be taken away of the place of disaster, transferred, categorized and cured. Methods: Delphi technique was used in this research. Firstly, a number of questions were framed and sent to a number of experts of different majors. They were asked to present their recommendation with regard to triage for casualties. Eventually, 18 people replied the questions. Results: The results of the study shows that the members of triage team were not knowledgeable enough in three educational subjects of chemical casualties including: the recognition of chemical poisoning symptoms, the necessity to teach caring and curing methods while dealing with special factors that cause symptoms and disorders in different parts of the body, and the control of stress and anxiety of casualties in incidents. 80% of the members agreed with the first part. Their recommendations and comments were collected. For the second subject, 90% believe that instructions should be developed for care and treatment. In third subject, 70% of the participants believed the use of chemical weapons and explosives is probable in incide nts. Conclusion: Awareness of educational needs in relation with incidents and triage has considerable importance; in most cases it could rescue casualties. Therefore, paying attention to special educational issues and recognizing the weaknesses of the educational programs would provide appropriate strategies in order to enhance triage. [ABSTRACT FROM AUTHOR]

Background: Snakebite in Iran has been a health concern. However, management of snakebite is not standardized and varies from center to center. This study is aimed at devising an evidence-based comprehensive protocol for snakebite management in Iran, to reduce unnecessary variations in practice. Materials and Methods: A narrative search in electronic databases was performed. Fifty peer-reviewed articles, guidelines, and textbooks were reviewed and practical details were extracted. Our currently used protocol in the Mashhad Toxicology Center was supplemented with this information. Consequently an improved wide-range protocol was developed. The protocol was then discussed and amended within a focus group comprised of medical toxicologists and internal medicine specialists. The amended version was finally discussed with expert physicians specialized in different areas of medicine, to be optimized by supplementing other specific considerations. Results: During a one-year process, the protocol was finalized. The final version of the protocol, which was designed in six steps, comprised of three components: A schematic algorithm, a severity grading scale, and instructions for supportive and adjunctive treatments. The algorithm pertains to both Viperidae and Elapidae snakebite envenomations and consists of a planned course of action and dosing of antivenom, based on the severity of the envenomation. Conclusion: Snakebite envenomation is a clinical toxicologic emergency, which needs to be treated in a timely and organized manner. Hence, a multi-aspect protocol was designed to improve the clinical outcomes, reduce unnecessary administration of antivenom, and help physicians make more proper clinical judgments. [ABSTRACT FROM AUTHOR]

The accumulations of Cd, Ni, Pb, and Cr were measured in muscle, gill, kidney, and liver of Platycephalus indicus and Pampus argenteus. Our results indicated that all metals were found to be the highest in tissues in P. indicus (benthic species). Except Ni in P. indicus, concentrations of metals and bioaccumulation factor were in the following sequence: liver > kidney > gill > muscle. The data revealed that there is a significant negative correlation between concentrations of metals and size and age factors. The Ni and Cr levels in the muscles were higher than the maximum acceptable limit recommended by WHO and FEPA. Similarly, the concentration of Pb measured in P. indicus muscle exceeded the FAO standard limit. [ABSTRACT FROM AUTHOR]

Background: Medial educations' models should train physicians with competencies and commitment to meet health needs in the community. This social accountability in me dical education is not a new concept but provides equity, quality, relevance and costeffectiveness in health care system. The aim of this study was to assess the knowledge of faculty members towards the situation and activities in this topic. Methods: 133 university faculty members participated in this research from seven schools (Medical, Dentistry, Pharmacy, Nursing, Paramedical, Health and Complementary Traditional Schools) at Medical Sciences of Mashhad University (MUMS) in Iran during 2012-2013. A questionnaire was distributed to faculties that asked about their knowledge about social accountability in medical education and its position at this university. Findings: The mean knowledge about social accountability was 3.80 ± 0.423 in clinical and 3.81 ± 0.368 in basic science faculty members (p>0.05). The mean knowledge in Professors, associates and assistant professors were 3 79 ± 0.11, 3 79 ± 0.08 and 3.90 ± 0.09, respectively (p>0.05). The faculties at Pharmaceutics School got the lowest level in this research. Conclusion: The level of knowledge among faculties at MUMS on educational accountability is limited, and is lowest at Pharmaceutics School. There is a need for informing the necessity, development of position and concepts about this method among faculties, especially at Pharmaceutics School, to improve health services. [ABSTRACT FROM AUTHOR]

The metal levels (Hg, As, Cu, and Zn) in tissues of edible fish species ( Pampus argenteus, Sillago sihama, Liza klunzingeri and Platycephalus indicus) were evaluated. The metal concentrations were found to follow the order: liver > kidney > gill > muscle, except for Zn from P. argenteus showing an inversion of liver and kidney. Generally, the benthic species ( P. indicus and S. sihama) showed a marked potential for tolerating high metal levels. Significant negative correlations were found between fish size/age and metals concentration in the most organs. The element levels in the muscles were lower than the maximum allowable concentrations, except for mercury in S. sihama and P. indicus. [ABSTRACT FROM AUTHOR]

Worldwide, lung cancer is the most common form of cancer. Saffron has been used in folk medicine for centuries. We investigated the potential of saffron to induce cytotoxic and apoptotic effects in lung cancer cells (A549). We also examined the caspasedependent pathways activation of saffron-induced apoptosis against the A549 cells. A549 cells were incubated with different concentrations of saffron extract; then cell morphological changes, cell viability, and apoptosis were determined by the normal invertmicroscope, MTT assay, Annexin V and propidium iodide, and flow cytometric analysis, respectively. Activated caspases were detected by treatment of saffron in lung cancer cells using fluorescein-labeled inhibitors of polycaspases. The proliferation of the A549 cells were decreased after treatment with saffron in a dose- and time-dependent manner. The percentage of apoptotic cells increased with saffron concentrations. Saffron induced morphological changes, decreased percentage of viable cells, and induced apoptosis. Saffron could induce apoptosis in the A549 cells and activate caspase pathways. The levels of caspases involved in saffroninduced apoptosis in the A549 cells indicating caspase-dependent pathway were induced by saffron. The anticancer activity of the aqueous extract of saffron could be attributed partly to its inhibition of the cell proliferation and induction of apoptosis in cancer cells through caspase-dependent pathways activation. [ABSTRACT FROM AUTHOR]

Copyright of Agriculture & Forestry / Poljoprivreda i šumarstv is the property of University of Montenegro, Biotechnical Faculty and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The concentrations of four metals (Cd, Ni, Pb, and Cr) were determined in the muscles, gills, and livers of two edible fish species (Liza klunzingeri and Sillago sihama) caught from the Hara biosphere of Southern Iran. In both fish species, metal concentrations and bioaccumulation factors were in the sequence liver > gill > muscle. Bioaccumulation factors were found to be highest in S. sihama. The metal concentrations were descending in the order of Ni > Cr > Pb > Cd, except for muscle samples from S. sihama showing an inversion of Pb and Cr. There is a significant negative correlation between the concentrations of the metals in each tissue with length, weight, and age, except for muscle in L. klunzingeri. Some metal levels in the muscle exceeded the limits recommended by FAO, WHO, and FEPA. [ABSTRACT FROM PUBLISHER]

Background: Illicit drug use is widely different among various societies. To date, no national curricula have been developed for medical students. To develop a community- oriented course for illicit drug use a preliminary need assessment as well as knowledge, attitude and performance of health care staff were performed. Methods: All personnel of Sarakhs Health Network were studied in 2011. A constract questionnaire was developed and validated. Results: The mean (SD) age of participants (n=185) was 32 (7.4) years with equal numbrs of males and females. "Family problems" (Likert Scale: 137), "having an addict friend" (135) and "low determination" (133) were the most common expressed reasons for starting drug use. The most effective people in helping addicts reported to be family (151), friends (148), and Narcotics Anonymous Group (NA) (147). "Admission in hospital" (110), "staying in rehabilitation camp" (102) and "Methadone Maintenance Therapy" (101) were stated as the most effective treatment methods. Males selected these items more than females (p=0.032). "Lack of family support" (151), "presence of an addict family member or friend" (149), and "craving" (148) were the effective factors for failure. "Family support" (160), "distance from addicts" (157), and "friendly help network" (156) were the most important factors in staying off the drugs after treatment. Females selected these items more than males (p=0.03). From health care staff perspectives "Methamphetamine" (157), "Heroin" (156) and "Opium" (149) were the most addictive drugs. The most common sources for participants' information were TV and radio (65.4%). Conclusions: Knowledge-related biological reasons of addiction and abstinence are limited among health workers, and sometimes misleading. Misperceptions and deviated knowledge and their attitude should be focused in curriculum development for health and medical educational courses. [ABSTRACT FROM AUTHOR]

A recent trend in human rights scholarship reflects the influence of the cultural relativist claims that have often been advanced by the political elites of the non-Western authoritarian states. This scholarly trend in which universalism meets cultural relativism gives birth to the notion of "chastened universalism," or "tempered universalism." The Politics of Women's Rights in Iran, by anthropologist Arzoo Osanloo, fits well in this trendy genre. I read these ethnographical studies with interest--and for an aftereffect. What comes after such knowledge? As an un-chastened advocate of universalism, I use the standards derived from the Universal Declaration of Human Rights model. How should I modify my approach, or methodology, in analyzing and presenting the violations that take place in a contemporary nation-state like Iran? These ethnographical explorations call for a retooling of human rights discourse and practice. My conclusion is, however, that these explorations hardly provide meaningful guidelines, or even vague recommendations, that could be of practical value to human rights monitors and researchers who must remain focused on the occurring violations, with the victims always in sight. [ABSTRACT FROM AUTHOR]

Objectives: Datura Stramonium (DS) is a common weed along roadsides, in cornfields and pastures and in waste areas. It belongs to the family Solanaceae and its toxic components are tropane belladonna alkaloids. It has been used voluntarily by teenagers for its hallucinogenic effect. The plant is named in Iran as Tatoore. Symptoms and signs of acute D. Stramonium poisoning usually are similar to anticholinergic syndrome. This study is done in order to clarify the status of this poisoning in our region. Materials and Methods: This study is a case series on all patients admitted to Imam Reza Hospital, Mashhad, Iran, with acute D. Stramonium poisoning between 2008 and 2011. We observed their symptoms, signs, routine laboratory test results and treatment used to control their symptoms. Results: There were 19 patients included in our study. Children were poisoned more commonly than teenagers and poisoning in adults was rare. All of the children ingested the plant accidentally. The most presenting symptom was irritability and the most common sign was sinus tachycardia. There was not any presentation of seizure or coma. Most of the symptoms were controlled by parenteral benzodiazepines and there were no need to use of cholinergic agents such as physostigmine. Conclusion: Our study showed most of D. Stramonium poisoned population in our region are children. We suggest decreasing accessibility to the plant in order to decrease the incidence of its poisoning. [ABSTRACT FROM AUTHOR]

Background: Medical Education has dramatically evolved in the past decades, and scholarly behaviors have gained popularity. In this study, scholarship-of-teaching activities from Mashhad University of Medical Sciences (MUMS) were evaluated for the first time in this country. Methods: Data related to all applicants who were nominated for promotion to associate and full professor positions were studied retrospectively from 2009 to 2011. All scores had been approved by MUMS scholarship committee. Results: In total, 85 teaching faculty members received scholarship score including 77% male (77%). Majority was from medical (61%) and dentistry (27%) faculties and mainly promoted to associate professor position (78%). Mean age of the promoted faculty members from faculty of Pharmacy was significantly lower. Most scores were obtained from preparing and implementation of L&CP (41%) and implementation of new educational methods (30%). The time elapsed from starting the scholarship evaluation program was significantly correlated with total score (r=0.245, Sig. 0.025) and implementation of new educational methods. Conclusions: Setting of a minimum mandatory score for scholarly teaching has been effective and should be stressed in future. [ABSTRACT FROM AUTHOR]

To investigate late toxic effects of sulfur mustard (SM) on the upper and lower respiratory tracts of Iranian veterans, 43 male veterans with more than 25% disability due to SM poisoning in 20−25 years after exposure, were studied. Direct laryngoscopy, pulmonary function tests, arterial blood gasses and pH, computed tomography of sinuses and lungs were investigated. The patients were aged 50.6 (8.9 SD) years with body mass index (BMI) of 26.6 (4.0) and disability of 53.2 (17.0%). The common findings of the upper respiratory tract were dysphonia (79.1%), post-nasal discharge (PND; 41.9%), lower larynx position (30.2%), limitation of vocal cords (25.6%) and mucosal inflammation of larynx (14.8%). The common lower respiratory diseases were diagnosed as chronic obstructive respiratory disease (84%), bronchiectasis (44.1%) and lung fibrosis (7.7%). Severity of disability was negatively correlated with BMI (p = 0.032), spirometric parameters (p < 0.001) and oxygen saturation (p < 0.001), but positively correlated with low-density lipoproteins (LDL <0.010), blood pressure (p = 0.008), diabetes mellitus (p < 0.001), wheezing (p = 0.0043) and bronchiectasis (p < 0.001). Delayed toxic effects of SM in upper and lower respiratory tracts were mostly inflammatory and infectious complications, SM-induced disabilities were significantly correlated with risk factors such as diabetes mellitus, hypertension, LDL and lower-respiratory complications. [ABSTRACT FROM AUTHOR]

This study examines the relation between seizure and plasma tramadol concentration in patients with tramadol poisoning, as a novel centrally acting analgesic used for the treatment of mild to severe pain. All patients admitted with a history of tramadol overdose accompanied by unconsciousness or seizures referred to Baharloo Hospital Poison Center, Tehran, Iran from March 2008 to March 2009 were included. Demographic information, clinical findings, and blood tramadol concentrations were studied. There were 401 patients with a history of tramadol overdose; 121 (30.2%) with a history of seizure and 14 (3.5%) with a history of unconsciousness were included. Most of overdoses involved men (83%). The mean age was 22.9 years (range, 14-50 years). Intentional overdose was the most common mode of poisoning (51.9%). The mean dose ingested was 1,511 mg (SD, 1,353; range, 200-7,000). Mean back-extrapolated tramadol blood concentrations were 3,843 ng/mL (3,715; 269-20,049). Back-extrapolated blood concentrations were correlated with dose ( r = 0.313; P < 0.001) as well as blood concentration levels ( r = 0.801; P < 0.001). Seizure was significantly correlated to higher reported dose ( P < 0.001) and tramadol only to overdose ( P < 0.001). However, it was neither related to higher tramadol blood concentrations, nor related to time elapsed, age, sex, history of addiction, and observed Glasgow Coma Scale of patients. Most patients experienced just one seizure (76%). The tramadol-induced seizure is dose dependent. Although higher doses of tramadol was related to higher blood concentration, blood tramadol concentrations was not associated with seizure. [ABSTRACT FROM AUTHOR]

Paracetamol is considered a safe analgesic and antipyretic drug. Cardiac toxicity has also been speculated to be a serious complication in paracetamol poisoning. Most of the claims made for paracetamol cardiotoxicity have been based on postmortem findings in patients who developed fulminant hepatic failure. A 24- year-old man reportedly ingested 50 tablets of 325 mg paracetamol. He presented to hospital 24 hours later. Intravenous N-Acetyl cysteine (NAC) was started immediately after admission. His hospital course included hepatic injury, coagulopathy, acute renal failure and cardiac injury. Cardiac function began to decline on the second hospital day with severe LV systolic dysfunction (EF=10-15%), and pulmonary edema, but began to improve on the 3rd day. Hepatic injury was mild. Renal injury, consistent with acute tubular necrosis, didn't recover and permanent hemodialysis resulted. A decline in cardiac function may occur following paracetamol overdose. [ABSTRACT FROM AUTHOR]