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Background: Methadone is one of the most useful opioids that can be used to achieve many therapeutic goals, and also it may be abused as an illicit drug. Methadone can cause different gastrointestinal, neurological, and cardiac complications. This study was performed to obtain a better understanding of the cardiac side effects of methadone in patients with methadone poisoning. Methods: This cross-sectional study was performed on 210 samples in Sina Hospital of Hamadan in a one-year period from March 2019 to March 2020. After assessing patients who had methadone poisoning and completing their demographic information and evaluation of changes in patients' EKGs, the data was collected and analyzed by SPSS 16 software. Results: Out of 210 participants, 178 (84.8%) were males and the rest were females. The average age of the studied patients was 39.56 years old. The study found that 6.1% of methadone-poisoned patients were illiterate. It was found in this study that the most common cardiac complications of methadone intoxication were sinus tachycardia (20%), QT interval prolongation (6.64%), and sinus bradycardia (4.3%), respectively; nevertheless, 66.2% of patients did not have any EKG abnormalities. Conclusion: According to the findings, it is necessary to have continuous cardiac monitoring for patients with methadone intoxication and by transferring such findings to medical centers, steps can be taken to use methadone more intelligently.

Background: Metal phosphides are widely used as a rodenticide and insecticide and poisoning with these substances has a very high mortality. The aim of this study was to evaluate the butyrylcholinesterase (BuCh) level in poisoning with metal phosphides. Methods: In this case series study, 60 poisoned patients with zinc phosphide (ZnP) and aluminum phosphide (ALP) who was admitted to poisoning ward in Hamadan, Iran, enrolled in the study and BuCh level was measured. The sex, age, amount of ingestion, time of consumption, signs and symptoms, ECG and arterial blood gas (ABG) changes and clinical outcomes were evaluated. Results: Most (58.3%) patients were males, the mean age was 32.76±17.65 years. The average amount of ingestion was 7.5±4.6 and 2.5±2.96 gr for ZnP and ALP, respectively. Most signs and symptoms were hypotension (97%), nausea and vomiting (82%) and abdominal pain (32%). The average amount of BuCh level in all patients was 5163.25±2158.31 U/L, that's while in ZnP and ALP poisoned patients was 5608±1577 U/L and 4721.46±2562U/L respectively. The most dysrhythmia (26.7%) was sinus tachycardia. Acidosis was seen in 33.3% of patients. 14 patients died after hospital admission, which caused a 23.3% fatality rate. Conclusion: Our results showed that, there was no significant change in BuCh level in poisoned patients with phosphide compounds.

Background: Tramadol is an analgesic drug being abused today a lot. Excessive ingestion will lead to hazardous complications such as convulsion and occasionally respiratory apnea. The aim of this study based on frequency respiratory apnea in patients with acute tramadol poisoning hospitalized in Farshchian Hospital of Hamadan, Iran from Jan 2014 to Dec 2015. Methods: All patients with tramadol poisoning who hospitalized and treated at poisoning ward were enrolled into the study. Their demographic data including age, gender, drug ingestion dose, and respiratory apnea leading to taking naloxone or intubation collected and analyzed statistically by SPSS software. Results: Overall, 350 patients aged between 14 to 68 yr old were investigated. About 75% of them were male and among them, 81.14% had deliberate self-poisoning. 4.86% developed apnea whose average tramadol consumption was 4158.83 mg. In patients who had not apnea, the average tramadol consumption was 122.38 mg, that was statistically significant difference (P

Background: Hormonal changes as a factor influencing the emotional state of women have an important role in the incidence of suicide. The aim of this study is to investigate changes in FSH-LH, Estrogen, and Progesterone hormones in women attempting suicide by drugs and chemicals. Methods: In this cross-sectional study, women of reproductive diagnosed with drug and chemical poisoning who were hospitalized in Farshchian Hospital, Hamadan, Iran, were assessed regarding LH, FSH estrogen and progesterone hormones over a period of six months in 2011. Overall, 80 patients were studied with regard to the inclusion and exclusion criteria. Results: The highest rate of suicide was in the age range of 14-25 years (47 patients, 60.1%). A significant relationship was observed among the blood levels of hormones FSH, LH, progesterone, and estrogen. The association of hormone levels and LMP and attempted suicide was significant. The LH level was significantly lower in patients with substance abuse. The estrogen level was significantly lower in patients with the history of self-injury. Most patients (67.5%) were in the follicular phase which was statistically significant. Conclusion: According to the obtained results, there was a significant relationship between the levels of different hormones. The significant relationship was positive in some cases but negative in other.

Background: A good proportion of poisoned patients treated at poisoning wards are elderly. This study was designed to evaluate the epidemiologic pattern of acute poisoning in elderly in Hamadan, western Iran. Methods: In this retrospective cross-sectional study, poisoned patients aged 60 years and older treated at department of poisoning of Farshchian Hospital from March 2008 to March 2013 were included. Results: In this 5-year period, 7951 poisoned patients were treated at Farshchian Hospital in Hamadan, Iran. Among them, 418 (5.3%) patients were 60 years old or older, with mean age of 71.6 ± 5.1 years. Narcotics and recreational substances were the most common type of poisons responsible for poisoning (46.4%), which among them, methadone was the most commonly used drug (20.3%). Neurologic medicines were the most commonly used pharmaceutical products (16%), among which, benzodiazepines (8.9%) were responsible for the highest number of poisonings due to pharmaceuticals. Fifteen patients (3.6%) including 13 men and 2 women died. The toxic agents used by cases with fatal outcome were opioids (8 patients), organophosphates (5 patients) and aluminum phosphide (2 patients). Men were found to be significantly more affected with recreational substances (P < 0.001) and pesticides (P < 0.001), while poisoning with pharmaceutical products (P = 0.017) was significantly more common in women. Regarding the intention of poisoning, accidental poisoning (P = 0.025) and overdose (P < 0.001) were significantly more common in men while deliberate self-poisoning was significantly more frequent in women (P < 0.001). Conclusion: Deliberate self-harm and poisoning with opioids especially methadone showed a high prevalence in elderly poisoned patients in Hamadan, Iran. It seems that drug trafficking control, addiction rehabilitation therapies and suicide prevention programs for elderly can be helpful in poisoning reduction in this age group in this part of the country.

Background: Rhabdomyolysis is one of the major complications of poisoning causedby alcohol, narcotics, and psychotropic substances acute toxicity, which might lead toacute renal failure and even death. This study aimed to evaluate clinical and laboratoryfindings of rhabdomyolysis syndrome in poisoning patients who were admitted topoisoning ward of Farshchian Hospital of Hamadan, Iran.Methods: In this cross-sectional study, patients with acute toxicity by alcohol, narcotics,or psychotropic drugs who were admitted in poisoning ward of Farshchian Hospital ofHamadan were investigated during a 6-month period in 2012. Clinical and laboratorydata were collected by a standard questionnaire and analyzed by the SPSS softwareversion 16.Results: Eighty-two patients aged between 14 to 81 years were investigated. Twentytwocases developed rhabdomyolysis and narcotics related toxicity was the mostcommon cause. The most common clinical symptom in all patients was muscle pain(51cases, Laboratory studies showed some significant differences between serumcreatine kinase (CK), lactate dehydrogenase (LDH), serum creatinine, andaminotransferases (AST,ALT) levels in rhabdomyolysis cases as compared to theothers (p