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Biomedical subjects

Mojgan Karbakhsh

Publications and source records attributed to Mojgan Karbakhsh.

9 recordsLinked to original sources

Acute opiate overdose in Tehran: the forgotten role of opium.

INTRODUCTION: The global epidemic of opiate use continues to spread and is an increasing burden especially in developing countries. Acute opiate overdose (AOO) is one of the most dramatic complications of drug abuse. The purpose of this study is to examine the epidemiology of acute opiate overdose in a poisoning center in Tehran. METHODS: In this cross-sectional survey, patients who attended the emergency room of Loghman-Hakim hospital - the only poisoning center in Tehran - and diagnosed with acute opiate overdose over a six month period were included. RESULTS: Overdose was more common among men (91.2%). The mean and standard deviation of age was 36.9+/-15. The most frequent opiate agent was opium (56.5%) followed by heroin. Opium was most commonly used by regular users, as a single agent and through ingestion. Benzodiazepines, antidepressants and alcohol were the most common agents consumed accompanied with opiates. The mortality rate was 8.8% which was not significantly different between cases of heroin and opium overdose. CONCLUSION: Opium was the major cause of overdose in our study. This result suggests that opium is not a harmless form of addiction although it is regarded as a thing of the past in many countries.

Acute Disease↗

Depression in mothers of children with thalassemia or blood malignancies: a study from Iran.

BACKGROUND: Several studies have found that parents of children with chronic diseases or disabilities have higher depression scores than control parents. Mothers usually take on the considerable part of the extra care and support that these children need and thus are at markedly increased risks of suffering from psychological distress and depression. The main aim of the present study was to investigate if mothers of children with thalassemia or blood malignancies have higher scores of depression compared with a group of control mothers. METHODS AND MATERIALS: In this cross - sectional study, 294 mothers were recruited in three groups and assessed using the Beck Depression Inventory (BDI): mothers of children with thalassemia, mothers of children with blood malignancies and a control group. SPSS version 11.5 with chi square, ANOVA, linear and logistic regression were used for statistical analysis. RESULTS: The only variable bearing a statistically significant relationship with the depression score of mothers was the child's disease: for thalassemia with OR of 2.17 (95% CI = 1.16-4.0, P = 0.015), for blood malignancies with OR of 2.71 (95% CI = 1.48-4.99, P = 0.001). DISCUSSION AND CONCLUSION: The results of this study can contribute to the development of a screening program for decreasing depression burden and promoting quality of life for mothers of children with thalassemia or blood malignancies.

Journal Article↗

Fever after percutaneous nephrolithotomy: contributing factors.

BACKGROUND AND PURPOSE: The exact mechanism of fever and urosepsis after percutaneous procedures has not been established. This research studied the frequency of fever after percutaneous nephrolithotomy (PCNL) and the contributing factors. METHODS: In a cross-sectional study, from September 2003 to March 2004, all 217 patients with nephrolithiasis treated with PCNL at the Labbafinegad Specialized Urology Center were studied. Data were collected before, during, and after surgery. RESULTS: The frequency of fever after PCNL was 25.8% (n=56) although in 62.2% of the cases (n=135), no prophylactic antibiotics had been administered. The mean durations of hospitalization in patients with and without fever were 5.4+/-2.3 and 3.4+/-1.7 days, respectively (p=0.001). Significant correlations were observed between fever and female sex (p=0.005), positive urine culture (p=0.02), and nephrostomy tube insertion (p=0.041). Other variables did not prove to be significant. In logistic regression analysis, female sex and nephrostomy tube insertion were independently related to post-operative fever. CONCLUSION: Although a considerable proportion of our patients had not received prophylactic antibiotics, the rate of fever after PCNL was no higher than is reported in the literature. Use of only a short course of antibiotics before surgery for staghorn stones did not result in a higher rate of fever. Female sex created a higher risk for fever, probably because of the greater propensity to urinary tract infection. The significant relation of a nephrostomy tube to fever could be attributed to its role as a foreign body or to use in more complicated cases.

Adolescent↗

Chest injury in victims of Bam earthquake.

OBJECTIVE: To analyze the data of trauma patients with thoracic injury in the earthquake of Bam admitted to hospitals of Tehran University of Medical Science (TUMS) for better understanding the type and consequence of thoracic injuries in a major earthquake. METHODS: After Bam earthquake registering 6.5 on the Richter scale, 526 trauma patients were admitted to hospitals of TUMS. Among them, 53 patients sustained thoracic injury. RESULTS: This group was composed of 21 females (39.6%) and 32 males (60.4%). Fifteen patients (28.3%) had isolated chest injuries. Rib fracture (36.4%) was the most common injury in our patients and haemo/pneumothorax (25.5%) followed. Superficial injury was the most common accompanying injury. Multiple-trauma patients with chest injury had higher injury severity score (ISS) versus patients with isolated chest injury (P=0.003). CONCLUSIONS: Chest wall injuries and haemo/pneumothorax comprise a considerable number of injuries in survival victims of earthquakes. Consequently, the majority of these patients can be treated with observation or tube thoracostomy. We should train and equip the health workers and members of rescue teams to treat and manage these patients in the field.

Adolescent↗

Epidemiology study of facial injuries during a 13 month of trauma registry in Tehran.

BACKGROUND: Many studies have recently noted a shift in the causative mechanism of facial injuries away from traffic accident to assaults. AIMS: Our study aimed to investigate patterns of facial injuries in trauma patients during 13 months study of trauma patients in six general hospitals in Tehran. MATERIAL AND METHODS: Trauma patients who were hospitalized for more than 24 hours and had sustained injuries within seven days from admission were included in the study. Of the 8000 trauma patients, four hundred (5%) sustained facial injuries. RESULTS: Male to female ratio was 4.5:1. Among them, 53.3% were aged 11-30 years. Traffic accidents were by the far the commonest cause of injury. Motorcyclists who wore a helmet sustained facial fractures less often during traffic accident than those patients who did not wear helmet. Soft tissue injury and facial bone fracture comprised 43.3% and 40.8% of facial injuries, respectively. The majority of Soft tissue injuries (79%) were located extra orally. The mandible and nasal bone were the most commonly fractured facial bones. Victims of assault sustained more severe injuries compared to those involved in falls and traffic accidents. CONCLUSIONS: Use of helmets by motorcyclists and the separation of pedestrians routes from motor vehicles could reduce the number of victims and consequently injuries due to road traffic accidents. For implementation of effective prevention programs for reduction of facial injuries due to assault, it seems to be necessary to conduct studies investigating causes and pattern of injuries resulting in assault.

Adolescent↗

The full moon and admission to emergency rooms.

OBJECTIVE: The purpose of this study was to investigate an ancient hypothesis; the moon effect might increase incidence of injuries and hence admission of patients with trauma to Emergency Rooms (ERs) on full moon days. METHODS: During thirteen months, 58000 trauma patients admitted in three hospitals that had the highest load of trauma patients in Tehran were studied. Due to lack of complete data, 3543 patients (6.1%) were excluded from the study, leaving 54457 cases for further analysis. We selected lunar calendar for our study, so dates of patients' admissions were converted to lunar months and three day- periods with 15th as middle day were defined as full moon days. RESULTS: In our study the number of trauma patients was not increased during the full moon days against other days of lunar month. Statistical analyses of data didn't exhibit a positive relation between full moon days and increasing of trauma patient admission to ERs. An association between assault and attempted suicide was not observed around the full moon days either. The results did not show significant reduction of GCS score of patients on full moon days and there was not any increase in severity of traumatic injury sustained during full moon days. CONCLUSIONS: It seems necessary to conduct studies regarding the probability of moon effect through on different database, geographic areas and for appropriate periods in order to reach a conclusive result.

Adolescent↗

Effect of allopurinol in chronic nonbacterial prostatitis: a double blind randomized clinical trial.

INTRODUCTION: The exact mechanism of chronic nonbacterial prostatitis has not been yet elucidated and the outcome with the current management is dismal. In this trial, we studied the effect of allopurinol in the treatment of this disease. MATERIALS AND METHODS: In this randomized double blind controlled trial, a calculated sample size of 56 were grouped into "intervention group" who received allopurinol (100 mg tds for 3 months) with ofloxacin (200 mg tds) for 3 weeks (n = 29) and "control group" who received placebo tablets with ofloxacin (n = 27). Patients' scores based on the National Institute of Health Chronic Prostatitis Symptom Score were recorded before therapy and then every month during the study. A four-glass study was performed before intervention and after 3 months. RESULTS: The 2 groups were similar regarding outcome variables. In the first month of study, a significant but similar improvement in symptom scores was observed in both groups. Microscopic examination of prostate massage and post-massage samples were also similar in both groups. No side effects due to allopurinol were observed in patients. CONCLUSION: We did not find any advantage for allopurinol in the management of chronic prostatitis versus placebo in patients receiving routine antibacterial treatment.

Adult↗

Breast cancer in Iran: results of a multi-center study.

INTRODUCTION: Breast Cancer is the most common cancer in Iranian women. This study aims to demonstrate the characteristics of breast diseases- and especially breast cancer- according to pathologic records in Tehran, Iran. METHODS: In this cross-sectional study, all records of pathologic specimens (biopsy or mastectomy) categorized as "breast diseases" from 1996 to 2000 in five teaching hospitals in Tehran were studied. For each patient, sex, age, breast pathology, pathological staging of malignant lesions, side and location of the tumor and the type of surgery were reviewed by a trained general practitioner. SPSS version 10 was used for statistical analysis. RESULTS: The mean age of women with breast cancer was 48.8. The highest frequency of malignancies was observed in the 40-49 age group (31.8%). Twenty-three percent of breast cancers were observed in women younger than 40 years. About 83 percent of malignant lesions in women were in T2, T3 or T4 at diagnosis. Only about 4 percent of women with breast cancers had tumors in stage I or in-situ carcinomas. Nearly 70 percent of the cancers were detected only after lymph node involvement. Only 4.3 percent of our female cases had the chance of conservative mastectomy. Twenty-eight percent of specimens from biopsies in women were malignant. DISCUSSION AND CONCLUSION: In Iran, breast cancer affects women at least one decade younger than their counterparts in developed countries. A considerable proportion of our cases (96%) were in stage II or III at diagnosis. These results show advanced cases at presentation in Iran which further mandate a national cancer detection program involving more effective public education and encouragement of women for breast self-examination and participation in screening campaigns.

Adult↗