مجله دانشگاه علوم پزشکی مازندران
پیاپی 203 (آذر 1400)

Today, implant treatment is one of the most popular dental treatments. To have a successful long-lasting implant treatment, enough bone is needed in that area. Given the positive effects of simvastatin on osteogenesis, this research aimed to compare the effect of freeze-dried bone allograft with and without simvastatin in extracted tooth socket in rats.

This experimental study was conducted in 72 Wistar rats (300 gr). Then rats were randomly divided into two groups (control and intervention). We evaluated osteogenesis, inflammation and granulation tissue formation after four and eight weeks. Data analysis was done applying ANOVA and Tukey post-test in SPSS V22.

After four and eight weeks, there were significant differences in the rate of osteogenesis between the intervention groups (FDBA+Simvastatin and FDBA) (P= 0.001). A thsese times, the rates of inflammation were found to be significantly lower in animals that received FDBA+Simvastatin compared to the control group (P<0.001). At weeks four and eight, the amount of granulation tissue was lower in FDBA+Simvastatin group than the FDBA group (P<0.05).

The study showed that simvastatin can significantly increase the amount of osteogenesis and also could reduce inflammation and granulation tissue formation.

Increase in ATP-dependent Citrate Lyase (ACLY) is observed in individuals with nonalcoholic fatty liver disease (NAFLD). One of the compounds considered for the prevention of fatty liver is Medium chain triglycerides (MCT). In this study, the preventive effect of MCT on ACLY enzyme gene expression and the level of histone 3 lysine 27 acetylation (H3K27ac) were investigated in an animal model.

In this study, 18 male Wistar rats were divided into three groups: control (n=6), fructose-fed (n=6), and fructose+MCT (n=6). Six weeks after the initiation of diets, the mice were sacrificed. ACLY gene expression was measured by Real-time qPCR. Also, H3K27 acetylation was investigated by western blotting. Data were analysed by one-way analysis of variance.

The liver index in mice fed with fructose+MCT showed a significant increase compared to those fed with fructose alone (P<0.05). Accumulation of triglyceride droplets in the slides prepared from the fructose+MCT group did not show significant changes compared to the fructose fed group (P<0.05). Fructose increased ACLY gene expression, but the changes were not found to be significant in the fructose+MCT group compared to the controls and fructose-fed group (P<0.05). Fructose+MCT significantly reduced the amount of H3K27ac compared to the control and fructose-fed groups (P<0.05).

The study showed that MCT alongside fructose is ineffective at preventing the development of non-alcoholic fatty liver.

Post-traumatic stress disorder (PTSD) is a condition that develops after experiencing major trauma. Selective serotonin reuptake inhibitors (SSRIs) are first-line treatment for PTSD. This study aimed at investigating the effects of moderate treadmill exercise and fluoxetine on anxiety, spatial memory, and positive tunnel cells in the hippocampus in a rat model of PTSD.

We used single prolonged stress (SPS) model as an animal model for PTSD. Male and female rats were divided into two groups: Sham and SPS. After Two weeks, interventions, including treadmill exercise (4 weeks, 5 days per week), fluoxetine (10 mg/kg/day), and combined treatment were performed. Then, anxiety and memory test and tunnel assessments were done.

SPS rats exhibited increased anxiety levels in light/dark box and enhanced hippocampal apoptotic cells. Male SPS rats showed impaired spatial memory in object-location memory task. Treadmill exercise, fluoxetine, and combined treatment reduced anxiety levels, improved spatial memory, and decreased positive tunnel cells in the hippocampus. Furthermore, combined treatment with fluoxetine and treadmill exercise was found to be more effective than fluoxetine alone. Female rats had more resilience than male rats.

Combined intervention with moderate exercise and fluoxetine is more useful in treatment of behavioral and cellular injuries in PTSD patients.

The use of testosterone enanthate has increased in athletes, especially in resistance trainings. The present study aimed at comparing the independent and interactive effects of resistance training, testosterone, and Phoenix dactylifera extract on the expression of adiponectin and GLUT4, as well as some oxidative stress indices in brown adipose tissue in male rats.

Thirty-six male rats were divided into different groups, including a control group, exercise training, phoenix dactylifera extract, testosterone, phoenix dactylifera extract + exercise training, and testosterone+ exercise training groups. Resistance trainings were done for four weeks (5 sessions/week) in experimental groups. On days of exercise, the rats were fed with phoenix dactylifera extract and testosterone (100 and 2 mg/kg, respectively). Forty-eight hours after the last intervention, the animals were sacrificed and brown fat tissues were removed. Then, the gene expression of adiponectin and GLUT4, activity of superoxide dismutase (SOD), and malondialdehyde (MDA) levels were measured.

Resistance training increased the expression of adiponectin and GLUT4, increased SOD activity and decreased MDA level. Testosterone also increased SOD activity and decreased MDA level in brown adipose tissue. Phoenix dactylifera increased the expression of adiponectin and the activity of SOD, and decreased MDA level. Exercise and simultaneous use of testosterone/phoenix dactylifera have synergistic effect on adipose tissue MDA compared to testosterone and phoenix dactylifera intervention alone.

This study reinforces the hypothesis of using phoenix dactylifera as a natural substance instead of synthetic testosterone.

Pancreatic lipase is a major digestive enzyme in digestion and absorption of fats.  Inhibition of the pancreatic lipase activity has always been one of the goals of researchers to control obesity and related disorders. Current inhibitory agents have several side effects. The aim of this study was to investigate the inhibitory effect of Ferula persica, Ginkgo biloba, Nelumbo nucifera, and Dicyclomine on pancreatic lipase activity.

In this experimental study, Ferula persica, Ginkgo biloba, and Nelumbo nucifera were extracted by soxhlet method. Methanolic or aqueous extracts of plants and dicyclomine at 10, 25, 50, 100, 200, and 400 μg/ml were prepared and their inhibitory effect on a fixed concentration of commercial pancreatic lipase were investigated. The combined extracts of Ferula persica and Nelumbo nucifera were also applied to the enzyme at the ratio of 1:3, 2:2, 3:1, and without quotas. Lipase activity was measured based on the release of methyl resorphine as colorimetric assay.

Extracts of Ferula persica and Nelumbo nucifera alone or combined in a ratio of 1:2 at 50 μg/ml led to further decrease in pancreatic lipase activity compared to the unexposed enzyme. Ginkgo biloba and Dicyclomine did not show any considerable inhibitory effect at concentrations and ratios studied.

The extracts of Ferula persica and Nelumbo nucifera, alone or in combination, showed inhibitory effect on pancreatic lipase activity. Further studies, especially clinical trials are suggested to evaluate the efficacy and safety of these compounds.

Pseudomonas aeruginosa is an opportunistic pathogen and the second leading cause of nosocomial infections, especially in the intensive care unit (ICU), and is responsible for high mortality rates. The aim of this study was to determine the pattern of antibiotic susceptibility and prevalence of multiple drug resistance strains of P. aeruginosa isolated from hospitalized patients in Mazandaran province, Iran 2020.

In this descriptive cross-sectional study, 80 strains of P. aeruginosa were collected from different clinical specimens. Antibiotic susceptibility of the isolates was determined by disk agar diffusion method according to the instructions of Clinical and Laboratory Standards Institute (CLSI). Finally, based on the resistance pattern, multi-drug resistant (MDR), extensive-drug resistant (XDR), and pandrug-resistant (PDR) isolates were identified.

Out of 80 P. aeruginosa isolates, the highest number of samples was collected from ICU (58.75%). The highest antibiotic resistance was observed against ticarcillin-clavulanate (95%), meropenem (80%), and ceftazidime (75%). Piperacillin-tazobactam and cefpime showed the highest inhibitory effect against P. aeruginosa isolates with 57.5% and 51.25% sensitivity, respectively. Altogether, 88.75% and 46.25% of the isolates were categorized as MDR and XDR, respectively. In this study, PDR phenotype was not observed among our tested strains.

This study showed that P. aeruginosa strains are resistant to a wide range of antibiotics. Given the role of this bacterium in nosocomial infections, especially in ICU, it is necessary to take immediate measures for timely identification, definitive treatment with appropriate antibiotics, and preventing the spread of resistant strains of this bacterium.

Giardia and Blastocystis are common parasites of humans with a wide range of hosts. The aim of this study was to identify the genotypes of Giardia intestinalis and Blastocystis hominis in individuals attending Bavi health centers in Khuzestan province, Iran.

In this study, 30 positive stool samples of Giardia and Blastocystis were collected from individuals attending Bavi health centers in 2019-2020. Then DNA extraction was performed on fecal samples. PCR was performed using GDH gene for Giardia and 18S rRNA region for Blastocystis and PCR products were drawn to determine sequence type and phylogenetic tree.

Sequence analysis was performed on PCR products from Giardia based on amplification of GDH gene. Based on the results of DNA sequence, all identified samples belonged to assemblage BIV. Sequence analysis was performed on PCR products from Blastocystis according to amplification of 18S rRNA gene and all identified samples belonged to ST3 subtype.

The study showed that the predominant genotype of Giardia in Bavi was BIV which indicates a zoonotic cycle in this region. In addition, the predominant subtype of blastocystis was previously reported in this region (ST3) often seen in human-to-human transmission cycle, although there have been reports of animal-to-human cycle. Therefore, alongside health measures to control these two parasites in this area, molecular epidemiology studies in local animals is necessary to determine the zoonotic transmission of Giardia and Blastocystis parasites in this region.

Migraine is a very debilitating disorder despite medication treatments. The aim of this study was to determine the effect of acupressure on severity of acute migraine headaches.

This randomized controlled trial was performed in 84 migraine sufferers attending the Emergency Department in Sari Buali Hospital, Iran 2019. Patients were randomly divided into three groups (n=28) of acupressure, control, and sham using Random Allocation Software. In intervention group, acupressure was applied to eight points for 8 seconds in each acupoint followed by two-second rest periods and this sequence was repeated for 3 minutes. The control group received only medical treatments and in sham group, acupressure was applied to eight unrelated points. Pain intensity was measured by Visual Analog Scale (VAS) before and 24 minutes after acupressure. Data were analyzed using Kruskal-Wallis test and Mann-Whitney U test.

Before the intervention, the median (Q3-Q1) pain intensity in intervention, sham, and control groups were 6, 5, and 5, respectively (P=0.175). After the intervention, the values were 1.5, 3, and 5 in intervention group, sham, and control groups, respectively (P<0.001). After the intervention, the mean score for pain intensity was significantly lower in intervention group than the sham (P<0.001) and control (P<0.001) groups. This rate was significantly lower in sham group than the control group (P<0.001).

Acupuncture alongside other treatments can be helpful in reducing the severity of pain caused by acute headaches.

Lumbar disc herniation is one of the most common types of low back pain and researchers are interested in novel exercises in treatment of this condition. The aim of this study was to investigate the effect of suspension exercises on electromyography in men with disc herniation.

Twenty two men with disc herniation in Rasht participated in this clinical trial in 2020 and were randomly divided into two groups of suspension exercises (n=12, age: 34.25±8.81, BMI: 24.02±01.7) and control (n=10, age: 34.4±6.67, BMI: 23.1±76.45). Before and after an intervention period, the electrical activity of rectus abdominis, internal and external oblique and erector spinae muscles were measured by electromyography and abdominal muscle strength was investigated using straight leg raising test. The intervention period consisted of 8 weeks of suspension exercises, while the control group was only followed up. Paired sample t-test and analysis of covariance were used for intragroup and intergroup comparisons, respectively.

Electromyography of four muscles and strength test showed significant improvements in post-test compared to pre-test in intervention group (P<0.05) while no significant change was observed in control group (P˃0.05). Patients who did suspension exercises were found with significant improvements in muscle electromyography compared to the control group (P<0.05), but no significant difference was observed in abdominal muscle strength test (P˃0.05).

In current study, suspension exercise improved core muscle activation and abdominal muscle strength, so, it could be considered in rehabilitation of low back pain caused by disc herniation.

Diabetes mellitus is a metabolic disorder. There are reports on the association between platelet indices and chronic diseases. In this study, we aimed to investigate the relationship between platelet indices and diabetes mellitus in a large-scale population based cohort study.

In this cross-sectional study, we utilized data collected from Tabari Cohort Study (TCS). In enrollment phase of TCS, 10251 people participated. Following ethics committee approval, laboratory parameters, including fasting blood sugar (FBS), platelet count (PLT), plateletcrit (PCT), platelet distribution width (PDW), and mean platelet volume (MPV) were measured. Other variables such as age, gender, socioeconomic level, education, place of residence, smoking, physical activity, and waist circumference were also collected. Chi-squared test, independent t-test, and logistic regression were applied to analyze the data.

Among total population studied, 17.2% (n=1765) had diabetes. Multivariate logistic regression showed that odds of having diabetes in participants with PCT levels of 0.17-0.19 (95% CI=0.71-0.98) were 0.83 higher compared to those with PCT level less than 0.17. On the other hand, OR of having diabetes in participants with MPV levels of 7.70-7.89 and 7.90-8.29 were 1.24 (95% CI=1.04-1.47) and 1.18 (95% CI=1.02-1.36), respectively.

The study showed that PCT levels of 0.17-0.19 have a protective role against diabetes, and MPV levels of 7.70-7.89 and 7.90 - 8.29 could predict the risk of developing diabetes. These findings are resulted from a cross-sectional study, therefore, should be interpreted with caution.

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

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

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

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

Extensive use of various forms of medicinal plants makes it necessary to continuously monitor the production and supply of these plants. Also, it is important to study metal and pesticide contaminants in medicinal plants in order to prevent hazards from their consumption. This study aimed at investigating the pollutants and mineral element levels in widely consumed medicinal plants in Mazandaran province, Iran.

In this descriptive study, 19 plant samples, including Melissa officinalis, Mentha piperita, Echium amoenum, Lippia citriodora, Rosa damascena, etc. were collected from four medicinal plant farms in Behshahr, Sari, Babol, and Baladeh Noor in Mazandaran province in spring and summer of 2020. Measurement of elements in plant samples was performed using induction coupled plasma device (ICP) and Determination of agricultural pesticide residues was carried out using GC/MS.

Among the samples examined, residues of agricultural pesticides were not detected in any samples. Different levels of heavy metals and essential elements in the same species of plants could be due to various factors, including water, soil, and air pollution. The highest amount of lead was observed in lemon beebrush (5.938 ppm) in Behshahr and peppermint (4.4 31 ppm) in Babol. The highest amount of cadmium was detected in stevia collected (0.291 ppm) from Sari.

Despite the relative lack of risk of samples studied, different forms of medicinal plants should be used with caution. Medicinal plant farms also need to be regularly monitored and precautions must be taken to control heavy metal contamination in plant-based foods.

This study was conducted for the first time to produce activated carbon (AC) from Milkvetch wood by physical activation in order to achieve the maximum adsorbent capacity in adsorption of dye. The aim of this study was to remove acid orange 7 (AO7) dye using AC produced by physical activation with nitrogen gas.

AC activation was performed by physical method using nitrogen gas at 700°C. Scanning electron microscopy and isotherm technique were used to determine the structural characteristics of the adsorbent. The effect of operating parameters was investigated. The isotherms and kinetics of the dye adsorption were also studied.

The synthesized AC-700°C sample had a specific surface area and a total pore volume of 774 m2/g and 181.49 m3/g, respectively. The maximum adsorption of dye was 57.125 mg/g (removal efficiency 91.4%) that occurred at pH= 3, 0.04 g absorbent in 50 ml of solution, and 50 mg/l of dye in 75 min. The adsorption data followed the Langmuir adsorption isotherm model and the pseudo-second order model kinetics. Also, the ability to reuse the adsorbent using the heating method showed that the synthesized adsorbent can be used for three consecutive times with good performance. Correlation coefficients (R2) for genetic program and neural network were 0.98 and 0.99, respectively, indicating the agreement of laboratory data with the models.

The as-prepared AC by physical activation has a high potential for adsorption of AO7 dye from aqueous solutions.

Wound is a type of injury with high prevalence in the society. The main requirement for wound management is rapid and complete wound healing without the spread of infection. Medicinal plants are affordable and accessible and suggested as one of the key treatment options. The aim of this study was to investigate the effect of lipogel formulations containing the extracts of Eryngium campestre L. and Satureja hortensis L. on wound healing in Wistar rats.

In order to prepare the lipogel formula, several formulations were designed with different ratios of paraffin, polyethylene, and extracts which were all examined to find the best formulation. To this end, 20 rats were divided into four groups (n=5 per group), including normal saline, lipogel base, lipogel containing extracts, and active water. Full thickness wounds (2.5 * 2.5 cm) were made on the dorsal neck area. Wound size evaluation and histopathological study were done on days 3,5,7, and 12.

The formulation containing 95% paraffin and 5% polyethylene was selected as the final lipogel formulation due to better skin coverage, good consistency, and better uniformity. In vivo results showed significant differences in wound size between treatment group and other groups (P<0.05). According to histological studies, the rates of collagen deposition in groups treated with lipogel containing extracts and lipogel base were higher than other groups. Furthermore, fibroblast maturity was found to be significantly different between the rats treated with lipogel containing extracts and normal saline group (P< 0.05).

This study showed that lipogel containing extracts of Eryngium campestre L. and Satureja hortensis L. was effective in full thickness wound healing.

Autologous hematopoietic stem cell transplantation may be one of the best treatment options for some patients with hematological malignancies. The process of stem cell homing in the bone marrow and the production and proliferation of denovo cell populations is called engraftment and could be considered as one of the key factors in the success of stem cell transplantation. The aim of this study was to investigate the main success factors in stem cell transplantation.

In this retrospective research, patients undergoing autologous stem cell transplantation (between 2009 and 2019) with lymphoma and multiple myeloma were included and the factors affecting engraftment time and the hospital length of stay were studied using patients' records.

In patients with Hodgkin's diagnosis, myeloid engraftment took longer than that in patients with multiple myeloma (P= 0.06). One-unit increase in platelet transfusion led to late myeloid engraftment (P= 0.09). Patients diagnosed with Hodgkin lymphoma also had a later platelet engraftment than patients diagnosed with multiple myeloma (P= 0.008) and increase in unit of platelets transfused caused later platelet engraftment (P= 0.05). Significant risk factors in multivariate analysis were entered into multiple models, among which only the number of packed cells transfusion was associated with duration of hospitalization (P<0.0001).

Myeloid and platelet engraftment are associated with numbers of transfusions and transfusion support should be provided for patients at the correct rate to avoid hospital length of stay.

Fingolimod, is one of the first oral disease-modifying treatments (DMT) that has shown efficacy in advanced clinical trials for the treatment of multiple sclerosis (MS). The present study examined the one-year effectiveness and side effects of fingolimod.

In this quasi-experimental study, 26 MS patients attending Kermanshah Imam Reza Hospital were treated with fingolimod for one year (2018-19). Before and after treatment, the severity of disability (EDSS score), frequency of active lesions on MRI, and incidence of drug-related complications were studied. Data were analyzed using SPSS V25.

The mean age of patients was 34.23 ± 6.9 (17-44 years old), including 20 (76.9%) females and 6 (23.1%) males. The average duration of disease was 7.63±4.7 years. Relapsing-remitting multiple sclerosis (RRMS) and relapsing progressive (PRMS) were observed in 23 (88.5%) and 3 (11.5%) patients, respectively. The EDSS score was significantly lower at the end of the study (2.29±2.0) than the beginning of the study (3.12±1.9) (P= 0.001). The frequency of cases with active lesions in MRI was 63.6% before the treatment that decreased to 40.0% after treatment (P>0.05). No immediate side effects were reported, but delayed complications occurred in 27% of RRMS patients, including hair loss (n=1), increased liver enzyme levels (n=3), cardiac complications (n=2), and depression (n=1). PRMS patients had no delayed complications.

Fingolimod has a good effect in RRMS and PRMS patients with tolerable side effects.

Hypothermia is a common complication during anesthesia and surgery which leads to complications such as shivering, delay in recovery, and prolonged hospital stay. Therefore, the aim of this study was to determine the effect of hypothermia prevention program on shivering and recovery time in patients undergoing abdominal surgery.

This single-blind clinical trial was performed in 80 patients who met the inclusion criteria and were randomly assigned to either an intervention group that received hypothermia prevention program (using warm prep solution, warm serum during surgery, and hot water bag to retain heat in recovery) or a control group. The patients were evaluated for shivering and recovery time. Data analysis was performed in SPSS V21 using t-test and Chi-square.

According to findings, temperature changes were different over time between the two groups (P=0.001). In control group, 82.5% had shivering, while in intervention group only 7.5% experienced shivering (P= 0.001). Recovery time was also significantly lower in intervention group (P= 0.001).

Due to the complications of hypothermia, implementing a hypothermia prevention program can greatly prevent the chills, shorten recovery time, and lower the risk of other complications. Therefore, it is recommended as a low-cost and effective care program in patients undergoing major surgeries such as abdomen and thorax and also in surgical practices of elderly patients.
 
(Clinical Trials Registry Number: IRCT20200304046691N1)

Millions of people undergo surgery worldwide each year. Families experience the highest levels of anxiety while waiting for a relative undergoing a surgical procedure. Communication between families and health care professionals reduces their anxiety at this time. The aim of this study was to determine the effect of Short Message Service (SMS) on the level of anxiety and satisfaction of patient companions during surgery.

This clinical trial was performed in 128 family members of patients undergoing surgery in Chalous Taleghani Hospital, 2020-2021. The participants were divided into an intervention group (n=64) and a control group (n=64). In intervention group, text messages were sent to companions and they were informed about their patient’s condition, while the control group received routine information about their patient. Anxiety levels were measured by Spielberger overt and covert questionnaire at two stages and satisfaction was measured by asking the level of satisfaction at the time of operating room discharge. Statistical analysis was performed using Chi-square, t-test, and Mann-Whitney test.

Demographic characteristics, including sex, educational level, and type of surgery were similar between the two groups. After the intervention, the mean scores for overt and covert anxiety were significantly lower in intervention group than the control group (P<0.001). Also, the mean score for satisfaction with the information provided about patient's condition was significantly higher in intervention group compared to the control group (P<0.001).

Using SMS is effective in reducing the anxiety level and increasing families’ satisfaction during the wait for a relative undergoing low-risk surgery, therefore, allocating facilities to support and care for families is recommended.

Toxocariasis is a zoonotic infection that can affect the human eye, some viscera, and even the nervous system. The infection is worldwide and is more prevalent in areas with poor hygiene such as rural areas. This investigation aimed at studying the seroprevalence of toxocariasis in Qaemshahr, north of Iran, for the first time, and recognizing its risk factors in rural areas.

In this cross-sectional study, 370 people were selected from different rural areas and after completing a questionnaire, blood samples were collected. After isolation of serums, anti-Toxocara antibody was examined by ELISA kit (Novatec, Germany). Data were analyzed in SPSS V24 using logistic regression.

Anti-Toxocara antibodies were detected in 159 (42.97%) patients. No significant association was observed between positive anti-Toxocara and variables studied (P>0.05). Among five selected areas, the rates of positive anti-Toxocara were significantly higher in two rural areas (P<0.05).

To the best of our knowledge, this study reported the highest seroprevalence of Toxocara in Iran. Physicians in this area are suggested to pay more attention to this infection. Due to the high seroprevalence of Toxocara in this region, further studies are required in other regions in Mazandaran province with a similar climate.

Tramadol poisoning is a serious medical emergency and one of the most common causes of drug poisoning. The present study aims to determine the epidemiological features of patients who were served by Qaemshahr pre-hospital emergency care due to tramadol toxicity in 2016.

In this descriptive cross-sectional study, medical records of patients with toxicity that received pre-hospital emergency care in Qaemshahr, Iran (2016-2017) were studied and relevant information were extracted.  Data analysis was done in SPSS V22.

Tramadol toxicity included 29.6% of the total poisonings and 50% of drug toxicity cases. There were 118 cases with tramadol poisoning, including 94.9% men and 5.1% women. The average age of patients was 26.61 years and the majority (66.1%) aged 21-30 years old. All patients took tramadol orally and the main cause of toxicity was drug abuse (94.1%). Among the patients, 65.3% had no medical history and 29.7% had the history of narcotic abuse.

In this study, tramadol toxicity was the most prevalent cause of drug poisoning especially in young people due to drug abuse. Therefore, informing young people and their families about the consequences of tramadol abuse, extra precautions in its distribution, and lower prescription rates are effective in preventing and reducing tramadol toxicity.