فهرست مطالب

  • Volume:6 Issue: 1, Winter-Spring 2014
  • تاریخ انتشار: 1393/02/12
  • تعداد عناوین: 10
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  • Najmeh Rahimi, Mohammad Hossain Gozashti, Hamid Najafipour, Mostafa Shokoohi, Hamid Marefati Page 1
    Background
    Due to this belief that opium may have beneficial effects on diabetes or cardiovascular risk factors، the present study aimed to assess the potential and possible effects of opium consumption on diabetes control and some cardiovascular risk factors in diabetic patients.
    Methods
    This study enrolled 374 diabetic subjects from diabetes care centers in Kerman، Iran including opium user group (n = 179) and a non opium user group (n = 195). The data were collected through a questionnaire completed by interviewing، physical examination and laboratory assessment.
    Findings
    Opium did not show any statistically significant effect on blood glucose، glycated hemoglobin (HbA1C)، fasting blood sugar (FBS)، low-density lipoprotein (LDL) and diastolic blood pressure. However، systolic blood pressure and prevalence of high systolic blood pressure were significantly higher in opium user group (P < 0. 050). In addition، lower serum high-density lipoprotein (HDL) and frequency of lower HDL was significantly higher in opium user group (P < 0. 001).
    Conclusion
    According to this study، opium does not seem to have beneficial effects on diabetes control or cardiovascular risk factors. Therefore، it would not be advisable to consume opium as an anti-diabetes or cardioprotective agent.
    Keywords: Opium, Diabetes mellitus, Cardiovascular risk factor, Dyslipidemia, Hypertension
  • Afsaneh Forood, Reza Malekpour, Afshar, Jamshid Sarnevesht Page 7
    Background
    The rate of cardiovascular diseases in developing countries is approximately 60% and it is still has an increasing trend. The clinical effectiveness of aspirin in preventing cardiovascular events has been well proven. Although aspirin is an effective and inexpensive drug, its consumption is not equally beneficial for all patients. Many factors can be affective on the efficacy of antiplatelet drugs such as aspirin.
    Methods
    This study was carried out on 260 patients who had stable angina pectoris and coronary artery disease was approved by coronary angiography. Based on opium addiction, the patients were divided into two groups. Opium addiction was diagnosed base on Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM IV) criteria. The mid stream morning urinary sample were collected for measuring the urinary 11-dehydroxy thromboxane B2 level (UTXB2). Urinary level of UTXB2 was considered as an aspirin resistance index.
    Findings
    The mean age of patients was 57.3 ± 8.9; and 44.6% of them were females. The aspirin resistance rate was 41.5%. Significant difference in aspirin resistance was observed between the opium addicts and non-addicts. (51.5% vs. 31.5%) (P = 0.001). The effects of confounding variables such as diabetes, hypertension, and hyperlipidemia were eliminated by regression logistic multivariable analysis.
    Conclusion
    The prevalence of aspirin resistance in patients with stable angina pectoris was 41.5%. The prevalence of aspirin resistance in patients with stable angina pectoris who had opium addiction was significantly higher them non-addicts.Keywords: Opium addiction, Aspirin resistance, Stable angina pectoris, Coronary angiography
  • Farzaneh Zolala, Ali Akbar Haghdoost, Roohollah Zahmatkesh, Mehdi Shafiei Page 14
    Background
    Since 2000, Iran has been delivering training and treatment services, including methadone therapy, to HIV positive patients through triangular clinics. This study aims to evaluate the effectiveness of these activities at the HIV Triangulation Centre in the city of Kerman, Iran, through clients’ views.
    Methods
    Participants were recruited using a convenience sample and assessed through in-depth interviews, and observations. Data were analyzed using a thematic analysis, matrix based method.
    Findings
    The results found problems in training and counseling which was described by the staff to be due to the effects of the economic difficulties of the clients, not being of the same sex as the consultant, and lack of utilization of a variety of training methods by the clients. Furthermore, the absorption of clients was perceived as being affected by the appearance of the center, gossip around the center, limited working hours, and interpersonal relations between clients and staff. The clients also criticized the building of the center as it failed to maintain anonymity of the patients. The need for supplementary services, such as dentistry, was perceived by many clients.
    Conclusion
    The application of appropriate strategies such as providing adequate training and removing the obstacles of absorption should be taken into account to increase the utility and coverage of the triangular clinic. These interventions could be a range of activities, such as relocating the center to a more decent place and encouraging the staff to appear in a professional white coat to help gain the trust of clients.
    Keywords: HIV, Triangulation clinic, Counseling, Methadone therapy
  • Amin Gousheh, Hassan Ziaaddini, Mohammad Reza Baneshi, Nouzar Nakhaee Page 22
    Background
    Identifying the status of substance misuse and its psychosocial correlates among residents of juvenile correctional centers, as a high risk group, could potentially illuminate the roadmap to prevention of drug use in this group.
    Methods
    In this cross-sectional study, 93 individuals aged 13 to 18 were enrolled. A self-administered questionnaire was completed and dropped in a sealed box. It consisted of 4 parts of Piers-Harris Children’s Self-Concept Scale, NEO Personality Inventory, drug use questions, and demographic variables. All questionnaires were well adapted in the Persian language. MANOVA was used to compare the subscale scores between the drug users and nonusers.
    Findings
    All respondents were male and 40% were illiterate. More than 40% had drug dependent fathers. Use of cigarette, opium, and alcohol in the previous 30 days was reported by 31.9, 52.2, and 15.9% of respondents, respectively. In this population, the score of 3 of the 5 personality factors (i.e., neuroticism, extraversion, and openness) were higher than in the general population (P < 0.001). More than 88% of subjects had negative self-concept. Both the scores of personality and self-concept showed no significant difference based on the status of drug use.
    Conclusion
    Prevalence of lifetime and last-month drug use was found to be high. Regarding the profiles of personality and self-concept, more comprehensive evidence-based interventions are needed for improvement of their mental health.
    Keywords: Adolescent, Questionnaires, Substance, Self, concept, Personality
  • Fahimeh Kamali, Sarvestani, Tahereh Motiallah, Farahnaz Ghaffarinejad Page 30
    Background
    Heroin is an extremely addictive narcotic drug derived from morphine. Its continued use requires increased amounts of the drug to achieve the same effect, resulting in tolerance and addiction. This study was done in order to determine the prevalence of musculoskeletal pain and forward head posture among heroin users during their withdrawal.
    Methods
    This research was a cross-sectional study that was done on 90 heroin users (83 males, 7 females) aged between 20 to 40 years (32.5 ± 3.81) during their withdrawal in Shiraz, Iran. They were selected by simple randomized sampling. Data were collected by a form regarding age, sex, the duration of heroin use, and musculoskeletal pain. Pain was measured by VAS (visual analog scale) and forward head posture was evaluated by plumb line. Pearson correlation technique and chi-square were used for analyzing the data.
    Findings
    The results revealed that the majority of heroin users suffered from musculoskeletal pain during their withdrawal. At the end of withdrawal 53.4% had severe pain, 38.8% had moderate pain, and 7.8% of them had mild pain. Pain in the lower extremities and low back was more common than the upper extremities. The intensity of pain before withdrawal was mild, during withdrawal was moderate, and at the end was sever, but there was no significant correlation between them. The results also showed 43.3% of subjects had normal posture and 56.7% had forward posture.
    Conclusion
    According to the results, the intensity of pain increased during the withdrawal period; therefore, more attention must be paid to this complication in heroin users for better evaluation and a successful withdrawal.
    Keywords: Addiction, Heroin, Withdrawal, Musculoskeletal pain, Forward head posture
  • Saiedeh Haji, Maghsoudi, Ali Akbar Haghdoost, Mohammad Reza Baneshi Page 36
    Background
    Prisoners, compared to the general population, are at greater risk of infection. Drug injection is the main route of HIV transmission, in particular in Iran. What would be of interest is to determine variables that govern drug injection among prisoners. However, one of the issues that challenge model building is incomplete national data sets. In this paper, we addressed the process of model development when missing data exist.
    Methods
    Complete data on 2720 prisoners was available. A logistic regression model was fitted and served as gold standard. We then randomly omitted 20%, and 50% of data. Missing date were imputed 10 times, applying multiple imputation by chained equations (MICE). Rubin’s rule (RR) was applied to select candidate variables and to combine the results across imputed data sets. In S1, S2, and S3 methods, variables retained significant in one, five, and ten imputed data sets and were candidate for the multifactorial model. Two weighting approaches were also applied.
    Findings
    Age of onset of drug use, recent use of drug before imprisonment, being single, and length of imprisonment were significantly associated with drug injection among prisoners. All variable selection schemes were able to detect significance of these variables.
    Conclusion
    We have seen that the performances of easier variable selection methods were comparable with RR. This indicates that the screening step can be used to select candidate variables for the multifactorial model.
    Keywords: Missing data, Multiple imputation, Drug injection, Prison, Variable selection
  • Nahid Kaviani, Kourosh Mohammadi, Eghbal Zarei Page 45
    Background
    The aim of this study was to examine the relationship between perfectionism and coping strategies in drug-dependent men. This study is a descriptive correlational study.
    Methods
    The statistical population of this study consisted of all drug-dependent men (n = 6237) in years 2010-2011, who were admitted to all self-referral rehabs in Kerman. From this statistical population, 361 individuals were selected using randomized cluster sampling. The measurement tools applied in this study were positive and negative perfectionism questionnaires (Terry short et al., 1995) and coping responses (Blinger and Moose, 1981).
    Findings
    The data was analyzed using statistical methods, Pearson Coefficient Correlation and multivariable regression inferential statistics. The results showed that there is a significant correlation between positive and negative perfectionism and problem- focused and emotion-focused coping strategies (P ≤ 0.01).
    Conclusion
    The results of the current study show that positive and negative perfectionism predicts problem- focused and emotion-focused coping strategies for drug-dependent men.
    Keywords: Perfectionism, Coping strategies, Opium, dependent men
  • Leila Ghamati, Vahid Hajali, Vahid Sheibani, Khadije Esmaeilpour, Gholamreza Sepehri, Mojtaba Shojaee Page 54
    Background
    Opioids have been shown to affect learning and memory processes. Different protocols of morphine withdrawal can substantially vary in their success to prevent opioid induced impairments of cognitive performance. In the present study, we report the effects of single and repetitive ultra-rapid detoxification (URD) on spatial learning and memory in morphine addicted rats.
    Methods
    Morphine (10 mg/kg) was intraperitoneally (IP) injected in male rats once a day over one week and after which they were detoxified with naloxone administration under anesthesia. For the repetitive procedure, a second one week morphine treatment with a second subsequent detoxification was performed. Control groups received an equivalent volume of saline injections. Spatial learning and memory was evaluated using the Morris water maze (MWM) task.
    Findings
    Both protocols of morphine administration resulted in a severe spatial memory impairment that could be significantly prevented by both single and repetitive URD. However, memory abilities in animals treated with repetitive URD were still significantly lower than in animals of the corresponding control group. Alterations in motor activity or sensory-motor coordination between morphine treated and control animals could be ruled out by comparing swimming speed and visible platform performances that were not different between groups. Thus, URD and, specifically single URD, can prevent the spatial memory impairments in addicted rats.
    Conclusion
    As opioid addiction is an extending and serious concern in many societies, these findings may have clinical values and therapeutic implications for patients who experience multiple opioid relapses.
    Keywords: Opioids, Addiction, Detoxification, Spatial memory, Morris water maze (MWM)
  • Nagesh Bhat, Jaddu Jyothirmai Reddy, Mandeepsinh Gohil, Megha Khatri, Mridula Ladha, Meenakshi Sharma Page 73
    Background
    Tobacco is one of the most important causes of morbidity and mortality. Tobacco toll in India has one-fifth of all worldwide death attributed to tobacco. There are 700000 deaths per year due to smoking and 800000-900000 per year to all forms of tobacco use of exposure in India. The role of dentist in supporting their patients to quit smoking has been recognized. The present study was conducted to know the attitudes, practices and barriers in tobacco cessation among dentists of Udaipur city (Rajasthan, India).
    Methods
    A pretested, close-ended, self-administered, coded questionnaire was distributed among all the 262 dental health practitioners and the teaching staff. Out of 262 questionnaires distributed among the dentist, 151 dentists filled out and returned the questionnaire.
    Findings
    The majority of the dentists (98.7%) agreed that it was their responsibility to provide smoking cessation counseling. 54.3% of dentists agreed that such discussions were too time consuming. 37.1% thought they lacked knowledge regarding this subject. 35.8% feared to an extent about patient leaving their clinic if counseled much.
    Conclusion
    In general, the dentists were in favorable attitude in tobacco cessation counseling for the patients; however, the lacks of time and knowledge and to an extent, a fear that the patients would leave their clinic, were the main identified barriers.
    Keywords: Dentists, Smoking Cessation, Attitudes, Barriers
  • Abdoul Reza Sabahi, Zahra Amini, Ranjbar, Ali Sharifi, Ali Kheradmand Page 81
    Background
    Enucleation is a topic discussed in psychiatry which is a self-injury matter. Enucleation is observed as psychotic disorder due to substance abuse. In people with mental disorders who also have substance use leading to hallucinations and delusions, unusual eye evacuation were reported. In most cases, enucleation was done using sharp tools.Case Report: This report describes a man suffering from psychosis after consuming hashish and has attempted to evacuate his eyes with his finger.
    Conclusion
    Given the increasing prevalence of hashish use by young people, and false beliefs about the use of hashish in order to withdraw other substances, preventive methods and education for young and vulnerable people are suggested.
    Keywords: Eye enucleation, Substance use, Hashish