Yafteh

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Background: Gamma-amino butyric acid (GABA) agonists have been effective in the treatment of withdrawal from benzodiazepines, sedatives and alcohol, and reducing the craving for cocaine. Valproate is a GABAergic drug effective in the treatment of neuropathic pain and also in withdrawal from benzodiaepines, sedatives, and alcohol. The purpose of this double-blind trial was to evaluate the efficiency of valproate in reducing acute opiates withdrawal symptoms and duration of detoxification. Materials and methods: A total of 60 opium addicts, who met the DSM-IV criteria for opiate dependence were assigned randomly to treat with sodium valproate or placebo during a 26 day double-blind clinical trial. Both groups received methadone on an as-needed basis, tapered gradually, and clonidine . The severity of withdrawal symptoms were measured on days 2, 5, 9, 12, 19 and 26 using the modified short opioid withdrawal scale (SOWS).The results were compared between two groups with independent t-test. Findings: Valproate was not more effective than placebo in reducing physical symptoms of withdrawal syndrome or the duration of detoxification process. However, valproate was significantly effective in the management of mental symptoms. Conclusions: Sodium valproate may be an effective adjunctive therapy for management of the mental symptoms of opiates withdrawal. Larger studies are required to confirm these findings and to assess the efficacy of sodium valproate in the management of protracted abstinence syndrome and relapse prevention.

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Abstract Background: poisoning is one of the most common medical emergencies. Every year many people refer to emergency wards due to poisoning and some of them are treated and some die because of severe complications. Most patients who refer to emergency wards are those who commit intentionally to suicide. This study is conducted to determine the prevalence of poisoning with pesticide (organophosphate and organochlorine) in persons referred to Shohada Ashaier hospital of Khorramabad in the first six months in 2006. Metrials and methods: Required information of poisoned people with poisoning pesticide (organophosphate and organochlorine) were collected using questionnaires which were distributed among the subjects. Results: In this study 153 patients including 118 patients who poisoned with organophophate and 35 patents with organochlorine were studied. Most of the patients (34.6%) aged between 21-71 years including 57.5% female and 42.5% male and their education was about under secondary school, 91.5% of them attempted to suicided. The total mortality rate was 12 that 7 of them died by toxifications with organochlorine and 5 cases by organophosphate, which in turn was due to their respiratory complications like ARDS and aspiration pneumonia. Conclusion: findings indicate that due to high prevalence and mortality of poisoning with pesticides, this problem should be taken into consideration.

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Background: About 8 percent of Iranian adult population are illicit drug abusers. Affected persons grow more each day. Ominous consequences such as divorce, prostitution, murder and other crimes and infectious diseases such as AIDS and hepatitis take place following drug abuse, as well as a loss equall to 29% of national income for our country. Traditional treatment methods wasted too much time and cost. professional inpatient clinics are not adequate for admission of all care seekers. Rapid detoxification methods are supposed to be better alternatives.

Materials and Methods: 140 male drug abusers in two matched groups were assessed from March to September, 2005. They used heroin or opium. Both groups were scheduled for detoxification and were closely observed for 3 months thereafter. First group received Clonidine, Benzodiazepine and Naltrexone besides symptom relieving modalities in first 4 days of treatment. Naltrexone was continued in maintenance dose for one month. Second group received Methadone for one month.

Results: Clients age was between 18 to 73 years, with mean age 34 years old. Their intelligence quotients were above the lower limit of normal range. There was no significant difference according to these parameters between two groups. Success rate in rapid detoxification group was 55 % and in Methadone group was 50 %. Relapse in rapid detoxification method occurred less frequent and slower (45 % vs. 50%). In Naltrexone group, better success rate was due to less duration of drug abuse and heroin dependency. In Methadone group, therapy had better results in patients with longer drug abuse history and opium addiction. There was no significant difference between success rate and either drug kind or job, marital status or education level. The most serious adverse effect in both groups was hypotension (10% in Naltrexone and 5 % in Methadone groups).