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Zarei MJ, Ramezani M, Sahraie Z, Shadnia S, Erfan Talab Evini P, Mostafazadeh B, Rahimi M. Comparing Two Naloxone Tapering Methods in Management of Methadone Intoxication; a Quasi-experimental Study. Arch Acad Emerg Med 2023; 11:e46. [PMID: 37609540 PMCID: PMC10440751 DOI: 10.22037/aaem.v11i1.2047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Introduction Even though naloxone is the main treatment for methadone poisoning treatment there are controversies about the proper method of its tapering. This study aimed to compare two methods in this regard. Method This study was a prospective, single-blind pilot quasi-experimental study on non-addicted adult patients poisoned with methadone. Patients were randomly divided into 2 groups. In one group, after stabilization of respiratory conditions and consciousness, naloxone was tapered using the half-life of methadone and in the other group, naloxone was tapered using the half-life of naloxone. Recurrence of symptoms and changes in venous blood gas parameters were compared between groups as outcome. Results 52 patients were included (51.92% female). 31 cases entered Group A (tapering based on methadone's half-life) and 21 cases entered Group B (tapering based on naloxone's half-life). The two groups were similar regarding mean age (p = 0.575), gender distribution (p = 0.535), the cause of methadone use (p = 0.599), previous medical history (p = 0.529), previous methadone use (p = 0.654), drug use history (p = 0.444), and vital signs on arrival to emergency department (p = 0.054). The cases of re-decreasing consciousness during tapering (52.38% vs. 25.81%; p = 0.049) and after discontinuation of naloxone (72.73% vs. 37.50%; p = 0.050) were higher in the tapering based on naloxone half-life group. The relative risk reduction (RRR) for naloxone half-life group was -1.03 and for methadone half-life group was 0.51. The absolute risk reduction (ARR) was 0.27 (95% confidence interval (CI) = 0.01-0.53) and the number needed to treat (NNT) was 3.7 (95% CI= 1.87- 150.53). There was not any statistically significant difference between groups regarding pH, HCO3, and PCO2 changes during tapering and after naloxone discontinuation (p > 0.05). However, repeated measures analysis of variance (ANOVA), showed that in the tapering based on methadone's half-life group, the number of changes and stability in the normal range were better (p < 0.001). Conclusion It seems that, by tapering naloxone based on methadone's half-life, not only blood acid-base disorders are treated, but they also remain stable after discontinuation and the possibility of symptom recurrence is reduced.
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Affiliation(s)
- Mohammad Javad Zarei
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maral Ramezani
- Department of Pharmacology, School of Medicine, Arak University of Medical Sciences, Arak, Iran
- Traditional and Complementary Medicine Research Center, Arak University of Medical Sciences, Arak, Iran
| | - Zahra Sahraie
- Department of Clinical Pharmacy, Faculty of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahin Shadnia
- Toxicological Research Center, Excellence Center & Department of Clinical Toxicology
| | | | - Babak Mostafazadeh
- Toxicological Research Center, Excellence Center & Department of Clinical Toxicology
| | - Mitra Rahimi
- Toxicological Research Center, Excellence Center & Department of Clinical Toxicology
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Murad HAS, AlHarthi NA, Bakarman MA, Gazzaz ZJ. Development and Validation of an Arabic Version of the Drug Abuse Screening Test-10 (DAST-10) among Saudi Drug Abusers. J Psychoactive Drugs 2022; 54:482-489. [PMID: 34955091 DOI: 10.1080/02791072.2021.2013580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The Drug Abuse Screening Test-10 (DAST-10) is a valid and reliable screening tool for drug use-related problems, however there is no Arabic version. To our knowledge, this is the first study to develop and validate an Arabic DAST-10 version. Saudi young adults participated in the study as two groups; drug users (n=360) recruited from Alamal Complex for Mental Health, Jeddah, and drug non-users (n=100). Three measures were used: (1) Demographic and drug use description questionnaire, (2) Arabic DAST-10 version, and (3) Urine analysis for drug use. The developed Arabic DAST-10 version demonstrated adequate internal consistency. High correlations were shown between its scores and the two standard measures (urine analysis and self-reporting question) indicating good criterion validity. Sensitivity and specificity values were between 91.5 - 99.7% and 57 - 92.5% with different DAST-10 cutoff values. An optimal performance at a cutoff score of 3 or more was most likely to significantly identify drug users. Discriminant analysis showed that more than 90% of cases were correctly classified. Distribution of participants in categories of DAST-10 scores according to degree of problems was reasonable. It is concluded that the developed Arabic DAST-10 version is a reliable and valid screening tool for drug use-related problems in Arabic speakers.
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Affiliation(s)
- Hussam Aly Sayed Murad
- Department of Pharmacology, Faculty of Medicine, Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Pharmacology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Marwan Abdulrhman Bakarman
- Department of Family and Community Medicine, Faculty of Medicine, Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Zohair Jamil Gazzaz
- Department of Internal Medicine, Faculty of Medicine, Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
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Abstract
BACKGROUND Epidemiological data are crucial in designing policies for the control of human immunodeficiency virus (HIV) infections. There is a lack of data on the epidemiology of HIV in Korean correctional facilities such as jails and prisons. METHODS Clinical characteristics of the study population were collected through a medical record review. RESULTS The number of people with HIV infection were 83 and the HIV infection prevalence in correctional facilities of Korea was 0.15%. Among them, 10 (12.0%) were diagnosed with the infection when they were incarcerated. The number of drug users was 38 (45.8%). Syphilis-HIV coinfection was observed in 21 (25.3%) patients. Individuals from the group comprising the drug users were more likely to belong to the lesbian, gay, bisexual, transgender, queer (LGBTQ) community, and had a higher incidence of psychological disorders (31.6% vs. 11.1%, P = 0.029; 50.0% vs. 28.9%, P = 0.049, respectively). CONCLUSION Inmates of correctional facilities showed a five times higher prevalence of HIV infection in Korea, nearly half of whom were drug users.
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Affiliation(s)
- Sejin Choi
- Seoul Detention Center, Ministry of Justice, Uiwang, Korea
- Department of Translational Medicine, College of Medicine, Seoul National University, Seoul, Korea
| | - Eunyoung Lee
- Division of Infectious Diseases, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea
| | - Ji Hwan Bang
- Division of Infectious Diseases, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
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Valois-Santos NT, Niquini RP, Sperandei S, Bastos LS, Bertoni N, Brito AM, Bastos FI. Reassessing geographic bottlenecks in a respondent-driven sampling based multicity study in Brazil. Salud Colect 2020; 16:e2524. [PMID: 33147401 DOI: 10.18294/sc.2020.2524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 07/15/2020] [Indexed: 11/24/2022] Open
Abstract
This study analyzes the spatial dynamics of drug users' recruitment chains in the context of a respondent-driven sampling (RDS) study in the city of Recife, Brazil. The purpose is to understand the geographic bottlenecks, influenced by social geography, which have been a major challenge for RDS-based studies. Temporo-spatial analysis was used. Sequential maps depicted the dynamics of the recruiting process, considering neighborhood of residence and/or places of drug use. Poisson regression was fitted to model the recruiting rate by neighborhood of residence and/or places of drug use, and the different neighborhoods' demographics. The distance between neighborhood of residence and/or places of drug use and the assessment center was negatively associated with recruitment. There was a positive association between the proportion of the population living in informal settings and the recruiting rate per neighborhood of residence and/or places of drug use. Recruitment chains depend on the social geography and demographics of the population. Studies should incorporate seeds from as many neighborhoods as possible, and more than one assessment center should be utilized.
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Clua-García R. [Managing pleasures and harms: An ethnographic study of drug consumption in public spaces, homes and drug consumption rooms]. Salud Colect 2020; 16:e2481. [PMID: 33147386 DOI: 10.18294/sc.2020.2481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 06/16/2020] [Indexed: 11/24/2022] Open
Abstract
Drug consumption rooms (DCR) aim to facilitate consumption in hygienic and safe conditions. However, users also consume drugs in public spaces and homes generating incremental risk for health. To strengthen our understanding of consumption practices, we conducted an ethnographic study in different consumption locations in Barcelona, including DCRs, public spaces, and homes. Focusing on consumption practices and narratives, we conducted participant observation and interviewed 16 DCR users. Our findings show that different consumption spaces allow users to experiment different types of pleasures. In addition, consumption in each type of location is associated with various types of harms, which are managed by users by self-regulating their practices. These aspects, therefore, must be taken into account to design harm reduction action aligned with users' practices.
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Alli A, Minond J, Embil Y, Kiss Rouan M. [Discontinuous and erratic ways of passing through a hospital specialized in mental health and addictions in the City of Buenos Aires: the point of view of the health professionals]. Salud Colect 2020; 16:e2521. [PMID: 33147396 DOI: 10.18294/sc.2020.2521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 06/16/2020] [Indexed: 11/24/2022] Open
Abstract
The purpose of this study was to describe the perspective of health professionals regarding the discontinuous and erratic clinical trajectories of individuals with problematic substance use at a hospital specialized in mental health and addiction in the City of Buenos Aires. From October 2017 to October 2018, a qualitative exploratory study was carried out based on six case studies recovered from previous research. Medical records were analyzed and semi-structured interviews were conducted with the professionals involved. Among the principal results, we found that the definition of erratic clinical trajectories formulated was not very descriptive of the course of some cases, leading us to propose a new concept, that of the segment (el tramo). This concept accounts for the moment in which the clinical trajectory is sustained, even if that entails switching to a different health service. With respect to objectives and therapeutic strategies, we found a clear difficulty on the part of professionals to name and describe them. Lastly, we found alarmingly little systematization of in-hospital referrals among mental health treatment teams, compared to clinical medical consultations and referrals to other health care providers.
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Almeida RBF, Santos NTV, Brito AM, Silva KSBE, Jacques IJAA, Nappo SA. [The use of "virado" as a harm reduction strategy among crack users in the State of Pernambuco, Brazil]. Salud Colect 2020; 16:e2528. [PMID: 32574452 DOI: 10.18294/sc.2020.2528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 04/14/2020] [Indexed: 11/24/2022] Open
Abstract
The aim of the study is to discuss the use of crack in the form of "virado" as a harm reduction strategy in Pernambuco, Brazil. This is a cross-sectional study with a qualitative approach in which semi-structured interviews were conducted regarding aspects related to the culture of crack use with 39 crack users between March and August 2016. Participants were recruited using saturation criteria and data were analyzed through content analysis. Respondents discussed the use of "virado" and compared its effects in relation to crack, addressing improvement in interpersonal relationships, libido, and non-compulsive drug use, which can all be understood as harm reduction strategies. On the other hand, equipment sharing for the use of "virado" was identified as a high-risk practice with regards to the transmission of infectious diseases. Knowing about the culture of crack use in different contexts is essential in order to plan and develop health care actions.
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De Santiago I, Ribeiro R, Nicolau LB, Marinho RT, Pereira-Miguel J. Consumption of Alcohol and Drugs in the School Population of Sao Tome and Principe. ACTA MEDICA PORT 2020; 33:237-245. [PMID: 32238237 DOI: 10.20344/amp.11876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 02/10/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION In Sao Tome and Principe there are no studies on alcohol and drug use among students, who could be potential allies in preventive interventions. The objectives of the present study are 1) to determine the frequency of alcohol and drug consumption in the school population, and 2) to identify the main characteristics associated with this behaviour. MATERIAL AND METHODS We applied a biographical, demographic and socioeconomic questionnaire on the use of licit and illicit substances to a sample of 2064 students. Demographic and social characteristics are presented based on observed frequencies and comparisons between groups were made using chi-square tests. Significance was assessed at α = 0.05. RESULTS More than half of the students reported consumed alcohol at least once in their lifetime, and 32% consumed in the last 30 days. Older students were more likely to consume alcohol (p < 0.0001), but even in students under 16 years, 17% consumed in the last 30 days. We also found that 7% consumed one or more times per week in the last 30 days. The reasons presented for frequent consumption were different for boys ("participation in their group of friends") and girls ("decrease anxiety") (p = 0.005). Less than 1% of respondents admitted to having used marijuana, cocaine, crack or ecstasy. DISCUSSION Despite some limitations, such as self-reporting, we provide a first overview showing high consumption of alcohol by young people and the existence of illegal drugs circulating in the schools. CONCLUSION It is urgent to implement preventive interventions, namely in the context of public health communication.
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Affiliation(s)
- Isabel De Santiago
- Comunicação em Saúde Pública. Instituto de Medicina Preventiva e Saúde Pública. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal
| | - Ruy Ribeiro
- Laboratório de Biomatemática. Instituto de Medicina Preventiva e Saúde Pública. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal
| | - Leonor Bacelar Nicolau
- Economia da Saúde. Instituto de Medicina Preventiva e Saúde Pública. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal
| | - Rui Tato Marinho
- Serviço de Gastrenterologia e Hepatologia. Hospital Universitário de Santa Maria. Centro Hospitalar Universitário de Lisboa Norte. Lisboa. Department of Gastroenterology and Hepatology. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal
| | - José Pereira-Miguel
- Medicina Preventiva. Instituto de Medicina Preventiva e Saúde Pública. Faculdade de Medicina. Universidade de Lisboa. Lisboa. Portugal
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De Santiago I, Nicolau LB, Marinho RT, Pereira-Miguel J. [Prevention Harmful Consumption of Alcohol and Drugs in Sao Tome and Principe Through Public Health Communication: The Scientific Protocol]. ACTA MEDICA PORT 2020; 33:229-236. [PMID: 32238236 DOI: 10.20344/amp.13435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 02/10/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Sao Tome and Principe is an African low-and-middle-income country, where extreme poverty causes major health inequalities. No systematic research has been done on the consumption of alcohol and drugs in Sao Tome and Principe, and only overall statistics are available based on the importation of alcoholic drinks and their distribution among the population. There are also no studies on consumption of alcohol and illicit substances in children and youth and no preventive measures being undertaken. Besides that, manual databases present significant limitations, considering the lack of causes associated with mortality rates (0 - 5 years and > 5), and the difficulty to establish a cause/effect relation between diseases, deaths and life expectancy. No relevant data with burden of life was found in the reports of Centro Nacional de Endemias or the non-governmental, organization Instituto Marques de Valle Flor, a facilitator on healthcare clinical specialties selected on a voluntary basis by doctors from Portuguese hospitals. So, we proposed to provide a first overview of family and housing conditions, and above all, the consumption of alcohol and illegal drugs in young people. Thus, a project, the National Survey on Harmful Consumption of Alcohol and Drugs in Schools of Sao Tome and Principe, will be realized in order to better characterize the situation among children and young students and test public health communication strategies and preventive interventions aimed at this target-population. Interventions were designed taking into consideration local sociocultural realities of target audiences. We considered dialect language, single-parent families (matriarchal structure) and polygamy (mostly) in men and a country and governments led by men (patriarchal structure) and, in which the woman's role, as Food and Agriculture Organization of the United Nations reports, remains overlooked. Subsequently, we will collect traditional alcohols samples from the two main islands for analysis (at Laboratório de Estudos Farmacêuticos and Laboratório Nacional de Engenharia Civil - Portugal) and to determine heavy metals in the production process and impact on burden of life. MATERIAL AND METHODS In order to characterise the country's situation in terms of alcohol and illicit substances consumption a literature review was carried out through a search in several international electronic databases, such as those of the World Health Organization, World Health Organization Africa, United Nation, The Lancet and Lancet Global Health, etc. Available data of the following institutions of Sao Tome and Príncipe was also analyzed: National Institute of Statistics, Ministry of Education, Culture and Training and Ministry of Health and Social Affairs. Several interviews with community and church leaders as well as with members of catholic missions were carried out to better understand the local situation. Following this, a nationwide cross-sectional survey of a sample of 2064 students will be carried out. This will include a questionnaire on socio-demographic characteristics, lifestyles, health behaviors/attitudes, alcohol and illicit substances consumption. Finally, based on the overall diagnosis obtained, some edutainment health communication preventive interventions will be tested in the primary schools of three districts (EDUCA_TURTLE) and on the radio journalists (EDUCA_PRESS). These were evaluated by primary school teachers and by radio journalists.
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Affiliation(s)
- Isabel De Santiago
- Unidade de Saúde Pública. Agrupamento de Centros de Saúde Lisboa Norte. Lisboa. Portugal
| | - Leonor Bacelar Nicolau
- Centro de Investigação em Saúde Pública. Escola Nacional de Saúde Pública. Universidade NOVA de Lisboa. Lisboa. Portugal
| | - Rui Tato Marinho
- Departamento de Epidemiologia. Instituto Nacional de Saúde Doutor Ricardo Jorge. Lisboa. Instituto de Bioética da Universidade Católica Portuguesa. Lisboa. Portugal
| | - José Pereira-Miguel
- Unidade Multidisciplinar de Investigação Biomédica. Instituto de Ciências Biomédicas Abel Salazar. Universidade do Porto. Porto. Portugal
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Zhang PF, Chen X, Zhao JS, He JM. [Survey of the depressive disorders prevalence and related risk factors among male new drug users in certain drug rehabilitation center of Changsha city]. Zhonghua Yu Fang Yi Xue Za Zhi 2018; 52:722-726. [PMID: 29996299 DOI: 10.3760/cma.j.issn.0253-9624.2018.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Objective: To understand the depressive disorders prevalence and related risk factors among new drug users in a male drug rehabilitation center. Methods: The cross-sectional study was used. A total of 250 new drug users from a male drug rehabilitation center were recruited during March, 2017. The drug users who only use new type of drugs single or use traditional drugs at the same time were collected as the new drug users. Their general information and drug-related information were collected by self-made questionnaire, and depressive disorders and sleep quality information were collected by the self-reported Patient Health Questionnaire-9 (PHQ-9) and the self-reported Pittsburgh Sleep Quality Index Questionnaire respectively. Logistic regression test was used to establish associations between variables. Results: Of all 250 drug users, the mean age (P(25), P(75)) was 30 (26, 35) years old, and 32.8% (82) had the depressive disorders. The individuals taking drug dose over 0.4 g daily before entering drug rehabilitation center had significantly more risk of the depressive disorders for 3.18 (1.71-5.90) than those not over 0.4 g daily.The individuals who bad sleep quality had significantly more risk of the depressive disorders for 6.07 (95%CI:3.31-11.12) than those had good sleep quality.The individuals who were depressive patients before the first drug use for 2.39 (95%CI: 1.12-5.10) than those were not depressive patients before the first drug use. Conclusion: There were a high rate of the depressive disorders among new drug users in the rehabilitation center; In addition, several risk factors including the individuals taking drug dose over 0.4 g daily and bad sleep quality, history of the depressive disorders were negatively associated with depressive disorders.
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Affiliation(s)
- P F Zhang
- School of Public Health, the University of South China, Hengyang 421000, China
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Oh JY, Chekal L, Kim SW, Lee JY, Lee DC. Comparing the Trend of Physical Activity and Caloric Intake between Lipid-Lowering Drug Users and Nonusers among Adults with Dyslipidemia: Korean National Health and Nutrition Examination Surveys (2010-2013). Korean J Fam Med 2016; 37:105-10. [PMID: 27073609 PMCID: PMC4826989 DOI: 10.4082/kjfm.2016.37.2.105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Revised: 09/09/2015] [Accepted: 09/27/2015] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND The purpose of this study was to compare the physical activity and caloric intake trends of lipid-lowering drug users with those of non-users among Korean adults with dyslipidemia. METHODS This study was a repeated cross-sectional study with a nationally representative sample of 2,635 Korean adults with dyslipidemia based on the 2010-2013 Korea National Health and Nutrition Examination Survey. Physical activity was assessed using the International Physical Activity Questionnaire, and caloric intake was estimated through 24-hour dietary recall. All statistical analyses were conducted using IBM SPSS ver. 21.0 (IBM Co., Armonk, NY, USA). The changes in physical activity and caloric intake were investigated for lipid-lowering drug users and non-users using generalized linear models. RESULTS The proportion of lipid-lowering drug users in the 2010-2013 survey population increased from 3.5% to 5.0% (P<0.001). Among adults of dyslipidemia, total of 1,562 participants (56.6%) reported taking lipid-lowering drugs, and 1,073 (43.4%) reported not taking lipid-lowering drugs. Drug users were more likely to be older and less educated and to have a diagnosis of diabetes, higher body mass index, and lower low density lipoprotein cholesterol level. Physical activity trends were tested separately for the lipid-lowering drug users and non-users, and a significant decrease was found among the drug users during the study period. Physical activity among the drug users in 2013 was 38% lower (1,357.3±382.7 metabolic equivalent [MET]; P for trend=0.002) than in 2010 (2,201.4±442.6 MET). In contrast, there was no statistically significant difference between drug users and non-users in the trend of caloric intake during the same period. CONCLUSION Physical activity significantly decreased among lipid-lowering drug users between 2010 and 2013, which was not observed among non-users. The importance of physical activity may need to be re-emphasized for lipid-lowering drug users.
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Affiliation(s)
- Jin-Young Oh
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Lan Chekal
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Se-Won Kim
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jee-Yon Lee
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Duk-Chul Lee
- Department of Family Medicine, Yonsei University College of Medicine, Seoul, Korea
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Habibi R, Nikbakht Nasrabadi A, Shabany Hamedan M, Saleh Moqadam A. The Effects of Family-Centered Problem-Solving Education on Relapse Rate, Self Efficacy and Self Esteem Among Substance Abusers. Int J High Risk Behav Addict 2016; 5:e24421. [PMID: 27162761 PMCID: PMC4859933 DOI: 10.5812/ijhrba.24421] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Revised: 02/01/2015] [Accepted: 02/15/2015] [Indexed: 11/18/2022]
Abstract
Background: The success of drug abuse treatment and relapse prevention methods depends widely on not only pharmaceutical and non-pharmaceutical therapies but also self efficacy and self esteem promotion. Objectives: The current study attempted to clarify the effects of Problem Solving Education (PSE) on relapse rate, self efficacy and self esteem among drug abusers. Patients and Methods: This non-controlled clinical trial (quasi-experimental) assessed 60 opium and heroin abusers who were willing to quit and were referred to the Mehr Center of Addiction Treatment and Rehabilitation Facility. The patients were allocated to two groups of 30 (intervention and control groups). While both groups received the routine care of the clinic, the intervention group also attended eight 45-minute family-centered PSE sessions. The Coopersmith Self esteem Inventory and Quit Addiction Self efficacy Questionnaire were filled out for all subjects before and after the intervention. Drug relapse was investigated four times with two-week intervals. The two groups were compared using chi-square and Student’s-t tests. Logistic regression analysis was applied to determine factors affecting drug relapse. Results: A total of 45 individuals (21 and 24 in the intervention and control groups, respectively) completed the study. At baseline, the two groups had no significant difference regarding their mean scores of self esteem and self efficacy (P = 0.692 and 0.329, respectively). After the intervention, however, the mean changes of self esteem scores were 20.10 ± 3.75 for the intervention group and 4.50 for the control group (P < 0.001). The mean changes of self efficacy scores in the mentioned groups were 34 34.17 ± 5.19 and 9.03± 2.04, respectively (P < 0.001). Drug relapse after two weeks was correlated with age (OR = 1.216; P = 0.026; 95% CI: 1.024-1.445) and implementation of the intervention (OR = 0.036; P = 0.003; 95% CI: 0.004-0.322). Conclusions: According to our findings, supplementing drug abuse treatment with cognitive behavior therapy, particularly PSE, can reduce relapse rate and enhance self efficacy and self esteem among patients.
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Affiliation(s)
- Rahim Habibi
- Deputy Dean For International Affairs, Operating Room Department, Paramedical Faculty, Qazvin University of Medical Sciences, Qazvin, IR Iran
| | - Alireza Nikbakht Nasrabadi
- Deputy Dean for International Affairs, Nursing and Midwifery Faculty, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Maryam Shabany Hamedan
- Brain and Spinal Cord Injuries Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Maryam Shabany Hamedan, Brain and Spinal Cord Injuries Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2177361961, E-mail:
| | - Amirreza Saleh Moqadam
- Nursing Management and Mental Health Department, Nursing and Midwifery Faculty, Mashhad University of Medical Sciences, Mashhad, IR Iran
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Karabulut N, Bulut Y, Telo S. Frequency of Hepatitis B and C Viruses, and HIV Among Drug Addicts in the Eastern Anatolia, Turkey. Jundishapur J Microbiol 2015; 8:e19698. [PMID: 26464763 PMCID: PMC4600201 DOI: 10.5812/jjm.19698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Revised: 09/12/2014] [Accepted: 10/18/2014] [Indexed: 02/06/2023] Open
Abstract
Background: Hepatitis B, hepatitis C and HIV infections constitute serious healthcare problems worldwide. Objectives: There are a limited number of studies regarding the prevalence of hepatitis B, hepatitis C and HIV infections among the drug addicts in Turkey; hence, the current study aimed to determine the frequency of these infections among 235 drug addicts treated in a drug addiction treatment centre/Elazig, Turkey. Patients and Methods: HBsAg, anti-HBs, anti-HCV and anti-HIV tests in 235 drug addicts were studied by ELISA technique. Urine samples obtained from drug addicts were analyzed for cannabis, opiate and cocaine metabolites. Results: All the 235 drug users were males, and their mean age was 30.69 ± 9.494 years; 112 (47.7%) of them were in the age group ranging 20 - 29 years (P < 0.05). Of 235 drug addicts, 113 (48.1%) and 115 (48.9%) were only cannabis and opiate users, respectively. In urine samples of seven (3%) drug addicts both cannabis and opiate metabolites were detected. Cocaine was detected in none of the urine samples. The frequencies of HBsAg, anti-HBs and anti-HCV among drug addicts were 2.6%, 38.3%, and 9.4%, respectively. None of the drug addicts was positive for HIV. Anti-HCV was more prevalent in opiate users than in cannabis users: 15.7% vs. 1.8% (P < 0.001). Conclusions: The obtained results showed that HCV infection was an alarming problem among opiate users in the eastern part of Turkey. It is suggested to rapidly diagnose the infected persons; thus preventive measures and appropriate control may limit further transmission of these infections.
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Affiliation(s)
- Nuran Karabulut
- Department of Medical Microbiology, Mental Health Hospital, Elazig, Turkey
- Corresponding author: Nuran Karabulut, Department of Medical Microbiology, Mental Health Hospital, Elazig, Turkey. Tel: +90-5052613347; Fax: +90-4242127831, E-mail:
| | - Yasemin Bulut
- Department of Medical Microbiology, Medical Faculty, Firat University, Elazig, Turkey
| | - Selda Telo
- Department of Medical Biochemistry, Mental Health Hospital, Elazig, Turkey
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Noori R, Jafari F, Moazen B, Khoddami Vishteh HR, Farhoudian A, Narenjiha H, Rafiey H. Evaluation of anxiety and depression among female spouses of Iranian male drug dependents. Int J High Risk Behav Addict 2015; 4:e21624. [PMID: 25861583 PMCID: PMC4386056 DOI: 10.5812/ijhrba.21624] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 08/24/2014] [Accepted: 10/01/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Existing evidences suggest the more vulnerability of spouses of drug dependents, in exposure to mental disorders. OBJECTIVES This study aimed to evaluate the associated parameters of anxiety and depression among female spouses of male drug dependents. PATIENTS AND METHODS With a cross-sectional design in 2010, a total of 237 Iranian women were selected and divided into three groups: 1. non-drug-dependent wives who had non-drug-dependent husbands (Group I), 2. non-drug-dependent wives who had drug-dependent husbands (Group II), and 3. drug-dependent wives who had drug-dependent husbands (Group III). Socio-demographic characteristics were collected by a checklist, and the levels of anxiety and depression were measured through the Hospital Anxiety and Depression Scale (HADS). Linear regression was applied for determination of anxiety and depression predictors. RESULTS Mean age of the participants was about 35 years, and mean duration of marriage was 14 years. Drug dependence of the husband (P = 0.010) and lower monthly income of the family (P = 0.007) predicted the higher level of anxiety among the participants, while older age (P = 0.031), shorter marital duration (P = 0.016), and lower educational level (P = 0.045) in addition to spousal drug dependence (P = 0.023), and lower family income (P = 0.014) were significantly associated with higher levels of depression. CONCLUSIONS Findings of the present study demonstrate that spousal drug dependence and lower monthly income were common predictors of anxiety and depression among spouses of drug dependents in Iran, while older age, shorter marital duration and lower educational level were predictors of depression. However, more research is needed to find casual relationships between spousal drug dependence and mental health in Iran.
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Affiliation(s)
- Roya Noori
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
| | - Firoozeh Jafari
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
- Corresponding author: Firoozeh Jafari, Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran. Tel/Fax: +98-2122180095, E-mail:
| | - Babak Moazen
- Non Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Hamid Reza Khoddami Vishteh
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
| | - Ali Farhoudian
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
| | - Hooman Narenjiha
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
| | - Hassan Rafiey
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
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Jalali A, Seyedfatemi N, Peyrovi H. Relapse Model among Iranian Drug Users: A Qualitative Study. Int J Community Based Nurs Midwifery 2015; 3:2-11. [PMID: 25553329 PMCID: PMC4280553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 10/19/2014] [Accepted: 11/08/2014] [Indexed: 12/02/2022]
Abstract
BACKGROUND Relapse is a common problem in drug user's rehabilitation program and reported in all over the country. An in-depth study on patients' experiences can be used for exploring the relapse process among drug users. Therefore, this study suggests a model for relapse process among Iranian drug users. METHODS In this qualitative study with grounded theory approach, 22 participants with rich information about the phenomenon under the study were selected using purposive, snowball and theoretical sampling methods. After obtaining the informed consent, data were collected based on face-to-face, in-depth, semi-structured interviews. All interviews were analyzed in three stages of axial, selective and open coding methods. RESULTS Nine main categories emerged, including avoiding of drugs, concerns about being accepted, family atmosphere, social conditions, mental challenge, self-management, self-deception, use and remorse and a main category, feeling of loss as the core variable. Mental challenge has two subcategories, evoking pleasure and craving. Relapse model is a dynamic and systematic process including from cycles of drug avoidance to remorse with a core variable as feeling of loss. CONCLUSION Relapse process is a dynamic and systematic process that needs an effective control. Determining a relapse model as a clear process could be helpful in clinical sessions. RESULTS of this research have depicted relapse process among Iranian drugs user by conceptual model.
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Affiliation(s)
- Amir Jalali
- Department of Psychiatric Nursing, Nursing and Midwifery College, Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran;
| | - Naiemeh Seyedfatemi
- Department of Mental Health Psychiatric Nursing, Nursing and Midwifery College, Iran University of Medical Sciences, Tehran, Iran;
| | - Hamid Peyrovi
- Department of Critical Care Nursing, Nursing and Midwifery College, Iran University of Medical Sciences, Tehran, Iran
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Eskandarieh S, Jafari F, Yazdani S, Hazrati N, Saberi-Zafarghandi MB. Compulsory maintenance treatment program amongst Iranian injection drug users and its side effects. Int J High Risk Behav Addict 2014; 3:e21765. [PMID: 25741482 PMCID: PMC4331656 DOI: 10.5812/ijhrba.21765] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 07/27/2014] [Accepted: 08/20/2014] [Indexed: 11/21/2022]
Abstract
Background: Psychoactive substance use can cause a broad variety of mental health disorders and social health problems for the drug users, their family and society. Objectives: The Ministry of Health, Treatment, and Medical Education of Iran has recently proclaimed an estimated number of 2 million drug abusers and 200,000 injecting drug users (IDUs). Patients and Methods: For data collection, the directory of mental, social health, and Addiction designed a questionnaire in cooperation with Drug Control Headquarters of Iran. Results: Among 402 IDUs patients, a large amount of them were male, single, and younger than 39 years. Regarding psychotic and somatic symptoms caused by methadone therapy, most of the participants had no problem with methadone maintenance treatment (MMT). Conclusions: There is a need to train health staff, and the community, concerning preventive measures, treatment, and reducing harm for substance drug users.
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Affiliation(s)
- Sharareh Eskandarieh
- Bureau of Mental, Social Health and Addiction, Ministry of Health, Treatment and Medical Education, Tehran, IR Iran
| | - Firoozeh Jafari
- Substance Abuse and Dependency Research Centre, Social Welfare and Rehabilitation Sciences University, Tehran, IR Iran
| | - Somayeh Yazdani
- Bureau of Mental, Social Health and Addiction, Ministry of Health, Treatment and Medical Education, Tehran, IR Iran
| | - Nazanin Hazrati
- Bureau of Mental, Social Health and Addiction, Ministry of Health, Treatment and Medical Education, Tehran, IR Iran
| | - Mohammad Bagher Saberi-Zafarghandi
- Tehran Institute of Psychiatry, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Mohammad Bagher Saberi-Zafarghandi, 3Tehran Institute of Psychiatry, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-9121055106, Fax: +98-2188364380, E-mail:
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Karajibani M, Montazerifar F, Dashipour A, Lashkaripour K, Abery M, Salari S. Effectiveness of Educational Programs on Nutritional Behavior in Addicts Referring to Baharan Hospital, Zahedan (Eastern of IR Iran). Int J High Risk Behav Addict 2014; 3:e18932. [PMID: 25032162 PMCID: PMC4080462 DOI: 10.5812/ijhrba.18932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Revised: 05/08/2014] [Accepted: 05/11/2014] [Indexed: 11/16/2022]
Abstract
Background: There are many factors which affect nutritional status of addicted such as lack o f knowledge, incorrect attitude toward modification of food pattern, and careless to food intake. Objectives: The aim of this study was to determine the effectiveness of educational program on nutritional behavior in addicts referring to Baharan hospital in Zahedan. Patients and Methods: Thirty-six addict patients were selected randomly. After recording general demographic data of patients, nutritional behaviors were determined. To determine the effectiveness of nutritional educational program, pre and post-tests were performed. Evaluation of nutritional behavior was determined as poor, fair and satisfactory levels. Statically analysis was performed by SPSS software. Results: Most addict patients had a medium level of education. Improvement in knowledge, attitude and practice (KAP) of patients after intervention was observed as follows; decreasing KAP in poor level (2.8% vs. 30.6%), (3% vs. 50%), (25% vs. 80.6%), respectively; also, increasing KAP in fair level (7% vs. 55.6 %), (15% vs. 15%), (19% vs. 7%), respectively and increasing KAP in satisfactory levels (77.8% vs. 13.8%), (50% vs. 8.3%), and (22.2% vs. 0%), respectively (P < 0.0001). There was a significant difference regarding the grade of KAP in patients based on gender, marital status, and education level after education (P < 0.0001). Conclusions: This study showed that nutritional KAP was improved in addicts. After intervention, there was a significant difference in the score of knowledge, attitude, and practice scores in patients in the current study. KAP was improved in patients after intervention including; decreased KAP in poor level and increased KAP in fair and satisfactory levels. This finding indicates that addict patients would like to modify their life style.
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Affiliation(s)
- Mansour Karajibani
- Department of Health Promotion Research Center and Nutrition, School of Medicine, Zahedan University of Medical Sciences, Zahedan, IR Iran
- Corresponding author: Mansour Karajibani, Department of Nutrition, Medical School, Zahedan University of Medical Sciences, Zahedan, IR Iran. Tel: +98-5413425716-20, Fax: +98-5413425728, E-mail:
| | - Farzaneh Montazerifar
- Department of Health Promotion Research Center and Nutrition, Pregnancy Health Research Center, School of Medicine, Zahedan University of Medical Sciences, Zahedan, IR Iran
| | - Alireza Dashipour
- Department of Nutrition and Food Science, School of Medicine, Zahedan University of Medical Sciences, Zahedan, IR Iran
| | - Kobra Lashkaripour
- Department of Psychiatry and Psychology, Baharan Psychiatric Hospital, Zahedan University of Medical Sciences, Zahedan, IR Iran
| | - Maryam Abery
- Department of Nutrition, School of Medicine, Zahedan University of Medical Sciences, Zahedan, IR Iran
| | - Sajedeh Salari
- Department of Nutrition, School of Medicine, Zahedan University of Medical Sciences, Zahedan, IR Iran
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Seyedfatemi N, Peyrovi H, Jalali A. Relapse experience in Iranian opiate users: a qualitative study. Int J Community Based Nurs Midwifery 2014; 2:85-93. [PMID: 25349849 PMCID: PMC4201189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Revised: 02/24/2014] [Accepted: 02/26/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND To understand the relapse process, it is required to notice the clients learned behaviors and environmental contexts. We aimed to explore and describe relapse experiences of Iranian drug users. METHODS This is a grounded theory study and twenty two participants were selected using purposive sampling, snowball and theoretical sampling. After obtaining written informed consent, data gathering was done by means of in-depth semi-structured interviews. According to Strauss and Corbin three phases of open coding, axial coding and selection coding were done for qualitative analysis and continuous comparison. During the research period Guba and Lincoln criteria were used to be reassured of the accuracy and rigor of the study findings. RESULTS The main categories of this study were craving and conflict, family stress and psychological indicators of relapse that emerged in three phases including recovery, tension and pre-relapse. High anxiety, withdrawal, rationalization and lying were the most common symptoms. CONCLUSION Family reactions and social conditions play a key role in relapse. Relapse process is an active and multidimensional event in which the clients experience a psychosocial status continuum from recovery to relapse. Most psychological problems are seen in the tension phase.
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Affiliation(s)
- Naiemeh Seyedfatemi
- Center for Nursing Care Research, Iran University of Medical Sciences, Tehran, Iran;
| | - Hamid Peyrovi
- Center for Nursing Care Research, Iran University of Medical Sciences, Tehran, Iran;
| | - Amir Jalali
- Department of Psychiatric Nursing, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Dahi-Taleghani M, Fazli B, Ghasemi M, Vosoughian M, Dabbagh A. Effect of intravenous patient controlled ketamine analgesiaon postoperative pain in opium abusers. Anesth Pain Med 2014; 4:e14129. [PMID: 24701419 PMCID: PMC3961031 DOI: 10.5812/aapm.14129] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2013] [Revised: 11/22/2013] [Accepted: 12/01/2013] [Indexed: 12/29/2022] Open
Abstract
Background: Acutepostoperative pain is among the worst experience that patient scan undergo, and many analgesics have been used to suppress it; especially in chronic opium abusers. Ketamine is an N-methyl-D-aspartate antagonist analgesic, having both anesthetic and analgesic properties, which are not affected to the same extent in chronic opium abusers. Objectives: In this study, we assessed the analgesic effects of ketamine added to morphine as a patient-controlled analgesia method for acute pain management, compared with a placebo, inchronic maleopium abusers. Patients and Methods: After institutional review board approval for ethical considerations, a randomized double-blinded placebo controlled clinical trial was conducted. A total of 140 male patients aged 18-65 years, undergoing orthopedic surgery, were entered into the study after matching inclusion and exclusion criteria. All patients received the same anesthesia method; while the first group received ketamine (1mg/mL) and morphine (0.5 mg/mL) as a patient-controlled analgesia (70 patients), the second group received morphine (0.5 mg/mL) plus normal saline (70 patients). P value less than 0.05 was considered statistically significant. Results: The ketamine and morphine group of patients experienced less postoperative pain and required less postoperative rescue analgesia. However, the unwanted postoperative side effects were nearly the same; although increased levels of postoperative nausea and vomiting were observed in the ketamine and morphine group Conclusions: This study demonstrated improved analgesic effects after using intravenous patient controlled analgesia with ketamine on postoperative pain in opium abusers.
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Affiliation(s)
- Mastane Dahi-Taleghani
- Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Benjamin Fazli
- Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahshid Ghasemi
- Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Vosoughian
- Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Dabbagh
- Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Corresponding author: Ali Dabbagh, Anesthesiology Research Center, ShahidBeheshti University of Medical Sciences, Tehran, Iran. Tel: +98-989121972368, Fax: +98-982122432572, E-mail: ,
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Flynn JK, Sacks-Davis R, Higgs P, Aitken C, Moneer S, Suppiah V, Tracy L, Ffrench R, Bowden S, Drummer H, George J, Bharadwaj M, Hellard M. Detection of HCV-Specific IFN-γ Responses in HCV Antibody and HCV RNA Negative Injecting Drug Users. Hepat Mon 2014; 14:e14678. [PMID: 24497881 PMCID: PMC3909641 DOI: 10.5812/hepatmon.14678] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 11/13/2013] [Accepted: 11/21/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND Detectable HCV-specific cellular immune responses in HCV antibody and RNA negative people who inject drugs (PWID) raise the question of whether some are resistant to HCV infection. Immune responses from people who have been exposed to hepatitis C virus (HCV) and remain anti-HCV negative are of interest for HCV vaccine development; however, limited research addresses this area. OBJECTIVES In a cohort of HCV antibody and RNA negative PWID, we assessed whether the presence of HCV-specific IFN-γ responses or genetic associations provide any evidence of protection from HCV infection. PATIENTS AND METHODS One hundred and ninety-eight participants were examined longitudinally for clinical, behavioral, social, environmental and genetic characteristics (IFNL3 genotype [formally IL-28B] and HLA type). Sixty-one of the 198 participants were HCV antibody and RNA negative, with 53 able to be examined longitudinally for HCV-specific IFN-γ ELISpot T cell responses. RESULTS Ten of the 53 HCV antibody and RNA negative participants had detectable HCV-specific IFN-γ responses at baseline (18%). The magnitude of IFN-γ responses averaged 131 +/- 96 SFC/106 PBMC and the breadth was mean 1 +/- 1 pool positive. The specificity of responses were mainly directed to E2, NS4b and NS5b. Participants with (10) and without (43) HCV-specific IFN-γ responses did not differ in behavioral, clinical or genetic characteristics (P > 0.05). There was a larger proportion sharing needles (with 70%, without 49%, P = 0.320) and a higher incidence of HCV (with 35.1 per 100 py, 95% CI 14.6, 84.4, without 16.0 per 100 py, 95% CI 7.2, 35.6, P = 0.212) in those with IFN-γ responses, although not statistically significant. Half the participants with baseline IFN-γ responses became HCV RNA positive (5/10), with one of these participants spontaneously clearing HCV. The spontaneous clearer had high magnitude and broad Th1 responses, favorable IFNL3 genotype and favorable HLA types. CONCLUSIONS This study demonstrated the detection of HCV-specific IFN-γ responses in HCV antibody and RNA negative individuals, with a tendency for HCV-specific IFN-γ responses to be associated with HCV exposure. The potential role of HCV-specific IFN-γ responses in those who remained HCV RNA negative is of value for the development of novel HCV therapeutics.
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Affiliation(s)
- Jacqueline K Flynn
- Centre for Biomedicine, Burnet Institute, Melbourne, Australia
- Department of Infectious Diseases, Monash University, Melbourne, Australia
- Corresponding Author: Jacqueline K Flynn, Centre for Biomedicine, Burnet Institute, 3001 Victoria, G.P.O. Box: 2284, Melbourne, Australia. Tel: +61-392822109, Fax: +61-392822100, E-mail:
| | - Rachel Sacks-Davis
- Centre for Population Health, Burnet Institute, Melbourne, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Peter Higgs
- Centre for Population Health, Burnet Institute, Melbourne, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Melbourne, Australia
| | - Campbell Aitken
- Centre for Population Health, Burnet Institute, Melbourne, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Sarah Moneer
- Department of Microbiology and Immunology, University of Melbourne, Parkville, Australia
| | - Vijay Suppiah
- Storr Liver Unit, Westmead Millennium Institute, University of Sydney, Sydney, Australia
- School of Pharmacy, University of South Australia, Adelaide, Australia
| | - Lilly Tracy
- Victorian Infectious Diseases Reference Laboratory, North Melbourne, Australia
| | - Rosemary Ffrench
- Centre for Biomedicine, Burnet Institute, Melbourne, Australia
- Department of Immunology, Monash University, Melbourne, Australia
| | - Scott Bowden
- Victorian Infectious Diseases Reference Laboratory, North Melbourne, Australia
| | - Heidi Drummer
- Centre for Biomedicine, Burnet Institute, Melbourne, Australia
- Department of Microbiology and Immunology, University of Melbourne, Parkville, Australia
- Department of Microbiology, Monash University, Clayton, Australia
| | - Jacob George
- Storr Liver Unit, Westmead Millennium Institute, University of Sydney, Sydney, Australia
| | - Mandvi Bharadwaj
- Department of Microbiology and Immunology, University of Melbourne, Parkville, Australia
| | - Margaret Hellard
- Centre for Population Health, Burnet Institute, Melbourne, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
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Barati M, Ahmadpanah M, Soltanian AR. Prevalence and factors associated with methamphetamine use among adult substance abusers. J Res Health Sci 2014; 14:221-226. [PMID: 25209911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 02/03/2014] [Accepted: 02/08/2014] [Indexed: 06/03/2023] Open
Abstract
BACKGROUND The use of methamphetamine and other drugs among young adults has been a theme of growing interest and concern on the part of researchers and health associations. This paper reports recent use of methamphetamine and its relation with some demographic variables among substance users in west of Iran. METHODS This cross-sectional study was carried out on 559 substance users of Hamadan, western Iran recruited through a snowball sampling method in 2012. The participants received a self-administered questionnaire contained questions regarding substance use, reasons of drug abuse and pattern of MA use. Data were analyzed using SPSS software using Chi-square, Fisher's exact tests and logistic regression methods. RESULTS A number of 248 (44.4%) people reported a history of having ever used methamphetamine and the mean drug abuse initiation age was 17.8 (SD= 3.9). According to the history, reducing effect of previous drug and resurfacing of new drug were common reasons associated with the changes in previous drug to use of methamphetamine. In multivariate analysis, 'being single' and higher school were obtained as independent predictors of methamphetamine use (P<0.001). CONCLUSIONS Methamphetamine use is common among adult substance abusers in Iran. Demographic, behavioral and psychosocial correlates of methamphetamine use identified in this research may be helpful for the development of preventive interventions.
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Affiliation(s)
- Majid Barati
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Ahmadpanah
- Research Center for Behavioral Disorders and Substance Abuse, Hamadan University of Medical Sciences, Hamadan, Islamic Republic of Iran.
| | - Ali Reza Soltanian
- Modeling of non-communicable Disease Research Center, Department of Epidemiology & Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
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Montazerifar F, Karajibani M, Lashkaripour K, Yousefi M. Evaluation of serum adiponectin concentrations among drug abusers on methadone maintenance treatment. Int J High Risk Behav Addict 2013; 2:117-21. [PMID: 24971288 PMCID: PMC4070161 DOI: 10.5812/ijhrba.14021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Revised: 10/07/2013] [Accepted: 11/02/2013] [Indexed: 12/25/2022]
Abstract
BACKGROUND Adiponectin, an adipocyte-derived protein, modulates a number of metabolic processes. Methadone maintenance treatment (MMT) changes the level of hormones produced by adipose tissue in addicts. However, current data remains contradictory. OBJECTIVES The aim of this study was to evaluate the effect of MMT on serum adiponectin levels in drug addicts. MATERIALS AND METHODS Twenty-five drug abusers with a mean age of 37.4 ± 8.7 years were referred to the Baharan Hospital, Zahedan, and 22 healthy age-matched control subjects with a mean age of 35 ± 9.5 years were enrolled in the study. Addicts were treated with methadone at (40 to 120 mg/d) for six months. Measurement of anthropometric parameters, serum adiponectin, and biochemical parameter levels, were assessed in the addicts, before and after six months of MMT, but only once in the healthy controls. RESULTS The mean basal serum adiponectin level was not significantly lower in the drug abuser group compared to the healthy subjects (P > 0.05). After six months of MMT, the mean serum adiponectin level of the drug addicts was not significantly different from their mean baseline level or that of the healthy subjects (P > 0.05). However, the mean baseline serum adiponectin level was significantly lower in overweight/obese addicts when compared to underweight patients and healthy individuals (P < 0.001). After six months of MMT, the mean level of serum adiponectin increased significantly in the underweight subjects compared to the normal weight and overweight/obese subjects (P < 0.0001) and the control group (P < 0.001). Adiponectin concentration was correlated inversely with body mass index and positively correlated with waist circumference and serum high-density lipoprotein levels. CONCLUSIONS This study showed that MMT did not markedly alter the concentration of serum adiponectin in drug abusers. However, in regard to the variations in the serum lipid profiles and anthropometric parameters, the findings indicated that low concentrations of serum adiponectin might play a role in the pathogenesis of obesity and other metabolic abnormalities. Thus, more long-term studies with larger sample sizes are recommended.
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Affiliation(s)
- Farzaneh Montazerifar
- Pregnancy Health Research Center, Zahedan University of Medical Sciences, Zahedan, IR Iran
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, IR Iran
- Department of Nutrition, School of Medicine, Zahedan University of Medical Sciences, Zahedan, IR Iran
- Corresponding author: Farzaneh Montazerifar, 1) Pregnancy Health Research Center, 2) Health Promotion Research Center, 3) Department of Nutrition, Zahedan University of Medical Sciences, Zahedan, IR Iran. Tel: +98-9155416903, Fax: +98-5413425728, E-mail:
| | - Mansour Karajibani
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, IR Iran
- Department of Nutrition, School of Medicine, Zahedan University of Medical Sciences, Zahedan, IR Iran
| | - Kobra Lashkaripour
- Health Promotion Research Center, Zahedan University of Medical Sciences, Zahedan, IR Iran
- Department of Psychiatry and Psychology, Baharan Psychatric Hospital, Zahedan University of Medical Sciences, Zahedan, IR Iran
| | - Maryam Yousefi
- Department of Psychiatry and Psychology, Baharan Psychatric Hospital, Zahedan University of Medical Sciences, Zahedan, IR Iran
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Mamani M, Majzoobi MM, Torabian S, Mihan R, Alizadeh K. Latent and active tuberculosis: evaluation of injecting drug users. Iran Red Crescent Med J 2013; 15:775-9. [PMID: 24616784 PMCID: PMC3929809 DOI: 10.5812/ircmj.6283] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 01/15/2013] [Accepted: 06/24/2013] [Indexed: 12/17/2022]
Abstract
Background There is a high risk of tuberculosis (TB) infection among injecting drug users (IDUs). Objectives This study aimed to determine the frequency of latent and active TB infection among IDUs. Materials and Methods In a cross-sectional study between 2008 and 2009, IDUs referred to the methadone maintenance treatment (MMT) centers in Hamedan-Iran, undergone tuberculin skin test (PPD; purified protein derivative) were recruited. The participants with positive results for PPD test (> 5 mm and > 10 mm in HIV positive and negative cases), undergone other complementary procedures such as chest-X-ray and sputum smear test. Results Overall, 268 IDUs between 18 and 70 (mean: 34.5 [8.2]) years were included in the study. PPD test had positive findings in 49 cases (18.3%). There was no significant difference of PPD positivity between HIV positive and negative participants (17.7% vs. 18.5%). An active TB was found among IDUs. Conclusions The high prevalence of latent and active TB among IDUs indicates the need for TB screening tests among this population.
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Affiliation(s)
- Mojgan Mamani
- Department of Infectious Diseases, Hamedan University of Medical Sciences, Hamedan, IR Iran
| | - Mohammad Mahdi Majzoobi
- Department of Infectious Diseases, Hamedan University of Medical Sciences, Hamedan, IR Iran
- Corresponding author: Mohammad Mahdi Majzoobi, Division of Infectious Diseases, Farshchian Hospital, Hamedan, IR Iran. Tel.: +98-9183148151, Fax: +98-8118269808, E-mail:
| | - Saadat Torabian
- Department of Social Medicine, Hamedan University of Medical Sciences, Hamedan, IR Iran
| | - Ronak Mihan
- Hamedan University of Medical Sciences, Hamedan, IR Iran
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Akbar Haghdoost A, Reza Baneshi M, Eybpoosh S, Khajehkazemi R. Comparison of three interview methods on response pattern to sensitive and non-sensitive questions. Iran Red Crescent Med J 2013; 15:500-6. [PMID: 24349749 PMCID: PMC3840838 DOI: 10.5812/ircmj.7673] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Revised: 12/31/2012] [Accepted: 05/04/2013] [Indexed: 11/16/2022]
Abstract
Background To get more precise responses when gathering information about sensitive topics such as drug use, it is important to use the most optimal method. Objectives This study was carried out to address the impact of three interview methods (street-based, household, and telephone interviews) on response pattern to sensitive and non-sensitive questions in terms of participation, disclosure and discontinuing rates. Patients and Methods We selected three culturally diverse major cities of Iran. Then, we randomly selected 300 subjects, 100 for each type of interview, from each major city (899 in total). For street-based interviews only pedestrians who were walking alone were recruited, for household interviews only one individual from each house participated (3-4 houses in each alley were selected), and for telephone interviews we selected phone numbers using a random number list. We asked five non-sensitive and five sensitive (related to drug use and sexual contact among their personal network) questions. Results For telephone and household interviews, relative to street-based interviews, participants were less likely to disclose alcohol and drug-related behaviors (Adjusted OR = 0.76; 95% CI: 0.60- 0.97) and sexual behaviors among their network (Adjusted OR telephone/street-based = 0.64; 95% CI: 0.39- 1.07 and Adjusted OR household/ street-based = 0.56; 95% CI: 0.33- 0.95). We found that participants who were interviewed via the telephone were more likely (Adjusted OR = 1.24) and those who were interviewed at home were less likely (Adjusted OR = 0.86) to report non-sensitive information compared to participants who were interviewed on the street; however, these findings were not statistically significant. The largest participation rate and the least discontinuation rate were observed for household interviews. Conclusions It seems that the methods of interview effect response to both sensitive and non-sensitive questions. We believe that for street-based interviews, respondents may disclose more sensitive information than telephone and household interviews.
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Affiliation(s)
- Ali Akbar Haghdoost
- Research Center for Modeling in Health, Kerman University of Medical Sciences, Kerman, IR Iran
- Regional Knowledge Hub for HIV/AIDS Surveillance, Kerman University of Medical Sciences, Kerman, IR Iran
| | - Mohammad Reza Baneshi
- Research Center for Modeling in Health, Kerman University of Medical Sciences, Kerman, IR Iran
| | - Sana Eybpoosh
- Research Center for Modeling in Health, Kerman University of Medical Sciences, Kerman, IR Iran
| | - Razieh Khajehkazemi
- Regional Knowledge Hub for HIV/AIDS Surveillance, Kerman University of Medical Sciences, Kerman, IR Iran
- Corresponding author: Razieh Khajehkazemi, Regional Knowledge Hub for HIV/AIDS Surveillance, Kerman University of Medical Sciences, Kerman, IR Iran. Tel: +98-3412263725, Fax: +98-3412263725, E-mail:
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Ralón G, Rossi D, Vila M, Latorre L, Bastos FI, Caiaffa WT. From local studies to a regional perspective: pooled analysis of secondary data in a collaborative project on vulnerabilities associated with drug use in Argentina, Brazil and Uruguay (1998-2004). Salud Colect 2012; 8:229-246. [PMID: 23681457 DOI: 10.18294/sc.2012.164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 08/09/2012] [Indexed: 11/24/2022] Open
Abstract
This paper develops the methodological principles of pooled analysis design, using it to study situations of vulnerability among drug users at a regional level. Data from thirteen cross-sectional studies carried out in Argentina, Brazil and Uruguay between 1998 and 2004 were integrated. A critical review of the concept of data matrix which identifies four structural components, allowed us to: define the units of analysis spanning the different original populations; identify a core of common variables (social and demographic characteristics, drug use, sexual practices, serology of blood-borne and sexually transmitted diseases) with their respective values; examine the indicators, dimensions and procedures used to measure the variables; and establish their compatibility with a thematic and comparative analysis of data collection tools. The main result was a new data matrix with 3,534 cases. Multidisciplinary collaboration between teams and institutions from the three countries made it possible to maximize the available sources in order to analyze characteristics of the local contexts and of the overall regional.
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Affiliation(s)
- Gonzalo Ralón
- Licenciado en Sociología. Investigador, Intercambios Asociación Civil. Investigador, Instituto Gino Germani, Universidad de Buenos Aires, Argentina.
| | - Diana Rossi
- Trabajadora Social. Especialista en Problemáticas Sociales Infanto-juveniles. Coordinadora, Área de Investigación, Intercambios Asociación Civil, Buenos Aires, Argentina.
| | - Marcelo Vila
- Médico. Especialista en Clínica Médica y Epidemiología. Asesor médico e investigador, Intercambios Asociación Civil, Buenos Aires, Argentina.
| | - Laura Latorre
- Licenciada en Sociología. Instituto de Investigación y Desarrollo Social (IDES), Montevideo, Uruguay.
| | - Francisco Inácio Bastos
- Médico. Doctor en Salud Pública. Investigador, Fundação Oswaldo Cruz, Río de Janeiro, Brasil.
| | - Waleska Teixeira Caiaffa
- Médica. Doctora en Ciencias. Directora del Observatório de Saúde Urbana & Grupo de Pesquisas em Epidemiologia, Faculdade de Medicina, Universidade Federal de Minas Gerais. Belo Horizonte, Brasil.
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Poorolajal J, Majdzadeh R. Prevalence of chronic hepatitis B infection in Iran: a review article. J Res Med Sci 2009; 14:249-58. [PMID: 21772891 PMCID: PMC3129112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2008] [Accepted: 03/17/2009] [Indexed: 11/28/2022]
Abstract
Hepatitis B virus infection is a major public health problem worldwide. Islamic Republic of Iran is a country in which hepatitis B prevalence is intermediate. The aim of this study is to assess prevalence of chronic hepatitis B infection in Iran according to demographic characteristics. All cross-sectional studies concerning prevalence of chronic hepatitis B infection in Iran were included irrespective of date and language. The outcome of interest was prevalence of chronic hepatitis B infection confirmed by blood specimen positive for HBsAg. The prevalence of chronic hepatitis B infection was estimated about 1.7% or lower in general population; 0.8% (95% CI: 0.6% to 0.9%) in blood donors and 3.2% (95% CI: 2.3% to 4.1%) in intravenous drug users and varied from zero to 1.5% in beta thalassemic patients. Since mass vaccination in 1993, prevalence of chronic hepatitis B infection has being reduced among children and adolescents. This reduction can be attributed to the effectiveness of the national immunization program and it may impact on reduction of prevalence of hepatitis B infection in general population.
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Affiliation(s)
- Jalal Poorolajal
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Corresponding Author E-mail:
| | - Reza Majdzadeh
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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