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کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Iranian Journal of Medical Sciences
- نوع مقاله: Journal Article
- کلمات کلیدی: Respiratory System,Chemical warfare agents,Sulfur mustard,Vision, ocular
- چکیده:
- چکیده انگلیسی: The present study aimed to review and discuss the recommended and recently suggested protocols by Iranian researchers for a long-term treatment of delayed complications of sulfur mustard (DCSM) in veterans. As indicated clinically, patients who suffer from delayed ocular complications of sulfur mustard (DOCS) benefit from treatments for dry eyes, therapeutic contact lenses, amniotic membrane transplantation; blepharorrhaphy, tarsorrhaphy, limbal stem cell transplantation; corneal transplantation, topical steroids, and immunosuppressive. In spite of penetrating keratoplasty, lamellar keratoplasty and keratolimbal allograft had a good long-term survival.Delayed respiratory complications (DRCS) are the most common effects and life-threatening in Iranian veterans. The recommended treatment protocols include regular clinical evaluations, respiratory physiotherapy and rehabilitation, N-acetyl cysteine; warm humidified air, long-acting β2-agonists, and inhaled corticosteroids. Azithromycin has also been effective in improving clinical conditions, pulmonary function tests, inflammatory indexes, and life quality of the veterans. Interferon gamma (IFN-γ) and helium: oxygen combination were also used in severe DRCS with good results. Some of the delayed cutaneous complications (DCCS) such as itching affects the quality of life of victims. Regular but not frequent showering and bathing, applying sunscreen compounds, topical corticosteroids, and systemic antihistamines reduce the problems of DCCS patients. Several compounds such as capsaicin cream, pimecrolimus, IFN-γ, phenol-menthol; Aloe vera/olive oil cream, cetirizine, doxepine, and hydroxyzine were evaluated in DCCS patients with some benefits. The physicians in charge of veterans emphasize the importance of a healthy lifestyle, appropriate financial/social/cultural supports, and a degree of reassurance and supportive care on the clinical improvement of patients.
- انتشار مقاله: 29-05-1396
- نویسندگان: Leila Etemad,Mohammad Moshiri,Mahdi Balali-Mood
- مشاهده
- جایگاه : پژوهشی
- مجله: Iranian Journal of Medical Sciences
- نوع مقاله: Journal Article
- کلمات کلیدی:
- چکیده:
- چکیده انگلیسی: Chemical warfare agents are the most brutal weapons among the weapons of mass destruction. Sulfur mustard (SM) is a potent toxic alkylating agent known as “the King of the Battle Gases”. SM has been the most widely used chemical weapon during the wars. It was widely used in World War I. Thereafter, it was extensively employed by the Iraqi troops against the Iranian military personnel and even civilians in the border cities of Iran and Iraq in the period between 1983 and 1988. Long-term incapacitating properties, significant environmental persistence, lack of an effective antidote, and relative ease of manufacturing have kept SM a potential agent for both terrorist and military uses. Even 3 decades after SM exposure, numerous delayed complications among Iranian victims are still being reported by researchers. The most common delayed complications have been observed in the respiratory tracts of chemically injured Iranian war veterans. Also, skin lesions and eye disorders have been observed in most Iranian SM-exposed war veterans in the delayed phase of SM intoxication. Thus, extensive research has been conducted on Iranian war veterans during the past decades. Nevertheless, major gaps still continue to exist in the SM literature. Part І of this paper will discuss the delayed complications and manifestations of exposure to SM among Iranian victims of the Iran–Iraq conflict. Part ІІ, which will appear in the next issue of Iran J Med Sci, will discuss the long-term management and therapy of SM-exposed patients.
- انتشار مقاله: 24-09-1394
- نویسندگان: Emadodin Darchini-Maragheh,Mahdi Balali-Mood
- مشاهده
- جایگاه : پژوهشی
- مجله: Iranian Journal of Medical Sciences
- نوع مقاله: Journal Article
- کلمات کلیدی: Iran,Sulfur mustard,Retina,Central retinal vein occlusion,Visual loss
- چکیده:
- چکیده انگلیسی: A 41-year-old man was referred with a complaint of visual loss in his left eye and his best corrected visual acuity was 20/80. Slit lamp examination showed arborizing conjunctival vessels and dry eye. Fundus examination and fluorescein angiography revealed a non-ischemic central retinal vein occlusion. Cardiovascular, rheumatologic, and hematologic work up showed no abnormal findings. An ascertained history of exposure to sulfur mustard during the Iran-Iraq war was documented in his medical history. Four sessions of intravitreal bevacizumab injections were done as needed. After two-year follow-up, visual acuity in his left eye improved to 20/25 and macular edema was resolved without any need for further interventions. We conclude that sulfur mustard gas exposure may be considered as a predisposing factor for central retinal vein occlusion, as was found in our patient (an Iranian war veteran) by excluding all yet known etiologies and predisposing factors.
- انتشار مقاله: 12-05-1392
- نویسندگان: Nasser Shoeibi,Mahdi Balali-Mood,Mojtaba Abrishami
- مشاهده
- جایگاه : پژوهشی
- مجله: Iranian Journal of Medical Sciences
- نوع مقاله: Journal Article
- کلمات کلیدی: occupational exposure,lead poisoning,Biochemical markers,Hematologic Tests
- چکیده:
- چکیده انگلیسی: Background: Lead is a toxic element which causes acute, subacute or chronic poisoning through environmental and occupational exposure. The aim of this study was to investigate clinical and laboratory abnormalities of chronic lead poisoning among workers of a car battery industry.
Methods: Questionnaires and forms were designed and used to record demographic data, past medical histories and clinical manifestations of lead poisoning. Blood samples were taken to determine biochemical (using Auto Analyzer; Model BT3000) and hematologic (using Cell Counter Sysmex; Model KX21N) parameters. An atomic absorption spectrometer (Perkin-Elmer, Model 3030, USA) was used to determine lead concentration in blood and urine by heated graphite atomization technique.
Results: A total of 112 men mean age 28.78±5.17 years, who worked in a car battery industry were recruited in the present study. The most common signs/symptoms of lead poisoning included increased excitability 41.9%, arthralgia 41.0%, fatigue 40.1%, dental grey discoloration 44.6%, lead line 24.1%, increased deep tendon reflexes (DTR) 22.3%, and decreased DTR (18.7%). Blood lead concentration (BLC) was 398.95 µg/L±177.40, which was significantly correlated with duration of work (P=0.044) but not with the clinical manifestations of lead poisoning. However, BLC was significantly correlated with urine lead concentration (83.67 µg/L±49.78; r2=0.711; P<0.001), mean corpuscular hemoglobin (r=-0.280; P=0.011), mean corpuscular hemoglobin concentration (r=-0.304; P=0.006) and fasting blood sugar or FBS (r=-0.258; P=0.010). Conclusion: Neuropsychiatric and skeletal findings were common manifestations of chronic occupational lead poisoning. BLC was significantly correlated with duration of work, urine lead concentration, two hemoglobin indices and FBS.- انتشار مقاله: 09-09-1392
- نویسندگان: Mahdi Balali-Mood,Sina Kianoush,Seyed Reza Mousavi,Mohammad Taghi Shakeri,Bita Dadpour,Valiollah Moradi,Mahmoud Sadeghi
- مشاهده
- جایگاه : پژوهشی
- مجله: Iranian Journal of Medical Sciences
- نوع مقاله: Journal Article
- کلمات کلیدی: treatment,Atropine,Oxime,Neurotoxicity,Organophosphorous
- چکیده:
- چکیده انگلیسی: Organophosphorous compounds have been employed as pesticides and chemical warfare nerve agents. Toxicity of organophosphorous compounds is a result of excessive cholinergic stimulation through inhibition of acetyl cholinesterase. Clinical manifestations include cholinergic syndromes, central nervous system and cardiovascular disorders. Organophosphorous pesticide poisonings are common in developing worlds including Iran and Sri Lanka. Nerve agents were used during the Iraq-Iran war in 1983-1988 and in a terrorist attack in Japan in 1994-1995. Following decontamination, depending on the severity of intoxication the administration of atropine to counteract muscarinic over-stimulation, and an oxime to reactivate acetyl cholinesterase are indicated. Supportive and intensive care therapy including diazepam to control convulsions and mechanical respiration may be required. Recent investigations have revealed that intravenous infusion of sodium bicarbonate to produce mild to moderate alkalinization is effective. Gacyclidine; an antiglutamatergic compound, was also proved to be beneficial in conjunction with atropine, pralidoxime, and diazepam in nerve agent poisoning. Intravenous magnesium sulfate decreased hospitalization duration and improved outcomes in patients with organophosphorous poisoning. Bio-scavengers including fresh frozen plasma or albumin have recently been suggested as a useful therapy through clearing of free organophosphates. Hemofiltration and antioxidants are also suggested for organophosphorous poisoning. Recombinant bacterial phosphotriesterases and hydrolases that are able to transfer organophosphorous-degrading enzymes are very promising in delayed treatment of organophosphorous poisoning. Recently, encapsulation of drugs or enzymes in nanocarriers has also been proposed. Given the signs and symptoms of organophosphorous poisoning, health professionals should remain updated about the recent advances in treatment of organophosphorous poisoning poisonings.
- انتشار مقاله: 11-09-1392
- نویسندگان: Mahdi Balali-Mood,Hamidreza Saber
- مشاهده
- جایگاه : پژوهشی
- مجله: Iranian Journal of Medical Sciences
- نوع مقاله: Journal Article
- کلمات کلیدی:
- چکیده:
- چکیده انگلیسی: Sulphur mustard is a chemical warfare agent, which was largely used during the World War One and in Iraq-Iran conflict. It may also be used as a chemical terrorism agent. Therefore, medical professions should have sufficient knowledge and be prepared for medical intervention of any such chemical attack.Sulphur mustard exerts direct toxic effects on the eyes, skin, and respiratory tract, with subsequent systemic actions on the nervous, immunologic, hematologic, digestive, and reproductive systems. It is an alkylating agent that affects DNA synthesis and thus, delayed complications have been considered since the World War One. Cases of malignancies in the target organs particularly in hematopoietic, respiratory, and digestive systems were reported. Common delayed respiratory complications include chronic bronchitis, bronchiectasis, frequent bronchopneumonia, and pulmonary fibrosis, all of which tend to deteriorate with time. Severe dry skin, delayed keratitis, and reduction of natural killer cells with subsequent increased risk of infections and malignancies are also among the most distressing long-term consequences of sulphur mustard intoxication. However, despite extensive research that has been conducted on Iranian veterans during the past decades, major gaps continue to remain in the sulphur mustard literature. Immunological and neurological dysfunctions and the relationship between exposure to sulphur mustard and mutagenicity, carcinogenicity, and teratogenicity are important fields that require further studies, particularly on Iranian veterans with chronic health problems caused by sulphur mustard poisoning. There is also a paucity of information on the medical management of acute and delayed toxic effects of sulphur mustard poisoning, a subject that greatly challenges the medical professions.
- انتشار مقاله: 23-02-1394
- نویسندگان: Mahdi Balali-Mood,Beeta Balali-Mood
- مشاهده
- جایگاه : پژوهشی
- مجله: Iranian Journal of Basic Medical Sciences
- نوع مقاله: Journal Article
- کلمات کلیدی: Iran,Sulfur mustard,Leukemia,FLT3-TKD835 mutation
- چکیده:
- چکیده انگلیسی: Objective(s):Sulfur mustard (SM) was used by the Iraqi army against the Iranian troops in the Iran-Iraq war from 1983–1988. This chemical gas affects different organs including the skin, lungs and the hematopoietic system. Any exposure to SM increases the risk of chromosomal breaking, hyperdiploidy and hypodiploidy. Studies have shown that the risk for acute myeloblastic and lymphoblastic leukemia increases in veterans exposed to SM. FLT3 mutations including ITD and TKD mutations had been observed in some cases of leukemia. Therefore, we aimed to investigate the frequency of FLT3-TKD835 mutations in the veterans exposed to SM agent.
Materials and Methods: We studied 42 patients who were exposed to SM during the war in Khorasan Razavi province, Mashhad, Iran in 2012. As control group, 30 healthy males were selected from first-degree relatives of the patients. For assessment of TKD835 mutation, DNA was extracted and RFLP-PCR was performed.
Results: Analysis of RFLP-PCR data showed no FLT-3 TKD mutation in any of the patients.
Conclusion: Although contact with SM can increase the risk of malignancy especially hematologic neoplasms, results of the study show that another mechanism of leukemogenesis, other than FLT3-TKD mutation, may be the reason for increased risk of leukemia in SM toxicity.- انتشار مقاله: 13-07-1394
- نویسندگان: Hossein Ayatollahi,Mohammad Rafiee,Mohammad-Reza Keramati,Mahdi Balali-Mood,Ali Asgharzadeh,Mohammad Hadi Sadeghian,Maryam Sheikhi,Nafiseh Amini,Azam Moradi Zarmehri
- مشاهده
- جایگاه : پژوهشی
- مجله: Avicenna Journal of Phytomedicine
- نوع مقاله: Journal Article
- کلمات کلیدی: Poisoning,Clinical trial,Organophosphorus pesticides,HESA-A
- چکیده:
- چکیده انگلیسی: Objective: Organophosphorus compounds (OPs) are common causes of poisonings. Atropine and oximes are pharmacological antidotes of OPs. However, because of their adverse effects and insufficient performance, several other compounds have been evaluated as adjuvant therapy. HESA-A is a herbal-marine drug that contains material from Carum carvi (Persian cumin), Penaeus latisculatus (king prawn), and Apium graveolens (celery) with anti-inflammatory and antioxidants properties, which has shown useful effects as adjuvant therapy on some diseases. We have evaluated the effect of HESA-A on 69 moderate to severe acute OPs poisoned patients (44 HESA-A treated and 25 controls) as an adjuvant drug.
Materials and Methods: Two randomized age and sex matched groups of OPs poisoned patients were treated in Medical Toxicology Center of Imam Reza hospital, Mashhad, by conventional therapy with or without HESA-A (50 mg/kg/day orally). The evaluation criteria were total administrated doses of atropine and pralidoxime, intensive care unit (ICU) admission rate, mechanical respiration need, number of hospitalization days and mortality.
Results: There were no significant differences between the morbidity and mortality rate criteria of the two groups; moreover, we did not observe significant adverse effects for HESA-A.
Conclusion: HESA-A did not reduce morbidity and mortality of OPs poisoning and did not induce any major side effect in the patients.- انتشار مقاله: 26-11-1397
- نویسندگان: Seyed Reza Mousavi,Mohammad Moshiri,Emadodin Darchini-Maragheh,Seyed Khosro Ghasempouri,Bita Dadpour,Faezeh Sardar Antighechi,Mahdi Balali-Mood
- مشاهده
- جایگاه : پژوهشی
- مجله: Asia Pacific Journal of Medical Toxicology
- نوع مقاله: Journal Article
- کلمات کلیدی: Atomic Absorption Spectrophotometry,Exclusive breastfeeding,Infants,Lead, Mothers
- چکیده:
- چکیده انگلیسی: Background: It has been shown that there is a partial correlation between blood lead level (BLL) of infants and their mothers. This study was designed to evaluate the BLL of exclusively breast-fed infants less than 6 months of age and their mothers. Methods: This was a cross-sectional study on infants below 6 months of age and their mothers who were referred to Mashhad Imam Reza Hospital, Iran. BLL was determined by atomic absorption spectroscopy method. Demographic features and economic status of the subjects were also collected. Results: Sixty infants and their mothers in total were studied and 76.7% of the infants were boy. Mean (SD) age of children was 24.6 (31.8) days. Economic status of 16.7% of subjects was evaluated to be "poor", 38.3% "middle" and 45% "good". All of the mothers were housewives. Most subjects (88.3%) were living in the urban areas, and the remainder (11.7%) in rural areas. Mean (SD) of mothers’ BLL was 75.9 (31.1) mg/L. Mean (SD) of BLL in infants was 63.6 (26.8) mg/L. In 8 mothers (13.3%) and 4 infants (6.7%) BLL was higher than 100 mg/L. There was a significant relationship between BLL of infants and mothers (P < 0.001, r = 0.64). No significant correlation between maternal BLL and infants’ age, infant birth weight and current infant weight was established. Mean BLL in male infants was 73.4 (25.4) mg/L and in female infants was 84.8 (45.3) mg/L which was not significantly different from each other. The relationship between economic status and infants’ BLL was close to the level of significance (P = 0.08). Mean BLL in infants living in urban areas was 65.2 (27.1) mg/L, while in infants living in rural areas was 51.9 (23.3) mg/L; nonetheless, it was not significantly different between them (P = 0.22). Conclusion: There was a direct relationship between BLL in exclusively breastfed infants and their mothers. This may ascertain that lead can be excreted to the breast milk. Also, it may also suggest that both mothers and children were exposed to same level of air lead pollution.
- انتشار مقاله: 06-06-1392
- نویسندگان: Ahmadshah Farhat,Ashraf Mohammadzadeh,Mahdi Balali-Mood,Morteza Aghajanpoor-Pasha,Yalda Ravanshad
- مشاهده