Seyed Mostafa Mirakbari; Amir Mohammad Kazemifar; Abbas Allami; Ameneh Barikani
Articles in Press, Accepted Manuscript, Available Online from 18 March 2024
Abstract
Objective: This study aimed to investigate the incidence and pattern of seizures and injuries induced by tramadol in patients admitted to the hospital.Materials and methods: The cross-sectional study included 300 patients with alleged tramadol poisoning. Data on demographics, tramadol dosage and duration ...
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Objective: This study aimed to investigate the incidence and pattern of seizures and injuries induced by tramadol in patients admitted to the hospital.Materials and methods: The cross-sectional study included 300 patients with alleged tramadol poisoning. Data on demographics, tramadol dosage and duration of abuse, co-existing illicit drug abuse, hospital stay length, and occurrence of seizures and trauma (type and site of injuries) were collected. The statistical analysis (the Mann-Whitney U-test, Pearson's Chi-square, and Student's t-test) was conducted to compare the patients with and without seizures, trauma, and co-ingestion of illicit drugs. The analysis was carried out using SPSS software (version 21.0). A P value of less than 0.05 was considered statistically significant.Results: The average patient age was 24.66±5.64 years, with males comprising 84.3% of the sample. The mean tramadol dose and duration of abuse were 1339.3±1310.2 mg and 2.43±1.35 years, respectively. Seizures were observed in 66% of patients, more frequently in males (69.6% vs. 46.8%; P=0.004). Trauma was reported in 23% of patients, representing 35.4% of seizure cases. All trauma patients had experienced seizures, with the head and neck being the most common injury sites (55.1%), typically presenting as abrasions (55.9%). The average hospital stay was 1.73±0.94 days, significantly longer for patients with seizures and trauma.Conclusion: Trauma occurs in more than one-third of tramadol-induced seizures, highlighting the need to perform physical examinations to detect and localize injuries. Tramadol-associated traumas prolong hospitalization times and thus require prompt attention to prevent further injuries during pre-hospital handling and transferring to hospitals.
Rasoul Salimi; Rasool Haddadi; Abbas Moradi; Farnoush Jalilvand; Farzin Firozian
Volume 7, Issue 3 , July 2019, , Pages 240-244
Abstract
Objective: To compare the anesthetic effects of topical amitriptyline 2% with lidocaine 2% in isolated limb wound repair with suturing.Methods: In a randomized clinical trial, 90 patients with a complaint of isolated ulcer and require a preliminary repair by suturing were selected from patients referred ...
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Objective: To compare the anesthetic effects of topical amitriptyline 2% with lidocaine 2% in isolated limb wound repair with suturing.Methods: In a randomized clinical trial, 90 patients with a complaint of isolated ulcer and require a preliminary repair by suturing were selected from patients referred to emergency department of Beast Hospital in Hamadan. First, the scars were washed and anesthetized with lidocaine 2%. If after the peak period effect of lidocaine, the pain score of patients did not decrease, they randomly assigned to two groups, Lidocaine or Amitriptyline gel. After the intervention and during the suturing, the patient's pain score was measured at the intervals specified time by the visual analogous scale (VAS) and results recorded on the checklist. Finally, the collected data were analyzed by SPSS software version 20 at 95% confidence levelResults: In the lidocaine and amitriptyline group, the mean age of the patients was 29.08 and 27.34 years, and male gender frequency was 71.1% and 80% respectively. Both groups were matched for age and sex. Mean score of pain in both groups decreased from the score of 10 before the intervention to 7.33 in the lidocaine group and 0.53 in amitriptyline group. Based on the results of the ANOVA repeated measure test, there was a statistically significant difference between the mean score of pain in the two groups (p<0.001).Conclusion: In patients with isolated limbs ulcers, requiring initial repair with suturing, numbness and analgesia effect of amitriptyline 2% gel, with dose 2 mg/kg is better than lidocaine 2%. Clinical Trial Registry: IRCT20120215009014N216
Shahram Paydar; Golnoush Sadat Mahmoudi Nezhad; Mohammad Yasin Karami; Hossein Abdolrahimzadeh; Mojtaba Samadi; Alireza Makarem; Ali Noorafshan
Volume 7, Issue 1 , January 2019, , Pages 41-48
Abstract
Objective: To evaluate the effect of imbibed fibrinogen gauze on survival, bleeding and healing in liver trauma.Methods: This animal experimental study was conducted on 20 adult male Sprague-Dawley rats; with a mean weight of 300±50 gram; divided into two groups. Grade IV injury was induced ...
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Objective: To evaluate the effect of imbibed fibrinogen gauze on survival, bleeding and healing in liver trauma.Methods: This animal experimental study was conducted on 20 adult male Sprague-Dawley rats; with a mean weight of 300±50 gram; divided into two groups. Grade IV injury was induced to the subjects’ liver. Then, the bleeding site was packed with simple gauze in the control group, and imbibed fibrinogen gauze in the experimental group. All animals were re-evaluated for liver hemostasis 48 hours after the initial injury. Bleeding in the intra peritoneal cavity was measured using Tuberculosis Syringe in the first and second operations. Subjects were followed-up for 14 days. Eventually, the rats were sacrificed and their livers were sent to a lab for stereological assessment. Statistical comparisons were performed via Mann–Whitney U-test using SPSS. P-Values less than 0.05 were considered to be statistically significant.Results: Half of the rats in the control group died, while all the rats in the imbibed fibrinogen gauze group survived after two weeks (p= 0.032). Bleeding in the imbibed fibrinogen gauze was significantly less than control group, 48 hours’ post-surgery (p<0.001). According to the stereological results, granulation tissue in the imbibed fibrinogen gauze group were more than the control group (P= 0.032). Also, fibrosis in the imbibed fibrinogen gauze group were more than the control group (P= 0.014).Conclusion: Our study indicated that imbibed fibrinogen gauze can potentially control liver bleeding and improve survival through increasing granulation tissue and fibrosis in injured liver.