Shahin Shadnia - Academia.edu (original) (raw)

Papers by Shahin Shadnia

International journal of medical toxicology and forensic medicine, Feb 1, 2024

Background: Benzodiazepines have been highly prescribed by physicians and have attracted public a... more Background: Benzodiazepines have been highly prescribed by physicians and have attracted public attention due to their high safety. These drugs have sedative, hypnotic, anti-anxiety, and anti-seizure properties. However, these drugs are also widely used for suicide. The present study was designed and implemented to determine the distribution of patients poisoned with benzodiazepines in terms of clinical and demographic characteristics. Methods: Investigation of poisoning with benzodiazepines in one year in the poisoning department of Loghman Medical Center in Tehran City, Iran, was carried out as a descriptive-prospective study. In this research, 458 poisoned patients were studied to collect data on their age, gender, drug dosage, type of drug, duration of hospitalization, blood analysis results, and mortality. Results: The majority of patients poisoned with benzodiazepines were women (62.2%). The mean age of people was 31.67 years. The most frequently used drugs were clonazepam and alprazolam. Other drugs used with benzodiazepines were propranolol, methadone, and acetaminophen. The death rate was 1.7%. The incidence of hypoglycemia and creatinine above 1.3 was 8.53% and 11.3%, respectively. Hyperglycemia was 10.6%. There were 11, 80, and 178 cases of elevated alanine transaminase, aspartate aminotransferase, and alkaline phosphatase, respectively. Conclusion: Benzodiazepines have the potential to cause liver and kidney damage and changes in insulin secretion and blood sugar. This issue should be considered when dealing with a poisoned patient to prevent serious injuries.

International Urology and Nephrology, Feb 6, 2017

was statistically significantly different between the two groups (P = 0.02). Median creatinine le... more was statistically significantly different between the two groups (P = 0.02). Median creatinine levels were 1.3 [1, 6] (0.8-2.7) and 1.4 [1.35, 2.1] (0.8-6.5) in the patients who were dialyzed once and twice, respectively. Conclusions As a conclusion, creatinine is possibly a readily available test that can predict the appropriate time needed for hemodialysis in methanol-poisoned patients.

International journal of medical toxicology and forensic medicine, May 3, 2017

Background: Methamphetamine (MA) is an illegal amphetaminelike which stimulate the central nervou... more Background: Methamphetamine (MA) is an illegal amphetaminelike which stimulate the central nervous system. In recent years, MA has been widely abused worldwide. Previous studies have suggested that oxidative stress (OS) plays an important role in MA-induced toxicity. From this view, antioxidant therapy could be considered as a potential drug therapy in MA abusers. Therefore, the objective of this study was to evaluate OS status in MA abusers. Methods: This was a cross-sectional study conducted on 21 MA abusers who referred to Iranian National Center for Addiction Studies and Congress 60 Humane Revivification Society, and 15 healthy males as a control group. The demographic data and peripheral blood sampling was obtained from both groups. The serum malondialdehyde (MDA) level as a marker of plasma lipid peroxidation and total antioxidant capacity (TAC) of plasma were analyzed. Results: Significant decrease in plasma TAC in case group was observed (101.85±12.5 vs. 130.7±16.12 mmol/L). No significant increase in MDA serum level was detected in case group in comparison with control (27.35±2.6 vs. 26.67±2.22 µmol/L, respectively). Neither the serum MDA levels nor the plasma TAC were significantly correlated with the duration and amount of MA abuse. Conclusion: It seems that, MA abuse is associated with prooxidant-antioxidant imbalance, which suggests evaluation the role of antioxidants administration for the prevention and treatment of MA-induced toxicity.

Archives of Medical Science, Apr 22, 2009

I In nt tr ro od du uc ct ti io on n: : Drug reactions are commonly seen in the skin but their fr... more I In nt tr ro od du uc ct ti io on n: : Drug reactions are commonly seen in the skin but their frequency has not been determined in Tehran yet. We aimed to evaluate adverse cutaneous drug events (ACDE) in hospitalized patients. M Ma at te er ri ia al l a an nd d m me et th ho od ds s: : A 6-year case series study (from 2000 to 2006) including all hospitalized patients in two referral dermatology wards of Loghman-Hakim and Shohada Hospitals was performed. R Re es su ul lt ts s: : A total of 54 patients (31 female and 23 males) were included. Adverse cutaneous drug events was slightly more frequent in females (1.34 : 1). Thirty three and 22% of the patients were in the age group of 31-40 and 41-50, respectively. The most commonly seen dermatoses were maculo-papular rashes (60%), erythroderma (10%), and urticaria (10%). Drugs most frequently associated with ACDE were anticonvulsants and antibiotics, with rates of 31 and 28%, respectively. No mortality due to ACDE was seen. In most of the patients (50%), the duration of hospitalization was 3-7 days. Most of the patients (74%) had no previous history of allergy. In most cases (65%), the adverse events began during the first day to first month after drug exposure. C Co on nc cl lu us si io on ns s: : Although the prevalence of ACDE in this study was found to be lower than reported data in the literature suggest, the results confirm that ACDE is a notable public health concern. Early and rapid recognition of severe ACDE and prompt withdrawal of the offending drug are the most important actions to minimize morbidity associated with drug use. K Ke ey y w wo or rd ds s: : adverse drug reaction, drug eruption, drug hypersensitivities, hospitalized patients, skin, toxicity. C Co or rr re es sp po on nd di in ng g a au ut th ho or r: :

Toxicology Letters, Sep 1, 2006

PubMed, 2021

Introduction: The most effective treatment for withdrawal syndrome in Opioid-dependent patients a... more Introduction: The most effective treatment for withdrawal syndrome in Opioid-dependent patients admitted to intensive care units (ICUs) remains unknown. This study aimed to compare fentanyl and methadone in this regard. Methods: This prospective, single-blinded, controlled pilot study was conducted on opioid-dependent intubated patients admitted to the toxicology ICU of Loghman Hakim Hospital, Tehran, Iran, between August 2019 and August 2020. Patients were alternately assigned to either fentanyl or methadone group after the initiation of their withdrawal syndrome. Duration and alleviation of the withdrawal signs and symptoms, ICU and hospital stay, development of complications, development of later signs/symptoms of withdrawal syndrome, and need for further administration of sedatives to treat agitation were then compared between these two groups. Results: Median age of the patients was 42 [interquartile range (IQR): 26, 56]. The two groups were similar in terms of the patients' age (p = 0.92), sex (p = 0.632), primary Simplified Acute Physiology Score (SAPS) II (p = 0.861), and Clinical Opiate Withdrawal Score (COWS) before (p = 0.537) and 120 minutes after treatment (p = 0.136) with either methadone or fentanyl. The duration of intubation (p = 0.120), and ICU stay (p = 0.572), were also similar between the two groups. The only factor that was significantly different between the two groups was the time needed for alleviation of the withdrawal signs and symptoms after the administration of the medication, which was significantly shorter in the methadone group (30 vs. 120 minutes, p = 0.007). Conclusion: It seems that methadone treats the withdrawal signs and symptoms faster in dependent patients. However, these drugs are similarly powerful in controlling the withdrawal signs in these patients.

International Pharmacy Acta, May 19, 2021

This open-access article is distributed under the terms of the Creative Commons Attribution Non C... more This open-access article is distributed under the terms of the Creative Commons Attribution Non Commercial 4.0 License (CC BY-NC 4.0).

Asia Pacific Journal of Medical Toxicology, Mar 1, 2016

Background: Acute poisoning has been reported to be the most common reason for hospitalization in... more Background: Acute poisoning has been reported to be the most common reason for hospitalization in Iran. This study was designed to delineate the toxic agents responsible for acute poisonings in Iran by reviewing poisoning cases treated at four major referral hospitals for treatment of poisoning across the country. Methods: This was a descriptive retrospective study on poisoned patients treated at four tertiary hospitals referral for poisoning in Iran, including Loghman Hakim Hospital (LHH) in Tehran, Imam Reza Hospital (IRH) in Mashhad, Noor and Ali Asghar Hospital (NAH) in Isfahan, and Ghaemshahr Razi Hospital (GRH) in Ghaemshahr, as reported to the National Drug and Poison Information Center during the years 2012 and 2013. Results: During the two-year study period, 61,187 poisoned patients (i.e. 32,107 patients in 2012 and 29,080 patients in 2013) were treated at the four hospitals. In these two years, 22,185 patients (36.3%) were treated at LHH, 22,160 patients (36.2%) at IRH, 10,897 patients (17.8%) at NAH and 5,945 patients (9.7%) at GRH. Cumulatively in all hospitals, the highest rate of admissions was due to drug poisoning (42,017, 68.7%), recreational substances overdose (7,302, 11.9%) and pesticide poisoning (5,217, 8.5%). Conclusion: Pharmaceutical products, substances of abuse and pesticides are the most common causes of poisoning-related admissions to referral Iranian poison treatment centers. Effective measures to reduce poisoning with these substances should be done.

Asia Pacific Journal of Medical Toxicology, May 1, 2014

Background: The analysis of ethanol in bio-samples is an important method for determination of ac... more Background: The analysis of ethanol in bio-samples is an important method for determination of acute alcohol use/abuse both in clinical and forensic toxicology. In forensic cases, it is known that microorganisms involved in the postmortem putrefaction process can produce alcohol and when the body has been traumatized. In clinical setting, post-ingestion time has a critical role for determination of alcohol level in biological fluids and the ethanol has been decreased during post-ingestion period, especially in chronic alcohol abusers. From this view, new biomarkers have been studied for evaluation of acute and chronic ethanol use/abuse in clinical and forensic cases. In this article, the role of each biomarker in determination of alcohol use/abuse was reviewed.

PubMed, 2020

Background: The present study is conducted with the aim to assess the lead contamination in opium... more Background: The present study is conducted with the aim to assess the lead contamination in opium tincture, methadone oral solution, and opium. Methods: 10 samples from each of the matters of opium tinctures, methadone oral solutions, and opium (provided by the Law Enforcement Force of the Islamic Republic of Iran) were collected. Then, an atomic absorption spectrophotometer (AAS) was used to measure lead concentration in each of the samples. Data were analyzed using the SPSS software. A P value of 0.05 or less was considered to be statistically significant (Two-tailed). Findings: In this study, the amount of lead measured in all samples was equal or less than 5 parts per million (ppm) and the only exception was the lead level of 5.6 ppm in one of the opium tincture samples, which was slightly higher than the standard lead level. Conclusion: The results of the current study showed that lead was present in opium tincture, methadone oral solution, and opium, but it was not in toxic levels. It is reasonable for opium derived medicinal products, but the low levels of lead in opium may need to be addressed at different times in different regions of the country.

Iranian Journal of Toxicology, Jul 1, 2016

Background: Snakebite is a serious public health problem in the world. The annual incidence of sn... more Background: Snakebite is a serious public health problem in the world. The annual incidence of snakebites ranges from 4.5-9.1 in 100,000 population in Iran. With regard to diversity of envenomation profiles in different geographical parts of Iran, the aim of this study was to determine the demographical data, clinical and laboratory findings, and the outcome of the snakebite victims referred to a tertiary referral hospital.

PubMed, Oct 1, 2011

With the establishment of the inadequate efficiency of atropines and oximes in reducing morbidity... more With the establishment of the inadequate efficiency of atropines and oximes in reducing morbidity and mortality of patients poisoned by organophosphates, more attention is given to using other methods such as Fresh Frozen Plasma (FFP) as a bioscavenger to mop up organophosphate toxins. This randomized clinical trial was conducted on 56 organophosphate poisoned patients who were randomly assigned to the FFP and control groups in order of admission. The routine treatment in both groups included atropine and, in moderate to severe cases of poisoning, pralidoxime. The FFP group received four packs of FFP as stat dose at the beginning of treatment. No significant difference was seen between the two groups on the atropine and pralidoxime dosage, hospitalization length and mortality. The present study showed that using four packs of FFP as stat dose at the onset of treatment had no significant effect on the clinical course of organophosphate poisoned patients.

Clinical Toxicology, Jan 24, 2014

International Journal of Preventive Medicine, 2018

Substance abuse and its consequences are major health hazards in the world. Opium addiction is a ... more Substance abuse and its consequences are major health hazards in the world. Opium addiction is a common form of substance abuse in Iran. Adulteration of illegal substances in the process of production and distribution of the drug in black market with many types of materials have been reported. One of the main goals of the adulteration of illegal substances is cutting of the substance for deal and increase of the weight for more benefit. However, adding of adulterating agents to illegal drugs could be considered as a cause of nonspecific and rare toxicity during substance abuse. Although the presence of lead in street-level heroin, marijuana, and amphetamines has been reported from some countries previously, recently, several reports suggested lead poisoning in Iranian opium addicts. Adulteration of opium with lead is a new source of lead poisoning in Iran in which the opium abuse is frequent and it could be a new health problem in the future. In this regard, evaluation of blood lead level would be important for early diagnosis of lead poisoning in opium addicts.

Journal of pharmacy practice and research, Dec 1, 2002

Aim: To describe the treatment and successful outcome of a patient who had taken an amount of alu... more Aim: To describe the treatment and successful outcome of a patient who had taken an amount of aluminium phosphide that would normally be lethal.Case report: A 47‐year‐old woman was admitted two hours after ingesting 16.8 g of aluminium phosphide with suicidal intent. Treatment consisted of: gastric lavage with potassium permanganate solution; intravenous bicarbonate, magnesium and calcium; and oral bicarbonate and coconut oil. Supportive therapy in intensive care was also provided. Her clinical course included hypotension, metabolic acidosis and liver dysfunction.Discussion: Aluminium phosphide produces phosphine gas and is used to control rodents in grain storage facilities. This patient had apparently ingested what would normally be a lethal amount of aluminium phosphide and had signs and symptoms of severe toxicity. She survived following rapid treatment and supportive care. Recommended measures to limit absorption and phosphine toxicity may have contributed to survival.

Journal of Medicinal Plants, May 1, 2019

Background: Because in today's societies, not only the nutritional role of plants and fungi is ve... more Background: Because in today's societies, not only the nutritional role of plants and fungi is very high, but also the main basis of many drugs are plants and plant products, therefore one of the problems of clinical toxicologists is the toxicity of these products. Objective: This study aimed to define the prevalence, symptoms, complications, effective treatments, type of substance use, the cause of intake, location, gender distribution and age of poisoning with herbs and mushrooms in hospitalized patients of Loghman Hakim Hospital in Tehran. Methods: This is a retrospective study with questionnaire formulation. Patients reviewed from the beginning of 2007 to the end of 2013. Results: of 103 cases of poisoning with plants and mushrooms 64.1% were male, and 35.9% were female. The mean age of patients was 21.59 ± 30.51 years. The most commonly used substance is Datura (34%). On the other hand, sole mushroom ingestion was found in 5.8% of cases. The most significant source of plants and mushrooms was reported from herbal-shops (27.18%). The reason behind intake was either random or euphoria. Four patients were admitted to the intensive care unit, and three patients needed intubation. The mean hospital stay was 1.64 ± 1.28 days. Ninety percent of the treatments were supportive, and 75.7% of the patients recovered without any clinical complications. Conclusion: Poisoning with toxic plants and mushrooms is one of the frequent causes of intoxication that is often accidental. In children poisoning is inadvertent, but youth are more likely wanted to have euphoria. Treatment strategies are supportive and symptomatic.

DOAJ (DOAJ: Directory of Open Access Journals), 2001

OBJECTIVE: It is important to pay attention to poisoning conditions that have special role in our... more OBJECTIVE: It is important to pay attention to poisoning conditions that have special role in our life. This study was done to investigate the mortality rate induced by acute chemical and drug poisoning in Loghman Hakim hospital (Tehran) during 1997-1998. METHODS: During this interval, 35580 Patients who were over 12 years old, were admitted and their information were registered on questionnaires and then analyzed.