Introduction: Tramadol, as a centrally-acting, opioid-like analgesic with serotonin reuptake inhibition property, is one of the most prescribed analgesics in the world. We assessed the incidence of seizure, as it is one of the most important adverse effects.Methods: In a cross-sectional study, 215 cases of tramadol users or abusers who were admitted to Loghman-Hakim Hospital Poisoning Center (LHHPC) in Tehran during a 5-month period, from April 2007 to September 2007, were assessed to evaluate the occurrence of seizure. Patients with positive history of co-ingestion of other drugs, addiction, convulsive disorders, renal diseases, or head trauma with abnormal electroencephalography (EEG) or computerized tomography (CT) scan of the brain were excluded, thus 132 patients were included in the study. For patients who had seizure, CT scan of the brain and EEG were performed, and frequency and type of seizure were identified. Mean tramadol dose was compared between patients with and without seizure.Results: Among the patients, 97 (73.5%) were male. Seizure occurred in 61 patients (46.2%) within 24 hours after tramadol ingestion. The majority of patients who had seizure were male (male, 83.6% vs. female, 16.4%). Mean tramadol dose was lower among females than males (males, 2413 mg vs. females, 1706 mg), but the difference was not statistically significant. Of 35 patients with documented seizure type, all showed generalized tonic-clonic seizure and 12 patients had abnormal EEG (35.3%). No statistically significant difference was observed in mean tramadol intake between patients with or without seizure. Analysis of patients with seizure, according to tramadol intake, indicated that most patients used tramadol in the dose range of 500-1000 mg followed in occurrence by 1500-2000 mg, then 100-500 mg, 2500-3000 mg, and 3500-4000 mg.Conclusions: Mean tramadol intake does not differ between patients with and without seizure, and the most common dose range in those with seizure is 500-1000 mg. We thus conclude that the incidence of seizure with tramadol is not dose dependent.

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The population of Iran is young and millions of youths are at risk for unprotected sexual relationships and their consequences. This questionnaire-based study was conducted in Shiraz, southern Iran. Singles were asked about premarital sex (PMS) and sexual health issues. A total of 1076 participants (634 males, 58.9%) with a mean age of 24 ± 5.8 years participated in this study. One out of 2 singles reported PMS and 1 out of 2 singles with PMS reported multiple partners. Median age at first sexual contact was 18 years. Of all singles, 452 (41.9%) were heterosexual, 61 (5.6%) were bisexual, 366 (33.9%) were alcohol users, 252 (23.3%) were smokers, 57 (5.2%) were opium users, and 392 (36.3%) did not know about preventive methods for HIV. Of 528 singles who had PMS, 126 (23.8%) never used a condom, 223 (42.2%) used it inconsistently, and 59 (11.1%) used it mainly against sexually transmitted diseases. In the regression analysis, alcohol use was the strongest associated factor of PMS in singles (OR 4.9, 95% CI 3.3-7.4), followed by lack of religious beliefs (OR 2.3, 95% CI 1.4-3.8). As a result, the PMS situation in our setting is cause for alarm and to protect singles against the risks associated with PMS, a multidisciplinary intervention including improving access to sexual behavioral counseling centers, education about sexual health and especially condom use, abstinence from alcohol use, and commitment to religious values is urgently needed to be established by health policymakers.

Matricaria chamomilla (MC) was shown to have anti-inflammatory effects. Flavonoids are major groups of MC immunomodulators. The anti-inflammatory effects of apigenin as an MC flavonoid has already been demonstrated. In this study, we aimed to report the amount of this compound by liquid chromatography-mass spectrometry (LC-MS) and measuring the total phenol content (TPC) in both the MC aqueous and alcoholic extracts. We also investigated the MC aqueous and ethanolic extracts effect on BALB/c separated macrophages and lymphocytes cell viability and macrophage nitric oxide production. Interferon-γ and interleukin-10 secretion were also measured in lymphocytes. We found that the amount of apigenin was 0.078 and 0.25 mg/g per each of dry aqueous and alcoholic extracts, respectively. Also, the total phenol content was 2.99% in aqueous and 3.95% in alcoholic extracts. BALB/c separated macrophages cell viability significantly increased when treated with the MC aqueous extract but decreased when treated by the MC alcoholic extract in the presence of lipopolysaccharide. Also, the amount of nitric oxide production by macrophages and BALB/c separated lymphocytes cell viability in treatment with aqueous and alcoholic extracts significantly decreased. Interferon-γ increased, and interleukin-10 decreased in lymphocytes treated with the MC aqueous extract, which may suggest Th1 polarization. There was no significant change in the interferon-γ level in lymphocytes when treated with the MC alcoholic extract, but the level of IL-10 increased in these cells. Altogether, besides the anti-inflammatory effect of MC extracts, we found MC aqueous extract effects as disrupting Th1/Th2 balance to Th1 upregulation. Overall, the anti-inflammatory effect of the MC alcoholic extract was higher than the MC aqueous extract.

BackgroundBreast cancer is the most common cause of cancer death among women in the world. With prevention and examinations, including breast self-examination, the death rate will be reduced.ObjectiveThe purpose of this study was to determine the effect of health-belief-model-based training on the performance of women in breast self-examination in the province of Fars (Iran).MethodsAn empirical study examined the effect of an eight-week training program based on the health belief model among 144 women who visited health care centers in the city of Abadeh in Fars Province (Iran) in 2015. Data gathered through researcher-made questionnaires including awareness, components of the health belief model, performance, and demographic information. IBM-SPSS software version 20, descriptive and inferential statistical tests such as T-test, chi-square, Mann–Whitney, and repeated measurements were used for data analysis.ResultsAfter the intervention, a significant difference was seen in average awareness, perceived susceptibility, and performance of women (p<0.05), while it was not significant in benefits constructs, perceived barriers, and perceived severity and practice guide. After intervention, the average score of awareness was increased significantly (p<0.001). Also, the average score of performance in breast self-examination showed a significant difference (p<0.001).ConclusionDue to the low level of awareness of women about breast self-examination, using a health belief model with an increase of the perceived susceptibility could be effective in improving their performance in breast self-examination.