Delayed neurotoxic complications of chemical warfare agents (CWA), such as sulphur mustard (SM) and tabun, in human beings have not been reported in detail. We thus aimed to investigate possible neurotoxic complications of these agents in Iranian veterans 22-27 years after exposure. After co-ordination with the veteran foundation and obtaining the approval of the medical research ethics committee, 43 Iranian veterans with late complications of CWA exposure during the Iran-Iraq conflict were studied after obtaining signed written informed consent. Demographic and clinical findings were recorded on pre-designed forms. Neurological examination was performed by a neurologist. Routine biochemical tests were performed for all the patients. Electromyography (EMG), nerve conduction velocity (NCV) and electroencephalography (EEG) were carried out as clinically indicated. The majority of the patients (38) had been exposed to SM and only five patients to tabun. Hyperaesthesia was the most objective finding (72.1%). Fatigue (93%), paraesthesia (88.3%) and headache (83.7%) were the most common subjective findings in the patients. Sensory nerve impairments, including paraesthesia (88.3%), hyperaesthesia (72.1%) and hypoesthesia (11.6%), were the most common observed clinical complications. EMG and NCV were impaired in seven patients (16.3%) who were all SM-exposed patients but did not show any significant correlation with organ complications. EEG was negative even in the seized patients. Cholesterol, LDL and triglyceride levels were significantly above the normal ranges. Late neurological complications of CWA, particularly SM poisoning, are considerable even after three decades of exposure and require medical attention.
Background and Objectives: Mental disorders, including obsessive-compulsive disorder, are multidimensional phenomena. Most patients with mental disorders reject or resist receiving treatments and hence, effective strategies are needed for their treatment.As an extension of cognitive behavioral therapy, schema therapy incorporates different views and presents a multi-component approach for the management of not only cognitions and behaviors, but also emotions. This study aimed to assess the effects of schema therapy on emotional self-awareness, vulnerability, and obsessive symptoms among patients with obsessive-compulsive disorder. Methods: This was an experimental clinical trial. Study population consisted of all patients with obsessive-compulsive disorder who, in a six-month period in 2016, referred to psychology clinics located in Birjand, Iran. A total of 32 eligible patients were recruited and randomly assigned to control and intervention (i.e. schema therapy) groups. Data collection instruments were a researchermade demographic questionnaire, Young schema questionnaire, and Yale-Brown obsessive-compulsive scale. The data were entered into the SPSS software (v. 22.0) and analyzed using the multivariate analysis of covariance at a significance level of less than 0.05. Results: One patient from the intervention group voluntarily withdrew from the study. The posttest mean score of emotional selfawareness in the intervention group was significantly greater than the pretest mean score, while the posttest mean scores of the vulnerability schema and obsessive symptoms were significantly lower than the pretest scores (P < 0.001). Moreover, the control and the intervention groups differed significantly from each other respecting the posttest mean scores of emotional self-awareness, vulnerability, and obsessive symptoms (P < 0.001). Conclusions: Schema therapy alleviates obsessive symptoms through positively affecting emotional self-awareness and the two schemas of vulnerability. These findings suggest that these variables play significant roles in the development of obsessive symptoms. Therefore, schema therapy is recommended as an effective treatment for outpatients suffering from obsessive-compulsive disorder.
Background: Neurodegenerative effects of illicit drugs have been proposed in many investigations. Amyotrophic lateral sclerosis is a fatal motor neuron disease characterized by degeneration of motor neurons, but the risk of amyotrophic lateral sclerosis among drug abusers is unknown. Methods: A nested case-control study was conducted in a teaching hospital to examine the association between drug abuse and amyotrophic lateral sclerosis. The study population included persons 18 to 40 years of age who were admitted in an electrodiagnostic medicine clinic for more than two year during the study period (January 2013 through April 2015) For each subject with ALS, 2 smoking-matched controls without ALS were randomly selected from the same population. Self-reported history of drug abuse was acceptable in both groups. Results: A total of 17 persons with ALS and 34 controls were identified, of whom 10 (58.8 percent) and 8 (23.5), respectively, had history of drug abuse. Persons with history of drug abuse had an increased risk of ALS (adjusted odds ratio, 2.6; 95 percent confidence interval, 1.2 to 5.7) as compared with controls. Conclusion: Drug abuse is an important risk factor for ALS, at least among young adults. The risk among drug abusers was at least or about double that among control group. The burden of mortality due to background ALS in drug abusers needs to be determined in future investigations.
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