Aims As an analgesic that acts upon the central nervous system (CNS), tramadol has gained popularity in treating moderate to severe pain. Recently, it has been increasingly reported as a drug of misuse with intentional overdoses or intoxications. This review focuses on tramadol intoxication in humans and its effects on different systems. Subject and method This narrative review provides a comprehensive view of the pharmacokinetics, mechanism of action, and incidence of tramadol toxicity with an in-depth look at its side effects. In addition, the main approaches to the management of tramadol poisoning are described. Results Tramadol poisoning can affect multiple organ systems: gastrointestinal, central nervous system (seizure, CNS depression, low-grade coma, anxiety, and over time anoxic brain damage), cardiovascular system (palpitation, mild hypertension to life-threatening complications such as cardiopulmonary arrest), respiratory system, renal system (renal failure with higher doses of tramadol intoxication), musculoskeletal system (rhabdomyolysis), endocrine system (hypoglycemia), as well as, cause serotonin syndrome. Seizure, a serious nervous disturbance, is more common in tramadol intoxication than with other opioids. Fatal tramadol intoxications are uncommon, except in ingestion cases concurrent with other medications, particularly CNS depressants, most commonly benzodiazepines, and ethanol. Conclusion With the increasing popularity of tramadol, physicians must be aware of its adverse effects, substantial abuse potential, and drug interactions, to weigh its risk–benefit ratio for pain management. Alternative therapies might be considered in patients with a previous overdose history to reduce risks for adverse outcomes.

Background: There has been a rapid increase in the prevalence of psychiatric and psychological disease, and this has attracted interest in identifying modifiable lifestyle factors that may affect an individual’s mood. Diet is one potential lifestyle factor that may affect psychological function. Aim: This study aimed to investigate the relationship between adherence to the health-promoting Nordic diet (ND) with neuropsychological function in young women. Methods: The study comprised 181 female students aged between 18 and 25 years. Psychological function was evaluated using a series of standardized questionnaires, including the Cognitive Ability Questionnaire, Depression Anxiety Stress Scale, Insomnia Severity Index, Epworth Sleep Scale and Quality of Life Questionnaire. A validated food frequency questionnaire, which included 65 types of foods, was used to evaluate the amount of different foods consumed. Results: Evaluation of the dietary composition of the participants showed that the rate of adherence to the ND was positively associated with total energy, carbohydrates, protein, fibre, iron, magnesium, potassium, zinc, folate, phosphorus, vitamin C, thiamine, riboflavin, niacin, vitamins B6 and B12, carotene, whole grain, legumes, cabbage/vegetables, vegetables and fruit ( p<0.05). Linear regression showed cabbage/vegetable consumption was inversely related to scores of stress (β=–0.04; p=0.038) and anxiety (β=–0.02; p=0.049) and directly associated with the quality-of-life score (0.02; p=0.036). Conclusions: Adherence to a ND with a high intake of cabbage/vegetables was inversely associated with stress and anxiety scores and directly associated with health-related quality of life.

Introduction:Menopause is accompanied by many physical and psychological symptoms that can affect the Quality of Life (QoL) of women. Nowadays, behavioral approaches, such as exercise programs, and herbal therapies are recommended to control menopause complications.Objective: This study aimed to compare the effects of exercise and licorice on the QoL of postmenopausal women. Materials and Methods:This quasi-experimental study was conducted in Arak City, Iran, in 2014. Sixty postmenopausal women were selected as study participants using the convenience sampling method and were divided into two equal groups (exercise and licorice) using a random number table. The licorice group received three tablets of licorice daily at three times, i.e., in the morning, noon, and night before meals, for 4 weeks; the exercise group adopted a regular walking program comprising 30-45 min of walking three times a week for 1 month.

Background Tramadol is a widely used synthetic opioid for moderate to severe pain. Some studies have shown that tramadol can increase oxidative stress in different tissues of the body. Quercetin is also a substance with various biological effects, including antioxidant, anti-inflammatory, hepatoprotective, nephroprotective, and cardioprotective activities. The current investigation aimed at determining the effects of quercetin, with or without naloxone, on tramadol intoxication. Methods This study was performed on 30 male Wistar rats divided into five groups: Group I) control group: intraperitoneal injections of normal saline 0.9% for 14 days; Group II) tramadol: 25 mg/kg for 14 days, and then a 50 mg/kg acute dose injection on the last day; Group III) acute quercetin (single dose): tramadol injection as with the second group plus 100 mg/kg of quercetin on the last day; Group IV) chronic quercetin: tramadol injection similar to the second group plus quercetin 100 mg/kg for 14 days; Group V) quercetin plus naloxone: tramadol injection similar to the second group plus injection of quercetin 100 mg/kg + intravenous naloxone 2 mg/kg on the last day, followed by a 4 mg/kg/h injection of naloxone for six hours. The rats were monitored for six hours on the last day, relating to the number and severity of seizures. Finally, the samples were prepared for biochemical investigation of the serum level of oxidative stress markers (MDA, SOD, NOx), inflammatory factors (IL-6, TNF-α), biochemical parameters (ALT, AST, creatinine, glucose) and hematological assay. The liver, heart, kidney, cortex, cerebellum, and adrenal tissues were collected to investigate the redox state. Results None of the treatments had positive effects on the number and severity of seizures. Chronic administration of quercetin led to alteration of some blood parameters, including reduced hemoglobin level and elevated platelet counts. Acute on chronic tramadol administration resulted in a significant rise in AST, where different treatments failed to reduce their levels down to the control group. Conclusion chronic administration of quercetin showed decreased oxidative/nitrosative stress in the liver, kidney, adrenal, and heart tissues. Quercetin plus naloxone decreased oxidative stress in the heart and adrenal tissues, but adverse effects on the brain cortex and hepatic function. Single-dose quercetin reduced cardiac oxidative stress.