Relationship of Serum Lead Level in Opium Consuming Patients with Clinical and Demographic Symptoms: A Retrospective Study
محورهای موضوعی :
Fatemeh Babazadeh
1
,
Zohreh Hosseini Marznaki
2
,
Rahim Sharafkhani
3
,
Hemmat Gholinia
4
,
Elham Salmalian
5
,
Ali Asghar Manouchehri
6
1 - General Physician, Student Research Committee, Babol University of Medical Sciences, Babol, Iran
2 - Master of Nursing, Department of Internal Surgery, Imam Ali Amol Hospital, Mazandaran University of Medical Sciences, Sari, Iran
3 - Assistant Professor of Epidemiology, Department of Public Health, Khoi School of Medicine, Khoi University of Medical Sciences, Khoi, Iran
4 - Master of Statistics, Clinical Research Development Unit, Shahid Beheshti Hospital, Babol, Babol University of Medical Sciences, Babol, Iran
5 - Assistant Professor of Internal Medicine, Department of Internal Medicine, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
6 - Assistant Professor of Forensic Medicine, Clinical Research Development Unit, Shahid Beheshti Hospital, Babol, Babol University of Medical Sciences, Babol, Iran
کلید واژه: Drug abuse, Lead poisoning, Opium, Patients, Retrospective Study, Abdominal pain,
چکیده مقاله :
Drug abuse and its complications and side effects are one of the big problems of the Middle East, especially in Islamic Republic of Iran. Lead is a mutagen and carcinogen and it causes disruption of the body's enzymatic reactions, disruption of molecule synthesis, reduction of the life of red blood cells, kidney, heart and nerve complications, effects on the fetus, hallucinations, memory loss, nephropathy, brain and nerve damage, pain. It is in the device. Drug providers may use lead during narcotics production to increase the weight of opium, leading to lead poisoning. The present study was conducted with the aim of epidemiologically investigating the clinical indicators of patients admitted to Shahid Beheshti Hospital in Babol due to lead poisoning. This is a retrospective descriptive cross-sectional study. Census sampling was used to include the medical records of all patients who attended Rouhani Hospital and Shahid Beheshti Hospital emergency departments in Babol city, Mazandaran province, Iran due to lead poisoning in a 5-year period from 2016 to 2021. In order to describe variables, the mean and standard deviation were used for quantitative data. For qualitative data, frequency and percentage were used. To evaluate the relationship between variables, t-test and Chi-square test were used. A p-value of less than 0.05 was considered statistically significant. According to the findings, 44.2% of patients were older than 57 years; 62.5% lived in urban areas; 50% were unemployed; 88.3% were married, and 42.5% held a diploma. The mean serum lead level in patients was 74.8±20.22. A total of 52 patients (43.3%) had mild poisoning, 45% had moderate poisoning, and 11.7% of patients had severe poisoning. The obtained results showed a statistically significant relationship between lead poisoning severity and the age, education level, place of residence, history of previous poisoning and duration of narcotics use by patients (P-value<0.05). Moreover, the results showed that there is a statistically significant relationship between serum lead level and abdominal pain, nausea, limb weakness and convulsions in patients (p-value <0.05). According to the results, measuring serum lead level in opium-addicted patients who attend the medical centers with clinical symptoms such as anemia, nephropathy, convulsions, limb weakness, fatigue and abdominal pain, can be a great help in poisoning diagnosis.
Drug abuse and its complications and side effects are one of the big problems of the Middle East, especially in Islamic Republic of Iran. Lead is a mutagen and carcinogen and it causes disruption of the body's enzymatic reactions, disruption of molecule synthesis, reduction of the life of red blood cells, kidney, heart and nerve complications, effects on the fetus, hallucinations, memory loss, nephropathy, brain and nerve damage, pain. It is in the device. Drug providers may use lead during narcotics production to increase the weight of opium, leading to lead poisoning. The present study was conducted with the aim of epidemiologically investigating the clinical indicators of patients admitted to Shahid Beheshti Hospital in Babol due to lead poisoning. This is a retrospective descriptive cross-sectional study. Census sampling was used to include the medical records of all patients who attended Rouhani Hospital and Shahid Beheshti Hospital emergency departments in Babol city, Mazandaran province, Iran due to lead poisoning in a 5-year period from 2016 to 2021. In order to describe variables, the mean and standard deviation were used for quantitative data. For qualitative data, frequency and percentage were used. To evaluate the relationship between variables, t-test and Chi-square test were used. A p-value of less than 0.05 was considered statistically significant. According to the findings, 44.2% of patients were older than 57 years; 62.5% lived in urban areas; 50% were unemployed; 88.3% were married, and 42.5% held a diploma. The mean serum lead level in patients was 74.8±20.22. A total of 52 patients (43.3%) had mild poisoning, 45% had moderate poisoning, and 11.7% of patients had severe poisoning. The obtained results showed a statistically significant relationship between lead poisoning severity and the age, education level, place of residence, history of previous poisoning and duration of narcotics use by patients (P-value<0.05). Moreover, the results showed that there is a statistically significant relationship between serum lead level and abdominal pain, nausea, limb weakness and convulsions in patients (p-value <0.05). According to the results, measuring serum lead level in opium-addicted patients who attend the medical centers with clinical symptoms such as anemia, nephropathy, convulsions, limb weakness, fatigue and abdominal pain, can be a great help in poisoning diagnosis.
1. Eizadi M., Mirakhori Z., Amini A., 2019. The effect of 8-week resistance training on IRS-1 gene expression in gastrocnemius muscle and glycemic profile in diabetes rats. Arch Med Lab Sci. 5(1), 23-30.
2. Biancuzzi H., Dal Mas F., Brescia V., Campostrini S., Cascella M., Cuomo A., 2022. Opioid misuse: a review of the main issues, challenges, and strategies. Int J Environ Res Public Health. 19(18), 11754.
3. Mohebbi E., Kamangar F., Rahimi-Movaghar A., Haghdoost AA., Etemadi A., Amirzadeh S., et al., 2019. An exploratory study of units of reporting opium use in Iran: Implications for epidemiologic studies. Arch Iran Med. 22(10), 541-5.
4. Lim T.Y., Stringfellow E.J., Stafford C.A., DiGennaro C., Homer JB., Wakeland W., 2022. Modeling the evolution of the US opioid crisis for national policy development. Proc Natl Acad Sci USA. 119(23), 2115714119.
5. Report W.D., 2021. United Nations publication, Sales No. E. 21. XI. 8. 1.
6. Abazid H., 2021. Drug Abuse in the Middle East: A focus on Syria. In: Handbook of Substance Misuse and Addictions: From Biology to Public Health. Springer; 1-20.
7. Wong J., Bourke E., Roberts V., Lim S.M., Johnson D., Hamblin P.S., 2020. Lead poisoning associated with illicit opium use. Intern Med J. 50(2), 239-42.
8. Soltaninejad K., Shadnia S., 2018. Lead poisoning in opium abuser in Iran: A systematic review. Int J Prev Med. 21(3), 9.
9. Rezaei N., Alinia P., Aghabiklooei A., Izadi S., 2019. Blood lead level in opium abuse; which is more dangerous? Opium smoking or opium ingestion? Asia Pac J Med Toxicol. 8(4), 124-9.
10. Khayyat A., Esmaeil Pour M.A., Poursina O., Zohouti S.A., Jian P.V., Patel N., 2024. Evaluations of Biomarkers CDX1 and CDX2 in Gastric Cancer Prognosis: A Meta-analysis. Int J Mol Cell Med. 13(1), 1-18.
11. Abangah G., Pirhadi M., Shojaei B., Nazer M., Ghaysouri A., 2024. Determining the Amount of Lead Heavy Metal in Glycyrrhiza glabra (Licorice) and Foeniculum vulgare (Fennel) Medicinal Plants. Plant Biotech Persa. 6(1),1.
12. Zamani N., Hassanian-Moghaddam H., Bahrami-Motlagh H., Ahmadi S., Phillips S., 2019. Lead poisoning due to ingestion of lead-contaminated opium: A diagnostic study on patients’ imaging findings. J Trace Elem Med Biol. 55, 26-32.
13. Zamani N., Hassanian-Moghaddam H., 2018. Ingestion of lead-contaminated packs of opium. N Engl J Med. 379(19), 1861.
14. Al-Sudani I.M., Al-Hamdany M.R., Al-Khayat A.S.I., 2024. Risk of heavy metal contamination in bottled drinking water in Iraq. Casp J Environ Sci. 1-5. doi: 10.22124/cjes.2024.7506.
15. Emami H., Abtahi B., Shokri MR., 2024. Heavy metal bioaccumulation (Ni, V and Hg) in soft tissues of crustaceans, bivalves and gastropods: A case study on the Northern Persian Gulf. Casp J Environ Sci. 22(2), 255-265. doi: 10.22124/cjes.2023.7212.
16. Kanliada D., Coskunpinar E., Orhan KS., Musteri Oltulu Y., Celik M., Eren A., 2012. Relationship of Podoplanin and Glutathione S-transferases T1 Expression with Laryngeal Cancer. Int J Mol Cell Med. 1(4), 217-224.
17. Karrari P., Mehrpour O., Abdollahi M., 2012. A systematic review on status of lead pollution and toxicity in Iran; Guidance for preventive measures. DARU J Pharm Sci. 20(1), 1-17.
18. Shiri R., Ansari M., Ranta M., Falah-Hassani K., 2007. Lead poisoning and recurrent abdominal pain. Ind Health. 45(3), 494-6.
19. Teerasarntipan T., Chaiteerakij R., Prueksapanich P., Werawatganon D., 2020. Changes in inflammatory cytokines, antioxidants and liver stiffness after chelation therapy in individuals with chronic lead poisoning. BMC Gastroenterol. 20(1), 1-9.
20. Shabani M., Hadeiy SK., Parhizgar P., Zamani N., Mehrad H., Hassanian-Moghaddam H., 2020. Lead poisoning; a neglected potential diagnosis in abdominal pain. BMC Gastroenterol. 20(1), 1-8.
21. Whitehead L.S., Buchanan SD., 2019. Childhood lead poisoning: a perpetual environmental justice issue? J Public Health Manag Pract. 25,115-S20.
22. Alinejad S., Aaseth J., Abdollahi M., Hassanian‐Moghaddam H., Mehrpour O., 2001. Clinical aspects of opium adulterated with lead in Iran: a review. Basic Clin Pharmacol Toxicol. 122(1), 56-6.
23. Vahabzadeh M., Mégarbane B., 2020. Abdominal pain related to adulterated opium: An emerging issue in drug addicts. World J Psychiatry. 10(5), 95.
24. Doodkanloy Milan F., Torabi M., Mirzaee M., 2018. The relationship between blood lead level and the severity of abdominal pain in opioid-addicted patients during a hospital outbreak. J Addict Dis. 37(3-4), 211-6.
25. Shahramian I., Noori NM., Afshari M., Delaramnasab M., Bazi A., Abdollahi M., 2019. The clinical relevance of elevated blood lead levels in opium addicts with severe abdominal pain. Arch Psychiatry Res. 55(2), 165-72.
26. Neghabi Z., Amiri H., Aghabiklooei A., Shekofte H.S., 2019. Relationship of serum lead level in patients consuming oral opium with abdominal pain. J Prev Epidemiol. 4(2), e10-e.
27. Ghasempouri S., Hatami M., Zakariaei Z., Khosravi N., Khadir M., 2019. Lead poisoning in opium abusers: a five-year retrospective study. J Mazandaran Univ Med Sci. 29(179), 169-73.
28. Soltaninejad K., Flückiger A., Shadnia S., 2011. Opium addiction and lead poisoning. J Subst Use. 16(3), 208-12.
29. Froutan H., Kashefi ZA., Kalani M., Andrabi Y., 2011. Lead toxicity: a probable cause of abdominal pain in drug abusers. 7(2), 1.
30. Najari F., Ghamsari A.A., Vahabzadeh M., Abolbagaei S.M., Kayal I.B., Najari D., 2016. Evaluation of lead poisoning in opium consumers in Mashhad, Iran, 2018. Int J Med Toxicol Forensic Med. 2, 45-50.
31. Afzali S., Torabian S., Taheri S.K., 2017. Do opium abusers develop lead toxicity? A study on opium abusers in Hamadan, Iran. Asia Pac J Med Toxicol. 6(2).
32. Domeneh B.H., Tavakoli N., Jafari N., 2014. Blood lead level in opium dependents and its association with anemia: A cross-sectional study from the capital of Iran. J Res Med Sci. 19(10), 939.
33. Sazegar S., Ebrahimi F., 2012. Oral opium: an unusual cause of lead poisoning. Singapore Med J. 53(6), 395-7.
34. Azizi A., Ferguson K., Dluzewski S., Hussain T., Klein M., 2016. Chronic lead poisoning in an Iranian opium smoker resident in London. Case Rep. 2016215965.
35. Yang Y., Li S., Wang H., Liu M., Tuo B., Wu H., 2020. Chronic lead poisoning induced abdominal pain and anemia: a case report and review of the literature. BMC Gastroenterol. 20(1), 1-5.
36. Nazer M.R., Abbaszadeh S., Anbari K., Shams M., 2019. A review of the most important medicinal herbs affecting giardiasis. J Herbmed Pharmacol. 8(2), 78-84.
37. Dokhani N., Nazer M., Skokri S., Darvishi M., 2022. Determination and evaluating the antioxidant properties of Ziziphus nummularia (Burm. F.) Wight & Arn., Crataegus pontica K. Koch and Scrophularia striata Boiss. Egypt J Vet Sci. 53(3), 423-429.
38. Abbasi N., Akhavan M.M., Rahbar-Roshandel N., Shafiei M., 2014. The effects of low and high concentrations of luteolin on cultured human endothelial cells under normal and glucotoxic conditions: involvement of integrin-linked kinase and cyclooxygenase-2. Phytother Res. 28(9, 1301-1307.
39. Manouchehri A., Shakib P., Biglaryan F., Nazer M., Darvishi M., 2021. The most important medicinal plants affecting bee stings: A systematic review study. Ulud Aricilik Derg. 21(1), 91-103.
40. Darvishi M., Nazer M.R., Alipour M.R., 2017. Investigating the end of patients suffering from diabetic foot hospitalized in Be'sat hospital of IRIAF from 2009 to 2014. Biomed Res India. 28, 4630-4633.
41. Mahmoudvand H., Badparva E., Khalaf A.K., Niazi M., Khatami M., Nazer M.R., 2020. Prevalence and associated risk factors of intestinal helminthic infections in children from Lorestan province, Western Iran. Parasite Epidemiol Control. 9, 00136.
42. Negahdari B., Darvishi M., Saeedi AA., 2019. Gold nanoparticles and hepatitis B virus. Artif Cells Nanomed Biotechnol. 47(1), 455-461.
43. Darvishi M., Nazer MR., Shahali H., Nouri M., 2022. Association of thyroid dysfunction and COVID-19: A systematic review and meta-analysis. Front Endocrinol. 13, 947594.
44. Forootan M., Tabatabaeefar M., Mosaffa N., Ashkalak H.R., Darvishi M., 2018. Investigating esophageal stent-placement outcomes in patients with inoperable non-cervical esophageal cancer. J Cancer. 9(1), 213.
45. Darvishi M., Nazer MR., Shahali H., Nouri M., 2021. Association of thyroid dysfunction and COVID-19: A systematic review and meta-analysis. Front Endocrinol. 13, 947594.
46. Mussavi M., Asadollahi K., Janbaz F., Mansoori E., Abbasi N., 2014. The evaluation of red reflex sensitivity and specificity test among neonates in different conditions. Iran J Pediatr. 24(6), 697.
