Tehran University Medical Journal

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Background: The aim of this study is to describe the mental health and social profile of adolescent thalassemic patients through self-report and GHQ-12 test.

Materials and Methods: With convenience sampling, 156 consecutive adolescent thalassemic patients, recruited during a 20month period, filled in a semi-structured self-administered questionnaire in addition to a GHQ-12 questionnaire.

Results: 100 cases (64.1%) denied having health problems. 71 patients (45.5%) described their health status as not bad and 39 cases (25%) as good. The average GHQ-score was 6.12 (0.95 CI- 5.69-6.56). Nine cases (5.8%) scored low (0-1) and 21 cases (13.5%) scored borderline (2-3), while the score of 124 patients (79.5%) was favorable (4-12). There was a significant difference between mean scores in different age groups (p= 0.036) and 78 percent of those with low scores were in their late adolescent period (18-21 yrs). 15 patients (9.6%) had quit school due to their health problems. Mean GHQ score for quitters was significantly lower than those going on with their studies (p= 0.017).

Conclusion: These adolescent thalassemic patients seemed to have coped properly with their disease. Possibility of denial should also be considered. Further studies for detection of high-risk groups for psychosocial derangements can help us in applying appropriate and timely preventive and supportive measures.

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Background: We aimed to demonstrate the mechanism of fracture and functional outcome of patients with hip injury in our clinical setting.
Methods: In a historical cohort, all women 50 years of age and older admitted to three university hospitals of Tehran University of Medical Sciences (Shariati, Imam Khomeini and Sina) with the diagnosis of hip fracture from 21 March 2003 to 21 March 2004 were included in this study (n=115). Follow up was conducted via telephone post and even home visit to record the functional status of the patients at the time of study (5 Jan 2005) measured with Barthel index in addition to the exact mechanism of injuries.
Results: The mean and standard deviation of age were 76.3 ± 10.6 years. About 88.7% of injuries had occurred at home (65.2% on the carpet), the remaining happening in the streets. Mean length of hospitalization was 11 ± 7.9 days. Among our patients, 71% could mobilize spontaneously without aids before injuries. This had reduced to 20% at the time of follow-up. The mean Barthel index was 97.2 ± 8.2 before fracture and 75 ± 21.1 at the present. Among our patients, five cases died during hospitalization and 29 of them died afterwards (total: 34 or 29.6%).
Conclusion: The most common external cause of injuries in our cases was stumbling at home especially on carpeted surfaces. This necessitates preventive measures aimed at physical standards of houses and education of elderly on healthy locomotion, indoors.

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Background: Drug abuse has been known as a growing contributing factor to all types of trauma in the world. The goal of this article is to provide insight into demographic and substance use factors associated with trauma and to determine the prevalence of drug abuse in trauma patients.
Methods: Evidence of substance abuse was assessed in trauma patients presenting to Sina trauma hospital over a 3-month period. They were interviewed and provided urine samples to detect the presence of drug/metabolites of opium, morphine, cannabis and heroin by “Morphine Check” kits. Demographic data, mechanisms of injury, history of smoking and drug abuse were recorded.
Results: A total of 358 patients with a mean age of 28.4 years were studied. The Patients were predominantly male (94.7%). There was a history of smoking in 136 cases (38%). 58 cases (16.2%) reported to abuse drugs (91.5% opium). The commonest route of administration was smoke inhalation (37.2%). Screening by Morphine Check test revealed 95 samples to be positive (26.5%). The preponderance of test-positive cases was among young people (of 20-30 years of age) with a history of smoking. Victims of violence and those with penetrating injuries also showed a higher percentage of positive screens (P=0.038 and P<0.001, respectively).
Conclusion: These results suggest that drug abuse is a contributing factor to trauma especially in violent injuries and among the young. Regarding the considerable prevalence of drug abuse among trauma patients, it’s highly recommended that all trauma patients be screened for illicit drugs

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Background: The object of this study was to determine the epidemiological characteristics of deliberate self-poisoning in adolescents referred to the only poisoning center in Tehran.
Methods: In a cross-sectional study, all cases of acute poisoning at the Loghman Hakim Hospital from May to December 2003 were reviewed. Data for adolescents (13-19 years of age) were analyzed by SPSS for Windows, version 13 and STATA, version 8.
Results: From a total of 9203 cases of deliberate self-poisoning, 28.5% were adolescents (2626 cases). The male/female ratio was 1/2.2. Approximately 87% were unmarried and 56% were students, while a total of 4859 different drugs/agents were used for self-poisoning (an average of 1.85 for each case). The majority of patients was from urban areas and had no history of attempted suicide. There was no difference between males and females regarding history of psychiatric and somatic disorders, though there was a significant difference in the average of age between male and female adolescents.
Conclusions: Among adolescents, self-poisoning is more common in girls while the mean of age is younger in boys. Although the prevalence of psychiatric disorders in adolescents appears to be less than the general population, this may be related to differences in their situations or due to underestimation of their frequencies. Psychiatric care should be a necessary component of the care administered to adolescents who attempt suicide and must be based on the needs and basic assessment of the patient’s status. Research regarding the familial history of abuse, neglect, self-harm/ poi- soning should be undertaken so that such social issues can be prioritized and addressed.

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Normal 0 false false false EN-GB X-NONE AR-SA MicrosoftInternetExplorer4 Background: One of the major problems in the medicine is personal identification in cases of skeletal remains. The first step is determination of sex. One of the elements that recently paied more attention to it is the patella. Since the measurements are population specific, so we measured the patellas of Iranians to determine their patellas dimensions for sex prediction.
Methods: In this study three metrical characteristics of patella were measured from 67 corps between 20-64 years refered to the autopasy hall of forensic medicine center in Tehran (L.M.O). For statistical analysis of datas, the statistical product and service solution (SPSS version 16) program was used and unvariate and multivariate discriminant function analysis were performed to indicate the efficiency of each variable for sex determination.
Results: The mean of patella height in male was 4.46 cm and in female was 3.87, the mean of patella width in male was 4.60 and in female was 4.03cm and the mean of patella thickness in male was 2.25 and in female was 2.07cm. Among these measurements maximal width with average accurancy of 94% and then maximal height with 91% and finally maximal thickness with 71.6-73.1% respectively were better variables for sex determination. Also in multivariate discriminant analysis, combination of all three measurements with average accuracy of 94% was the best function for sex determination.
Conclusion: The results of this study revealed that we can determine sex with high confidence in situations such as explosions, air crashes and etc, just by using the patella measurement.