Determining the Cause of Death Among Drug Addicts in Residential Rehab Campuses in Tehran

Background: Determining the cause of death among drug addicts in Residential Rehab Campuses (RRCs) is of paramount importance, since it may prevent and reduce morbidity and mortality rates. Therefore, the present study was done to investigate the cause of death among drug addicts in RRCs in Kahrizak Dissection Hall, Tehran Province, Iran, from September 2011 to September 2019. Methods: In this descriptive cross-sectional study, a total number of 166 drug addicts, who had died in the RRCs located in Tehran, Iran were examined, and the findings were analyzed using the SPSS v. 26. Moreover, the Chi-square test was utilized to compare the results. Results: In this study, the most important causes of death, were infections, drug side effects, Myocardial Infarction (MI), and drowning, respectively. The highest frequency of death had occurred in the 31-40-year-old age group and was mostly observed in unmarried individuals. The most common causes of death were infection among the single and divorced ones and were MI for married cases. Toxicological results were generally negative in 60.84% of the cases. Also, 86.74% of the cases were non-pathological with regard to the brain tissue samples and 65.66% of the individuals had no pathological cardiac lesions. Besides, the most common microscopic findings of the lungs were associated with pulmonary edema. In the trauma group and also drug side effects and drowning groups, the most frequent pathological findings were pulmonary hemorrhage and pulmonary edema, respectively. As a whole, 69.87% of the deaths had occurred in the RRCs and 55.42% of them were assumed natural in terms of mode of occurrence. Conclusion: The majority of the deaths in the RRCs should not have occurred if the given centers were authorized and the illegal centers were closed. Moreover, these centers should have proper management with the presence of resident physicians and trained medical staff as well as necessary medical equipment, proper nutrition, no access to drugs and other illicit substances, along with adherence to hygienic principles to minimize mortality rates among the drug addicts living in the RRCs.

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All-cause and cancer mortality in a private health plan in Brazil: Ten years retrospective analysis.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e13610 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e13610-e13610

Author(s):

Joao Paulo Reis Neto ◽

Juliana Martinho Busch ◽

Stephen D. Stefani

Keyword(s):

Cause Of Death ◽

Health Plan ◽

Cancer Mortality ◽

Causes Of Death ◽

Direct Method ◽

Mortality Rates ◽

Years Of Life Lost ◽

Early Screening ◽

Cross Sectional ◽

Circulatory System Diseases

e13610 Background: Cancer is the second leading cause of death worldwide. From 2014 to 2015 Brazil estimated more than 500,000 new cases of cancer, which placed the country among those with the highest cancer incidence. This study evaluates the 10-year evolution of mortality rates due to all causes and cancer and to estimate the potential years of life lost (PYLL) in beneficiaries of health plan, according to sex, age and geographic region. Methods: Retrospective cross-sectional, descriptive study evaluated the causes of death, between 2008 and 2017, by sex and age groups, for all causes (AC) and cancer (CA) data from the health insurance system. The information on the death certificates (DC) was coded according to the ICD-10. Age was stratified into groups: up to 49 years, 50–59 years, 60–69 years, 70–79 years and 80 years or more. Data were analyzed by checking the proportions and mortality rates (MR), grouped into two five-year periods, 2008-2012 (P1) e 2013-2017 (P2). Annual MR per 100,000 population was estimated using the direct method and proportional mortality rates (PMR). To calculate the potential years of life lost (PYLL) the upper limit was 76 years old. The avoidable MR was also analyzed for individuals up to 75 years and cancer. Microsoft Excel v2010 and Qlik Sense v13.21 were used to analyze data and statistics. Results: 5,779 deaths were analyzed, 4,447 in men (77.0%, average 70.1 years) and 1,332 women (33%, 75.9 years). Cancer was the second leading cause of death (n = 953, PMR 16.5%), behind cardiovascular disease (n = 1,662 PMR 28.8%). The major crude death rate per 100,000 was due circulatory system diseases (347), followed by cancer (199) and respiratory system diseases (110). The highest cancer MR were in men, elderly and Brazilian regions with the lowest Human Development Index (HDI). Greatest number of deaths in men at P1 were from cancers of lung (CMP 19.8%), prostate (14.2%) and pancreas (8.0%). At P2, prostate (18.2%), lung (16.8%) and stomach (7.6%). In women, during P1, breast (20.2%), lung (13.1%) and pancreas (83%), and during P2, the same order, 22.5%, 14.6% and 9.3%, respectively. Cancer accounted for a total of 6,335 PYLL and 40.9% of causes of death were classified as avoidable. Conclusions: Cancer was one of the leading causes of mortality during the study. High pancreatic cancer MR differs from national statistics, requiring more analysis that involves possible occupational exposure. Although preventive actions for healthy life habits, early screening and diagnosis, Brazil presents high cancer mortality rates as showed in this analysis.

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Treatment outcomes and influencing factors on patients with Pulmonary Tuberculosis: a retrospective study

Iberoamerican Journal of Medicine ◽

10.53986/ibjm.2021.0018 ◽

2021 ◽

Vol 3 (2) ◽

pp. 105-108

Author(s):

Jamshid Ayatollahi ◽

◽

Abolhasan Halvani ◽

Mohammadhesam Gharaei Khezri ◽

Hossein Shahcheraghi ◽

...

Keyword(s):

Side Effects ◽

Frequency Distribution ◽

Cross Sectional Study ◽

The Body ◽

Sputum Culture ◽

Response To Treatment ◽

Sputum Smear ◽

Drug Side Effects ◽

Cross Sectional ◽

Significant Difference

Introduction: Tuberculosis infection caused by Mycobacterium tuberculosis is one of the most common infectious diseases, especially in countries such as Iran. The course of treatment and the number of drugs used vary depending on the severity of the disease and the parts of the body involved. The resistant tuberculosis to treatment has increased in recent years. Thus, this study was conducted to investigate the frequency distribution of response to treatment of patients with tuberculosis in Sirjan, Iran. Methods: This descriptive cross-sectional study investigated all patients with tuberculosis in Sirjan city who had referred to health centers during the years 2011-2019. The data collection tool was a pre-prepared checklist that included information on age, sex, sputum smear results, sputum culture results, diabetes, patients' nationality, drug side effects, and response to treatment. Finally, data was entered into SPSS version 22, and analyzed. Results: In this study, the overall response rate was 83% and the mortality rate was 10%. Between the frequency distribution of response to treatment in terms of gender, age, sputum smear results, sputum culture results, patients' nationality and diabetes was not statistically significant difference. Also, no statistically significant difference was found between the frequency distribution of pulmonary TB treatment response in terms of drug allergy, drug hepatitis and other drug side effects. Conclusion: According to results, can be concluded that none of the variables: age, sex, smear and culture result, and history of diabetes have no an effect on response to treatment and mortality of tuberculosis.

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Iatrogenic pulmonary edema as a cause of death in burns

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i1.1868 ◽

2020 ◽

Vol 11 (1) ◽

pp. 635-638

Author(s):

Thamir M. Kadhim

Keyword(s):

Pulmonary Edema ◽

Cause Of Death ◽

Forensic Medicine ◽

Laboratory Tests ◽

Causes Of Death ◽

Fluid Replacement ◽

Burn Victims ◽

Burn Unit ◽

Burn Units ◽

One Year

Global mortality from the burn is decreasing while in Iraq is still rising. This study was designed to determine the paucity of data regarding the cause of death in the burn, which may be a participating factor and should eliminate it. A post-mortal field study was conducted in the Department of Forensic Medicine in the province of Babylon, Iraq, for a year period, from the 1st of January 2017 to the 1st of January 2018. The total deaths were 1310, and the whole number of deaths by burn accidents in Babylon, Iraq, was 81(6.18% of all causes of death in a year). 65 were females (80.24%), 16 were males (19.75%). Deaths with no history of admission more than 3day in burn units, age over 45years, cardiovascular diseases patients, heavy smokers, inhalational injuries victims, all were excluded, so 68 burn victims were subjected to a full, typical autopsy at the Department of Forensic Medicine in the province of Babylon for one year period, with all necessary laboratory tests, in order to diagnose the direct cause of their death. For assessing small size area burn, we used small paper the size of the victim whole hand (represent 1% of TBSA), for a larger area, the Lund and Browder chart was used. Deaths were divided into 2 groups according to the period of admission at the burn unit. The first group (3-7 days of admission) with 60 victims, and the second (more than 7 days) with 8 victims. 17 victims with in the first group, had no prominent autopsy findings, but severe pulmonary edema, edema of other organs, no pathogenic organisms were isolated, the laboratory tests were accepted. Their medical records in the burn unit showed overestimation in the assessment of burn area size above the actual percentage by (20-35%). The major causes of death in the first group were septicemia 42.46%, pneumonia 32.35% and primary pulmonary edema 25%, caused mainly by overloading the circulation with fluids. Precise assessment of burn area size, ensuring proper fluid replacement and lowering the mortality rate.

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Study of Clinical-Pathological Discrepancies in Autopsie

Journal of Clinical & Experimental Immunology ◽

10.33140/jcei.06.03.03 ◽

2021 ◽

Vol 6 (2) ◽

Keyword(s):

Cause Of Death ◽

Causes Of Death ◽

Cross Sectional Study ◽

Age Group ◽

Porto Alegre ◽

Cross Sectional ◽

Previous Decade ◽

Clinical Diagnoses ◽

Epidemiological Profile ◽

Clinical Records

Background: Autopsy is a traditional method in pathology for the study of diseases or injuries, being key to elucidate the cause of death. However, the number of autopsies has been decreasing progressively. Design and Context: Retrospective cross-sectional study to analyze the presence of discrepancy between clinical and pathological diagnoses as to the cause of death according to the Goldman criteria, verify the epidemiological profile of the main causes of death, and tabulate the number of procedures conducted annually. Method: Analyzing clinical records and autopsy reports from the Department of Pathology and Legal Medicine of the Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) from 1963 to 2012 and performing statistical analysis on the data collected. Results: The predominant age group was of dead fetuses (30.6% of all cases). The main cause of death was infection (68.4% of diagnoses). After a peak in the early 1980s, there was a progressive drop in the rates of postmortem examination. In the 1990s, the average number of autopsies fell by 58% in relation to the previous decade, and the last decade of the Century registered a decrease of 80% as compared to the average of the 1980s. According to the Goldman criteria, there was discrepancy between ante- and postmortem diagnoses as to the cause of death in 26.2% of the cases. Conclusion: The rates of discrepancy between clinical diagnoses and autopsy findings regarding the cause of death remain high, even though medicine has become more and more advanced in technology.

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Tuberculosis and lactic acidosis as causes of death in adult patients from a regional hospital in Johannesburg

African Journal of Primary Health Care & Family Medicine ◽

10.4102/phcfm.v4i1.266 ◽

2012 ◽

Vol 4 (1) ◽

Author(s):

Ntambwe Malangu ◽

Maryet Mogashoa

Keyword(s):

Side Effects ◽

Lactic Acidosis ◽

South African ◽

Cause Of Death ◽

Antiretroviral Treatment ◽

Causes Of Death ◽

Regional Hospital ◽

Adult Patients ◽

African Countries ◽

Collection Form

Background: Tuberculosis and adverse effects have been shown to affect both the quality of life and the survival of patients on antiretroviral treatment. This study sought to investigate the causes of death in a sample of adult HIV-infected patients on antiretroviral treatment at Thembisa Hospital, Johannesburg, South Africa. Methods: A retrospective study was conducted by examining the charts of 498 adult patients treated from January 2004 to December 2006 at the antiretroviral clinic of a regional hospital in Johannesburg. A data collection form was used to collate both sociodemographic and clinical data.Results: The majority of the patients were female (71.7%) with a mean age of 37.7 ± 11.6 years, and in the age group of 18–77 years. The greater number of the patients was South African citizens, with only 2.2% citizens of other Southern African countries. At baseline, 29.9% had been on anti-tuberculosis treatment. Most of the patients had been prescribed the regimen comprising stavudine, lamivudine, and nevirapine or efavirenz; two of them (0.4%) were on the second line regimen made of zidovudine, didanosine, and lopinavir–ritonavir. At least one side effect was documented in 82.1% of patients; the ten most documented side effects were skin rashes (62.9%), peripheral neuropathy (48.4%), headaches (38.2%), chest pain (21.9%), coughing (21.7%), anaemia (21.5%), diarrhoea (19.3%), vomiting (16.7%), dizziness (15.3%), and lactic acidosis (11.2%). A mortality rate of 3.6% was recorded during the 2-year study period. Although the cause of death was undetermined in 11.1% of patients, 50.0% and 38.9% of deaths respectively were a consequence of tuberculosis and lactic acidosis.Conclusions: In addition to tuberculosis, side effects in particular, lactic acidosis was the other main cause of death in patients treated at the study site. These findings suggest that patients on regimens containing drugs that cause lactic acidosis should be closely monitored when the first complaints suggesting lactic acidosis are reported or noticed.

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Maternal Mortality in an Iraqi Tertiary Hospital: Lessons From the Years of the Crisis

International Journal of Women s Health and Reproduction Sciences ◽

10.15296/ijwhr.2020.58 ◽

2020 ◽

Vol 8 (4) ◽

pp. 362-367

Author(s):

Reshed Zeki Obeid ◽

Dina Akeel Salman ◽

Zainab Abdul Ameer Jaafar

Keyword(s):

Maternal Mortality ◽

Cause Of Death ◽

Causes Of Death ◽

Maternal Mortality Ratio ◽

Tertiary Hospital ◽

Cross Sectional Study ◽

Islamic State ◽

Care Provision ◽

Cross Sectional ◽

Mortality Ratio

Objectives: Maternal mortality is a crucial indicator of health care provision within a nation, particularly during the periods of instability. This study aimed to assess the maternal mortality ratio in one of the largest hospitals in Baghdad over eight years including the time of the threat of the so-called Islamic State of Syria and Iraq. Materials and Methods: A cross-sectional study was undertaken by reviewing the records of mothers who passed away in the hospital from February 2011 to February 2018. The gathered data included the patients’ demographic features as well as obstetrical and medical conditions and causes of death each year. Results: During the eight years, the total live births numbered 95 800 while 52 mothers died for a maternal mortality ratio of 58.12 per 105 . Most of the deceased mothers aged between 30 and 39 years (P = 0.0015), were multiparous and from rural residence (P = 0.000), booked no antenatal care (P = 0.0014), and completed delivery via a cesarean section (P = 0.0184). The majority died in the postpartum period (P = 0.000) within the first 12 hours of admission (P = 0.000). Finally, the major presentation and cause of death were often obstetrical hemorrhage. Conclusions: The maternal mortality was high and obstetrical hemorrhage was the main cause of death. In addition, the majority of patients died within the first 12 hours of admission, which is attributed to delays in access to the hospital and the lack of needed facilities during that critical period of time.

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Study of Clinical-Pathological Discrepancies in Autopsies

Journal of Clinical & Experimental Immunology ◽

10.33140/jcei.06.02.03 ◽

2021 ◽

Vol 6 (2) ◽

Keyword(s):

Cause Of Death ◽

Causes Of Death ◽

Cross Sectional Study ◽

Age Group ◽

Porto Alegre ◽

Cross Sectional ◽

Previous Decade ◽

Clinical Diagnoses ◽

Epidemiological Profile ◽

Clinical Records

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Thirty-day mortality rates after immunotherapy initiation

Immunotherapy ◽

10.2217/imt-2021-0082 ◽

2021 ◽

Author(s):

Osman Sütcüoğlu ◽

Ayşegül İlhan ◽

Seher Yıldız Tacar ◽

Deniz Can Güven ◽

Gökhan Uçar ◽

...

Keyword(s):

Side Effects ◽

Cause Of Death ◽

Patient Population ◽

Palliative Therapy ◽

Mortality Rates ◽

Thromboembolic Events ◽

Tertiary Referral ◽

Common Cause ◽

Referral Hospitals ◽

Line Of Therapy

Background: The aim of this study was to determine the cause of death in patients who died within 30 days after the first dose of immunotherapy. Methods: The data of 1432 patients treated with immunotherapy in six tertiary referral hospitals were retrospectively analyzed. Results: It was determined that 34 (2%) of the patients died within 30 days after the first dose of immunotherapy. Death occurred in all patients who received palliative therapy, and most patients (88%) received immunotherapy as second- or subsequent-line of therapy. The most common cause of death was disease progression and thromboembolic events. Conclusion: Preliminary results of the current study might give some clues to define the patient population in whom the fatal side effects of immunotherapy might be encountered.

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Abstract P059: Multiple Cause-of-Death Analysis Reveals Under Reporting of Disease Burden for Diabetes

Circulation ◽

10.1161/circ.135.suppl_1.p059 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Katherine G Hastings ◽

Jiaqi Hu ◽

Nadejda Marques ◽

Eric J Daza ◽

Mark Cullen ◽

...

Keyword(s):

Ethnic Groups ◽

Cause Of Death ◽

Causes Of Death ◽

Mortality Rates ◽

Minority Populations ◽

Race Ethnicity ◽

Underlying Cause Of Death ◽

The Impact ◽

Racial Ethnic ◽

The U.S

Introduction: Despite being considerably under reported as the underlying cause of death on death certificates, and consequently on mortality figures, diabetes is among the ten leading causes of death in the U.S. A multiple cause-of-death analysis shows the extent to which diabetes is associated with other leading causes of death. Hypothesis: Analysis of multiple-cause-of-death will confirm prevalence rates of diabetes among racial/ethnic minority populations, demonstrate the impact of diabetes in association with other causes of death, and highlight variations of burden of disease among different racial/ethnic groups. Methods: Causes of death were identified using the Multiple Cause Mortality Files of the National Center for Health Statistics from 2003 to 2012. Age-adjusted mortality rates were calculated for diabetes both as the underlying cause of death (UCD) and as multiple causes of death (MCD) by racial/ethnic groups (NHWs, Blacks, Asians, and Hispanic/Latinos). Frequencies and proportions were calculated by race/ethnicity groups. Linear regression model was used for number of causes per death. Results: A total of 2,335,198 decedents had diabetes listed as MCD in the U.S. national death records from 2003-2012. Mortality rates of diabetes as MCD were 3.4 times than UCD for Asians, 2.9 times for Blacks, 2.9 times for Hispanics and 3.7 times for NHWs (Figure). Minority populations had higher proportion of deaths with diabetes reported as MCD than NHWs (1.7 times higher for Hispanics, 1.5 times higher for Blacks and Asians). Adjusting for age, gender, and race/ethnicity, there were 1.7 more causes per death co-occurred for diabetes decedents compared to decedents who died due to all other causes (95% CI: 1.714, 1.718). Conclusions: Our findings underscore the importance of a multiple-cause-of-death approach in the analyses for a more comprehensive understanding of the impact of diabetes.

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Self-Reported Antidepressant Drug Side Effects, Medication Adherence, and Its Associated Factors among Patients Diagnosed with Depression at the Psychiatric Hospital of Nepal

Depression Research and Treatment ◽

10.1155/2020/7024275 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Nirmal Raj Marasine ◽

Sabina Sankhi ◽

Rajendra Lamichhane ◽

Nabin Raj Marasini ◽

Nim Bahadur Dangi

Keyword(s):

Medication Adherence ◽

Side Effects ◽

Psychiatric Hospital ◽

Associated Factors ◽

Antidepressant Drug ◽

Antidepressant Drugs ◽

Psychiatric Hospitals ◽

Bivariate Analysis ◽

Drug Side Effects ◽

Cross Sectional

Objective. The present study is aimed at evaluating the side effects of antidepressant drugs, medication adherence (MA), and associated factors among patients diagnosed with depression at a psychiatric hospital in western Nepal. Methods. A prospective cross-sectional study was conducted among 174 patients visiting the outpatient clinic of a psychiatric hospital. The antidepressant side effect checklist (ASEC) was used to classify the reported antidepressant drug side effects into mild, moderate, and severe types. The Naranjo adverse drug reaction (ADR) probability scale was employed to assess the ADRs, and the Morisky Green Levine Adherence (MGLA) score was employed to determine the rate of medication adherence. Descriptive statistics and bivariate analysis were used, and a P value < 0.05 was taken as statistically significant in the multivariate analysis. Results. The patients were mostly female (55.74%), with a median (IQR) age of 32 (20) years. Approximately 74.13% of the patients experienced antidepressant side effects, where insomnia (17.05%) and anxiety (17.05%) were the most common. More than half of the patients (52.29%) had a low level of adherence. Females were 1.01 times more likely to be nonadherent to their antidepressant medications compared to males, adjusted odds ratio (AOR): 1.001 (0.31-1.63). Similarly, illiterate patients tended to be more nonadherent compared to literates, AOR: 1.342 (0. 93-2.82), and unemployed individuals were 1.5 times more likely to be nonadherent to their medications compared to employed individuals, AOR: 1.46 (1.16-4.13). Likewise, patients with severe side effects were more prone to develop nonadherence than those with moderate side effects, AOR: 1.173 (0.42-3.25). A significant association was found between the Naranjo score and medication adherence. Conclusions. This study suggests that antidepressant drug side effects were more prevalent and medication adherence was extremely poor among depressive patients in psychiatric hospitals. Factors such as gender, occupation, education, side effects, and ADRs attributed to poor medication adherence in patients.

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