Abuse of Power in Nancy Farmer's The House of the Scorpion (2002)

This study aims to reveal abuse of power depicted in Nancy Farmer’s The House of the Scorpion using Daniel Sankowsky’s definition and characteristics of abuse of power by leader, Bob Jessop’s Marxist Approaches to Power, and Nicos Poulantzas’s destruction of the state. El Patrón as the leader of a country named Opium, abuse his power in Marxist way, which leads to destruction of the state. The analysis focuses on how abuse of power done by El Patrón and destruction of the state as the consequence. Throughout the analysis, El Patrón’s abuse of power is done by him as a leader through economic, political, and ideological class domination. Destruction of the state as the consequence of his abuse of power include the destruction of the Church and the family.

Investigating the Prevalence of Substance Abuse Among Students of Medical Science Universities in the Eighth Macro-region of Iran

Background: The growing trend of substance abuse among students is a serious threat for the health of young adults. Using Network Scale-up (NSU) method Objectives: The present study was designed to indirectly estimate the prevalence of substance abuse among students of medical science universities in the eighth macro-region of Iran to attract government attention to this problem. Methods: This cross-sectional study was performed on 3,900 students from medical science universities in the eighth macro-region of Iran (2300 from Kerman and 1600 from Sistan and Baluchestan provinces) in 2019. The sample size of each university was determined using a multistage non-random sampling approach. The participants were asked to introduce their academic close friends who did high-risk behaviors during last year. Results: Out of 3,900 participants, 1,872 (48%) were males and 2,028 (52%) were females. Students from all academic degrees contributed to this study. The prevalence of alcohol, marijuana, hemp, chewing tobacco, tramadol, methylphenidate, and opium abuse were 20.6% (95% CI: 19.3 - 21.9), 13.5% (CI: 12.4 - 14.5), 4.1% (CI: 3.5 - 4.7), 6.3% (CI: 5.5 - 7.1), 3.1% (CI: 2.6 - 3.7), 6.5% (CI: 5.7 - 7.3), and 4.0% (CI: 3.1 - 4.9), respectively. Also, the prevalence of substance abuse was higher among male students than females. Conclusions: Male students are more at risk for substance abuse. The rates of alcohol and marijuana consumption were higher among students. Training programs are recommended to increase awareness level of young people and the society about disadvantages of these behaviors.

Comparison of the Epidemiological Features of COVID-19 Patients Transported by the Emergency Medical Service in the First vs. Second Wave of the Pandemic; a Comparative Report from Tehran, Iran

Background: COVID-19 pandemic, which started in late 2019, has brought various ups and downs worldwide. Planned policies were highly useful in the first wave of the COVID-19 pandemic in Iran. However, due to several reasons, the country faced the second wave. Objectives: The current study aimed to compare patients’ features in the first two waves of the COVID-19 pandemic in the city of Tehran, Iran. Methods: Following a retrospective, cross-sectional design, the current study was carried out on 5000 suspected/confirmed COVID-19 cases who were randomly selected from all cases transferred by ambulance to hospitals located in the city of Tehran. The first wave of the COVID-19 epidemic was from February 20 to May 04, 2020, and the second wave was from May 05 to August 05, 2020. Data for both waves, were collected using a researcher-made checklist. Results: In this study, data of 5000 suspected/confirmed COVID-19 cases were analyzed (2773 cases belonged to the first wave and 2227 to the second one). The mean age of patients (P < 0.001), the frequency of cigarette smoking (P < 0.001), opium abuse (P = 0.004), and the presence of underlying diseases (P < 0.05) were more frequent in the second wave than in the first one. The notable finding in this study was the significant increase of non-respiratory symptoms of patients in the second wave. The number of cases who reported close contact with COVID-19 patients was higher in the second wave. Also, hypoxia, intubation during the hospital stay, length of hospitalization, and mortality rates were significantly lower in the second wave. During the second wave, the odd ratio of positive findings in lung CT-scan was 3.4 (95% confidence interval: 2.51 to 4.55) compared to the first wave (P < 0.001). Conclusions: This study demonstrated considerable differences between the first and second waves of the COVID-19 pandemic concerning the patients’ features.

Lipid Profile in Opium Users: Results of Fasa PERSIAN Cohort Study, First Phase

Background: One of the main health problems in many societies is the increase of opium abuse which correlated with many problems such as cardiovascular disease. The goal of our study is to evaluate the correlation of opium use with blood lipoproteins as risk factors of CVD.Methods: This is a cross-sectional study on participants of the first phase of the PERSIAN Cohort study who were 35 -70 years old. Demographic characteristics, history of smoking, alcohol, and opium consumption, medical history and medications were asked and checklists were filled out. level of physical activity and fat intake was registered. lipoprotein profiles were investigated by blood sampling. IBM SPSS Statistics v21 was used to analyze the correlation of opium and lipid profile and the significant level was <0.05.Results: From 9300 participants with a mean age of 48.06±9.44 years old, 49.6% were male. About 24.1% of participants used opium. The level of total cholesterol (adjusted p= 0.02) and HDL (adjusted p= 0.04) in people who used opium was significantly lower than others. But, the level of triglyceride (p=0.11) and LDL (adjusted p= 0.06) was not different in users and non-users. LDL (OR=0.8, adjusted p= 0.009) and total cholesterol (OR=0.81, adjusted p= 0.007) had normal level in people who used opium than non-consuming people.Conclusion: This study showed that there is correlation between opium usage and lower level of total cholesterol and LDL, however the lower level of HDL in normal range was seen in opium users.

Smoking Water-Pipe, Opium Use and Prevalence of Heart Disease: A Cross-sectional Analysis of Baseline Data from the Pars Cohort Study, Southern Iran

Background: Associations between hookah and opium use and an increased risk of ischemic heart disease (IHD) have been suggested in a few studies, but more research is needed on the nature of these associations. We aimed to investigate the association between hookah and opium use and the prevalence of IHD in a population with relatively high prevalence of these exposures in Iran. Methods: Using baseline data from the Pars Cohort Study (PCS), a prospective study of individuals aged 40-75 years in Fars province, southern Iran, we calculated adjusted and crude odds ratios (ORs) and corresponding 95% confidence intervals (CIs) for the independent association of hookah and opium use with prevalence of IHD. Results: Of 9248 participants, 10.2% (95% CI: 9.5, 10.9) had self-reported IHD. Prevalence of ever use of hookah and opium was 48.9% (95% CI: 44.6, 53.6) and 10.2% (95% CI: 8.3, 12.5) among those with IHD, and 37.0% (95% CI: 35.7, 38.3) and 8.1% (95% CI: 7.5, 8.7) among those without IHD, respectively. Adjusted OR for the association with prevalence of IHD was 1.26 (95% CI: 1.08, 1.46) for hookah use and 1.71 (95% CI: 1.30, 2.24) for opium abuse. No dose-response association was found between hookah and prevalence of IHD. Conclusion: Hookah and opium abuse were associated with prevalent IHD in this study. Although more research is needed on these associations, particularly in prospective settings, reducing hookah and opium use could potentially reduce IHD risk.

The Impact of Opium Abuse on Lipid Profile in Patients with Diabetes: A Systematic Review and Meta-Analysis

There is an increasing prevalence of diabetes worldwide and substance abuse has been observed as a problem among some people with diabetes. Therefore, there is an urgent need to understand the association between unhealthy drug use including the abuse of opium and clinical outcomes including its impact on lipid profile in patients with diabetes as the presence of these conditions can increase the risk of cardiovascular morbidity and mortality. Aim: This was a systematic review and meta-analysis which evaluated the impact of opium abuse on lipid profile in patients with diabetes. Method: This systematic review was conducted in line with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Three databases (Embase, PubMed, and PsycINFO) plus Google Scholar were searched for relevant articles from database inception to 18 July 2019 based on the Population, Intervention, Comparator, and Outcomes (PICO) framework. The studies included were based on a set of inclusion and exclusion criteria including patients with diabetes who abused opium. Articles were evaluated for risk of bias and the meta-analysis was conducted using Revman. Results: Six articles that met the criteria were included in the systematic review and meta-analysis. The type of substance abused was opium in all the studies. The results of the meta-analysis showed that opium abuse significantly (P = 0.01) lowered total cholesterol compared to control with a mean difference of −0.17 (95% CI, −0.29, −0.04) in patients with diabetes. With respect to high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, and body mass index, the differences were not statistically significant (P > 0.05) between those who abused opium compared with the control. Nutritional deficiencies, weight loss and lipid dysregulation due to liver dysfunction which are found in people who abuse substances may explain the findings of the current review with respect to lipid profile in patients with diabetes who abuse opium compared with the control. Conclusion: The findings of this systematic review and meta-analysis have shown that opium abuse significantly decreased total cholesterol (P < 0.05) in patients with diabetes. However, the effect of opium abuse on HDL cholesterol, triglycerides, body mass index (BMI) and LDL cholesterol in these patients were not statistically significant (P > 0.05) compared with the control. This result has public health significance in terms of ensuring the promotion of adequate nutritional intake in patients with diabetes who abuse opium.

2 Combat use of opioid analgesia and its complications: a retrospective review of data from OP herrick

BackgroundOn the battlefield, acute pain, particularly secondary to trauma, is a common condition which requires treatment in the pre-hospital, evacuation and hospital settings. The use of morphine to manage pain during combat has been well established since the 19th century. Despite this, there are relatively few papers reviewing analgesia use in a combat environment. This study aims to review the use and complications from morphine and other opioids during Op HERRICK.MethodsA database search of the Joint Theatre Trauma Registry (JTTR) was carried out looking for all incidences of administration of either morphine, fentanyl or naloxone from January 2007 to September 2014. Microsoft Excel was then used to analyse the dataset and perform descriptive statistics on the data retrieved.ResultsOpioid analgesia was administered to 5801 casualties. Morphine was administered 6742 times to 3808 patients. Fentanyl was administered 9672 times to 4318 patients. Naloxone was used 18 times on 14 patients, giving a complication rate of 0.24%. Opioid doses prior to naloxone administration range from 0–72 mg of morphine and 0–100 mcg of fentanyl. 4 casualties (2 local civilian and 2 coalition forces) received naloxone despite no recorded opioids being administered. Opium abuse was prevalent amongst the local population in Afghanistan, and this could explain the rationale behind 2 local national casualties receiving naloxone without any documented opioids being given.ConclusionThe use of opioids in a battlefield environment is extremely safe, with very few incidences of complications requiring the use of naloxone. Complication rates are comparable to previously published research. We are unable to comment on the effectiveness of opioids in relieving pain in this study, and further research is needed, particularly following the introduction of oral transmucosal fentanyl citrate (OTFC) and the availability of non-opioid analgesia.

Opioid analgesia on the battlefield: a retrospective review of data from Operation HERRICK

BackgroundAcute pain secondary to trauma is commonly encountered on the battlefield. The use of morphine to manage pain during combat has been well established since the 19th century. Despite this, there is relatively little research on analgesia use in this environment. This study aims to review the use and complications of morphine and other opioids during Operation HERRICK.MethodsA database search of the Joint Theatre Trauma Registry was completed looking for all incidences of morphine, fentanyl or naloxone use from February 2007 to September 2014. Microsoft Excel was used to analyse the results.ResultsOpioid analgesia was administered to 5801 casualties. Morphine was administered 6742 times to 3808 patients. Fentanyl was administered 9672 times to 4318 patients. Naloxone was used 18 times on 14 patients, giving a complication rate of 0.24%. Opioid doses prior to naloxone administration range from 0 to 72 mg of morphine and from 0 to 100 mcg of fentanyl. Four casualties (two local civilians and two coalition forces) received naloxone despite no recorded opioids being administered. Opium abuse was prevalent among the local population in Afghanistan, and this could explain the rationale behind two local national casualties receiving naloxone without any documented opioids being given.ConclusionThe use of opioids in a battlefield environment is extremely safe. Complication rates are similar to previously published data which is reassuring. The efficacy of different opioids was not covered by this study, and further analysis is required, particularly following the introduction of oral transmucosal fentanyl citrate and the availability of novel non-opioid analgesics.