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Background During the first wave of COVID‐19, many Iranians were poisoned by ingesting hand sanitizers and/or alcoholic beverages to avoid viral infection. To assess whether the COVID‐19 pandemic resulted in an increased prevalence of accidental hand sanitizer/alcoholic beverage exposure in children and adolescents, we compared pediatric hospitalization rates during COVID‐19 and the previous year. For poisoning admissions during COVID‐19, we also evaluated the cause by age and clinical outcomes. Methods This retrospective data linkage study evaluated data from the Legal Medicine Organization (reporting mortalities) and hospitalization data from nine toxicology referral centers for alcohol‐poisoned patients (age 0 to 18 years) for the study period (February 23 to June 22, 2020) and the pre‐COVID‐19 reference period (same dates in 2019). Results Hospitalization rates due to ethanol and methanol exposure were significantly higher in 2020 (n = 375) than 2019 (n = 202; OR [95% CI] 1.9 [1.6, 2.2], p, During the first wave of COVID‐19 pandemic, Iran experienced the worldwide biggest methanol outbreak recorded to date. The outbreak triggered by consumption of toxic alcoholic beverages or hand sanitizers, partially motivated by the belief that ingestion would protect against COVID‐19 infection. Our study shows that children and adolescents were also affected, with 22 deaths due to methanol exposure recorded in 2020. These were significantly higher in Feb‐June 2020 (during COVID‐19), compared to the corresponding time period in 2019.

Background: Given the increasing prevalence of methadone overdose and the growing number of deaths in Iran, the present study was conducted to determine the mortality rate of methadone detected in the cadavers brought to the Forensic Medicine Organization between 2015 and 2017. Methods: This cross-sectional study was performed on 7,486 cases of substance abuse deaths registered in the Forensic Medicine Organization during 2015-2017. In order to investigate the drug abuse, samples collected from the cadavers were initially examined for their drug contents, such as methadone, by standard screening methods and then confirmed by Thin Layer Chromatography (TLC). Using two checklists, the information collected about each cadaver consisted of the identity, autopsy and laboratory data. After data collection, they were entered into the Stata software version 14 MP. Results: The cadavers’ mean age was 36.6±12.6 years. Over the 3-year duration of the study, the standardized mortality rate increased from 35 to 39 cases per million per year. Of these cases, 6066 were randomly assigned to toxicology, 50.1% had used methadone one month before their death. Approximately 75% of the methadone abusers had taken another drug simultaneously, mostly morphine or methamphetamine. Conclusion: Considering the relatively high prevalence of methadone detected post-mortem, monitoring for methadone entry into public market and identifying the death-related factors in the drug abusers are considered as significant measures to improve upon the current alarming situation in the Iranian society.

Introduction: In chronic drug abuse, opioidergic, dopaminergic signaling, and endocytosis are implicated in neural circuit disruption. We evaluate the impact of Methadone Maintenance Therapy (MMT) on opioid addiction.Method: The expression of dopamine (DRD1- DRD5) and opioid (mu-, delta-, and kappa) receptors, Catechol-O-methyltransferase (COMT), Dynamin 1 like (DNM1L), and RAS-associated (RAB22A) genes in Peripheral Blood Mononuclear Cells from MMT (n= 40) and control (n= 40) were detected by qPCR. Protein-protein interaction (PPI) investigation into addiction-associated genes was performed to elucidate the possible pathways which may have an interference impact on the treatment of addiction.Results: We found that DRD1, DRD2, MOR, DOR, and KOR expressions increased, and the COMT and DNM1L expressions were decreased in MMT. A complex brain network orchestrated by three stages of interactions I) opioid receptors II) Dopamine receptors III) Intracellular vesicular transport (RAB22A), and synaptic vesicle recycling (DNM1L), involved which led to resistance. We elucidate possible pathways that may have an interfering effect on the opioid use disorder (OUD) treatment, and protein-protein interaction (PPI) studies were performed on addiction-associated genes.Conclusion: We introduce Mitogen-Activated Protein Kinase (MAPK) signaling as a significant mediator in addiction and represent DRD2 as a potential therapeutic target for OUD. PPI downstream off-target stimulation may involve ERK activation. Thus, the use of novel agonists and antagonists, in combination with ERK inhibitors, may be of particular interest for future research in addiction treatment.

Background: Traffic accidents are one of the most common causes of mortality and physical disabilities, endangering the lives of many people all over the world annually and are among the top public health problems worldwide. In the present study, we aimed to investigate the trend of mortality rate due to traffic accidents in the provinces of Iran.Methods: In this cross-sectional study, all the deaths caused by traffic accidents in Iran during 2006-2018 were investigated. Using the population of the country by age, sex, and provinces of the country, the mortality rate was calculated and the trend of 13-year changes was studied. The negative binomial regression was used to analyze the linear or nonlinear trend of reduction in mortality rate during the study years. Microsoft Excel 2016 and Stata version 14 software were used to analyze the data.Results: During the study period, 259995 traffic accidents deaths occurred in Iran, of which 78.6% were men and 21.4% were women. The mean age of the deceased was 37.6 ± 20.7 years (37.4 ± 20 years in men and 38.6 ± 23 years in women). The number of the deaths in these years has decreased from 27,567 in 2006 to 17,183 in 2018 and the mortality rate has dropped from 39 per 100,000 in 2006 to 21 per 100,000 in 2018.Conclusion: Despite the decreasing trend in the mortality rate of traffic accidents in Iran during the study years, this trend was different across the provinces. Therefore, it seems necessary to design epidemiological studies to be conducted in different area and provinces of a country, to better and more accurately determine the factors affecting the occurrence of these deaths.

Background : Addiction disrupts the nervous system of the reward system, stimulus, and memory in the brain. The disruption of these systems in the brain causes biological, physiological, social, and psychological complications. Addiction is considered a psychological, social, and economic disorder in terms of medicine, psychology, and sociology, as well as philosophy, law, ethics, and religion. The most important place of narcotic effect is the brain, and receptors affect these substances. Dopamine and serotonin receptors are among the most important receptors, in which drugs affect them. Methadone is also an opiate drug that is even more addictive than morphine and heroin and is often used as a preservative to control heroin and narcotic addiction. Methods : In this study, 3 genes of 5-Hydroxytryptamine Receptor 2 A (5HT2Ra), 5-Hydroxytryptamine Receptor 3 A (5HT3Ra), and Monoamine Oxidases A (MAOA), which play an important role in serotonin function, were examined in Peripheral Blood Mononuclear Cells (PBMCs) of heroin addicts, who had been quitting addiction with methadone for 3 months. Therefore, peripheral blood PBMCs were isolated. cDNA was synthesized from mRNA; then, the expression of the gene was measured by real-time Polymerase Chain Reaction (PCR). Results : The expression of MAOA gene in the PBMCs of the addicted patients with methadone was significantly reduced compared to the control group, while the expression of 5HT2Ra and 5HT3Ra genes showed no change in the two groups. Conclusion : These results suggest that Methadone Maintenance Treatment (MMT) may be moderated by 5HT2Ra and 5 HT3Ra serotonin receptors and returned to their previous efficacy, but MAOA was significantly reduced.

Background: Murder is one of the public health problems. According to the WHO reports, murder is fourth leading cause of death among young people. The aim of this study was applying joint point regression model to study trend of homicide mortality in Iran, 2006-2016. Study design: A cross-sectional panel (pseudo-panel) study. Methods: Homicide data during 2006 to 2016 were extracted from Iranian legal medicine organization. Trends of homicide incidence were summarized by annual percent change (APC) and average annual percent change (AAPC) using non-linear segmented regression model. Results: Totally, 26918 homicide cases occurred during the period from 2006 to 2016. The highest and lowest frequency was related to the 15-29 yr (46.5%) and 0-4 yr (1.5%) age groups, respectively. The homicide incidence rate of the country in 2016 was 2.81 per 100,000. The four provinces of Sistan & Baluchistan, Khuzestan, Kerman and Ilam had the highest incidence rate in 2016, respectively. During the study period, the incidence rate of homicide in Iran and men have been significantly decreased (APC: -2.8% (95% CI: -3.9, -1.7) and -3.2% (95% CI: - 4.5, -1.8) respectively (PConclusion: The pattern of homicide rate has a downward trend in the country. Moreover, the varying observed trends in some provinces can be due to the variability in mental, geographical, socio-economic and cultural conditions in each region.

This study aims to investigate the attentional bias toward drug-related stimuli along with subjective craving after encountering such stimuli in methamphetamine users. Studies of cue reactivity have confirmed a bias in attention and gaze toward drug-related stimuli for most substances; however, methamphetamine drugs are less studied through a direct measure, such as eye tracking.A total of 30 male subjects in the case group (methamphetamine users) and 36 subjects in the control group (no prior drug use) participated in this study. The participant's eye movement data were collected while they were viewing pairs of drug-related and non-drug images in a dot-probe paradigm. Craving was assessed via a self-report questionnaire on a scale of 0 to 10 before and after the psychophysical task.The analysis of eye-movement data showed a meaningful gaze bias toward cue images (drug-related) in the case group. Additionally, the gaze duration on cue images was significantly higher in the case group, in contrast to the control group. The same effect was observed in analyzing the dot-probe task; that is, the mean reaction time to a probe that replaced a cue image was significantly lower. The mean of the first-fixation measure in the control group was not significantly higher than chance; however, the percentage of the first-fixation on cue images in the drug users was meaningfully biased. Reported craving was significantly greater after performing the task compared to before.Our results indicated an attentional bias toward drug-related cues in methamphetamine users as well as subjective craving after encountering such cues.The gaze duration on cue images was significantly higher in methamphetamine users.The mean reaction time to a probe that replaced a cue image was significantly lower in methamphetamine users compared to the control group.The mean of the first-fixation measure in the case group was significantly better than chance.Craving was reported to be significantly greater after performing the task.Substance users tend to focus on the stimuli associated with substances. This is known as attention bias. Attention bias leads to increased craving. Attention bias for various substances has been previously reported; however, methamphetamine attention bias has not been evaluated so far. In this study, we measured the attention bias toward stimuli related to methamphetamine in methamphetamine users and control subjects with direct (eye tracking) and indirect (dot probe paradigm) methods. In addition, we measured the number of cravings in the case group. Our results confirmed the bias in attention toward methamphetamine-related stimuli in the case group compared to the control group.

Background: Occupational injury is a cause of premature mortality, mainly in low- and middle-income countries. Occupational injuries estimated to kill more than 300,000 workers worldwide every year. We estimated the years of life lost (YLL) of fatal unintentional occupational injuries in Iran for the five years of 2012-2016. Study design: A cross-sectional study. Methods: To estimate the YLL, registered deaths due to occupational unintentional injury were identified from the Iranian Legal Medicine Organization. Estimated YLL was calculated according to Global Burden of Disease 2010 guideline. Population life expectancy in each corresponding years was retrieved from the national health database. All data collected entered into Excel software for calculations. Results: In 2012-2016, fatal unintentional occupational injuries were the cause of 8,606 deaths in Iran, resulting in 4.6 prematurely lost life yr per 1000 males and 0.3 yr per 1000 females among workers, every year. 98.7% of the deaths occurred in males. Males from 15 to 19 yr of age and females from 10 to 14 yr of age showed the highest YLL rates. The rate of YLLs per 1,000 workers per year was 3.99 overall, 4.6 in males, and 0.4 in females. Conclusion: Premature mortality due to occupational injury is still a serious problem in the Iranian population. Our findings may be useful from a health policy perspective for designing and prioritizing interventions focused on the prevention of premature loss of life. Known prevention strategies need to be implemented widely to diminish avoidable injuries in the workplace.

Background Drug abuse is a severe and chronic disorder that leaves morbidity, disability and premature mortality in the society. The study of death due to substance abuse provides useful information for local, national and international administrators. Thus, by identifying the factors that have an impact on overdose-related mortality we can provide suitable intervention for vulnerable groups. The aim of this study was an investigation of mortality rate caused by consumption of narcotic and psychoactive substances in Iran. Methods In this cross-sectional study, demographic and epidemiological data about all people whose cause of death was substance abuse in March 2014 to February 2015 were collected from Legal Medicine Organization (LMO). Finally, the information that was extracted from two checklists was analyzed by descriptive statistics. Findings In this study, 2986 cases died from substances abuse were evaluated. Most deaths have befallen in unmarried young men with mean age of 36.9 ± 12.3, in the private locations. The mortality rate of drug abuse in the whole country was 38.4 per 1000000 population. The proportion of mortality was higher in Iranian nationality and in people who had a diploma and less education. History of overdose, suicide, hospitalization in a psychiatric hospital, staying in prison and substance abuse in the family were investigated in the study population. Conclusion The present study revealed that mortality rate from substance abuse is more among unmarried young men aged 30-39 years with low education level and also in the self-employed group. We suggest that policies should be taken to prevent these people from accessing and using the drug.

Suicide is a major global public health problem and much burden in the societies. This study aims to calculate the years of life lost (YLL) due to suicide and investigate its trend in Iran. Information on deaths due to suicide in Iran was extracted from Iran Legal Medicine Organization. The years of life lost was calculated in each year according to gender and age-groups. To examine the trend for different years, joinpoint regression was used. The 35,297 deaths due to suicide were recorded in 2006–2015. The total YLL in the 10-year period was 34.52 per 1000 persons in males, 13.61 per 1000 persons in females and 23.35 per 1000 persons in both sexes. Hanging comprised the largest YLL of suicide. The annual percent change of YLL rate was 3.3%. The results revealed that male shows an increasing trend in YLL specifically among youth and adult, while there is no improvement in females. There is a national need to implement an effective health policy intervention in Iran.