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        Relationship between Opium Abuse and Severity of Depression in Type 2 Diabetic Patients

        Sepehrmanesh Zahra,Sarmast Hossein,Kord Valeshabad Ali 대한당뇨병학회 2012 Diabetes and Metabolism Journal Vol.36 No.2

        Background: Opium use in diabetic populations is associated with major depressive disorder (MDD). This study was designed to investigate the relationship between opium use and severity of depression in Iranian diabetic patients. Methods: In this case-control study, 642 type 2 diabetic patients were recruited from those presenting at two outpatient clinics at the Akhavan Hospital in Kashan, Iran; of them, 600 diabetic patients were included in the study and divided into two groups: opium-abusers (150 patients) and non-opium-abusers (450 patients). Clinical and demographic information was obtained through a detailed questionnaire. Depression symptomalogy and severity were assessed with the Beck Depression Inventory (BDI), and a corresponding diagnosis was made based on the Diagnostic and Statistical Manual of Mental Disorders-IV, Text Revision, 2000 (DSM-IV TR) criteria. Results: The mean depression score was higher in the opium abuse group than in the non-abuser group (29.27±1.44 vs. 18.29±1.31, P<0.001). In general, a significant association was found between opium abuse and depression among patients (odds ratio [OR], 4.54; 95% confidence interval [CI], 2.87 to 7.44; P=0.001). No significant relationship was found between dysthymia and opium abuse (OR, 0.68; 95% CI, 0.18 to 1.192; P=0.155), while MDD was significantly higher in the opium abuser group (OR, 7.32; 95% CI, 5.20 to 12.01; P<0.001). Conclusion: Depression is more frequent in opium-dependent diabetic patients, and its severity is also greater. Given these findings,opium-dependent diabetic patients should be advised about the increased risks of depression and related comorbidities.

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        Proper Management for Morbid Iatrogenic Retroperitoneal Barium Insufflation

        Jalal Vahedian-Ardakani,Shahram Nazerani,Amir Saraee,Ali Sarmast,Ehsan Saraee,Mohammad Reza Keramati 대한대장항문학회 2014 Annals of Coloproctolgy Vol.30 No.6

        A barium enema is a diagnostic and therapeutic procedure commonly used for colon and rectum problems. Rectal perforation with extensive intra- and/or extraperitoneal spillage of barium is a devastating complication of a barium enema that leads to a significant increase in patient mortality. Due to the low number of reported cases in recent scientific literature and the lack of experience with the management of these cases, we would like to present our treatment approach to a rare case of retroperitoneal contamination with barium, followed by its intraperitoneal involvement during a diagnostic barium enema. Our experience with long-term management of the patient and the good outcome will be depicted in this paper.

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