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Background and Objective: Methadone is a synthetic opioid which is used in opium addiction therapy and relief of acute and chronic pain. Side effects of Methadone were reported on heart and induction of Torsade De Pointes disease and increase QTc interval in electrocardiogram. This study was conducted to determine the effect of Methadone therapy on QTc interval in electrocardiogram and its relationship with dosage and duration of Methadone therapy. Method: This cohort study was conducted on 60 opium addicted patients (57 males, 3 females) whom referred to “Methadone Therapy Clinic” in 5 Azar teaching hospital in Gorgan, northern Iran during 2009-10. Patients were divided to three groups based on the dosage of methadone: 0-35 mg (27 cases), 35-55 mg (27 cases) and 55-120 mg (26 cases) per day. QTc interval in electrocardiogram was measured at the beginning of study, one month and 5 months afterward. Results: The mean±SD of QTc interval in patients at the beginning, one month and 5 months afterward of study was 0.42±0.027, 0.43±0.029 and 0.43±0.041 seconds, respectively. There was a significant increase in QTc interval after one month of methadone therapy, compared to the beginning of study. There was no significant difference in QTc interval between 1 month and 5 months following methadone therapy. There was no significant difference between QTc interval and different dosage of methadone. Conclusion: Methadone therapy increase QTc interval but there is not any relationship between dosage and duration of methadone therapy and QTc interval.

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Background and Objective: Anxiety and depression are experienced following addicted patients durg withdrawal. This study was done to determine the effect of methadone and valproate combination on morphine withdrawal-induced anxiety and depression in male mice. Methods: In this experimental study, ninety-eight male mice were allocated into acute and chronic categories. Animals in acute chronic categories allocated into seven groups including: saline, morphine, methadone (10 mg/kg/bw), valproate (150 mg/kg/bw), three groups of valproate+methadone, in of ratio 1:1, 2:1 and 1:2. Animals were received escalating dose of morphine for 8 consecutive days except saline group. In chronic group, drugs were injected for 30 minutes before morphine administration, while in acute group the drugs were used only at day 8. Anxiety and depression due to naloxone injection (5 mg/kg/bw) was investigated by elevated plus-maze, tail-suspension and open field tests. Results: In the chronic group, valproate + methadone (2:1) combination therapy showed a significant increase in the percentage of open arm entries (53.86±1.9) and percentage of time spent in the open arm (58.58±4.15) compared to the morphine group, with a percentage of entering (28.12±2.03) and percentage of time (17.88±1.77) (P<0.05). In open field test, the ratio of the number to the duration of time spent in the central square, in the combination therapy groups of methadone+valproate (27±2), valproate+methadone (1:2) and valproate+methadone (2:1) were significantly increased in compare to the morphine group (P<0.05). In tail-suspension test, duration of immobility as an indicator of depression, in the treatment group of valproate+methadone (2:1) was significantly reduced (P<0.05). Conclusion: Valproate and methadone combination therapy particularly in ratio of 2:1 can reduce morphine withdrawal-induced anxiety and depression in animal model.

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Background and Objective: Poisoning is a major public health problem and a serious form of the common causes of hospital emergency visits in many countries. Incidence of toxicity based on cultural and economic characteristics of communities are varied. This study was done to determine the pediatric poisoning factors in children.

Methods: This descriptive-cross sectional study was performed on 201 patients younger than 12 years old with posinnig symptoms whom referred to hospitals in Shahroud city of central part of Iran from April 2011 to March 2012. Demogaphic data, posinnig symptoms, posinnig agents, time of hospitalization and outcome of posinnig for each child were recored in quetionare.

Results: Opium was the most common consumed material with (51.2%) while metadon considered to be the major opium. 180 (89.6%) and 21 (10.4%) children were poisoned accidentaly by their parant respectively. The clinical manifestation of the affected children were 15 (7.5%), 11 (5.5%), 93 (46.3%), 26 (12.9%), 19 (2.5%) and 22 (10.9%) without any symptoms, neuro-respiratory, nervous, gastrointestinal, gastrointestinal-respriatory and weakness respectively. Two children were died in the course of this project. There was a significant statistical correlation between the reason for poisoning and age parant education level and type of poisoning. Also, there was a relation between the type of poisoning and place of residence (P<0.05).

Conclusion: This study shows that the most common cause of poisoning among children was opiums.

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Background and Objective: Poisoning is one of the most common causes of emergency room visits. Opioids and methadone are the causes of unintentional poisoning, especially in children, who have a high burden of emergency referrals in children's hospitals. This study was performed to evaluate methadone poisoning in the pediatric emergency department in Gorgan, North of Iran.
Methods: This cross-sectional study was performed on the records of patients admitted (85 boys and 70 girls) cases due to methadone poisoning in Taleghani Hospital in Gorgan, North of Iran during 2001-19 .The symptoms of patients and the costs of treatment and care of patients were analyzed.
Results: A total of 258 cases of poisoning were registered, of which 155 (60%) were methadone poisoning. Poisoning occurred for 136 cases (87.8%) with methadone syrup and for 19 cases (12.2%) with methadone tablets. The mean of age and age range was 47.94±36.25 months and 4-156 months, respectively. The mean and standard deviation of the time interval from consumption to the time of admission was 164.84±160.11 minutes and the maximum and minimum time interval were 720 and 15 minutes, respectively. 34 cases (22%) were conscious, 110 cases (71.5%) had impaired level of consciousness, seven cases (4.5%) presented with cardio respiratory arrest and three patients (1.9%) presented with seizures and one child (0.1%) was dead. Moises, bradypnea and apnea were seen in 78 (51.3%), 62 (40%) and 7 (4.5%) children, respectively. Six children had a history of hospitalization due to methadone poisoning, of which 2 were the day before, 3 were the month before, and 1 was 2 years ago. Two children were addicted. The mean±SD of the number of hospitalization days were 2.39±1.57 and the minimum and the maximum were 1 and 9 days. The mean±SD of hospitalization cost was 7642249±5341725 Rials. The average consumption of naloxone was 6.83± 10.41mg and the minimum and the maximum were one and 68 milligrams.
Conclusion: The results of this study showed that meiosis is not observed in half of children with methadone poisoning. Therefore, it is recommended that in the case of children with impaired level of consciousness or seizures without a specific reason; methadone poisoning should be concerned as a differential diagnosis by medical staff and this diagnosis should not be ignored only in the absence of meiosis or respiratory dysfunction.