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The effects of transcranial direct current stimulation compared to standard bupropion for the treatment of tobacco dependence: A randomized sham-controlled trial
- Shahram Ghorbani Behnam, Seyed Abbas Mousavi, Mohammad Hassan Emamian
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- Journal:
- European Psychiatry / Volume 60 / August 2019
- Published online by Cambridge University Press:
- 01 January 2020, pp. 41-48
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Background:
Current treatments for smoking cessation are not effective for most smokers. This study aims to examine the effectiveness of transcranial Direct Current Stimulation (tDCS) on smoking cessation.
Methods:In this randomized, sham-controlled trial study, tobacco-dependent (by DSM-5) male participants were recruited from the general public invitation. Participants were randomly allocated to 5 groups; (A), treatment with 300mg bupropion for 8 weeks; (B), active tDCS (20 sessions for 4 weeks); (C), sham for group B ; (D), active tDCS (20 sessions for 12 weeks), and (E), sham for group D. The electrode montage was anode F3 and cathode F4. Study outcomes include salivary cotinine, Fagerstrom test for nicotine dependence, and smoked cigarette per day, were examined on three time points. Repeated-measures analysis of variances and the generalized estimation equation (GEE) model were employed for data analysis.
Results:Among 210 volunteers, 170 participants completed the study. Mean age of participants was 42.9 years, ranging from 21 to 64 years. The 6-month point abstinence rates in groups A, B and D were 20%, 7% and 25.7%, and in C, D sham groups were 3.1% and 3% respectively. Results of the GEE model showed that although group D was not different from group A in abstinence rate, i.e., salivary cotinine >4 (p = 0.266), nicotine dependency by Fagerstrom test was lower in this group compared to group A (p = 0.019).
Conclusions:The 12-week tDCS had a clinically good therapeutic effect on smoking cessation and its dependency. It may be a substitute for bupropion treatment.
Epidemiological Study of Child Casualties of Landmines and Unexploded Ordnances: A National Study from Iran
- Batool Mousavi, Mohammad Reza Soroush, Mehdi Masoumi, Shahriar Khateri, Ehsan Modirian, Hamid Shokoohi, Mohammad Javad Fatemi, Mohammad Ali Hematti, Mansour Soroush, Mohammad Ghassemi-Broumand, Mehdi Rassafiani, Mostafa Allami, Farshad Nouri, Amir Yavari, Zohreh Ganjparvar, Mojtaba Kamyab, Seyed Abbas Mirsadeghi
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- Journal:
- Prehospital and Disaster Medicine / Volume 30 / Issue 5 / October 2015
- Published online by Cambridge University Press:
- 16 September 2015, pp. 472-477
- Print publication:
- October 2015
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Background
Despite landmine-risk education programs and extensive demining activities on the Western border of Iran, landmines and unexploded ordnance (UXOs) still cause civilian and child casualties three decades after the Iraq-Iran war (1980-1988). The objective of this study was to understand the epidemiological patterns and risk factors of injury in child casualties of landmines and UXOs in Western and Southwestern Iran.
MethodsChildren who were 18 years old or younger at the time of study and who sustained injuries from landmines and UXOs were identified through a search at the Iranian National Veterans Registry. These children participated in a 5-day gathering. The information on socioeconomic status, health-related issues, quality of life, health care utilization, and clinical profiles concerning the landmine and UXO injuries were collected. The method of data collection consisted of three component surveys: health interview, social survey, and medical examinations. Social surveys and health interviews were conducted in a face-to-face method by utilizing a questionnaire consisting of 39 questions addressing household and individual components, including information on time and type of injuries, physical activity, mental health, and quality of life. A comprehensive team of physicians in different subspecialties evaluated and examined children to assess the current medical and psychiatric conditions and physical activity, and recommended and arranged further medical, rehabilitation, or surgical planning.
ResultsSeventy-eight child casualties were identified and participated in the study. The mean age of the participants at the time of study was 16.11 years old (SD=2 years). The mean age of victims at the time of injury was 8.2 years (SD=3.12 years; ranged from 2 to 15 years old). Sixty-seven (85.9%) of the children were male. Provinces of Kurdistan and Kermanshah had the highest number of casualties, with a total number of 54 children (68.3%). Eighty percent of the injuries were caused by landmines, and UXO explosions were reported in 20% of the cases. Overall, 24 children (30%) had received some landmine-risk education before or after the events. Sixty percent of the explosions had happened in the morning between 9:00 am and 12:00 pm. Playing and grazing livestock were the most prevalent activities/reasons at the time of injury, which were reported in 77% of the subjects. Sixty-three percent of incidents had multiple casualties and in only 13 explosions were the children the only victims of the explosion. The most prevalent injuries were amputations in 41 subjects (52.56%), followed by hearing loss in 23 subjects (29.5%). Amputations were more common in upper extremities (62%) than in lower extremities (38%).
ConclusionLandmines and UXOs comprise a significant safety hazard to the children living in the Western border of Iran decades after the Iraq-Iran War. The large number of injuries and lack of risk training among victims suggest that landmine cleanings and landmine-risk education should be age-specifically targeted and expanded substantially.
,Mousavi B ,Soroush MR ,Masoumi M ,Khateri S ,Modirian E ,Shokoohi H ,Fatemi MJ ,Hematti MA ,Soroush M ,Ghassemi-Broumand M ,Rassafiani M ,Allami M ,Nouri F ,Yavari A ,Ganjparvar Z ,Kamyab M ,Mirsadeghi SA Epidemiological Study of Child Casualties of Landmines and Unexploded Ordnances: A National Study from Iran . Prehosp Disaster Med.2015 ;30 (5 ):472 –477 .