Chemical%20warfare%20victims:%20Early%20cutaneous%20findings%20and%20late%20skin%20complaints - PowerPoint PPT Presentation

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Chemical%20warfare%20victims:%20Early%20cutaneous%20findings%20and%20late%20skin%20complaints

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Soroush MR, MD, Honari G, MD. Janbazan Medical and Engineering Research Center (JMERC) ... All cases were interviewed for any skin complaints. Then, ... – PowerPoint PPT presentation

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Title: Chemical%20warfare%20victims:%20Early%20cutaneous%20findings%20and%20late%20skin%20complaints


1
  • Chemical warfare victims Early cutaneous
    findings and late skin complaints
  • Mousavi B, MD, MPH
  • Soroush MR, MD,
  • Honari G, MD

2
Janbazan Medical and Engineering Research
Center (JMERC) www.jmerc.ac.ir
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Iran Iraq war (1980-1988)
  • 200,000 lost their lives
  • 400,000 war injured
  • Chemical warfare history
  • 100,000 hospitalization
  • 55000 chemical victims
  • 10 Moderate Severe
  • 90 Mild

6
What is sulfur mustard gas?
  • AKA vesicants or blistering agent
  • Lipophilic liquids and cytotoxic alkylating
    agent
  • Easy penetrate
  • Upon contacts with skin
  • 80 percent evaporates
  • 20 percent penetrates the skin
  • 10 percent binds to the skin sites

7
Mustard gas
  • Quickly cyclizes in tissue
  • Alkylates cell components (DNA, proteins)
  • DNA damage leads to
  • cell death
  • mutation

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Direh
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Study objectives
  • This study was part of a Health monitoring
    project in chemical warfare victims
  • The specific objective of the study was to assess
    the relationship between early and late skin
    complaints in Chemical warfare survivors
    suffering from moderate to severe complications

12
Methods (N149)
  • First,
  • All cases were interviewed for any skin
    complaints
  • Then,
  • History of the skin reactions at the time of
    exposure
  • - Patients recall, and
  • - Medical records
  • The most severe reactions were considered

13
Results
  • Mean age
  • 44.9 (SD 8.7) years
  • Range 21-75 yrs
  • Mean age at the time of exposure 23.3 (SD
    8.5) years
  • Range 1-53 yrs

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Results
  • Marital status
  • Married 146
  • Single 3
  • Education
  • Illiterate 10.7
  • Less than 12 yrs of education 35.5
  • High school certificate and above 53.8

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Results
  • Time of Chemical Exposure
  • 1985 1986 83
  • 1985 58.5
  • 1986 24.5
  • Exposure frequency (1-6)
  • 33.7 (n 50) gt once

19
Results
  • Early cutaneous findings were based on
  • Medical records 21 (n 31)
  • Patient recall 79 (n 118)

20
Skin complaints at the time of study
21
Skin complaints at the time of study
22
Skin lesions at the time of exposure
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Cutaneous findings at the time of exposure
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Combination of skin lesions
  • Blister, redness, scaling and dispigmentation
    100(67.1)
  • Redness, scaling and dispigmentation 16 (10.1)
  • Scaling and dispigmentation 10 (6.7)
  • No skin lesions 12 (8.1)

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Results
  • A significant relationship between early
    cutaneous lesions and developing latent skin
    complaints (Odds ratio 13.5, Plt0.001)

29
Early cutaneous lesions and developing latent
skin complaints
P value Odds ratio Early cutaneous lesions
.000 14.3 Blister
.006 5.2 Redness
.000 9.1 Scaling
.001 6.8 Dispigmentation
30
Discussion
  • Early cutaneous lesions
  • Risk of developing latent skin complaints

31
Discussion
  • Odds of having blister
  • among cases with latent skin complaints

32
  • Limitation
  • Part of the data was collected based on patient
    recall after 22 years of exposure
  • Recall bias

33
Peace is not a gift from God to man, but a gift
from man to himself
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