Author/Authors :
Etemad, Leila Pharmaceutical Research Center - Pharmaceutical Technology Institute, Mashhad University of Medical Sciences , Moshiri, Mohammad Medical Toxicology Research Centre - Faculty of Medicine, Mashhad University of Medical Sciences, , Balali-Mood, Mahdi Medical Toxicology Research Centre - Faculty of Medicine, Mashhad University of Medical Sciences
Abstract :
The present study aimed to review and discuss the
recommended and recently suggested protocols by Iranian
researchers for a long-term treatment of delayed complications
of sulfur mustard (DCSM) in veterans. As indicated clinically,
patients who suffer from delayed ocular complications
of sulfur mustard (DOCS) benefit from treatments for
dry eyes, therapeutic contact lenses, amniotic membrane
transplantation; blepharorrhaphy, tarsorrhaphy, limbal stem
cell transplantation; corneal transplantation, topical steroids,
and immunosuppressive. In spite of penetrating keratoplasty,
lamellar keratoplasty and keratolimbal allograft had a good
long-term survival.
Delayed respiratory complications (DRCS) are the most
common effects and life-threatening in Iranian veterans. The
recommended treatment protocols include regular clinical
evaluations, respiratory physiotherapy and rehabilitation,
N-acetyl cysteine; warm humidified air, long-acting β2-agonists,
and inhaled corticosteroids. Azithromycin has also been
effective in improving clinical conditions, pulmonary function
tests, inflammatory indexes, and life quality of the veterans.
Interferon gamma (IFN-γ) and helium: oxygen combination
were also used in severe DRCS with good results. Some of
the delayed cutaneous complications (DCCS) such as itching
affects the quality of life of victims. Regular but not frequent
showering and bathing, applying sunscreen compounds, topical
corticosteroids, and systemic antihistamines reduce the problems
of DCCS patients. Several compounds such as capsaicin cream,
pimecrolimus, IFN-γ, phenol-menthol; Aloe vera/olive oil
cream, cetirizine, doxepine, and hydroxyzine were evaluated
in DCCS patients with some benefits. The physicians in charge
of veterans emphasize the importance of a healthy lifestyle,
appropriate financial/social/cultural supports, and a degree of
reassurance and supportive care on the clinical improvement of
patients.
Keywords :
Chemical warfare agents , Sulfur mustard , Vision, ocular , Respiratory system
