Outcome predictors in anterior and posterior ischemic strokes: a study based on the Iranian SITS registry.

Ischemic stroke is the major form of stroke with two separate vascular territories. Many risk factors are related to stroke outcomes in both territories. The present descriptive research was carried out on the basis of data obtained from the Safe Implementation of Treatments in Stroke (SITS) registry on Iranian intravenous thrombolysis ischemic stroke cases. Vascular territory involved in each case and three-month excellent outcome, functional independence, mortality rate, and brain hemorrhage occurrence were determined. Univariable and multivariable logistics regression analyses were utilized in order to investigate association of ischemic stroke outcomes with the vascular territory involved and other related factors. Among 1566 patients 95.4% was anterior circulation stroke patients and 4.6% was posterior circulation stroke cases. There is no significant association between vascular territory with mortality (OR of PCS vs ACS: 0.74, 95% CI 0.37-1.46), excellent functional outcome (OR 0.72, 95% CI 0.44-1.19), functional outcome (OR 0.86, 95% CI 0.52-1.42) and local hemorrhage (OR 0.98, 95% CI 0.30-3.21). Among major risk factors, age, diabetes, NIHSS score and admission duration, increased significantly odds of three-month mortality, excellent outcome, and functional independence in the multivariate analysis. The highest of odds was in NIHSS score with a dose-response association. The vascular territory was not an outcome predictor in ischemic strokes. The most important predictor was baseline NIHSS.

Effects of tactile stimulation on the sensory, motor and cognitive function in people with multiple sclerosis.

OBJECTIVE: Multiple sclerosis (MS) is a chronic inflammatory neurodegenerative disease that causes demyelination in the brain and spinal cord. Repetitive sensory stimulation (RSS) can enhance sensory perception and motor function, improve inappropriate synaptic connections and adaptable malformations, and increase cognitive function. The purpose of this study was to specify the effect of RSS on the sensory, motor, and cognitive function in people with MS. METHODS: RSS was applied to 50 people with MS. In this study, the following tests were used: two-point discrimination, 9-Hole Peg Test (9-HPT), Box and Block Test (BBT), hand mental rotation (HMR), Paced Auditory Serial Addition Test (PASAT), and Symbol Digit Modalities Test (SDMT). The tests were performed before and after the intervention. RESULTS: The results of this study showed significant difference before and after the stimulation in intervention and control groups two-point discrimination threshold (both groups= 0.001), BBT score (both groups: P < 0.001) and 9-HPT score (both groups: P < 0.001), HMR ability (reaction time: both groups: P = 0.003; accuracy rate: intervention: P = 0.004, control: P < 0.001), PASAT score (intervention: P < 0.001, control: P = 0.012) and SDMT score (intervention: P = 0.008, control: P < 0.001), but there was no statistical difference observed between the two groups before and after the intervention in terms of the mentioned variables (P > 0.05). CONCLUSION: The application of 30 min of RSS in the right index finger of people with MS could not improve the two-point discrimination threshold and the manual dexterity. In addition, this intervention did not improve cognitive function.

Clinical dental finding in Iranian horses.

BACKGROUND: A horse's well-being is directly related to the management of its dental health. A good knowledge of the epidemiology and aetiology of dental disorders could help the owners and clinicians to prevent not only dental problems but also severe gastrointestinal diseases. OBJECTIVES: In this study we report the prevalence of dental disorders in horses in Iran. METHODS: We examined 317 horses randomly in eight provinces in Iran and 21 diseases were characterized in the examined horses. The observed diseases were compared among different breeds, genders and ages of the examined horses. RESULTS: The factor of age among the other three factors was more important in the incidence of diseases because most of the diseases found were significantly different among age groups. Between different breeds examined, only cheek teeth cemental caries in Kurdish and Arabian horses was significantly different (p = .022). Enamel point with an occurrence of 34.4% was the most common disease. Broken cheek teeth were more prevalent in male horses in comparison with female horses (p = .035). CONCLUSION: Our study showed a moderate prevalence of dental disorders in Iranian horse clubs, which could be reduced with better management.

The SDF-1 3'a genetic variation of the chemokine SDF-1α (CXCL12) in parallel with its increased circulating levels is associated with susceptibility to MS: a study on Iranian multiple sclerosis patients.

Immune system-related factors are important in pathogenesis of multiple sclerosis. The CXC chemokine SDF-1α (CXCL12) is involved in the immune responses. Hence, the aim of this study was to investigate the association between serum levels of SDF-1α (CXCL12) and its gene polymorphisms at position +801 with multiple sclerosis. In this experimental study, blood samples were collected from 100 multiple sclerosis patients and 100 healthy controls on EDTA pre-coated tubes. DNA was extracted and DNA samples were analyzed for SDF-1α (CXCL12) polymorphisms using PCR-RLFP in patients and controls. The serum levels of SDF-1α (CXCL12) were measured by ELISA. Demographic data were also collected by a questionnaire which was designed specifically for this study. Our results showed a significant difference between the A/A, A/G, and G/G genotype and A and G alleles of polymorphisms at position +801 of SDF-1α (CXCL12). Our results also showed that serum levels of SDF-1α (CXCL12) were markedly higher in patients than healthy controls, but no association was observed between SDF-1α (CXCL12) polymorphism and its serum levels. The results of this study might suggest the serum levels of SDF-1α (CXCL12) and its polymorphism play an important role in pathogenesis of multiple sclerosis. It is also worth noting that these factors could probably use as pivotal biological markers in the diagnosis of MS.

Cerebral venous sinus thrombosis--clinical features, predisposing and prognostic factors.

PURPOSE: Cerebral venous sinus thrombosis (CVST) is a disease with potentially serious consequences and usually affecting young to middle aged people. This study was designed to investigate the clinical features, and predisposing and prognostic factors of CVST in a prospective series of 61 patients. METHODS: This prospective study comprised 61 consecutive patients with confirmed diagnosis of CVST who were hospitalized in Namazi Hospital in Shiraz, south of Iran, between January 2000 and August 2003. The diagnosis was confirmed using conventional MRI or cerebral angiography. RESULTS: The male to female ratio was 1/3.1. The mean age of patients was 35.6 +/- 12.1 years. Headache was seen in 91.8% of the patients. The most frequent risk factor was oral contraceptive consumption (62.2%). Elevation of ESR and CRP titer were seen in 37.7%, and 36.1% of patients, respectively. Involvement of superior sagittal sinus and lateral sinus was 80.3% and 41%, respectively. The final diagnosis was neurobechet in 5 ppatients (8.2%). The fatality rate was 14.7% and an altered consciousness was associated with poor prognosis. DISCUSSION: CVST presents with a wide spectrum of symptoms and signs. Headache was the most frequent symptom. Women who used OCP were especially at risk. Because of moderate to high mortality rate, patients at increased risk of death, specially comatose patients, should be closely monitored.