فهرست مطالب

Caspian Journal of Neurological Sciences - Volume:4 Issue: 15, Dec 2018

Caspian Journal of Neurological Sciences
Volume:4 Issue: 15, Dec 2018

  • تاریخ انتشار: 1397/09/07
  • تعداد عناوین: 7
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  • Jafar Mehvari Habibabadi , Navid Naghibi , Masih Falahatian , Maryam Izadi * Pages 137-143
    Background
    Epilepsy is a neurologic functional disorder occurs due to the abnormal electrical discharge in neurons of the brain.
    Objectives
    The current study aimed at evaluating the relationship between perceived social support and self-esteem in patients with epilepsy referring to Kashani Hospital in Isfahan, Iran, from 2017 to 2018.
    Materials & Methods
    The present cross sectional, correlational study was conducted on 211 patients with epilepsy, referring to Kashani Hospital in Isfahan from 2017 to 2018, selected through a consecutive sampling method according to the inclusion criteria. The data collection instruments used in the current study were self-esteem and social support questionnaires. The collected data were analyzed using descriptive and statistical inference with SPSS V. 23. In addition, multiple regression analysis and Pearson correlation coefficient were employed.
    Results
    The results of multiple regression analysis showed that social support dimensions including spouse (F=44.88), family members (F=47.64), friends (F=31.57), physician (35.28), and nurse (F=44.25) have a significant effect on self-esteem (P<0.05).
    Conclusion
    Effective support from spouse, family members, friends, physician, and nurse can increase the self-esteem of patients with epilepsy.
    Keywords: Epilepsy, Social support, Self concept
  • Mohammad Ali Nazari , Maryam Taghavi Jelodar*, Hasan Shahrokhi Pages 144-151
    Background
    Attention-Deficit Hyperactivity Disorder (ADHD) is a common psychiatric complication in children, which affects about 5-10% of the population. Although ADHD is a multi-factorial disorder, one of its causes refers to dysfunction of the arousal.
    Objectives
    The current study aimed at investigating whether a change in arousal level in children with ADHD differs from the control group.
    Materials & Methods
    To achieve the research objectives, the mean Skin Conductance Levels (SCLs) as an useful index of measuring arousal levels was used, and then the changes during resting eyes-open condition and after that during playing computer games on 15 male subjects aged 8 to 12 years as the ADHD group and other 15 age-gender matched in the control group were evaluated; then, the recorded data were analyzed with repeated measures analysis of variance. The study was conducted in a child mental health services center in Tabriz, Iran, in 2012.
    Results
    Across conditions, mean SCL index was lower in the ADHD group than that of controls. Computer games caused a significant increase in SCL index, which was not different between the both groups. The findings showed a similar pattern of changes during testing conditions for both the ADHD and control groups F(1,28)=85.90; P<0.0001).
    Conclusion
    Results confirmed a primary deficit related to autonomic hypoarousal in children with ADHD. The SCL results, in addition to behavioral findings, made the authors to suggest that the dynamic changes of activities in neural system are impaired in children with ADHD.
    Keywords: Attention, Attention Deficit Disorder With Hyperactivity, Arousal, Video games
  • Kamran Ezzati , Javad Sarrafzadeh*, Ismael Ebrahimi Takamjani , Saemeh Khani Pages 152-158
    Background
    Few studies have compared superficial and deep dry needling techniques in treatment of trigger points in patients with Myofascial Pain Syndrome (MPS).
    Objectives
    To compare the effects of Superficial Dry Needling (SDN) and Deep Dry Needling (DDN) on Range of Motion (ROM) and functional ability in subjects with upper trapezius MPS.
    Materials & Methods
    This is a quasi-experimental study conducted on 50 patients with MPS of upper trapezius muscle. They were randomly divided into two groups of 25 treated with SDN and DDN. They were examined in Physiotherapy Clinic of Iran University of Medical Sciences during 2016-2017. Neck disability and cervical ROM were measured using Neck Disability Index (NDI) instrument a goniometer, respectively. The subjects were evaluated before the treatment, after the treatment, and 7-and 15-day follow-up periods. The Independent t-test and ANOVA were used to compare the two groups at different times of evaluation.
    Results
    There was no significant difference between SDN and DDN groups in terms of age (P=0.41), weight (P=0.99), and height (P=0.51). Interaction effect between group and time on the lateral cervical ROM over the unaffected side and NDI were significant (P<0.001). The simple main effect of time and group on NDI and ROM were also significant (P<0.001).
    Conclusion
    The changes in the ROM and NDI were observed over time when SDN and DDN techniques were used, but these changes were more significant in patients treated with DDN, especially in the follow-up periods.
    Keywords: Myofascial Pain Syndrome, Disability, Neck pain, Range of Motion
  • Shahrokh Yousefzadeh, Chabok , Naema Khodadadi, Hassankiadeh*, Alia Saberi , Atefeh Ghanbari Khanghah , Homa Zarrabi , Mohammad Reza Yeganeh , Hamideh Hakimi , Anoush Dehnadi Moghadam Pages 159-168
    Background
    Anxiety and depression are among the most common psychological symptoms in patients with life-threatening illnesses, and have a close relationship with hospitalization in specialized care units.
    Objectives
    This study aimed at evaluating anxiety and depression and their related factors in patients admitted to Intensive Care Units (ICUs).
    Materials & Methods
    This is an analytical cross-sectional study conducted on 135 patients hospitalized in ICUs (neuro ICU and general ICU) of Poursina Medical Education Center in Rasht City, Iran. The patients were selected by convenience sampling method. The study data were collected using a checklist surveying demographic, clinical and psychosocial characteristics of the patients, and Hospital Anxiety and Depression Scale (HADS). Then, the obtained data were analyzed by Mann-Whitney U and Kruskal-Wallis tests in SPSS V. 18.
    Results
    The Mean±SD anxiety and depression scores of the study patients were 6.12±9.3 and 7.10±2.3, respectively. There was a significant relationship between short-term hospitalization and anxiety (P=0.03), and a high score of depression was observed in those with middle-school education (P=0.03) and non-invasive ventilation (P=0.01). Moreover, administration of sedatives (P=0.001) and tracheostomy ventilation (P=0.04), showed a significant correlation with depression.
    Conclusion
    Anxiety and depression (symptoms of mood disorders) among ICU patients were relatively high and the duration of hospitalization was significantly associated with anxiety. Moreover, the administration of sedative drugs had significant correlation with depression. In addition, the type of received mechanical ventilation was associated with both disorders. Routine screening of anxiety and depression by nurses in ICUs is useful for early treatment, and can prevent long-term complications of these disorders.
    Keywords: Anxiety, Depression, Intensive Care Units
  • Maedeh Majidi Shad , Alia Saberi*, Maryam Shakiba , Shademan Rezamasouleh Pages 169-177
    Background
    Prolong hospitalization after a stroke is associated with increased cost, higher risk of complications, and adverse effects.
    Objectives
    The purpose of this study was to determine the length of stay and its related factors among stroke patients admitted to one of the educational and therapeutic centers in the north of Iran.
    Materials & Methods
    In this descriptive-analytic study, 253 stroke patients admitted to an academic hospital affiliated to Guilan University of Medical Sciences were enrolled during 2016-2017. Their socio-demographic characteristics and medical records associated with their admission were collected. A linear regression model was used to estimate the adjusted risk factors in predicting the duration of hospitalization in SPSS 21.
    Results
    The Mean±SD duration of hospitalization in stroke patients was 5.6±2.1 days (range 2-12 days). The multivariate regression model indicated that the unemployed versus the self-employed subjects (β=0.74), hemorrhagic versus the ischemic stroke (β=0.84), strokes with moderate volume (β=0.61) and large volume (β=1.22) compared to small volume, infectious complications, and certain physicians had an independent and significant association with increased duration of hospital stay.
    Conclusion
    Assessing the duration of hospitalization and identifying its potential predictors can be useful in the proper use of the resources and discharge of patients with stroke.
    Keywords: Length of stay, Stroke
  • Kavian Ghandehari*, Sharife Shahedi , Zahra Valipour , Mohammad Reza Sobhani , Hojat Salehian , Shokat Nazemian , Masumeh Rezae Pages 178-183
    Despite the development of Intravenous thrombolysis with tissue Plasminogen Activator (IVtPA) guidelines in each affiliated stroke center, protocol violations may be observed in each hospital with IVtPA facilities. An extensive search of scientific electronic databases including PubMed, OVID, Index Medicus, Index Copernicus, Google, ISI, and Scopus was performed with keywords of Thrombolysis, Off-label, Out of Protocol, Violation, Time Window, Dose, tPA, and Stroke terminated on 01 May 2018. Safety and functional outcomes are less favorable beyond three hours; however, the wider time window until 4.5 hours is recommended. Lower dose of alteplase (0.6 mg/kg) is approved in Japan. The proposed dose of tPA in Iranian population is similar to that of the Japanese. Overall, the outcomes in patients treated with off-label IVtPA or protocol violation were better than those of the controls based on registry data. There is little disagreement about time window of IVtPA. The dose of 0.6 mg/kg is used in some Asian countries with similar therapeutic results.
    Keywords: Stroke, Tissue Plasminogen Activator
  • Mohsen Janghorbani , Mahdi Barzegar , Omid Mirmosayyeb , Vahid Shaygannejad* Pages 184-189
    Background
    The current case report aimed at describing the clinical, radiological, and immunological findings of a case of ischemic stroke due to acute thrombosis of the left internal carotid artery and multiple watershed infarctions mimicking Multiple Sclerosis (MS).
    Clinical Presentation and Intervention
    A 24-year-old right-handed Iranian female was initially diagnosed with Multiple Sclerosis (MS). She presented with weakness in right lower limb. The cerebral Fluid Attenuation Inversion (FLAIR) Magnetic Resonance Imaging (MRI) showed few small and round lesions in deep white matter, semi-oval centrums, paraventricular region, and subcortical region on left hemisphere. MS was suspected. The patient’s neurological status worsened, after four days she presented hemi-paresis, dysarthria, and hemi-facial paresis. The cerebral Diffusion-Weighted (DW)-MRI, Apparent Diffusion Coefficient (ADC), Duplex Scan (DS), Complete Blood Count (CBC), coagulation, blood chemistry, blood lipids, and autoimmune and immunodiagnostic pathology were performed. Test for Anti-double stain DNA (dsDNA), IgG anti-cardiolipin antibodies, and lupus anticoagulant were positive. DNA bound lactoferrin, anti-Sm antibodies, Anti-Sjögren’s-Syndrome-related Antigen (Anti-SSA) autoantibodies, IgM anti-cardiolipin antibodies, and Anti-beta-2 glycoprotein-1 (IgMIgG) were negative. Ischemic stroke due to acute thrombosis of the left internal carotid artery and multiple watershed infarctions were confirmed in the patient. Heparin and then warfarin therapy was started. At that time she was treated with warfarin, hydroxychloroquine (200 mg/d) and atorvastatin (20 mg/d). The outcome was favorable.
    Conclusion
    The current case presented with clinically susceptible symptoms of MS, but had a stroke. Therefore, stroke in young patients can mimic MS symptoms.
    Keywords: Diagnosis, Multiple Sclerosis, Stroke