mohammad sayad nasiri

This study aimed to assess the clinical features, Electroencephalography (EEG) findings, and brain imaging results in psychiatric patients diagnosed with epilepsy at Razi Psychiatric Hospital.

This retrospective descriptive-analytical study was carried out on patients with epilepsy and psychiatric disorders admitted to Razi Psychiatric Hospital over two years. A total of 94 patient files seizure and epilepsy comorbidity, recorded in the hospital’s health information system (HIS), were reviewed. Data collection involved a demographic checklist and an epilepsy scale; the latter, developed by DiIorio, Colleen, et al., encompassed personal characteristics, mental disorders, epilepsy, and seizures. The Kruskal-Wallis and Mann-Whitney non-parametric tests were utilized to compare the mean scores of variables, with SPSS software, version 21 facilitating the analysis.

Out of 94 patients with seizure and epilepsy, 9.6% had focal seizure, 26.6% had generalized epilepsy, 36.1% had focal-generalized seizure, and 26.8% had unknown seizure. About 12% had a structural etiology, while the remaining 88% had an etiology that remained unidentified.

The findings indicate that epilepsy, affecting individuals from adolescence through to old age, can lead to psychiatric disorders. For many patients, the etiology of their condition remains elusive, and EEG findings and brain imaging appear normal in the majority of cases.

This study aimed to investigate neuropsychological rehabilitation’s effectiveness on stroke patients’ cognitive status.

This quasi-experimental study examined 22 adults with ischemic stroke of the left hemisphere (with an average age of 64.31 years) before and after the intervention. The patients had fluent aphasia (10 people) and non-fluent aphasia (12 people), along with cognitive disorders such as memory or attention disorder. Medical examination and para-clinical diagnosis of magnetic resonance imaging (MRI) with different causes, along with the Persian diagnostic aphasia battery bedside version (P-DAB-AQ1, 2016), were conducted. The severity of language disorder and type of aphasia were investigated using the Persian diagnostic aphasia battery (P-DAB-1) and Persian picture naming battery tests. Also, the mini-mental state examination (MMSE) test checked the cognitive dimensions. Verb network strengthening therapy, treatment of underlying forms, Persian verb, and sentence production protocol, and semantic feature analysis (SFA) for patients were also used.

Findings show that the participants’ average aphasia quotient (AQ1) score increased from 74.80 to 80.12, and the average MMSE score increased from 17 to 22.59. The main variables do not follow a normal distribution (P<0.05), but the difference between scores before and after the intervention follows a normal distribution (P<0.05). Both the AQ1 and MMSE variables significantly differ before and after the intervention, according to the Wilcoxon test. The non-fluent aphasia group has a higher increase in MMSE scores than the fluent aphasia group.

Neuropsychological rehabilitation interventions can effectively improve AQ1 and MMSE. In addition, further research on neuropsychological rehabilitation interventions with two intervention and control groups and the treatment methods used during this study can be suggested for the treatment of stroke patients.

One of the most common psychological problems among people who use drugs (PWUD) is cognitive impairments (CIs). Several studies show that the prevalence of cognitive impairments in PWUD is higher than in the general population.

The aim of the current study was to investigate the prevalence of CI and its related factors among people who inject drugs (PWID) in Iran.

A cross-sectional study was designed among PWID in 2023. About 410 PWID were recruited using snowball and convenience sampling in four provinces in Iran. Demographic and clinical data, as well as the status of cognitive impairments, were collected using bio-behavioral and Montreal Cognitive Assessment questionnaires, respectively. We examined the relationship between all independent variables and CIs status using bivariate logistic regression.

The prevalence of CI among participants was 28% (95% confidence interval (CI): 22% - 32%). Behaviors associated with an increased risk of CIs included the length of injecting drug use [adjusted odds ratios (aOR) = 2.7, P = 0.01], methamphetamine use (aOR = 2.8, P < 0.05), and alcohol use (aOR = 2.8, P < 0.05).

Methamphetamine and alcohol use were identified as the main predictors of cognitive impairments among PWID. It also seems necessary to consider new interventions in harm reduction programs to address cognitive impairments.

Pre-hospital emergency medical services are one of the vital parts of the health system, which was created to timely diagnose and treat patients injured in life-threatening conditions. The use of motorcycles has increased in recent years to reach the golden time standard and overcome traffic in some countries, especially Iran. This study was conducted to investigate the effectiveness of a motor ambulance compared to an ambulance in Tehran City, Iran.

The present study is a cross-sectional descriptive-analytical type. The time to reach the patient’s bedside, death at the scene, and physiological parameters of the patient at the time of delivery to the hospital were studied as effectiveness indicators in this model. Since the primary data on the effectiveness of these two interventions is mortality, according to previous studies, the mortality data should be converted into the form of prevented mortality and enter the analysis phase. In this study, since the mortality index is expressed as a percentage, the difference in the mortality index from 100 was estimated as the prevented mortality index and entered into the analysis.

The results showed that the chance of death in the motor ambulance group with an ambulance in severe level patients is 44.8% and 66.9% in the ambulance group. In the motorcycle and ambulance group, the probability of death for patients with mild and moderate injuries was estimated at 0.02% in ambulance missions and 0.7% in motorcycle and ambulance missions (P=0.05). 

According to the desired outcome (reduction of death), the use of motor ambulance with ambulance was effective in severe group patients. Of course, this outcome alone cannot be an accurate basis for judgment, and outcomes such as survival, disability-adjusted life years, and quality-adjusted life years seem necessary for a more accurate evaluation.

Falls are among the most common accidents in psychiatric hospitals. One of the possible causes of falls is vitamin B12 deficiency, which is especially prevalent among older adults. However, it was not ignored in previous studies.

This clinical trial was conducted on older patients with chronic psychiatric diseases admitted to a psychiatric hospital. Based on the data obtained from the multi-factorial fall risk assessment tool (MAHC-10) developed by the Missouri Alliance for Home Care (MAHC) and Tinetti Balance Assessment Tool, the patients at risk of falls were identified and their serum vitamin B12 levels were measured. The patients with vitamin B12 deficiency were selected to be studies in a 3-month trial. At the end of the trial, the patients took the Tinetti test once again. Pre- and post-intervention variables were compared with each other using the dependent t-test. P values of ≤ 0.05 were considered statistically significant.

After screening, 10 patients showed vitamin B12 deficiency and were included in the intervention. The mean age and length of stay of the patients were 66.30 ± 10.17 years and 24.55 ± 18.39 months, respectively. The mean scores for the “balance-gait” variable before and after the intervention were 13.40 ± 4.30 and 23.70 ± 4.15, respectively. These figures revealed a significant difference between the two groups (P = 0.001). 

This study showed that vitamin B12 deficiency may be an often-overlooked cause of gait disorders in older patients with psychiatric problems. Treatment with vitamin B12 supplements can reduce the risk of falls in such patients.

Arachnoid cysts are developmental cerebral disorders that are mostly asymptomatic and diagnosed accidentally on routine brain imaging. Sometimes, these cysts can lead to serious complications such as intracystic and subdural hemorrhage. These hematomas often occur after minor head trauma but in some cases, hemorrhagic complication can occur without obvious predisposing insult. Our reported case is a 19 years old man admitted with acute neurological signs and diagnosed as subdural hematoma and treated without any history of recent head trauma. The only risk factor causing bleeding was arachnoid cyst.

Cognitive dysfunction, especially memory impairment is common in schizophrenia.
According to impact of memory problems on everyday life of schizophrenic patients, this research intended to assess the relationship between memory and behavioral signs of these patients for better therapeutic decision.
In this cross sectional study, seventy one schizophrenic patients admitted at Razi psychiatric hospital (Tehran, Iran) from July to December 2015, were included. Verbal memory was analyzed by Persian translated Wechsler memory subtests (WMS-III) of paired associates, recognition and numerical memory. Positive and negative symptoms scale (PANSS) for schizophrenia is used for evaluation of psychiatric symptoms. Data were analyzed with a statistical software program (SPSS 20).
Word association memory has a significant correlation with negative signs, positive signs, excitement, anxiety and depression (P There is significant relation between verbal memory dysfunction and type and severity of psychological symptoms of schizophrenia patients. So, routine evaluation and treatment of these cognitive impairments should be considered as a part of comprehensive schizophrenia therapeutic approach.

Multiple cerebral cavernous angiomas (CCA) have genetic origin. They are uncommon entity and rarely occurring with psychiatric manifestations.
A 28- year-old man presented with delusional disorder some months after diagnosis of CCA for which a neurosurgical intervention had been performed. According to clinical and neuroimaging findings, we discuss the possible correlation of CCA with psychotic symptoms of this patient.
Possibly, abnormal brain development secondary to a genetic abnormality or peri-natal insult predisposed patient to two different neuropsychiatric conditions.

Asterixis, firstly described in metabolic encephalopathies, may occur unilaterally in patients with various focal brain diseases. Although hardly localizing, most reported cases have showed a contralateral thalamic pathology; but Lesions in the medial frontal lobe, parietal lobe, brain stem, basal ganglia, insular lesions, may also cause unilateral asterixis. In this article, three cases of acute cerebral vascular event with unilateral or asymmetrical asterixis were described: first patient with left sided hemiparesis and asterixis that ultimately diagnosed as right thalamic hemmorrage; second patient with right sided hemiparesis and asterixis after acute left thalamic infarction and a patient with transient right sided weakness and bilateral asymmetrical asterixis secondary to a transient ischemic attack in left internal carotid territory. We then provided a literature review of published similar cases to emphasize on asterixis as a focal neurological sign.

Oculodentodigitalis dysplasia (ODDD) is an extremely rare inherited disorderinvolving the development of the face, eyes, teeth and limbs. In addition,some patients develop neurological problems mostly a spastic paraparesisassociated with white matter abnormalities on magnetic resonance imaging.This report describes a patient with epilepsy, a rare neurologic manifestationof this syndrome.