جستجوی مقالات مرتبط با کلیدواژه « ischemic » در نشریات گروه « پزشکی »
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INTRODUCTION
Stroke is the second leading cause of death worldwide. Recent studies have shown that the COVID-19 pandemic has been associated with a higher frequency of stroke. This study aimed to investigate the epidemiologic aspects of stroke two years before and during the COVID-19 pandemic in Kerman.
METHODThis cross-sectional study was conducted in Kerman. The participants included all patients with a confirmed diagnosis of stroke. COVID-19 confirmation was based on a positive PCR test. The data was analyzed with SPSS.V24 software.
RESULTSIn this study, 4152 patients with stroke were evaluated. The frequency of stroke before and during the COVID-19 pandemic was the same. The total number of stroke patients with COVID-19 was 298 (8.16%). The frequency of ischemic stroke patients before the COVID-19 pandemic was 1751 and during the pandemic was 1770. Before and after the pandemic, the mean age of ischemic stroke patients was 67.42±14.14 and 64.49±14.46 respectively, which showed a statistically significant difference (P>0.001). Our findings showed a significant difference between the NIHSS of ischemic stroke before and after the pandemic (P<0.001). The mortality rate of stroke patients was 111 before COVID-19 and 115 patients in the first two years of COVID-19. Except for the mortality rate (P<0.001), there was no significant difference in other demographic variables between ischemic stroke patients with and without COVID-19.
CONCLUSIONThe patients with ischemic stroke during the COVID-19 pandemic were younger and had more neurological deficits than the ischemic stroke patients before the pandemic. COVID-19 was associated with higher mortality in patients with ischemic stroke.
Keywords: Frequency, corona, Sex, Mortality, Ischemic} -
International Journal of Musculoskeletal Pain prevention, Volume:7 Issue: 3, Summer 2022, PP 730 -740Aim
Stroke is the third leading cause of death after cardiovascular disease and cancer. Stroke causes disability in various forms in sufferers. It has been suggested that various pathological mechanisms are involved in causing this injury. Articles show that regular exercise is a way to treat stroke patients. One of the most common exercise therapy models is treadmill exercise.However, there is still controversy about when to start treadmill workouts, the intensity of the workout, the type of treadmill workout, and how it has positive effects. This article offers an overview of treadmill exercise and its’ effects on post-ischemic stroke rehabilitation. In this study, the effect of exercise time, exercise intensity, exercise style, and the positive effects of this type of exercise on rehabilitation of patients after ischemic stroke were briefly examined.
Keywords: Ischemic, Rehabilitation, Stroke, Exercise, Treadmill} -
انسفالیت ناشی از HSV یکی از شایع ترین انسفالیت های ویروسی در اطفال می باشد که علایم و نشانه های شناخته شده ای دارد که شامل تغییر شخصیت، تب، اختلال در سطح هشیاری و نقص نورولوژیک فوکال می باشد. همچنین یافته های تصویر برداری در این بیماری شامل در گیری لوب تمپورال و فرونتواربیتال می باشد. در مطالعه حاضر ما یک دختر 7 ساله را با تشخیص انسفالیت هرپسی ناشی از HSV1 با علایم غیر معمول شامل عدم وجود علایم نورولوژیک فوکال و وجود ضعف عضلانی قرینه با یافته های تصویربرداری مطرح کننده نواحی مولتی فوکال ایسکمیک معرفی می کنیم که تحت درمان با آسیکلویر قرار گرفت و علایم بیمار کاملا بهبود یافت.
کلید واژگان: انسفالیت, ویروسی, نورولوژیک فوکال, لوب تمپورال, فرونتواربیتال, ایسکمیک}HSV-induced encephalitis is one of the most common viral encephalitis in children with known signs and symptoms, including personality changes, fever, impaired consciousness and focal neurological deficits. Imaging findings also include temporal lobe and fronto-orbital involvement. In the present study, we present a 7-year-old girl diagnosed with HSV1-induced herpes encephalitis with unusual symptoms including absence of focal neurologic deficits and persistent muscle weakness with imaging findings suggestive of ischemic multifocal areas that Treated with acyclovir and the patient’s symptoms improved.
Keywords: Encephalitis, Viral, Focal neurological, Temporal lobe, Fronto-orbital, Ischemic} -
Serum Estrogen Level in Postmenopausal Women with Ischemic Stroke: An Analytic Cross-Sectional Study
Stroke is the third cause of death worldwide. The present study aimed at determining serum estrogen levels in postmenopausal women with ischemic stroke and compare with a control group admitted to Department of Neurology in Kowsar Hospital of Semnan, Iran in 2017.In this analytic cross-sectional study, serum estrogen levels in 33 women with ischemic stroke (who were eligible to be included in the study) were compared with a control group through the convenience sampling method. The demographic data were collected, and serum estrogen levels were measured through the quantitative luminescence Immunoassay technique in both groups and, the degree of disability was determined using the Modified Rankin Scale (MRS) in case group. In case and control group, the age of patients was 74.48±13.44 (mean ± SD) and 73.35±12.89 years respectively, and estrogen levels were 16.65±2.83 and 22.94±3.11 pg/dl respectively, with a significant difference (p=0.03). Hypertension was the most common risk factor in case and control group (84.8% and 78.7%). In case group there was a significant relationship between the degree of disability at discharge from the neurology ward and the degree of disability before undergoing stroke treatment (p < 0.001) and, there was no statistically significant relationship between serum estrogen levels and age, number of risk factors, and disability at admission and at discharge. The results showed that serum estrogen levels in postmenopausal women with ischemic stroke were significantly lower than control group and normal estrogen range in healthy postmenopausal women.
Keywords: Stroke, Ischemic, Estrogen, Menopause, Women} -
BACKGROUND
The infections are common complications after the ischemic stroke. The aim of this study was to evaluate the anticipatory value of C-reactive protein (CRP) and procalcitonin (PCT) biomarkers in diagnosis of stroke-induced infection.
METHODSIn the current prospective study, 184 patients with cerebral ischemia were enrolled. Serum samples were obtained from patients. The CRP and PCT, white blood cells (WBCs) and monocytes, and final infections were evaluated.
RESULTSIn the first 72 hours, the analysis for CRP revealed that the sensitivity was 41.6%, the specificity was 100%, positive pressure ventilation (PPV) was 100%, and negative pressure ventilation (NPV) was 82.9%. PCT showed that the sensitivity was 85.41%, the specificity was 98.54%, PPV was 95.34%, and NPV was 95%.
CONCLUSIONAccording to our findings, the evaluation of CRP and PCT with simultaneous clinical observation could be considered as a good step in start of antibiotic therapy.
Keywords: C-Reactive Protein, Procalcitonin, Infection, Ischemic} -
BackgroundBoth Transthoracic Echocardiography (TTE) and Transesophgeal Echocardiography (TEE) are effective investigation tools to detect cardioaortic sources of embolism in ischemic stroke. Nevertheless, there are still uncertainties about the cost-effectiveness of these methods in non-selected patients with acute stroke.ObjectivesThis study aimed to investigate the cost-effectiveness of TTE and TEE using a decision analytic model in non-selected patients with acute ischemic stroke with or without clinical and radiological signs of embolic pattern.
Patients andMethodsThis cross-sectional cost-effectiveness study was performed in Nemazee hospital affiliated to Shiraz University of Medical Sciences from January 2014 to April 2014. TTE and TEE were performed for all 65 consecutive patients with ischemic stroke (51.3% male, mean age of 69.7 ± 17.9 years). The required data were direct costs related to performance of TTE and TEE, which were obtained from the patients bills in their charts. A decision analytic model was implemented to assess the cost-effectiveness of these two methods, which demonstrated an Incremental Cost-Ef-fectiveness Ratio (ICER). Effectiveness was determined based on the number of disorders diagnosed using each of the two echoes confirmed by two cardiologists. All analyses were done using Tree Age Pro 2011.ResultsThe results showed that TEE was more expensive than TTE in non-selected patients. Performing TEE increased the cost by 1494 USD and the effectiveness by 7%. As per ICER equation, for each increment unit in the effectiveness, performing TEE would increase the cost by 213.4 USD compared to TTE. TEE was cost-effective in comparison to TTE regardless of age factor considering the cutoff of Gross Domestic Product (GDP) by three for ICER. Moreover, TTE was cost-effective in 41-60- and 61-80-year-old age groups, while TEE was cost-effective in the 41-60-year-old age group. However, none of the techniques was cost-effective in patients above 81 years old.ConclusionsThe results of this study can help reduce the unnecessary use of echocardiography by considering the age group and their corresponding risk factors for developing ischemic stroke.Keywords: Stroke, Ischemic, Embolic, Cost, Benefit Analysis, Echocardiography} -
ObjectivePrevious studies reported that asafetida from Ferula assa-foetida Linn. species and its essential oil (AEO) have antioxidant effects. In the present study, the effect of AEO was evaluated on ischemic-reperfusion injury in isolated rat hearts.Materials And MethodsForty-eight male Wistar rats were divided into 6 groups: 1) control group, 2) vehicle group, 3-5) AEO groups and, 6) carvedilol group. In the control group, hearts were only subjected to 30-min global ischemia followed by 120-min reperfusion. Hearts in other groups were perfused with vehicle (Tween 0.1%), AEO (0.125, 0.25 or 0.50 µL/g heart) or carvedilol (10 µM) for 5 min immediately before the induction of ischemia.ResultsCompared to the control group, myocardial dysfunction was significantly more severe only in group 5 in which a significant increase in left ventricular end diastolic pressure and a significant decrease in left ventricular developed pressure and ±dp/dt. Also, the activities of lactate dehydrogenase and creatine kinase as the markers of myocardial injury were significantly higher only in group 5 compared to control group. The size of infarct and the incidence of irreversible fibrillation did not show any significant differences between the control group and groups 3-5.ConclusionThese results showed that perfusion of isolated rat hearts with AEO 0.5 µL/g heart, but not at lower concentrations, might worsen myocardial ischemic-reperfusion injury.Keywords: Asafoetida, Heart, Essential oil, Ischemic, reperfusion injury}
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BackgroundDifferentiating ischemic from non-ischemic functional mitral regurgitationý (FMR) in patients with cardiomyopathy is important in terms of the therapeutic decision-making and prognosis, but might be clinically challenging. In this study, the deformation of mitral valve (MV) indices in the prediction of the etiology of FMR was assessed using 2D transthoracic and tissue Doppler echocardiography.MethodsThis case-control study was conducted from April 2015 to January 2016 in Imam Reza Hospital in Mashhad, Iran. The participants consisted of 40 patients with ischemic cardiomyopathy (ICM) and 22 with non-ischemic dilated cardiomyopathy (DCM) who referred to the heart failure clinic. Transthoracic echocardiography was performed using the conventional 2D and tissue Doppler imaging (TDI). MV tenting area (TA), coaptation distance (CD), anterior and posterior mitral leaflet angles (AMLA and PMLA), and regional systolic myocardial velocity (Sm) were measured.ResultsThere were no significant differences in echocardiographic indices between the two groups, besides Sm and PMLA which were significantly lower and higher, respectively, in ICM subjects in comparison with DCM patients (P = 0.002). PMLA ≥ 40 degrees and Sm ≤ 4 cm/second have a relatively high value for discriminating the ischemic from non-ischemic origin of functional MR in subjects with systolic heart failure (sensitivity: 80.0% and 70.0%, specificity: 73.0% and 77.3%; P = 0.001 and PConclusionThe present study showed that PMLA and Sm had an independent significant association with the mechanism of FMR. These findings are suggestive of the predictive role of mitral deformation echocardiographic indices in the determination of the etiology of FMR in systolic heart failure.Keywords: Ischemic, Cardiomyopathy, Systolic Heart Failure, Mitral Regurgitation, Transthoracic Echocardiography}
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پیش زمینه و هدف
سکته مغزی مهم ترین عامل در ایجاد ناتوانی و معلولیت در افراد بالغ می باشد. اغلب بیماران سکته ای، دوباره به طور مستقل می توانند به فعالیت های حرکتی خود ادامه دهند؛ درحالی که مشکلات حرکتی درنتیجه اختلال تعادل و ضعف حرکتی است، در این افراد ادامه می یابد. استفاده از روش های درمانی موثر جهت بهبود ناتوانی این بیماران ضروری است. ازاین رو پژوهش حاضر باهدف بررسی اثربخشی بیوفیدبک بر بهبود شدت فلج حرکتی عضلات اندام تحتانی بیماران مبتلا به سکته مغزی ایسکیمیک و هموراژیک انجام شد.
مواد و روش کارپژوهش بر پایه ی طرح خط پایه چندگانه با ورود پلکانی به درمان اجرا شد. نمونه ی این پژوهش 4 نفر از بیماران مبتلا سکته مغزی ایسکیمیک و هموراژیک بود. روش نمونه گیری در این پژوهش نمونه گیری هدفمند بود. برای نمونه گیری، نخست به کمک مصاحبه با متخصص مغز و اعصاب و همچنین بررسی پرونده های بیماران، افراد مبتلا به سکته مغزی ایسکیمیک و هموراژیک مشخص شدند. و 4 نفر (2 بیمار سکته مغزی ایسکمیک و 2 بیمار سکته مغزی هموراژیک) به تصادف به عنوان نمونه انتخاب شدند. بیماران طی 20 جلسه به صورت یک روز در میان تحت درمان قرار گرفتند. به منظور بررسی میزان فلج حرکتی از مقیاس نمره دهی شدت فلج حرکتی و برای ارزیابی حرکت کردن از دستگاه بیوفیدبک استفاده شد. اطلاعات حاصل از آزمون ها و همچنین درمان، جمع آوری گردید. جهت تجزیه و تحلیل داده ها از نمودار پلکانی استفاده شد.
یافته هانتایج تحلیل دیداری نمودارها حاکی از تفاوت معنی دار در بین موقعیت مداخله و خط پایه برای هر 4 آزمودنی در متغیر شدت فلج حرکتی اندام تحتانی (PND 60 درصد برای آزمودنی 1، 80 درصد برای آزمودنی 2 و 3 و 40 درصد برای آزمودنی 4) بود. به بیان دیگر، میزان تونیسیته عضلانی افراد نمونه پس از مداخله افزایش یافته بود. همچنین در موقعیت پیگیری (1 ماه و یک هفته بعد) این میزان در افراد حفظ شده بود.
بحث و نتیجه گیرینتیجه پژوهش حاضر نشان داد که درمان بیوفیدبک الکترومیوگرافی بر تونیسیته عضلانی اندام تحتانی بیماران سکته مغزی ایسکمیک و هموراژیک موثر بوده است.
کلید واژگان: :بیوفیدبک الکترومیوگرافی, فلج حرکتی, اندام تحتانی, سکته مغزی - ایسکمیک, هموراژیک}Background and AimsStroke is the most important cause of disability among adults. Although most stroke patients regain the ability to move independently, many will have persisting problems with mobility due to impaired balance and motor weakness. It seems imperative to use effective therapeutic methods in order to improve disability conditions of stroke patients. The present study aimed to investigate the efficacy of electromyography biofeedback on motor paralysis of the lower extremities in patients with ischemic and hemorrhagic strokes in Isfahan city.
Materials and MethodsThis study was carried out based on a multiple baseline with a staging initiation of treatment. The subjects were comprised of 4 patients with ischemic and hemorrhagic strokes who were referred from neurologic clinics. The patients firstly were selected according to a purposeful procedure. Then, they were identified according to an interview administered by the neurologist and reviewing their medical records, and finally 4 subjects were randomly selected as the sample. In this study, Motor Arm & Grading Motor Leg questionnaire was used to collect the data.
ResultsThe results of data chart visual analysis revealed a significant difference between the intervention and baseline phases for 4 patients considering motor paralysis of the lower extremities (PND 60% subject number 1 & 80% subject number 2&40% subject number 3 & subject number 4). In other words, motor paralysis of the lower extremities in the sample had reduced. The motor paralysis remained stable in the follow up phase (1 month and 1 week after intervention). As a result, electromyography biofeedback treatment had reduced the motor paralysis.
ConclusionUsing electromyography biofeedback can be an effective way in preventing or reducing motor paralysis in patients with stroke.
Keywords: Biofeedback, Motor paralysis, Lower extremities, Hemorrhagic, Ischemic, Stroke} -
BackgroundCrushed fingers are one of the most common reasons that patients visit the emergency centers for hand surgery, and based on the level of injury, it can cause many disabilities for patients. It is difficult to decide the treatment strategies (amputation, aggressive revascularization, immediate or delayed complex reconstruction and immediate conservative treatment) for crushed fingers..ObjectivesThe current study aimed to compare the blood sugar (BS) levels measured by the glucometer in healthy and crushed fingers to predict gangrene in patients referred to 15 Khordad Hospital in Tehran, Iran..MethodsThis cohort study was conducted on 265 patients with crushed fingers referred to the emergency center of 15 Khordad hospital in Tehran, Iran, from March 2015 to March 2016. Blood glucose levels were measured by glucometer in the crushed fingers and in the finger of the opposite side at the same time and measurements were recorded. Data were analyzed using t-test and chi-square test with SPSS software version 22..ResultsThe results showed that 317 crushed fingers of 265 patients were ischemic based on the color, temperature, capillary refill time and pulse oximetry and accordingly the vascular reconstruction was not possible. Of 317 crushed fingers, 61 (19.24%) became gangrene (all with sugar levels lower than 37). The mean BS levels of the amputated and non-amputated fingers were 33.5 ± 1.52 and 111.04 ± 15.27 mg/dL, respectively. Therefore, there was a significant difference in the mean BS level between the patients with amputated and non-amputated fingers (PConclusionsThe lower levels of sugar in crushed fingers compared to healthy fingers can help to diagnose gangrene in crushed fingers..Keywords: Ischemic, Gangrene, Blood Sugar, Glucometer}
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Background and AimStroke is the second common cause of deaths and the third common cause of disability-adjusted life years worldwide in 2010, so knowledge of risk factors within a certain country is an essential step in reducing the stroke rate and resulting disease burden .
Methods & Materials: This was a casecontrol study to determine and assess risk factors influencing ischemic stroke. In this study, 72 stroke patients hospitalized in Firoozgar Hospital of Tehran city for ischemic stroke from June 2012 to September 2013 were considered as a case group, and 72 individuals were selected as a control group that referred to the same laboratory of the hospital due to the causes other than risk factors for cardiovascular disease. The association between various risk factors such as history of cardiovascular disease, hypertension, diabetes mellitus, migraines, and stroke has been investigated. Multivariate regression analysis was implemented to estimate the odds ratio (OR) of each risk factor for stroke events.ResultsFindings showed that according to multivariate logistic regression, factors such as a history coronary heart disease (OR = 23.33, P = 0.002) and hypertension (OR = 6.9, P = 0.001), low high-density lipoprotein (HDL) (OR = 6.84, PConclusionFollowing this hospital-based study of Iranians, we demonstrated that among various risk factors, history of coronary heart disease, hypertension, as well as low HDL, and history of coronary heart disease and cerebrovascular disease in first degree relatives are the strongest independent predictors of stroke.Keywords: Stroke, Ischemic, Risk factors} -
Background And AimOxidative stress is a major mechanism involved in stroke pathogenesis. The present study evaluated and compared oxidative stress parameters in patients with ischemic and hemorrhagic stroke (IS and HS) at the time of hospitalization and 1 week after hospitalization.MethodsThis was a case-control study with 87 stroke patients (58 IS and 29 HS) as the case and 58 normal individuals as the control group. Sampling was done at the time of hospitalization and after 1 week. The serum total antioxidant capacity (TAC), thiol group, and F2-isoprostan levels were measured using Ferric Reducing Antioxidant Power (FRAP), Elman, and Enzyme Linked Immunosorbent Assay ELISA methods, respectively.ResultsAt the time of hospitalization, there was no significant difference in TAC and F2-isoprostan levels between the case and control groups (TAC for IS = 852.4 ± 238.9, HS = 1064.1 ± 271.1, and control = 947.6 ± 203.1 µmol/L; P = 0.074), yet, the thiol group levels were significantly lower (PConclusionsThe results showed that antioxidant defense status in stroke patients was lower than for the control group. Improving the antioxidant defense system, especially for HS patients by strategies such as natural antioxidant consumption is suggested.Keywords: Ischemic, Hemorrhagic, Oxidative Stress, Thiol, Total Antioxidant Capacity, Antioxidant Enzyme, NIHSS}
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گیاه مریم گلی از خانواده ی نعنائیان می باشد که بیشتر خواص دارویی پیچیده ی آن مربوط به حضور فنولیک ها می باشد. این گیاه با داشتن خاصیت آنتی اکسیدانی قادر است رادیکال های آزاد اکسیژنی را که در طی قطع و برقراری مجدد جریان خون به وجود می آید ، پاکسازی نماید. در این تحقیق با هدف بررسی اثر عصاره ی گیاه مریم گلی لاله زاری بر تعداد سلولهای لایه های مختلف قشر مخچه ناشی از قطع و برقراری مجدد جریان خون در سرخرگ کاروتید مشترک چپ و سرخرگ مهره ای چپ ، تعداد 35 موش صحرایی نر بالغ به طور تصادفی به 7 گروه 5 تایی تقسیم شدند. گروه1 (کنترل منفی): نمونه گیری بدون ایجاد ایسکمی ، گروه2 (کنترل مثبت):ایجاد ایسکمی در مخچه از طریق بستن سرخرگ کاروتید مشترک چپ و سرخرگ مهره ای چپ به مدت 10 دقیقه با تجویز سالین نرمال. گروه3 (شم): دستکاری سرخرگ کاروتید مشترک چپ و سرخرگ مهره ای چپ بدون ایجاد ایسکمی با تجویز سالین نرمال. گروه های درمان ( 4 ، 5 ، 6 و 7): بستن سرخرگ کاروتید مشترک و سرخرگ مهره ای چپ به مدت 10 دقیقه. گروه 4: تجویز عصاره آبی الکلی مریم گلی mg/kg BW2/3 ، دو ساعت بعد از ایجاد ایسکمی. گروه 5 : تجویز داروی سیلیمارین mg/kg BW 50 ، دو ساعت بعد از ایجاد ایسکمی. گروه 6: تجویز عصاره آبی الکلی مریم گلی mg/kg BW2/3 ، 72 ، 48 ، 24 و 0 ساعت قبل از ایجاد ایسکمی. گروه 7: تجویز داروی سیلیمارین mg/kg BW 50، 72 ، 48 ، 24 و 0 ساعت قبل از ایجاد ایسکمی. 24 ساعت بعد از قطع و برقراری مجدد جریان خون، موش ها توسط بیهوشی عمیق معدوم و پس از خونگیری، نمونه گیری از مخچه صورت گرفت. سپس برش های بافتی از هر نمونه به صورت سریال تهیه و با رنگ آمیزی متداول هماتوکسیلین- ائوزین رنگ شدند و شمارش سلول ها در قشر مخچه انجام گرفت. نتایج به دست آمده از شمارش سلول های عصبی قشر مخچه بیانگر کاهش معنی دار تعداد سلول های عصبی در لایه گرانولار در گروه ایسکمی بدون درمان و گروه هایی که تجویز عصاره ی مریم گلی و داروی سیلیمارین، دو ساعت بعد از ایسکمی انجام گرفت ، می باشد (05/0 < P). در حالی که در تعداد سلولهای این لایه در گروه هایی که تجویز عصاره ی مریم گلی و داروی سیلیمارین قبل از ایجاد ایسکمی انجام گرفته بود کاهش آشکاری مشاهده نگردید. اما تعداد سلولهای لایه مولکولار و پورکینژ درگروه های فوق الذکر اختلاف معنی داری نسبت به گروه کنترل نشان ندادند(05/0 P). در نهایت با استناد به تحقیق انجام شده می توان گفت که با ایجاد ایسکمی در مخچه، تعداد سلولهای عصبی لایه گرانولار قشر مخچه کاهش می یابد. پیش درمانی با عصاره ی مریم گلی لاله زاری و داروی سیلیمارین، در عدم تغییر این فاکتور ها تاثیر خواهد داشت. اما تجویز عصاره ی مریم گلی و سیلیمارین بعد از ایجاد ایسکمی تاثیری در بهبود این فاکتورها ندارد. بنابراین پیش درمانی با عصاره ی گیاه مریم گلی لاله زاری با اثری مشابه داروی سیلیمارین در بهبود عوارض ناشی از ایسکمی در مخچه موثر است.کلید واژگان: عصاره ی مریم گلی لاله زاری, سیلیمارین, قشر مخچه}Armaghane-danesh, Volume:21 Issue: 6, 2016, PP 536 -551The salvia is one of the membranes of the Laminaceae family that its pharmacologic effects are associated to Phenolics. According to its antioxidative effect, it can remove the free O2 radicals which produced during ischemia reperfusion. In this study in order to investigate the effect of Salvia rhytidea extract on changes of cellular numbers in different layers of cerebellar cortex following ischemia and blood reperfusion in left common carotid and left vertebral arteries, 35 adult male rats were randomly divided into 7 groups of 5 rats:Group 1 (control-): Sampling whitout ischemia. Group 2 (control ): Cerebellar ischemia induced by left common carotid and left vertebral arteries occlusion with administration of normal saline. Group 3(sham): Manipulation of the left common carotid and the left vertebral arteries whitout ischemia with normal saline administration. Treatment groups (4 , 5 , 6 and 7):Cerebellar ischemia induced by the left common carotid and left vertebral arteries occlusion. Group 4 received (3.2 mg/kg) aqueous and alcoholic Salvia extract 2 hours after ischemia. Group 5 received 50 mg/kg silymarin drug, 2 hours after ischemia. Group 6 received 3.2 mg/kg aqueous and alcoholic Salvia extract 72, 48, 24 and 0 h before ischemia. Group 7 received silymarin drug (50 mg/kg), 72, 48, 24 and 0 h before ischemia. 24 h following reperfusion, the rats were euthanized, and after blood collection, samples of the cerebellum were obtained. By using routine histological technique, the sections were stained by H&E. The measurement of cell count in cerebellar cortex were accomplished.
The neuronal cell counting of cerebellum revealed that neuronal cell numbers in granular layer significantly decreased in ischemic group without treatment and in groups that received salvia extract and silymarin 2 h after ischemia compared to the control (P˂0.05).While there was no significant decrease in the number of cells of this layer in the groups that received salvia extract and silymarin before ischemia. But the cell number of molecular and purkinje layers in above groups no significant difference observed compared to the control group (P˃0.05).
Finally, according to this study, following cerebellar ischemia, the number of neuronal cells in granular layer of cerebellar cortex decreased. But pretreatment with Salvia rhytidea extract and silymarin did not change this factor. But administration of salvia extract and silymarin after ischemia, does not affect improving the number of neuronal cells in granular layer. So pretreatment with Salvia rhytidea extract silimar to silymarin drug improves the cerebellar injuries following ischemia.Keywords: Ischemic, Salvia rhytidea, Rats} -
Pharmacotherapy Updates of Recombinant Tissue Plasminogen Activator (r-TPA) in Acute Ischemic StrokeContext: According to published articles, thrombosis is the main reason for death all over of the world. With stroke time missing is brain missing, therefore, the FDA-approved drug r-TPA, could be administered as initial IV bolus in less than 3 - 4.5 hours from onset of Acute Ischemic Stroke (AIS). The aim of this review was to provide updated pharmacotherapy related to r-TPA in AIS.
Evidence Acquisition: Searches for associated published articles were conducted in major databases until September 2015. The main terms used in the search were a combination of words and phrases such as ischemic stroke and tissue plasminogen activator.ResultsAge, time of onset, systolic blood pressure, diabetes, stroke severity, co-morbidities and premorbid medical situation, stroke scale according to national institute of health and outcomes related to CT (head, angiogram and perfusion) were considered when determining successful treatment by endovascular thrombectomy. According to the 2015 guidelines, strategies related to successful pharmacotherapy management should be based on class I evidence-care on a stroke unit, IV-r-TPA within 3 - 4.5 hours of stroke onset, aspirin commenced within 48 hours of stroke onset, and decompressive cranioctomy for supratentorial malignant hemispheric cerebral infarction. Hemorrhagic stroke (intraparenchymal, subarachnoid, intraventricular, intracerebral such as orolingual angioedema), hematoma (epidural and subdural) and head trauma are the absolute contraindications related to r-TPA prescription..ConclusionsDue to considerable inter- and intra- heterogeneity among studies performed by other centers such as differences in study project, background, and population features, determining a pharmacotherapy model based on Safe Implementation of Treatments in stroke or SITS seem advantageous..Keywords: TPA, Ischemic, Stroke, Pharmacotherapy} -
مقدمهادم ایسکمیک مغزی یکی از مهم ترین عوارض سکته مغزی می باشد که بروز آن سبب تشدید ضایعه ایسکمیک ابتدایی مغز می شود. در این مطالعه تلاش شده است ارتباط بین اثر پیش تغذیه روغن دانه کتان بر سطح چربی های خون و میزان بروز ادم مغزی را در مدل سکته مغزی رت مشخص شود.مواد و روش هااین تحقیق به صورت تجربی روی 5 گروه که شامل 7 سر موش صحرایی نر بود انجام گرفت. گروه شاهد آب مقطر دریافت کردند در حالی که سه گروه تیمار، روغن دانه کتان را از طریق گاواژ 30 روز به صورت روزانه دریافت می کردند(25/0، 50/0 و 75/0 میلی لیتر بر کیلوگرم وزن بدن به ترتیب). برای گروه شم تیمار و القای ایسکمی صورت نگرفت. دو ساعت بعد از آخرین گاواژ گروه ها تحت جراحی مدل MCAO (انسداد شریان میانی مغز) به منظور القای ایسکمی و بررسی ادم مغزی و چربی های خون قرار گرفتند. داده ها با استفاده از آزمون ANOVA تجزیه و تحلیل شدند.
یافته های پژوهش: پیش تیمار با روغن دانه کتان باعث کاهش کلسترول، تری گلیسرید و LDL، هم چنین باعث افزایش سطحHDL در دوزهای 50/0 و 75/0 گردیده و پیش تغذیه توسط روغن دانه کتان باعث کاهش میزان ادم مغزی بعد از MCAO در رت ها گردید.بحث و نتیجه گیرینتایج این مطالعه نشان داد که روغن دانه کتان با دوز های 50/0 و 75/0 می تواند از ادم مغزی در موش های صحرایی دچار ایسکمی محافظت نماید و میزان لیپیدهای سرم را کاهش دهد.کلید واژگان: کلسترول, تری گلیسرید, روغن دانه کتان, ایسمکی, ادم مغزی}IntroductionCerebral ischemic edema is one of the most important complication of cerebral stroke that result in intensification of early (primitive) ischemic lesion in brain. In this study¡ we determinate relationship between effect of pre-nutrition of flax seed oil on level of blood oils and the amount of cerebral edema in model of rat stroke.Materials and MethodsThis study was performed on 5 groups included 7 male rats. Blank group received distil water¡ where 3treatment groups received flax seed oil by gavage 30 days. (0.25¡0.50¡0.75). For sham group isn''t performed treatment and ischemic induction. Two hours after the last gavege¡ group operated by surgery of model MCAO(Middle Cerebral Artery Occlusion) for ischemic induction and study of cerebral ischemic and blood oils. Data were analyzed by test ANOVA investigation.
Findings: Pretreatment with flax seed oil resulted in decrease of cholesterol¡ triglycerides and LDL and also resulted in increase of level of HDL in doses of 0.50 and 0.75(PDiscussion &ConclusionResults of this study indicated that flax seed oil with doses of 0.50 and 0.75 protected ischemic rat in contrast to cerebral edema and decreased the amount of serum lipids.Keywords: Cholesterol, Triglycerides, Flaxseed oil, Ischemic, Cerebral edema} -
Biolmpacts, Volume:5 Issue: 4, Dec 2015, PP 183 -190IntroductionRetinal capillary nonperfusion (CNP) is one of the retinal vascular diseases in diabetic retinopathy (DR) patients. As there is no comprehensive detection technique to recognize CNP areas, we proposed a different method for computing detection of ischemic retina, non-perfused (NP) regions, in fundus fluorescein angiogram (FFA) images.MethodsWhilst major vessels appear as ridges, non-perfused areas are usually observed as ponds that are surrounded by healthy capillaries in FFA images. A new technique using homomorphic filtering to correct light illumination and detect the ponds surrounded in healthy capillaries on FFA images was designed and applied on DR fundus images. These images were acquired from the diabetic patients who had referred to the Nikookari hospital and were diagnosed for diabetic retinopathy during one year. Our strategy was screening the whole image with a fixed window size, which is small enough to enclose areas with identified topographic characteristics. To discard false nominees, we also performed a thresholding operation on the screen and marked images. To validate its performance we applied our detection algorithm on 41 FFA diabetic retinopathy fundus images in which the CNP areas were manually delineated by three clinical experts.ResultsLesions were found as smooth regions with very high uniformity, low entropy, and small intensity variations in FFA images. The results of automated detection method were compared with manually marked CNP areas so achieved sensitivity of 81%, specificity of 78%, and accuracy of 91%.The result was present as a Receiver operating character (ROC) curve, which has an area under the curve (AUC) of 0.796 with 95% confidence intervals.ConclusionThis technique introduced a new automated detection algorithm to recognize non-perfusion lesions on FFA. This has potential to assist detecting and managing of ischemic retina and may be incorporated into automated grading diabetic retinopathy structures.Keywords: Capillary, nonperfusion, Ischemic, retina, Image, processing, analysis, Diabetic, retinopathy, Fluorescein angiography, Diagnostic imaging}
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Background and AimStroke in young adults is rare but can be devastating for the affected individuals and their families. Some triggers of stroke may be acute but transient effects on the pathophysiological condition while other factors may be effective overa longer period.
Methods & Materials:This study was a case-crossover study on 18 young adults. The study included patients aged 15-49 years who hospitalized for ischemic stroke for the first time from June 2012 to September 2013. In this study, mental health status was considered during the 6-month period so that exposure within 1 month of stroke onset (hazard period) was compared with exposure during five control periods of 1 month preceding the hazard period.ResultsConditional logistic regression showed there was an association between mental health and stroke so that for every 5 unit increase in mental health, odds of stroke will increase about 13-fold.In the other words, much higher scores on mental health, mental health condition weaker.ConclusionMental health status is associated with the occurrence of ischemic stroke in young adults so that whatever mental health condition weaker odds of ischemic stroke incidence is high.Keywords: Mental health, ischemic, stroke, young adults, case, crossover} -
BackgroundThe hippocampus is a tiny nub in the mammalian brain that is involved in forming, organizing, and storing memories. Global cerebral ischemia (GCI) and reperfusion induced apoptosis lead to cell injury and death. FK-506 is a strong immunosuppressant drug that has neuroprotective effects on the hypoxic-ischemic effects of brain damage. BAD and Bcl-xL are pro-apoptotic and anti-apoptotic genes, respectively. These genes belong to The B-cell lymphoma-2 (Bcl-2) family..ObjectivesIn this study, we assessed the neurotrophic properties of FK-506 on expression of the BAD and Bcl-xL genes in the hippocampus following global ischemia and reperfusion..Materials And MethodsIn the present experimental study, adult male Wistar rats were obtained and housed under standard conditions in the Tehran University of Medical Science in Iran. Rats were equally distributed in groups of three among the following groups: normal control, treated-1 (ischemia/reperfusion), and treated-2 (ischemia/reperfusion followed by FK-506). Global ischemia was induced for animals in the treated-1 and treated-2 groups. In treated-2, two doses of FK-506 were injected: one dose as an IV injection immediately after reperfusion and another as an intra-peritoneal (IP) injection after 48 hours. Then, the hippocampus tissue was removed after anaesthetizing the rats. RNA was isolated, cDNA was synthesized, and real-time PCR was performed. Finally, the obtained data were analyzed statistically (P value 0.05)..ResultsThe quantitative results of real-time PCR show that the mRNA expression ratio of Bcl-xL down-regulated was 0.75 ± 0.06 in the ischemia/reperfusion group versus 1.57 ± 0.09 in the control group (P value < 0.001), whereas Bcl-xL gene expression was greater in the ischemia/reperfusion +FK506 group (1.93 ± 0.15) than in the ischemia/reperfusion group. Moreover, the mRNA expression ratio of BAD up-regulated in the ischemia/reperfusion + FK506 group was 3.65 ± 0.49 compared to Normal control (1.39 ± 0.09) and Ischemia/reperfusion + FK506 was 1.09 ± 0.20 (P value < 0.001)..ConclusionsThe analysis of the pro-apoptotic gene to anti-apoptotic gene expression ratio (BAD /Bcl-xL) confirmed that expression of the pro-apoptotic gene significantly decreased (P value 0.001) under the ischemia/reperfusion condition. In contrast, the expression of the anti-apoptotic gene increased after administration of FK-506 (P value 0.001)..Keywords: Ischemic, Reperfusion, Real, Time RT, PCR, Hippocampus, Tacrolimus, Bcl, xL Gene, BAD Gene}
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Cardiovascular diseases are still the main cause of mortality around the world. Therefore, it is essential to develop practical means to reduce their burden. A wealth of evidence supports the role of physical exercise in attenuating many of the risk factors of cardiovascular diseases. Moreover, endurance training warrants protection against myocardial infarction. Exercise, even if performed only in a few days, can protect the heart against ischemia-reperfusion (IR) injury, and this protection will be even more in longer exercises. It is yet to be clarified how exercise maneuvers provide protection against IR. However, it is suggested that some molecular and cellular mechanisms in addition to metabolic and hormonal alterations are seemingly involved in exercise-induced cardioprotection (EICP), such as increased capacity of antioxidant system, higher expression of heat shock proteins, improvement in ATP-sensitive potassium channels, change in nitric oxide production, and adaptive cardiac mitochondrial modulations. This paper discusses the current data on molecular and cellular mechanisms of EICP. Understanding the molecular basis of EICP against IR injury will provide us with the required knowledge for development of preventive and therapeutic approaches. In addition, exercise characteristics leading to more pronounced cardioprotection will be concisely addressed.Keywords: Exercise, Ischemic, reperfusion, Cardioprotection}
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زمینه و هدفسکته مغزی، به عنوان سومین علت مرگ و مهمترین عامل ناتوانی در دنیا به شمار می رود. مطالعات اخیر نشان داده اند که روغن زیتون، دارای اثرات آنتی اکسیدانی قوی در زمان ایسکمی مغزی است. مطالعه حاضر، با هدف بررسی محافظت عصبی احتمالی روغن زیتون بر ضایعه مغزی و اختلالات عصبی در مدل ایسکمی موضعی گذرا در موش صحرایی انجام شد.
روش تحقیق: در این مطالعه تجربی، از 30 سر موش صحرایی بالغ نر نژاد ویستار، در محدوده وزنی 270 تا 320 گرم استفاده شد. موش ها، در سه گروه (هر گروه 10 سر) شامل: گروه شاهد، گروه کنترل ایسکمی و گروه ایسکمی تیمارشده قرار گرفتند و آزمایش بر روی آنها انجام شد. ایسکمی مغزی، با 80 دقیقه انسداد شریان میانی مغز (MCAO) و 24ساعت خونرسانی مجدد انجام گردید. روغن زیتون با دوز یک میلی لیتر بر کیلوگرم، به صورت داخل صفاقی، در شروع ایسکمی تزریق شد. ارزیابی اختلالات عصبی-حرکتی (NDS) و حجم ضایعه (رنگ آمیزی TTC) و مطالعات بافت شناسی، 24 ساعت پس از MCAO انجام گرفت.یافته هاروغن زیتون، به طور معنی داری توانست حجم ضایعه را در قشر و جسم مخططبه ترتیب: 65% و 52% کاهش دهد؛ همچنین این روغن توانست اختلالات عصبی-حرکتی را در موش های ایسکمی شده، از 1/0±4/3 به 2/0±5/2 در گروه تیمارشده کاهش دهد. در بررسی های بافت شناسی، روغن زیتون، تعداد نورون های ائوزینوفیلیک و آسیب دیده نواحی ایسکمی را کاهش داد (001/0P<).نتیجه گیرییافته های این مطالعه نشان داد که روغن زیتون، به طور موثری آسیب های ایسکمی/خونرسانی مجدد را کاهش داده و اختلالات عصبی-حرکتی را بهبود می بخشد؛ همچنین روغن زیتون به عنوان عامل محافظت کننده عصبی، قادر است از تخریب نورونی در ایسکمی مغزی موضعی گذرا و مرحله اولیه خونرسانی مجدد جلوگیری نماید.
کلید واژگان: ایسکمی, خونرسانی مجدد, روغن زیتون, محافظت عصبی, ضایعه مغزی}Background And AimStroke is the third leading cause of death and the most important factor of disability in the world. Recent studies have shown that olive oil has antioxidant effects during cerebral ischemia. The present study investigated the probable protective effects of olive oil on the brain infarction and neurological disability after a transient model of focal cerebral ischemia/reperfusion in rats.Materials And MethodsIn this experimental study, 30 adult male wistar rats whose weight ranged 270-320 g were divided into three equal groups. : sham, control ischemia, and ischemia treated. . Transient focal cerebral ischemia was induced by means of 80 min middle cerebral artery occlusion (MCAO) followed by 24 hours reperfusion. Olive oil(1 ml/kg) was intraperitoneally injected into the cases at the beginning of ischemia. Neurologic outcome (NDS scale), infarct volume (TTC staining) and histological studies were done 24 hours after the end of MCAO.ResultsTreatment with olive oil significantly reduced the cortical and striatal infarct volume by 65% and 52%, respectively. Olive oil also decreased the NDS of ischemic rats from 3.4±0.1 to 2.5±0.2 in the treated group. Besides, histological studies showed that olive oil reduced the number of eosinophilic and damage neurons in the ischemic area (P< 0.001).ConclusionThe findings of the current study indicated that olive oil effectively reduced ischemia, helped to the reperfusion of injuries, and improved neurological outcome. Olive oil is also a potent neuroprotective factor that is able to prevent neurodegeneration of transient focal ischemia in the beginning of reperfusion at ischemic areas.Keywords: Ischemic, reperfusion, Olive oil, Neuroprotection, Brain infarction}
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