Serum Iron and Free Hemoglobin Concentrations in Patients with Acute Ischemia Stroke

A number of evidences suggest that during ischemic stroke, serum iron and hemoglobin (Hb) levels are changed. Yet, there are few reports in the literature related to this issue and resolution of this mechanism requires further experiments. The aim of the present study was to investigate the potential role of serum iron and hemoglobin levels as a  biomarker in diagnosis of acute ischemic stroke.  The sample size was  60 ischemic  stroke patients who were admitted to the Rouhhani hospital in Babol, with 60 healthy volunteers selected as control group. Clinical evaluation consisted of complete medical history and physical examination and neuro-imaging's  studies. Sampling strategy was  based on clinical characteristics, including age, gender, and history of diseases. Laboratory measurements were performed in the department of clinical biochemistry. Serum iron and plasma hemoglobin levels were measured by standard kit of iron and hemoglobin ELISA Kit, as of the manufactures' manual. Data were analyzed through statistical software SPSS version 22. The mean level of serum iron and hemoglobin in patients with acute ischemic stroke were higher than those in control group (P<0.05). However, there was no relation between these biomarkers and age and gender of subjects (P>0.05). Our results reinforce the possibility of serum iron and hemoglobin as biomarker in diagnosis of ischemic stroke patients

Examining the frequency of dysphagia and the predictive factors of dysphagia that require attention in patients with Parkinson's disease

Introduction. Due to the prevalence of dysphagia in patients with Parkinson's disease (PD) and its complications such as aspiration pneumonia, which is the main cause of death in these patients, PD-related disability can be prevented by early diagnosis and treatment of dysphagia. Objective. The present study was aimed at investigating the frequency of dysphagia in PD patients. Materials and methods. This cross-sectional study included 150 PD patients visiting a Neurology Clinic. The severity of PD was determined based on the Unified Parkinson Disease Rating Scale (UPDRS) and modified Hoen and Yahr (HYS) Scale. The Munich Dysphagia Test-Parkinson's disease (MDT-PD) questionnaire was used to assess dysphagia. Comparisons were made using generalized Fisher exact, Chi-square, ANOVA, and KruskalWallis tests. Predictive factors were analyzed using logistic regression. Statistical analyses were performed at significance level of 0.05. Results. Out of all 150 patients referred to the Clinic, the prevalence of dysphagia requiring attention was 25.3% (n = 38). The patients of the three groups according to the MDT-PD (no noticeable dysphagia, noticeable oropharyngeal, and dysphagia with aspiration risk) had a significant difference only in terms of the PD duration (p 0.001). In the predicting of dysphagia, the longer PD duration (p = 0.011) and homemaker occupation (p = 0.033) were protective factors, while female gender was a risk factor (p = 0.011). Conclusion. The prevalence of dysphagia requiring attention in the studied patients was 25.3%. It decreased with the longer duration of the disease, and its prevalence was lower in homemaker patients, while the odds of dysphagia was 5.8 times higher in women than in men

Increased Zinc Serum Level: New Clues in Babol Stroke Patients, Northern Iran

Background. Stroke is the second leading cause of death worldwide. The role of zinc as a new predictor of stroke was considered. Methods. This prospective study was conducted in Ayatollah Rouhani Hospital within a year on 100 stroke and 100 control patients. Findings. The difference in zinc serum level in two groups was significant (deficiency: 3 (3%) in patients versus 20 (20%) in control group, normal: 25 (25%) versus 54 (54%), and increased level: 72 (72%) versus 26 (26%); p<0.001). Difference in zinc serum levels was statistically significant with ischemic heart disease (deficiency: 0 cases (0%), normal: 8 cases (24%), increased level: 24 cases (75%), p=0.003). Increases in zinc serum level were significantly correlated with the frequency of hemorrhagic and ischemic patients (deficiency: 3 (3.3%) hemorrhagic versus 0 (0%) ischemic; normal: 19 (21%) versus 6 (60%), increased level: 68 (75.6%) versus 4 (40%); p=0.025). Regression logistics showed that ischemic heart disease (p<0.001; OR = 28.29, %95 CI: 5.53; 144.87), hyperlipidemia (p<0.001; OR = 0.26, %95 CI: 0.12; 0.56), and zinc serum level (p<0.001, OR = 15.53, %95 CI: 4.03; 59.83) each had a significant role. Conclusions. Babol stroke patients are prone to increased zinc serum level as a new parameter. Ischemic heart disease, increased levels of zinc, and hyperlipidemia were found to be probable predictor factors for stroke in Babol

Prevalence of headache at the initial stage of stroke and its relation with site of vascular involvement. a clinical study

Background: Stroke is the most common neurologic disease and an important cause of morbidity and mortality. Headache is an initial presenting feature of ischemic stroke and sometimes preceedes the development of stroke and thus, provides an opportunity for offering preventive measures. The aim of the present study was to determine the association of new onset headache with stroke. Methods: A total of 263 consecutive patients with stroke entered the study. Development of headache 24 have prior to admission lasting <3 days was considered the new onset headache. The intensity of headache was graded as mild, moderate and severe. Stroke was classified with respect to the localization of brain damage using magnetic resonance image (MRI). Chi-square test was applied for comparison of proportions.  Results: One hundred thirty-nine males and one hundred twenty-four females with mean age of 76.4±10 (40-89) years were analyzed. Ischemic stroke involving anterior circulation was diagnosed in 210 (79%) patients and vertebrobasilar ischemia in the remaining population. Diabetes, hypertension, hyperlipidemia and coronary artery disease were observed in 36%, 52%, 38% and 42%, respectively. New onset headache was found in 49 (18.9%) patients in who 81.6% was mentioned as new onset. Six out of 9 patients with severe headache had involvement of posterior circulation, whereas in the remaining population, anterior circulation was involved. Conclusion: The findings of this study indicate no association of new onset headache with stroke. There was only a trend for severe headache toward the involvement of vertebrobasilar ischemia

Evaluation of Serum Magnesium, Iron, Copper and Zinc Levels in Ischemic and Hemorrhagic Stroke Patients and Healthy Controls

Introduction: Many studies have shown a relationship between serum level of trace elements and risk of stroke, but the exact mechanism of this relationship is not clear. The purpose of this study was to measure changes of serum magnesium, iron, copper, and zinc levels in ischemic and hemorrhagic stroke patients to evaluate their potential diagnostic utility.Materials and methods: Overall, 53 healthy individuals (30 men, 32 women) and 53 ischemic and hemorrhagic stroke patients (30 men, 23 women) who were admitted to the Rouhani Hospital in Babol (Iran) were enrolled in the study within 24 hours after stroke onset. Diagnosis was made based on medical history and physical examination by a neurologist. After blood sampling, serum copper was assessed by atomic absorption spectrophotometry, and zinc, magnesium and iron levels were assessed by spectrophotometry. Data analysis was performed in SPSS (version 21) using independent sample t-test and chi-square test. Results: Serum concentrations of copper was significantly higher in the patients (58.8 ±14.7 mg/dL) compared with the controls (45.7 ±10.0 mg/dL). Serum concentrations of zinc was significantly higher in the patients (113.2 ±17.3 mg/dL) compared with the controls (95.60 ±12.80 mg/dl). Moreover, serum concentrations of iron was significantly higher in the patients (148.5 ±30.4 mg/dL) compared with the controls (74.22 ±33.3 mg/dL). However, the patients (1.4 ±0.8 mEq/L) had significantly lower level of magnesium level compared to the controls (2.1 ±0.3 mEq/L). Conclusions: Our results suggest that evaluation of serum magnesium, iron, copper and zinc levels in ischemic and hemorrhagic stroke patients may be useful for the prediction and diagnosis of stroke status

Original Article Seyed-Reza Hossini (MD) 2* Associated factors of headache in an unstudied cohort of elderly subjects

Abstract Background: Headache and depression are prevalent among general population. The aim of this study was to determine the associated factors of headache in elderly subjects with emphasis to depression. Methods: All cohort of elderly individuals of the Amirkola Health Study Project were included. Data regarding several clinical and demographic characteristics were provided via fill in quesstionnaire, interview and clinical examination. Presence and duration as well as severity of headache were collected through an interview based on self-reported data. Diagnosis of depression was confirmed according to standard Geriatric Depression Scale (GDS) criteria. In statistical analyses chi-square test with logistic regression analysis was used for association. Results: A total of 832 men and 667 women aged &gt;/= 60 years old were studied. Headache and depression were diagnosed in 42% and 42.4% respectively. In depressed subjects, headache was significantly higher by OR=3.1(95% CI, 2.5-3.83, P=0.001). Proportions of headache increased by severity of depression with a dose-response pattern of relationship from 53.3% in mild depression to 72.6% in severe depression. The magnitude of OR for headache increased from 2.59 (95% CI, 2.03-3.31) in patients with mild depression to 6.04 (95% CI, 3.54-10.3) in patients with severe depression. After adjustment for all covariates, headache was significantly associated with female gender and back pain as well as with depression with a significant dose-response relationship. Conclusion: The findings of this study indicated an independent association between headache and psychological factors in elderly subjects, particularly in women

Analgesic Effect of Duloxetine Compared to Nortryptiline in Patients with painful Neuropathy: A Randomized, Double-Blind, Placebo-Controlled Trial

Background:&#160; Diabetic neuropathic pain (DNP) is a common complication of diabetes and has a profound effect on patients quality of life. Therefore. The purpose of the present study was to compare the analgesic effects of duloxetine and nortryptiline in the management of patients with diabetic neuropathy. Methods: This was a randomized, double-blind, parallel-group, placebo-controlled trial in subjects with a proven diagnosis of DM and suffered from neuropathic pain. Patients were recruited in this study from 20 February 2016 (first patient, first visit) to 22 June 2017 (last patient, last visit), including 5 weeks follow-up. A diagnosis of DNP was based on history, clinical examination, Nerve conduction velocity and Diabetic neuropathy symptom score (more than one point). Results: Both drugs reduced pain when compared with placebo. A significant VAS reduction from 6.4 at baseline to 3.75 at endpoint was observed in the duloxetine group. However, there was no significant difference in the efficacy between nortriptyline and duloxetine based on patientchr('39')s visual analogue scale (VAS) (p&#62;0.05). No clinically significant changes or serious adverse events were found among treatment groups including changes in vital signs, laboratory assessments, physical examination or electrocardiograms. The decrease in the mean pain intensity was significantly greater in the duloxetine and nortriptyline group compared to the placebo group both in the primary analysis and in the by-visit analysis (p&#60;0.003) Conclusions: The present study demonstrates the safety and effectiveness of both duloxetine and nortriptyline in the management of DNP

Evaluation of relationship between memory and temperament in 18-28 years old students

Background: Mizaj (Temperament) is a concept to express individual differences in Persian medicine and according to this theory, there is a relationship between Mizaj type and the abilities of different body organs. This cross-sectional study aimed to investigate the relationship between the type of Mizaj and the memory score (Quotient). Methods: The target population was the 18 to 38 years old students of Babol University of Medical Sciences. Mojahedi’s Mizaj questionnaire (MMQ) was used for determining the whole Mizaj. The physical Persian version of Wechsler Memory Scale III (WMS III) was used to assess memory score. The collected data were analyzed by SPSS Version 22 and the chi square (x2) and t-test were run and p- value 0.05 was considered as significant difference. Results: Forty-two of participants were females and 18 were males. The average age of them was 23.6 (21-27). The average of Memory Quotient (MQ) was 122.1 ± 5.7. The average of MQ in warm Mizaj was 125.46 ± 1.2 and in cold Mizaj was 118.79 ± 6.5. The difference between two groups is statistically significant (p< 0.001). The average of MQ in dry Mizaj was 124.16 ± 2.67 and in wet Mizaj was 118.40 ± 7.64. The difference between two groups is statistically significant (P= 0.005). Conclusion: The results showed there are significant relationship between memory score and warm/cold Mizaj and dry /wet Mizaj. It means students with warm or dry Mizaj had better memory score than students with cold or wet Mizaj. This relation was also detected between subtypes of memory and Mizaj expect between working memory and dry/wet Mizaj. These results are in accordance with theories in PM which indicate people with warm Mizaj and dry Mizaj have better memory and people with cold Mizaj and wet Mizaj have weaker memory and are more at risk of memory dysfunction