Traumatic Pneumorrhachis in a Young Male Motor Vehicle Accident Victim

Pneumorrhachis (PR), which involves the entrapment of air or gas within the spinal canal, is a rare clinical entity. The pathogenesis and etiology of this uncommon entity vary and may present a diagnostic challenge. Air in the spinal canal can be divided into primary and secondary PR, extra- or intradural PR and etiologically classified as iatrogenic, traumatic and non-traumatic. PR is typically asymptomatic but can be symptomatic–by itself or by its underlying pathology. The latter, although often severe, might be concealed and must be carefully examined to facilitate adequate patient treatment. Here we report a rare case of traumatic PR in a 28-year old man following a motor vehicle accident in northern Iran, who sustained paraplegia and sphincter dysfunction without any laceration and wound in the spinal area

Effect of Hydroalcoholic Extract of Stachys lavandulifolia on Pentylenetetrazole-induced Seizures in Male Mice: The Role of GABAergic and Opioidergic Systems

Introduction: Epilepsy is one of the most common neurological disorders. Though there are several effective drugs for treating epilepsy, most drugs are associated with side effects and drug interactions. Stachys lavandulifolia used in Iranian traditional medicine has proven anti-anxiety and sedative properties. The current study aimed to evaluate the anticonvulsant effect of hydroalcoholic extract of S. lavandulifoliaon the Pentylenetetrazole (PTZ)-induced seizure in male mice and the role of benzodiazepine and opioid receptors.  Methods: This study was conducted on 100 male mice, randomly categorized into 10 groups: Normal Saline (NS), two diazepam groups (0.025 and 0.1 mg/kg), three S. lavandulifolia extract groups (50, 100, and 200 mg/kg), diazepam 0.025 mg/kg+S. lavandulifolia extract 50 mg/kg, and three groups that pretreated with NS, flumazenil, or naloxone, 5 min before injection of 200 mg/kg S. lavandulifolia extract. After 30 min, PTZ (80 mg/kg) was injected into animals, and seizure indices were evaluated.  Results: The S. lavandulifoliaextract attenuated the PTZ-induced seizures in a dose-dependent manner, and pretreatment with flumazenil reversed this effect. However, pretreatment with naloxone could not reverse this effect because seizure indices in the naloxone pretreated group were lower than that in the normal saline group. The combination of an ineffective dose of diazepam and S. lavandulifoliaextract decreased PTZ-induced seizures.  Conclusion: The results of our study showed the anticonvulsant properties of hydroalcoholic extract of S. lavandulifolia. These effects might be due to the impact of the components of this extract on the central benzodiazepine system

Hydatid Disease of the Cervical Spine Mimicking Traumatic Burst Fracture

Background & Importance: Hydatid disease of the spine is rare but constitutes approximately 50% of bone involvement cases in human hydatidosis. It is a severe condition associated with a high rate of morbidity, disability and mortality. Case Presentation: In the present paper, we report an intriguing case of cervical spinal hydatid disease mimicking traumatic burst fracture. Conclusion: A high degree of suspicion combined with good-quality neuroimaging is important for early and correct diagnosis. Because of th

Simultaneous Diffuse Idiopathic Hyperostosis, Ossification of the Posterior Longitudinal Ligament and Ligamentum Flavum

Background and Importance: A 60-year-old diabetic man with simultaneous diffuse idiopathic hyperostosis, massive ossification of the posterior longitudinal ligament and cervical and higher part of thoracic ligamentum flavum is reported in this article. Such comorbidity rarely occurs. Case Presentation: The patient’s chief complaint was sensation abnormalities without gait disturbance or severe cord compression symptoms despite the advanced stage of the disease. Computed tomography scan and magnetic resonance imaging confirmed multi-level involvement of cervicothoracic spine. Conclusion: After surgical treatment, his symptoms resolved completely with no complication

Incidence of Spinal Cord Injury in Traumatic Patients Admitted to a Trauma Referral Center in Guilan

Background & Aim: Patients with spinal cord injury (SCI) impose a heavy burden on health care system. Awareness on prevalence and incidence of SCI is important because this would show the necessity of prevention. This study aimed to investigate the epidemiology and types of traumatic spinal cord injuries in a trauma referral center in Guilan. Methods & Materials/Patients: This is a descriptive study which was conducted on patients with spinal cord trauma using a questionnaire during one year. The questionnaire included demographic information, injured spinal cord area, mechanism of injury, and type of neural damage based on ASIA scale. The data were analyzed using SPSS18 and descriptive statistics. Results: Out of 76 study patients, 68 (88.2%) were men with mean age of 35.2 ± 1.45 years. The most common cause of SCI was motor vehicle accidents (MVA) (48.7%). 34 patients (44.7%) had cervical spine injury and in 23 patients (30.3%), thoraco-lumbar injuries caused SCI. 29.7% of patients suffered from paraplegia and 10.8% quadriplegia. 25 patients (38.5%) had complete SCI. 7 patients with SCI (9.2%) died during hospitalization. In this study, increased age was identified as a risk factor for death. In 4 of these patients (57.1%) cervical SCI was the underlying cause of death. Conclusion: Young men were the group at highest risk and the most mechanism leading to SCI was motor vehicle accidents. Many of these accidents are preventable; thus, more attention should be devoted to safety policies based on needs of the vulnerable groups. Besides, comprehensive education program with clear and practical goals should be developed

Outcomes and Complications of Incomplete Spinal Cord Injury in the Thoracolumbar Region

Background and Aim: Improvement of neurological disorders in patients with incomplete spinal cord injury (SCI) remains an important issue worldwide. This study aimed to explore the outcomes and complications of patients with incomplete SCI in the thoracolumbar region within one year after trauma. Methods and Materials/Patients: In this longitudinal prospective study, patients with traumatic incomplete SCI were studied. The demographic and clinical variables including age, sex, site of injury, motor force, sensory disorder, and sphincter dysfunction were recorded on admission and 3, 6, 9, and 12 months after discharge. SPSS software, version 28 was used for data analysis. Results: Out of 120 patients with incomplete SCI, 100 patients were included. The mean age of the participants was 32.39±7.47 years and the mean duration of hospitalization was 14.78±3.81 days. The most common injury site was T12-L1 (43%). Over time, the average motor force of patients increased. The lowest and highest averages were observed during hospitalization and 12 months after discharge, respectively. No significant difference was observed in the paired comparison of motor force at 3, 6, 9, and 12 months after discharge. The frequency of sensory disorders decreased over time. The highest and lowest frequencies belonged to the hospitalization time (81%) and 12 months after discharge (9%). No significant difference was observed between the time intervals of 6, 9, and 12 months, as well as the time of hospitalization and discharge. Over time, the frequency of sphincter dysfunction decreased. Pulmonary infection (12%) and bed sores (9%) were the complications observed during hospitalization. Complications observed 12 months after admission were bed sores (21%) and venous thrombosis (17%). Conclusion: The highest recovery rate of motor force was recorded within the first three months. The frequency of sensory and sphincter disturbances in patients decreased over time with the highest recovery rate during the first six months after the injury

Novel Ordered Mesoporous Carbon Based Sulfonic Acid as an Efficient Catalyst in the Selective Dehydration of Fructose into 5‑HMF: the Role of Solvent and Surface Chemistry

Novel ionic liquid derived ordered mesoporous carbons functionalized with sulfonic acid groups IOMC-ArSO₃H and GIOMC-ArSO₃H were prepared, characterized, and examined in the dehydration reaction of fructose into 5-hydroxymethylfurfural (5-HMF) both in aqueous and nonaqueous systems. To study and correlate the surface properties of these carbocatalysts and some other SBA-15 typed solid acids with 5-HMF yield, hydrophilicity index (H-index) were employed in the fructose dehydration. Our study systematically declared that almost a criterion may be expected for application of solid acids in which by increasing H-index value up to 0.8 the HMF yield enhances accordingly. More increase in H-index up to 1.3 did not change the HMF yield profoundly. Although, it has been shown that the catalyst with larger H-index (∼1.3) resulted in higher activity both in aqueous and 2-propanol systems, during the recycling process deactivation occurs because of more water uptake and the catalysts with optimum amount of H-index (∼0.8) is more robust in the dehydration of fructose

Association Between Serum Electrolyte Disturbances and Glasgow Coma Scale Score in Patients With Diffuse Axonal Injury

Background: Appropriate clinical measures to prevent secondary brain damage in traumatic brain injury are of critical importance. Objectives: This study aims to investigate the relationships between serum electrolyte disturbances and Glasgow Coma Scale (GCS) score in patients with Diffuse Axonal Injury (DAI) at the time of admission and discharge. Materials & Methods: In this retrospective cross-sectional study, we evaluated 101 patients with DAI having GCS score <15 admitted to Poursina Hospital in Rasht, Iran from 2019 to 2020. Based on the presence or absence of serum potassium (K), sodium (Na), magnesium (Mg), and zinc (Zn), disturbances on the first day of hospitalization, patients were divided into two study groups of with and without abnormal electrolyte levels. The GCS scores of the two groups at the time of admission and discharge were recorded and the relationship between electrolyte disturbances and GCS score was evaluated. Results: There were no significant differences in the mean GCS score at the time of admission and discharge between patients with and without disturbances in serum Na, K, Zn and Mg levels based on the crude analysis. Regarding the simultaneous effects of the study variables on the GCS score, only Mg serum level exerted a significant impact on the GCS score at the time of admission (P=0.041) and discharge (P=0.017). Conclusion: The GCS score in patients with DAI at the time of admission and discharge has an association with the Mg serum level but not with Na, K, and Zn levels

A Comparison between Therapeutic Effect of Granulocyte Colony-stimulating Factor and Methylprednisolone in Treatment of Patients with Acute Traumatic Spinal Cord Injury

Background & Aim: Spinal cord injury (SCI) is one of the worst kinds of traumatic injuries with remarkable social and economic effects on communities.  Methods & Materials/Patients: In this prospective randomized clinical trial, 122 patients with traumatic spinal cord injury were admitted to Poursina hospital within 48 hours of injury to compare granulocyte colony stimulating factor (G-CSF) and high-dose methylprednisolone as neuroprotective therapy. Results: In this research, 122 patients were studied out of whom 62 patients were included in the granulociote colony-stimulating factor (G-CSF) group with a mean age of 40.4, and 60 patients in the methylprednisolone group with an average age of 40.10 years. 55 out of 122 patients (45%) were completely paralyzed (Grade AIS:A) and 67 (55%) were with incomplete spinal injury (Grade AIS:B,C,D). The average American spinal injury association (ASIA) sensory scores in the two groups were similarly compared in the same four time intervals, and p values were 0.7, 0.3, 0.2, and 0.1. They were not statistically significant.  Conclusion: According to the results, the G-CSF was shown to be beneficial in average ASIA motor and sensory scores in the two groups of male patients at six months of onset of G-CSF treatment (p value=0.04), and average ASIA motor scores improvement in the falls subgroup patients also differed significantly within six months of onset of G-CSF treatment (p value=0.03). A multicentre prospective randomized clinical trial to compare the placebo effect with G-CSF protocol's treatment, and also assessment of the cost benefits of the common medical treatment versus G-CSF are needed