Multifocal dystonia, Clinical feature of Hallervorden-Spatz

Hallervorden-spatz disease is an inherited metabolic disorder with autosomal recessive trait. Onset is in late childhood or early adolescence. Clinical manifestation is variable but pyramidal and extrapyramidal signs are often prominent. Many of patients show progressive dementia and extrapyramidal symptoms. Ataxia or myoclonus is reported in the course of the disease in individual cases. Focal dystonias including tongue, eyelids (blepharospasm) and optic atrophy, retinitis pigmentosa, rarely familial parkinsonism are also reported. Pathologically pigmentary degeneration of globus pallidus, substantia nigra (pars reticular) and red nucleus is characteristic. In our case the main clinical feature was multifocal dystonia without obvious pyramidal or other extrapyramidal symptoms, and diagnosis was based on clinical and MRI findings

Epidemiology, etiology and study of clinical findings of headache

In a cross-sectional epidemiological study of headache disorders in neurology clinic of Fatemieh hospital of Semnan (August 22-November 20.1996), information on types of headaches, quality, severity, location, duration, frequency, precipitating factors, age of onset, influence of menstruation and pregnancy, positive familial history, use of oral contraceptive pills and other epidemiological factors including socioeconomic and age/sex composition was collected. The presence of any types of headaches was ascertained by a clinical interview and examination using the operational diagnostic criteria of the International Headaches Society. The prevalence of migraine and tension type headache was also analysed in relation to variables of life style (physical activity and sleep pattern) and associated signs and symptoms (nausea, vomiting, photophobia and phonophobia). In this study migraine and tension headache were also compared in variable aspects with each other. 1) Headache was more prevalent in women than men (F/M=3/1). 2) The most common types of headache included: tension type headache (41.4%), migraine (31.2%) and unclassified headaches (17.2%). 3) Migraine and T.T.H were more prevalent in early adult life and middle ages. 4) In both migraine and tension type headache the time profiles (duration, frequency, age of onset), quality and location were like that noted in textbook and previous studies. 5) In both migraine and tension type headache the most conspicuous precipitating factor was stress and mental tension and frequent headaches were accompanied with psychiatric problems (e.g depression and or anxiety). 6) Nausea, vomiting, phonophobia and photophobia were the most common associated symptoms in both of them. 7) Positive familial history and aggravation of headache in perimenstual period were more commonly seen in patients with migraine than tension type headache. In conclusion using the operational diagnostic criteria of International Headache Society in clinical practice, treating, teaching, clinical and epidemiological research is very useful and must also be applied for Iranian patients

"Neurologic complications in Hemophilia: A study in 214 cases "

Intracranial hemorrhage and entrapment neuropathy are the most serious and disabling complications in hemophilia.The occurance of these neurological complications was studied in 214 hemophiliac patients during a 3 month period. Nine patients (4.2%) suffered intracranial hemorrhage (One epidural and others intracerebral). All of intracranial hemorrhage patients had the sevee form of disease (<1% factor VIII or IX). 6 out of 9 intracranial hemorrhage cases mentioned a history of head trauma. Entrapment neuropathy was presen in 10 patients (femoral neuropathy 5, ulnar n. 3, radial n. 1 median n. 1) all of entropament neuropathy patients described a history of trauma to the extremities. Eight patients in the latter group had severe disease and two patients had moderate disease (1-5%). The proportion of intracranial hemorrhage following head trauma (20% in this series) was greater than other studies. In conclusion, early diagnostic evaluation and replacement therapy may be beneficial in hemophilic patients with trauma

The prevalence of iron deficiency anemia (IDA) in female students of Zahedan

325 female students of Zahedan at the average age of 16.2 years old (16-22) were randomly selected to study the prevalence of iron deficiency anemia. Hb, hematocrit, MCV, MCHC, iron, TIBC and ferritin were measured. Results showed that in the population studied 3.4%, 27.7%, 4.3%, 11.7%, 25.5%, 11.4% had their Hb, MCV, serum iron, tranferrin saturation, ferritin respectively below the WHO standards. The correlation coefficient between Hb, MCV and hematocrit, serum iron was r=0.54, P<0.00001, r=0.38, P<0.00001 respectively. Also the correlation coefficient between transferring saturation, serum iron and ferrin was r=0.94, P<0.00001, r=0.31, P<0.00001 respectively. Our study shows that hematological and biochemical markers of iron status of the young Zahedan girls at puberty are lower than WHO standards and these girls might be at risk of iron deficiency anemia

Effect of MS14® on physical activity of multiple sclerosis patients : a randomized triple-blind placebo-controlled clinical trial

Introduction: Multiple Sclerosis (MS) is a neurological disorder with an increasing global prevalence and severe complications. MS14® is a Persian-medicine-derived natural product with herbal and marine origin which has shown beneficial effects in the management of MS complications. In this study, its effect on physical activity of MS patients was investigated. Methods: A triple-blind placebo-controlled clinical trial was conducted. Participants used either MS14 capsule or placebo 3 times a day for 3 weeks. At baseline and end of the study, physical activity indices were assessed using international physical activity questionnaire (IPAQ). Secondary outcome measures were Fatigue Severity Scale (FSS), timed 10 m walk, Ashworth scale, and Timed Get up and Go. Results: A total number of 80 MS patients completed the study. At the end of study, improvement of general physical activity (p-value=0.047) and Timed 10 m walk index (p-value=0.003) in the MS14 group was significant when compared to placebo. No serious adverse effects were observed in this study. Conclusion: Considering the improvement of some physical activity indices, MS14® is seems to be a safe natural product which could be considered as a supplementary treatment in MS patients. Future larger trials are suggested to further evaluate its efficacy