A 62-year-old Man with Acute Dizziness, Nausea and Vomiting

The patient was a 62-year-old man presenting to the emergency department 6 hours after the onset of dizziness, nausea and vomiting. The patient complained of numbness of the right side of her body and reported swallowing problems. The initial examination showed the patient was alert and stable. The left side of her face was sweating while the right side was completely dry. The neurological examination revealed the patient was alert, and the right pupil was about 2 mm smaller than the left eye pupil, and both pupils responded to light. A paresis was observed in the right side of the face, tongue and uvula. Uvula was slightly deviated to the right. Other signs included hoarseness and swallowing impairment. The muscle strength of all four limbs was 5/5. Babinski reflex was downward on both sides. The patient could not sit by herself, and leaned to the right. The patient had a history of primary coronary intervention (PCI) and stent placement four years ago. She had smoked a pack of cigarettes for 40 years. She used nitrocontin, pearl, lisinopril, carvedilol and furosemide. Laboratory tests were normal. The first CT scan in the emergency department was normal. As a brain stem infarction was suspected, MRI was performed and revealed an infarct (Figure 1). The patient received neurology consultation and was discharged with stable vital signs and the daily order of aspirin and atorvastatin after five days. The patient was asked to have weekly follow-up visits

A 62-year-old Man with Acute Dizziness, Nausea and Vomiting

The patient was a 62-year-old man presenting to the emergency department 6 hours after the onset of dizziness, nausea and vomiting. The patient complained of numbness of the right side of her body and reported swallowing problems. The initial examination showed the patient was alert and stable. The left side of her face was sweating while the right side was completely dry. The neurological examination revealed the patient was alert, and the right pupil was about 2 mm smaller than the left eye pupil, and both pupils responded to light. A paresis was observed in the right side of the face, tongue and uvula. Uvula was slightly deviated to the right. Other signs included hoarseness and swallowing impairment. The muscle strength of all four limbs was 5/5. Babinski reflex was downward on both sides. The patient could not sit by herself, and leaned to the right. The patient had a history of primary coronary intervention (PCI) and stent placement four years ago. She had smoked a pack of cigarettes for 40 years. She used nitrocontin, pearl, lisinopril, carvedilol and furosemide. Laboratory tests were normal. The first CT scan in the emergency department was normal. As a brain stem infarction was suspected, MRI was performed and revealed an infarct (Figure 1). The patient received neurology consultation and was discharged with stable vital signs and the daily order of aspirin and atorvastatin after five days. The patient was asked to have weekly follow-up visits

Prevalence and Factors related of psychiatric symptoms in low risk pregnancy

Background: Psychiatric disorders are associated with poor pregnancy outcomes both for mother and child. This study aimed to determine the prevalence and related demographic risk factors of psychiatric symptoms among the pregnant women in Babol City. Methods: This cross-sectional study was conducted in five private and public obstetrics clinics of Babol city. During routine appointments of prenatal care, 176 pregnant women filled in three questionnaires including; sociodemographic questionnaire, Edinburg Prenatal Depression Scale (EPDS), and Symptom Checklist-25 (SCL-25). Wilcoxon test, Spearman correlation, and multivariate logistic regression tests were used to interpret the data. Results: The prevalence of depressive disorders was 15.4 for Edinburg scores ≥13.  The overall rate of maternal psychiatric symptoms (global severity index or GSI scores ≥ 1.75) was 48.5. The prevalence of psychiatric symptoms was high; for 25 somatization, 258 anxiety, obsession-compulsion disorders or OCD 6.4, 8.8 interpersonal sensitivity, 5.3 phobia, 7.6 paranoid ideation, and 1.2 psychoticism. Multivariate logistic regression revealed that pregnant women with history of abortion in previous pregnancy were at risk of depressive symptoms more (β=3.18, CI 1.28-7.93, p=0.01) than those without history of abortion. Also, the only demographic factor related to psychiatric symptoms was the age of pregnant women; younger age was associated with higher symptom levels for GSI ((r=-0.17). Conclusion: The high prevalence of psychiatric symptoms, especially depressive symptoms, in pregnant women highlights the need for continued research on screening, identifying the risk factors, and developing effective treatments for mental disorders in pregnant women

Mucormycosis in Uncontrolled Diabetic: A Case Report

Background: Mucormycosis is an opportunistic infection produced by various fungi in the order Mucorales, which is most commonly seen in people with a defect, especially diabetics. Introduction of this infection can involve processes such as insulin injections and tooth extractions. Mucormycosis mortality is significantly high  even with surgical treatment and management of diabetes. In this paper, a case of 28-year-old female with a history of Type 1 Diabetes Mellitus referred to emergency ward 5 days after tooth extraction experiencing a progressive pain and swelling was reported. Patient's examinations showed left orifice edema, left 7th nerve paralysis, and ocular-paralysis of 3rd, 4th and 6th on the left side. The patient was deployed to a more equipped facility in Mashhad (Iran), and after several days she died

Mucormycosis in Uncontrolled Diabetic: A Case Report

Background: Mucormycosis is an opportunistic infection produced by various fungi in the order Mucorales, which is most commonly seen in people with a defect, especially diabetics. Introduction of this infection can involve processes such as insulin injections and tooth extractions. Mucormycosis mortality is significantly high  even with surgical treatment and management of diabetes. In this paper, a case of 28-year-old female with a history of Type 1 Diabetes Mellitus referred to emergency ward 5 days after tooth extraction experiencing a progressive pain and swelling was reported. Patient's examinations showed left orifice edema, left 7th nerve paralysis, and ocular-paralysis of 3rd, 4th and 6th on the left side. The patient was deployed to a more equipped facility in Mashhad (Iran), and after several days she died