Factors associated with in-hospital mortality following intracerebral hemorrhage: a three-year study in Tehran, Iran

BACKGROUND: Primary intracerebral hemorrhage (ICH) is one of the common vascular insults with a relatively high rate of mortality. The aim of the current study was to determine the mortality rate and to evaluate the influence of various factors on the mortality of patients with intracerebral hemorrhage (ICH). Demographic characteristics along with clinical features and neuroimaging information on 122 patients with primary ICH admitted to Sina Hospital between 1999–2002 were assessed by multivariate analysis. RESULTS: Of 122 patients diagnosed with intracerebral hemorrhage, 70 were men and 52 were women. Sixtynine percent of subjects were between 60 to 80 years of age. A history of hypertension was the primary cause in 67.2% of participants and it was found more frequent compared to other cardiovascular risk factors such as a history of ischemic heart disease (17.2%), diabetes mellitus (18%) and cigarette smoking (13.1%). The overall mortality rate among ICH patients admitted to the hospital was 46.7%. About one third of the deaths occurred within the first two days after brain injury. Factor independently associated with in-hospital mortality were Glasgow Coma Scale (GCS) score (≤ 8), diabetes mellitus disease, volume of hematoma and and intraventricular hematoma. CONCLUSION: Higher rate of mortality were observed during the first two weeks of hospitalization following ICH. Neuroimaging features along with GCS score can help the clinicians in developing their prognosis

Warning signs and symptoms of subarachnoid hemorrhage

Objectives: The objective of this Study was to assess the warning signs and symptoms in patients with spontaneous subarachnoid hemorrhage (SAH). Methods: Patients admitted with spontaneous SAH were enrolled in the study and were asked for their history of frequent warning signs and symptoms, as cited in other Studies. Results: Overall. 28 cases of spontaneous SAH were identified during the study period. A history of headache as the most frequent warning symptom was present in 64.3% of the cases. Transient loss of consciousness (42.8%). difficulty ill walking (21.4%), hemiparesis (14.2%). ocular signs (14.2%) and seizure (3.6%) were the next most frequent symptoms. Hypertension and smoking, the most frequent risk factors for SAH. were found in 39.3 and 32.1% of the cases, respectively. Conclusion: Despite recent advances in neurosurgical techniques, the overall outcome after aneurysmal SAH remains poor. Sudden, severe onset of headache With Or Without neurologic deficits is an important warning symptom for spontaneous subarachnoid hemorrhage. Further reduction of the possible risk factors and earlier diagnosis oil the basis of warning symptoms and treatments are desirable

Gabapentin and uremic pruritus in hemodialysis patients

Background. Pruritus is a common and bothersome problem in 30-50% of hemodialysis patients. The aim of this study was to determine the effect of gabapentin, 100 mg/three times a week (after each hemodialysis session), on uremic pruritus. Study design. Patients older than 18 years who had undergone hemodialysis for more than three months were enrolled in this double-blind clinical trial. They had experienced pruritus refractory to antihistamines for at least two weeks. The patients were assigned to receive gabapentin 100 mg following hemodialysis for a period of four weeks, and after a washout week, they received the placebo for another four weeks. They were asked to evaluate the severity of their pruritus using a visual analogue scale (VAS). The reduction of pruritus 50% was accepted as the response. Results. The mean pruritus score reached 6.44 8.4 (p 0.0001), 15 11.2 (p 0.001), and 81.11 11.07 (p 0.001) during gabapentin, washout, and placebo periods, respectively. No significant correlation was found between age, sex, duration of dialysis, underlying diseases, and systolic and diastolic blood pressures and the gabapentin effect. Conclusion. Gabapentin is an effective agent in treating uremic pruritus