Post-Operative Infections in Spine Procedures: A Brief Review

Background and Aim: Surgical site infection is an important complication after spinal surgery. Prevention and treatment of this complication requires more and reliable information. In this article, we investigated the epidemiology, pathogenesis, diagnosis and treatment of post-operative infection in spine procedures by reviewing previous related studies. Methods and Materials/Patients: In this paper, original articles available in PubMed and Scopus published between 1991 and 2017 were reviewed and studied. Results: Organisms resistant to antibiotics have increased and made treatment harder, especially in patients with instrumentation of spine. The frequency of surgical site infection depends on surgical technique, anatomical location, and duration of surgery. Conclusion: Prevention is the best way to reduce the frequency of post-spinal surgical infection. Excessive use of antibiotics increases the risk of infection with bacteria resistant to treatment

Clivus Chordoma with an arachnoid Cyst, coincidence or causative factor?

The clivus is the surface of a portion of the occipital and sphenoid bones in the base of the skull. (1)It is surrounded by the neurovascular structures of the brainstem, as well as internal carotid arteries. Tumors of the clivus can be benign (chordoma)or malignant (chondrosarcoma).(2) Chordomas are rare, aggressive, slow-growing, invasive, and locally destructive tumors that arise from the notochord, a structure that appears in embryonic stages and guides the growth of the bony skull and spine. Normally, notochordal remnants form part of the intervertebral discs. A chordoma occurs when additional notochordal cells are enclosed by the developing bones. Although these  tumors are benign and slow-growing, they may invade nearby structures and destroy surrounding tissue and spread to other parts of the body.(2) Most arachnoid cysts are probably present at birth, or develop soon after. Once they are formed, they are thought to remain stable, apparently in some kind of equilibrium with the rest of the intracranial space(3). We report a rare case of clivus chordoma associated with an arachnoid cyst.

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

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

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

Cerebrospinal Fluid Indices in Acute Drug Intoxication; Do They Predict the Patients’ Outcome?

Introduction: In some intoxicated patients, cerebrospinal fluid (CSF) is examined due to the prolonged loss of consciousness, focal neurologic findings, and fever of unknown origin. We aimed to evaluate the probable relationship between the different toxicity causes and the CSF indices in poisoned patients and determine if they could predict the patients’ outcome. Methods: All patients who had been admitted to the toxicology intensive care unit of Loghman-Hakim hospital between March 2006 and March 2011 and had undergone lumbar puncture (LP) were included into this retrospective study. The patients’ demographic data and results of CSF evaluation (level of glucose, lactate dehydrogenase, protein, and white blood cells in CSF fluid) were evaluated. The data was analyzed using SPSS software version 17. Results: A total of 111 patients were evaluated. Mean age of the patients was 37±15 years. Thirteen (11.7%) had deceased. No relation was found between the cause of poisoning (medication involved) and the changes in CSF indices. A statistically significant difference was found between the survivors and non-survivors in terms of CSF protein, LDH, and WBC. However, such a difference was not detected between these two groups regarding CSF glucose. Conclusion: In intoxicated patients with prolonged decreased level of consciousness or prolonged fever, early evaluation of CSF can help early diagnosis of complications such as meningitis and prompt treatment. Also, high level of protein, LDH, and WBC in the CSF can predict higher mortality rates in these patients

Psychopathological Symptoms in Caregivers of Patients With Vegetative State

Background: Taking care of patients in a vegetative state is a great challenge and affects the mental health of the caregivers. Objectives: This study aimed to determine the psychopathological symptoms in caregivers of patients with Vegetative State (VS) and determine the demographic and social predictors of the common symptoms. Materials & Methods: This cross-sectional study was conducted in an educational hospital in the north of Iran from 2012 to 2013. The psychopathological symptoms of 80 caregivers of VS patients were evaluated by Symptom Checklist-Revised (SCL-90-R) questionnaire. Results were analyzed using SPSS (Version 18) by the Mann-Whitney U test. Finally, the predictors of psychopathological symptoms were determined through a simple regression model. Results: The highest scores of the psychological symptoms were of the depression subscale (2.88±0.86) and somatoform subscale (2.85±0.83). The psychopathological symptoms including somatoform (P=0.012), obsessive-compulsive (P=0.032), depression (P=0.035), anxiety (P=0.027), phobia (P=0.015), and paranoid ideations (P=0.027) were significantly higher in women than in men. However, there was no significant relationship between these symptoms and marital status. The simple regression model showed that none of the sociodemographic variables could predict psychopathological symptoms in the caregivers. Conclusion: A significant number of caregivers had psychopathological symptoms, especially depression and somatoform complaints

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