The Hospitalization Rate of Cerebral Venous Sinus Thrombosis before and during COVID-19 Pandemic Era: A Single-Center Retrospective Cohort Study

Objectives: There are several reports of the association between SARS-CoV-2 infection (COVID-19) and cerebral venous sinus thrombosis (CVST). In this study, we aimed to compare the hospitalization rate of CVST before and during the COVID-19 pandemic (before vaccination program). Materials and methods: In this retrospective cohort study, the hospitalization rate of adult CVST patients in Namazi hospital, a tertiary referral center in the south of Iran, was compared in two periods of time. We defined March 2018 to March 2019 as the pre-COVID-19 period and March 2020 to March 2021 as the COVID-19 period. Results: 50 and 77 adult CVST patients were hospitalized in the pre-COVID-19 and COVID-19 periods, respectively. The crude CVST hospitalization rate increased from 14.33 in the pre-COVID-19 period to 21.7 per million in the COVID-19 era (P = 0.021). However, after age and sex adjustment, the incremental trend in hospitalization rate was not significant (95% CrI: -2.2, 5.14). Patients \u3e 50-year-old were more often hospitalized in the COVID-19 period (P = 0.042). SARS-CoV-2 PCR test was done in 49.3% out of all COVID-19 period patients, which were positive in 6.5%. Modified Rankin Scale (mRS) score ≥3 at three-month follow-up was associated with age (P = 0.015) and malignancy (P = 0.014) in pre-COVID period; and was associated with age (P = 0.025), altered mental status on admission time (P\u3c0.001), malignancy (P = 0.041) and COVID-19 infection (P = 0.008) in COVID-19 period. Conclusion: Since there was a more dismal outcome in COVID-19 associated CVST, a high index of suspicion for CVST among COVID-19 positive is recommended

The Epidemiologic, Clinical and Laboratory Findings of Patients with Guillain Barre´ Syndrome in Southern Iran Since 2007 to 2012

Background ;Objective: Guillain Barre´ syndrome is an autoimmune neuropathy which is considered to be the most acute areflexic paralysis with albuminocytologic dissociation.1 Areflexia or hyporeflexia, pain in limbs, autonomic dysfunction, progressive bilateral and symmetric weakness of limbs, numbness and paresthesia are described as the clinical features of GBS.Nevertheless, with having less prognosis, the treatment is usually effective. Most patients diagnosed with GBS were previously infected with CMV or C.jejuni. Subtypes of the disease are either Axonal or Demyelinating. Due to increase use of Guillain Barre´ in south of Iran, the present study has done a retrospective study on the epidemiology of Guillain Barre in the south part of Iran.Materials & Methods: We performed our retrospective study in Namazi hospital in Shiraz, Iran. Medical records were analyzed using computer and were presented through percentages.Results: 214 patients were studied in which 119(55.6%) of them were men and 95 (44.4%) of them were women. 15 % of the participants had respiratory disturbance and 5.1% of them had histories of common cold and 1.4 of them were vaccinated before the study. Moreover, six people had died but 208 patients were treated and healed either by prescribed dosage of IVIg (69.2%) or plasmapheresis (24.3%) and one patient was also seen who had HIV virus.Conclusion: This study provides more details on the epidemiology of GBS in Shiraz, and south of Iran. Our study also revealed the difference in pattern of GBS in Iran and other countries. however, there is still a need for further clarification of the issues

Eye movement in reading and linguistic processing among bilingualism in oculomotor apraxia in patients with aphasia

The present study compared linguistic processes and eye movement among individuals diagnosed with oculomotor apraxia (OMA) and the influence of bilingualism on OMA. Four patients consisting of one male and three females were diagnosed with OMA, and a group of four healthy individuals, comprising two males and two females who were all right-hand dominant. Also, a group of four stroke patients without ocular apraxia. Findings show that pointing skills in both the first (L1) and second language (L2) have increased, demonstrating statistical significance (P-value < .001 and P-value = .02, respectively). Also, simple commands over time have increased in L1 and L2, showing statistical significance (P-value < .01 and P-value < .01, respectively). Naming skills in L1 have increased over time, demonstrating statistical insignificance (P-value < .01). However, in L2, no statistically significant change was observed (P-value = .08). This skill in L1 in patients with OMA was significantly reduced compared to the healthy control group (P-value = .03). Still, patients with OMA showed no statistically significant difference from their healthy counterparts (P-value = .15). The orthographic ability of patients in L1 during the study period did not statistically change significantly (P-value = .11). This skill level in L1 between patients with OMA and the healthy control group did not show a statistically significant difference (P-value = .06). Still, there was a statistically significant change in the healthy control group in L2 (P-value < .01). These findings suggest that the bilingual does not reflect a general executive in attentional guidance but could reflect more efficient guidance only under specific tasks

Physicians' beliefs about brain surgery for drug-resistant epilepsy: A global survey

Purpose: To investigate the opinions of physicians about brain surgery for drug-resistant epilepsy worldwide. Methods: Practicing neurologists, psychiatrists, and neurosurgeons from around the world were invited to participate in an online survey. The survey anonymously collected data about demographics, years in clinical practice, discipline, nation, work setting, and answers to the questions about beliefs and attitudes about brain surgery for drug-resistant epilepsy. Results: In total, 1410 physicians from 20 countries and different world regions participated. The propensity to discuss brain surgery with patients, who have drug-resistant seizures, was higher among men (versus women) [Odds Ratio (OR) 1.67, 95% CI 1.20-2.31; p = 0.002]. In comparison to neurologists, psychiatrists were less likely (OR 0.28, 95% CI 0.17-0.47; p < 0.001) and neurosurgeons were more likely (OR 2.00, 95% CI 1.08-3.72; p = 0.028) to discuss about it. Survey participants working in Africa, Asia, the Middle East, and the Former Union of Soviet Socialist Republics showed a lower propensity to discuss epilepsy surgery with patients. Conclusion: This study showed that on an international level, there is still a knowledge gap concerning epilepsy surgery and much needs to be done to identify and overcome barriers to epilepsy surgery for patients with drug-resistant seizures worldwide

The Hospitalization Rate of Cerebral Venous Sinus Thrombosis before and during COVID-19 Pandemic Era: A Single-Center Retrospective Cohort Study

Objectives: There are several reports of the association between SARS-CoV-2 infection (COVID-19) and cerebral venous sinus thrombosis (CVST). In this study, we aimed to compare the hospitalization rate of CVST before and during the COVID-19 pandemic (before vaccination program). Materials and methods: In this retrospective cohort study, the hospitalization rate of adult CVST patients in Namazi hospital, a tertiary referral center in the south of Iran, was compared in two periods of time. We defined March 2018 to March 2019 as the pre-COVID-19 period and March 2020 to March 2021 as the COVID-19 period. Results: 50 and 77 adult CVST patients were hospitalized in the pre-COVID-19 and COVID-19 periods, respectively. The crude CVST hospitalization rate increased from 14.33 in the pre-COVID-19 period to 21.7 per million in the COVID-19 era (P = 0.021). However, after age and sex adjustment, the incremental trend in hospitalization rate was not significant (95% CrI: -2.2, 5.14). Patients > 50-year-old were more often hospitalized in the COVID-19 period (P = 0.042). SARS-CoV-2 PCR test was done in 49.3% out of all COVID-19 period patients, which were positive in 6.5%. Modified Rankin Scale (mRS) score ≥3 at three-month follow-up was associated with age (P = 0.015) and malignancy (P = 0.014) in pre-COVID period; and was associated with age (P = 0.025), altered mental status on admission time (P<0.001), malignancy (P = 0.041) and COVID-19 infection (P = 0.008) in COVID-19 period. Conclusion: Since there was a more dismal outcome in COVID-19 associated CVST, a high index of suspicion for CVST among COVID-19 positive is recommended