Caspian Journal of Neurological Sciences
Volume:3 Issue: 10, Oct 2017

Hemodialysis is a treatment for end-stage renal disease (ESRD) that is an underlying factor of cognitive impairment in patients.
This study was conducted to evaluate the prevalence of cognitive impairment and its associated factors in patients undergoing hemodialysis using Montreal Cognitive Assessment (MoCA).
This cross-sectional study was carried out in 2016 in the dialysis unit of an academic hospital in the north of Iran. A total of two hundreds and twenty-four patients with chronic renal failure and ESRD presenting to for hemodialysis were included. All the patients were evaluated by the MoCA and the cut-off point was set at ≤25 for confirming cognitive impairment. The data obtained were analyzed in SPSS-18 using the Chi-square test, Mann-Whitney’s U-test, Fisher’s exact test, the independent t-test and the binomial logistic regression.
From the total of 224 patients examined, 93 (41.52%) had developed cognitive impairment. The variables of age, stroke, education and diabetes were entered into the logistic regression model to analyze the associated risk factors, but only age and a history of stroke showed a significant relationship with this impairment; that is, the possibility of cognitive impairment increases with increasing age and a history of stroke can increase its risk six-fold.
Cognitive impairment was a relatively frequent complication of hemodialysis in this study which was performed in the north of Iran. Aging and a history of stroke are risk factors of cognitive impairment in patients with chronic kidney failure undergoing hemodialysis treatment.

Multiple Sclerosis (MS) is a debilitating disease of the central nervous system. Usually, long-term MS medications are injected intramuscularly or subcutaneously, making them intolerable for many MS patients.
In the present study, the rate and the causes of non-adherence to MS disease-modifying drugs (DMDs) were assessed in patients with MS.
Two hundred and three MS patients of Guilan MS Society were interviewed demographic and clinical data of the patients were collected.
Among the 203 patients, 73.9% were female. The mean±SD age of the patients was 32.47±9.15. Non-adherence to DMDs was due to side effects (21.7%) and requests of the families (21.7%) or ineffectiveness (17.4%). Significant association was seen between the non-adherence to DMDs and gender (p=0.015) and relapses (p=0.021).
The evidence from the present study suggests that there is a high rate of non-adherence to DMDs in MS patients in Guilan.

Electroretinography (ERG) is known as a diagnostic test for evaluating the performance of different layers of the retina. Its normal values maybe different in different populations.
Determining the normal values of ERG parameters in patients presenting to an ophthalmologic center in Guilan in northern Iran.
Fifty-five people presenting to a teaching hospital affiliated to Guilan University of Medical Sciences were studied in autumn and winter 2013.The subjects were diagnosed as healthy in the eye examinations and were examined in terms of the values of amplitude and latency time of ERG waves in accordance with international guidelines for clinical electrophysiology of vision.
In this study, 55 patients with a mean age of 35±14 years were studied (40% males with a mean age of 36.00±15.4 years; 60% females, with a mean age of 34.5±14 years). The following results were obtained: amplitude of scotopic 0.01=149±144 µV, scotopic 3=317±157µV, photopic=129±86 µV, 30-Hz flicker=134±38 µV, OS2=25.6±13.9 µV, Latency time scotopic 0.01=53.5±29 sec, Latency Time Scotopic 3=34.3±15.2 sec, N1=13.59±2 sec, P1=18.63±1 sec, N2=21.3±1 sec, P2=26.1±2.7 ms, N3=31.1±4 sec, P3=33.8±4.7 sec, N4=40.9±6.4 sec, P4=44.3±6.4 sec, Latency Time photopic=22.9±7.7 ms, and flicker=54.3±7.5 ms. Men and women were not significantly different in terms of the variables. Left and right eyes, as well as age groups were not significantly different (p=0.05).
The results of the current study differed from other studies in terms of the values of amplitude and latency times. Therefore, it is necessary to standardize ERG for each center.

The carpal tunnel syndrome (CTS) is a common neuropathy caused by the entrapment of the median nerve in the carpal tunnel. It causes pain and paresthesia in the hand.
To evaluate the role of clinical symptoms of CTS to determine the severity of this disorder.
This descriptive cross-sectional study examined 75 hands of 40 patients were referred with CTS symptoms to Kashani and Alzahra hospitals in Isfahan, Iran, with signs of CTS from 2014 to 2015. The definitive diagnosis and severity of the disease were determined using electromyography and nerve conduction study (EMG-NCS). The correlation of the severity of CTS with clinical symptoms was examined using Spearman’s correlation coefficient and Man-Whitney test.
A total of 75 hands with CTS in 40 patients with mean age of 49.73 ± 12.53 years were examined (24% males, 76% female). The severity of CTS directly and significantly correlated with age, physical activities done with the involved hand, shaking or ringing the hands, weakness or atrophy of the thenar eminence, positive Phalen's test, and positive reverse Phalen’s test (p0.05).
It is concluded that the different severities of the disease cannot be differentiated only through evaluation of clinical symptoms although they played the main role in diagnosis of the disease. Thus, electrodiagnostic evidence is still required for determining its severity and planning the treatment.

Multiple sclerosis (MS) is a progressive chronic neurologic disorder which topically causes the destruction and inflammation of the myelin sheath in the brain and the spinal cord. It also affects the patient's emotions and can be treated using complementary medicine.
The present study was conducted to investigate the effectiveness of yoga therapy in reducing anxiety, stress and depression in MS patients.
The present experimental case-control study was conducted using a pretest-posttest approach. The statistical population comprised female MS patients in Rasht, Iran in 2016, 30 of whom were randomly assigned to the control and experimental groups. The experimental group underwent yoga therapy for three months. The two groups completed the depression anxiety stress scale (DASS-21). All the data obtained were analyzed in SPSS-21. p The repeated measures ANOVA showed that yoga therapy significantly reduces anxiety, stress and depression in MS patients (p The results of the present study revealed that yoga therapy can be widely used as an effective and efficient method to improve the symptoms of anxiety, stress and depression in MS patients. This method can prevent the increasing debilitation in MS patients and help them improve their mood and overcome their anxiety.

Analysis of biofluids provides a unique window into the biochemical status of a living organism since the composition of a given biofluid will be modulated according to the level of function of the cells that are intimately concerned with its manufacture and secretion. One of the most successful approaches to biofluid analysis has been the application of NMR spectroscopy.
The aim of this study was the survey of the role of Nuclear Magnetic Resonance (NMR) Spectroscopy in differential diagnosis of septic bacterial meningitis.
Using the search strategy from three databases (MEDLINE/PMC, Web of Science, Scopus), list of references of selected articles and gray literature, without time and language limitation, articles up to March 2017 were entered into this review. In this review, 219 articles were acquired at the primary search. Study selection and quality assessment processes were done based on Cochrane library guidelines. After assessing the quality and inclusion and exclusion criteria, 4 articles were selected and entered into the data synthesis.
The results of 4 studies demonstrated relative elevation of lactate value and extracellular acidosis in bacterial meningitis not in aseptic meningitis. Moreover in most of them, decreasing its level by treatment was evident.
Metabolomic analysis with NMR spectroscopy of cerebrospinal fluid can become a powerful helping in differentiation of septic meningitis from aseptic meningitis.

This is a case study of a 34-year-old woman who was admitted to hospital with a history of severe orthostatic headache. She was diagnosed as having spontaneous intracranial hypotension (SIH) by undetectable cerebrospinal fluid (CSF) pressure at lumbar puncture, and with evidence of diffuse dural enhancement of the brain detected by magnetic resonance imaging (MRI). However, the contrast-enhanced MRI of the spinal cord did not show a CSF leak site and she was treated conservatively. After a few days, the patient’s recurrence of headache with continuous duration and progressive worsening led to further investigations by contrast-enhanced MRI, magnetic resonance venography (MRV) and computed tomography venography (CTV) that showed an extensive thrombosis in the superior sagittal sinus, left sigmoid sinus and both transverse sinuses. Then, the patient was treated successfully with heparin and oral anticoagulant. She had no neurological deficit after six months. SIH with concomitant intracranial cerebral venous thrombosis is a rare condition. We hypothesize that SIH may change cerebral blood-flow velocity and viscosity and can cause intracranial cerebral venous thrombosis.