محمدرضا امیری نیک پور

The emergence of thrombolytic drugs has opened new horizons in the treatment of patients with acute ischemic stroke, and this study was conducted with the aim of evaluating the barriers of receiving tissue plasminogen activator in patients with acute ischemic stroke in Imam Khomeini Hospital of Urmia.

This descriptive-analytical, cross-sectional study was conducted from April 21, 2015 to March 19, 2016 on patients with acute ischemic stroke referred to the emergency department of Imam Khomeini Hospital in Urmia using census sampling method. To collect data, a checklist containing demographic information was used. After collecting the data, it was entered into SPSS 18 and analyzed with the help of descriptive statistics.

In this study, the results showed that out of 100 patients, most of the participants were male (58%)58 and the rest were female, and the average age was 63.71±17.3 years, and 86% were in the age range of 18-80 years, which was the appropriate age to receive or thrombolytics. and the rest were over 80 years old. The fastest visit time was 25 minutes and the latest was 10080 minutes (168 hours). Among these 40 people, only four people (40%) were in the golden time period of thrombolytic drug, i.e. Three hours from the onset of symptoms to the final evaluation. Among the four people who were placed in the golden time, in 50% of the cases there was a history of taking anticoagulants, in 25% a history of head injury, in 50% of the blood sugar less than 50 and finally 1 person (25% of the people placed in the golden time) that is, 1% of all patients were eligible to receive rtPA. About 24% of patients had NIHSS<4 and 2% had NIHSS>25, and the average number obtained was 10.

The most important obstacle in the timely initiation of thrombolytic therapy is the delay in visiting the emergency room. Therefore, public education in order to improve the level of general awareness of the society can be effective in reducing this time delay.

Epilepsy is a chronic disease of the brain occurring in the form of loss of consciousness, abnormal movements, and emotional disturbances. This disorder may be recurrent and have lifelong durability that requires regular and natural cares. In order to help the sick, the present study compared the theory of mind among tonic-clonic epilepsy, juvenile myoclonic epilepsy and healthy people. This causal-comparative study was conducted on 134 individuals (60 healthy people and 74 patients with epilepsy) who referred to health centers of Urmia city. Baron Cohen’s Reading Mind from Eyes Test (RMET) was used as a study tool. T-tests for independent samples and ANOVA and Scheffe post hoc test were used. Accordingly, the theory of mind in epileptic patients and healthy subjects has a significant difference, and this defect in juvenile myoclonic epilepsy is more than tonic-clonic epileptic patients and normal subjects. The deficit of theory of mind in epileptic patients is affected by same neurological base, drugs and the clinical characteristics, and personality and status of patients. Thus, the evaluation of this theory can explain some of the behavioral and psychological problems for planning effective non-pharmacologic therapy.