p. saadat

Neuropathic diseases are neurodegenerative conditions and a wide and difficult group of peripheral nerve diseases in humans. Since well-being therapy emphasizes the high levels of six domains of psychological well-being, this study was conducted to investigate the effectiveness of well-being therapy on pain coping strategies and self-efficacy of patients with chronic neuropathic pain.

This clinical trial was conducted on 30 chronic neuropathic patients referred to Ayatollah Rouhani hospital in Babol and a neurologist's private office in two groups of experimental and control (n=15). Well-being therapy was performed in 8 sessions of 120 minutes, once a week for the experimental group, while the control group received the routine treatment. After the follow-up period, the control group also underwent psychotherapy. Both groups completed questionnaires of pain coping strategies (Rosenstiel and Keefe, 1985) and pain self-efficacy (Nicholas, 1989) in the pre-test, post-test and follow-up (two months after the post-test) and were compared.

The results showed that there was a statistically significant difference between the two experimental and control groups in the score of the subscales of pain coping strategies in distraction from pain (23.13±3.88 versus 11.47±7.34) (p<0.001), reinterpretation of pain (17.33±5.56 versus 13.0±8.65) (p=0.114), catastrophizing (10.0±6.24 versus 16.33±5.4) (p<0.001), ignoring pain (24.4±6.67 versus 12.6±5.11) (p<0.001), hoping/praying (29.13±9.97 versus 22.4±5.7) (p=0.031), self-talk (25±4.03 versus 21.2±4.79) (p=0.026), behavioral activation (20.47±4.43 versus 11.20±4.94) (p<0.001) and pain self-efficacy (43.2±9.45 versus 33.33±13.34) (p=0.027). These results were maintained in the follow-up period.

The present study showed that wellness therapy can be an effective intervention in improving pain coping strategies and increasing pain self-efficacy in chronic neuropathic patients.

Stroke is one of the main causes of death and disability in the world, and its treatment includes the re-supply of blood to the brain tissue using different methods, including alteplase injection. The aim of this study is to determine the outcome of treatment with intravenous alteplase.

This cross-sectional study was conducted on all stroke patients referred to Babol Rouhani Hospital in 2019-2021. Patients were divided into two groups receiving intravenous alteplase and routine and supportive treatment groups. Demographic information and the scores of National Institutes of Health Stroke Scale (NIHSS) to evaluate the improvement of stroke symptoms and Modified Rankin Scale (mRS) to evaluate the severity of disability in three periods of 7, 30 and 90 days were investigated and compared.

Out of 100 studied patients, 49 people were in alteplase group and 51 people were in routine and supportive treatment group. In examining the NIHSS scale of patients in three follow-up periods, there was a significant difference in the alteplase group compared to the routine and supportive treatment group (p<0.001). Moreover, regarding the mRS scale, on the 90th day (0.65±0.80 vs. 1.55±1.11) unlike the 30th day (1.65±1.07 vs. 1.31±0.92), there was a significant difference between the two groups receiving alteplase and the routine and supportive treatment group (p<0.001).

The results of the study showed that treatment with intravenous alteplase can have a suitable effect on neurological disorders after a stroke and can improve the level of disability in daily functioning in the long term, up to the 90th day of patient follow-up.

Hyponatremia is associated with adverse outcomes and increased mortality in acute stroke patients. However, the role of hyponatremia as a negative prognostic indicator has been controversial. This study was conducted to determine the relationship between serum sodium level and impairment and disability in stroke patients in Babol, northern Iran.

This cross-sectional study was conducted in 6 months on 125 stroke patients admitted to Ayatollah Rouhani Hospital in Babol. The National Institutes of Health Stroke Scale and the Modified Rankin Scale were used to determine the impairment and disability caused by stroke. Venous blood was collected to determine the serum concentrations of sodium. The normal ranges were defined as 135-145 mEq/L.

Of 125 stroke patients, 108 cases (86.4%) were ischemic stroke. Eighty-two cases (65.5%) had hyponatremia. The type of stroke showed statistically significant difference with hyponatremia in 14 hemorrhagic stroke cases (17%) versus 68 ischemic stroke cases (83%) (p=0.01). Furthermore, the difference in gender showed statistically significant difference with hyponatremia in 49 women (59%), and 33 men (41%) (p=0.02). In hyponatremic patients, the severity of impairment at admission (p=0.01) and disability at discharge time (p=0.02) was higher than patients with normal sodium serum level. In patients with a history of smoking, 9 cases (21%) had normal sodium level while 33 cases (79%) had hyponatremia (p=0.03).

The results of the present study showed that the severity of impairment and disability at the time of discharge in stroke patients is related to serum sodium level. Therefore, paying attention and correcting serum sodium level should be considered more in acute stroke patients.

Elevated CRP level is independently associated with the excessive risk of ischemic stroke. However, there is currently no consensus on the use of CRP in detecting and tracking the progression of cerebrovascular diseases. The aim of this study was to determine the relationship between CRP and outcome in stroke patients.

This was an analytical cross-sectional study. Patients admitted with diagnosis of ischemic stroke were enrolled. Demographic, and clinical characteristics, medical history, drug abuse and tobacco use and severity of stroke (National Institute of Health Stroke Scale) were completed in checklist.

Of the total 214 patients, the serum CRP levels in 122 cases (57%) were positive. The mortality during the first week of hospitalization included 17 cases (8%). The differences in CRP serum level with underlying disease such as Diabetes Mellitus (82 cases (51%) of positive CRP vs. 77 cases (49%) of negative CRP, p= 0.007) and Hypertension (59 cases (50.4%) of positive CRP vs. 58 cases (49.6%) of negative CRP, p=0.03) were statistically significant. In addition, high CRP was seen in 10 thrombotic (91%) and 4 embolic (67%) of stroke expire patients (p= 0.034). The difference in CRP serum level in mortality cases was statistically significant (14 cases (82%) of positive CRP vs. 3 cases (18%) of negative CRP, p= 0.032).

The positive CRP serum level at the admission was accompanied by more severity of disability in stroke survivor. Checking serum level of CRP in admission is suggested for predicting disability and mortality rate during the first week of post-stroke hospitalization.

Low levels of vitamin D are associated with clinical effects such as gastrointestinal disorders, cardiovascular disorders, autoimmune disorders, neuropathic diseases, cancer and metabolic syndrome. Carpal Tunnel Syndrome (CTS) is the most common cause of compression neuropathy, which has recently been linked to vitamin D deficiency in the onset or severity of symptoms. Therefore, this study was performed to evaluate the serum levels of vitamin D in patients with carpal tunnel syndrome.

This case-control study was performed on 100 patients referred to the neurology clinic of Ayatollah Rouhani Hospital with clinical symptoms of CTS for at least 3 months and 100 patients as a control group who referred to the same clinic for nerve conduction velocity test and did not show symptoms of CTS in clinical examination and electrophysiology. Patientschr('39') function, disease severity and pain were measured based on the Boston Carpal Tunnel Questionnaire (BCTQ). Serum vitamin D levels were also measured and compared between the two groups.

The mean age of patients was 43.53±10.68 years and controls were 45.48±7.12 years. The mean serum vitamin D levels in patients and controls were 19.18±11.39 ng/dL and 21.39±15.93 ng/dL, respectively. In controls, 57 women suffered from vitamin D deficiency (p<0.05). There was no significant difference between the two groups in terms of disease severity, function status, pain severity, electrophysiological defect, involved hand, dominant hand and symptoms associated with vitamin D deficiency and there was a negative correlation in vitamin D levels with disease severity, function and pain of patients.

The results showed that there was a relationship between serum vitamin D levels and gender. In addition, a negative correlation was observed between serum vitamin D levels and patientschr('39') disease severity and function and electrophysiological defects.

Primary angiitis of the central nervous system (PACNS) is an inflammatory vasculitis with very low frequency and prevalence. It is not clear why the inflammatory process of this disease is limited to cerebrovascular disease without systemic manifestations. A case of primary angiitis of the central nervous system with cerebrovascular manifestations is reported here. 
CASE REPORT: The patient is a 50-year-old woman with headache, nausea, vomiting, and visual symptoms without clear motor impairment. Normocytic normochromic anemias tests and function tests of kidney, liver and thyroid and serology of infectious diseases were reported to be normal. The patient underwent brain imaging, and due to multiple lesions in both cerebral hemispheres and cerebellum, she underwent biopsy with a probable diagnosis of cerebral vasculitis. After histopathologic confirmation, the patient was discharged with glucocorticoid and cyclophosphamide therapy, and the symptoms subsided after one year follow-up. Based on the results of this case report, some general and common symptoms of the primary angiitis of the central nervous system should also be considered.