ایسکمیک

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.

HSV-induced encephalitis is one of the most common viral encephalitis in children with known signs and symptoms, including personality changes, fever, impaired consciousness and focal neurological deficits. Imaging findings also include temporal lobe and fronto-orbital involvement. In the present study, we present a 7-year-old girl diagnosed with HSV1-induced herpes encephalitis with unusual symptoms including absence of focal neurologic deficits and persistent muscle weakness with imaging findings suggestive of ischemic multifocal areas that Treated with acyclovir and the patient’s symptoms improved.

Hypoxic Ischemic Encephalopathy (HIE) neonatorum is very important due to its high morbidity and mortality rates and long-term neuromotor outcomes.

In order to evaluate outcomes in moderate to severe HIE, in a historical cohort study, medical records of all neonates with HIE during 1999-2006 in a university hospital were reviewed. Of 134 neonates who had been admitted, 94 cases could be evaluated and were in reach of follow-up.

A total of 77 deaths (81.9%) were found due to sequel of asphyxia. The survival rate was 17% with a median of 5 days. Of 17 alive neonates, 5 cases (29.4%) had cerebral palsy. The most important risk factors related to survival were: heart massage more than one minute, low first minute APGAR score, low PH in arterial blood gas analysis and low birth weight (P<0.05). Also emergency cesarean section was a major risk factor for death.

HIE has high morbidity and mortality rates and needs urgent attention for implementation of prevention programs including more intensive intrapartum monitoring.