فهرست مطالب

  • Volume:10 Issue: 1, Jan 2023
  • تاریخ انتشار: 1401/12/14
  • تعداد عناوین: 8
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  • Behzad Darabi, Maryam Alemzadeh *, Ali Karbasfrushan, Milad Borji Page 1
    Background

     Delirium is often not diagnosed or treated in pediatric intensive care unit (PICU). Delirium leads to a longer hospital stay period, which in turn can result in an increase in hospital treatment costs and an increase in the risk of nosocomial infections.

    Objectives

     The present study aimed to determine the prevalence of delirium and its risk factors in PICU pediatric.

    Methods

     This cross-sectional study was conducted in 2021 - 2022 in hospitals affiliated to Kermanshah University of Medical Sciences. The data collection instruments included the Richmond Agitation-Sedation Scale (RASS) and the Cornell Assessment of Pediatric Delirium (CAPD) questionnaire. Delirium was assessed by the researcher twice a day, in the morning and the evening. The assessment was carried out by a trained person, and the examination results were confirmed by an anesthesiologist who was a member of the research team. Data analysis was carried out using SPSS ver. 16.

    Results

     According to our study results, the majority of the 89 examined patients were male (n = 52 cases, 59.8%), aged 13 - 16 years (n = 37 cases, 42.5%), and were admitted due to pneumonia (n = 24 cases, 27.6%). The prevalence of delirium was higher in patients with pain and those requiring oxygen therapy (P < 0.05). Furthermore, the overall prevalence of delirium in PICU patients was 25.3% (n = 22 cases).

    Conclusions

     Investigating the prevalence of delirium in all age groups – pediatric and adolescents, in particular – was found to be extremely important. It was also found that the prevalence of delirium in PICU patients was significant; therefore, it was recommended that necessary preventive and medical interventions should be made to deal with these patients.

    Keywords: Delirium, Intensive Care Units, Pediatric
  • Mohammad Hedayatjoo, Mehdi Tehrani Doost *, Zahra Vahabi, Malahat Akbarfahimi, Reza Khosrowabadi Page 2
    Background

     There is a growing need for predicting Alzheimer disease (AD) based on emerging neurocognitive dysfunction before the onset of the disease.

    Objectives

     According to neuropathological changes in the mesial temporal lobe (MTL) before the onset of clinical symptoms and the relationship between the function of these structures and cognitive functions (such as visual memory, working memory, and new learning), we aimed to investigate the possibility of these cognitive functions as markers of transition from mild cognitive impairment (MCI) to AD.

    Methods

     In this case-control study, 15 patients with AD, 18 patients with MCI (from memory clinics of Tehran University of Medical Sciences), and 15 healthy people were compared using the 3 subtests of the Cambridge Neuropsychological Test Automated Battery (CANTAB), including spatial working memory (SWM), pattern recognition memory (PRM), and paired-associate learning (PAL). The tests were performed between 9 AM and 12 noon. The scores were compared by a 1-way analysis of variance (ANOVA).

    Results

     The mean ages of AD, MCI, and healthy groups were 68.66, 68.22, and 64.26 years, respectively. In terms of the SWM test, in 2 of 3 variables, there were significant differences between the 3 groups (P = 0.000 and P = 0.001). Regarding the PRM test, there were significant differences between the 3 groups in accuracy and response time (P = 0.000 and P = 0.004, respectively). Regarding PAL, there were significant differences between the 3 groups in all 3 variables (P = 0.000). The Mini-mental State Examination (MMSE) scores were associated with almost all variable scores (P = 0.000).

    Conclusions

     Dysfunction in new learning and recognition memory can be indicators of MCI and its progression to AD, whereas the assessment of SWM can only be used to assess the progression of MCI to AD.

    Keywords: Alzheimer Disease, Mild Cognitive Impairment, Cognitive Dysfunctions, Paired-associate Learning, Spatial Working Memory, Pattern Recognition Memory
  • Naba Al-Zubaidi, Omid Mirmosayyeb, Fatima Khatavi, Mahdi Barzegar, Sara Bagherieh, Pegah Noorshargh Page 3
    Background

     Three-thirds of people with radiologically isolated syndrome (RIS) develop multiple sclerosis (MS) within five years following their first brain magnetic resonance imaging (MRI). Subclinical applications of optical coherence tomography (OCT) include measuring the thickness of different retinal layers and monitoring the progression of visual pathway atrophy and neurodegeneration in relation to the progress of the entire brain.

    Objectives

     Our OCT study was conducted in individuals with RIS to evaluate the thickness of the macular retinal nerve fiber layer (mRNFL) and the retinal ganglion cell layer (RGCL).

    Methods

     In this study, 22 patients with RIS and 23 healthy individuals healthy control (HC) were enrolled. The control group and the RIS subjects underwent retinal imaging with OCT.

    Results

     Total mRNFL thickness was 110.34 ± 13.71 μm in the RIS patients and 112.10 ± 11.23 μm in the HC group. Regional analysis of the mRNFL showed that the difference in thickness was more prominent in the superior quadrant. In regards to ganglion cell layer (GCL)++ thickness, the RIS and HCs population showed statistically significant differences in the nasal (P = 0.041), inferior (P = 0.040), and superior (P = 0.045) quadrants. The nasal (P = 0.041) quadrant showed the highest reduction in thickness compared to other regions of the GCL++. Meanwhile, no significant reduction was seen in GCL+ thickness (P-value > 0.05). When the thickness of the retinal layer of the right eye was compared to that of the left eye of the RIS group, no statistically significant differences were found (P-value > 0.05).

    Conclusions

     Compared to the control group, the RIS group had a lower mean thickness of mRNFL and GCL++, indicating retinal neuroaxonal loss.

    Keywords: Radiologically Isolated Syndrome, Retinal Nerve Fiber Layer, Retinal Ganglion Cell Layer
  • Mohamed Amine Baba *, Mohamed lmejjati, Nawal Adali Page 4
    Background

     Glioblastoma is the most common brain cancer in adults. It is caused by the abnormal proliferation of central nervous system cells called astrocytes, with an incidence rate of 4.32 per 100,000 in the United States. The median survival for glioblastoma is about 1 to 2 years. In Morocco, the survival of patients with glioblastoma is relatively little explored.

    Objectives

     This research aims to study overall survival and these prognostic factors in patients with glioblastoma.

    Methods

     This is a retrospective study; the data were extracted from the files of patients with glioblastoma in the public reference oncology center in the southern region of Morocco; it is a prognostic study including all patients with glioblastoma cancer between 2014 and October 2021.

    Results

     The present study ultimately focused on 71 files of cases diagnosed with glioblastoma. The median age at diagnosis was 57, with a sex ratio of 1.44. The median survival time for all glioblastoma patients in this study was 11 months (95% CI: 9.96 to 12.03 months). Univariate analysis revealed that age, sex, geographical origin, type of treatment, and type of surgery were significant at P = 0.20 and then included in the multivariate model. After adjusting for all factors, the results revealed that only gender, age, and geographical origin were statistically significant predictors of overall survival.

    Conclusions

     The survival rate in patients with glioblastoma is improved with surgery, followed by concomitant radio-chemotherapy. We also confirmed that age and sex are important prognostic factors for the survival of patients with glioblastoma. Moreover, the data suggest the effect of the geographical origin of the patients on the overall survival of the patients as the only modifiable prognostic factor.

    Keywords: Glioblastoma, Brain, Overall Survival, Prognostic Factors, Morocco
  • Mona Amiri, Samira Ghorbani, Fahime Zavvari, Hassan Hosseini Ravandi, Fariba Karimzadeh * Page 5
    Background

     A variety of receptors may be involved in the pathogenesis of absence seizures. The c-Met receptors have a critical role in modulating the GABAergic interneurons and creating a balance between excitatory and inhibitory neurotransmission, sensorimotor gating, and normal synaptic plasticity.

    Objectives

     This study aimed to assess the changes of the c-Met receptor during the appearance of absence attacks in the experimental model of absence epilepsy.

    Methods

     A total of 48 animals were divided into four groups of two- and six-month-old WAG/Rij and Wistar rats. Epileptic WAG/Rij rats showing SWP in electrocorticogram (ECoG) were included in the epileptic group. The two-month-old WAG/Rij rats as well as two- and six-month-old Wistar rats not exhibiting SWP in ECoG were selected as the non-epileptic. Gene (RT-PCR) and protein expression (western blotting) of c-Met receptors as well as c-Met protein distribution (immunohistochemistry) in the somatosensory cortex and hippocampus were assessed during seizure development of the absence attacks.

    Results

     According to the study findings, a lower c-Met gene and protein expression, as well as a lower protein distribution, were observed in the hippocampus (P < 0.001, P < 0.05, and P < 0.001, respectively) and cortex (P < 0.01, P < 0.001 and P < 0.001, respectively) of the two-month-old WAG/Rij rats compared to the same-age Wistar rats. Moreover, the data revealed a reduction of hippocampal and cortical c-Met protein expression (P < 0.001, for both) in six-month-old WAG/Rij rats compared to two-month-old ones. Six-month-old WAG/Rij rats had a lower cortical c-Met gene (P < 0.05) and protein expression (P < 0.001) as well as lower hippocampal and cortical protein distribution (P < 0.05 and P < 0.001) than the same-age Wistar rats.

    Conclusions

     In sum, the c-Met receptor was found to play a significant role in the development of absence epilepsy. This receptor, therefore, may have been considered as an effective goal for absence seizure inhibition.

    Keywords: C-Met Receptors, Absence Epilepsy, Somatosensory Cortex, Hippocampus, Seizure
  • Azam Navazesh, Homa Rasoolijazi, Ghazal Rahmani, Saad Bavi, Gelareh Vahabzadeh, Mansoureh Soleimani Page 6
    Background

     Epilepsy is one of the most important diseases of the central nervous system, for which has no definitive treatment. Neurotrophic factors increase the survival of nerve cells and improve the treatment of neurological diseases. Identifying factors that affect the increase of neurotrophins in the brain is an important goal for brain health and function.

    Objectives

     This study aimed to investigate the effectiveness of exercise on neurotrophic factors by influencing the expression of vanilloid receptor type 1 (TRPV1).

    Methods

     Convulsions were induced by injecting pentylenetetrazol (PTZ; 35 mg/kg) five hours after exercise. Animals were divided into five groups: sham (Sham), seizure (PTZ), exercise (EX), exercise with seizure induction (EX+PTZ), and exercise before seizure induction (EX-PTZ). The exercise was 30 minutes of forced running on a treadmill, five days a week for four weeks.

    Results

     The average percentage of NGF cells in the exercise groups (EX), exercise with seizure induction (EX+PTZ), and exercise before seizure induction (EX-PTZ), and GDNF in the exercise group with seizure induction (EX+PTZ) had a significant increase compared to the seizure group (PTZ). Also, TRPV1 activity in exercise groups (EX), exercise with seizure induction (EX+PTZ), and exercise before seizure induction (EX-PTZ) showed a significant increase compared to the seizure group (PTZ).

    Conclusions

     Our findings suggested the possible antiepileptic and antiepileptogenesis effects of exercise through activation of neurotrophic factors and TRPV1 modulation.

    Keywords: Epilepsy, Exercise, Seizure, Hippocampus, NGF, GDNF, TRPV1
  • Maher Kurdi Page 7
    Introduction

     Myasthenia gravis disease (MGD) and inflammatory myopathy (IM) are commonly reported in the literature and usually appear with thymic pathology. Lambert-Eton myasthenic syndrome (LEMS) associated with IM is extremely rare.

    Case Presentation

     We report a 42-year-old female patient who presented with proximal muscle weakness of the upper and lower limbs, normal creatinine kinase (CK) level, and positive acetylcholine and voltage-gated calcium channel receptor antibodies. There were no oculobulbar symptoms and no history of thymoma, and the electrophysiological tests were unremarkable. Muscle biopsy revealed focal perimysial and perivascular inflammation, predominantly B-cell lymphocytes, in a non-necrotizing muscle.

    Conclusions

     LEMS associated with IM, particularly B-cell inflammation, has never been reported in the absence of cancer history. Clinical investigations and myopathological features can help establish the diagnosis.

    Keywords: Myasthenia Gravis Disease, Lambert-Eaton Myasthenic Syndrome, Inflammatory Myopathy, Muscle Biopsy
  • Seyed Hamzeh Hosseini, Mahya Kaveh, Hamed Ghazvini, Seyedeh Masoumeh Seyedhosseini Tamijani, Raheleh Rafaiee * Page 8
    Introduction

     Dementia presents with a variety of behavioral and psychiatric disorders, including a range of psychosis, anxiety, depression, behavioral aggression, and delirium.

    Case Presentation

     This study aimed to report a 74-year-old man showing gradually progressive deterioration in his memory for five years. The patient developed trichotillomania (TTM) subsequent to his dementia. Neuropsychological examination indicated the deficits to be more predominantly in the frontal lobe.

    Conclusions

     This study reviewed the literature on TTM in dementia case reports that had mostly investigated the cases of right-handed men aged > 65 years. TTM Patients with underlying disease had not any improvement. Although there was some heterogeneous evidence for the presence of brain abnormalities in individuals with hair-pulling behavior, no definitive conclusion was drawn. Mild to severe generalized atrophy in the cerebral cortex was observed in the frontal, parietal, temporal, occipital, and cingulate lobes.

    Keywords: Dementia, Trichotillomania, Psychiatric Disorders