International Journal of Preventive Medicine
Volume:4 Issue: 3, Mar 2013

Stroke is an important cause of death in the world and disability world‑wide especially in developed countries. Following acute phase of stroke, some procedures and medical treatment such as thrombolytic agents has been recommended; nevertheless many patients have enduring deficits. Thus, there is a realistic need to develop treatment strategies for reducing neurological deficits. However, the stem cell (SC) therapy could arrange an alternative intervention for disease modifying therapy. In this article, we present a brief review of different methods of SC therapy in stroke patients and discuss the results with different cell types and routes of administration.

A variety of techniques for the management of spasticity have been suggested, including positioning, cryotherapy, splinting and casting, biofeedback, electrical stimulation, and medical management by pharmacological agents, Botulinum toxin A (BTA) is now the pharmacological treatment of choice in focal spasticity. BTA by blocking acetylcholine release at neuromuscular junctions accounts for its therapeutic action to relieve spasticity. A computerized search of Pub Med was carried out to find the latest result about efficacy of BTA in management of post stroke spasticity. Among 84 articles were found, frothy of them included in this review and divided to lower and upper extremity. BTA is a treatment choice in reducing tone and managing post stroke spasticity.

Multiple sclerosis (MS) is a multifactorial disease (caused by both environmental and genetic features) that could results from a demyelination of the myelin sheath. Subsequently, it leads to many scars or lesions in different places within the central nervous system. The symptoms that occur depend on the site and rigorousness of the lesions and this is why people with MS experience different symptoms. Although, it is not clearly known that why people develop MS, research suggests that vitamin D plays a key role in preventing or repairing the damaged myelin. Previous studies have shown that vitamin D is a potent natural immune‑regulator and has an anti‑inflammatory action. Increased exposure to vitamin D may result in changed immunologic profiles or commotion that donates to MS risk. Vitamin D deficiency is caused by insufficient sunlight exposure or low dietary vitamin D3 intake. Recent studies have also indicated that, there are several polymorphisms for vitamin D receptor (VDR) gene, but the effect of VDR gene polymorphisms on protein function of VDR and how exerts second signaling pathways in cells is still unknown. Therefore, this review focuses on vitamin D metabolism and genetic polymorphisms related to VDR and MS to better understand of discrepancies among patients.

Stroke is one of the leading causes of death and certainly the major cause of disability in the world. Diet and nutrient has an effective role in prevention and control of the risk of stroke. The aim of this study was to review the studies on the relationship between dietary intake and stroke incidence. In this study, the terms of “Fat”, “cholesterol”, “antioxidant”, “vitamins”, “salt”, “potassium”, “calcium”, “carbohydrate”, “vegetables”, “fruits”, “meat”, “tea”, “whole grains”, “sugar‑sweetened beverages”, “Mediterranean diet”, “dietary approaches to stop hypertension diet (DASH diet)”, “Western diet”, and “stroke”were searched in Pubmed search engine. The observational studies, cohort studies, clinical trial studies, systemic review, and meta‑analysis reviews are also included in this study. The study revealed that adherence to theimprovements in nutrition and diet canreducethe incidence ofstroke. Higher antioxidant, vitamins, potassium, calcium, vegetables, fruits, whole grain intake, and adherence to the Mediterranean dietor DASH diet can lower stroke incidence. Adherence to Mediterranean diet or DASH diet and increasing the consumption of antioxidant, vitamins, potassium, calcium food sources, vegetables, fruits, and whole grains intake can lower the risk of stroke. Healthy diet is effective in reducing risk of stroke, however, more studies need to be carried out in this area.

The association between the prevalence of multiple sclerosis (MS) and latitude gradient indicates the importance of environmental factors in MS susceptibility. Sunlight’s ultraviolet radiation, its ability to influence melatonin, and an imbalance of melatonin in the central nervous system (CNS) may be involved in this process. This case‑control study was conducted in Isfahan MS Society (IMSS), Isfahan, Iran. Enrollment was limited to patients with MS referring to the MS clinic of Alzahra and Kashani hospital during January and February 2012. Thirty‑five patients with MS and 35 healthy individuals were included in our study. The melatonin levels were analyzed using enzyme‑linked immunosorbent assay (ELISA) kits. There was no significant difference between saliva melatonin level of two groups (patients and healthy individuals) (P = 0.417); however, after controlling the effect of age, a significant difference (P = 0.022) was found. In the present study, it is proposed that environmental conditions in Isfahan city might have increased the susceptibility to MS, but more studies in different parts of the world are needed to evaluate this claim.

The effect of nutrition in the course of multiple sclerosis (MS) is a topic of great interest. The present study was aimed to evaluate the immunoglobin E (IgE) against egg and fish in MS patients compared to healthy controls. Between March 2012 and July 2012, 48 MS patients were selected and compared with 48 healthy subjects to assess the frequency of IgE against egg and fish in MS patients compared to healthy control. Fish and Egg specific IgE was determined by Immuno CAP. Sex and the frequency of specific IgE were compared between study groups by Chi‑square test. Total of 96 subjects was assessed (22% male and 78% female). The mean age of the study subjects was 30.8 ± 6.6 years. Mean age of case and control groups was 30.7 (±6.9) versus 30.9 ± 6.3, respectively (P = 0.83). There were no detection of egg and fish specific IgE in serum of MS patients and healthy subjects. IgE allergy against fish and egg may be very unlikely to affect MS course.

Restless legs syndrome (RLS) is a common movement disorder. The occurrence of this syndrome is due to genetic factors and lifestyle. This study performed to determine restless legs syndrome (RLS) prevalence in Iranian multiple sclerosis (MS) patients and the possible risk factors. This cross‑sectional study was conducted with MS patients, and the age‑ and sex‑matched control group comprised healthy persons. Then, all subjects were asked about RLS symptoms. After the diagnosis of RLS, the patients were divided into two groups: With and without RLS. In both groups, the following variables were evaluated: Age, sex, other underlying disease, duration of MS, MS course, family history of RLS, history of anemia, and drug intakes. The severity of the disease in subjects diagnosed with RLS was also evaluated. A total of 126 patients in the MS group and 126 healthy controls were included in the study, with no statistically significant differences between them in terms of age and gender. In MS group, 82 (65.1%) and, in control group, 16 (12.7%) had RLS. The frequency of RLS in the MS patients was significantly higher than that in the control group. Among MS patients, 60 male (73.2%) and 22 female (26.8%) had RLS. Mean age of MS patients with RLS was significantly higher than that in MS patients without RLS. MS patients and higher EDSS score had more RLS symptoms. We suggest that RLS always be considered during neurological examinations of MS patients.

There are few articles studding the factors associated with successful smoking cessation in Iranian smokers. The aim of this study is to clarify the association between socio‑demographic factors and smoking behavior, such as number of failed smoking cessation and duration of abstinence in Iranian population. A self‑administered questionnaire survey of 673 participants was conducted in a local government health‑care center. The questionnaire included items on socio‑demographic information including, age, marital status, education, income, and job. Furthermore, information on smoking cigarettes including number of smoking per day, duration of smoking, cigarettes brand, nicotine concentration, and history of cessation was obtained. Mean ± SD of age and daily cigarette consumption were 39.7 ± 1.1 and 22.1 ± 1.1 respectively. Failure rate of smoking cessation was higher in the lower age group (odds ratios [OR] 2.9; 95% confidence intervals [CI] 1.1, 7.7) and less than 10 numbers smoking per day (OR 2.4; 95% CI 1.3, 4.5) and duration of smoking more than 30 years (OR 3.4; 95% CI 1.2, 9.3) and foreign cigarette brand (OR 1.8; 95% CI 1.1, 2.7). Length time of cessation was prominent in participants with lower age group (OR 5.4; 95% CI 1.3, 22.1), and less than 10 numbers smoking per day (OR 2.7; 95% CI 1.5, 4.9) and lower in smokers with duration of smoking more than 10 and 10‑19 years (OR 0.32; 95% CI 0.12, 0.89), (OR 0.34; 95% CI 0.17, 0.76), respectively. The above results suggest that there are a significant association between socio‑demographic factors and smoking‑related behaviors in the Iranian population, consistent with previous reports world‑wide. These factors should be considered to have appropriate public‑health and policy response.

Alzheimer’s disease (AD) is one of the most important neurodegenerative disorder. Anti‑cyclic citrullinated peptide (anti‑CCP) may all be involved in the development of vascular disease such as AD. The aim of this study is detection of seropositivity for anti‑CCP antibody in AD patients. In our study, 30 patients with AD and 29 healthy controls (age and‑sex matched) were recruited. Homocysteine and anti‑CCP was measured by spectrophotometrically and immunoassay. Mean ± SE anti‑CCP was higher significantly between AD (13.6 ± 3) and healthy subjects (4.8 ± 0.2) (P = 0.006). In the patients, anti‑CCP serum level was in high range (32.1%) of abnormal levels, but there was no significant difference in serum homocysteine in AD patients compared with controls. There is no correlation between anti‑CCP and homocysteine levels in AD patients (P = 0.75), but between age and anti‑CCP level observed a significantly correlation (P = 0.04). It needs more studies to clarify confirmation the role of anti‑CCP antibody production in AD patients.

Alzheimer’s disease (AD) is a progressive neurodegenerative disease and nowadays the role of endothelial cell (EC) injury has been proposed in pathological process in AD. Peroxisome proliferator‑activated receptor‑γ (PPAR‑γ) agonist has anti‑inflammatory properties through activation in glial cells and improves vascular function and prevent atherosclerotic disease progression. The aim of this study is evaluation of pioglitazone effects as a drug of PPAR‑γ agonist on endothelial apoptosis induced by sera from AD patients. Human umbilical vein endothelial cells (HUVECs) were treated with sera from AD patients (n = 10) and sera from controls (n = 10). Apoptosis was identified by annexin V‑propidium iodide staining and cell death detection kit. Apoptosis was evaluated after and before adding of 10 μM pioglitazone on EC. Nitrite (NO2‑) levels were determined in the culture supernatants. Induced apoptosis by the serum of patients was inhibited markedly when pioglitazone used before treating HUVECs with the sera of AD. Also, the measurement of nitrite concentration showed significantly greater levels of dissolved NO2/NO3 metabolite in the culture media of HUVECs treated by sera of AD patients (P < 0.05), while the rate of nitric oxide significantly decreased when pioglitazone exists in culture media. Further studies are justified to investigate the novel role of the PPARs in the prevention of the neuronal and endothelial damage in neurological disorder and present a new therapeutic approach for Alzheimer`s patients.

Multiple sclerosis (MS) is an autoimmune disease of central nerves system, in which neurological disabilities occur in young adults. Despite increasing number of studies on MS, some aspects of this disorder are still unclear. In the previous studies, it has been proven that there is direct relation between MS incidence and vitamin D deficiency. Thereby, strong evidence in MS pathogenesis suggests that endothelial cells (EC) could be harmed in MS. In addition, functional changes in EC and macrovascular injuries lead blood‑brain barrier disruption in MS. Current study is the first investigation to elucidate positive influences of vitamin D against EC apoptosis in MS. Human umbilical vein endothelial cells (HUVECs) were cultured and then treated with sera from patients with active MS (in relapse) and sera from healthy volunteer participants as control group (each group n=15). 3‑(4,5‑dimethylthiazol‑2‑yl)‑5‑ (3‑carboxymethoxyphenyl)‑2‑(4‑sulfophenyl)‑2H‑tetrazolium, inner salt (MTS) assay for cell surveillance and cell‑death detection kit for evaluating apoptosis were used in this study. There was a significant decrease in apoptosis rate by the serum of patients, just when 1,25(OH)2D3 applied before treating HUVECs with sera from active MS (in relapse). Furthermore, the cells surveillance increased markedly with the presence of 1,25(OH)(2)D(3) in culture, too. Withregard to increment in EC apoptosis rate, which treated by the sera from MS patients and decrement in apoptosis rate by the presence of vitamin D in culture media, it could be proposed that vitamin D pre-treatment can be used for MS patients, due to its beneficial effects on protecting EC apoptosis.

Status epilepticus (SE) is a type of persistent lasting seizure with high mortality and morbidity. Numerous medications are suggested for the treatment of SE, two of which are sodium valproate and phenytoin. The purpose of this study is to conduct a comparison between the effi ciencies of intravenous sodium valproate and phenytoin in the treatment of this type of epilepsy. This is a clinical trial study conducted on SE-suffering patients admitted to the emergency departments of Al-Zahra and Ayatollah Kashani Medical Centers of Isfahan in 2009 and 2010. The patients were randomly assigned into two groups and taken under treatment, separately by intravenous infusion sodium valproate and phenytoin. No significant difference was observed between the two groups (at P = 0.06). In terms of incidence of the clinical complications, the incidence of clinical complications in the two groups was significantly different (at P = 0.03). Based on the findings the efficiency of sodium valproate is larger than that of the phenytoin, and thus, the treatment by sodium valproate is preferred over the treatment by phenytoin.

Previous studies have shown that morphine consumption during pregnancy may cause delay or defect of embryo development or abnormal nervous system function in the human and animal models. In the present study, the highest density of morphine accumulation in the central nervous system of rat embryos was evaluated using C14‑morphine. Female Wistar rats (W 170‑200 g) used and were crossed with male rats and coupling time was recorded (Embryonic day 0-E0). Experimental groups received 0.05 mg/ml of C14‑morphine in drinking water daily. On the 10th and 17th days of pregnancy, pregnant rats were anesthetized and the embryos with these uterus and placenta were surgically removed and were fixed in formalin 10% for 4 week. Then the embryos were processed, sectioned in 25 μm and 5 μm thicknesses, fixed on the glasses for further evaluations. The sectioned in 25, the glasses were fixed on the Blanc black and white film for 6 h. Then, the films were appeared and their negatives were prepared. The sectioned in five staining hematoxylin and eosin by light microscope and MOTIC software. Our results indicated that the highest C14‑morphine accumulation was observed in the vesicles and the ventricular choroid plexus (CP) of (E17) embryos, whereas, in the (E10) embryos. Highest concentration was observed in the brain vesicles and the ventricular CP. In addition, this study showed the surface area of lateral, 3rd and 4th ventricular CP in the experimental groups were increased in compared to control groups. Our results indicated that effects of morphine on reduction of embryos brain development may be due to the highest accumulation of C14‑morphine in the CP and brain vesicles.

Parkinson’s disease (PD) is a progressive neurodegenerative disorder causing motor and non‑motor symptoms. The latter are common and include autonomic dysfunction, cognitive impairment, and sleep difficulties. Many of the non‑motor aspects of PD such as sleep disturbance are more common and significantly affect the day‑to‑day activities of patients and their quality of life. The most important aim of this study was to evaluate the sleep quality in patients with PD. This case‑control study was performed on patients with PD referred to the Neurology Clinic of our teaching hospital in 2011. Thirty‑four patients with PD and 34 healthy people as control group were enrolled in this study. Sleep quality of patients and control was evaluated by Parkinson’s disease sleep scale (PDSS) questionnaire. PDSS is a reliable and valid tool to measure sleep disorders in PD. The mean total PDSS score in patient group was 55.29 (SD = 26.92) indicating moderate to severe sleep disturbances whereas, the mean total score in control group was 20.34 (SD = 10.65). Difference between the two groups’ mean scores was significant (P < 0.05). Our study demonstrated that patients with PD experienced poorer nocturnal sleep quality than the control group.

Diabetes is one of the most common chronic diseases in which antioxidant capacity changes. Omega‑3 fatty acids have extensive biological effects including their advantage on lipoprotein metabolism, platelet function, cytokine production, clotting, fibrinolysis, and inflammatory factors. This study aimed to investigate the effect of omega‑3 fatty acid supplements on antioxidant capacity in patients with type 2 diabetes. This clinical trial enrolled 71 women with type 2 diabetes in two case (treated with omega‑3 capsules) and control (treated with placebo) groups. In the first stage, participants filled out a demographics questionnaire including age, height, weight, waist circumference, and hip circumference.Their blood sample was taken to evaluate glycosylated hemoglobin and antioxidant capacity. Then the case group received intervention for 8 weeks and weight, waist circumference, and hip circumference were measured and a blood sample was taken again. The data were analyzed using SPSS 18 software. The mean difference of antioxidant capacity before and after intervention was significant (P < 0.001). Antioxidant capacity increased in the case group and reduced in the control group. With regard to the results of the present study, patients with type 2 diabetes increase their antioxidant capacity, enhance their antioxidant defense system, and probably prevent diabetes complications and related disease progress by taking omega‑3 supplements.

Given miscarriage psychological consequences on the women health, the aim of the present study is the survey of effectiveness rate of attributive retraining interventions on women depression and anxiety reducing after miscarriage. The present study is semi‑empiric and it’s made using control group, pre‑ and post‑test execution and follow‑up. Thirty‑two women, who had recent experience of miscarriage, were selected among female referents to obstetricians and clinics in Esfahan city by accessible sampling and then they were placed on two groups, case and control, randomly. Case group participated in 6 weekly sessions for attributive retraining interventions and both groups completed hospital depression and anxiety questionnaire on three steps: Pre‑test, post‑test, and follow‑up. Collected data were analyzed statistically, using Statistical Package for the Social Sciences (SPSS) software and variance by repeated measuring. Obtained results show that average post‑test and follow‑up scores of depression and anxiety in case group is less than average post‑test scores in control group, significantly (P < 0.0005). The findings of this research, ‘‘Attributive Retraining Effectiveness on Women’s Depression and Anxiety Reducing after Miscarriage,” were confirmed.

Today there are abounding collected data in cases of various diseases in medical sciences. Physicians can access new findings about diseases and procedures in dealing with them by probing these data. This study was performed to predict stroke incidence. This study was carried out in Esfahan Al‑Zahra and Mashhad Ghaem hospitals during 2010‑2011. Information on 807 healthy and sick subjects was collected using a standard checklist that contains 50 risk factors for stroke such as history of cardiovascular disease, diabetes, hyperlipidemia, smoking and alcohol consumption. For analyzing data we used data mining techniques, K‑nearest neighbor and C4.5 decision tree using WEKA. The accuracy of the C4.5 decision tree algorithm and K‑nearest neighbor in predicting stroke was 95.42% and 94.18%, respectively. The two algorithms, C4.5 decision tree algorithm and K‑nearest neighbor, can be used in order to predict stroke in high risk groups.

In some studies, the involvement of dangerous psychological and behavioral factors in etiology and physiotherapy of vascular disturbances have been shown. In other studies, the relationship between the personality type and increase in cardiovascular disease has been demonstrated. The type D personality is defined as having two characteristics of negative affect and social inhibition. It is thought that individuals with type D personality are at increased risk of carotid artery intima‑media thickening which predisposes them to vascular disease that is one of the most important factors for the stroke. In this study, we try to determine whether type D personality is a contributing factor to an increase in the intima‑media of the carotid artery. This study was done in 2012 in the teaching hospital of Alzahra in Isfahan Iran. This is a case/control study which is done at Alzahra hospital in Isfahan in 2011-12. The statistical population in this study is composed of individuals who do not have any risk factors for stroke and are randomly selected among the hospital staff or the patient’s family members who accompanied the patient at the hospital. They filled out a questioner that would assist in detecting type D personality. A carotid Doppler ultrasound that measures the intima‑media thickness in the selected individuals was performed. The information obtained from the study was evaluated by Statistical Product and Service Solutions (SPSS) software and the intima‑media thicknesses were compared in two groups of patients. The average thickness of intima media in two groups, consist of placebo and patients, was 0.739 ± 0.12 and 0.759 ± 0.14 millimeter, respectively. There was no meaningful difference between the two groups based on t‑test values (P = 0.19). It is important to note that based on the results, 22.9% of placebos and 48.6% of individuals with type D personality presented with abnormal thickness. The difference between the two groups were meaningful based on Chi‑Squared test (P = 0.001). We conclude that type D personality increases the risk of cardiovascular diseases specially the stroke and myocardial infarction due to the higher prevalence of hormonal imbalances leading to arterial vasospasm and atherosclerotic disease. As a result, it is necessary to evaluate and treat these patients due to increased risk of atherosclerotic diseases, stoke, and myocardial infarction.

Regarding high prevalence and injurious consequences of postpartum depression, the aim of the present work is the study of the effect rate of interpersonal psychotherapy on marriage adaptive and postpartum in women. The present study is semi‑empiric, and included control group and pre‑ and post‑test groups. Thirty‑two women suffering from postpartum depression were selected from among female referents to counseling centers and clinics in Esfahan city by purposive sampling and were placed in two groups (control and test) randomly case group participated in a 10‑weeks marriage interpersonal psychotherapy meetings. Beck II depression questionnaire and marriage adaptive scale were completed by two groups at pre‑test and post‑test steps. Collected data were analyzed using SPSS software and multivariable covariance analysis. The scores of average of depression and marriage adaptive post‑test in test group was significantly less than that in the control group (P < 0.0005). The findings of this research confirm marriage interpersonal psychotherapy on the depression recovery and the increasing marriage satisfaction of women suffering from postpartum depression.

Regarding the social and economic changes and developments, the increasing presence of working women in the present society and their important role in the family, paying more attentions to the importance of maternal role among working women who face multiple roles seems to be necessary. Hence, the process of maternal role among working women has been investigated in this study. The grounded theory approach is used in this qualitative research. In-depth and unstructured interviews were the main way in collecting the data. Initially, the targeted sampling was started and continued gradually to the data saturation, in the form of theoretical sampling based on the obtained classes. The data was analyzed using Strauss and Corbin analysis. Accuracy and validity by four criteria in this study included: Credibility, dependability, Confirmable potential, Transferability or Fittingness. Data analysis led to the identification of the core variable of role conflict. The main classes of occupied mothers’ experiences included: different pregnancy experience, returning concerns, supportive umbrella, role assignation, role overlap, role strain, gradual acceptance, satisfaction and erosion. The acceptance of numerous roles such as maternal and marital roles by working women creates various role expectations of them from their children, spouses, family and the society which in turn forces them to meet both family and job requirements and expectations; This causes role conflict in working mothers and endure a lot of pressure and stress, that can influences of mental and physical health of the mothers.

The aim of this study was to compare the effects of olanzapine versus haloperidol to control the signs and symptoms of stuttering. Ninety‑three patients were recruited in a 12‑week single‑blind randomized clinical trial, which was held between October 2009 and October 2010. Forty‑three patients received olanzapine (5 mg/day) and 50 patients, haloperidol (2.5 mg/day). Before and after the study, they were evaluated by a speech pathologist by Van Riper`s questionnaire. The data were analyzed using the SPSS version 16. T‑test was used to compare the data between the two groups. Mean of stuttering score (SD) before treatment was 4.67 (0.81) and 4.40 (1.14) in haloperidol and olanzapine groups, respectively (P > 0.05). After treatment, the mean (SD) score was 2.87 (1.32) and 1.56 (0.71) in haloperidol and olanzapine groups, respectively (P = 0.000). It seems that olanzapine does have better impact in controlling stuttering, and it may be recommended to prescribe olanzapine for stutters as the first choice to control the stuttering under a careful follow‑up.

To manage relapsing‑remitting multiple sclerosis (MS) in the course of acute exacerbations, methylprednisolone (MP) (Medrol or Solu‑Medrol), has the ability to lock the injured blood‑brain barrier and decrease irritation in the central nervous system. The aim of this preliminary study was to investigate the frequency and time interval related to MP pulse therapy in patients with MS. This Study is conducted in the MS clinic of the Isfahan Kashani hospital, that was carried out on patients (n = 901) from June 2011 to December 2012. Patients who visited MS clinic just for once disinterested from analysis. According to the incidence of MP pulse therapy in females and males, two groups were made. Group 1 included patients with 2‑3 times and Group 2 included patients with more than 4 times pulse therapy. Demographical data, pharmacological variables including number and time interval related to pulse therapy for each individual were recorded in dBase. The statistical analyses of d‑Base were performed using SPSS. 901 patients in 1592 occasions were studied. The mean age of patients was 34.6 years old (ranged: 8‑87 years old). 586 patients included 465 females and 121 males visited MS clinic just for once. 245 females in 797 occasions and 70 males in 209 occasions received pulse therapy with a mean of 4 times (ranged: 2‑11 times). 51.1% and 48.9% of patients received MP pulse therapy for two and more than two up to 11 times respectively. In the 70% of the patients’ time interval between pulse therapy was with a mean of 137 days (ranged: 28‑480 days). For pulse therapy, it seems that the female subjects refer to clinic are approximately 3.7 times higher than male subjects. To reduce the demand of patients to pulse therapy, disease management could be rationalized on the basis of illness expansion and its correlation to inter and intra individual variability. Finally, to understand the effectiveness of pharmacotherapy, in MS population (Isfahan/Iran), clinical neuropharmacology in relation to better understand of the individualized pharmacokinetics could be useful.

In adults, throughout life, uniqueness maintains the equivalent; but, it might be tailored in the track of neurological disarrays. As in the partition of cognitive function associated with multiple sclerosis (MS), numerous studies have been performed, but there are very few reports in this area of behavior. The aim of this study was to investigate the prevalence of personality types A and B in relation to individuals’ behaviors with MS and type A behavior with demographic characteristics and the level of disability. A cross‑sectional descriptive study was performed between September 2010 and March 2011 on 50 patients who were referred to MS clinic (located at the Kashani hospital), Isfahan Neurosciences Research Centre (INRC). The subjects were evaluated using Friedman and Rosenman questioner and the Expanded Disability Status Scale (EDSS). The data were analyzed by SPSS software (version 17) based on Chi‑square test and independent T‑test. Of the subjects, 65% were of personality type A and 35% were of personality type B (X2: 3.5, P < 0.05). There were no significant differences in individuals with type A behavior in relation to gender and marital status. In connection to EDSS (EDSS < 4.5 or EDSS > 4.5), patients with higher EDSS score, i.e., individuals with EDSS > 4.5 mostly had type A behavior pattern. People with type A behavior pattern are reported to have more stress, nervousness, and anxiety. In this study, MS patients had more characteristics of type A than type B behavior. This behavior was increased in individuals with EDSS score >4.5.

Stroke is a leading cause of death in developed countries. However, current therapeutic strategies for stroke have been largely unsuccessful. Several studies have reported important benefits on reducing the risk of stroke and improving the post‑stroke‑associated functional declines in patients who ate foods rich in micronutrients, including B vitamins. Folic acid, vitamin B6, and vitamin B12 are all cofactors in homocysteine metabolism. Growing interest has been paid to hyperhomocyste inemia as a risk factor for stroke. Experimental studies suggest that oxidative stress plays an important role in the pathogenesis of ischemic cerebral injury, and higher intake of antioxidants has been associated with a lower risk of stroke in large population studies. The aim of this study was to examine whether the dietary intake of B vitamins and antioxidants in patients with stroke were comparatively worse than those in patients without stroke. In this case control study, 69 stroke patients (46 male, age = 56 ± 18 years and 23 female, age = 52 ± 7 years) admitted to Azzahra hospital between April 2009 and May 2010 were matched for age and sex with 60 patients (30 male and 30 female) from the same hospital who were not affected with acute cerebrovascular diseases and did not have a history of stroke. Dietary intake was assessed with a validated self‑administered food frequency questionnaire (FFQ). FFQ was collected conducting face‑to‑face interview with one of the patients’ close relatives. Food intakes, translated into nutrient data, were compared between the two groups and with the recommended values. Intake of folic acid in men with stroke and vitamin B12 in women with stroke was significantly lower than that in the patients without stroke (P < 0.05), but there was no significant difference between the two groups in the level of antioxidant consumption in women and men (P > 0.05). Our findings suggest that increased folic acid, vitamin B12, and vitamin E, C intake may be associated with decreased risk of stroke.

Stroke is a leading cause of preventable morbidity and mortality in the United States. Numerous studies have shown that dietary carbohydrates play an important role in stroke incident. Therefore, this study aimed to assess the association between dietary intake of carbohydrate and its types and stroke incidence among Iranian adults. A case‑control study was performed among 46 men (5618) and 23 women (527) admitted to the Al Zahra hospital with stroke and 60 healthy people were chosen in control group. Dietary intake was measured by food frequency questionnaire (FFQ) including 168 items. Food processor software (version 2) was used to analyze data. Anthropometric indices of male and female patients were (BMI: 297.5), (Waist: 11215) and (BMI: 25.53.5), (Waist: 925) respectively. Energy intake and carbohydrate consumption of patients in both genders was higher than the healthy subjects which was statistically significant among men (P < 0.05). Across different carbohydrate sources, refined carbohydrates consumption was higher among patients in both gender rather than the healthy subjects While, the healthy people had a higher whole grain consumption. High carbohydrate intake specially refined sources with high glycemic index (GI) and glycemic load (GL) is associated with increased risk of stroke. Hence, dietary intake requires improvement to provide protection from life threatening outcomes.

Stroke is one of the most common causes of life‑threatening disabilities and death around the world. Mortality rate is going to be doubled by 2030 in the Middle East countries. Prevention is a cost‑effective approach to decrease risk of stroke. The present study assessed the relationship between dairy intake and stroke risk. This hospital‑based case‑control study was directed in a University hospital. The common food consumption of 129 men and women was assessed with food frequency questionnaire (FFQ). The relationship between fermented and non‑fermented dairy intake and stroke were assessed between two patient groups. Total of dairy intake were lower in patients with stroke than control group (13.36 vs 19.61% in men and 11.14 vs 15.02% in women). Similar relationships were observed betweenfermented and non‑fermented dairy intake and stroke in both genders. Lower dairyconsumption can increase stroke risk in men and women.

Stroke is a leading cause of death. Current therapeutic strategies have been unsuccessful. Several studies have reported benefits on reducing stroke risk and improving the poststroke associated functional declines in patients who ate foods rich in fruits and vegetables. Their potential protective effects may be due to their antioxidants, calcium, potassium, riboflavine, peridoxin, riboflavin contents. Folic acid, peridoxin, and riboflavin are all cofactors in hyperhomocysteinemia as a stroke risk factor. Studies suggest that oxidative stress plays important roles in pathogenesis of ischemic cerebral injury and higher intake of antioxidants has been associated with a lower stroke risk. The aim of this study was to examine if the dietary intake of vegetables and fruits in patients with stroke were comparatively worse than those in patients without stroke. In this case control study,93 stroke patients admitted to Alzahra hospital were matched for age and sex with 60 patients who were not affected with acute cerebrovascular diseases and did not have a history of stroke. Dietary intake was assessed with a validated food frequency questionnaire.Food intakes were compared between two groups and with recommended value. Mean daily intake of vegetable and fruits was more in male with stroke than male without stroke as well as calorie intake from vegetables and fruit was higher in male with stroke.Mean daily intake of vegetable and fruits were lower in women with stroke than women without stroke as well as calorie intake from vegetables and fruit was lower in women with stroke Our findings suggest that increased vegetable and fruits intake may be associated with decreased risk of stroke

Ischemic brain strokes consisttwo‑thirdsof strokesand their complications bear a lot of disability for patient and society. In this study, we seek for effect of Erythropoietin on ischemic brain stroke’s outcomes according to National Institutes of Health Stroke Scale (NIHSS) changes. This study is a RCT (randomized clinical trial). All patients with focal neurologic deficit with primary suspicion of brain stroke undergone neuroimaging evaluations.After confirmation of new ischemic brain stroke, the patients with inclusion criteria’srandomized into two groups of cases and controls.NIHSS was defined for each patient and all patients received a routine treatment protocol. Erythropoietin 16,000 IU as a bolus intravenous dose was given to case patients as soon as neuroimaging study confirmed new ischemic stroke and continued as 8000 IU each 12 h up to total dose of 56,000 IU during 3 days. Patients re‑evaluated at days 14 and 28 and NIHSS was assessed by another neurologist blinded to patient’s group. Finally, NIHSS changes of both groups compared with each other’s. Evaluations revealed that in days14 and 28 during follow‑up, Erythropoietin was effective in NIHSS (P= 0.0001). This effect was of value in level of consciousness Commands (P= 0.024), facial palsy (P= 0.003), motor arm (P= 0.0001), motor leg (P= 0.0001), sensory (P= 0.009), and best language (P= 0.023). Administration of high‑dose erythropoietin in first 24 h can be effective on reduction of ischemic stroke complication. A larger scale clinical trial is warranted.

Obesity is a common health problem around the world. Studies have shown inverse relationship between serum vitamin D levels with obesity among patients and healthy population. The aim of this present study is to examine the relationship between serum vitamin D levels with general and abdominal obesity among migraine patients. The present study is a cross‑sectional and 66 migraine patients aged 19‑61 years were included for analysis. Partial correlation was performed to assess association between serum 25‑OH‑D with general and abdominal obesity. Adjustments were performed for age, sex, and education. No relationship was found between serum levels of vitamin D with general and abdominal obesity. However, a significant association was shown between waist circumferences (WC) with body mass index (BMI). Serum levels of 25‑OH‑D were not associated with WC and BMI. Furthermore, after adjustment for confounder variables, no association was observed.

University entrance is accompanied by major changes in social relationship, rules, and expectations that lead to psychological disorders in susceptible students. The goal of this research is to study the anxiety rate in Iranian medical residents in 2010‑2011. This study is a cross‑sectional, descriptive study. It contains 370 medical residents from the 1st year to the 4th year of medical universities in Isfahan, Gilan, Zahedan, Sanandaj, and Kashan. The stratified sampling method proportionate to volume of participants is used in this study. The information is collected based on researchers’ questioners and Zung self‑rating anxiety scale and analyzed with the use of spss software version 16, addition to descriptive and analytic tests (Pearson, one‑way analysis of variance, t‑test). Meaningful level is regarded as P ≤ 0.05. The study showed that more than 92% of residents participated in the study did not demonstrate anxiety. Among 370 subjects 5.5% presented with mild symptoms of anxiety and no one had symptom of severe anxiety. A meaningful statistical relationship was observed between anxiety and sex, major of study and the city of study (P < 0.05). The results showed a positive meaningful relationship between the number of visits and the score of anxiety. On average the number of night floats were two in 1 week and the number of patient visit was 19 in the past 24 h. A meaningful statistical relationship between anxiety score and number of patient visits was observed. The anxiety rate in medical students in this study compared to the findings of previous studies reveled very low anxiety in medical residents. The low rate of anxiety could be attributed to the sense of job security and the hope for a better future among residents. The high percentage of anxiolytics abuse and absence of anxiety producing factors among residents in addition to inaccurate response to the questionnaire may all contribute to the low rate of anxiety in this study.

Nowadays Medical equipment plays an important role in the treatment and in the medical education. Using outdated preventive maintenance (PM) system may cause problems in the cutting edge medical equipment, Nervous system disease’s equipment (In diagnosis and treatment) which are crucial for every medical center. Based on above facts we focused on nervous system treat units’ equipment and informed the supervisors and their colleagues about the latest equipment maintenance status and promoted methodical and correct method to be used for medical equipment maintenance. This research is an analytical descriptive and has been done on the base information from a particular time to past. We gathered our required information of 2009 from Alzahra Medical Center. We divided this research info 2 main phases. In the first phase, we picked out Neurosurgery and Neourology diseases medical equipment (diagnosis and therapy equipment) and in the second phase, we need to implement a methodical PM for every equipment. Research has shown that there are 19nervous system equipment in Alzahra Medical center, categorized in diagnostic (13 pcs), therapeutic (4 pcs) and diagnostic‑therapeutic (2 pcs). As we declare in methods part of this research, we categorized medical equipment in Food and Drug Administration (FDA) segmentation. Capital‑scarce equipment: Magnetic resonance imaging, Eco Doppler, Kamalaarak ultrasonic surgical aspirator, Stereotactic, computed tomography‑scan, euroendoscope/vital‑scarce equipment: Coblation, Sonoco, vaterjet/ scarce equipment: Transcranial color Doppler, electroencephalogram, electromyography, surgical microscope. Survey of application and preventive maintenance of neurology medical equipment in Isfahan Alzahra hospital show there is no P.M system. Implementing a complete P.M system for this medical center is crucial to preventing cause problems for these medical equipment and decreasing maintenance costs and gaining uptime. Researchers of this article have tried to provide PM, use of texts, web and experts.

The challenge of antiepileptic drugs (AEDs) management is to attain the best compromise between the desire to maximize seizure control and the need to keep side‑effects within tolerable limits for the individual patient. To reduce devastation in Iranian epileptic patients, the aim of this study was to explore the overall outcome following AEDs prescription. A cross‑sectional study of 36 patients located at the epilepsy ward, conducted to Isfahan Neurosciences Research Centre was carried out during the year 2011. Female (n = 17) and male subjects (n = 19) with a mean age of 27 years (range; 7‑74 years) were studied. Variables including, sex, age, age of seizure onset, type, and number of AEDs, biochemical and hematological data were recorded in d‑Base and statistical analyses were performed using SPSS (version 18) for windows. The main drug to control seizure attack was carbamazepine and valproic‑acid. The following tests were the most frequently influenced; alkaline phosphatase (AP), lymphocyte (Lymph), white blood cell (WBC) counts and hemoglobin (Hgb). There was a significant increase in (AP) (mean; 534.6 u/l↑; [P = 0.02] in three patients and (Lymph) (55%↑; [43‑84] %↑; [P = 0.04] in seven patients. WBC was lower than 4400 mm3↓ (P = 0.02) in six patients. Hgb was significantly lower in 70.6% of women (11.8↓; [10‑14.2] g/dl↓; [P = 0.04] and 68.4% of men population (12.3↓; [9.7‑13.8] g/dl↓; [P = 0.01]. Mean age of epilepsy onset was 15.6 years (range: Birth‑74 years). Analysis of drug prescriptions showed that the incidence of monotherapy and polypharmacy (2 up to six AEDs simultaneously) was 19.4% plus 80.6% respectively. In Iranian epileptic population, effectiveness of treatment should be attributed by the close supervising of AEDs in relation to clinical circumstance, laboratory data, and therapeutic drug monitoring. Any significant change in patients’ biochemical and hematological data may require close verifying for the rapid detection of severe anemia, leukopenia, lymphocytosis, osteomalacia, or liver failure.

The study of economics is important in Iranian stroke patients, because it is one of the costly diseases that could be linked to disability, mortality, and morbidity. The aim of this preliminary study was to investigate total treatment costs of hospitalized patients with stroke. A cross‑sectional study of 24 patients conducted to Isfahan Neurosciences Research Centre was carried out between April 1, 2012 and September 31, 2012. Demographic (sex, age) and economic variables (Raise tariffs, accumulated surplus, the total amount, of patients’, patients’ paid, and home insurance contribution) were extracted from the patients’ profiles. All information recorded and processed using Excel. The mean age of patients was 71 years (ranged; 40‑93 years old). Preliminary analysis of available costs issues could be described as: Raise tariffs (mean: 3500256 Rial, ranged: 504460-9775455 Rial), accumulated surplus (mean: 565578 Rial, ranged: 56700‑2343664 Rial), the total amount (mean: 4045556 Rial, ranged: 715460‑12219119 Rial), of patients’ (mean: 756037 Rial, ranged: 0‑8365447 Rial), patients’ paid (mean: 1307762 Rial, ranged: 45300‑9193000 Rial), and home insurance contribution (mean: 3070713 Rial, ranged 0‑8887907 Rial). The cost disparity within this study after stroke could be mainly connected to variations in duration of hospital stay. Inspecting agenda towards this direction could reduce the economic cost of stroke significantly. Therefore, further assessment correlated to attain strategies in order to reduce costs associated to patients’ paid and home insurance contribution could be much more advantageous.

Carbamazepine (CBZ) is mostly considered as the first line of effective treatment against simple or complex partial seizure and primary‑secondary generalization. To prevent side‑effects related to higher amount of CBZ minimum concentration (C0) in body fluid or seizure attacks associated to lower amount of CBZ‑C0, the suggested minimum therapeutic concentrations range from 4 to 12 ng/ml (according to previous publications). The aim of this preliminarily study was to investigate the scope of discrepancy associated to the C0 of CBZ in patients visited Isfahan Epileptic Clinic. A cross‑sectional study of 22 patients located in neurology ward of Isfahan Neurosciences Research Centre (INRC) was carried out between April 1, 2012 and December 31, 2012. Female (n = 9) and male subjects (n = 13) with a mean age of 27.4 years (range; 16‑38 years) were studied. Pharmacological (CBZ‑C0) and demographical variables were recorded and processed in excel. The results of CBZ‑C0 showed wide inter‑individual variability. The mean value of CBZ‑C0 was 7.2 ng/ml. In 10 out of 22 patients, CBZ‑C0 were lower than the suggested therapeutic window (4‑12 ng/ml). CBZ‑C0 in nine patients was non‑detectable and in one patient was 0.5 ng/ml (45% <4 ng/ml). In 55% of the patients, CBZ‑C0 ranged from 4.8 to 12 ng/ml. A schedule therapeutic drug monitoring based on measurement of CBZ‑C0 for individual patient could be a practical marker to achieve therapeutic objectives. Further study related to correlating of CBZC0 to clinical events in Iranian Epileptic population seems to be valuable.

According to the international reports, brain stroke is the main reason of death and disability. In ischemic stroke, early and precise classification of patients who may profit from conflicting finest therapeutic interference is necessary if enhanced effects in terms of survival are to be talented. Due to uncomplicated, easy performance, and inexpensive method the aim of this preliminary study was to investigate changes related to biochemical and hematological variables in patients with stroke. A cross‑sectional study located at the neurology ward of the Ayatolah Kashani and Alzahra Hospitals’ (conducted to Isfahan Neurosciences Research Center) was carried out on fifty patients (females; n = 20 and males; n = 30) between April 1, 2012 and September 31, 2012. The data from subjects’ records were taken for analyzing variables. The statistical analysis of d‑base was performed using (SPSS) for windows. Analysis of available data showed that with a mean of 182.4 mg/dl, blood sugar (BS) ranged from 75 to 300 mg/dl (n = 15/50). The changes in hemoglobin (Hgb) (mean 4.6 g/dl, n = 27/50), platelet (mean 210, 653/mm3, n = 26/50) and lymphocyte (Lymph) (mean 37, n = 26/50) seems to be significant. The mean age of females was 76 years (ranged 46‑93 years). The mean age of males was 70 years (ranged 31-90 years). Information related to previous drug history was available only in 24 patients. In 5 out of 22 cases ischemic heart disease (IHD) were positive. In 8 out of 29 cases, diabetes mellitus was positive. In 5 out of 28 cases, hypertension (HTN) was positive. In the four patients both IHD and HTN were positive. Any considerable alter in patients’ biochemical and hematological figures (BS, Hgb, Plt and Lymph) may necessitate further attention related to inter‑ and intra‑individual variability in clinical supervision and drug’s assortment. Therefore, success in treatment could be achieved by the close management of clinical, biochemical, hematological, and pharmacological manifestation. To reduce disability, mortality, and morbidity in Iranian stroke population further clinical studies are needed to correlate drugs and laboratory markers to associated clinical events in order.