[ cerebrolysin efficacy in acute ischemic stroke]

Cerebrolysin, a preparation of low molecular weight neuropeptide and free amino acids, has been shown to have a great affect against excitotoxicity, inhibiting free radical formation, microglia activation and additionally neurotrophic action, promoting neuronal sprouting, and improving cellular survival and stimulating neurogenesis following stroke. The aim of this study was to determine the efficacy of Cerebrolysinon acute ischemic stroke. The present study was a randomised double blind clinical trial. The sample was 89 patients with confirmed the diagnosis of acute ischemic stroke. The patients divided in the intervention or control group with simple randomization. Patients in intervention group received 50ml Cerebrolysin diluted in 100ml normal saline solution [totally 150 ml] infused over a time period of 30 minutes for 7 days and for control group patients, administered just 150ml normal saline infusion. Patients were assessed on days 1,30 and 90 by Orgogozo, barthel index, MRS and NIHSS score. The findings indicated that the mean of scores at the end of the first month was increased in comparision with the first day, 1.68 in intervention and -10.95 in intervention and case groups respectively and these differences were meaningful statistically [p<0.05]. The comparison of scores at the end of three month treatment to the first day reported meaningful too [p<0.05]. The findings demonstrated that at the end of the third month as compared with the first day, added 1.68 to case group score and reduced -13.21 from the control group score. Cerebrolysin is efficient in acute ischemic stroke patients and decreases the tissue damage severity in these patients. On the other hand, presumably it can reduces disability of the disease

[Prevention of infectious diseases during military deployments]

This paper aims to introduce the importance of infectious diseases among military personnel in the peace time as described for the humanitarian force to be deployed in conflict areas during both war time operations and maneuvers has been developed. Referring to the texts and numerous articles that were published in this field, their results are summarized. Physical, occupational and environmental conditions of the military and as a new activity that are associated with exposure to multiple incidents including multiple trauma, mental and psychological problems and infectious disease. It is necessary that these three categories of military medicine to be seriously pursued. The literature review indicated that annual military force based on the mission at the beginning of vaccination against polio, hepatis A, tetanus, varicella, DT, menangococ, influansa, MMR, Japanese B encephalitis, yellow fever, smallpox and anthrax. And the year of internal medicine, dental and eye screening and fallow up from the response to vaccination

[Approach to tuberculosis in air travelers]

Tuberculosis is one of the major health problems, especially in developing countries. This study aimed to further understanding of the medical community with this problem in domestic and international air travel, and ICAO has been predicted that by 2015 that is reached number of travel- air to more than 5 / 2 million per year. Ease and duration of air travel, with large numbers of international travelers- international, has increased the likelihood of contact with infectious TB. To access the resources of articles were used PubMed .nejm. Civil aviation, WHO and the papers published in reputable scientific journals of Iranian and foreign research data from 2000 to 2011 and the Ministry of Health and Medical Education. pulmonary tuberculosis is the most common type of tuberculosis in Iron and world and sputum smear-positive pulmonary TB, so that makes up 53 percent of all TB cases. Non pulmonary tuberculosis is 28% of all cases of tuberculosis. Considering that more tuberculosis in pulmonary tuberculosis is spread through the air, air travel time outlast 8 h is danger for travelers. Over 80 percent of the total number of people with TB annually is in developing country, regarding the transmission of tuberculosis, information is necessary required for reduced risk of transmission of TB on flights travelers

[ role of negative pressure wound therapy in the treatment of war wounds]

Wartime injuries are frequently high-energy wounds. In modern warfare wounds involve in many cases the musculoskeletal system and therefore military orthopedic surgeons have assumed a pivotal role in the frontline treatment of these injuries. The majority of injuries were caused by exploding [approximately 55 percent] and approximately 20 percent were from gunshot wounds. The increased numbers of extremity injuries have led to the necessity for new technologies in managing complex war wounds. In warfare situations and particularly from long-distance evacuations, it became necessary to develop alternate forms of wound management. Sometimes, due to massive secretion, dressing changes were necessary twice daily. Therefore, starting 2003 negative pressure wound therapy [NPWT] dressings were instituted to treat the complex war injury. However, the use of NPWT for the care of complex war wounds at battlefield trauma hospitals and/or in the aeromedical evacuation transport system aboard aircraft is still a new application of this wound treatment not yet accepted as doctrine

Report of one case of neurobrucellosis

The neurobrucellosis can affect any part of the central or peripheral nervous system. The clinical syndromes are ultimately diverse and clinical picture may be confused by the coexistence of two or more clinical syndromes in the same patient. The most common neurologic manifestation is a sub-acute or chronic meningoencephalitis. Acute toxic manifestations [e.g., headache, neck ache, backache, insomnia, depression and muscle weakness] are seen during the acute phase of infection. Incidence of neurobrucellosis cannot be exactly estimated. The most important clinical syndromes include: Brucella meningitis and encephalitis, vascular syndromes, myelopathy and spinal disease and psychiatric disturbances. Diagnosis is made by reviewing patient history, physical examination, CSF and serum serological and other laboratory studies. Treatment is difficult. Doxycycline in addition to rifampin and streptomycin are the best-studied regimen which should be continued until CSF is clear. In the year following treatment, serum agglutinins fall to normal. The efficacy of corticosteroids is not proved. Neurobrucella has a better prognosis rather than other forms of chronic meningitis and the lesser of mortality; however, incidence of minor sequella [not limiting the normal life] is high. We presented one case of neurobrucellosis with presentation Acute toxic manifestations infection, include headache, neck ache, backache, insomnia, depression and muscle weakness several days before admission. The serologic study of both serum and CSF will usually reveal normal. But antibody against Brucella demonstrated in CSF by enzyme - linked immunosorbent assay [ELIS]. Doxycycline in addition to rifampin; ceftriaxon cotrimoxazol started for patient and patient cured. The diagnosis of neurobrucellosis require differentiation from other chronic meningitis, encephalitis, and granulomatous disease, most importantly tuberculosis and fungal infectious.early diagnosis and treatment are crucial factors leading to a good outcome