ABSTRACT
Antipsychotic drugs have an important role in psychiatric treatment. Their side effects such as drug induced Parkinsonism, which has been a historical challenge for patients and physicians, account a major cause of treatment rejection by the patients. Drug induced Parkinsonism is the second cause of Parkinson syndrome. The aim of this study was to evaluate antipsychotic induced Parkinsonism in patients with schizophrenia. This cross sectional descriptive study was done in the year 1999 in Noor and Shariaty Hospitals of Isfahan. 200 patients with schizophrenia, affected with Parkinsonism complication, were investigated. Variables were sex, age, dosage and group of drug, duration of treatment, Parkinsonism criteria and simultaneous anti cholinergic prescription. Data was gathered in a questionnaire and analyzed by descriptive statistics and frequency distribution tables. 122 men and 78 women were studied. 26.5% of patients had drug induced Parkinsonism, which was mostly seen in women [32% versus 22.9% in men], higher age [10-19 years: 0%, 50 years and higher: 33%], and when anticholinergic was not used simultaneously [35.7% versus 25% in anticholinergic users group]. Prevalence of Parkinsonism, in high, medium, and low drug potentials was 28.7%, 29.4% and 19.2%, respectively. Differences in all of the above groups were not significant. Prevalence increased in dosage of less than 100mg [chlorpromazine equivalent dosage] versus 101-300mg [p>0.05], and in 3-6 months after onset of treatment [p<0.05]. The most prevalence criterion was rigidity [84.9%]. Parkinsonism was diagnosed in 11.76% of patients using atypical drug [clozapin]. Anti psychotic induced Parkinsonism increased in higher ages, women and when anticholinergic was not used simultaneously. This side effect was found in all groups even with clozapin. It had a greater prevalence in the beginning of treatment but decreased with treatment continuation and anticholinergic prescription. Future studies particularly on the atypical groups are suggested
ABSTRACT
Myasthenia gravis is an autoimmune disorder affecting postsynaptic acetylcholine receptors of voluntary muscles. Since Blalock et al. first demonstrated the beneficial effect of thymectomy in 1939. The procedure has become increasingly accepted in the treatment of myasthenia gravis. we studied clinical results of thymectomy in myasthenia gravis cases during 12 years retrospectively and antegradly. Our variables included: patient's age, sex, and signs at the time of admission, disease onset to operation interval, postoperative complications, and duration of hospitalization, thymus histology and clinical response to thymectomy. Data were analyzed appropriate analysis. 16 women and 11 men with median age of 29.8 [ +/- 12.7] years were operated on by median sternotomy approach. Thymectomy was done during less than 1 year after disease onset in 44%, 1-3 years later in 42% and later than 3 years in 14%. Most had mild to moderate generalized myasthenia. Thymic hyperplasia was reported to be the most common pathologic finding. Clinical response to thymectomy was good [70.4%]. The best results were obtained in female less than 40 years old, with out thymoma, disease onset to operation interval less than 2 years and mild myasthenia. Because of its high beneficial rate thymectomy is an advantageous therapeutic option. The chance of benefit increases when the history of myasthenia gravis is short and the stage of the disease is early