Cerebral vein thrombosis in women using short course oral contraceptive consumption

Muslim women tend to postpone their menstrual period using short course oral contraceptives [OC] during Ramadan, Muslims fasting month. Recently, many cases of stroke, particularly cerebral vein thrombosis [CVT], have been reported in Ramadan. This work studies the incidence of CVT and its relation to Ramadan. This is a cohort study conducted from October 2006 to October 2009 and included 4 consecutive Ramadan's. All patients with definite diagnosis of CVT who were referred to the neurology department of Ghaem Hospital, Mashhad, Iran in this four-year period were included in the study. During the study period, 70 cases with CVT [11 males and 59 females] were recruited. Twenty five cases were admitted during Ramadan months which was significantly higher than all the other 32 months [p=1.9×10[-7]]. The higher frequency of females [6 times more] among CVT cases probed by investigating possible risk factors and short term OC consumption was revealed as the major risk factor [p=0.00071]. Higher incidence of CVT in females during Ramadan suggests the presence of specific risk factors in this group. Our study revealed that short-term use of OCs may be a major risk factor for CVT

Recognition of special form of amphetamine acquaintance in iran and presentation of 4 cases with neurovascular complication

Ecstasy and crystal are recently new most widely abused illegal drugs in Iran. Ecstasy/MDMA abuse may cause acute complications that have fatal consequences. Pt 1: A 26 year old who referred to emergency room due to acute paraplegia and finally died with cardiac arrest. Pt 2: A 45 year old woman who came with seizure disorder and unconsciousness. Finally she died due to cardiac arrest. Pt 3: A 32 year old man was admitted due to acute flaccid paraplegia. He had diffused skin rash due to vasculitis. The patient died despite of supportive cares. Pt 4: A 23 year old man who referred to neurological ward because of generalized tonic-clonic seizures following Crystal and Ecstasy abuse. The patient was discharged after 4 days with good general conditions. Unfortunately recently, the rate of Ecstasy and Crystal drugs abusers in Iran have increased. This paper notify about the neurological side effects of these drugs

Brain venous thrombosis

The First Cerebral vein thrombosis was reported in 1825. Early diagnosis is very important, because early treatment can prevent mortality in most cases. Also, cerebral vein thrombosis is preventable by finding the underlying etiology. True incidence of cerebral vein thrombosis is not predicative. This descriptive study was performed from 2005 through 2006 on patients referred to Qaem Hospital neurological emergency ward. All of the patients with clinical feature of ICP rising were evaluated and underwent CT scan and MRI of brain. In cases suspicious to cerebral vein thrombosis, the disease was actually diagnosed with MR venography of brain, after discharge Patients were followed up every week for 3 weeks in neurological clinic of Qaem Hospital. From 20 evaluated patients, 70% were female and 30% were male, in which the ratio of F/M was 3/2. Patients mean age was 30 year. The most clinical feature was headache. Underlying etiologies in above patients were: OCP consumption, post partum period, mediaotitis, nephrotic syndrome and Crystal abuse. In MRI and MRV assays of studied patients, 20% had superior sagital sinus, 10% lateral sinus, 5% sigmoid sinus and 65% had superior sagital and lateral sinus involvement simultaneously. In patients who refer having headache and papilla edema, cerebral vein thrombosis should be considered. Early diagnosis is achieved by precise diagnostic methods like MRI and MRV, and the prevention of severe irreversible and fatal side effects of disease with the early treatment

Evaluation of patients with inflammatory myopathies

Inflammatory Myopathies are a group of acquired diseases in which most important finding is subacute progressing symmetrical proximal muscle weakness and fatigue with mononuclear cells infiltration in the muscle tissue along with degeneration and regeneration of muscle fibers and elevation of the muscle enzymes. In nonspecific myositis, the important point is the prominent infiltration of the macrophages rather than lymphocytes in the muscle tissue, and intact fibers with infiltration are less common. In this retrospective and descriptive study, files and pathological slides of patients with myositis, hospitalized in the neurologic ward of Ghaem hospital or outpatients visited the neuropathology center from 1996 to 2006, were again evaluated. This study was approved by the local ethics. Overall, 39 patients with inflammatory myopathy diagnosis admitted during this period, of which were 56.4% males and 43.6% females. The average age of the women and men was 31 and 35.5 years respectively. Dysphagia was seen in 33.3%, tenderness and muscle pain in 41%, Reynoud's phenomen in 7.6%, elevated muscle enzymes in 82%, lung involvement in 5.1%, heart involvement in 5.1%, positive ANA in 5.1% and elevated ESR in 53.8% of the patients. Thirty-nine patients were evaluated in the neuropathology ward and amoung this group 36 cases had nonspecific myositis and 3 patients had polymyositis. In this study it is shown that polymyositis is a rare disease, and the presence of inflammation in muscle biopsy, elevated muscle enzymes and weakness of girdle muscles are not necessary for the polymyositis diagnosis confirmation. However, most of these cases are nonspecific myositis which will not respond to corticosteroid therapy