[Does high dose erythropoietin administration reduce ischemic stroke complications?]

Ischemic brain strokes consist two Third of all strokes and their complications bear a lot of cost and disability for the patient and society. In this study we seek for the effect of Erythropoietin on ischemic brain strokes' outcome according to NIHSS [National Institutes of Health Stroke Scale] changes. This study is a RCT. All patients with focal neurologic deficit with primary suspicion of brain stroke underwent neuroimaging evaluations. After confirmation of new ischemic brain stroke, the patients with inclusion criteria randomized into two groups of cases and controls. NIHSS was defined for each patient and all patients received a routine treatment protocol. Erythropoietin 16000 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 12hr up to total dose of 56000 IU during 3 days. Patients were 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 were compared with each other. Evaluations revealed that in days 14 and 28 during follow up, Erythropoietin was effective in NIHSS [P-value: 0.0001]. This effect is of value in LOC 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 hours can be effective on the reduction of ischemic stroke complication. However, a larger scale clinical trial is warranted

[Evaluation of the pre-emptive effect of acetaminophen codeine on the pain after liver biopsy]

Liver biopsy is one of the most important diagnostic procedures for liver diseases. Pain is the most common complication of liver biopsy and it can lead to clear morbidity. Finding a way to reduce pain of liver biopsy its complication is very important for investigators. There are limited studies on evaluation of pre-emptive effect of acetaminophen on liver biopsy. The aim of this study was to investigate pre-emptive effect of Acetaminophen codeine on the pain of liver biopsy during the first 24 hours after biopsy. This was a double blind randomized clinical trail study from Oct 2007 to Oct 2008 in gastroenterology and liver disease unit of Tohid hospital in Sanandaj. Sample size included all the patients who were candidate for liver biopsy. Forty four patients [23 in experimental group and 21 in placebo group] were enrolled into the study on the basis of randomized blocking method. Exclusion criteria included any contraindication for liver biopsy or need of penetration of needle for two or more times for biopsy. Visual analogue scale [VAS] was used to assess pain after liver biopsy, 0,1,3,6 and 24 hours after biopsy. This study was conducted after approval of Ethical review Committee of Kurdistan University of medical Sciences and obtaining the informed written consent from the patients. The patients received acetaminophen codeine or placebo one hour before biopsy. Data were analyzed by means of Chi square, t-test, analysis of variances, and nonparametric tests. The mean value of the pains intensity in zero, one, three, six, and twenty four hours after biopsy in experimental group was higher than that of placebo group but there was no significant differences between two groups [P>0.05]. Intensity of the pain after liver biopsy in females was higher than in males in the two groups but there was no significant differences between two groups [P>0.05]. Comparison of the results of the present study with those of other studies shows that acetaminophen codeine is not effective in reducing the pain of biopsy. Further clinical trail studies for determination of the effect of other analgesics drugs are recommended in the future

Role of wheat enrichment with zinc compounds in changes of zinc blood level in general population

Bread constitutes the main food of Iranian people. The consumption of bread supplies 70% of protein and 20% of calorie needed by body. The zinc content of Iran's agricultural soil is less than 0.7 mg/kg while the standard value is more than 1 mg/kg. This study was carried out to assess the effect of soil enrichment with zinc compounds on the serum zinc level in general population. In the first stage agricultural soil was enriched with 15 kg/hectare iron sexsothirin, 40 kg/hectare manganese sulfate and 50kg/hectare zinc sulfate. The amount of zinc in the prepared flour, before and during the study, was measured by atomic absorption machine through dry oxidation. 1795 people were selected from rural areas of Urmia city, in Iran for this intervention. Blood samples were obtained from 10% of the population before and after intervention. The amount of serum zinc was measured by means of auto analyzer machine Hitadin 704 using UK Randox kit. This was a clinical trial study and collected data before and after intervention; considering mean, standard deviation and confidence interval 95% for all sex and age groups in the population were analyzed. The mean values for serum zinc before and after intervention were 80.05 and 109.73 microgram/deciliter blood respectively [CI=102.58, 116.89]. [p<0.0001], showing a significant difference. The mean values for serum zinc in women and men before intervention were 75.23 and 87.92 accordingly with p=0.028, the difference between the two groups were significant. The mean values for serum zinc levels after intervention in women and men were 103.39 and 108.66 respectively which showed no significant difference [p=818%]. Differences between the mean values for serum zinc levels in women and men before and after intervention with respective [p<0.0001] and [p<0.001] were significant. This study indicated use of zinc compounds for soil enrichment led to improvement of zinc standards in wheat and use of enriched flour for 6 months resulted in an increase in the serum zinc level in both sexes and all age groups of the community

Evaluation of vasomotor reactivity by transcranial doppler sonography: Age and sex related differences in breath holding index in Iranian Population

The assessment of cerebral vasoreactivity can provide information regarding the reserve capacity of cerebral circulation. Reduction of this property has been found in association with situations predisposing one toward cerebrovascular disease. In this study, we defined the vasoreactivity of brain vesseles according to age and sex of the patients. In this descriptive study, 289 healthy subjects [without hypertension, diabetes mellitus, obesity, smoking, CHF, CHD,] were admitted from January 2004 to June 2004. The population was divided to four groups, according to age and sex [women and men more and less than 30]. After determination of each patient's flow velocity of middle cerebral artery [MCA] by mean of a transcranial doppler instrument [TCD], before and after 30s apnea, breath holding index [BHI] was calculated. Data was analyzed, using SPSS software. BHI was significantly higher in women than men [0.918 +/- 0.40 versus 0.637 +/- 0.22; P 30] women [0.812 +/- 0.31] than in younger [ 0.05]. The average of BHI was lower in men than in women in total and in all age subgroups. BHI was relatively constant in all age subgroups in men but there was significant decline in BHI by increasing age in women. So despite of many physiologic changes related to aging, vasomotor reactivity remains relatively constant in men but decreases in women. Findings of our study suggest that changes of cerebrovascular vasomotor reactivity in healthy subjects may be related to aging, but they are probably mainly influenced by sex

Electrophysiogical findings in a family with hereditary neuropathy and liability to pressure palsies

Hereditary neuropathy with liability to pressure palsies is an autosomal dominant and demyelinative peripheral neuropathy which characterized by reversible episodes of sensorimotor deficits after neural compression injuries. Their clinical hallmarks are recurrent and painless focal neuropathies maintly preceded by minor trauma or compression at entrapment sites of peripheral nerves. We describe multiple compression mononeuropathies in an individual who presented with left sided ulnar palsy after drilling for a period of 8 hours and report neurophysiologic findings in two clinically asymptomatic family members. We believe that this entity may be clinically and neurophysiologically underdiagnosed by orthopaedic surgeons and electromyographers. Electrophysiological abnormalities can be detected even in asymptomatic patients and it should be considered in differential diagnosis of patients with atypical presentations of compression neuropathies