Neuroprotective effects of erythropoietin in acute ischemic stroke

Ischemic brain strokes consist two-thirds of strokes and 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's randomized 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

Characteristics of headache at altitude among Trekkers; a comparison between acute mountain sickness and non- acute mountain sickness headache

Headache at altitudes has had an incidence of 25-62% through many related studies. Many reasons are identified concerning headache at altitudes such as acute mountain sickness [AMS], sinus headache, migraine, tension type headache, and frontal tension headache. This study tried to compare different types of headache among trekkers on Mount Damavand, a 5671m mountain, Iran, to find their incidence and related symptoms and signs. Through a cross-sectional study, we evaluated headache incidence and its correlation to AMS among people who climbed Mount Damavand. Lake Louise Score, a self-report questionnaire, was applied to make AMS diagnosis through three separate stages of trekking program. Chi-square test was employed as the main mean of analysis. Totally, 459 between 13-71 years old participated in the study among which females were 148 [32.1%] and males 311 [67.8%]. Headache was found in 398 [86.7%] among whom 279 [70%] were proved as AMS. Investigating the types of headache in the cases of AMS showed 64.5% steady, 31% throbbing, and 4.5% stabbing characters which had significant differences with a P value = 0.003. The majority of headaches were stated as frontal [38.9%] and the least prevalence belonged to parietal area [4.4%], while global headache was reported 27%. This study specifies the exact location of headaches at altitude in cases of AMS and non-AMS headaches. Many cases of high altitude non-AMS headache are resulted by tension and light reflection at altitude