ABSTRACT
@#Objective: This study aimed to investigate the intermediate survival of patients with cerebral venous sinus thrombosis (CVST). Methods: This is a retrospective study recruiting patients with a definite diagnosis of CVST who were referred to teaching hospitals of “Shiraz University of Medical Sciences” from 2007 to 2017. Follow-up phone calls were conducted in March 2019 till June 2019. All-cause mortality, mortality due to CVST, and CVST recurrence were investigated. Results: Of the total of 301 patients, 213 (70.8%) were female. Patients’ age ranged from 1 to 95 year with a mean of 39.9 year. Intermediate follow-up (mean 46.9, 95%CI: 43.6-50.2 months) was done. Intermediate term mortality was 12.3%, mostly from CVST, and largely occurred within the first month. Age was a significant risk factor for survival (HR=1.056, 95%CI:1.037-1.075). The difference was not statistically significant in males in comparison to females (HR=1.3, 95%CI:0.67-2.60, P=0.41). Patients with recurrent CVST hada higher risk of mortality (HR=9.14, 95%CI:4.70-17.89, P<0.001). There was statistically higher risk of mortality in patients with deep vein thrombosis (DVT) (HR=8.97, 95%CI: 4.32-18.61, P<0.001). Although the risk of death for patients using oral contraceptives (OCPs) was 16% higher, this was not statistically significant (HR=1.16, 95%CI: 0.52-2.55, P= 0.21). Conclusions: Intermediate-term mortality was 12.3%, and associated with older age, recurrent CVST and DVT. The reasons for these findings need further investigation.
ABSTRACT
Background:: Multiple sclerosis [MS] is a chronic inflammatory and demyelinating disease of the central nervous system, which is accompanied by significant disabilities. Although there are some published data regarding the epidemiological features of MS in other parts of Iran, scarce data are available about the prevalence and demographic characteristics of MS in Pars province. The current study aimed to address the prevalence and incidence rate of MS as well as the temporal trend of the disease in Pars province, southern Iran
Methods: This historical retrospective cohort study was carried out in Pars Multiple Sclerosis Society affiliated with Shiraz University of Medical Sciences. All the consecutive patients who fulfilled 2010 McDonald criteria for definite MS were included in the study. The patients' gender, age at time of diagnosis, education, and clinical course were recorded. The prevalence and incidence rates were also calculated
Results: This study was conducted on 3,354 patients. Among the patients, 2,689 [80.2%] were female and 665 [19.8%] were male. The female/male ratio was 4.04. The point prevalence rate of the disease was 72.1/100,000 persons in October 2013. This index was 116.5 per 100,000 persons in females [95% CI: 113.4-119.6] and 28.3 per 100,000 persons in males [95% CI: 26.8-29.9]. The mean annual incidence rate was 5.2/100,000 from 2002 until 2012
Conclusion: Considering Kurtzke classification, Pars is a high-risk area for MS and women are affected more compared with men. Moreover, the incidence rate sharply increased in the last decade
ABSTRACT
Objective: Cerebral venous thrombosis (CVT) is an important cause of stroke, especially in young adults, that has many predisposing factors. G20210A mutation in prothrombin gene (Factor II) and G1691A mutation in Factor V Leiden (FVL) are two common hereditary causes of CVT. This study aimed to study the rate of these mutations in patients with CVT from Fars Province in southern Iran. Methods: In a case-control study, 57 case patients with defi nite diagnosis of CVT, confi rmed clinically and by MRI and MRV, and 50 sex and age matched healthy controls, with no family history of thrombosis, were enrolled from March 2008 to March 2010. G1691A mutation of FVL and G20210A mutation of factor II were determined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Results: Mutation in G20210A of factor II was found in 3.6% of patients and 4% of the controls (P=1). For FVL mutation, 7% of the patients carried the mutant allele while this mutation was not found in the controls (P=0.12). Two and 4 patients were heterozygous for prothrombin G20210A and FVL G1691A mutations, respectively. Conclusions: It seems that G20210A mutation in Factor II and G1691A mutation in FVL are not responsible for CVT in the southern Iran population with predominant Fars ethnicity.
ABSTRACT
Cerebral venous-sinus thrombosis is an uncommon form but important cause of stroke, especially in young-aged women. We performed a retrospective descriptive-analytical study in which 124 patients with cerebral venous-sinus thrombosis, who referred to Nemazee Hospital, Shiraz University of Medical Sciences from January 2000 to March 2008, were included, and their demographic, etiologic, radiological and prognostic characteristics were evaluated. The patients' mean age was 34.01 +/- 10.25. Eighty seven [70.16%] were women and 37 [29.83%] were men. The most frequent clinical manifestations were headache, papilledema and seizures. Fifty seven [65.5%] women took oral contraceptive pills. Twenty of 57 women [35.08%] took the pill longer than one month to be able to fast in Ramadan or perform the Hajj ceremonies. In the mean time they developed cerebral venous-sinus thrombosis. Superior sagital sinus, with or without lateral sinuses, was the most involved area [70.96%]. High mortality and morbidity rates [14.51%] and 35.48%, respectively] were found in patients. Poor prognostic factors at the time of admission were stupor and coma [P=0.001] and evidence of hemorrhage in primary CT scan [P=0.005]. Taking oral contraceptive pills was a main factor associated with cerebral venous-sinus thrombosis. Clinical manifestations, prognostic factors, common involved sinuses and image findings of this study were similar to those of other studies. Health care policy makers should design a plan to warn susceptible women of the risk of cerebral venous-sinus thrombosis, and to educate them the ways to prevent it