Khorasan disease: prevalence of HTLV-I associated myelopathy/tropical spastic paraparesis [HAM/TSP] in west Azarbaijan from 2004 to 2007

Because of the low prevalence of Human T Lymphotropic Virus type I [HTLV-I] in comparison with Khorasan Province, considering HTLV-I as an etiology of spastic paraparesia, it may be neglected in evaluation of spastic paraparesis in the other regions of Iran. Some reports of spastic paraparetic patients due to HTLV-I infection in West Azarbaijan, caused us to reconsider the importance of HTLV-I epidemiology in the other areas of the country. All spastic paraparetic patients who referred to Motahari and Imam Khomeini educational hospitals of Urmia from September 2004 to September 2007 were assessed for HTLV-I infection antibodies. In our 3 years study, 11 cases were diagnosed as Human T Lymphotropic Virus type I Associated Myelopathy/Tropical spastic Paraparesis [HAM/TSP, 2 males and 9 females]. The mean age of patients at the time of diagnosis was 45.8 years. Dorsal and cervical MRI of all patients was normal. Serum Enzyme-Linked Immuno-Sorbent Assay [ELISA] and Western blot [WB] for anti HTLV-I antibody in all patients was positive. Four patients underwent for lumber puncture in which were normal in respect of cells and biochemistry, but positive for anti-HLTLV-I antibodies. HAM/TSP detection in West Azarbaijan in spite of its long distance from Khorasan Province shows the importance of anti-HTLV-I Ab assay in the blood and CSF of every spastic paraparetic patient all over the country

Evaluation of risk factors of patients with subarachnoid hemorrhage in Motahari Hospital of Urmia University [March 2002-March 2006]

Subarachnoid Hemorrhage [SAH] accounts for 5% of all strokes, Risk factors for SAH include hypertension, Cigarette smoking, alcohol and oral contraceptive pills [OCPs]. In this study the risk factors of SAH in West Azerbaijan Province, Iran were evaluated. This case-control study carried out from March 2002 to March 2006 at Motahari Hospital of Urmia University. Using saved data of the patients of the hospital, 375 patients [exposed group] compared with 750 non exposed cases [Control]. All of the risk factors evaluated in two groups, then were analyzed using the SPSS software. Data processing accomplished by the Chi-square test. Odd Ratios evaluated for all of the risk factors. Logistic regression model was used to find out the interaction of risk factors for SAH. Of patients, 60% were women. SAH most frequently occured between 40 to 60 years old. The Odd Ratios of cigarette smoking was 3.46, of hypertension 3.59, of alcohol use 2.69, and of oral contraceptive pills 2.19; So SAH had a relationship with these factors. The Results of this study were similar to other studies of this type. The important point of this study was the ability of controlling each of the risk factors which led to the decrease of prevalence of SAH in the Community

Evaluation of relation between brain tumours and epilepsy

Subject: Epilepsy is one of the most important presenting symptoms of brain tumours. The slow-growing brain tumours may be treated for the idiopathic epilepsy for years. The relation of brain tumours and epilepsy is significant and early diagnosis of tumours presenting with seizure increases the social health level

Material and Method: In this study we evaluated the relation between type and location of brain tumour, age of patients and epilepsy. In this study, we reviewed prospectively the clinical findings, the imaging, and the pathological reports of 288 patients who were operated for brain tumour in the neurosurgical department of Ghaem hospital, Iran, between 1992-1996

Results: Among 288 patients, 65 cases [22.6%] were 20 years old or younger and 223 [77.4%] were more than 20 years old. Seventy-eight patients [27.1%] had seizure. Among these 78 patients, 72 cases had supratentorial tumours and six infratentorial tumours. The seizure was significantly more common in supratentorial tumour than infratentorial tumours [p=0.0000021]. Supratentorial tumours had seizure seven times more than infratentorial tumours [odds ratios=7.09]. The tumours with more tendency of seizure were Oligodendroglioma [100%], low-grade astrocytomas [44%], high-grade astrocytoma [40%], meningioma [33.8%], and glioblastome multiform [26%]. Seizure was not seen in any suprasellar and parasellar tumours. There is significant relation between tumour pathology and seizure occurrence [p=0.0000356]

Conclusion: Neuroimaging should be carried out for every patient with seizure, especially for patients more than 20 years old. The MRI is preferred because of the high sensitivity of MRI for brain tumours