[Postoperative mortality and morbidity of carotid endarterectomy in patients with carotid stenosis]

Carotid stenosis is the most common cause of cerebrovascular accidents. If we select the patients appropriately, carotid endarterectomy would be acceptable regarding to mortality and morbidity for vascular complications. Since, carotid endarterectomy related complication is dependent on experience, equipment and facilities of surgical team, each surgical ward should be evaluated for complication separetely. Evaluating the postoperative mortality and morbidity and complication of carotid endarterectomy in patients with carotid stenosis in surgical wards of Razi Hospital in Rasht during September 2006 until end of February 2010. In this descriptive study, 51 patients undergoing carotid endarterectomy in surgical wards of Razi Hospital were recruited. Postoprative complications, mortality and morbidity of carotid endarterectomy were recorded during hospitalization and one month follow up period after discharge. The mean age of patients was 66.69 +/- 10.33. 35 subjects of patients were male and 16 subjects of patients were female. Mortality was reported in one case [%1.96], complication in asymptomatic patient was [%1.96], in symptomatic patient with Transient Ischemic Attack was [1.96%] and in Cerebro Vascular Accident patients was [0%]. Results of this study showed that the rate of mortality and morbidity is acceptable after endarterectomy surgery in Razi hospital in comparison with NASCET. So in order to elevation of quality of surgery in this center, results of surgery should be recorded and analysed every year

Comparison between immediate and delayed imaging after gadolinium chelate injection for detecting enhanced lesions in multiple sclerosis

Magnetic resonance imaging [MRI] is a noninvasive and valuable method in the diagnosis of Multiple Sclerosis [MS]. Compared with other modalities, the sensitivity of MRI for detection of the lesion increases using magnetization transfer [MT] and delayed imaging. Our aim was to compare the two methods in detecting MS lesions. In this double-blind clinical trial, twenty-one patients with the definite diagnosis of MS referred to Poursina Hospital, Rasht were included. Two radiologists evaluated all the images. First, images without contrast were conducted, then 0.1 mmol/kg contrast material [Dotarem, single dose] was injected and after 30 minutes, T1W and MT images were obtained. Seventy-two hours later, T1W images were obtained immediately after injection of 0.2 mmol/kg contrast material [double dose]. The data were analyzed using Fisher's and McNemar tests by SPSS for Windows. Delayed magnetization transfer showed 44 enhanced lesions using MT [69.84%] and 29 lesions using T1 [46.03%]. In addition, the number of enhanced lesions in the delayed method were significantly more than those in the immediate method [p value=0.003]. The use of single dose in combination with MT and delayed images after 20-30 minutes enables us to detect more enhanced lesions