[Pattern of diet and supplement consumption among multiple sclerotic patients pre and post diagnosis and their attitudes toward the effects of these parameters on disease progression]

Multiple Sclerosis [MS] is one of the central nervous system white matter disorders, with variable prevalence in various districts. Some researches proposed the probable effects of diet as a risk factor in the etiology and control of MS due to its variety of patterns in diverse cultures and regions. Determination of the MS patients' dietary habits, before and after diagnosis of the disease and their attitude toward the effect of dietary parameters on the disease progression. In this cross-sectional study, A total of 166 confirmed MS patients referred to Tabriz MS society during 2005 to 2006 were assessed by a pretested questionnaire composed of 3 sections of questions about demographic informations, dietary habits pre and post disease diagnosis, weight and appetite changes and also changes in dietary patterns after diagnosis. Data were analyzed by t-student test and qi2 in SPSS version 16. A total of 122 women and 44 men participated with the mean age of 31.97 +/- 9.21 years, and the mean age of diagnosis 28.33 +/- 8.84 years, in this study. As revealed, 79.8% of the patients didn't change their dietary patterns mainly because of their inattention to probable effect of nutrition on symptoms of disease in 80% of cases. There was a significant change in the type of using oil that reduced the disease severity among 50% of the patients. Also, there was a significant increase in the usage of dietary supplement and fish oil and a significant decrease in tendency toward egg, sugar, and pickles, following the disease. The patients suggested that fruits, milk, olive and its oil, vegetables, fish and nuts are sequentially alleviating the symptoms but pickles, hot [chilli] foods, confectionary products, fried foods, conserved food and red meat aggrevating the symptoms. From patients' viewpoints, dietary patterns and supplements are somehow effective on the symptoms of multiple sclerosis

relationship between mid-face fractures and brain injuries

Statement of Problem: Although advances in technology have led to improvements in man's life in different aspects, statistics show that the incidence of fractures is increasing in different regions of the body. Recent studies show that midface fractures are strongly associated with patient's death. The exact relationship between different types of facial fractures and brain injuries is still controversial

Purpose: To evaluate individuals with midface fractures from different causes and determine if there is any relationship between various midface fractures and brain injuries

Materials and Methods: In this descriptive cross-sectional retrospective study, we assessed the hospital charts of all the patients with midface fractures at the trauma center of Poursina hospital. The complete medical record of each patient was reviewed. The etiologic and demographic data, the type of midface fracture and brain injury, and Glasgow coma scale [GCS] were assessed. The data were analyzed by, the Chi-square, and the Fisher's exact tests. The statistical package SPSS was used for all the analyses

Results: Of all the patients 47% had brain injury. The Important significant correlations were as follows: Le Fort III with Brain Contusion [p =0.0001], nasal orbital ethmoid fractures with subdural hematoma [p =0.0001], frontal fracture with subdural hematoma [p =0.0001]. Zygomatic complex fracture with Brain Contusion [p =0.009]. Nasal fracture correlated with Brain Contusion [p =0.0001]. The zygomatic complex fracture was the most prevalent fracture

Conclusion: Different midface fracture patterns have the risk of brain injury simultaneously. So midface fractures need more attention. According to the results, more attention is needed to be paid to driving rules specially the use of helmet and seat belt

[Psychosis secondary to traumatic brain injury with manifestation of prominent grandiosity delusion: a case study with a 4-month follow-up]

Traumatic brain injury [TBI] has been known as one of rare etiological factors of psychotic disorder. In this case study we investigated the trend of evaluation, diagnosis and treatment of a patient with psychosis secondary to TBI who developed prominent grandiosity delusion. The patient was a young 35-year-old man who was hospitalized due to a motorcycle accident and developed decreased level of consciousness, restlessness and nausea. CT findings indicated contusion of the left temporal lobe. Moreover, loss of consciousness [LOC], cognitive impairment, post-traumatic amnesia [PTA], disorientation, lack of attention and concentration, memory disturbances, aggression and grandiosity delusions were observed during psychological evaluations. 27 days after TBI, he was diagnosed as a case of psychosis secondary to TBI based on DSM-IV-TR in psychiatric examinations. Then, the patient gradually recovered after medical treatment and the symptoms of injury disappeared during a follow-up period of 4 months. Presentation and treatment of this patient cannot clarify the vague relationship between TBI and psychosis secondary to TBI; however, the results of this study emphasize the importance of psychological evaluations, investigation of serious symptoms of mental disorders, monitoring and protection of these patients for proper treatment. Identifying the risk factors of secondary psychosis complicating TBI can be helpful to rule out differential diagnoses, detect those with higher risk of psychosis and facilitate timely implementation of management strategies for this disorder before the onset of its advanced symptoms

[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