Psychiatric disorders in patients with idiopathic tonic-clonic seizure

Mental disorders severely affect the quality of life of epileptic patients. Due to the lack of adequate research, in the present study we assessed psychiatric disorders in patients with idiopathic tonic-clonic seizure. This descriptive-cross-sectional research was conducted on 170 patients using the SCL-90-R questionnaire and the results were analyzed by t-test and chi[2] test. The prevalence of psychiatric disorders in patients was 38.8%. In order, the highest frequency belonged to obsessive compulsive, depression and interpersonal sensitivity 46.5%. Mental disorders are present in a high percentage of epileptic patients, which shows the need for psychological evaluation

prediction of malignant course in cerebral infarction by electroencephalography

Prediction of the malignant course is important in patients with stroke in order to begin interventional treatment strategies. In this study, predictive value of electroencephalography was evaluated in detection of malignant cases. In this study electroencephalography findings were evaluate in 36 patients suffering stroke. Data were analyzed with Fishers exact test. Fourteen patients had malignant and 22 patients had a non-malignant course. Six patients in malignant course group and 1 patient in non-malignant course group had focal delta activity [p=0.008]. Electroencephalography findings had predictive value in malignant course in stroke patients

Prevalence of multiple sclerosis and environmental factors in Kerman province, Iran

Objective: In this study we investigated the epidemiology of MS and some related environmental factors in Kerman province, southeastern Iran. Methods: The MS diagnosis was based on the revised Mc-Donald criteria. The patients were those registered at the Iran MS society, Kerman branch; those in the MS registration centers of Kerman and Rafsanjan University of Medical Sciences, and the Department of Neurology at Shafa Medical Center were studied. Results: The prevalence of MS was 31.5 per 100,000 population in Kerman province, and 57.3 per 100,000 population in Kerman city. The male to female ratio was 1:3. Average age at onset was 28.35 years, and 3.9% of cases were early onset at ≤16 years of age. A linear relationship was observed between prevalence and average environmental temperature as prevalence tended to be lower in areas where the annual average temperature was higher. However, in the town of Shahrbabak which has cold weather, prevalence was low, which might be related to the presence of copper in this area. Average disability was 4.5± 1.9 (4.83 ± 1.9 in men and 4.26 ± 1.8 in women, p=0.0035) on the Kurtzke Disability Status Scale. The mean duration of illness was 8.2 ± 1 year. Almost all patients in this study used beta-interferon for a period of at least 4 years. Conclusion: The prevalence of MS in Kerman province was 31.5 per 100,000 people. A linear relationship between an increase in prevalence and low average temperature was observed. Copper may have a preventive effect.

Evaluation of self-medication prevalence, diagnosis and prescription in migraine in Kerman, Iran

To investigate different diagnosis aspects, prescribed drugs and self-medications of migraine in Iran. We selected 210 migraineurs from high school and university students in Kerman, Iran over a period of 6 months in 2002 by multistage randomized screening based on the International Headache Society criteria. We classified them into 2 groups on the basis of whether they had consulted a physician or not. We then evaluated the physician prescriptions, and prevalence of self-medications. Only 49% of migraineurs consulted a physician, and only 53% were correctly diagnosed by physicians according to the International Headache Society criteria. Our study shows that 69% of general practitioners diagnoses were wrong. In spite of indications for prophylactic treatment, it was not prescribed in 76% of the patients, and 50% of the general practitioners prescribed it without any indications. Furthermore, 91% of patients used self-medication; Acetaminophen and Codeine were the most common. General practitioners' misdiagnosis and mismanagement of the migraineurs, and easy access to various drugs in Iran, have led to a high rate of self-medication. Self-medication with Codeine, with regard to its side effects, such as increase of secondary headaches and dependency is the major problem. Consequently, medical education systems, physician reevaluating methods, and the concept of self-medication among patients have to be revised

Evaluation of self-medication prevalence, diagnosis and prescription in migraine in Kerman, Iran

To investigate different diagnosis aspects, prescribed drugs and self-medications of migraine in Iran. We selected 210 migraineurs from high school and university students in Kerman, Iran over a period of 6 months in 2002 by multistage randomized screening based on the International Headache Society criteria. We classified them into 2 groups on the basis of whether they had consulted a physician or not. We then evaluated the physician prescriptions, and prevalence of self-medications. Only 49% of migraineurs consulted a physician, and only 53% were correctly diagnosed by physicians according to the International Headache Society criteria. Our study shows that 69% of general practitioners diagnoses were wrong. In spite of indications for prophylactic treatment, it was not prescribed in 76% of the patients, and 50% of the general practitioners prescribed it without any indications. Furthermore, 91% of patients used self-medication; Acetaminophen and Codeine were the most common. General practitioners' misdiagnosis and mismanagement of the migraineurs, and easy access to various drugs in Iran, have led to a high rate of self-medication. Self-medication with Codeine, with regard to its side effects, such as increase of secondary headaches and dependency is the major problem. Consequently, medical education systems, physician reevaluating methods, and the concept of self-medication among patients have to be revised

lidocaine acts in morphine dependency

To study the effect of analgesia caused by a local anesthetic agent [Lidocaine] in morphine dependent and independent rats. We carried out this experimental study in the Neuroscience Research Center of Kerman Medical University, Iran in 2003. We evaluated 2 groups of morphine dependent and independent rats. Morphine dependency was induced orally, and formalin was used as a noxious stimulus. The orofacial formalin test in rats is a valid and reliable model of nociception. The formalin test induces 2 distinct periods of nociception reaction, the first phase occurs in the first 3 minutes and the second phase 15-45 minutes later. The behavioral response of the animals to the noxious stimulus [formalin] was measured by the time the animal spent rubbing the injected area. All the injections were carried out subcutaneously into the upper lip of the animal, at the same site if possible. The effect of morphine dependency on local analgesia was assessed by injection of 50 micro L lidocaine prior to 50 micro L diluted formalin [2.5% in saline] in one group, and after formalin in the other group. Subcutaneous injection of lidocaine prior to morphine completely abolished the first phase of formalin nociceptive response in both morphine dependent and independent rats. Injection of lidocaine after formalin did not affect the first phase in both groups, but abolished the first part of the second phase in both groups. Considering different mechanisms of morphine and lidocaine in the body, the results verified that the analgesia induced by lidocaine in both morphine dependent and independent groups was the same, and we do not need higher doses of lidocaine to suppress formalin induced pain in the morphine dependent group

efficacy of decompressive craniectomy in treatment of patients with massive hemispheric cerebral infarction

Massive cerebral infarction is often accompanied by early death, secondary to brain edema and trans-tentorial herniation. Several reports indicate beneficial effects of decompressive craniectomy in this situation, but the efficacy of this procedure is still a matter of debate. An experimental study in a period of 3 years was done on 23 patients with brain edema due to massive cerebral infarction; 11 patients were subjects and were operated, and 12 were in the non-operated group who only underwent conservative treatment. All patients in this study had GCS below 8. The mean age of the operated patients was 54.5 years and for the unoperated patients 64.4 years. Mean GCS in the operated cases was 7.00 and in the unoperated cases was 7.66. In the operated group 4 of 11 patients lived [36.4%] and in the unoperated group 1 of 12 cases lived [8.3%]. In the living operated cases, 1 had GOS 4 and 3 cases had GOS 3. In unoperated cases 1 patient lived who had a GOS of 2. These results show that decompressive craniectomy can be an effective lifesaving procedure for malignant brain edema after cerebral infarction and can also give acceptable functional recovery