[Complication rates of carotid endarterectomy in Taleghani and lranmehr hospitals, Tehran, Iran]

Previous studies demonstrated the efficacy of carotid endarterectomy [CEA] in reducing the risk of strokes and deaths in selected patients afflicted with carotid artery stenosis. Selection of patients for CEA depends on degree of stenosis, whether patient is symptomatic or asymptomatic and complication rate of CEA; so, it has been recommended that surgical departments publish their complication rates. As there were no data regarding complication rates of CEA in Iran, this study was performed. We performed a retrospective study of all CEAs performed in Taleghani and Iranmehr hospitals till March 2001.In-hospital mortality or strokes were determined by review of patients' files. Telephone interview of patients or their families achieved additional follow-up for complications occurring within 30 days of CEA. The cohort consisted of 246 consecutive cases of CEA. There were 12 [6.4%] strokes and 4[2.1%] deaths in Iranmehr and 2[3.4%] strokes and 3[5.2%] deaths in Taleghani hospitals. Overall complication rate was 8.5%. Risk factors for stroke or death were history of diabetes mellitus and, unexpectedly, history of previous CEA on contra lateral side. According to the results of this study, CEA is appropriate for symptomatic patients with stenosis greater than 70% and not recommended for asymptomatic patients. Determining complication rates of CEA in other centers will help the selection of appropriate patients for CEA

clinical survey in determination of common side effects of AVONEX [b if 1a] therapy in 50 Iranian MS patients

To determine common systemic, local and laboratory side effects of Avonex therapy in Iranian multiple sclerosis patients. 50 confirmed MS patients [according to McDonald 2001criteria] treated with 30mcg weekly bifia, Avonex, were studied and questioned for presence of common known adverse effects of the drug and probable depression induced or aggravated by it. The study was following up regularly at the onset of Avonex therapy and afterl,3 and 6 months. At the end of 6 months follow up study the data was analyzed. 70% of the patients were between 20 to 30 years. 78% were female. The patients had a duration of MS of 0-12 years. The most common side effects were systemic type out of which flu like syndrome was predominant [90%]. Local [injection site] side effects were seen in 42% and anemia was seen in 8% as a predominant laboratory side effect. Reduction of the frequency of all of the side effects except local one was seen in the follow up duration. No correlations were found between side effects and sex and age of the patients. Avonex therapy had no effect in inducing induction or aggravating depression in our patients. Discontinuation of Avonex therapy was not seen among these patients because of the side effects. It seems that Avonex therapy in Iranian MS patients has more and relatively prolonged adverse effects but mainly these side effects fade away with continuation of therapy. The side effects do not lead to discontinuation of therapy. In spite of frequent complaints of the patients, all of the adverse effects are well tolerated

Comparison of urinary neopterin to creatinin ratio in multiple sclerosis patients and controlled group

Multiple Sclerosis as the most common cause of demyelinating disorders has a basis of autoimmunity. To describe a procedure to determine total and aromatic UNCR and their ratio as a marker of cell mediated immunity in MS patients and controlled groups. In this project UNCR was determined and compared in MS patients who reffered to the neurology department of Shariati's Hospital and normal subjects. Using HPLC and Novapak C18 [3.9x300mm] column at 25 degrees centigrade. Mean of aromatic UNCR were 337.6 +/- 47.2 and 1273.1 +/- 201.64 micromol/mol, mean of total UNCR were 484.64 +/- 60.2 and 1800.3 +/- 250.1 micromol/mol, and the ratio of aromatic/total UNCR were 0.664 and 0.73 in normal subjects and MS patients respectively. Prominent elevation of aromatic UNCR in MS patients in comparison with normal subjects is the sign of high activity of cell- mediated immunity in this group even though with treatment