[Appointment of correlation between stroke and serum level of homocysteine, folic acid and vitamin B[12]]

A stroke, or cerebrovascular accident [CVA], occurs when blood supply to part of the brain is disrupted, causing brain cells to die. Often by a blood clot or a fatty deposit due to atherosclerosis. CVA is third cause of death in the world and the most common causes of neurologic dysfunctions. There are different risk factors associated with CVA including systolic or diastolic hypertension, hyperlipidemia, smoking, alcohol abuse. Moderately increased concentration of homocysteine without homocystuinoria associated with increase of atherosclerosis, CVA and over ally mortality. The most common form of hyperhomocysteinemia is genetic. Increased serum level of homocysteine may reflect deficiency of folate, vitB[6] and vitB[12]. To determine the relationship between serum level of homocysteine, folic acid and vitB[12] and CVA this study was done at a case control survey in 2008 in 40 known case of CVA and 40 control cases are selected among the out patient of neurology clinics of neurologist in Kashan city. Demographic data and other inhumation [age, sex,.] match at case and control group. 2cc venous blood of each patient tested for serum level of homocysteine folic acid and vitB[12] [with HPLC] and of all cases and control classified and analyzed. Among 40 CVA cases 52/5 female [21 cases] 47/5 male [19 cases] and in control group 50 female [20 cases] and 50 male [20 cases]. The mean of the ages at cases attached was 67/15 and in control group was 63/5 and all of the cases and controls was 65/32 and there was not meaningful difference between two groups. In this study the mean of serum level of homocysteine at case attached was 15/56 +/- 4/69 micro mol/l and in control group was 10/15 +/- 4/7 micro mol/l And there was meaningful difference between two groups [P<0/05]. The mean of serum level of folic acid was 8/405 +/- 5/33 ng/ml in case groups was and in control groups 10/87 +/- 8/02ng/ml there was meaning full difference between two groups [P<0.005]. The mean of serum level of vitB[12] in cases attached was 389.02 +/- 208.02 pg/ml and in control groups was 522.82 +/- 218.3 pg/ml and there was meaning full difference between two groups [P<0.05]. This study showed correlation between CVA and serum level of homocysteine, folic acid and vitamin B[12]. It is recommended to conduct prospective studies to evaluate the cause and effect between these supplements and stroke and practical ways of prevention of CVA

Preemptive effects of Lidocain on postoperative pain in patients undergoing disc operation: a Randomized, double blind, placebo-controlled trial

Postoperative pain is a major poorly managed problem in millions of operations performed all over the world each year. Since infiltration of the operative field with lidocain as a local anesthetic is very cheap, it is easily available, and there are few side effects, this study aimed to evaluate its efficacy on post-op-pain of patients undergoing open intervertebral disc surgery. In this double blind clinical trial on 188 patients undergoing elective open intervertebral disc operation, the surgical incision site was infiltrated with 2 ml of 1/500,000 epinephrine for each centimeter in the control group and the same solution with 20 mg lidocain for each centimeter of the incision in the case group. Post-oppain was measured with visual analog scale [VAS] in the 6[th], 12[th], 24[th], and 48[th] hours. The mean age was 41.8 +/- 12.4 for the study group, and 43.5 +/- 15.6 for the control one. Statistical analysis revealed no significant difference in pain severity in females, but for males it was significant at the 6th and 24th hours. Interestingly, it was more severe in those receiving lidocain. The amount of narcotics used postoperatively revealed no significant difference in the groups. Lidocain used locally before skin incision has no effect on reducing post-op-pain, post-op-narcotics demand, and duration of hospital stay