Evaluation of the effects of resting in appearance of post lumbar puncture headache

Lumbar puncture [LP] is a procedure for obtaining spinal fluid from spinal meningeal spaces this can be done as a diagnostic or therapeutic procedure which can result in to a typical positional headache named as post lumbar puncture headache .This can cause a lot of discomforts for patients and makes fear from the procedure. This study designed to evaluate the effect of resting position after LP on post lumbar puncture headache [PLPH]. Patients who had a diagnostic lumbar puncture were divided randomly in two groups .Group A patients had one hour rest in the supine position while group B patients had one hour rest in the prone position. Both groups followed for appearance of symptoms of PLPH for 5 days. 119 patients completed the study, 57 [48%] male patients and 62 [52%] female .PLPH totally appeared in 38 [31.9%] patients .In the group A PLPH was present in 20 patients whereas in group B it was present in 18 patients. Statistical analysis showed no significant differences between two groups [P>0.07]. Position of rest after LP has no significant effect on reducing post lumbar puncture headache and there is no need to emphasize on position of rest after LP

Prevalence of psychiatric disorders in the general population of Kashan, Iran

Mental health is one of the most important public health issues because of its major contribution in decreasing the global burden of disease and its important role in assurance, dynamism, and efficacy. The present study evaluates the prevalence of mental disorders in the over 18-year-old population in Kashan, Iran during 2008-2009. This was a descriptive, cross-sectional study. Subjects were selected via stratified random sampling. The study was conducted in two stages. In the first stage, subjects were evaluated using the General Health Questionnaire. In stage two, two psychiatrists used a DSM-IV checklist to conduct clinical interviews. The collected data were analyzed by SPSS version 16, OR, Cl, Chi-square, and Mantel-Heanszel tests. The prevalence of mental disorders in Kashan was 29.2%. In women it was 35.5%, and in men, 21.2%. The most prevalent disorders were mood [9.3%] and anxiety disorders [4.7%]. Among the 505 subjects with mental disorders based on clinical interviews, 162 [32.1%] suffered from mood disorders, 129 [25.6%] anxiety disorders, 21 [4.2%] psychotic disorders, 16 [3.4%] neurologic disorders, 17 [3.4%] dissociative disorders, and 120 [23.7%] had other disorders. In this study, 7.8% of the subjects had more than one mental disorder. In the case of mood disorders, major depression [8.2%] was the most common; as for anxiety disorders, generalized anxiety disorder [7.2%] was the most prevalent. The prevalence was higher in people aged 56-65 [35.8%], widows [35.8%], the illiterate [42.8%], and the unemployed [38.8%]. Mental disorder was significantly affected by gender, education, occupation, and marital status. The results show that psychiatric disorders in Kashan are higher than at the time of the previous research in this region [1999]. Therefore, prevention programs and treatment of psychiatric disorders in this city are of great priority

Effect of dimenhydrinate on benign paroxysmal positional vertigo after Epley maneuver therapy

Benign Paroxysmal Positional Vertigo [BPPV] is the most common cause of peripheral vertigo in adults. Reason of this type of vertigo is movement of otoliths in semicircular canals [especially posterior]. Main treatments for BPPV are antivertiginous drugs and maneuvertherapy. The purpose of this study is to determine the efficacy of Dimenhydrinate after maneuvertherapy of Epley on duration, number of vertigo attacks and duration of dizziness after each vertigo attack in patients with Posterior canal BPPV. One hundred forty eight patients with posterior Canal BPPV were evaluated in a randomized clinical trial in 2008 2009.Maneuvertherapy of Epley were done for all patients. They were divided into two groups: Dimenhydrinate group [75] and Placebo group [73] and drug prescribed for 2 weeks. Patients were followed up after treatment for duration of vertigo [days], number of vertigo attacks and duration of dizziness after each vertigo attack [minute]. Data were analyzed with statistical software SPSS 11/5 and comparison of means were done with T test and relationship between qualitative variables with X[2] square. Mean duration of recovery from vertigo attacks were 3/2 +/- 2/9 days in Dimenhydrinate and 3/8 +/- 3/3 in Placebo groups, mean number of vertigo attacks after treatment were 2 +/- 0/7 in Dimenhydrinate and 2/2 +/- 1 in placebo groups and Mean duration of dizziness after each vertigo attack was 32/75 +/- 2/07 minutes in Dimenhydrinate and 39 +/- 3/55 minutes in placebo groups with no statistically difference [P<0/05]. Epley maneuvertherapy is an effective treatment for Posterior canal BPPV and adding Dimenhydrinate does not increase its effectiveness

Acute paraplegia after general anesthesia

Acute paraplegia is a rare but catastrophic complication of surgeries performed on aorta and corrective operations of vertebral column. Trauma to spinal cord after spinal anesthesia and ischemia of spinal cord also may lead to acute paraplegia. Acute paraplegia as a complication of general anesthesia in surgeries performed on sites other than aorta and vertebral column is very rare. Here we present a 56 year old woman with acute paraplegia due to spinal cord infarction after laparoscopic cholecystectomy under general anesthesia probably caused by atherosclerosis of feeding spinal arteries and ischemia of spinal cord after reduction of blood flow possibly due to hypotension during general anesthesia