effectiveness of exercise-therapy on improvement of balance, gait, quality of life and depression in elderly patients with vertigo due to peripheral disturbances of vestibular system

Vertigo is the sign of vestibular system complications that induce sense of rotation in individual toward environment or the patient himself. It also induces imbalance in gait and operational activities of patients that may lead to depression in individuals. In this study Cawthorne-cooksey exercises were used to remove signs of vestibular system complications and consequently improve balance and gait in patients suffer from vestibular complications. This study was a non-randomized prospective quisi-experimental investigation done in physiotherapy clinic of Al-zahra hospital in Isfahan province during the year 2007. As a consultation with expert statisticians, among old patients with vestibular system complications referred Al-zahra hospital, 41 patients were enrolled in to our study non-randomly. The exercises were taught to patients during three steps. Patients were asked to perform each group of exercises 10 minutes three times a day for one week. To assess the balance, gait, quality of life and depression in patients before and after treatment and also after one month follow-up, we used Berg Balance Scale, Dynamic Gait Index, Dizziness Handicap Inventory, and Beck questionnaire respectively. To analyze data paired t-test and Wilcoxon test were used. There was statistical significant difference in balance before and after treatment [P < 0.001], before treatment and after follow-up [P < 0.001], and also after treatment and after follow-up [P < 0.001]. There was statistical significant difference in gait before and after treatment [P < 0.001], before treatment and after follow-up [P < 0.001], and also after treatment and after follow-up [P < 0.001]. There was statistical significant difference in quality of life before and after treatment [P < 0.001], before treatment and after follow-up [P < 0.001], and also after treatment and after follow-up [P < 0.001]. There was statistical significant difference in depression before and after treatment [P < 0.001], before treatment and after follow-up [P < 0.001], and also after treatment and after follow-up [P < 0.001]. We conclude that using Cawthorne-cooksey exercises lead to improve balance, gait, quality of life and depression in adult patients for at least one month. To achieve desired treatment goals, patients should continue their daily activities even after one month for a long period of time

Relationship between helicobacter pylori immunoglobulin G antibody and thrombotic ischemic stroke

Several studies have assessed association between Helicobacter pylori infection and thrombotic ischemic stroke. This study was designed to investigate the association between this organism and ischemic strokes. Antibody against H. pylori [Hp IgG] was measured in 81 patients with stroke and 43 subjects without stroke. Hp IgG titer more than 20 u/ml was defined as positive. Hp IgG seropositivity was found in 67.4% of control subjects and 70.4% of cases [P = 0.838]. The means of serum Hp IgG titers in control subjects and cases were 51.1859 u/ml and 50.1641 u/ml, respectively [P = 0.927]. The difference between these 2 groups was not significant statistically. There wasn't any significant difference in seropositivity of Hp IgG between case and control subjects in men and women. It seems that H. pylori IgG titer hasn't a predictive role for thrombotic ischemic stroke

comparative study about effectiveness of an exercise therapy program on improvement of gait and balance in left and right hemiplegia

Impairment in the function of the brain caused by deficiency in the brain circulation is called stroke. Stroke is the most important factor of disability in adults. One of the most prevalent consequences of stroke is disability of walking or so-called [gait disorder] so that more than 50 percent of the patients who are in the acute phase of the disease are not capable of walking, and need to a rehabilitation period to reach for walking. In order to compare the effect of exercise therapy on the function of walking and balance and Improvement of depression in left and right hemiplegics patients, a Non-randomized clinical study was done. This study consisted of 13 right- hemiplegics patients with an average age of [60.46 +/- 1.47] and 13 left hemiplegics patients with an average age of [61.92 +/- 2.01] who were matched in age, height and weight. To measure the function of walking the Gait Dynamic Index, function of balance the Berg Balance Scale and Depression Beck Depression Questionnaire were used. The data were analyzed by SPSS software. To compare the effect of exercise therapy on the improvement of walking and balance before and after the treatment in each group t-paired -test and for more comparison of the two groups an independent T-test was used. With analyzing the received data the following results were derived: From the viewpoint of walking, a significant difference in the right hemiplegics group [p<0.001] and the left hemiplegics one [P=0.0] before and after the treatment is derived. From the viewpoint of balance, a significant difference in the right hemiplegics group [p<0.001] and the left hemiplegics group [P=0.0] before and after the treatment was noticed. About the improvement of depression, a significant difference in the right hemiplegics group [p<0.001] and the left one [p<0.00l] before and after the treatment was noticed. There was no significant difference between two groups before [p=0.85] and after [0.36] the treatment from the point of view of walking. There was no significant difference between two groups before [p=0.056] and after [p=0.067] the treatment in balance. There was no significant difference between two groups before [p=0.067] and after [p=0.054] treatment from the viewpoint of depression. This study showed that performing the exercise therapy protocol improves the function of walking, balance and depression in herniplegic patients; never the less, no differences were observed between the two right and left hemiplegics groups

[Chlamydia pneumoniae infection and thrombotic ischemic stroke]

Several studies have assessed the association between Chlamydia pneumoniae infection and thrombotic ischemic strokes. This study was designed to investigate the association between this organism and ischemic strokes in Iranian patients. Antibodies to Chlamydia pneumoniae[CP IgA and IgG] were measured in 81 patients with stroke and 43 controls. CP IgG and CP IgA titers more than 1.1 Immune Status Response [ISR] were considered as positive. We found that 9.3% of controls and 13.6% of cases were CP IgA seropositive. Although the difference between these two groups was prominent but it was not statistically significant [p=0.25]. The mean CP IgA titer was significantly higher in the case than in the control group [0.6 +/- 0.3 vs. 0.47 +/- 0.3 ISR, respectively, p=0.03]. This difference was not significant for CP IgG titer. The higher titer of CP IgA in patients with ischemic stroke than in controls might suggest the co-existence of this infection with ischemic stroke. Assessment of this association needs longitudinal studies

[Effect of blink reflex in diagnosis of central vertigo and its comparison with brain MRI]

Vestibulitis and VIII nerve lesions are the final diagnosis in most of the patients presenting with acute true vertigo, but central vertigo due to brainstem lesions must always be considered. In most of the patients, brain MRI is the only available solution. In this study, blink reflex [BR] abnormalities in acute true vertigo were compared with MRI findings. One hundred and five patients who were presented with acute true vertigo without other signs of brainstem involvement, and who had normal neurologic examination were evaluated. In 18 patients in whom new neurologic signs were appeared or their symptoms were lasted for more than 72 hr, BR and brain MRI were requested and their results were compared. From 18 patients, in 5 patients BR and brain MRI were normal and central vertigo was ruled out. In 8 patients both BR and brain MRI were abnormal. Three patients had normal BR and abnormal brain MRI. In the last two patients, brain MRI was normal but BR was abnormal. Abnormal response of BR [76.9%] were well correlated with abnormal MRI findings [84.6%], and the results of the two tests were additive. Therefore, BR can be a good accompaniment for brain MRI in evaluation of central vertigo. Based on low practice of mothers, it is recommended to give necessary knowledge to mothers by regular educational program and make them sure that fluid therapy is effective. Therefore, they can learn necessary skills to prevent mortality of children due to dehydration