Frequency of Asymptomatic Intracranial and Extracranial Arterial Stenosis in a Group of Healthy General Papulation in Kerman (South of Iran).

INTRODUCTION: This study aimed to investigate the frequency of asymptomatic intracranial and extracranial artery stenosis in healthy volunteers in Kerman, Iran, in 2019 using Doppler ultrasound imaging. METHOD: This cross-sectional study was conducted on healthy volunteers in Kerman in 2019 following a public elicitation. After the general examination, 138 healthy volunteers who had no history of any disease and were not treated with any medication underwent cerebrovascular evaluation with Doppler ultrasound. Demographic information, history of addiction, and sonographic findings were recorded in a checklist and then analyzed using SPSS 22. RESULTS: Stenosis was found in 14.4% of volunteers. The mean age of participants was 45.8±10.12 years, and 74 (54%) of them were male. In volunteers with stenosis, a significant correlation was found between age (P = 0.03) and addiction (P = 0.04) with the involved artery. There was also a significant correlation between addiction and intracranial and extracranial artery stenosis (P = 0.04). Logistic regression analysis showed a significant relationship between being female, addiction, and age with stenosis, as well as between addiction and intracranial artery stenosis (P <0.05). CONCLUSION: The majority of healthy residents of Kerman have asymptomatic cerebrovascular stenosis, and this is more prevalent in the elderly, addicts, and women.

Early and mid-term outcomes of carotid angioplasty and stent placement in 579 patients.

BACKGROUND AND PURPOSE: Carotid angioplasty and stenting (CAS) could be considered for preventing stroke in patients with carotid artery stenosis. This study aimed to determine the incidence and the risk factors of the early and mid-term complications associated with CAS. METHODS: This is a retrospective cohort study conducted at Shiraz University of Medical Sciences from March 2011 to March 2019. Patients at high risk and standard risk for carotid endarterectomy were included. The primary composite outcome was defined as stroke, myocardial infarction (MI), and death in the first 30 days after CAS. All-cause mortality, vascular mortality, and stroke were investigated during mid-term follow-up. RESULTS: A total of 579 patients (618 CAS) were recruited (mean age: 71.52 years). Overall, 394 (68.40%), 211 (36.63%), 179 (31.07%), and 96 (16.72%) patients had hypertension, dyslipidemia, diabetes mellitus, or were cigarette smokers, respectively. Primary composite outcomes were observed in 2.59% of patients (1.55% stroke, 0.69% MI, and 1.72% death). Atrial fibrillation was a predictor of primary composite outcome in multivariate logistic regression (p = .048). The presence of total occlusion in the contralateral carotid artery was significantly associated with the risk of stroke in univariate logistic regression (p = .041). The patients were followed for a period ranging from 1 to 83 months. The overall survival rate for all-cause mortality was 93.48% at 1 year, 77.24% at 5 years, and 52.92% at 8 years. All-cause mortality was significantly higher among patients with symptomatic carotid stenosis (p = .014). CONCLUSION: CAS provides acceptable short-term and mid-term outcomes in a unique population of high- and standard-surgical-risk, symptomatic and asymptomatic, octogenarian, and nonoctogenarian patients.

Lavender improves fatigue symptoms in multiple sclerosis patients: A double-blind, randomized controlled trial.

BACKGROUND: Fatigue is one of the most common complications of Multiple Sclerosis (MS) patients. Several pharmacological and non-pharmacological interventions have been recommended to control this complication. Lavender is one of the plants considered by Persian Medicine (PM) and recommended by scholars of past centuries in the treatment of neurological diseases. This study aimed to investigate the efficacy of lavender capsule on improving fatigue symptoms in MS patients. MATERIAL AND METHODS: In a double-blind, controlled trial, using a computer block randomization approach, 48 confirmed MS patients with eligibility criteria of being 18 years or older, Modified Fatigue Impact Scale (MFIS) ≥25, relapsing-remitting MS patients, EDSS ≤6, not pregnant, not breastfeeding, and not suffering from other diseases that cause fatigue, were randomized to receive capsules containing 600mg of lavender flowers as the intervention group or capsules containing 600mg cornstarch as the control group. Patients were randomized after completing the MFIS and were asked to take one capsule three times daily for 60 days. The MFIS again checked to assess the impact of two interventions. Analysis of Covariance (ANCOVA) was used to assess the impact of two interventions. RESULTS: 24 patients included in each group. The mean (standard deviation) of MFIS was 40.56 (7.63) in the intervention and 41.43 (7.89) in the control groups (p=0.706) before the intervention. However, there was a significant reduction (p0.001˂) in the intervention group, 7.04 (4.91) compared to the control group, 38.17 (9.78) after the intervention. CONCLUSION: In comparison to cornstarch capsules, consuming the capsules of lavender flowers decreased the MFIS in MS patients.

A bibliometric study of the movement disorder field by analyzing classic citation data on publication.

Background: The extent to which a publication attracts scientific attention by virtue of its focus, provides clues about the trend and volume of scientific production in a particular field. Bibliometric analysis is a method to quantify aspects of a specific research area. This article focused on publication on the movement disorders. Methods: The bibliometric data on movement disorder were retrieved in relation to set of keywords from the Thomson Reuters Web of Science (WOS) available by January 2017. As many bibliometric statistics, such as citation indexes change during time, it was decided to compare two successive 5-years periods, 2007-2011 and 2012-2016. In addition, the citation classics publications with more than 100 times cited were taken into consideration. Results: In total, the number of movement disorder papers rose from 49,444 to 61,942. Clinical neurology was the most studied WOS subfield at 35.6%. About 12.0% of these studies were published by the Movement Disorders Journal. Original papers accounted for 63.7% of publications. The United States of America was the leading country as the source of these publications followed by China. University College London (UCL) was associated more than any other university regarding these publications whereas the National Institute of Health (NIH) was the major source of funding. The number of papers with more than 100 citations totaled 87, out of which only one paper had more than 400 citations. Conclusion: This study demonstrates that the total number of publications in movement disorders has increased remarkably during the past decade.

Knowledge, attitude, and practices among Iranian neurologists toward evidence-based medicine.

Background: Evidence-based medicine (EBM) is a current practice in medicine to produce clinical practice guidelines from well-designed, randomized, controlled trials. We studied knowledge, attitude, and practice of EBM of neurologists who participated in the Iranian congress of neurology. Methods: A self-administered anonymous questionnaire was distributed and filled by neurologists. Results: A total of 200 neurologists were randomly sampled and with response rate of 56%. 33.9% of responder had previously participated in EBM courses. The average total knowledge score was 4.05 ± 0.80 out of a maximum possible score of 5.0. Textbooks were still the most favorite source of knowledge for our neurologists. A lack of time was the highest, and motivation the least mentioned barrier in using EBM. Conclusion: Overall, the Iranian neurologist had acceptable knowledge and attitude toward EBM and had same similar as found in other studies.

Topiramate-induced paresthesia is more frequently reported by migraine than epileptic patients.

Topiramate is an approved and effective drug in migraine prophylaxis. Paresthesia is the most commonly reported side effect. The primary objective of this study was to compare the frequency of topiramate-induced paresthesia in migraine headache to epileptic patients. Patients with migraine without aura and epilepsy were enrolled in this observational study. All cases were interviewed by telephone about their history of paresthesia. Confounding factors were controlled through logistic regression. The odds ratio of developing topiramate-induced paresthesia in migraine compared to epilepsy patients was 3.4. Three factors were independent contributors to developing topiramate-induced paresthesia: female sex (odds ratio 2.1), topiramate dosage (odds ratio 0.3) and duration of therapy. Our findings indicate an independent association between migraine and development of paresthesia. Migraineurs were more likely than epileptic patients to report paresthesia as topiramate adverse effects. Female sex, treatment duration and topiramate dosage contribute significantly to subsequent development of paresthesia.