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Neuropsychiatric manifestations of systemic lupus erythematosus: Iranian experience
Haghighi Afshin,Haza Shahab
Annals of Indian Academy of Neurology , 2010,
Abstract: Aims: To evaluate the prevalence and characteristics of different neurological and psychiatric presentations in patients admitted to hospital with systemic lupus erythematosus (SLE). Materials and Methods: In this retrospective hospital-based study, we examined the medical records of patients with SLE who were referred to the hospitals affiliated to Shiraz University of Medical Sciences from 1995 to 2005. All patients of SLE who had clinical neurological or psychiatric features were included in this study. The patients′ demographic data, findings on general examination, neuropsychiatric manifestations, and the results of laboratory investigations and imaging studies were recorded. Clinical manifestations were classified according to the American College of Rheumatology (ACR) case definitions. Results: Of the 407 study patients, 11.3% had neuropsychiatric complications. The most frequent findings were seizure (63%), headache (60%), and decreased level of consciousness (50%). Cerebrovascular disease (28.3%), seizure disorder (26.5%), and acute confusional state (19.6%) were the most prevalent syndromes. Conclusion: The prevalence and nature of different neurological presentations of SLE in Iranian patients has some similarities to that seen in other populations, as well as some differences. Ethnic and environmental factors may contribute to these differences.
The impact of disability, fatigue and sleep quality on the quality of life in multiple sclerosis
Ghaem Haleh,Haghighi Afshin
Annals of Indian Academy of Neurology , 2008,
Abstract: Background: Only few papers have investigated the impact of multiple sclerosis (MS), especially MS-related fatigue and the impact of the quality of sleep on the quality of life (QoL) in MS patients. Objective: The objective of this study was to measure the quality of life in MS patients and the impact of disability, fatigue and sleep quality, using statistical modeling. Materials and Methods: A cross-sectional study was conducted and data was collected from 141 MS patients, who were referred to the Mottahari Clinic, Shiraz, Iran, in 2005. Data on health-related quality of life (MSQoL-54), fatigue severity scale (FSS), and Pittsburgh sleep quality Index (PSQI) were obtained in the case of all the patients. Epidemiology data concerning MS type, MS functional system score, expanded disability status scale (EDSS) etc. were also provided by a qualified neurologist. Spearman a coefficient, Mann-Whitney U test, and linear regression model were used to analyze the data. Results : The mean ±SD age of 141 MS patients was 32.6±9.6 year. Thirty five (24.8%) of them were male and the others were female. Eighty two (58.1%) of the patients had EDSS score of ≤ 2, 36 (25.5%) between 2.5 and 4.5, and 23 (16.3%) ≥ 5. As per PSQI scores, two (1.4%) of the patients had good sleep, 16 (11.3%) had moderate sleep and 123 (87.2%) had poor sleep. There was a significant high positive correlation between the quality of mental and physical health composite scores (r = 0.791, P < 0.001). There was a significant negative correlation between the quality of physical score and age (r = -0.88, P < 0.001), fatigue score (r = -0.640, P < 0.001), EDSS score (r = -0.476, P < 0.001) and PSQI (sleep quality r = -0.514, P < 0.000). Linear regression analysis showed that PSQI score, EDSS, and fatigue score were predictors in the model between the quality of physical score and covariates ( P < 0.001). Linear regression model showed that fatigue score and PSQI were predictors in the model between the quality of mental score and covariates ( P < 0.001). Discussion and Conclusion: In conclusion, it may be said that MS patients had poor and moderate quality of mental and physical health. The quality of life was impaired as seen by PSQI, EDSS, and FSS. It is our suggestion that these patients require the attention of health care professionals, to be observed for the need of possible psychological support.
Low Levels of Triiodothyronine in Patients with Alzheimer’s Disease
Fariba Karimi,Afshin Borhani Haghighi,Payman Petramfar
Iranian Journal of Medical Sciences , 2011,
Serum Levels of Homocysteine, Vitamin B12, and Folic Acid in Patients with Alzheimer’s Disease
Fariba Karimi,Afshin Borhani Haghighi,Payman Petramfar
Iranian Journal of Medical Sciences , 2009,
Abstract: Background: Alzheimer's disease is the most common formof dementia in the elderly. Serum levels of homocysteine havebeen related to increased cortical and hippocampal atrophy.We aimed to determine the serum levels of homocysteine,folate, and vitamin B12 in patients with Alzheimer's disease.Methods: Blood levels of homocysteine and its biologicaldeterminants, folate, and vitamin B12 were measured in 51patients who were diagnosed as having Alzheimer's diseaseaccording to DSM-IV criteria and compared with the serumlevels obtained from 49 control individuals.Results: The mean serum homocysteine concentration wassignificantly higher in patients with Alzheimer's disease thanthe controls (20.4 ± 16.5 μmol/L v 14.5 ± 5 μmol/L; P= 0.02).There were no statistically significant differences between themean serum levels of vitamin B12 (P=0.6) and folate (P= 0.3)in the patients and the controls. There was no correlation betweenage and serum homocysteine concentration in bothgroups (P= 0.8).Conclusion: Serum homocysteine concentration was significantlyhigher in the patients with Alzheimer's disease. Thisbiomarker might be considered as a predictor of cognitive performance.
Cerebral Venous-Sinus Thrombosis: A Case Series Analysis
Nahid Ashjazadeh,Afshin Borhani Haghighi,Maryam Poursadeghfard,Hoseinjan Azin
Iranian Journal of Medical Sciences , 2011,
Abstract: Background: Cerebral venous-sinus thrombosis is an uncommon form but important cause of stroke, especially in young-aged women. Methods: We performed a retrospective descriptive-analytical study in which 124 patients with cerebral venous-sinus thrombosis, who referred to Nemazee Hospital, Shiraz University of Medical Sciences from January 2000 to March 2008, were included, and their demographic, etiologic, radiological and prognostic characteristics were evaluated. Results: The patients' mean age was 34.01±10.25. Eighty seven (70.16%) were women and 37 (29.83%) were men. The most frequent clinical manifestations were headache, papilledema and seizures. Fifty seven (65.51%) women took oral contraceptive pills. Twenty of 57 women (35.08%) took the pill longer than one month to be able to fast in Ramadan or perform the Hajj ceremonies. In the mean time they developed cerebral venous-sinus thrombosis. Superior sagital sinus, with or without lateral sinuses, was the most involved area (70.96%). High mortality and morbidity rates (14.51% and 35.48%, respectively) were found in patients. Poor prognostic factors at the time of admission were stupor and coma (P=0.001) and evidence of hemorrhage in primary CT scan (P=0.005). Conclusion: Taking oral contraceptive pills was a main factor associated with cerebral venous-sinus thrombosis. Clinical manifestations, prognostic factors, common involved sinuses and image findings of this study were similar to those of other studies. Health care policy makers should design a plan to warn susceptible women of the risk of cerebral venous-sinus thrombosis, and to educate them the ways to prevent it
Guillain-Barre Syndrome after Kidney Transplantation: a Case Report
Mohsen Farazdaghi,Anahita Zoghi,Mahnoosh Moghimi,Afshin Borhani Haghighi
Galen Medical Journal , 2013,
Abstract: Background: Guillain-Barre Syndrome is an unusual complication of hematopoietic stem cell transplantation but it is extremely rare after solid organ transplantation such as kidney or liver transplantationCase report: A 48-year-old man, a case of kidney transplantation presented with generalized weakness in an ascending pattern. History and examination were compatible with the diagnosis of Guillain-Barre Syndrome (GBS) and paraclinical studies confirmed this diagnosis. He was treated for Guillain-Barre syndrome but no significant response was observed.Conclusion: Guillain–Barre′ syndrome rarely appears after organ transplantation but it should be considered in a patient presenting with its associated symptoms after transplantation.
Epidemiologic and Clinical Characteristics of Migraine and Tension-Type Headaches among Hospitals Staffs of Shiraz (Iran)
Ayatollahi Seyyed Mohammad Taghi,Sahebi Leyla,Borhani Haghighi Afshin
Acta Medica Iranica , 2009,
Abstract: Headache is a common symptom that constitutes a major health problem to all countries in the world. This study was conducted to estimate the prevalence of migraine and tension -type headaches(TTH), its associated occupational risk factors among Shiraz hospitals staffs, and to report on clinical characteristics of migraine and TTH with using the International Headache Society (IHS) diagnosis criteria. A random sample of 1023 staffs constituting a 20% sample of the hospitals staff population was selected. Sampling method was categorical random sampling. Within each group sampling was carried out systematically. Data were collected by screening questionnaire followed by clinical interviews, general physical and neurological examination, and diagnostic criteria of IHS. Prevalence of migraine, TTH and coexisting migraine and TTH were estimated as 11.2% (115 cases), 19.5% (199 subjects) and 3.2% (33 subjects) respectively. In this study , clinical characteristics of headache including type, site, number , intensity ,concomitant symptom of headaches had been surveyed. TTH and migraine headaches were significantly associated with self reported abnormal sleep pattern and female gender (P < 0.001). Also TTH was negatively associated with total 24hr duration of sleep and history of involvement in second job significantly (P<0.026). The average of prevalence of migraine and TTH were lower than their counter parts in western countries but higher than previous studies conducted in other Asian countries. Clinical characteristics were almost parallel with IHS criteria, headache- related missed work rates were higher for subjects with migraine headache, and also TTH and migraine were separate disorders and were not as a part of a continuum of headache disorders. Headache disorders deserve more attention, especially concerning strategies leading to adequate primary prevention, diagnosis and treatment.
Positioning a New Vertex that Minimize the Number of New Crossings
Hamid Sanatnama,Afshin Amini,Alireza Bitaraf Haghighi,Farshad Brahimi
Journal of Applied Sciences , 2011,
Abstract: Routing, scheduling and location problems in our real-life can be formulated as combinatorial optimization problems whose goal is to find a linear layout of an input graph in such a way that the number of edge crossings is minimized. The problem of adding a new vertex to an existing straight-line graph drawing and connecting it to its adjacent vertices in such a way that the number of crossings made by adding this vertex is minimized is known as crossing minimization problem. Although many crossing number related problems are NP-Complete or NP-Hard. In this study, we present a polynomial time algorithm; O (|V|5.|E|). It checks a point in every Fully Drawing Region (FDR) and returns a point which is the position of the new vertex that minimizes the number of added crossings. It may be useful when we have an existing drawing which cannot be changed and we dont know how vertices will be added in future.
The Frequency of Proximal ICA Plaques in Ischemic Symptom-Free Patients with Incidentally Detected Carotid Siphon Calcification
Sepideh Sefidbakht,Mohsen Khalili,Afshin Borhani haghighi,Reza Jalli
Iranian Journal of Radiology , 2009,
Abstract: Introduction: Following the wide popularity of coronary artery Calcium scoring, efforts have been made to determine clinical significance of cavernous carotid calcification in relation to the risk of stroke. In this study we aimed to determine the correlation of carotid siphon calcification incidentally detected in head CT scans done for non-ischemic causes with presence and severity of bifurcation region plaques. "nMaterials and Methods: Overall 52 patients (29 male and 23 female, age range 67.8±10.76) with head CT scans done for non-ischemic causes were included. They included 40 patients with carotid siphon calcification detectable in the CT scan and 12 patients without cavernous carotid calcification included as control cases. All patients were evaluated for evidence of recent or previous ischemic events and atherosclerotic risk factors including blood pressure, BMI, history of smoking and cholesterol levels. All patients underwent color Doppler ultrasound of the cervical carotid artery by a single examiner blinded to the CT scan results. Calcification in the cavernous carotid region was semi-quantitatively graded according to Woodcock et al to no, mild, moderate and severe calcification. The degree of narrowing of the proximal ICA was graded to normal, narrowings <50%, 50-69%, ≥70% to near occlusion, near occlusion and total occlusion according to the Society of Radiologists in ultrasound consensus conference. Presence and degree of siphon calcification was correlated with presence and degree of bifurcation plaques using Mann-Whitney test. "nResults: Age range and atherosclerotic risk factors were not significantly different between case and control groups. Among 40 patients with siphon calcification of various degrees in the brain CT, 32 (75%) were found to have at least mild narrowing plaques in color Doppler ultrasound. 7 out of 12 patients (58%) with no calcification in CT were also found to have at least mildly narrowing plaques. The difference however was not statistically significant (p=0.147). Statistically significant correlation was however found between the laterality of siphon calcification and the side of ICA plaques (p=0.043 and p=0.013, respectively for right and left sides). "nConclusion: A high percentage of patients with no prior evidence of ischemia with cavernous carotid calcification incidentally detected in their CT scans will have at least mildly narrowing plaques in their carotid bulbs and/or ICA's. The routine practice of ignoring incidentally detected carotid siphon calcifications in brain CT's is at least questionable and
Diagnosis and quantitative detection of HSV DNA in samples from patients with suspected herpes simplex encephalitis
Ziyaeyan, Mazyar;Alborzi, Abdolvahab;Haghighi, Afshin Borhani;Jamalidoust, Marziyeh;Moeini, Mahsa;Pourabbas, Bahman;
Brazilian Journal of Infectious Diseases , 2011, DOI: 10.1590/S1413-86702011000300005
Abstract: diagnosis of herpes simplex encephalitis (hse) is based on the detection of herpes simplex virus (hsv) dna in patients' csf samples. hsv dna quantitation has the potential for estimating the effects of antiviral therapy. the aim of this study was to diagnose hsv dna in hse suspected patients and the quantitative analysis of its genome using real-time pcr to assess the value of the viral load in the course of antiviral treatment. the csf samples were collected from 236 consecutive hse suspected patients from november 2004 to may 2008. upon dna extraction, the samples were analyzed by real-time pcr assay. a set of primers amplified a common sequence of hsv glycoprotein b gene. the copy numbers of unknown samples were expressed via a standard curve drawn with a known amount of amplified cloned plasmid. of the 236 samples, 137 (58%) came from males and 99 (42%) from females. the hsv genome was detected in 22 (9.3%) patients by pcr, 13 males/ 9 females. serial csf samples were available from 10 of the 22 patients. the range of the hsv dna copy numbers in the clinical samples ranged from 2.5 × 102 to 1.7 × 106 copies/ml of csf. quantitative pcr results can be helpful in evaluating the efficacy of antiviral therapy in the above-mentioned patients. there is an association between the initial viral load and the duration of treatment course.
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