Objectives: Intravenous thrombolytic therapy has established acceptable results in treating ischemic stroke. However, there is little information on treatment outcome especially in different subtypes. The aim of current study was to evaluate early and intermediate prognosis in intravenous thrombolytic therapy for acute ischemic stroke subtypes. Methodology: Forty eligible patients (57.5% male with mean age of 63.18±13.49 years) with definite ischemic stroke who were admitted to emergency department of Imam Reza University Hospital, in the first 180 minutes after occurrence received recombinant tissue plasminogen activator. All investigation findings were recorded and stroke subtypes were determined according to the Causative Classification of Stroke System. Stroke severity forms including modified Rankin Scale (mRS) and National Institutes of Health Stroke Scale (NIHSS) scores were recorded for all patients in first, seven and 90 days after stroke and disease outcome was evaluated. Results: The etiology of stroke was large artery atherosclerosis in 20%, cardio-aortic embolism in 45%, small artery occlusion in 17.5% and undetermined causes in 17.5%. NIHSS and mRS scores were significantly improved during time (P < 0.001 in both cases). Three months mortality rate was 25%. Among the etiologies, patients with small artery occlusion and then cardio-aortic embolism had lower NIHSS score at arrival (P = 0.04). Caplan-meier analysis showed that age, sex and symptom to needle time could predict disease outcome. Conclusion: Intravenous thrombolytic therapy is accompanied by good early and intermediate outcome in most patients with ischemic stroke. Small artery occlusion subtype had less disease severity and higher improvement.
The prevalence of migraine in the world is about 15 and 7% among women and men, respectively. The purpose of this study was comparison of somatoform dissociation, fatigue severity and pain behavior in patients with migraine headache and its relationship with coping strategies. This descriptive analytical study has been done on 120 patients with migraine headache and 120 healthy subjects were selected randomly. Data collected by somatoform dissociation questionnaire (SDQ-20), fatigue severity scale, pain behavior scale and coping strategies scale. For data analysis we used SPSS.19. The means of the somatoform dissociation, pain behavior scale, help searching subscale and pain compliant in migraine and healthy subjects were statistically significant. There was not significant difference in avoidance subscales between the two groups. Comparison of fatigue severity in patients with migraine and control group was meaningful. There was significant positive correlation between all four scales and coping strategies. It seems that these symptoms can play an important role in this disease; thus, their careful evaluation in the treatment of migraine headache is essential.
Background: The multiple sclerosis (MS) disease is more common in women than men with a ratio of 2.7 to 1. According to Iran MS society, there are about 80,000 MS patients in the country Iran. Having knowledge about MS can reduce significantly the anxiety and stress of pregnant women and promote their life expectancy and the probability of having a successful pregnancy and making pregnancy easier for them.Methods: This is a descriptive– analytical study that has been done on 150 pregnant women which selected randomly and referred to health centers of Ardabil city at 2017. Data collected by a questionnaire included questions about MS. The collected data were analyzed by statistical methods in SPSS version 19.Results: Of all women, 20% considered gender as one of the most effective factors in the disease and 44.7% believed that women are more likely to suffer from MS than men. The knowledge of pregnant women about MS with 63.3% was in moderate level and friends and relatives was the most source of their awareness. 43.3% of women believed that knowledge people with MS could marry. 63.3% of women pointed that the health care centers knowledge about MS was inadequate and 68.7% pointed that government's support for patients was significantly low.Conclusions: Results showed that the awareness of pregnant women about MS was in moderate level. So, planning to increase the awareness of pregnant women in centers and support of women with MS by governmental centers seems necessary.
Objective: Currently, treating ischemic stroke by intravenous thrombolytic therapy has acceptable results in patients with stroke. This study aimed to evaluate the three months prognosis of patients treated with recombinant tissue plasminogen activator (rt-PA). Methods: This cross-sectional prospective study was conducted on 30 patients with cerebral ischemic stroke with the National Institutes of Health Stroke Scale (NIHSS) >5. Data such as demographic information, signs and symptoms, medical history, risk factors, focused neurological examination, and the NIHSS were collected for all patients. Then, all patients received 0.9 mg/kg of rt-PA as intravenous bolus doses and intravenous infusion under close monitoring in the emergency department. All patients were checked for necessary outcomes and also disability at the admission time, 7 days later and after three months all patients were checked again. All collected data were analyzed by appropriate tests using SPSS version 22. Results: Of all patients, 63.3% were males and 36.7% were females. The mean age of the patients was 62.37 ± 12.62 years with a range of 40-91 years. The mean of NIHSS was 12.46 ± 4.28 at admission time, in day seven it was 8.06 ± 3.72 and in month three after treatment it was 3.62 ± 2.31. There was a significant relationship between age, place of residence and NIHSS. Thirty percent of patients had NIHSS more than 15 at admission time and after 7 days this rate reached to 10% and three months later it declined to 6.7%. These differences were statistically significant. Conclusion: Intravenous thrombolytic therapy is associated with proper short term results in most patients with ischemic stroke.
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