Elyar Sadeghi-Hokmabadi; Abdoreza Ghoreishi; Reza Rikhtegar; Payam Sariaslani; Shahram Rafie; Alireza Vakilian; Ehsan Sharifipour; Masoud Mehrpour; Mohammad Saadatnia; Mohammad Mirza-Aghazadeh-Attari; Mehdi Farhoudi
Abstract
Background: Rates of intracranial hemorrhage (ICH) after intravenous thrombolysis (IVT) differ depending on ethnicity, one reason that few Eastern countries have approved a lower dose of alteplase. Data in this regard are scarce in the Middle Eastern region. Methods: The present retrospective study ...
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Background: Rates of intracranial hemorrhage (ICH) after intravenous thrombolysis (IVT) differ depending on ethnicity, one reason that few Eastern countries have approved a lower dose of alteplase. Data in this regard are scarce in the Middle Eastern region. Methods: The present retrospective study was performed on data extracted from the Safe Implementation of Treatments in Stroke (SITS) registry. Computed tomography (CT) image analysis was based on the SITS-Monitoring Study (SITS-MOST) definition for symptomatic ICH (SICH). Functional outcome at 3 months was assessed using the modified Rankin Scale (mRS). Multivariate logistic regression including adjusted analysis was used for comparison between groups. Results: Of 6615 patients, 1055 were enrolled. A total of 86% (n = 906) received a standard dose and 14% (n = 149) received a low dose of alteplase. Favorable 3-month outcome was achieved in 481 (53%) patients in the standard group and 71 (48%) patients in the low-dose group [adjusted odds ratio (AOR) = 1.24, 95% confidence interval (CI): 0.87-1.75, P = 0.218]. SICH occurred in 14 (1.5%) patients in the standard group and 3 (2%) patients in the low-dose group [odds ratio (OR) = 2.77, 95% CI: 0.36-21.04, P = 0.120]. At 3 months, mortality occurred in 145 (16.0%) patients in the standard group and 29 (19.4%) patients in the low-dose group (OR = 1.22, 95% CI: 0.78-1.91, P = 0.346). Conclusion: Low-dose compared to standard-dose alteplase for patients with acute ischemic stroke (AIS) was not associated with fewer hemorrhagic events and there was no significant difference in the favorable 3-month outcome (mRS: 0-2) or mortality rate.
Vida Mohammadzadeh; Masoud Mehrpour; Abdolreza Ghoreishi; Koorosh Kamali; Babak Zamani
Abstract
Background: Subclinical atherosclerosis is the asymptomatic phase of carotid atherosclerosis, and its early diagnosis is important to prevent cerebrovascular diseases. Although the vitamin D plays a role in the structure of vessels, the association between the serum level of vitamin D and subclinical ...
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Background: Subclinical atherosclerosis is the asymptomatic phase of carotid atherosclerosis, and its early diagnosis is important to prevent cerebrovascular diseases. Although the vitamin D plays a role in the structure of vessels, the association between the serum level of vitamin D and subclinical atherosclerosis has not been well-studied. We aimed to investigate the association between serum vitamin D level and carotid artery intima-media thickness (CIMT) in Iranian population. Methods: One hundred individuals with the age range from 20 to 50 years with no history of cardiovascular risk factors were selected for the analysis. Measurements of serum25-hydroxyvitamin D3 [25(OH) D3] concentration and CIMT were made. Confounding factors such as diabetes, hypertension (HTN), smoking, alcohol, tobacco, dyslipidemia, cardiovascular disease (CVD), high body mass index (BMI), history of drug intake especially calcium, vitamin D, statins, and anti-hypertensive drugs were considered and then excluded from our study. Results: The mean serum vitamin D level was 15.55 ± 0.42 ng/ml, whereas in the increased intima-media thickness (IMT), it was 12.50 ± 9.50 ng/ml. 55% of the subjects were diagnosed with subclinical atherosclerosis (IMT ≥ 0.75 mm). Mean IMT was 0.74 ± 0.12 mm; however, it was higher (0.86 ± 0.30) in severe vitamin D deficiency group. The analysis showed an association between serum 25(OH) D3 level and CIMT (P = 0.002). 44% of those participants with subclinical atherosclerosis had also a severe vitamin D deficiency, while only 13% of normal people had a severe vitamin D deficiency. Also, a correlation was observed between severe vitamin D deficiency and the presence of plaque or higher IMT. Conclusion: Serum 25(OH) D3 level was inversely correlated with CIMT in our investigated subjects with no cardiovascular risk factor.
Masoud Mehrpour; Hessam Rahatlou; Negar Hamzehpur; Sahand Kia; Mahdi Safdarian
Volume 15, Issue 4 , October 2016, , Pages 214-218
Abstract
Background: The aim of this study was to evaluate whether higher serum levels of insulin-like growth factor-I (IGF-I) in the acute phase of ischemic stroke are associated with less severe strokes and better functional outcome in a period of 12-month follow-up.Methods: From October 2014 to August 2015, ...
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Background: The aim of this study was to evaluate whether higher serum levels of insulin-like growth factor-I (IGF-I) in the acute phase of ischemic stroke are associated with less severe strokes and better functional outcome in a period of 12-month follow-up.Methods: From October 2014 to August 2015, patients with the diagnosis of acute ischemic stroke admitted to the stroke unit of Firoozgar Hospital, Tehran, Iran, entered this prospective study. National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Scale (MRS) for stroke scores were used to measure the severity and outcomes of an acute ischemic stroke at the time of admission and 1 year after the stroke, respectively.Results: A total of 60 acute ischemic stroke patients (28 male, 32 female) with the mean age of 71.1 ± 9.0 years were evaluated for the serum level of IGF-I at the time of admission to the stroke unit of Firoozgar Hospital. There was seen a significant correlation between the IGF-I serum level and the MRS scores (P = 0.020; correlation coefficient = −0.32). IGF-I serum level had no significant correlation with NIHSS scores.Conclusion: These results support that the higher serum levels of IGF-I at the time of stroke is associated with a significant better outcome in a 1-year period of follow-up. However, this hormone serum level seems not to have a predictable value for the ischemic stroke severity. Further studies are required to clarify the neuroprotective mechanisms of IGF-I in ischemic stroke process.
Masoud Mehrpour; Fahimeh Akhoundi; Zahra Rezaei
Volume 15, Issue 1 , January 2016, , Pages 23-27
Abstract
Background: To determine whether Islamic fasting would change cerebral blood flow during Ramadan.Methods: The study group comprised 20 subjects (16 males and 4 females) on a regimen of 1 month food and water intake restriction, according to Islamic fasting ritual. Subjects were evaluated for cerebral ...
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Background: To determine whether Islamic fasting would change cerebral blood flow during Ramadan.Methods: The study group comprised 20 subjects (16 males and 4 females) on a regimen of 1 month food and water intake restriction, according to Islamic fasting ritual. Subjects were evaluated for cerebral bolo flow through a middle cerebral artery (MCA) by means of transcranial Doppler (TCD), the day before starting Ramadan fasting and the day after the month of Ramadan.Results: Our results showed no statistically significant changes after Ramadan in cerebrovascular hemodynamic, in comparison before Ramadan.Conclusion: Although some studies showed metabolic changes during Ramadan fasting (increasing hematocrite, decreasing amount of hemoglobin, dehydration, platelet aggregation, and lipid profile alternations) the findings suggest that Islamic fasting has no significant effects on cerebral blood flow.
Aliasghar Molana; Masoud Mehrpour; Nasim Vousooghi; Mahmoud Reza Hajighasem; Mohammad Taghi Joghataei
Volume 13, Issue 3 , September 2014, , Pages 154-159
Abstract
Background: Migraine is a chronic neurological disorder, characterized by recurrent moderate to severe headaches. Worldwide migraine a=ects nearly 15%. Studies suggest that genes involved in the production of nitric oxide (NO) may act as genetic factors for migraine. NO synthase 3 (NOS3) ...
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Background: Migraine is a chronic neurological disorder, characterized by recurrent moderate to severe headaches. Worldwide migraine a=ects nearly 15%. Studies suggest that genes involved in the production of nitric oxide (NO) may act as genetic factors for migraine. NO synthase 3 (NOS3) by expressing enzyme NOS regulates endothelial derived NO. One class of medications used as first-line treatment in migraine prophylaxis is tricyclic antidepressants (TCAs). The aim of this study was to determine e=ects of NOS3 gene Glu298Asp polymorphism in the production of NO and response of patients to TCAs in migraine attacks.Methods: A total of 80 migraine patients were invited to participate in the study. Patients recorded the characteristics of their migraine attacks such as frequency of attacks and intensity of headaches for the 1st month of the study. Then peripheral blood samples were taken from all subjects in order to determine patients’ genotype distribution, mRNA expression level of NOS3 and NO content of plasma. Patients were then instructed to use 25 mg nortriptyline at night before bed for 3 months. At the end of 3rd month of the treatment patients again recorded the migraine characteristics for 1 month and blood sampling was performed in order to determine the level of plasma NO.Results: The patients’ genotype distribution for TT, GT, and GG was 9, 24, and 47 subjects, respectively. Mean NO level in patients with TT genotype was less in comparison to GT and GG genotypes before and after use of TCAs (P < 0.05). Mean intensity of headaches in patients with TT genotype was lower in comparison to GT and GG genotypes before and after use of TCAs (based on verbal numerical rating scale). Mean frequency of migraine attacks after use of TCAs was significantly decreased in all genotypes of NOS3 Glu298Asp polymorphism particularly in TT genotype (P < 0.05).Conclusion: Presence of T allele of the Glu298Asp polymorphism may be a factor for TT genotype patients to produce less NO and is a favorable factor for better response to TCAs in reducing migraine attacks in comparison to GT and GG genotypes.
