Caspian Journal of Neurological Sciences

Background: Knowledge about Immune-Mediated Necrotizing Myopathy (IMNM) has received significantly attention in recent years. In this study, we report a rare case of IMNM with increased Creatine Phosphokinase (CPK) and positive Signal Recognition Particle (SRP). Clinical Presentation and Intervention: The case was a 67-year-old male patient referred to Firozgar hospital affiliated to the Iran University of Medical Science, Tehran, Iran in June 2018 with a chief complaint of pain in the proximal lower extremity. According to Medical Research Council Scale for muscle strength, the motor function of proximal upper extremities was 4/5 and for the proximal of the lower extremities, it was 3/5. Laboratory findings showed an increase in CPK, CK-MB, lactate dehydrogenase, creatinine, alanine aminotransferase, aspartate aminotransferase and aldolase levels. Six days after admission, autoantibody test was requested which showed positive SRP. In muscle biopsy, the myopathic atrophy with multiple necrotic and many degenerative/regenerative fibers was associated with mild endomysial fibrosis, and no inflammation was observed. Two g/kg dose of Intravenous Immunoglobulin (IVIG) was administrated after diagnosis of IMNM. Prednisone 50 mg/day orally, calcium vitamin D daily, pantoprazole 40 mg/day, physiotherapy, and occupational therapy were administrated for after discharge. Conclusion: Reporting a case of anti-SRP associated IMNM and reviewing its pathophysiology, diagnosis and treatment options can help increase the physicians’ knowledge of this rare and debilitating condition.

Seyed Mohammad Masoud Hojati

Payam Saadat

Shayan Alijanpour

Immune-mediated Necrotizing Myopathy With Increased Creatine Phosphokinase and Positive Signal Recognition Particle: A Case Report

免疫介导性坏死性肌病伴肌酸激酶升高及信号识别颗粒阳性：一例报告

Background: Appropriate clinical measures to prevent secondary brain damage in traumatic brain injury are of critical importance. Objectives: This study aims to investigate the relationships between serum electrolyte disturbances and Glasgow Coma Scale (GCS) score in patients with Diffuse Axonal Injury (DAI) at the time of admission and discharge. Materials &amp; Methods: In this retrospective cross-sectional study, we evaluated 101 patients with DAI having GCS score &lt;15 admitted to Poursina Hospital in Rasht, Iran from 2019 to 2020. Based on the presence or absence of serum potassium (K), sodium (Na), magnesium (Mg), and zinc (Zn), disturbances on the first day of hospitalization, patients were divided into two study groups of with and without abnormal electrolyte levels. The GCS scores of the two groups at the time of admission and discharge were recorded and the relationship between electrolyte disturbances and GCS score was evaluated. Results: There were no significant differences in the mean GCS score at the time of admission and discharge between patients with and without disturbances in serum Na, K, Zn and Mg levels based on the crude analysis. Regarding the simultaneous effects of the study variables on the GCS score, only Mg serum level exerted a significant impact on the GCS score at the time of admission (P=0.041) and discharge (P=0.017). Conclusion: The GCS score in patients with DAI at the time of admission and discharge has an association with the Mg serum level but not with Na, K, and Zn levels.

Hamid Behzadnia

Mesbah Dibavand

Mohammadreza Emamhadi

Sasan Andalib

Mahsa Pakseresht Mogharab

Naghmeh Khoshsima

Zoheir Reihanian

Association Between Serum Electrolyte Disturbances and Glasgow Coma Scale Score in Patients With Diffuse Axonal Injury

血清电解质紊乱与弥漫性轴索损伤患者格拉斯哥昏迷评分之间的关联

Hippocampus is a part of the brain that has an essential role in memory and learning. It is involved in many cognitive and behavioral phenomena, including the pattern separation process: the ability to distinguish patterns with very high similarity. The present study compared the models of pattern separation in the dentate gyrus of the hippocampus and aimed to investigate the significant cells and factors affecting pattern separation. In this review, we intend to describe the anatomy of the dentate gyrus as a part of the hippocampus, which has an essential role in pattern separation. Other adjacent neural populations are further addressed, too. Models of the dentate gyrus, including neurocomputation and functional, that represent the process of separating patterns in the dentate gyrus are reviewed and analyzed. In this regard, five major models were highlighted and compared from several perspectives. While some models are based on the entorhinal cortex and dentate gyrus regions, others point to the mediation of cornu ammonis (CA3) as well. Models with the lowest cells for pattern separation are addressed first. Finally, inhibition is discussed in the comparison of pattern separation models.

Nazal Modhej

Azam Bastanfard

Mohammad Teshnehlab

Somayeh Raiesdana

Computational Pattern Separation Models of Dentate Gyrus Neural Subpopulation in the Hippocampus

海马体中齿状回神经亚群的计算模式分离模型

Background: General anesthesia (GA) for caesarean section (CS) has distinctive characteristics that may increase the risk of awareness during GA (AGA). Objectives: The aim of this study was to investigate the incidence of unintended awareness during GA (AGA) in CS. Materials &amp; Methods: This cross-sectional descriptive study was performed in Alzahra Hospital in Rasht City, Iran. Eligible women with term pregnancy candidates for CS under GA were enrolled in this survey from May 2018 to August 2021. After delivery, a questionnaire including demographic data and questions related to different stages of anesthesia was completed via a faceto- face interview. The collected data were analyzed using repeated measurement, the Chi-square, Fisher exact, and t-test in SPSS v. 21. Results: The data from 174 women were analyzed, and 12 (6.9%) experienced AGA. Among them, dreaming and feeling the manipulation of the surgical area (27.8%) were the most common reported awareness states. Body mass index had a significant (P=0.034) relationship with AGA, but age (P=0.843), the level of education (P=0.714), history of anesthesia (P=0.552), 5-minute Apgar score (P=0.49), and surgery time (P=0.686) had no significant relationship with AGA. Conclusion: The incidence of AGA during CS was almost close to the high limit established by the credible evidence, and a significant number of the women were not in completely acceptable conditions. Therefore, the management of GA for CS should be revised in this academic hospital.

Mandana Mansour Ghanaie

Fatemeh Hosseinzadeh

Soheil Soltanipour

Zahra Rafiei Sorouri

Zahra Hamidi Madani

Gelareh Biazar

Haniye Dalir

Mahin Tayefeh Ashrafiyeh

Intraoperative Awareness During Cesarean Delivery Under General Anesthesia

全身麻醉下剖宫产手术中的术中知晓

Background: There is limited data about the short-term stroke mortality rates for patients in treatment settings. Objectives: This study aimed to estimate the short-term stroke (in hospital, one month, one year) mortality rates in Iran through a systematic review and meta-analysis. Materials &amp; Methods: We searched electronic databases, including three national (IranDoc, Megiran, SID) and four international (Scopus, PubMed, Web of Science, Google Scholar), from January 1990 to March 2020. We considered all observational studies on stroke mortality, such as cohort and crosssectional studies. Furthermore, the sub-group analyses were performed based on each province and metaregression analysis based on the study’s year and patients’ mean age. Results: Among 143 studies, 28 were eligible (11 cohort and 17 cross-sectional studies). Based on the random model, the mortality rates for in-hospital, 1-month, and 1-year mortality were reported as 18.71% (95% CI: 15.09%-22.34%), 23.43% (95% CI: 20.08%-26.78%), and 34.44% (95% CI: 32.02%- 36.85%), respectively. The results also revealed that mortality rates were neither related to the year studies conducted nor to the patient’s age. Conclusion: Approximately one-fifth of stroke patients in Iran die in the hospital after admission. The mortality rate increased in the one-month and one-year period, and about one-third of the patients died in the first year. Therefore, it is cardinal to focus on programs and solutions in which we can ameliorate mortality in the short-term period after stroke by performing primary specific treatments on patients.

Hossein-Ali Nikbakht

Layla Shojaie

Nasim Niknejad

Soheil Hassanipour

Hassan Soleimanpour

Sohrab Heidari

Sima Afrashteh

Ehsan Sarbazi

Saber Ghaffari-Fam

Mortality Rate of Acute Stroke in Iran: A Systematic Review and Meta-Analysis

伊朗急性卒中死亡率：系统综述与Meta分析

Background: Anxiety as an important psychological disorder that has affected many people and has made them to spend a lot of money for its treatment. Objectives: This study aims to assess the anxiolytic effect of the hydro-alcoholic extract of Anethum Graveolens L. seed (AGS) combined with the antagonist of estrogen receptor in female rats with anxiety. Materials &amp; Methods: In this study, 66 female Wistar rats were divided into eight groups as follow as: Negative control (10 ml/kg saline), positive control (0.6 mg/kg diazepam), five groups of AGS extract (0.1, 1, 10, 100 and 1000 mg/kg) and tamoxifen+AGS extract (10 mg/kg). Anxiety indicators were measured by the elevated plus maze (EPM) test. Results: The percentage of time spent open arms (%OAT) and percentage open arms entry (%OAE) significantly increased after using 10 mg/Kg dose of AGS extract compared to control group. Tamoxifen could significantly reduce this increase caused by AGS extract on anxiety indices. Conclusion: Considering the anxiolytic effect of the hydro-alcoholic extract of AGS and the reduction of this effect by the antagonist of estrogen receptor (tamoxifen), it can be concluded that the extract’s anxiolytic effect may be due to interaction with estrogen receptor.

Rana Shahabi

Mohammad Rostampour

Behrouz Khakpour

Edris Mahdavi Fekjur

Farshid Saadat

Anxiolytic Effect of Anethum Graveolens Seed Extract Combined With the Antagonist of Estrogen Receptor in Female Rats With Anxiety

莳萝籽提取物与雌激素受体拮抗剂联合对焦虑雌性大鼠的抗焦虑作用

Background: Immature teratomas are very rare in adults, especially in the suprasellar area, but they should be considered in the differential diagnosis, particularly when dealing with tumors located in the midline structure. Case presentation: In this study, we present a rare case of an immature teratoma in the suprasellar region of a 20-year-old male. A contrast-enhanced brain MRI revealed a multilocular cystic mass in the suprasellar area, accompanied by non-communicating hydrocephalus. To alleviate intracranial pressure, a shunting procedure was performed to redirect the cerebrospinal fluid. Moreover, tumor resection was carried out using an interhemispheric transcallosal approach. Conclusion: Histopathological examinations unveiled the presence of all three germ layers, followed by immature tissue, consistent with the features of an immature teratoma.

Nyoman Golden

Kevin Kristian Putra

Steven Awyono

Christopher Lauren

Suprasellar Immature Teratoma in A 20-year-old Male: A Case Report

20岁男性鞍上未成熟畸胎瘤病例报告

Background: To our knowledge, there is scant research on the use of rehabilitative ultrasound imaging (RUSI) method for evaluating bladder base displacement in pregnant women. The RUSI is a non-invasive and simple method that assesses the function of pelvic floor muscles (PFM) based on the movement of the bladder base. Objectives: This study aims to assess the reliability of the RUSI for the assessment of PFM function in pregnant women during voluntary muscle contractions. Materials &amp; Methods: In this cross-sectional study, 18 pregnant women with different gestational ages participated. The amount of bladder base displacement during PFM contraction was assessed in all women and considered an indicator of PFM function. The test re-test reliability was evaluated using the intraclass correlation coefficient (ICC) and Bland-Altman plot. The percentages of standard error of measurement (SEM%) and minimal detectable change (MDC%) were also calculated. Results: The mean amount of bladder base displacement during PFM contraction at time points 1 and 2 was 4.89±1.43 and 4.81±1.41, respectively. The ICC was 0.989 (95% CI, 0.969%, 0.996%), which indicates excellent reliability. The Bland-Altman plot showed that all the points were within the 95% limits of agreement with no considerable trend or bias. The SEM% and MDC% were 3.09% and 8.41%, respectively. Conclusion: The intra-rater reliability of the RUSI to assess PFM function in pregnant women is high, and can be useful for further studies on the PFMs in pregnant women.

Parisa Ghadiri Harati

Seyed Majid Hosseini

Atiyeh Javaheri

Farideh Dehghan Manshadi

Alireza Akbarzadeh Baghban

The Reliability of the Rehabilitative Ultrasound Imaging Method for Assessing Pelvic Floor Muscles Function in Pregnant Women

孕妇盆底肌功能评估中康复超声成像方法的可靠性

Background: Idiopathic intracranial hypertension (IIH) or pseudotumor cerebri is a rare disorder. Regarding the latest diagnostic criteria for this disorder, we present a rare case of IIH. Case presentation: The case was an 11-year-old girl referred to our center with generalized body pain and mild left-eye deviation with no other visual symptoms. She had a severe generalized pain especially in her back and prevertebral area. In the neurological examination, there was a mild left sixth nerve palsy and bilateral papilledema. We treated the patient with acetazolamide and to lumbar puncture, which reduced intracranial pressure. The generalized body pain was reduced gradually in ten days, eye deviation in three weeks, and papilledema in two months after treatment. Conclusion: Based on the serious complications of IIH, a thorough assessment of suspicious cases, including ophthalmoscopic examinations, is mandatory. Furthermore, clinicians should consider even rare and unknown specific symptoms in these patients.

Afagh Hassanzadeh Rad

Vahid Aminzadeh

Idiopathic Intracranial Hypertension With Unusual Presentation in an Adolescent Girl: A Case Report

青少年女孩以不典型表现发病的特发性颅内高压症：一例报告

Background: Evidence highlighted the high prevalence of some mental problems among individuals with psoriasis, including alexithymia and suicidal ideation. Objectives: The present study aims to investigate the prevalence and comorbidity of alexithymia and suicidal ideation in individuals with psoriasis in Iran. Materials &amp; Methods: This cross-sectional study was conducted on 100 patients with psoriasis referred to Razi Dermatology Clinic and Beesat Clinic of hospitals affiliated to Guilan University of Medical Sciences, Rasht, Iran, in 2020. Psoriasis was diagnosed by a dermatologist, and the demographic and clinical characteristics of patients were recorded. The Toronto alexithymia scale (TAS-20) and the Beck scale for suicidal ideation (BSSI) were used to assess alexithymia and suicidal thoughts. Results: The mean age of patients was 37.56±10.58 years, and 51% were female. Among patients, 52% had alexithymia, 23% were at high risk of suicide, and 6% were at very high risk of suicide. The moderate severity of psoriasis had a significant association with suicidal thoughts (P&lt;0.05). The TAS-20 score had a significant association with the male gender and younger age, and the BSSI score had a significant association with the psoriasis area (P=0.003). The highest score of BSSI was seen in those with psoriasis in the face and limb/trunk (10±4.36 and 8.56±8.52, respectively). Conclusion: Patients with psoriasis exhibit a significant prevalence of alexithymia and suicidal thoughts. Additionally, younger age and male gender were identified as factors associated with alexithymia in this population.

Publication Information	Publisher: Guilan University of Medical Sciences，Publishing cycle: ，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 2019，Proportion of original research papers: ，Self Citation Rate:， Gold OA Rate:

Caspian Journal of Neurological Sciences

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