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Introduction: Cognitive disorders, characterized by transient stages and potential Alzheimer's disease, are influenced by changes in iron deposits in the brain. These changes can lead to toxicity and neuron death. Quantitative susceptibility mapping is used to accurately represent these changes, allowing for a more accurate evaluation of the time window of each cognitive disorder stage and the need for targeted treatment. Material and Methods: The Alzheimer's Disease Neuroimaging Initiative research database was used to download the data and eight healthy participants and twenty-one participants with cognitive disorders based on MMSE cognitive test scores in 5 groups of cognitively normal, Subjective Memory Concern, Early Mild Cognitive Impairment, Late Mild Cognitive Impairment and Alzheimer's disease were included in this study. Quantitative Susceptibility Mapping processing was performed using the SEPIA toolbox in MATLAB, and segmentation was performed using FSL software. Finally, statistical analyzes were performed using SPSS V26 software. Results: Statistically significant changes were observed in the QSM values of the right thalamus (p-value = 0.043) in the LMCI group and the right hippocampal nucleus (p-value = 0.050) in the control group. Conclusion: After one year, the right hippocampal nucleus shows increased iron accumulation in healthy individuals, suggesting that the nucleus is susceptible to the highest rate of iron deposition in healthy individuals. Based on this result, the hypothesis that iron deposits are the cause of the unknown cause-andeffect relationship between iron deposits and Alzheimer's disease may be confirmed. [ABSTRACT FROM AUTHOR]

Introduction: Iron deposition is vital for damaging neurons and causing different cognitive disorders. Today, using the quantitative susceptibility mapping (QSM) technique, iron deposits in other brain areas can be assessed and measured. This study aimed to identify changes in iron deposition of 12 brain nuclei through different stages of dementia using the QSM technique to introduce biomarkers for the early detection of cognitive disorders. Material and Methods: The Alzheimer's Disease Neuroimaging Initiative (ADNI) database was used to download data. A 3T MRI scanner scanned thirty-five participants with normal cognition and forty-six patients with cognitive disorders who were classified into four groups based on the severity of the condition. QSM processing determined twelve regions of interest (ROIs) by automatic nuclei segmentation and statistical analysis performed in these groups' MRI images. Results: Based on previous findings, QSM values increase proportionally to iron deposition. In this study, the increase in the QSM values of different nuclei of the early mild cognitive impairment (EMCI) stage indicates iron deposition in these participants. In the EMCI group, The QSM value of the bilateral thalamus (P<0.05) and left amygdala (P=0.006) nuclei were higher than in the control group. Based on the results of the receiver operating characteristic curve (ROC) analysis, the left amygdala (P=0.005), left putamen (P=0.002), left thalamus (P=0.05), and right thalamus (P<0.05) have an appropriate sensitivity and specificity to identify the different stages of cognitive disorders. Conclusion: The left amygdala and bilateral thalamic nuclei are the first areas exposed to iron deposition during cognitive impairment. Mentioned nuclei, especially the left amygdala, have high efficiency and sensitivity for the early detection of cognitive disorders. [ABSTRACT FROM AUTHOR]

The application of nano drug delivery systems, particularly those utilizing natural bioactive compounds with anticancer properties, has gained significant attention. In this study, a novel nano-phytosome-loaded phenolic rich fraction (PRF) derived from Allium ampeloprasum L. was developed. The antitumor activity of the formulation was evaluated in BALB/c mice with TUBO colon carcinoma. The PRF-loaded nano-phytosome (PRF-NPs) exhibited a sphere-shaped structure (226 nm) and contained a diverse range of phenolic compounds. Animal trials conducted on TUBO tumor-bearing mice demonstrated that treatment with PRF-NPs at a dosage of 50 mg TPC/Kg/BW resulted in significant improvements in body weight and food intake, while reducing liver enzymes and lipid peroxidation. The expression of apoptosis-related genes, such as Bax and caspase-3, was upregulated, whereas Bcl2 was significantly downregulated (p < 0.05). Furthermore, the expression of GPx and SOD genes in the liver was notably increased compared to the control group. The findings suggest that the phytosomal encapsulation of the phenolic rich fraction derived from Allium ampeloprasum L. can enhance the bioavailability of natural phytochemicals and improve their antitumor properties. The development of PRF-NPs as a nano drug delivery system holds promise for effective breast cancer treatment. [ABSTRACT FROM AUTHOR]

Background: The accuracy of current laboratory and imaging studies for diagnosis and monitoring of Parkinson's disease (PD) severity is low and diagnosis is mainly dependent on clinical examination. Proton magnetic resonance spectroscopy (MRS) is a non-invasive technique that can assess the chemical profile of the brain. In this study, we evaluated the utility of proton MRS in diagnosis of PD and determination of its severity. Methods: Patients with PD and healthy age-matched controls were studied using proton MRS. The level of N-acetylaspartate (NAA), total creatine (Cr), and total choline (Cho), and their ratios were calculated in substantia nigra (SN), putamen (Pu), and motor cortex. PD severity was assessed by the Unified Parkinson's Disease Rating Scale (UPDRS) and the Hoehn and Yahr scale. Results: Compared to 25 healthy controls (18 men, age: 59.00 ± 8.39 years), our 30 patients with PD (24 men, age: 63.80 ± 12.00 years, 29 under treatment) showed no significant difference in the metabolite ratios in SN, Pu, and motor cortex. Nigral level of NAA/Cr was significantly correlated with total UPDRS score in patients with PD (r = -0.35, P = 0.08). Moreover, patients with PD with Hoehn and Yahr scale score = 2 had a lower NAA/Cr level in SN compared to patients with a lower stage. Conclusion: This study shows that 1.5 tesla proton MRS is unable to detect metabolite abnormalities in patients with PD who are under treatment. However, the NAA/Cr ratio in the SN might be a useful imaging biomarker for evaluation of disease severity in these patients. [ABSTRACT FROM AUTHOR]

We investigate the possible effects of acupuncture on the improvement of neurological problems in HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP)disease. Twenty patients with HAM/TSP were studied in this pre and post-test clinical trial. Urinary incontinence, global motor disability, spasticity, and pain severity were evaluated before, one month, and three-month after the intervention. Analyses demonstrated a significant reduction of urinary symptoms one month after acupuncture (P = 0.023). A significant improvement was observed in patients' pain and the spasticity at the upper extremity joints, one and three-month after the intervention (P < 0.05). This study suggests that body acupuncture can be used as a complementary treatment to improve HAM/TSP neurological symptoms. [ABSTRACT FROM AUTHOR]

The International Parkinson Disease and Movement Disorder Society PSP study group (IPMDS-PSP) recently published new clinical diagnostic criteria for progressive supranuclear palsy (PSP). Currently, there is no data regarding the accuracy of these sets of criteria for differentiating various PSP phenotypes. We discuss the accuracy of the IPMDS-PSP criteria for differentiation of patients with the PSP- Richardson phenotype (PSP-RS) from those with the PSP-Parkinsonism (PSP-P) using data from a sample of 274 clinically diagnosed PSP patients participating in the Environmental Genetic PSP (ENGENE-PSP) case control study. Using National Institute of Neurological Disorders and Stroke and the Society for PSP (NINDS-SPSP) criteria and the Williams criteria we categorized 259 of these patients as probable PSP-RS and 15 as PSP-P. The IPD-MDS PSP-RS and PSP-P criteria were unable to distinguish the PSP-RS from the PSP-P phenotypes in this sample. Nearly all (92.6%; 240 out of 259) the PSP-RS patients and over half (60%; 9 out of 15) of the PSP-P patients fulfilled both the IPMDS criteria for PSP-RS and PSP-P. Applying the newly proposed multiple allocation extinction rules decreased the number of overlapping diagnoses among the NINDS-SPSP PSP-RS patients, however problems remained in the PSP-P group. Diagnostic accuracy might be improved by modification of timelines for development of falls and other parkinsonian features. [ABSTRACT FROM AUTHOR]

Introduction: To avoid bias and optimize statistical power of disease-modifying therapeutic trials, it is critical to include homogeneous populations with similar rate of progression over time. Patients with Progressive Supranuclear Palsy (PSP)-Parkinsonism phenotype have overall slower disease progression than those with PSP-Richardson syndrome phenotype. However, it is unclear if the progression rate of PSP-Parkinsonism is the same when the PSP-Parkinsonism converts to PSP Richardson syndrome. We aimed to determine and compare disease progression rate of patients with the two most common PSP phenotypes: PSP-Parkinsonism and PSP Richardson syndrome, participating in the TAUROS trial.Methods: 138 patients, 56 with PSP-Parkinsonism and 82 with PSP-Richardson syndrome, with similar clinical severity at baseline, were followed up to 60 weeks. PSP-Parkinsonism allocation was based on experts' judgement and PSP-Richardson on probable NINDS-PSP criteria. Global disease progression was measured by the PSP Rating Scale as primary outcome measure and several secondary outcome measures.Results: PSP-Richardson syndrome patients had significantly faster progression based on the primary and three secondary outcome measures: the Dementia Rating Scale-2, Frontal Assessment Battery, and lexical fluency scale. Analyses including only patients with a baseline symptom duration under five years showed similar results. PSP phenotype was the strongest predictor for disease progression.Conclusion: This research showed that even when disease severity and clinical features at baseline are similar, patients with PSP- Richardson syndrome progressed significantly faster than those with PSP-Parkinsonism. Therefore, unless stratified by phenotype, future therapeutic clinical trials should not lump PSP patients with these phenotypes as a single disorder even if they have similar disease severity at screening. [ABSTRACT FROM AUTHOR]

Progressive supranuclear palsy (PSP), corticobasal degeneration (CBD), multiple system atrophy (MSA), and dementia with Lewy bodies (DLB) are the four major proteinopathic neurodegenerative disorders. Currently, there are no disease modifying therapies for these disorders. However, better understanding of the etiopathogenic mechanisms of these disorders has allowed the development of novel therapeutic approaches. These mainly include strategies directed to the pathologic conformational shift, seeding and aggregation, as well as transcellular spread of the proteins that aggregate in the brain which are α-synuclein and tau. Modulation of inflammatory responses and neuroprotection are also targets of interest. A number of clinical trials have been performed and others are ongoing or are planned to address the authentic need for disease modifying treatments. However, challenges exist in terms of accurate early clinical diagnostic criteria and robust outcome measures, and preclinical animal models that would best recapitulate human disease. [ABSTRACT FROM AUTHOR]

We reported a 71 years old woman, with history of rest and postural tremor, bradykinesia and memory problems. In her dynamic MRI, a contrastenhanced tumor in the cerebellopontine (CP) angle was found which was compatible with a meningioma. 99mTc-TRODAT SPECT showed decreased activity in the left putamen, indicating idiopathic Parkinson disease. There was also a focus of increased activity on the right side of the skull base, which was compatible with meningioma in MRI. [ABSTRACT FROM AUTHOR]

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Background In developing countries, there are few comprehensive studies of mortality following stroke. Aims and/or hypothesis We aimed to determine the one-year case fatality rate following stroke and to identify factors associated with death in a population-based stroke incidence study in Iran. Methods Six hundred eighty-four patients who had suffered a stroke between November 21, 2006, and November 20, 2007, and were recruited to the Mashhad Stroke Incidence Study were followed up at one-year. Most patients were seen in an outpatient visit. When patients had died, a verbal autopsy was conducted by telephone with the next of kin. Results A total of 226 (34·3%) patients died during the first year following stroke. The cumulative one-year case fatality rate was 30·6% following ischemic stroke and 53·0% following hemorrhagic stroke (55·8% after intracerebral hemorrhage and 35·7% after subarachnoid hemorrhage). The majority of these deaths occurred in the first 28 days after stroke (17·7% with ischemic and 43·0% with hemorrhagic stroke). Factors associated with greater mortality at one-year (excluding those who died during the first week) were hemorrhagic stroke [hazard ratio ( HR) 3·99; 95% confidence interval 1·90-8·37], age ( HR 1·05; 95% confidence interval 1·03-1·08), previous transient ischemic attack ( HR 2·45; 95% confidence interval 1·00-5·99), and National Institutes of Health Stroke Scale on admission ( HR 1·14; 95% confidence interval 1·10-1·17). Conclusion Despite the younger age of stroke occurrence in Iran, the one-year case fatality rate following stroke is similar to that reported in developed countries. [ABSTRACT FROM AUTHOR]

Introduction: Chronic inflammations including infectious disorders such as HIV infection are now considered as risk factors for atherosclerosis. In this study, conducted for the first time on human subjects, human T-lymphotropic virus type 1 (HTLV-1) infection was examined as a potential risk factor for atherosclerosis. Materials and Methods: This is a matched-pair cross-sectional study on 58 HTLV-1-infected cases and 55 healthy control subjects. The subjects did not have any major cerebrovascular risk factors. Carotid intima-media thickness (IMT) was measured for each patient using the standard protocol of the Atherosclerosis Risk in Communities (ARIC) Study. Results: The mean age of the subjects was 42.9 ± 10.52 years, and males made up 33% of the population. The difference between the mean IMT of the infected case group and that of the healthy control group was significant (p < 0.05). Discussion: This study indicated that the HTLV-infected individuals showed a greater carotid IMT than the age- and sex-matched control subjects.Observing no other known risk factor for atherosclerosis, we concluded that this significant difference in IMT might support the hypothesis that HTLV-1 infection is an independent risk factor for atherogenesis. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the education board of Mashhad University of Medical Sciences on the EDO and EDC, and their awareness of, attitude towards, and satisfaction with these centers. Methods: In this descriptive study, all the members of the education board of Mashhad University of Medical Sciences in the basic and clinical departments were taken as the target group. The data was collected through a researcher-designed questionnaire. Results: On average, 37.22 % of the board had a thorough knowledge of the mission, goals, and activities of X; another 42.17% of them were familiar with these centers to some extent, and 20.6% knew nothing about them. Regarding the attitude, 39.7% of the board had a positive view about the activities and the necessity of the existence of such centers. Another 40.2% had a rather positive attitude. On the other hand, about the rate of their satisfaction, 13.03 % were satisfied with their activities, and 60% were fairly pleased. In deductive analysis of the data, results indicated no strong correlation between the awareness and satisfaction scores of the board with their academic rank. Nevertheless, there is a significant correlation between attitude scores and their rank. Conclusion: According to the findings, the board of education in Mashhad University of Medical Sciences did not have an appropriate attitude toward EDO and EDC; in other words, the position and activities of these centers have remained unknown to them. [ABSTRACT FROM AUTHOR]

Abstract: Epilepsy is a common disorder in pediatric neurology, and electroencephalography (EEG) continues to play an important role in its diagnosis. However, the small size of a child''s head and immaturity of the brain make EEG interpretation more difficult in children than in adults. This article presents a new method of EEG recording for children younger than 2 years designed to improve recording accuracy in children with small heads. This novel method of EEG recording, in which an increase in distance between recording electrodes is achieved without decreasing the number of electrodes or channels, compares with the traditional 10-20 system in terms of pathologic waves, artifacts, sleep spindles, and wave frequencies. Increased wave amplitude was noted with the new montages in 90 of 105 (85.7%) individuals. The calculation of wave frequency was easier and more reliable in the new montages in comparison with the prevailing recordings. More numerous sleep spindles were detected in 49 of 105 (47.6%) children. The number of detected pathological waves increased in 49 of 105 (47.6%) children on the new montages versus the 10-20 electrode system. The incidence of artifact waves in the traces was similar between the two methods in 94 (89.5%) patients and diminished in 11 of 105 (10.5%) patients. These preliminary studies suggest that the new recording system might be a suitable substitute for the routine 10-20 system, especially in young infants and neonates. Further evaluation and multicenter clinical trials will contribute to the reliability of this proposed method. [Copyright &y& Elsevier]

Human T-cell lymphotropic virus (HTLV) types 1 and 2 belong to the Oncorna group of retroviridae, a large family of viruses, grouped initially by pathogenic features, but later revised on the basis of genome structure and nucleotide sequence. HTLV-I was the first discovered human retrovirus to be associated with a malignancy in 1980. The malignancy, first described by Uchiyama and co-workers in southwestern Japan, was named Adult T-cell Leukemia/Lymphoma (ATL) and characterized with cutaneous and respiratory involvement, hepatosplenomegaly, lymphadenopathy and various metabolic abnormalities such as hypercalcemia. The HTLV-I has been known to be endemic to certain parts of Iran like the province of Khorasan in the northeast since 1990, with a 2.3% prevalence rate of infection. The main manifestations of HTLV-I infection are neurologic and hematologic (such as ATL) disorders, but it has also other manifestations such as uveitis, arthritis, dermatitis, vitiligo and lymphocytic alveolitis. Its main neurologic manifestation is a chronic progressive myelopathy that is referred to HTLV-I Associated Myelopathy (HAM) in Japan and Tropical Spastic Paraparesis (TSP) in Caribbean. But other disorders such as peripheral neuropathy, polyradiculoneuropathy, myopathy, peripheral facial paresis, and so on have been reported too. In this review we wish to give some brief information on the different aspects (including epidemiology, pathogenesis and pathology, clinical findings, and treatment) of HTLV-I infection according to our twenty-year researches. The department of neurology of Mashhad University of Medical Sciences has been a pioneer in researches on HTLV-I in the last twenty years. [ABSTRACT FROM AUTHOR]

Progressive supranuclear palsy, jaw tremor, tongue tremor, pathology, parkinsonism Keywords: progressive supranuclear palsy; tongue tremor; jaw tremor; pathology; parkinsonism EN progressive supranuclear palsy tongue tremor jaw tremor pathology parkinsonism 348 349 2 02/23/23 20230201 NES 230201 In January 2018 we reported isolated tongue and jaw tremor as a rare clinical feature in a patient with progressive supranuclear palsy (PSP).[1] At the time, some investigators raised concerns and proposed that the pathological diagnosis might be both PSP and idiopathic Parkinson's disease (PD) because there were no previous reports of isolated tongue tremor in PSP. Mild parkinsonism, late occurrence of supranuclear gaze palsy, and a predominantly resting jaw and tongue tremor led to this patient being misdiagnosed as PD the first few years. [Extracted from the article]

• Normal aging adversely impacts certain linguistic prosodic parameters in prosody perception assessments. • Parkinson's disease affects not only language prosodic parameters but also emotional parameters in prosody perception assessments. • It is recommended to include prosody perception as part of communication assessments for individuals with Parkinson's disease. Parkinson's disease (PD) is a progressive neurodegenerative disorder that affects approximately 1%–2% of individuals aged 60 and above. Communication disorders in PD can significantly impact the overall quality of life. As prosody plays a vital role in verbal communication, the present study examines Persian prosody perception in PD, focusing on linguistic and emotional aspects of prosody. This cross-sectional study aimed to compare the perception of linguistic and emotional prosody in three groups: middle-aged adults (n = 22; mean age = 50.40 years), healthy older adults (n = 22; mean age = 68.31 years), and individuals with Parkinson's disease (n = 22; mean age = 65years). All individuals with PD were classified in stages 1; 1.5; 2; 2.5, and 3 of the disease using the Hoehn and Yahr scale. All participants had an MMSE score of 24 or above. The Florida Affect Battery (FAB) was used to evaluate prosody perception. This Battery was validated in the Persian language and its reliability and validity were reported as 94 % and 100 % respectively. Participants with PD presented significantly lower scores than the older adults in all subtests of the FAB (p < 0.05), while healthy older adults were significantly different only in linguistic discrimination (β = -2.14; -3.68 to -0.61), and linguistic naming of prosody (β = 1.25; 0.17 to 2.33) compared to middle-aged adults. The present study sheds light on the influence of PD on Persian prosody perception. Given the crucial role of prosody in verbal communication, these findings enhance our understanding of communication disorders in PD and could bring attention to consider prosody perception, among other aspects, when assessing individuals affected by PD. [ABSTRACT FROM AUTHOR]

Introduction: The genetic basis of autosomal-recessive dystonia remains poorly understood. Our objective was to report identification of additional individuals with variants in AOPEP, a recently described gene for recessively inherited dystonic disorders (OMIM:619565).Methods: Ongoing analysis on a high-throughput genetic platform and international case-recruitment efforts were undertaken.Results: Novel biallelic, likely pathogenic loss-of-function alleles were identified in two pedigrees of different ethnic background. Two members of a consanguineous Iranian family shared a homozygous c.1917-1G>A essential splice-site variant and featured presentations of adolescence-onset generalized dystonia. An individual of Chinese descent, homozygous for the nonsense variant c.1909G>T (p.Glu637*), displayed childhood-onset generalized dystonia combined with later-manifesting parkinsonism. One additional Iranian patient with adolescence-onset generalized dystonia carried an ultrarare, likely protein-damaging homozygous missense variant (c.1201C>T [p.Arg401Trp]).Conclusions: These findings support the implication of AOPEP in recessive forms of generalized dystonia and dystonia-parkinsonism. Biallelic AOPEP variants represent a worldwide cause of dystonic movement-disorder phenotypes and should be considered in dystonia molecular testing approaches. [ABSTRACT FROM AUTHOR]

Lavender essential oil has been used as an anxiolytic drug, a mood stabilizer, a sedative, spasmolytic, antihypertensive, antimicrobial, analgesic agent as well as a wound healing accelerator. We have studied for the first time the efficacy of lavender essential oil inhalation for the treatment of migraine in a placebo-controlled clinical trial. Methods: Forty-seven patients with definite diagnosis of migraine headache were divided into cases and controls. Cases inhaled lavender essential oil for 15 min, whereas the control group used liquid paraffin for the same time period. Patients were asked to record their headache severity and associated symptoms in 30-min intervals for a total of 2 h. We matched the two groups for key confounding factors. Results: The mean reduction of headache severity in cases was 3.6 ± 2.8 based on Visual Analogue Scale score. The reduction was 1.6 ± 1.6 in controls. This difference between the controls and cases was statistically significant with p < 0.0001. From 129 headache attacks in cases, 92 responded entirely or partially to lavender. In the control group, 32 out of 68 recorded headache attacks responded to placebo. The percentage of responders was significantly higher in the lavender group than the placebo group (p = 0.001). Conclusion: The present study suggests that inhalation of lavender essential oil may be an effective and safe treatment modality in acute management of migraine headaches. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Headache is a common occurrence among the general population. Although the pain could be a symptom of acute sinusitis, chronic sinusitis is not considered as a usual cause of headache. In addition, autonomic-related symptoms in the sinonasal region may be associated with vascular pain. Confusion regarding these symptoms could lead to an incorrect diagnosis of sinusitis. A prospective cross-sectional study was conducted at two tertiary referral centers with residency programs in otorhinolaryngology, head and neck surgery and neurology. The study included 58 patients with a diagnosis of 'sinus headache' made by a primary care physician. Exclusion criteria were as follows: previous diagnosis of migraine or tension-type headache; evidence of sinus infection during the past 6 months; and the presence of mucopurulent secretions. After comprehensive otorhinolaryngologic and neurologic evaluation, appropriate treatment was started according to the final diagnosis and the patient was assessed monthly for 6 months. The final diagnoses were migraine, tension-type headache and chronic sinusitis with recurrent acute episodes in 68, 27 and 5% of the patients, respectively. Recurrent antibiotic therapy was received by 73% of patients with tension-type headache and 66% with migraine. Sinus endoscopy was performed in 26% of the patients. Therapeutic nasal septoplasty was performed in 16% of the patients with a final diagnosis of migraine, and 13% with tension-type headache. Many patients with self-described or primary care physician labeled 'sinus headache' have no sinonasal abnormalities. Instead, most of them meet the IHS criteria for migraine or tension-type headache. [ABSTRACT FROM AUTHOR]

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Background: Multiple sclerosis (MS) is one of the most common autoimmune disorders of the central nervous system. In spite of various imaging modalities, the definitive diagnosis of MS remains challenging. Objectives: This study was designed to evaluate the usefulness of diffusion weighted imaging (DWI) in the diagnosis of acute MS attack and to compare its results with contrast enhanced MRI (CE-MRI). Patients and Methods: In this cross sectional study, seventy patients with definite diagnosis of relapsing-remitting MS were included. CE-MRI using 0.1 mmol/kg gadolinium as well as DWI sequences were performed for all patients. The percentage of patients with positive DWI was compared with the results of CE-MRI and the consistency between the two imaging modalities was evaluated. Moreover, the relationship between the time of onset of patient's symptoms and test results for both methods were investigated. Results: CE-MRI yielded positive results for 61 (87%) patients and DWI yielded positive for 53 (76%) patients. In fifty patients (71.42%), both tests were positive and in six cases (8.57%), both were negative. The test results of three patients turned out to be positive in DWI, while they tested negative in CE-MRI. There was no significant relationship between the results of CE-MRI as well as DWI and the time of imaging from the onset of symptoms. Conclusion: These data indicate that while CE-MRI will depict more positive results, there are cases in which DWI will show a positive result while CE-MRI is negative. We suggest that the combination of these two imaging modalities might yield more positive results in diagnosing acute MS attack giving rise to a more accurate diagnosis. [ABSTRACT FROM AUTHOR]

Background The Hajj Ceremony, the largest annual gathering in the world, is the most important life event for any Muslim. This study was designed to evaluate the incidence of stroke among Iranian pilgrims during the Hajj ceremony. Methods We ascertained all cases of stroke occurring in a population of 92,974 Iranian pilgrims between November 27, 2007 and January 12, 2008. Incidence and risk factors of the first ever stroke in Hajj pilgrims were compared, within the same time frame, to those of the Mashhad residents, the second largest city in Iran. Data for the latter group were extracted from the Mashhad Stroke Incidence Study (MSIS) database. Results During the study period, 17 first-ever strokes occurred in the Hajj pilgrims and 40 first-ever stroke strokes occurred in the MSIS group. Overall, the adjusted incidence rate of first ever stroke in the Hajj cohort was lower than that of the MSIS population (9 vs. 16 per 100,000). For age- and gender-specific subgroups, the Hajj stroke crude rates were in general similar to or lower than the general population of Mashhad, Iran, with the exception of women aged 35 to 44 years and aged >75 years who were at greater risk of having first-ever stroke than the non-pilgrims of the same age. Conclusion The first ever stroke rate among Iranian Hajj pilgrims was lower than that of the general population in Mashhad, Iran, except for females 35-44 or more than 75 years old. The number of events occurring during the Hajj suggests that Islamic countries should consider designing preventive and screening programs for pilgrims. [ABSTRACT FROM AUTHOR]

Background: Muslim women tend to postpone their menstrual period using short course oral contraceptives (OC) during Ramadan, Muslims fasting month. Recently, many cases of stroke, particularly cerebral vein thrombosis (CVI), have been reported in Ramadan. Objective: This work studies the incidence of CVT and its relation to Ramadan. Materials and Methods: This is a cohort study conducted from October 2006 to October 2009 and included 4 consecutive Ramadan's. All patients with definite diagnosis of CVT who were referred to the neurology department of Ghaem Hospital, Mashhad, Iran in this four-year period were included in the study. Results: During the study period, 70 cases with CVI (11 males and 59 females) were recruited. Twenty five cases were admitted during Ramadan months which was significantly higher than all the other 32 months (p=l.9xl0-7). The higher frequency of females (6 times more) among CVT cases probed by investigating possible risk factors and short term OC consumption was revealed as the major risk factor (p=0.00071). Conclusion: Higher incidence of CVI in females during Ramadan suggests the presence of specific risk factors in this group. Our study revealed that short-term use of OCs may be a major risk factor for CVT. [ABSTRACT FROM AUTHOR]

Background: The Hajj Ceremony, the largest annual gathering in the world, is the most important life event for any Muslim. This study was designed to evaluate the incidence of stroke among Iranian pilgrims during the Hajj ceremony.Methods: We ascertained all cases of stroke occurring in a population of 92,974 Iranian pilgrims between November 27, 2007 and January 12, 2008. Incidence and risk factors of the first ever stroke in Hajj pilgrims were compared, within the same time frame, to those of the Mashhad residents, the second largest city in Iran. Data for the latter group were extracted from the Mashhad Stroke Incidence Study (MSIS) database.Results: During the study period, 17 first-ever strokes occurred in the Hajj pilgrims and 40 first-ever stroke strokes occurred in the MSIS group. Overall, the adjusted incidence rate of first ever stroke in the Hajj cohort was lower than that of the MSIS population (9 vs. 16 per 100,000). For age- and gender-specific subgroups, the Hajj stroke crude rates were in general similar to or lower than the general population of Mashhad, Iran, with the exception of women aged 35 to 44 years and aged >75 years who were at greater risk of having first-ever stroke than the non-pilgrims of the same age.Conclusion: The first ever stroke rate among Iranian Hajj pilgrims was lower than that of the general population in Mashhad, Iran, except for females 35-44 or more than 75 years old. The number of events occurring during the Hajj suggests that Islamic countries should consider designing preventive and screening programs for pilgrims. [ABSTRACT FROM AUTHOR]