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Background: According to the Global Burden of Disease Study (GBD), cerebrovascular diseases are the second leading cause of death in the world. This is a cross-sectional study on deaths due to cerebrovascular diseases in southern Iran. Methods: In this cross-sectional study, data on all deaths caused by cerebrovascular diseases in the Fars province between 2004 and 2019 was extracted from the Electronic Death Registry System (EDRS). To eliminate or minimize the influence of age composition, standardized mortality rate was used based on the 2013 Segi standard populations of low- and middle-income countries. In order to measure the years of life lost (YLL) from cerebrovascular diseases, the standardized life table was considered. The Joinpoint Regression method was used to examine the trend of the crude and standardized mortality rate and the YLL rate. Results: Over the study period, 24,051 deaths occurred due to cerebrovascular diseases in Fars with 12,586 cases in men (52.3%). The trend of standardized mortality rate in males and females was decreasing (P value = 0.001 and < 0.001 for males and females, respectively). All YLL due to premature mortality from cerebrovascular disease during the 16-year study period were 119,436 (3.8 per 1000 persons) in men, and 111,172 (3.6 per 1000 persons) in women. Based on the joinpoint regression, the 16-year trend of YLL rate due to premature death was decreasing: annual percent change (APC) was -1.6% (95% CI -3.4 to 0.3, P = 0.098) for males, and -2.0% (95% CI -3.6 to -0.4, P = 0.017) for females. Conclusion: The trend of mortality rate and YLL caused by cerebrovascular diseases has decreased in our study. Necessary measures, mainly primary and secondary prevention, should be taken to continue the diminishing trend of cerebrovascular diseases. [ABSTRACT FROM AUTHOR]

Ischemic stroke seems to be one of the most serious neurologic complications in patients with COVID-19 infection. Herein, we report a series of 10 ischemic stroke patients with concomitant COVID-19 disease. Out of 10, 8 had large infarcts (3 massive middle cerebral artery, 2 basilar artery, 2 posterior cerebral artery, and 1 internal carotid artery infarct territory). Two had cardiogenic embolic stroke due to atrial fibrillation. Almost half of our patients did not have a vascular risk factor. Nine did not have fever and were diagnosed with COVID-19 upon admission for stroke. Stroke occurred in the first week of respiratory symptoms with moderate pulmonary involvement. Most Patients did not have hypoxia and did not establish respiratory failure or acute respiratory distress syndrome. The blood pressures were low and hemorrhagic transformation did not occur even after antiplatelet or anticoagulant therapy. Patients had markedly increased levels of lactate dehydrogenase, C-reactive protein, and Ddimer. Three patients died. It seems that ischemic strokes in COVID-19 patients tend to occur as large infarct and can be seen in patients with mild to moderate pulmonary involvement. [ABSTRACT FROM AUTHOR]

Background: Iran lacks a population level comprehensive assessment of stroke epidemiology. Using data from the NASBOD Study, we estimated the mortality of stroke among the Iranian population from 1990 to 2015. Methods: Data were collected from all the available sources including the national death registration system and two major cemeteries. After addressing incompleteness of child and adult death data and by using mixed effect model, spatio-temporal model and Gaussian Process Regression, levels and trends of child and adult mortality were estimated. By considering cause fraction to these estimates; cause specific mortality was estimated. In these process wealth index, urbanization, and years of schooling were used as covariates. Results: In 2015, the age-standardized stroke mortality rate due was 47.76 (95% UI: 34.68–65.03) for males and 40.16 (30.38–5 2.72) for females, per 100,000 population. Stroke occurrence for both ischemic and non-ischemic strokes showed decreasing trends in both sexes after 2001–2002, at national and sub-national levels. The highest and lowest mortality rates between provinces ranged from 52.11 (40.3–66.66) to 24.47 (18.71–31.79) in men and from 65.51 (47.13–89.41) to 30.43 (21.95–41.82) in women per 100,000 population. Conclusion: Although age-standardized rates of stroke mortality are falling, in the past three decades, the absolute number of people who have had a stroke has increased. Stroke mortality remains high in Iran. [ABSTRACT FROM AUTHOR]

Background: There is still no consensus among researchers on the impact of opium dependency on cerebrovascular stenosis. Some studies suggest that opium may be a risk factor for ischemic stroke. This study compared carotid intima-media thickness (CIMT) and cerebrovascular reactivity between opiumdependent and healthy people. Methods: This case-control study was done among opium addicts at Shafa hospital in Kerman, Iran, in year 2018. People with systemic disease or who took any medicine were excluded from our study. The control group were selected from healthy non-addicted volunteers. The control group was matched in age and sex with the case group. Cerebrovascular reactivity of middle cranial artery and intima-media thickness of carotid artery were measured for all in both groups. The results were analyzed using chi-square, independent samples t, and logistic regression tests. Findings: 47 opium addicts and 47 healthy people entered this study. 88% of them were men and 12% were women. 68.1% of the case group and 31.9% of the control group were cigarette smokers; this difference was statistically significant. Comparison of cerebrovascular reactivity and CIMT between the two groups was statistically significant (P < 0.001). This relationship remained significant for the CIMT after removing confounding factors (P = 0.018). Conclusion: Overall, our findings show that opium dependency affects the carotid intima-media thickness as an indicator of cerebral atherosclerosis. [ABSTRACT FROM AUTHOR]

Short-term exposures to air pollution have been associated with various adverse health effects. In this study, we investigated the associations between ambient air pollutants with the number of hospital admissions and mortality from cardiovascular diseases (CVDs). This time series study was conducted in Tehran for the years 2014-2017 (1220 day). We collected the ambient air pollutant concentration data from the regulatory monitoring stations. The health data were obtained from the Ministry of Health and Medical Education. A distributed lag non-linear model (DLNM) was used for the analyses. Total CVDs and ischemic heart disease (IHD) admissions were associated with CO for each 1 mg/m 3 increase at lags of 6 and 7 days. Also, there was a positive association between total CVDs (RR 1.01; 1.001 to 1.03), IHD (RR 1.04; 1.006 to 1.07), and cerebrovascular diseases (RR 1.03; 1.005 to 1.07) mortality with SO 2 at a lag of 4 days. PM 2.5 and PM 10 were associated with cerebrovascular disease admissions in females aged 16-65 years and 16 years and younger for each 10 µg/m 3 increase, respectively. Short-term exposure to SO 2 , NO 2 , and CO was associated with hospital admissions and mortality for CVDs, IHD, cerebrovascular diseases, and other cardiovascular diseases at different lags. Moreover, females were more affected by ambient air pollutants than males in terms of their burden of CVDs. Therefore, identifying the likely harmful effects of pollutants given their current concentrations requires the planning and implementation of strategies to reduce air pollution., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Cerebral venous sinus thrombosis (CVST) causes significant problems for patients in the working age and may therefore negatively affect their quality of life (QOL). In the present study, we sought to evaluate the QOL and its predictors in subjects with CVST., Methods: This observational, prospective study investigated several outcomes of 56 CVST patients after thrombosis onset. Demographic characteristics, medical history, neurological signs and symptoms during hospitalization, and the employment status of the patients were retrospectively collected. Stroke-related functional scales, including the modified Rankin Scale (mRS) and Barthel Index (BI) were employed. For physical and mental aspects of the QOL, we used the validated Persian version of the Stroke Specific Quality of Life (SS-QOL) scale., Results: The physical and functional outcomes in the long-term were promising according to mRS and BI tools, as well as the improved rate of return to work. Mental domains of the SS-QOL, such as energy and personality represented the lowest scores. According to the multiple linear regression analysis, lower mRS score, and longer time interval between CVST onset and interview were associated with higher physical function of the patients while their better mental function was correlated with lower mRS score and thrombosis in merely one cerebral venous., Conclusion: CVST patients experience an acceptable alleviation of the primary physical disabilities, while residual symptoms, mostly in psychologic/mental domains, impair their QOL., (© 2021 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Previous genetic and epidemiological studies have shown the contribution of genetic factors in conferring the risk of ischemic stroke. Among the acknowledged risk factors of stroke are the single nucleotide polymorphisms (SNPs) near Ninjurin 2 (NINJ2) gene which encodes a surface adhesion protein. In the current study, we investigated the role of two SNPs near this gene in ischemic stroke in Iranian population. The frequency of the A allele of the rs11833579 was significantly lower in cases compared with controls (OR (95% CI) = 0.68 (0.54-0.86), adjusted P value = 0.002). The rs11833579 was significantly associated with risk of stroke in co-dominant (AA vs. GG: OR (95% CI) = 0.39 (0.23-0.66), adjusted P value = 0.003) and recessive (OR (95% CI) = 0.44 (0.27-0.72), adjusted P value = 0.001) models. The rs3809263 was associated with risk of stroke in dominant model (OR (95% CI) = 1.5 (1.09-2.06), adjusted P value = 0.02). The A C haplotype (rs11833579 and rs3809263) decreased the risk of stroke (OR (95% CI) = 0.72 (0.57-0.91), adjusted P value = 0.03), while the G T haplotype conferred susceptibility to stroke (OR (95% CI) = 1.42 (1.11-1.82), adjusted P value = 0.02). Consequently, the present case-control study supports the role of NINJ2 as a risk locus for ischemic stroke in Iranian population.