OTHERS_CITABLE Comparison Outcome of Nerve Regeneration across an Eggshell Membrane Guidance Channel and Autograft Background: Peripheral nerves may be damaged during an injury and its current standard treatment is using an autologous nerve. Objectives: The purpose of this experimental study is to evaluate and compare the histological results of nerve regeneration after using the eggshell membrane (ESM) guidance channel with autograft. Materials and Methods: Thirty adult male rats were divided into three experimental groups: ESM guidance channel, autograft, and sham surgery. The decalcifying membrane of egg rotated over the Teflon mandrel and dried at 37°C. A 10 mm nerve segment of left sciatic nerve was cut and removed. In ESM group, the ends of the sciatic nerve were telescoped into the nerve guides. In autograft group, the nerve segment was reversed and used as an autologous nerve graft. At 90 days after surgery, all animals were evaluated by histological and immunohistochemical assessment. Results: The diameters of regenerated myelinated fibers were 5.24±2.14 µm for the ESM group, and 5.89±2.99 µm for the autograft group. The number of myelinated axons regenerated in the ESM group (9824±218 nerve fibers) was significantly greater than autograft group (7865±314 nerve fibers) (p<0.05). Conclusion: These findings demonstrate that ESM effectively enhances nerve regeneration in injured rat sciatic nerve. http://cjns.gums.ac.ir/article-1-80-en.pdf 2016-03-06 1 8 10.18869/acadpub.cjns.2.4.1 Nerve Regeneration Nerve Fibers Myelinated Rats Gholam-Hossein Farjah 1 Neurophysiology Research Center, Department of Anatomy, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran ; hfarjah@hotmail.com AUTHOR Malak-Sadat Naeimi 2 Resident of Emergency Medicine, Tabriz University of Medical Sciences, Tabriz, Iran AUTHOR Ali Saberi 3 Graduated from School of Medicine, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran AUTHOR
OTHERS_CITABLE The Effect of Core Stability Exercise Program on the Balance of Patients with Multiple Sclerosis Background: Multiple sclerosis (MS) is a chronic disease characterized by degradation of the central nervous system myelin which may impair the balance of patients. Core Stability Exercises have been the focus of attention for repairing the stability of some patients.   Objectives: To assess the effect of core stability exercise on the balance of patients with multiple sclerosis. Materials and Methods: In this quasi-experimental (pretest-posttest study with no control group), 15 MS patients have been selected according to convenient sampling and Expanded Disability Status Score (EDSS) of less than 4.5. Participants performed core stability program according to the Jeffreys protocol (2002) at 9 O'clock in the morning over 8 weeks in summer 2015. Static (in second) and dynamic (in centimeter) balances were measured using modified stork and modified star (Y) tests respectively. Data were analyzed in SPSS-16 using Kolmogorov-Smirnov test to ensure normal distribution of data, and paired t-test to compare mean values before and after exercise program as they have normal distribution.  Results: Mean and standard deviation of static balance were 3.56±1.81 and 11.17±6.36 in pretest and posttest in the dominant foot, and 3.67±1.89 and 9.42±2.94 in the non-dominant foot, respectively. The sum of the 3 measurements in Y balance was 256.01±32.68 and 340.68±38.33 in pretest and posttest in the dominant foot, and 262.35±42.49 and 344.55±47.25, respectively, in the non-dominant foot (p≤0.05). Conclusion: The core stability exercise program positively and significantly improved static and dynamic balance of patients with multiple sclerosis. http://cjns.gums.ac.ir/article-1-81-en.pdf 2016-03-06 9 17 10.18869/acadpub.cjns.2.4.9 Exercise Balance Multiple Sclerosis Razieh Farid 1 MSc Student, Faculty of Physical Education, University of Guilan, Rasht, Iran ; Raziyeh.farid@yahoo.com AUTHOR Ali-Asghar Norasteh 2 Associate Professor of Physical Therapy, Faculty of Physical Education, University of Guilan, Rasht, Iran AUTHOR Hamidreza Hatamian 3 Professor, Department of Neurology, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran AUTHOR
OTHERS_CITABLE The Applicability, Concurrent Validity and Internal Consistency Reliability of the Persian Version of the National Institutes of Health Stroke Scale (NIHSS): Evidences for Gender Differences Background: The National Institutes of Health Stroke Scale (NIHSS) can objectively quantify the severity of stroke. However no information is available about psychometric properties and it’s applicability in the Iranian population. Objectives: The present study purposed by utilization of this instrument for neurological deficits measurement due to stroke, to determine the internal consistency reliability and concurrent validity of NIHSS to separate two groups of men and women patients. Materials and Methods: In a cross-sectional study, 206 ischemic stroke patients were selected and the internal consistency reliability and concurrent validity of NIHSS were assessed. For this purpose, Barthel index that measures the functional disability was used. Data also were analyzed by Independent t-test, Chi-square, Pearson correlation, Fisher's z tests and bivariate regression analysis. Results: Internal consistency for men (α=0.881), women (α=0.913) and total patients (α=0.893) was excellent. Negative correlation was found between NIHSS and Barthel index in both men (r=-0.43, p<0.0001) and women (r=-0.63, p<0.0001) and this relationship estimated to be more significant among women rather than men (p<0.05). In addition, NIHSS scores could significantly predict the Barthel score in both groups (p<0.0001) but the results revealed the more ability of NIHSS in predicting functional disability for women (R2=0.40) rather than men (R2=0.18). Conclusion: Persian version of NIHSS was reliable and valid instrument that can be applicable in both men and women with ischemic stroke; however, it was found that the degree of concurrent validity is better among women than men. http://cjns.gums.ac.ir/article-1-82-en.pdf 2016-03-06 18 28 10.18869/acadpub.cjns.2.4.18 Reliability Validity Stroke Scale Ehsan Kazemnejad-Leili 1 Department of Community Medicine, Associate Professor of Bio-Statistic, Guilan University of Medical Sciences, Rasht, Iran AUTHOR Sajjad Rezaei 2 PhD Candidate in Psychology, Clinical Research Development Center, Guilan University of Medical Sciences, Rasht, Iran ; Rezaei_Psy@hotmail.com AUTHOR Mozaffar Hosseini-Nejad 3 Department of Neurology, Assistant Professor, Guilan University of Medical Sciences, Rasht, Iran AUTHOR Babak Bakhshayesh-Eghbali 4 Department of Neurology, Assistant Professor, Guilan University of Medical Sciences, Rasht, Iran AUTHOR Alia Saberi 5 Department of Neurology, Associate Professor, Guilan University of Medical Sciences, Rasht, Iran AUTHOR Parvaneh Keshavarz 6 Associate Professor of Human Genetic, Cellular and Molecular Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran AUTHOR
OTHERS_CITABLE Helicobacter pylori and Migraine: Is Eradication of Helicobacter pylori Effective in Relief of Migraine Headache? Background: Association between Helicobacter pylori (HP) infection and migraine and the effect of HP eradication on relief of migraine headache have been studied but the results are controversial. Objectives: To evaluate the effect of HP eradication in treatment of patients affected by migraine. Materials and Methods: Eighty consecutive HP infected patients affected by migraine without aura were enrolled in this clinical trial. They have referred to an endoscopy clinic for work-up of HP infection from October 2013 to November 2014. Patients were randomly assigned in 2 groups using 2 different regimens; Group A: migraine treatment and a 14-day triple therapy for HP infection and Group B: migraine treatment without HP eradication. The mean duration (hour), headache severity (MIDAS) and the frequency (per month) of clinical headache attacks were calculated upon enrollment in the study and at 6 months and 12 months after treatment. All data were analyzed using SPSS version 16. Comparison of categorical variables across the groups was performed using Chi-square test. Results: In group A, HP infection was eradicated in 34 of 40 patients (85%). After treatment in eradicated patients compared with the control group there was significant decrease in severity and frequency (but not in duration) of the migraine attacks at 6 months (p<0.001) and significant decrease in intensity, frequency and duration of the migraine attacks at 12 months (p<0.001). Conclusion: HP should be considered and examined in migranous patients and eradication treatment can be beneficial for relief of clinical attacks. http://cjns.gums.ac.ir/article-1-83-en.pdf 2016-03-06 29 35 10.18869/acadpub.cjns.2.4.29 Helicobacter pylori Disease Eradication Migraine Disorders Mohammadreza Seyyedmajidi 1 Golestan Research Center of Gastroenterology and Hepatology-GRCGH, Golestan University of Medical Sciences, Gorgan, Iran AUTHOR Seyed-Amir Banikarim 2 Golestan Research Center of Gastroenterology and Hepatology-GRCGH, Golestan University of Medical Sciences, Gorgan, Iran AUTHOR Afsaneh Ardalan 3 Golestan Research Center of Gastroenterology and Hepatology-GRCGH, Golestan University of Medical Sciences, Gorgan, Iran AUTHOR Seyed-Hossein Hozhabrossadati 4 Golestan Research Center of Gastroenterology and Hepatology-GRCGH, Golestan University of Medical Sciences, Gorgan, Iran AUTHOR Alireza Norouzi 5 Golestan Research Center of Gastroenterology and Hepatology-GRCGH, Golestan University of Medical Sciences, Gorgan, Iran AUTHOR Jamshid Vafaeimanesh 6 Gastroenterology and Hepatology Research Center, Qom University of Medical Sciences, Qom, Iran ; j.vafaeemanesh@muq.ac.ir AUTHOR
OTHERS_CITABLE Migraine and Irritable Bowel Syndrome: an Epidemiological Study Background: Migraine and irritable bowel syndrome (IBS) are chronic conditions that seem to share common pathophysiological aspects. Objectives: Our study aimed to estimate the prevalence of IBS in an Iranian migraine population, investigate its association with headache's characteristics and depression. Materials and Methods: This cross-sectional study was done in a tertiary hospital clinic in Iran. Of patients referring for headache, migraineurs were diagnosed using international classification of headache disorder second edition (ICHD-II) by an experienced neurologist. Then, they were asked to answer to IBS section of SEPAHAN (The study on the epidemiology of psychological, alimentary health and nutrition) questionnaire, Persian version of Rome III questionnaire, to identify IBS and its subtypes in patients. Depression was evaluated by using Persian version of Beck-Depression Inventory second edition (BDI-II). The data were analyzed in SPSS software version 20 using the Chi-square test, the independent t-test and the Mann-Whitney U test. Results: Of 215 participants, 84% were female. Their mean age was 34±10.5 years. The frequency of IBS was 13.5% among migraineurs. The most common type of IBS was undifferentiated (58.6%). IBS was more common among patients with migraine with aura (p=0.03). A significant association was observed between constipation dominant IBS and migraine (p=0.04). IBS patients were significantly depressed than non-IBS ones (p=0.01). Conclusion: IBS prevalence is high in migraine patients. Therefore, its diagnosis and treatment should be regarded in their management to improve their quality of life. http://cjns.gums.ac.ir/article-1-84-en.pdf 2016-03-06 36 41 10.18869/acadpub.cjns.2.4.36 Irritable Bowel Syndrome Migraine Disorders Samira Mirzaei 1 MD, Isfahan University of Medical Sciences, Isfahan, Iran AUTHOR Fariborz Khorvash 2 Associate Professor of Neurology, Department of Neurology, Isfahan Neuroscience Research Center, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran AUTHOR Majid Ghasemi 3 Department of Neurology, Isfahan Neuroscience Research Center, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran ; ghasemimajid59@yahoo.com AUTHOR Sahar Memar-Montazerin 4 MD, Isfahan University of Medical Sciences, Isfahan, Iran AUTHOR Mahdis Khazaeili 5 MD, Isfahan University of Medical Sciences, Isfahan, Iran AUTHOR
OTHERS_CITABLE Grading of Glioma Tumors by Analysis of Minimum Apparent Diffusion Coefficient and Maximum Relative Cerebral Blood Volume Background: Gliomas are the most common primary neoplasms of the central nervous system. Relative cerebral blood volume (rCBV) could estimate high-grade Gliomas computed with dynamic susceptibility contrast MR imaging which it is artificially lowered by contrast extravasation through a disrupted blood-brain barrier. Objectives: Our intent was to clarify the usefulness of diffusion-weighted magnetic resonance imaging (DWI) and perfusion weighted magnetic resonance imaging (PWI) in the grading of Gliomas. Materials and Methods: Both PWI and DWI with a three-tesla scanner investigated nineteen consecutive patients with Gliomas. The means of rCBV and ADC values have been compared among the tumor groups with t-test and ROC curve analysis to determine threshold values of Gliomas grading. Results: Mean maximum rCBV were 2.71±1.41 for low grades (I & II), and 8.14±2.58 for high grades (III & IV) Gliomas (p=0.001). Mean minimum ADC were 1.47±.46 ×103 mm2/s for low grades (I & II), and .47±.38×103 mm2/s for high grades (III & IV) Gliomas (p=0.001). We can get 0.94×103 mm2/s for minimum ADC and 3.85 for maximum rCBV as a difference cutoff point between low and high-grade Gliomas. Conclusion: Combination of both DWI and PWI techniques, with measurement of minimum ADC and maximum rCBV can be used to distinguish between high grade and low-grade Glioma tumors. http://cjns.gums.ac.ir/article-1-85-en.pdf 2016-03-06 42 53 10.18869/acadpub.cjns.2.4.42 Diffusion Magnetic Resonance Imaging Neoplasm Grading Mahdiyeh Saberi 1 Medical Imaging Physicist, Department of Radiology Technology, Faculty of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran AUTHOR Fariborz Faeghi 2 Medical Physicist, Assistant Professor of Medical Imaging, Department of Radiology Technology, Faculty of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; f_faeghi@sbmu.ac.ir AUTHOR Hossein Ghanaati 3 Radiologist, Advanced diagnostic and Interventional Radiology Research Center (ADIR), Tehran University of Medical Sciences, Tehran, Iran AUTHOR Mojtaba Miri 4 Neurosurgen, Department of Neurosurgery, Emam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran AUTHOR Ayoob Rostamzadeh 5 Neuroscientist, Funding Member of Iranian Society of Cellular and Molecular Imaging, Department of Anatomy and Neuroscience, Faculty of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran AUTHOR Soheila Khodakarim 6 Epidemiologist, Department of Epidemiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran AUTHOR Farhad Naleini 7 Radiologist, Emam Reza Hospital, Faculty of Medicine, Krmanshah University of Medical Sciences, Krmanshah, Iran AUTHOR
CASE_STUDY Cerebral Sinus Vein Thrombosis Following Ovarian Hyperstimulation: A Case Report Thromboembolic phenomena are the serious consequences of assisted reproductive technology. We present a case of cerebral sinus vein thrombosis (CVST) following ovarian hyper stimulation syndrome (OHSS). Ten days after recovering from OHSS, the patient presented in the emergency department with thunderclap headache. Her Magnetic Resonance Venography (MRV) showed occluded left transverse sinus and left sigmoid sinus. The patient was treated with low molecular weight heparin. She made a good recovery and was independent in activities of daily living in follow up after six months. Disturbances of the coagulation system may occur in moderate OHSS and also persist even after the clinical symptoms of OHSS have resolved. http://cjns.gums.ac.ir/article-1-86-en.pdf 2016-03-06 54 57 10.18869/acadpub.cjns.2.4.54 Ovarian Hyperstimulation Syndrome Cerebral Veins Thrombosis Nasrin Moradian 1 Department of Neurology, Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran ; moradiannasrin60@yahoo.com AUTHOR Daryoush Afshari 2 Department of Neurology, Kermanshah University of Medical Sciences, Kermanshah, Iran AUTHOR Nazanin Razazian 3 Department of Neurology, Kermanshah University of Medical Sciences, Kermanshah, Iran AUTHOR Arash Bostani 4 Department of Neurology, Kermanshah University of Medical Sciences, Kermanshah, Iran AUTHOR Mohamad Moradian 5 Department of Neurology, Kermanshah University of Medical Sciences, Kermanshah, Iran AUTHOR