CASPIAN JOURNAL OF NEUROLOGICAL SCIENCES
Year:2022 | Volume:8 | Issue:4 (31)|Papers Count:8

Background: The prevalence of cognitive impairment among patients with epilepsy is about 70%. There is still no approved medication for the treatment of this problem. Objectives: The present study aims to assess the safety and efficacy of memantine in improving the cognitive function of patients with epilepsy. Materials & Methods: This is a pilot, randomized, double-blind, placebo-controlled, parallel-group clinical trial, conducted in a hospital in Tehran, Iran during 2018-2019. Participants were randomly allocated to receive memantine (5 mg/day in the first eight weeks and 10 mg/day in the second eight weeks) or placebo in a 1: 1 ratio. Participants underwent the mini-mental state examination (MMSE), montreal cognitive assessment (MoCA), and frontal assessment battery (FAB) before and after the intervention. The primary and secondary measures were safety and change in the cognitive test scores, respectively. Results: Out of 53 allocated participants, 33 completed the study. Drug intolerance including headache, somnolence, and dizziness was not significantly different between the two groups. The Intention-to-Treat analyses demonstrated no significant change in MoCA and FAB scores between the two groups after the intervention, but a significant improvement in the MMSE score of the memantine group (P=0. 047) was observed. After controlling confounding factors, there was no significant difference in scores of any cognitive tests between the two groups. Conclusion: Memantine is a safe drug for patients with epilepsy, but it may not exert a beneficial effect on the cognitive function of these patients.

Background: As previous studies show, several effects of morphine are induced by the dopaminergic system. Sulpiride is a dopamine D2 receptor (DAD2) antagonist widely used in clinics to treat DArelated disorders. DAD2 receptors are abundant at hippocampal cornu ammonis (CA1). Objectives: This study aimed to investigate the possible interaction of morphine and sulpiride on DA synapses in CA1. Materials & Methods: In this study, 48 Wistar rats weighing 220 to 250 g were used. These animals were classified into eight groups (6 rats per group): saline control group (1 mL/kg), morphine group (5 mg/kg), sulpiride groups alone (1, 2, and 4 mg/kg) and sulpiride groups (1, 2, and 4 mg/ kg)+morphine (5 mg/kg). Saline or substances were injected once intraperitoneally. After 48 h, the animals’,brains were removed under anesthesia and placed in 10% formalin for fixation. Then, 3-to 4-μ, m slices were cut from these tissues, and the DA synapse was examined by histochemistry and immunohistochemistry techniques. The data were statistically analyzed by the analysis of variance. Results: The control group had DA synapses and healthy neurons. A relative increase in DA synapses compared to the control group was observed in the morphine and single sulpiride groups. However, in sulpiride+morphine groups, DA synapses were reduced compared to morphine or sulpiride alone, but neurons were not destroyed. Conclusion: The interaction effect of sulpiride and morphine in the CA1 region may decrease DA synapses.

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 & 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.

Background: Cognitions and attitudes, especially anthropological attitudes, are influential in human behavior. Objectives: The present study was conducted to investigate the cognitive evolution of the human concept in elementary school female students and its adaptation to Piaget’, s theory of cognitive development. Materials & Methods: The present research method is qualitative of deductive-inductive type. Participants were first (n=12), second (n=13), and third-grade (n=12) elementary female students selected through the available sampling method. Semi-structured interviews were conducted with them to the point of theoretical saturation. Consistent with the research method, the findings were analyzed by theme analysis. Results: The findings showed that regarding human nature, students of all three grades have concrete thinking. Regarding the distinction between humans and animals, first and second grade students have concrete thinking, and third-grade students have concrete-abstract thinking. Regarding the purpose of life, students of all three grades have concrete thinking. Regarding the end of life, students of all three grades have abstract thinking. Regarding the beginning of human life, first-grade students have abstract thinking, and second-and third-grade students have concreteabstract thinking. Conclusion: Research findings consistent with some studies have shown that students can achieve abstract cognitive growth at younger ages than what Piaget stated, which can be a function of cultural, religious, and social factors.

Background: Breaking bad news is an unpleasant task for physicians, especially for patients with cancer. In this regard, the SPIKES protocol, which is prevalent in several countries, has not been discussed in Iran. Objectives: This study evaluated how the SPIKES protocol was followed by physicians. Materials & Methods: This descriptive cross-sectional study was conducted at Guilan academic hospitals from December 2021 to April 2022. Patients with cancer participated in the survey who were referred to the oncology academic centers for follow-ups or radiotherapy and chemotherapy. They were over 18 years old with the ability of proper communication. The SPIKES questionnaire consists of 12 questions with 6 subscales (settings, invitation, perception, knowledge, emotion, and strategy). It was filled out through a direct interview. Results: The data from 280 patients were analyzed. Everyone stated that at the time of receiving the diagnosis, the doctor was not in a hurry and made appropriate eye contact. About 61. 1% believed they were emotionally supported, and 65. 4% were satisfied with their final knowledge about the disease and treatment planning. Patients with older ages and lower levels of education were significantly more likely to state that physicians’,language was not comprehensive,physicians did not understand them, and the patients were not emotionally supported (P=0. 0001). Conclusion: This study showed that more attention should be paid to older patients with lower levels of education. They needed more time for conversation and simpler dialect. Some areas, such as “, invitation”,are required to be improved.

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.

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 & 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.

Background: Traumatic pseudoaneurysm of the supratrochlear artery is a rare lesion. It manifests, as a painless mass, in the frontal region following trauma. The unusual incidence and confusing presentation require the clinicians to thoroughly understand its presentation and diagnosis. Diagnosis is typically made on history and physical examination, but it can be confirmed by duplex ultrasound. Definitive treatment is surgical resection of the aneurysm after proximal and distal ligation of the vessel. However, in some cases, follow-up is recommended because there is a possibility of spontaneous relapse. Case Presentation: We present a case of traumatic pseudoaneurysm of the supratrochlear artery, which developed a few weeks after blunt trauma to the forehead. The radiologist reported a pseudoaneurysm originating with a narrow stalk of the supratrochlear artery. In the patient’, s followup after three months, the patient’, s mass became very small, and in the follow-up after five months, the mass completely disappeared. Conclusion: Pulsatile and or soft-tissue masses that are continuous with an artery with a history of trauma should be considered pseudoaneurysm. Color Doppler sonography is a convenient and noninvasive modality in diagnosis. If the pseudoaneurysm of the supratrochlear artery is small and contains thrombosis, waiting and seeing might be an effective option.