Introduction:Coronavirus disease 2019 (COVID-19) is a novel coronavirus that was extracted from patients with respiratory tract infections. The most common symptoms of patients are fever and respiratory tract involvement. In this report, we describe one patient with frequent seizures probably due to COVID-19 infection for the first time. Case Presentation: A 30-year-old previously healthy female was admitted with generalized tonic-clonic seizure in the neurology emergency room. The patient complained of dry cough five days before the admission. She had seizures (five times) approximately every 8 hours. Brain MRI was normal and chest CT revealed focal ground-glass opacities. The respiratory specimen was positive for COVID-19 using real-time PCR assay. The symptoms of the patient improved with anticonvulsive and antiviral medications. Conclusions: To the best of our knowledge, this is the first case study to report an association between frequent seizures and COVID-19. In our opinion, there is a hypothesis about this subject that the etiology of seizure may be due to encephalitis and invasion virus to the brain or toxic effect of inflammatory cytokines.
Background: Disability due to headache in migraine and being chronic of it can lead to sadness and depression. Objective: This study was aimed to determine the effect of lavender aromatherapy on depression and headache disability. Methods: This clinical trial study was conducted on 60 migraine patients referred to Toba Clinic of Sari (Mazandaran, Iran) during 2016-2017. Patients in the experimental group inhaled 2-3 drops of lavender essence for 15 min, three times a week for 4 consecutive weeks. The dose, duration and inhalation method of paraffin (as placebo) in control group were similar to those in the experimental group. Before the intervention, at the end of the second and fourth weeks, the intensity of depression and headache disability were measured by Beck Depression Inventory (BDI-13) and Jacobson questionnaire. For analyzing in each group and groups, repeated measure tests and Boneforeni were used.Results: In experimental group, depression (P <0.001, F=64.49) and headache disability scores (P <0.001, F=29.95) were significantly different in the pre intervention, two and four weeks after the intervention. No statistically significant differences were observed between the two groups in terms of the depression (P = 0.13, f = 2.6) and headache disability (P = 0.15, f = 1.93) scores before, two and four weeks after intervention. Conclusion:Lavender essential oil can be useful for reducing depression and headache disability in migraine patients.
Introduction Carpal tunnel syndrome (CTS) is a prominent compressive neuropathy. There are a number of risk factors for creating CTS but the effect of these factors on the severity of CTS is unclear. In this study, we aimed to assess the correlation of serum lipid profile and obesity with the severity of CTS. Methods this cross-sectional study was conducted on 118 patients with idiopathic CTS. Blood samples were obtained for determining the serum levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL-C), and high-density lipoprotein (HDL-C) after 12 hours of overnight fasting. The participants were then divided into two groups of normal and abnormal serum lipids. Body mass index ≥ 30 kg/m 2 was considered as obesity. The severity of CTS was determined based on the electrophysiological results and Boston CTS Questionnaire (BCTSQ) that evaluates symptoms severity (SSS) and functional status (FSS) of patients. Results out of 118 participants, 108 patients performed lipid profile test that 41.17%, 50.42%, 25.21%, and 20.16% of them had TC ≥ 200, TG ≥ 150, LDL-C ≥ 130, and HDL-C < 60 milligrams per deciliter (mg/dl), respectively. The mean scores of SSS in patients with dyslipidemia including the high level of TC, TG, LDL-C, and low level of LDL-C were 34.59±7.86, 34.05±8.73, 34.93±8.21, and 33.48±7.56, respectively. There was no significant association between lipid profile and the symptom severity scale of CTS (p-value > 0.05). The mean BMI of participants was 31.35±5.35 kg/m 2 , and 58.5% of them had a BMI ≥ 30 kg/m 2 . The mean score of SSS and FSS was 33.18±8.24 and 24.43±7.12 in obese patients (BMI ≥ 30 kg/m 2 ), and was 34.06±7.85 and 23.06±7.67 in patients with BMI < 30 kg/m 2 . We found no significant association between obesity with the SSS and FSS (p-value = 0.53 and 0.32, respectively). In terms of the relationship between electrophysiological grading with obesity, 44 (63.8%) of patients with BMI ≥ 30 kg/m 2 and 22 (45.8%) patients with BMI < 30 kg/m 2 had severe to extreme severe CTS. There was no significant association between obesity and the severity of CTS (p-value = 0.054). Conclusion the results of this study did not demonstrate an association between serum lipid profile and obesity with the severity of carpal tunnel syndrome. The findings of this study may not be extrapolated to other populations. Further studies with more samples are needed to investigate this association.
Context: Zika virus (ZIKV) is an arbovirus of the family Flaviviridae. This virus, which is transmitted by mosquitoes, usually affects children and causes self-limited diseases, associated with fever, maculopapular rash, conjunctivitis, arthralgia, and myalgia. There is a significant relationship between ZIKV infection and central nervous system disorders in infants. In this study, we aimed to review neurologic manifestations of ZIKV infection in infants. Evidence Acquisition: We searched the following Mesh terms in scientific databases: "Zika virus", "infants", "children", "neurologic manifestations", and "congenital infection". Electronic databases including Google Scholar, Science Direct, PubMed, Web of Science, Scientific Information Database, and Scopus were searched from 2000 to 2016. Results:The literature review showed a probable relationship between ZIKV infection and prevalence of microcephaly in newborns. Besides microcephaly, other central nervous system abnormalities included abnormal gyral arrangement, decreased brain parenchymal volume, cortical atrophy and malformation, cerebellar hypoplasia, and delayed myelination of the brain stem. Conclusions: Vertical transmission of ZIKV in pregnant women is associated with intrauterine infection and brain malformations in the developing fetus, including microcephaly, calcification, cortical displacement, ventriculomegaly, and white-matter abnormalities.
Background: The most common symptom of the novel Coronavirus Disease 2019 (COVID-19) infection is fever and dyspnea that leads to hypoxia in severe cases. Some COVID-19 patients experience neurological symptoms, including ischemic stroke and intracerebral hemorrhage. Sickle Cell Disease (SCD) is a hypercoagulable state, however, it has not been approved as a significant cause of Cerebral Venous Thrombosis (CVT). Case presentation: In this case report, we described CVT in an SCD patient who had COVID-19, as well. We reported a 32-year-old man with a history of sickle cell anemia presented with left hemiparesis, headache, and seizure. After evaluation of the patient, CVT accompanied by COVID-19 infection was diagnosed. He was treated with intravenous unsaturated heparin, antiepileptic drugs, and antiviral agents with a favorable outcome. Based on our knowledge, this is the first case study to describe an association between CVT and COVID-19 infection in a patient with SCD. Conclusion: During the recent pandemic, vaso-occlusive attacks in SCD patients can be evaluated for COVID-19 as an etiological factor.
PFO is one of common congenital cardiac anomalies. It's incidence is 15-30% and decreases with age.PFO is associated with several disease processes such as transient ischemic attacks and stroke. Various studies have reported that 45-54% of patients with cryptogenic stroke have PFO.The underlying pathological mechanism of PFO-associated stroke is the passage of abnormal material from the venous circulation through the PFO into the systemic circulation.As individuals age and develop comorbid cardiovascular disease such as heart failure or diastolic dysfunction the propensity to shunt right to left may increase and the risk of hypercoaguability may increase as well. Thus PFO only become pathogenic in the setting of certain comorbid conditions that cause the formation of phatogenic material with embolic potential.Controversy exists regarding closure of PFO as a therapeutic treatment modality for cryptogenic stroke.In properly selected patient closure of PFO is a safe and effective treatment modality. Contemporary indication for PFO closure in stroke or TIA is: 1.Documented paradoxical embolus. 2. Recurrent cryptogenic events. 3. Single cryptogenic event and inability to tolerate medical therapy. 4. Single cryptogenic event with high risk anatomical PFO features.
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