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Showing 14 results for Headache

Darioush Savadi Oskoui , Maziyar Hashemilar ,
Volume 3, Issue 3 (9-2003)

  Temporal arthritis (TA) is a systemic inflammatory vasculitis with unknown etiology, which involves large and medium sized arteries. A wide spectrum of systemic, neurological and ophthalmological complications appears in the course of the disease the most serious of which is visual impairment leading to permanent blindness in 60% of the cases.

  TA is diagnosed through an elevated ESR (>60 mm/Hg) and pathological findings of arterial biopsy. It is considered as one of the urgent neurological cases in which the patient should be treated with corticostroid immediately after diagnosis. The subject of this research was a 62-year-old male who had had headache associated with fatigue, night sweats and low mood for four month. The diagnosis of TA was made considering an elevated ESR and temporal artery biopsy findings. Treatment with prednisolone was initiated and continued for 19 months resulting in complete recovery.

Shahnam Arshi , Ali Majidpoor , Homayoun Sadeghi , Seyedhashem Sezavar , Reza Gasemi Bargi , Darioush Emdadi , Nategh Abbasgholizadeh , Parvaneh Naftchi ,
Volume 4, Issue 1 (4-2004)

 Background & Objective: Ardabil province is the main area of Iran affected by relapsing fever (RF) for which Borrelia Persica is the most common cause. The aim of this study was to determine the epidemiologic characteristics of the disease, and the frequency of infection among ticks in this region in order to take necessary measures to decrease it is incidence and increase awareness about the characteristics of this disease.

 Method: In this study a total of 391 patients who were diagnosed to have been effected by tick borne relapsing fever were investigatated in terms of clinical epidemiology between 1998 and 2001. The kind of Borrelia as well as the clinical characteristics of the disease were observed. The kind and prevalence of Borrelia infection was determined in 1,421 ticks collected from 130 indoor and 14 outdoor sites. The ticks were crushed and the suspension obtained was injected into the peritoneum of two mice and two guinea pigs to determine the frequency of infection among the ticks living in this region. Data including the tick species determination were collected through a questionnaire and analyzed using Chi-square and ANOVA tests.

 Results: The most prevalent clinical manifestations were fever, chills and headache. Other findings included nausea, vomiting, sweating, abdominal pain, arthralgia, cough, photophobia, eosinophilia, hematuria, jaundice, petechiae and sclera congestion. Laboratory tests performed on 60 patients showed leukocytosis, high erythrocyte sedimentation rate (ESR) and anemia. Of the 1,421 ticks collected, 45.9%, 40.3% and 13.8% were infected by Ornithodoros lahorensis Ornithodoros tholozani and Argas persicus species, respectively. The prevalence of ticks was highest in Khanadabil village. The ticks collected from three villages were found to be infected with Borrelia.

 Conclusions: The clinical manifestations were similar to those reported in other studies. Petechiae occurred less frequently in our study compared to louse-borne RF. The high frequency of anemia in this region, which was not stated in other reference articles, requires further investigation.

Maziyar Hashemilar , Nayereh Aminisani , Darioush Savadi Oskoui , Mahzad Yosefian ,
Volume 4, Issue 1 (4-2004)

 Background & Objective: Studying the epidemiology and impact of headache can help improve patient care, estimation of burden of disease and classification systems. Migraine is common worldwide and has a geographically variable prevalence in the world. Moreover, its peak of incidence is the age of 20-30. The aim of this study was to determine the prevalence of migraine among the medical students in order to plan for future health interferences.

 Methods: In this cross-sectional study 631 students filled out a questionnaire designed according to the criteria of the international headache society. The data were analyzed using SPSS software (release 12) and descriptive statistics.

 Results: 76.6% of the subjects were female and 23.4% of them were male. The females were 20.6 and males were 21.4 years old on average. The total prevalence of migraine was 7.3% (1.6% with aura, 5.4% without aura and 0.3% with both of them). Moreover, females, single subjects and students of medicine, except the migraine with aura that was more prevalent among students of associate degrees. A positive family history of headache was found in 45.6% of the students. 65.2% of those suffering from migraine had not referred to a physician and were unaware of their headache.

 Conclusions: Compared to similar researches there is a low prevalence of migraine among the students but most of the students do not take measures to cape with and treat them in the proper manner. This requires necessary health interferences.

Hesam Abdolhoseinpour , Mojtaba Malek , Mohammad Mohammadi , Gholamreza Bakhshandepour,
Volume 6, Issue 4 (12-2006)

 Background & Objectives: Delayd post-traumatic intracranial hemorrhage (DTICH) is a kind of brain hemorrhage which occurs after the first six hours of the head trauma, and is not detected in the initial CT Scan taken from the patient in the first 6 hours after the trauma. As DTICH is one of the most important factors in occurance of secondary brain injuries in patients with head trauma, its early diagnosis and treatment could significantly decrease mortality and morbidity of these patientes. This diagnosis is a contraindication to anti-coagulant therapy. This study was conducted to determine the frequency of factors associated with DTICH incidence.

 Methods: This was a case-control study conducted in Semnan trauma center. In this research all the patients with head trauma who referred to Emdad hospital between 2002 and 2004 were studied and the data about the delayed post-traumatic intracranial hemorraege (20 cases) were included. Then, beside determining the incidence of DTICH in the patients with hemorrhage, some risk factors such as headache, contusion, reduction level of conciousness, skull fracture and impact intensity to the head were compared with a control group (40 cases) who had head trauma without primary or delayed hemorrhage. The groups were age and sex-matched. The data were analyzed using Chi-aquare and computing odds ratio.

 Results: This study showed that the frequency of DTICH was 10.6%. There was a meaningful relationship between DTICH and skull fracture, reduction of conciousness level, contusion and impact intensity. But, there was no meaningful relationship between DTICH and intractable headache.

 Conclusions: The results indicated that cases such as skull fracture, contusion, impact intensity and findings such as the reduction of consciousness in patients with head trauma (with no hemorrhage in the first CT scan), can be the risk factors for DTICH.

Parviz Molavi, Hosein Mohammadnia, Roohollah Arab , Akbar Atadokht ,
Volume 7, Issue 1 (4-2007)

  Background & Objectives: Tension headache is one of the most common types of headaches that millions of people suffer from it. So far different treatments have been used to confront with tension headaches. According to the studies, tension headaches usually respond well to nonpharamacological treatment. The objective of this survey is the comparison between efficacy and effectiveness rate of SIT and medical treatment for tension headache treatment.

  Methods: In this study, 30 patients who had referred to neurology clinic of Alavi Hospital and private clinics, during the months of June and July in 2003, with chronic tension headache complaint, were selected randomly. These 30 patients were entered to two study groups and the third control groups. The patients in the first and second group received SIT and medical treatment respectively. The third group was considered as the control group and received no intervention. Indices of headache (frequency, severity and duration) were evaluated in 3 stages (Before treatment, after treatment and within one-month follow up period) by using a headache record device for all of patients. The collected data were analyzed by inferential statistical SIT methods, variance analysis and LSD pair comparison.

  Results: The data found from ANOVA methods (Analysis of variance) showed that both methods (Stress inoculation training and medical treatment) are effective in the treatment of chronic tension headache, but comparison between two groups showed that the group who received SIT had a significant difference compared to the group who received medical treatment in terms of efficacy rate on duration and consistency of headache symptom (p<0.05). In other indices of headache (freauency and severity), there was no significant difference between these two groups.

  Conclusion: This study showed that effiectiveness rate of stress inoculation training is more effective than medical treatment of tension headache (in terms of headache symptoms duration and consistency).

Nasrin Homayounfar , Fahimeh Sehhati , Afrooz Mardi , Firooz Amani , Hamid Jafarzadeh ,
Volume 7, Issue 4 (12-2007)

  Background & Objective: Depot-medroxyprogesterone acetate (DMPA) is an injectable contraceptive method that is widely used by 68 million women in over 114 countries and was reported Different medical and non medical reasons were reported for discontinuation of DMPA use. Due to little information about continuation rate and reasons for discontinuations of DMPA in this region and because of the different result of the research in other countries this study was designed. to evaluate the use of DMPAincluding continuation rate and side effects.

  Methods: In this cross sectional retrospective study 396 DMPA user women referring to health care centers in Ardabil were selected through classified sampling. The data were collected by a questionnaire by interviewing the subjects and data were analyzed by SPSS software using analysis variance (ANOVA) and correlation and T-test.

  Results: The mean age of the study population was 32±7.8 years, 33.8% had primary education and the majority of the users were housewives (%95) and only20 (%5) were employed. 6, 9, 12 and 24 month cumulative continuation rate of DMPA were recorded as %44.5, %26.5, %18.2 and %2.3 respectively. The most common reason for discontinuation among all of groups was amenorrhea. The most common side effects were amenorrhea (%69.7), low back pain (%13.4), and weight gain (%13.4) and headache (%10.4). There was a significant corvelation belween education level and spouse's education level, spouse's job, family income, grariding, number of off spring, type of previous delivery and continuity of DMPA (p<0.05).

  Conclusion: The result of this study could help health authorities and care givers in term of correct counseling and follow up. This factor could result in more satisfaction and improve continuation rate of DMPA.

Mehrdokht Mazdeh , Mansoor Nazari ,
Volume 8, Issue 2 (6-2008)

  Background & Objective: Migraine is one of the chronic and Common Kinds of headache. Among important treatments which are advised for improvement of acute migraine attack, there are tryp tans and Ergot Alkaloids Because of side effects of Ergot Alkaloids Like nausea, vomiting, lack of appetite, Peripheral vessel contractions and induced headache and its limited consumption and patients age limitation, the patients face some difficulties using Ergot Alkaloid. On the other hand Tryp tans are Consumed as a monotherapeutic regimen but Ergot Alkaloids must be used with metoclopramide in order to prevent nausea and also they should be used in the acute phase of migraine so we decided to Compare the two groups of drugs so that if they have positive effectiveness in favor of Tryp tans, using them would be advised.

 Methods: The range of age for patients was 20- 40 years who suffered from classic and common migraine according to IHS criteria, were randomly placed in two groups. One group (36) was treated in the acute phase of disease by sumatryptan and the other (39) by a combination of 3 dihydroergotamine and naproxen and metoclopramide, and therapeutic effectiveness was studied by three Criteria of intensity, attack and frequency of attack. After the treatment, they were analyzed through chi square.

 Results: In terms of intensity, duration and frequency of the headache after the treatment, there was no significant difference between two groups and the results in both group were the same.

 Conclusion: As there were no significant statistical difference between the effect of two drugs on attack intensity, headache duration and frequency in patients of classic and common migraine, and because of the complications of Ergot Alkaloids like vomiting it should be consumed with metoclopramide and because of vessels contractions which may result in the organs gangrene and induced headache, and its maximum dose is 6 mg per week, sumatryptan is advised as the monotherapeutic.

Marjan Akhavan Amjadi , Faraz Mojab, Samira Shagbazzadegan,
Volume 9, Issue 3 (9-2009)

 Background & Objectives:Primary Dysmenorrhea (PD) is common gynecology problem in women. It is defined as a menstrual pain that occur in absence of pelvic pathology. PD is common reason of women and girls’ absence from schoole. Pain is main complain of PD but other systemic symptoms like headache, nausea and vomiting, diarrhea, fatigue, irritability and dizziness are common. Many chemical drugs have been used to cure dysmenorrheal, but each has its own side effects.

  Cinnamomum zeylanicum has been used as an anti-spasmodic agent in traditional medicine .

  Methods : This study was a placebo-control, triple blind and randomize clinical trial. We research. The efficacy of C. zeylanicum on severity of symptoms with PD Severity of symptoms were assessed. Data were collected by question validated questionnaires. The subjects of study were 47 single women, who sufrred from primay dysmenorrhes, They were randomly selected and their age use between 18-30 years old. We divided them two group, 26 case women in (treatment group) whom needed capsules contain C. zeylanicum and control group whom revided placebo capsules. administered as soon as onset of pain feeling or bleeding, five capsule a day and continued for minimum three days. Severity of systematic symptoms was assessed with Andersch & Milsom verbal multidimensional scoring system. Data were analyzed through by SPSS software.

  Results: The mean age of women in case and control groups were 20.69 ± 1.93 and 21.7+4.6. There was a significant differences (p<0.001) in the Severity of pain between two groups. The severity of all the systematic symptoms decreased in both groups, but this reduction was not significant between two groups. No significant difference was seen for systematic symptoms between twogroups. In this study, had not been observed any side effects by using of C. zeylanicum .

  Conclusion: The results our study should that C. zeylanicumcan be effective in reducing the severity of dysmenorrheal, but C. zeylanicum has no sufficient effect on relief of systematic symptoms accompanying with dysmenorrhea.

Amir Mohammad Asnaashari , Hasan Ghobadi Moralou, Shahrzad Mohamadzadeh Lari , Elham Ghalenoei ,
Volume 10, Issue 3 (9-2010)

 The OHS is characterized by hypersomnolence, hypoxia, polycytemia, headache and edema. Polysomnography is the gold standard diagnostic test. Overnight oximetry with significant oxyhemoglobin desaturation is reasonable to begin treatment. Weight reduction and Non invasive positive pressure ventilation (NIPPV) has evolved as the mainstay of treatment.

 Obesity is a risk factor for deep vein thrombosis (DVT). Heparin and warfarin are the drugs that used for treatment of DVT. HIT typically appears as a 50% or greater reduction in the platelet count after the first exposure to heparin. This case is a obese man with extreme DVT that diagnosed by duplex sonography and symptoms of obesity hypoventilation syndrom.

 In overnight pulseoximetry oxyhemoglobin desaturation was occurred more than 15 times per hours and treatment begins with NIPPV. Patients thrombosis were treated with heparin and warfarin. Heparin induced thrombocytopenia (HIT) and cutaneous necrosis was occurred and drug therapy withdrawn. After healing of cutaneous necrosis low dose warfarin was started.

 NIPPV promote airway occlusion and improve hypercapnia.hypoxia and quality of life and reduced cardiovascular complications.

Sevda Parsa, Davar Altafi ,
Volume 14, Issue 3 (9-2014)

  Background &objections: Migraine is the second most common cause of headache in15% of women and 6% of men. Migraine headaches areperiodic and usually with unilateral and throbbing quality,and often accompanied by nausea, vomiting, phonophobia, photophobia and malaise. Approximately 15-20% of migraine attacks start with visual aura or other neurological symptoms. So far there isn’t accurate and practical diagnostic test for this patients and diagnosis is based on clinical features and other causes. The aim of this study was to investigate the role of visual evoked potential (VEP) in patients with common and classic migraines and t effects on the electrophysiology of visual system and understanding pathophysiology in neurological symptoms.

  Methods: In this study, 44 migraine patients, including 28 patients with common and 16 patients with classical migraines admitted to neurology private clinics from January to June 2013 in Alavi hospital of Ardabil city and16 healthy volunteers (control group) were used. Mean wave, P100 Latency and P100-N140 Amplitude were compared and determined between three groups.

  Results: The mean latency of P100 migraine group was significantly higher than healthy people. Average P100-N140 amplitude of migraine group was fewer than the control group, and the mean P100-N140 amplitude was more common than classical group.

  Conclusions: Despite differences in results of VEP tests, VEP can be used as an adjuvant test in the diagnosis of migraine, as well as a confirmation for distinguishing common and classical migraine and can be used as a tool in determining the severity of migraine and/or a parameter for its electrophysiological effects. However, more detailed studies are needed in this area .

Amirabbas Ghasemi , Behnam Daneshpajouh ,
Volume 14, Issue 3 (9-2014)

  Background &objectives: Echinococcosis, referred to as hydatid disease or hydatidosis, is a parasitic disease caused by larval stage of Echinococcus granulosus. In the life cycle of this parasite, dogs and other carnivores are definitive hosts and herbivores are intermediate hosts. Humansin this cycle may incidentally involve by ingestion of parasite eggs and play as intermediate host. Hydatid disease can involve any organ but liver and lung are the most commonly affected organs and kidney, brain, heart, bone may also be affected to a lesser degrees. Cerebral hydatid cyst occurs in about 2% of all echinococcosis cases. In this paper we report two cases of cerebral echinococcosis in whom diagnoses were made based on MRI findings and confirmed by pathology reports after surgery.

  First Case Report: The first case was a 30 years old man who was admitted after an episode of generalized tonic-clonicseizure. The MRI imaging performedand patient underwent surgery with diagnosis of a right frontal cystic lesion. The patient was improved progressively and there was no seizure attack and recurrence during 18 months follow up period.

  Second Case Report: The second case was a 28 years old woman presented by headache and abnormal behavior. MRI of this patient revealed a large cystic lesion in left frontal lobe and then underwent surgery. No complication was seen during postoperative period. The headache and behavioral disorder were improved completely and there was no sign of recurrence during 18 months follow up period.

  Conclusion: Hydatid cyst should be considered as a differential diagnosis of cystic brain lesions in endemic areas. Although hydatid cyst is a benign lesion but surgical removal of it without rupture is very important for prevention of probable future complications.

Marjan Akhavan Amjadi , Samira Shahbazzadegan, Maryam Shakiba ,
Volume 15, Issue 1 (4-2015)

  Background & objectives : Primary dysmenorrhea (PD) is a common gynecological problem in women. It is defined as a menstrual pain that occurs in absence of pelvic pathology. PD causes school absence and job restriction for many women and girls. Pain is the main complain of PD but other systemic symptoms like headache, nausea and vomiting, diarrhea, fatigue, irritability and dizziness are common. Many chemical drugs have been used to manage dysmenorrhea, but most of them have side effects. Acupoint stimulation therapies, like acupressure, might be an effective intervention for primary dysmenorrhea. SP6 and Liv3 are two important acupoints to improve primary dysmenorrhea. The aim of this study was to compare the effect of acupressure in two points SP6 and Liv3 on primary dysmenorrhea.

  Methods: This is a single-blind, randomized clinical trial study. Severity of pain and symptoms were assessed at baseline and also after two menstrual cycles of the investigation using validated questionnaires. 94 non-married women between 18-30 years old, who suffered from primary dysmenorrhea, completed the study (n=50 Liv3, n=44 SP6). The SP6 group received 20 min of acupressure during the initial intervention session and educated to perform the technique twice a day, from 3-5 days before to third days of their menstrual cycle, for two cycles. In contrast, the Liv3 group, performed this method but on Liv3 acupoint. Severity of dysmenorrhea was assessed with Andersch and Milsom verbal multidimensional scoring system. In order to analysis of data, Friedman test and GEE statistics test were used.

  Results: In comparison with baseline, severity of pain in both treated groups decreased (p=0.001). But statistical significance was not observed between two groups.

  Conclusion: It seems that acupressure on SP6 and Liv3, without any preference, is effective to decrease of severity of pain of dysmenorrhea.

Maryam Khooshideh, Tiba Mirzarahimi ,
Volume 17, Issue 3 (10-2017)

Background & objectives: Treatment of dysmenorrhea in women is aimed to bring them to their normal condition. In the present study, the effect of mefenamic acid, a non-steroidal anti-inflammatory drug, was compared with that of transdermal glyceryl trinitrate (GTN) as a tocolytic drug in the management of primary dysmenorrhea.
Methods: A total of 160 nulliparous women aged 18-30 years with primary dysmenorrhea were included in this single blind, clinical trial, which was carried out from 2014 to 2015. The patients were randomly divided into two equal groups. At the beginning of menstruation cycle, the patients in group A received 500 mg oral mefenamic acid, followed by 250 mg mefenamic acid every 6 hours. The patients in group B initially were administered 2.5 mg transdermal glyceryl trinitrate 0.2% every 12 hours to the abdominal skin under the umbilical cord. Treatment was continued for up to 48 hours and repeated for three cycles. Pain scores were assessed by Numerical Rating Scale (NRS) every 4 hours. Adverse effects such as headache and gastrointestinal disorders were recorded. The decrease of pain scale was the primary outcome and adverse effects were the secondary outcome.
Results: The mean pain severity score in in the first 24-hours in mefenamic acid group was lower than that of the glyceryl trinitrate group (p=0.01). On the second day, the mean pain severity scores were not significantly different between the two groups. The mean pain severity scores in the second day of second cycle (p<0.001) and in the first day of third cycle (p=0.001) were significantly lower in mefenamic acid group than in glyceryl trinitrate group. The side effects were also higher in the glyceryl trisitrate group than in the mefenamic acid group, but this difference was not statistically significant. The most common complication was headache in the group receiving glyceryl trinitrate (18.75%) and nausea in the group receiving mefenamic acid (26.25%). The satisfaction rate was 42.2% in the patients receiving transdermal glyceryl trinitrate, while it was 78.5% in patients receiving mefenamic acid; therefore, the patients in the mefenamic acid group were more satisfied (p=0.004).
Conclusion: The analgesic effects of oral mefenamic acid were better than transdermal glyceryl trinitrate in the management of primary dysmenorrhea. The adverse effects of these two drugs were not significantly different, but the type of complications was different in both groups.
Yousef Fekri, Habib Ojaghi,
Volume 18, Issue 4 (3-2019)

Background: Topiramate, is an oral sulfonamide medication that is increasingly used for treating headache. We report a rare case of bilateral myopia and acute, secondary angle closure glaucoma following use of topiramate.
Case history: A 33 year-old woman, who referred to emergency ward of Alavi hospital in Ardabil, with bilateral painful loss of visual acuity following one week after starting topiramate. Her uncorrected visual acuity was two meter counting finger in both eyes. The patient had complete vision before administration of topiramate. At present, the eye refractive error was -6.00 diopters.The right and left intraocular pressure was 50 mm Hg OD and 45 mmHg OS respectively. Slit examination revealed conjunctival injection, corneal edemaand shallow anterior chambers. The patient had a history of taking topiramate tablets one week earlier. Topiramate was discontinued and she was treated with anti-glaucoma and cycloplegic drugs. Intraocular pressure and refractive errors were normalized within 3 days and 2 weeks, respectively.
Conclusion: Topiramate can cause acute angle-closure glaucoma and myopia even at low doses or for a short period usage.

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مجله دانشگاه علوم پزشکی اردبیل Journal of Ardabil University of Medical Sciences
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