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Introduction. Due to the prevalence of dysphagia in patients with Parkinson's disease (PD) and its complications such as aspiration pneumonia, which is the main cause of death in these patients, PD-related disability can be prevented by early diagnosis and treatment of dysphagia. Objective. The present study was aimed at investigating the frequency of dysphagia in PD patients. Materials and methods. This cross-sectional study included 150 PD patients visiting a Neurology Clinic. The severity of PD was determined based on the Unified Parkinson Disease Rating Scale (UPDRS) and modified Hoen and Yahr (HYS) Scale. The Munich Dysphagia Test-Parkinson's disease (MDT-PD) questionnaire was used to assess dysphagia. Comparisons were made using generalized Fisher exact, Chi-square, ANOVA, and KruskalWallis tests. Predictive factors were analyzed using logistic regression. Statistical analyses were performed at significance level of 0.05. Results. Out of all 150 patients referred to the Clinic, the prevalence of dysphagia requiring attention was 25.3% (n = 38). The patients of the three groups according to the MDT-PD (no noticeable dysphagia, noticeable oropharyngeal, and dysphagia with aspiration risk) had a significant difference only in terms of the PD duration (p 0.001). In the predicting of dysphagia, the longer PD duration (p = 0.011) and homemaker occupation (p = 0.033) were protective factors, while female gender was a risk factor (p = 0.011). Conclusion. The prevalence of dysphagia requiring attention in the studied patients was 25.3%. It decreased with the longer duration of the disease, and its prevalence was lower in homemaker patients, while the odds of dysphagia was 5.8 times higher in women than in men.

Background: Parkinson’s disease (PD) is one of the most common neurodegenerative diseases (ND). Studies have demonstrated that biochemical markers have an association with PD. We aimed to investigate an association of biochemical markers including calcium, vitamin D, alkaline phosphatase (ALP), parathormone (PTH), and phosphorous with PD. Methods: This study was conducted on 139 PD patients and 100 healthy individuals. Serum levels of calcium, phosphorous, ALP, PTH and vitamin D were evaluated. Furthermore, student’s t-test and logistic regression models were used by SPSS. Results: The mean levels of calcium (9.4±0.7 and 9.0±0.8 ) and vitamin D (29.7±22.1 and 25.8±23.7) were higher in PD patients as compared with healthy controls, which only status of calcium being significantly different in the two groups (P

Background. The aim of this study was to determine the knowledge and attitude of nurses of hospitals affiliated to Babol University of medical sciences with regard to epilepsy and its related factors. Method. This descriptive study was performed on 500 nurses working at educational hospitals of Babol, Iran, in 2017. A questionnaire including 7 demographic questions, 14 questions of knowledge and 10 questions of attitude was used to collect the related data. Results were gained through ANOVA and T-test. Results. In this study, the level of knowledge about epilepsy was significantly higher in subjects younger than 25 years old (P = 0.03), but the attitude toward epilepsy across different age groups was not significantly different. Also, there was no significant difference between knowledge and attitude between the two sexes, marital status and work experience. Nurses’ knowledge was not significant in terms of education, but their attitude toward epilepsy was higher in those with undergraduate education than those with higher educated (P

Objectives The involvement of factors such as serum lipids and lipoproteins concentration has been reported as a potential risk factor for cognitive impairment. This study aimed to investigate the effect of underlying factors and serum lipid levels on cognitive impairment in the elderly. Methods & Materials This cross-sectional study was conducted on 1519 elderly in Amirkola City by the census method, from September 2016 to March 2017 (6 months). The data collection tools were a background information form of older adults and the mini-mental state exam. The obtained data were analyzed in SPSS version 23 using descriptive statistics and inferential statistics such as the Kolmogorov-Smirnov test, the Chi-squared test, analysis of variance (1-way ANOVA) and Tukey’s post hoc test. Results According to the results, 9% (13 elderly) of the study population had severe cognitive impairment. The results of the Chi-square test did not show a significant relationship between gender and cognitive impairment (P>0.05). The significant differences were found between age, blood pressure, total cholesterol, and low-density lipoproteins variables with the categorized groups of cognitive impairments of the elderly (P≤0.05). Conclusion Screening for cognitive impairments is one of the recommendations of this study. Early diagnosis and treatment of this disease, especially in high-risk groups such as women and elderly with hypertension and disrupted serum lipid profile can play an important role in controlling the disease and reducing the care burden.

Clusterin (CLU) is the third most important associated risk gene in cognitive disorders. Regarding the controversy about the association of CLU rs11136000 with mild cognitive impairment (MCI), the aim of this study was to investigate a putative association of CLU rs11136000 with MCI as well as the serum biological factors with a special attention to the age as a main dimension of a multifactorial elderly disease in an Iranian elderly cohort in which the mentioned association was not previously investigated. The study also checked the association between diabetes and MCI in this population. A population of 418 individuals containing 236 MCI and 192 control subjects was recruited from the Amirkola health and aging population cohort. Serum biological indexes were assessed by biochemical and enzyme-linked immunosorbent assay, and rs11136000 genotyping was performed using polymerase chain reaction-restriction fragment length polymorphism. Bioinformatics analyses were used to identify the putative effect of rs11136000 on the secondary structure of RNA and chromatin location in different cell lines and tissues. Type 2 diabetes was present with a higher proportion in the MCI group in comparison with the control group (P = 0.041). The frequency of the C allele of CLU rs11136000 was significantly different between cases and controls and was associated with MCI risk (OR 1.79, P = 0.019). Under a dominant genetic model, the CC genotype showed a predisposing effect in individuals aged ≥ 75 years (OR 3.33, P = 0.0004). Interestingly, under an over-dominant model, the CT genotype had a protective effect in this population (OR 4.52, P = C transition of CLU rs11136000 could not cause significant mRNA folding (P = 0.950). Contrary to other studies on Asian populations, this study demonstrated an association between rs11136000 and MCI in an elderly Iranian population. This study also suggests that an age-dependent approach to the previous studies may be performed in order to revise the previous belief in this geographical area. The rs11136000 genotypes in combination with HDL levels and knowledge about diabetes background may be used as a predictive medicine tool for cognitive disorders.

Introduction: Stroke recognized as the third most common cause of death. Stroke survivors often suffer a large amount of physical and mental disability. Due to assess difference between stroke types, progression and distribution of risk factors according to residential status, to get the correct information for prevention planning and management, this study was conducted. Methods: This descriptive cross-sectional study on stroke patient from 2016 to 2017 that admitted to Ayatollah Rohani Hospital of Babol was conducted. Type of stroke, their severity, risk factors, and urban or rural area of residence of patients were recorded in the checklist. The chi-square test was used to compare frequencies of gender, and stroke risk assessment between the urban and rural residents. Binary logistic regression modeling was used to estimate the association of risk factors with living in urban and rural areas. The results were expressed as multivariable-adjusted odds ratios (ORs) and 95 % confidence intervals (95 % CIs). A two-sided p < 0.05 was considered statistically significant. All data analyses were performed, using SPSS statistical analysis software. Results: Of 241 stroke patients, 133 patients (55 %) were female and 213 patients (88.4 %) were ischemic. Also, 140 cases were (58 %) rural. Embolic strokes more in urban population and thrombotic strokes were more in rural populations. Hyperlipidemia was more in urban than rural p = 0.01. Severity of stroke in admission time (p = 0.03) and at discharge (p = 0.005) was more in rural than urban. The mortality was higher in rural 12 (8.6) vs. 2 (2) urban resident,( p = 0.03). Conclusion: Rural patients had more severity, thrombotic type and mortality than urban. Suitable policy regard to residential parameter is suggested.

Background: Parkinson’s disease (PD) is one of the most common neurodegenerative diseases (ND). Studies have demonstrated that biochemical markers have an association with PD. We aimed to investigate an association of biochemical markers including calcium, vitamin D, alkaline phosphatase (ALP), parathormone (PTH), and phosphorous with PD. Methods: This study was conducted on 139 PD patients and 100 healthy individuals. Serum levels of calcium, phosphorous, ALP, PTH and vitamin D were evaluated. Furthermore, student’s t-test and logistic regression models were used by SPSS. Results: The mean levels of calcium (9.4±0.7 and 9.0±0.8 ) and vitamin D (29.7±22.1 and 25.8±23.7) were higher in PD patients as compared with healthy controls, which only status of calcium being significantly different in the two groups (P

Introduction: Many studies have shown a relationship between serum level of trace elements and risk of stroke, but the exact mechanism of this relationship is not clear. The purpose of this study was to measure changes of serum magnesium, iron, copper, and zinc levels in ischemic and hemorrhagic stroke patients to evaluate their potential diagnostic utility.Materials and methods: Overall, 53 healthy individuals (30 men, 32 women) and 53 ischemic and hemorrhagic stroke patients (30 men, 23 women) who were admitted to the Rouhani Hospital in Babol (Iran) were enrolled in the study within 24 hours after stroke onset. Diagnosis was made based on medical history and physical examination by a neurologist. After blood sampling, serum copper was assessed by atomic absorption spectrophotometry, and zinc, magnesium and iron levels were assessed by spectrophotometry. Data analysis was performed in SPSS (version 21) using independent sample t-test and chi-square test. Results: Serum concentrations of copper was significantly higher in the patients (58.8 ±14.7 mg/dL) compared with the controls (45.7 ±10.0 mg/dL). Serum concentrations of zinc was significantly higher in the patients (113.2 ±17.3 mg/dL) compared with the controls (95.60 ±12.80 mg/dl). Moreover, serum concentrations of iron was significantly higher in the patients (148.5 ±30.4 mg/dL) compared with the controls (74.22 ±33.3 mg/dL). However, the patients (1.4 ±0.8 mEq/L) had significantly lower level of magnesium level compared to the controls (2.1 ±0.3 mEq/L). Conclusions: Our results suggest that evaluation of serum magnesium, iron, copper and zinc levels in ischemic and hemorrhagic stroke patients may be useful for the prediction and diagnosis of stroke status.

In the elderly, decline in physical activity (PA) is associated with decreased quality of life. To determine the prevalence and the associated factors of low PA in the elderly. All participants of the Amirkola town aged ≥60 years were studied. Data were collected for demographics, clinical and biochemical parametes. PA was determined by using physical activity scale for the elderly (PASE) questionnaire. In statistical analysis the study population was classified as normal or low PA defined as PASE score

Neurodegenerative diseases (NDs) are a diversity of neurological disorders characterized by the progressive degeneration of the structure and function of the central nervous system (CNS). The most common NDs are Alzheimer's disease (AD), Parkinson's disease (PD), and Huntington's disease (HD). Recently, many studies have investigated associations between common NDs with noncoding RNAs (ncRNAs) molecules. ncRNAs are regulatory molecules in the normal functioning of the CNS. Two of the most important ncRNAs are microRNAs (miRNAs) and long noncoding RNAs (lncRNAs). These types of ncRNAs are involved in different biological processes including brain development, maturation, differentiation, neuronal cell specification, neurogenesis, and neurotransmission. Increasing data has demonstrated that miRNAs and lncRNAs have strong correlations with the development of NDs, particularly gene expression. Besides, ncRNAs can be introduced as new biomarkers for diagnosis and prognosis of NDs. Hence, in this review, we summarized the involvement of various miRNAs and lncRNAs in most common NDs followed by a correlation of ncRNAs dysregulation with the AD, PD, and HD.

Clusterin (CLU) is the third most important associated risk gene in cognitive disorders. Regarding the controversy about the association of CLU rs11136000 with mild cognitive impairment (MCI), the aim of this study was to investigate a putative association of CLU rs11136000 with MCI as well as the serum biological factors with a special attention to the age as a main dimension of a multifactorial elderly disease in an Iranian elderly cohort in which the mentioned association was not previously investigated. The study also checked the association between diabetes and MCI in this population. A population of 418 individuals containing 236 MCI and 192 control subjects was recruited from the Amirkola health and aging population cohort. Serum biological indexes were assessed by biochemical and enzyme-linked immunosorbent assay, and rs11136000 genotyping was performed using polymerase chain reaction-restriction fragment length polymorphism. Bioinformatics analyses were used to identify the putative effect of rs11136000 on the secondary structure of RNA and chromatin location in different cell lines and tissues. Type 2 diabetes was present with a higher proportion in the MCI group in comparison with the control group (P = 0.041). The frequency of the C allele of CLU rs11136000 was significantly different between cases and controls and was associated with MCI risk (OR 1.79, P = 0.019). Under a dominant genetic model, the CC genotype showed a predisposing effect in individuals aged ≥ 75 years (OR 3.33, P = 0.0004). Interestingly, under an over-dominant model, the CT genotype had a protective effect in this population (OR 4.52, P = 0.0001). We also found a significant association between the genotypes and high-density lipoprotein (HDL) levels in MCI patients (P = 0.0004). Bioinformatics analysis showed that rs11136000 is located in the transcribed region without any regulatory features such as being enhancer or insulator. Also, the TC transition of CLU rs11136000 could not cause significant mRNA folding (P = 0.950). Contrary to other studies on Asian populations, this study demonstrated an association between rs11136000 and MCI in an elderly Iranian population. This study also suggests that an age-dependent approach to the previous studies may be performed in order to revise the previous belief in this geographical area. The rs11136000 genotypes in combination with HDL levels and knowledge about diabetes background may be used as a predictive medicine tool for cognitive disorders.

Background Falls are a major health issue in the elderly people and an important cause of bone fracture. The aim of this study was to determine the association between quadriceps muscle strength (QMS) and falls in the elderly subjects. Methods All eligible participants of the Amirkola Cohort Study entered the study. Data regarding demographic characteristics, clinical and laboratory examinations were provided between 2011 to 2014. Occurrence of falls during previous year was determined by interview and review of the medical records. The study patients were divided into low, moderate and high muscle strength groups according to QMS values ≥ 30, 15–30, and 70 years old. Compared to group with QMS ≥ 30 kg, the prevalence of falls in low and moderate QMS groups increased by OR = 3(95% CI, 1.78–5.05) and 2.18 (95% CI, 1.22–3.42) respectively. Conclusion These findings indicate that older subjects with lower QMS are at greater risk of falls. These findings provide a rational for muscle strengthening exercise in older people.

Background: Parkinson’s disease is a neurodegenerative disorder more commonly seen in people aged over 50 years old. The etiology of the disease is unknown, yet the impact of factors, such as vitamin D as a hormone on Parkinson's disease has been demonstrated in previous studies. Objectives: The aim of the current study was to investigate the role of low levels of this factor on the severity and duration of the disease. Methods: In 2015 to 2016, the current researchers conducted this case-control study on 50 patients with Parkinson's disease and 50 healthy subjects as the control group in Babol, Iran. Demographic information (age, gender, and education), serum levels of vitamin D in the two groups, disease duration, disease severity, and cardinal features of the disease in the patient group were investigated. Data were analyzed using the SPSS 23 software with the t-test, Kruskal Wallis, Mann-Whitney, and adjusted logistic regression. Results: The mean serum vitamin D levels was 27.28 ± 27.75 (ng/mL) and 32.00 ± 17.76 (ng/mL) in patient and control groups, respectively (P = 0.009). In terms of the duration of the disease, 34 (68%) patients had the disease for less than five years, nine (18%) for five to ten years and seven (14%) for more than ten years. The duration was significantly higher in females (P = 0.001). Logistic regression analysis with adjusted demographic variables showed that the observed lower levels of serum vitamin D in cases compared with the control group was statistically significant (OR = 4.17; 95% CI: 1.37, 12.71; P = 0.012). Conclusions: There was a significant relationship between low serum vitamin D levels and the duration and severity of Parkinson's disease in patients under 60 years of age.

Background. Stroke is the second leading cause of death worldwide. The role of zinc as a new predictor of stroke was considered. Methods. This prospective study was conducted in Ayatollah Rouhani Hospital within a year on 100 stroke and 100 control patients. Findings. The difference in zinc serum level in two groups was significant (deficiency: 3 (3%) in patients versus 20 (20%) in control group, normal: 25 (25%) versus 54 (54%), and increased level: 72 (72%) versus 26 (26%); p<0.001). Difference in zinc serum levels was statistically significant with ischemic heart disease (deficiency: 0 cases (0%), normal: 8 cases (24%), increased level: 24 cases (75%), p=0.003). Increases in zinc serum level were significantly correlated with the frequency of hemorrhagic and ischemic patients (deficiency: 3 (3.3%) hemorrhagic versus 0 (0%) ischemic; normal: 19 (21%) versus 6 (60%), increased level: 68 (75.6%) versus 4 (40%); p=0.025). Regression logistics showed that ischemic heart disease (p<0.001; OR = 28.29, %95 CI: 5.53; 144.87), hyperlipidemia (p<0.001; OR = 0.26, %95 CI: 0.12; 0.56), and zinc serum level (p<0.001, OR = 15.53, %95 CI: 4.03; 59.83) each had a significant role. Conclusions. Babol stroke patients are prone to increased zinc serum level as a new parameter. Ischemic heart disease, increased levels of zinc, and hyperlipidemia were found to be probable predictor factors for stroke in Babol.

Introduction. Stroke is one of the most common neurological disorders with high mortality rates. A large financial burden is imposed on the families and health systems of countries in addition to the problems related to the disabilities caused by the disease for the patients. Extensive research is being conducted on the disease, including studies seeking possible relationships between some biomarkers such as uric acid and stroke. Methods. This descriptive-analytic cross-sectional study was conducted on 170 stroke patients at Babol Ayatollah Rohani Hospital during 2015-2016. Serum uric acid (SUA) levels were measured and recorded at admission time. Patients’ demographic data as well as the stroke type and some of their risk factors were entered in a checklist. The data were analyzed by SPSS.v.23 using chi-square and logistic regression tests. P<0.05 was considered as significant in all analyses. Results. Of the total 170 included patients, 57% had normal, 25% had low, and the remaining patients (18%) had high SUA levels. There was no significant difference in SUA levels in different types of stroke in both genders. Diabetic ischemic embolic patients had higher levels of SUA than diabetic ischemic thrombotic cases. Patients with low magnesium levels had higher rate of low levels of SUA in ischemic stroke. Conclusion. Serum uric acid levels are not associated with stroke types and gender. Diabetic embolic ischemic stroke cases had high SUA levels than thrombotic types and in ischemic stroke patients with low serum levels of magnesium, SUA levels were also lower.

Background: Syncope is a common clinical problem which can be remarkably debilitating and associated with high health care costs. Syncope is a clinical syndrome with many potential causes. The aim of the study was to determine the etiologies of patients with syncope in the emergency department (ED) of a referral and general university hospital. Methods: One hundred sixty-five consecutive patients aged more than 18 years old with syncope were admitted to the emergency department of Ayatollah Rouhani Hospital. Initially organized, systematic approach included detailed medical history and structured questionnaires for history taking, physical examination, ECG and cardiac monitoring, cardiology and neurology were done. Advanced diagnostic tests were carried out if the etiology of syncope remained unexplained. Results: Out of the 165 patients who presented to the ED between February 2012 and February 2013, 124 had definition of syncope. The mean age of male patients was 59.5±19.8, 58. The etiology of syncope was diagnosed in 104 (83%) patients. Neurocardiogenic syncope was found in 36 (29.03%) patients, cardiac arrhythmias in 40 (32.25%) patients, and acute coronary syndrome in 8 (6.45%) patients. There are some infrequent etiologies like intracranial hemorrhage in 5 patients, aortic stenosis in 4 patients, hypertrophic cardiomyopathy and aortic dissection in 3 patients, Brugada and pulmonary embolism in 2 patients and carotid hypersensitivity in one patient. Conclusion: We found that cardiac arrhythmias and neurocardiogenic type are the frequent causes of syncope. In about one-sixth of the patients, no etiology was found. Approximately one-third of patients had traumatic syncope.

Background: Stroke is the most common neurologic disease and an important cause of morbidity and mortality. Headache is an initial presenting feature of ischemic stroke and sometimes preceedes the development of stroke and thus, provides an opportunity for offering preventive measures. The aim of the present study was to determine the association of new onset headache with stroke. Methods: A total of 263 consecutive patients with stroke entered the study. Development of headache 24 have prior to admission lasting

Background Stroke is the second leading cause of death worldwide and is associated with several risk factors with variable risk factor distribution by population. We report the types and frequency of the associated factors of stroke in north Iran. Methods Consecutive patients with stroke were recruited from 2014 to 2015. The two groups of ischemic and hemorrhagic stroke were compared with respect to age, sex, the prevalence, and distribution of the risk factors. Results Among 230 patients (84.3% ischemic stroke) with mean age of 61.2 years, hypertension (73%), diabetes mellitus (53%), cardiovascular disease (51%), and dyslipidemia (47%) were the most frequent risk factors. Hypertension was significantly more prevalent in males compared with females (88% vs. 60%, OR = 4.91, 95% CI: 2.48–9.71). Hypertension, smoking, and opioid consumption were associated with hemorrhagic stroke. Dyslipidemia was significantly higher in ischemic stroke (OR = 2.65, 95% CI: 1.21–5.8). Overall, 84.3% of stroke occurred in patients aged >50 years (92.8% of women vs. 74.5% of the men, OR = 4.43, 95% CI: 1.93–10.16, p = 0.001). Conclusion Stroke was more prevalent in females; hypertension was more prevalent in males. In the age group less than 50 years old, stroke is more prevalent in men.

Background and Purpose. Due to the high prevalence of Parkinson’s disease (PD) in the elderly, a large financial burden is imposed on the families and health systems of countries in addition to the problems related to the mobility impairment caused by the disease for the patients. Studies on controversial issues in this disease are taken into consideration, and one of these cases is the role of serum homocysteine level in Parkinson’s patients. In this study, the serum level of homocysteine and its association with various variables in relation to this disease was compared with healthy individuals. Materials and Methods. In this study, 100 patients with PD and 100 healthy individuals as control group were investigated. Serum homocysteine level and demographic and clinical data were included in the checklist. Data were analyzed by SPSS version 23. In all tests, the significance level was below 0.05. Results. The mean level of serum homocysteine in case and control groups was 14.93 ± 8.30 and 11.52 ± 2.86 µmol/L, respectively (95% CI: 1.68; 5.14, P<0.001). In total patients, 85 had normal serum homocysteine level, while 15 had high serum homocysteine level. In controls, the homocysteine level was 98 and 2, respectively (P=0.002). In multivariate logistic regression analysis, serum homocysteine level higher than 20 µmol/L was accompanied by 8.64-fold in Parkinson’s disease involvement (95% CI: 1.92; 38.90, P=0.005). Conclusion. Increasing serum homocysteine level elevates the rate to having PD. Serum homocysteine levels did not have any relationship with the duration of the disease, type of cardinal manifestation, and the severity of Parkinson’s disease.

Background: Stroke is the leading cause of serious long-term disability. In recent studies hyponatremia as a risk factor for stroke.Methods: This cross-sectional descriptive study was to evaluate serum zinc level in serum sodium over the first 24 hours after the onset of stroke. Different intensities were determined on Stroke Scale NIH (National Institute of Health) (mild 4-1) and (average moderate 15-5) and (moderate to severe 20-16) and (extreme severe 42- 21). Determination intensity of stroke after admission and discharge with Modified Rankin Scale and Barthel index. Blood serum concentrations of sodium 0.5 mL of venous blood were taken and sodium serum level was performed with Latex particle agglutination test in Ayatollah Rouhani Hospital. That normal range was defined 136-146 meq / LFindings: 125 patients were entered into this study; the prevalence of hyponatremia in female was 70% vs 60% in male. Of stroke patients included in this study 66% of them had hyponatremia and the frequency of hyponatremia in ischemic and hemorrhagic was 82% and 63%, respectively. Increase in hyponatremia with disability period of admission had statistically significant (10(12) mild vs 40(32) moderate, 32(25.6) severe, p=0.01) also with disability before discharge (24(19.2) mild, 26(20.8) moderate, 32(25.6) severe, p=0.03).Conclusions: Hyponatremia can effect on severity of the stroke and can be considered as a predictor of increased stroke severity and disability at admission and discharge.

Background and Purpose: Stroke is the second leading cause of death worldwide. The role of zinc as a contributing factor in the pathogenesis of stroke was considered.Results: This cross-sectional study on 100 stroke patients in Ayatollah Rouhani Hospital and 100 control group from cohort master plan "Ageing and health projects Amirkola was conducted. Zinc levels Serum simultaneously with other blood tests in the early hours of hospitalization. Zinc serum level was defined 70 to 120 micrograms per deciliter.Findings: The difference in mean of zinc level in patients and control group was not significant (102.6±47.7 in control group vs 100.9±35.8 in patient, p=0.7). Difference in zinc Serum level had statically significant with IHD (under70 0 cases (0), 70 to120 8 cases (24), 120 and upper24 cases (75), p=0.003) and with type of stroke (under70 (3(3.3) hemorrhagic vs 0(0) ischemic), 70 to 120(19(21) vs6 (60)), 120 and upper68 (75.6) vs4 (40), p=0.025) and also with patient and control group (under70 (3(3) in patient's vs 20(20) control group), 70 to 120(25(25) vs54 (54)), 120 and upper72 (72) vs26 (26), p

Background Myocardial infarction (MI) and stroke are the second and third leading causes of death in the world. By identifying the risk factors we can take the necessary measures to prevent the occurrence of these diseases. Methods In this retrospective study, 90 MI patients and 90 stroke patients 15 - 45 year admitted to hospitals of Babol University of Medical Sciences that randomly arranged by the time of hospitalization conducted. Demographics, laboratory test and risk factors were collected using check list. The data analyzed with McNemar and Npar tests by using SPSS 21 version software. Results The most common risk factor in young patient was a history of cerebrovascular disease that in stroke was 31 cases (34%) And in MI was 33 cases (37%). History of cerebrovascular disease with MI was significant 33 (37%), 57(63%), P = 0.047). A history of cardiovascular disease with stroke was significant (20 (22%), 70 (68), P = 0.001). A history of addiction with MI was significant (23 (26%), 67 (74%), P < 0.001). In stroke patients 52 cases (% 57) low-density lipoprotein (LDL) was high and in 66 cases (73.1%) high-density lipoprotein (HDL) was low. In patients with MI in 46 patients (51%) LDL was high and the 66 patients (73%) HDL was low. Conclusions Young peoples with a history of cerebrovascular, cardiovascular disease and addictions should be considering as target society. Primary health care system must identify high-risk individuals, and policy barriers that prevent implementation of programs to lower death rate.

Introduction/Background An important cause of bone fractures and a major health issue in the elderly people is falling. The aim of study was to determine association quadriceps muscle strength (QMS) with falling and the prevalence of falls in the elderly subjects. Material and method All participants of the Amirkola Cohort Study entered the study. Data regarding demographic characteristics, clinical and laboratory examinations were provided from the database. Occurrence of falls during previous year was determined by interview and review of medical records. The QMS was determined by dynamometry method. The participants were classified according to QMS values to high, moderate and low groups (QMS values > 30, 15–30, and Results A total 1028 patients and controls with respective with mean age of 69.8 ± 7.7 vs. 67.9 ± 7.7 years old (P = 0.001) were analyzed and 178 (17.3%) patients experienced fall. Individuals with falls had higher age (P = 0.001) and lower QMS value (P = 0.001). After adjustment for all clinical and demographic variables the association of falls remained at significant levels only for QMS and age > 70 years. Occurrence of fall was independently associated with QMS with a negative dose-response pattern of relationship. Compared with high QMS, prevalence of fall increased by 2.18 (95% CI: 1.22–3.42) in moderate group and by 3 (95% CI: 1.78–5.05) in low QMS group. Conclusion These findings indicate that occurrence of falls in older adults are negatively associated with QMS and positively with age > 70 years. These issues suggest a beneficial effect for muscle strengthening exercise.

Background: Headache and depression are prevalent among general population. The aim of this study was to determine the associated factors of headache in elderly subjects with emphasis to depression. Methods: All cohort of elderly individuals of the Amirkola Health Study Project were included. Data regarding several clinical and demographic characteristics were provided via fill in quesstionnaire, interview and clinical examination. Presence and duration as well as severity of headache were collected through an interview based on self-reported data. Diagnosis of depression was confirmed according to standard Geriatric Depression Scale (GDS) criteria. In statistical analyses chi-square test with logistic regression analysis was used for association. Results: A total of 832 men and 667 women aged >/= 60 years old were studied. Headache and depression were diagnosed in 42% and 42.4% respectively. In depressed subjects, headache was significantly higher by OR=3.1(95% CI, 2.5-3.83, P=0.001). Proportions of headache increased by severity of depression with a dose-response pattern of relationship from 53.3% in mild depression to 72.6% in severe depression. The magnitude of OR for headache increased from 2.59 (95% CI, 2.03-3.31) in patients with mild depression to 6.04 (95% CI, 3.54-10.3) in patients with severe depression. After adjustment for all covariates, headache was significantly associated with female gender and back pain as well as with depression with a significant dose-response relationship. Conclusion: The findings of this study indicated an independent association between headache and psychological factors in elderly subjects, particularly in women.

Background: Syncope is a common clinical problem which can be remarkably debilitating and associated with high health care costs. Syncope is a clinical syndrome with many potential causes. The aim of the study was to determine the etiologies of patients with syncope in the emergency department (ED) of a referral and general university hospital. Methods: One hundred sixty-five consecutive patients aged more than 18 years old with syncope were admitted to the emergency department of Ayatollah Rouhani Hospital. Initially organized, systematic approach included detailed medical history and structured questionnaires for history taking, physical examination, ECG and cardiac monitoring, cardiology and neurology were done. Advanced diagnostic tests were carried out if the etiology of syncope remained unexplained. Results: Out of the 165 patients who presented to the ED between February 2012 and February 2013, 124 had definition of syncope. The mean age of male patients was 59.5±19.8, 58. The etiology of syncope was diagnosed in 104 (83%) patients. Neurocardiogenic syncope was found in 36 (29.03%) patients, cardiac arrhythmias in 40 (32.25%) patients, and acute coronary syndrome in 8 (6.45%) patients. There are some infrequent etiologies like intracranial hemorrhage in 5 patients, aortic stenosis in 4 patients, hypertrophic cardiomyopathy and aortic dissection in 3 patients, Brugada and pulmonary embolism in 2 patients and carotid hypersensitivity in one patient. Conclusion: We found that cardiac arrhythmias and neurocardiogenic type are the frequent causes of syncope. In about one-sixth of the patients, no etiology was found. Approximately one-third of patients had traumatic syncope.

This retrospective descriptive analytical study was performed on 250 patients (130 males and 120 females) diagnosed to have stroke in the Department of Neurology, Babol, Iran, from April 2001 to April 2003.The risk factors for stroke were recorded. The frequencies of hypertension, diabetes mellitus, cardiac diseases and hyperlipidemia were 54, 24, 43.2 and 26%, respectively. All these epidemiological factors were associated with stroke (p < 0.05). The incidence of stroke was 50/100,000 population during 2 years. It happened more often in females than males, and ischemic stroke (67%) was twice as frequent than hemorrhagic stroke (33%). The mortality rate was 32%. The most common epidemiological risk factors for stroke in our region were hypertension, cardiac diseases and diabetes mellitus.

Background: Stroke is the third leading cause of death worldwide. Data on the epidemiology of stroke, patterns and risk factors in recent years in our region are brief.Methods and Material: This retrospective study from 2014 to 2015 on stroke patients was conducted. The NIHSS, the MRS and the Barthel index were used at admission and discharge. Patient’s demographic data and checklist used to identify risk factorFindings: A total of 230 stroke patients, 122 (53%) was female. 194 patients (%84) was ischemic type vs 36(%16) hemorrhagic, P

Introduction. Non-motor symptoms (NMS) are common in Parkinson’s disease. It can be predominant as the disease advances, thereby constituting a major source of disease burden for patients. Current study was conducted to determine the prevalence of these symptoms in the north of Iran. Method. This cross-sectional study was performed on 109 patients with Parkinson’s disease in Ayatollah Rouhani Hospital in Babol, North of Iran, during 2017-2018. NMS were obtained from a NMS standard questionnaire containing 30 questions plus the clinical and demographic information in a separate checklist of patients. NMS were then classified into nine distinct categories. The association of NMS with clinical and demographic variables was evaluated by the SPSS software version 23. In all cases, the significance level of the tests was less than 0.05. Results. The mean age of the patients was 70.59 ± 9.69 years (46-97 years) and 61 (56%) were male. The duration of the disease was 5.61 ± 4.89 years. NMS associated with sleep / fatigue with the prevalence of 76.1% were the most prevalent symptoms. NMS related to mood / cognition with frequency of 65.1%, cardiovascular with 51.4% and miscellaneous with 51.4% frequency were the most commonly reported symptoms in patients. Severity of the disease was significantly correlated with the symptoms of the cardiovascular, attention / memory and GI tract (P = 0.001). Age and education of the patients with cardiovascular symptoms and attention / memory had a significant relationship (P < 0.05). Occupation and marriage of the patients were significant with attention/memory symptoms (P < 0.05). Conclusions. The sleep-related symptoms and fatigue were the most common NMSs in Parkinson’s patients. Also, the severity of the disease and ageing were statistically significant with the prevalence of the NMS in patients. Therefore, consideration should be given to older patients suffering from more severe Parkinson’s disease.

Background. Epilepsy is caused by frequent generation of excitatory impulses in different part of the brain and it would affect different aspects of quality of life in these patients.The present study was conducted to evaluate the quality of life and diverse Confounding Factors in epileptic patients. Methods. This Descriptive-analytical study was performed in 2017 with a simple random sampling method on 150 patients with epilepsy who admitted to the neurology department of Rouhani hospital of Babol. We used Patient Weighted Quality Of Life In Epilepsy (QOLIE-31-P) questionnaire. All statistics were carried out using SPSS v21.0 and P