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Mohammad Reza Amiri-Nikpour
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Medicine & Pharmacology

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Investigating the Effect of Atorvastatin in Preventing Ventilator Associated Pneumonia among Patients with Cerebral Ischemia Hospitalized in ICU in Imam Khomeini Hospital in Urmia City Mohammad Reza Amiri-Nikpour
Journal of Global Pharma Technology .
Publisher : Journal of Global Pharma Technology

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Introduction:  ventilator associated pneumonia is one of the main reasons of death in patients under ventilator, especially those with impaired consciousness hospitalized in intensive care unit (ICU). Having anti-apoptotic, antioxidant, and immunomodulatory effects, atorvastatin can be effective in preventing pneumonia in patients with stroke who are under ventilator, while it is also prescribed to reduce cholesterol and accelerate recovery process in ischemia cases. The present study aims at investigating the preventive effects of atorvastatin on ventilator associated pneumonia among patients who suffer from stroke and are under the ventilator. Methodologies in the present study, 60 patients hospitalized in ICU unit under ventilator following an ischemic attack were divided to two groups of 30. The treatment group received a daily 40-mg dose of atorvastatin, while the control group didn’t. Then the occurrence of pneumonia was extracted for both groups during at least 14days of hospitalization, and the results were analyzed using SPSS20 software. Results the results of the study indicated that the amount of occurrence of pneumonia among patients treated by 40 mg atorvastatin was significantly lower than the patients in control group. Therefore prescribing daily 40 mg atorvastatin for the patients with ischemia in ICU unit who are incubated and are under mechanical ventilation would reduce ventilator associated pneumonia significantly. Conclusion atorvastatin has a significant reducing effect on occurrence of ventilator associated pneumonia in patients suffering from ischemic stroke in ICU unit, who are incubated and under mechanical ventilation, which will be proved clinically in the present study. Keywords: ventilator associated pneumonia, Cerebral ischemia, Atorvastatin. 
Evaluation of Risk Factors affects Length of Hospitalization in Patients with Transient Ischemic Attack or Ischemic Stroke Mohammad Reza Amiri-Nikpour
Journal of Global Pharma Technology .
Publisher : Journal of Global Pharma Technology

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Introduction: Cerebral artery diseases are the most prevalent neural disorder leading to serious diseases and death. Stroke is the third cause of death in the U.S. and is the most prevalent neurological disabling disease. This study aims to evaluate the influential factors of the duration of hospital stay in transient ischemic attack (TIA) or ischemic stroke   patients. Method of study This is re retrospective study. The population of study consists of all patients diagnosed as TIA or ischemic stroke who admitted in the neurology department of Urmia Imam Khomeini hospital from August, 2014 to August 2015. Data was collected from the cases’ records and analyzed using SPSS 22.\0 results A total number of 349 TIA and ischemic stroke cases was included in the study of whom, 322 (95.1%) and 17 (4.9%) cases were diagnosed and studied as ischemic stroke and TIA cases, respectively. In 258 cases (73.9%), the involved area was anterior circulation while in 91 cases (26.1%), it was posterior circulation. Considering relevant risk factors, hypertension with 212 cases (60.7%) was the most frequent risk factor followed by past medical history of stroke in 115 cases (33%), congestive heart failure in 113 cases (32.4%), diabetes mellitus in 86 cases (24.4%) and smoking in 72 cases (20.6%), respectively. Conclusion: According to our results, AF rhythm and anterior circulation involvement apparently affects the duration of hospital stay and increases it. This agrees with medicinal literature where AF has been introduced as a risk factor for cerebral embolic diseases and can be considered as a cause of TIA or ischemic stroke.  Keywords: Duration of hospital stay, Ischemic brain stroke, TIA.
Comparison of the Changes of D-Dimer and FDP Serum Levels in Ischemic Brain stroke Patients with and without Malignancy Mohammad Reza Amiri-Nikpour
Journal of Global Pharma Technology .
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Introduction: Cerebral artery diseases are the third cause of death in the U.S. proceeded only by the heart diseases and cancer. It is the most prevalent neurological disorder leading to illness and death. Stroke is a syndrome characterized by the initiation of acute neurological disorders lasting at least for 24 hours. It reflects the focal involvement of central nervous system induced by blood circulation disorders in brain. This study was designed to study D-Dimer and FDP serum levels in ischemic brain stroke patients with and without malignancy. Method of study: This is a randomized clinical trial in the form of a case-control study. The population of study consists of all cases admitted in the neurology department of Imam-Khomeini Hospital in Urmia who included in the study via randomized allocation after obtaining their consent. Cases with underlying malignancy were grouped in case group and those with no malignancy were grouped in control group. Results: In this study, 60 and 120 cases were studied in the case and control groups, respectively. There was a significant difference in mean D-Dimer (P=0.01), mean FDP (P=0.02), mean ESR (P=0.01) and mean CRP (P=0.01) between case and control groups. Lung cancer was the most prevalent cancer (31.7%) in the case group. In addition, diabetes mellitus, hyperlipidemia and hypertension risk factors were reported in the case group with a frequency of 28.3%, 33.3% and 30%, respectively. Conclusion: In patients with ischemic stroke and malignancy, the serum levels of D-dimer and ESR was elevated and risk factors such as DM, HLP, and HTN had a high rate in these patients, so in patients with cancer, occurrence of cerebral ischemia is higher compared to patients without malignancy. So knowing mechanisms, type and stage of cancer is critical for survival of these patients.Keywords: Diabetes mellitus, D-Dimer, ESR, Hyperlipidemia, Hypertension, Ischemic stroke.
Effect of Atorvastatin on Cerebral Vasomotor Reactivity in Patients with Ischemic Stroke Mohammad Reza Amiri-Nikpour
Journal of Global Pharma Technology .
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Background and Objectives: statins are effective in the prevention of atherosclerotic plaques formation. According to the observed effects of statins in improving regional blood flow and their protective role against brain stroke, it seems that some of these effects are involved in improving the cerebrovascular reactivity in patients. The objective of this study was to evaluate the effect of statins on cerebrovascular reactivity in patients with ischemic stroke. Methods: This study is a single-blinded randomized clinical trial conducted on 180 patients referred to Imam Khomeini Hospital of Urmia in Iran. The patients were hospitalized due to ischemic stroke and they were included in study based on inclusion and exclusion criteria. Then, they were randomly assigned into control and intervention groups. Intervention group patients, in addition to receiving common drug treatments, were treated with daily atorvastatin 80 mg for three consecutive months and their cerebrovascular reactivity was measured and compared on the arrival, seventh and ninetieth days by Transcranial Doppler(TCD). Finally, results were analyzed using spss20 software. Results: In this study, 180 patients with ischemic stroke were examined, which some of them were excluded from study due to lack of referring for follow-up or death after study. Finally, 75 patients were assigned to intervention group and 72 of them were included in control group. The mean of variables Breath holding index (BHI) and Apnea Mean flow velocity(MFV) in patients of intervention group increased significantly compared to the that in patients of control group (P = 0.049, P = 0.003). According to the results, the difference in increase of mentioned variables in the seventh day, and especially in the ninetieth day, after taking atorvastatin was more prominent, which it can be justified by mechanism of drug. Rest MFV patients in any of the two groups showed no significant difference, which suggests lack of the drug effect on the Rest MFV patients. Conclusion: This study found evidence of significant improved cerebrovascular reactivity of patients after taking Atorvastatin, which this process is independent from benefits caused by reduced blood fat following taking statins and it is created as result of self-regulation improvement of endothelial nitric oxide synthase enzyme.Keywords: Stroke, Atorvastatin, Cerebrovascular reactivity, BHI.
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