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Articles by S.E.M. Nejad
Total Records ( 3 ) for S.E.M. Nejad
  S.E.M. Nejad , M.R.A. Nikpour , F. Rahim , S.N. Naghibi and M.A. Bahrammi
  The aim of this study was to evaluate the efficacy and tolerability of lamotrigine and valproate in patients with different types of generalized epilepsy characterized by myoclonic seizures as well as compare the efficacy of those two drugs. A pilot, randomized controlled trial analysis of 46 female patients (age 8-30 years) in a large university hospital. All patients underwent several interictal EEG including routine awake and sleep EEGs. Lamotrigine was started at the dose of 500 mg day-1 and was progressively increased to a mean dose of 1500-2000 mg day-1 in a time course of 8 weeks. The target maintenance dose for valproate was 800 mg day-1 after starting valproate at the dose of 200 mg/12 h. The mean dose was reached within 4 weeks. Out of total 46 patients, 46 (100%) had juvenile myoclonic epilepsy; 43 (93.48%) had tonic-clonic; 5 (11%) had myoclonic absences. In the valproate and lamotrigine groups, there was significant reduction (p<0.001, p<0.001) in myoclonic seizure and tonic-clonic seizure frequencies. There was no clinically significant difference (p>0.05) between the effect of those two drugs that means the lamotrigine and valproate have similar effect in reducing the myoclonic seizure and tonic-clonic seizure frequencies. There was statistically significant effect (p<0.05) of those two drugs that means the lamotrigine and valproate also have significant effect in reducing the absences seizure frequency. The results suggest that lamotrigine monotherapy is a possible alternative for valproate among patients with juvenile myoclonic epilepsy who experienced unaccepted side effects or inadequate seizure control with valproate monotherapy.
  R. Bavrasad , N. Sharaf al-Din Zadeh , S.E.M. Nejad , N.M. Nasab and F. Rahim
  This study was accompanied due to high mortality and morbidity in these patients trying to find more useful treatment. A total 54 patient with ICH Next to stroke referred to Ahwaz Golestan hospital from Jul 2008 to 2009 were selected. Patients were randomly assigned to receive a single intravenous dose of 40 μg kg -1 of rFVIIa or placebo. The performance by a clinical neurologist and based on the international ranking (Rankin's scale) on the first day of hospitalization and 90 days after discharge was evaluated. There was no significant difference in mean arterial blood pressure between placebo and patient groups. Percentage increase in both the second day of bleeding volume in the patient and placebo groups was 2.35 and 0.35%, respectively. The total difference between the first day and third day in the patient and placebo group was -7.76- and -2.99%, respectively. Patients with MAP value of more than 120 mmHg, showed a significant response to rFVIIa treatment. Recombinant activated factor VII has the potential to limit or even halt the progression of bleeding in brain hemorrhagic patients that would otherwise place growing pressure on the brain. As such, these data suggest that the use of rFVIIa holds promise in the setting of non-surgical intracranial bleeding. Whether this usage will have a positive impact on the neurological outcome lies in a future prospective clinical trial whose planning is underway.
  R. Bavrasad , S.E.M. Nejad , A.R. Yarahmadi , S.I. Sajedi and F. Rahim
  This randomized-double-blind aimed to show the effect of middle dose of topiramate and monitor the sodium valproate as a treatment quite acceptable in migraine prophylaxis as well as compare health and treatment effects in reducing both frequency and the severity of headache. Seventy-three females patients filled questionnaire based on the migraine disability assessment score (MIDAS) in the beginning and end of the study. Frequency, severity, duration of headache attacks and symptoms of drug in each of the patients are listed in his file. The effects of middle dose of topiramate (50-75 mg) and sodium valproate (400-600 mg) in the prevention of migraine headache was compared. Out of the 73 patients three cases were excluded due to unwanted and adverse events. Although, both drugs have been successful in reducing headache frequency more than 50% within the study, but there was no significant difference. The MIDAS score in topiramate group reduced more than the group receiving valproate sodium, which indicates changes, was statistically significant in both groups before treatment. The most common complications recorded in the group receiving topiramate were, paresthesia followed by weight loss, drowsiness and dizziness in topiramate group. While, the most common complications recorded in the group receiving sodium valproate were, drowsiness, weight gain, hair loss, nausea and Tremor. This trial demonstrates that topiramate significantly reduced mean monthly migraine and was a safe and well-tolerated preventive therapy in this group of subjects with migraine, a therapeutic area in which profound clinical needs exist.
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