Zahra Mirzaasgari - Academia.edu (original) (raw)
Papers by Zahra Mirzaasgari
International Journal of Stroke
Background: Adenovirus-based COVID-19 vaccines are extensively used in low- and middle-income cou... more Background: Adenovirus-based COVID-19 vaccines are extensively used in low- and middle-income countries (LMICs). Remarkably, cases of cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) have rarely been reported from LMICs. Aims: We studied the frequency, manifestations, treatment, and outcomes of CVST-VITT in LMICs. Methods: We report data from an international registry on CVST after COVID-19 vaccination. VITT was classified according to the Pavord criteria. We compared CVST-VITT cases from LMICs to cases from high-income countries (HICs). Results: Until August 2022, 228 CVST cases were reported, of which 63 were from LMICs (all middle-income countries [MICs]: Brazil, China, India, Iran, Mexico, Pakistan, Turkey). Of these 63, 32 (51%) met the VITT criteria, compared to 103 of 165 (62%) from HICs. Only 5 of the 32 (16%) CVST-VITT cases from MICs had definite VITT, mostly because anti-platelet factor 4 antibodies were often not test...
Beni-Suef University Journal of Basic and Applied Sciences
Background N-acetylcysteine (NAC) is a tolerable and safe drug capable of reducing free radicals ... more Background N-acetylcysteine (NAC) is a tolerable and safe drug capable of reducing free radicals and other oxidants. We included 74 individuals with ischemic stroke in this randomized, single-blind clinical trial and placed them into intervention (n = 37) and control (n = 37) groups. In the intervention group, in addition to standard treatment for ischemic stroke, they received NAC at a dose of 100 mg/kg bolus and then at a dose of 10 mg/kg/h for 10 h. The control group received only standard stroke treatment. Blood samples were taken before starting NAC and standard stroke treatment and 24 h after receiving the drug to measure the catalase, paraoxonase, malondialdehyde (MDA), neopterin, total antioxidant capacity (TAC), and total oxidant status (TOS) parameters. The National Institutes of Health Stroke Scale (NIHSS) was also calculated before and after 24 h, 2 weeks, 1 month, and 3 months after starting the drug. Results There was no significant difference between the results of pa...
European Journal of Neurology
Neurology Letters
This open-access article distributed under the terms of the Creative Commons Attribution NonComme... more This open-access article distributed under the terms of the Creative Commons Attribution NonCommercial 3.0 License (CC BY-NC 3.0) On behalf of our editorial board, editorial team, authors, reviewers, and supporting institutions-we warmly welcome you to the first issue of the Neurology Letters. This is the official journal of the Neurology department of the Firoozgar hospital, supported by the Iran University of Medical Sciences. Neurology Letters is a new Gold Open Access journal committed to publishing high-quality papers in the field of neurology.
BMC Endocrine Disorders
Objectives The goal of this study was to see whether there was a link between the monocyte/high-d... more Objectives The goal of this study was to see whether there was a link between the monocyte/high-density lipoprotein cholesterol ratio (MHR) and carotid intima-media thickness (CIMT) in people with type 2 diabetes. Methods Duplex ultrasonography parameters and demographic, physical, and paraclinical assessments were recorded. Using the t-test, the MHR and CIMT were compared between the two groups. Regression models were also constructed. Results A total of 118 diabetics and 126 non-diabetics were included in the cross-sectional research. According to the stated diabetes duration, the observed age difference of 7 years might be considered. The MHR and CIMT were not substantially different between the two groups. In the DM and non-DM groups, the Spearman correlations between MHR and CIMT were 0.32 and − 0.08, respectively (p-values = 0.001 and 0.379). Thus, regression models (stratified for DM/non-DM and male/female) revealed that the MHR is a significant predictor of CIMT, but only in...
We report two cases of previously healthy young men with COVID-19 infection who developed acute i... more We report two cases of previously healthy young men with COVID-19 infection who developed acute ischemic stroke due to large vessel occlusion followed by secondary events concerning for a further thromboembolic event. We hypothesize that the hypercoagulable state related to COVID-19 exacerbated the underlying hereditary thrombophilia due to MTHFR-gene mutation.
Journal of Iranian Medical Council
Background: Head injury is a silent epidemic in developed countries and is one of the leading cau... more Background: Head injury is a silent epidemic in developed countries and is one of the leading causes of death and disability. Determining the precise and early prognosis of head injury, especially in severe cases, is essential and will help define treatment actions and rehabilitation plans and counsel other family members. The purpose of this study was to determine the relationship between electroencephalographic findings and prognosis in patients with decreased levels of consciousness due to head injury. Methods: This is a retrospective descriptive-analytical study on patients with reduced levels of consciousness due to head injury, referred to Tir Hospital (Tehran) in the first half of 2018. Overall, 52 patients were studied and divided according to their GCS into two groups: favorable prognosis (30 patients, 57.7%) and poor prognosis (22 patients, 42.3%). We tried to find the relation between EEG findings such as voltage, electrographic seizures, periodic and rhythmic patterns, a...
Journal of Clinical Neuroscience
Iranian Journal of Medical Sciences, Jul 1, 2022
1Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical... more 1Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran; 2Firoozgar Clinical Research Development Center, Iran University of Medical Sciences, Tehran, Iran; 3Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran; 4Shefa Neuroscience Research Center, Khatam Alanbia Hospital, Tehran, Iran; 5Department of Neurology, Firoozgar Hospital, School of Medicine, Iran University of Medical Science, Tehran, Iran
Stroke
Background: Cerebral venous thrombosis (CVT) due to vaccine-induced immune thrombotic thrombocyto... more Background: Cerebral venous thrombosis (CVT) due to vaccine-induced immune thrombotic thrombocytopenia (VITT) is a severe condition, with high in-hospital mortality rates. Here, we report clinical outcomes of patients with CVT-VITT after SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination who survived initial hospitalization. Methods: We used data from an international registry of patients who developed CVT within 28 days of SARS-CoV-2 vaccination, collected until February 10, 2022. VITT diagnosis was classified based on the Pavord criteria. Outcomes were mortality, functional independence (modified Rankin Scale score 0–2), VITT relapse, new thrombosis, and bleeding events (all after discharge from initial hospitalization). Results: Of 107 CVT-VITT cases, 43 (40%) died during initial hospitalization. Of the remaining 64 patients, follow-up data were available for 60 (94%) patients (37 definite VITT, 9 probable VITT, and 14 possible VITT). Median age was 40 years...
Clinical Neurology and Neuroscience
HGPPS (horizontal gaze palsy with progressive scoliosis) presents in early childhood ages and one... more HGPPS (horizontal gaze palsy with progressive scoliosis) presents in early childhood ages and one of the cardinal manifestations of the syndrome, progressive scoliosis, is the main disabling feature which usually seeks for orthopedic correction surgeries in early years. Nevertheless, the presence of scoliosis has not been explained yet by the pathogenesis of the disease, the ROBO3 mutation, which is a well-known pathology for gaze palsy by failure of axonal decussation toward the pontomedullary junction. This article highlights a novel case of HGPPS with prominent extrapyramidal findings including torticollis, cervical dystonia and facial spasm along with classic clinical, imaging and genetic correlation. Aiming to investigate the prevalence of extrapyramidal signs in this syndrome, the published cases of HGPPS in the literature have been reviewed in this study. 32% of all HGPPS cases between years of 1975 to 2020 founded to have one or more extrapyramidal features and the dystonia was the most reported sign which even proceed to the presence of scoliosis. Regarding to the fact that the scoliosis could be as a consequence of axial dystonia, its relationship to ROBO3 mutation can be explained by structural and functional changes toward the brainstem and cerebellum, which are involved in this syndrome and known to contribute with the extrapyramidal system. Knowing this possibility, not only could solve the 35-year mystery of scoliosis in the syndrome, but also would be considered as a target of treatment to prevent scoliosis in the future.
Human Vaccines & Immunotherapeutics
Journal of vessels and circulation, Feb 10, 2021
Journal of the Neurological Sciences, Oct 1, 2019
^R esults Among 810 IDD patients, MOG-IgG1 was detected in 133 patients (16.4%): ON in 86(65%) of... more ^R esults Among 810 IDD patients, MOG-IgG1 was detected in 133 patients (16.4%): ON in 86(65%) of whom 38(33%) were recurrent; isolated TM in 26(19.5%) of whom 16(56%) were longitudinally extensive lesions; ADEM in 26(19.5%). Thirty-four patients (25.5%) fulfilled revised NMOSD diagnostic criteria. Eighty-eight percent received methylprednisolone alone or with subsequent plasma exchange or IVIG for acute attacks. Maintenance oral immunosuppressants were used in 63(45%). Relapsing disease was seen in 40% and annualized relapse rate was 0.36 with the median disease duration of 6 years. Eighty-seven percent of patients are currently walking unsupported, 51% had normal vision, 42% had mild visual impairment, and 7% had blindness in one eye but none in both. None had coexistent AQP4-IgG. Conclusions MOG-IgG-associated disorders account for one-sixth of IDDs in Sri Lankan patients. The most common phenotype is isolated ON followed by TM and ADEM. Relapsing disease was seen in almost half of such patients. The majority of patients had good outcomes.
Journal of the Neurological Sciences, Oct 1, 2019
Conclusion This study shows that tenecteplase before thrombectomy was associated with a high inci... more Conclusion This study shows that tenecteplase before thrombectomy was associated with a high incidence of reperfusion and appears to be effective in thrombolysis among patients with ischemic stroke.
Since the beginning of worldwide vaccination against coronavirus disease 2019 (COVID-19), studies... more Since the beginning of worldwide vaccination against coronavirus disease 2019 (COVID-19), studies have reported a possible association between vaccination and Guillain-Barré syndrome (GBS). In this regard, we conducted a systematic review assessing different demographic, clinical, and neurophysiological aspects of patients with GBS following immunization with COVID-19 vaccines. A comprehensive search of PubMed, Web of Science, Scopus, and Google Scholar was performed. Articles in English between January 2020 and November 2021 were included. Data on demographics, clinical characteristics, vaccines information, treatment approaches, and outcomes were extracted. The data of a total of 88 patients out of 41 studies was included. The mean age of patients was 58.7 ± 16.6 years and 55 cases (62.5%) were male. AstraZeneca was the most-reported vaccine associated with GBS with 52 cases (59.1%) followed by Pfizer with 20 cases (22.7%). GBS occurred after the first dose of vaccination in 70 ca...
A growing number of studies indicate a broad range of neurological manifestations, including seiz... more A growing number of studies indicate a broad range of neurological manifestations, including seizures, occur in patients with COVID-19 infection. We report a 29-yers old female with status epilepticus and positive SARS-CoV-2 in the cerebrospinal fluid. Our findings support previous reports suggesting seizure as a possible symptom of COVID-19 infection.
Annals of Medicine and Surgery, 2022
International Journal of Stroke
Background: Adenovirus-based COVID-19 vaccines are extensively used in low- and middle-income cou... more Background: Adenovirus-based COVID-19 vaccines are extensively used in low- and middle-income countries (LMICs). Remarkably, cases of cerebral venous sinus thrombosis due to vaccine-induced immune thrombotic thrombocytopenia (CVST-VITT) have rarely been reported from LMICs. Aims: We studied the frequency, manifestations, treatment, and outcomes of CVST-VITT in LMICs. Methods: We report data from an international registry on CVST after COVID-19 vaccination. VITT was classified according to the Pavord criteria. We compared CVST-VITT cases from LMICs to cases from high-income countries (HICs). Results: Until August 2022, 228 CVST cases were reported, of which 63 were from LMICs (all middle-income countries [MICs]: Brazil, China, India, Iran, Mexico, Pakistan, Turkey). Of these 63, 32 (51%) met the VITT criteria, compared to 103 of 165 (62%) from HICs. Only 5 of the 32 (16%) CVST-VITT cases from MICs had definite VITT, mostly because anti-platelet factor 4 antibodies were often not test...
Beni-Suef University Journal of Basic and Applied Sciences
Background N-acetylcysteine (NAC) is a tolerable and safe drug capable of reducing free radicals ... more Background N-acetylcysteine (NAC) is a tolerable and safe drug capable of reducing free radicals and other oxidants. We included 74 individuals with ischemic stroke in this randomized, single-blind clinical trial and placed them into intervention (n = 37) and control (n = 37) groups. In the intervention group, in addition to standard treatment for ischemic stroke, they received NAC at a dose of 100 mg/kg bolus and then at a dose of 10 mg/kg/h for 10 h. The control group received only standard stroke treatment. Blood samples were taken before starting NAC and standard stroke treatment and 24 h after receiving the drug to measure the catalase, paraoxonase, malondialdehyde (MDA), neopterin, total antioxidant capacity (TAC), and total oxidant status (TOS) parameters. The National Institutes of Health Stroke Scale (NIHSS) was also calculated before and after 24 h, 2 weeks, 1 month, and 3 months after starting the drug. Results There was no significant difference between the results of pa...
European Journal of Neurology
Neurology Letters
This open-access article distributed under the terms of the Creative Commons Attribution NonComme... more This open-access article distributed under the terms of the Creative Commons Attribution NonCommercial 3.0 License (CC BY-NC 3.0) On behalf of our editorial board, editorial team, authors, reviewers, and supporting institutions-we warmly welcome you to the first issue of the Neurology Letters. This is the official journal of the Neurology department of the Firoozgar hospital, supported by the Iran University of Medical Sciences. Neurology Letters is a new Gold Open Access journal committed to publishing high-quality papers in the field of neurology.
BMC Endocrine Disorders
Objectives The goal of this study was to see whether there was a link between the monocyte/high-d... more Objectives The goal of this study was to see whether there was a link between the monocyte/high-density lipoprotein cholesterol ratio (MHR) and carotid intima-media thickness (CIMT) in people with type 2 diabetes. Methods Duplex ultrasonography parameters and demographic, physical, and paraclinical assessments were recorded. Using the t-test, the MHR and CIMT were compared between the two groups. Regression models were also constructed. Results A total of 118 diabetics and 126 non-diabetics were included in the cross-sectional research. According to the stated diabetes duration, the observed age difference of 7 years might be considered. The MHR and CIMT were not substantially different between the two groups. In the DM and non-DM groups, the Spearman correlations between MHR and CIMT were 0.32 and − 0.08, respectively (p-values = 0.001 and 0.379). Thus, regression models (stratified for DM/non-DM and male/female) revealed that the MHR is a significant predictor of CIMT, but only in...
We report two cases of previously healthy young men with COVID-19 infection who developed acute i... more We report two cases of previously healthy young men with COVID-19 infection who developed acute ischemic stroke due to large vessel occlusion followed by secondary events concerning for a further thromboembolic event. We hypothesize that the hypercoagulable state related to COVID-19 exacerbated the underlying hereditary thrombophilia due to MTHFR-gene mutation.
Journal of Iranian Medical Council
Background: Head injury is a silent epidemic in developed countries and is one of the leading cau... more Background: Head injury is a silent epidemic in developed countries and is one of the leading causes of death and disability. Determining the precise and early prognosis of head injury, especially in severe cases, is essential and will help define treatment actions and rehabilitation plans and counsel other family members. The purpose of this study was to determine the relationship between electroencephalographic findings and prognosis in patients with decreased levels of consciousness due to head injury. Methods: This is a retrospective descriptive-analytical study on patients with reduced levels of consciousness due to head injury, referred to Tir Hospital (Tehran) in the first half of 2018. Overall, 52 patients were studied and divided according to their GCS into two groups: favorable prognosis (30 patients, 57.7%) and poor prognosis (22 patients, 42.3%). We tried to find the relation between EEG findings such as voltage, electrographic seizures, periodic and rhythmic patterns, a...
Journal of Clinical Neuroscience
Iranian Journal of Medical Sciences, Jul 1, 2022
1Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical... more 1Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran; 2Firoozgar Clinical Research Development Center, Iran University of Medical Sciences, Tehran, Iran; 3Gastrointestinal and Liver Diseases Research Center, Iran University of Medical Sciences, Tehran, Iran; 4Shefa Neuroscience Research Center, Khatam Alanbia Hospital, Tehran, Iran; 5Department of Neurology, Firoozgar Hospital, School of Medicine, Iran University of Medical Science, Tehran, Iran
Stroke
Background: Cerebral venous thrombosis (CVT) due to vaccine-induced immune thrombotic thrombocyto... more Background: Cerebral venous thrombosis (CVT) due to vaccine-induced immune thrombotic thrombocytopenia (VITT) is a severe condition, with high in-hospital mortality rates. Here, we report clinical outcomes of patients with CVT-VITT after SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) vaccination who survived initial hospitalization. Methods: We used data from an international registry of patients who developed CVT within 28 days of SARS-CoV-2 vaccination, collected until February 10, 2022. VITT diagnosis was classified based on the Pavord criteria. Outcomes were mortality, functional independence (modified Rankin Scale score 0–2), VITT relapse, new thrombosis, and bleeding events (all after discharge from initial hospitalization). Results: Of 107 CVT-VITT cases, 43 (40%) died during initial hospitalization. Of the remaining 64 patients, follow-up data were available for 60 (94%) patients (37 definite VITT, 9 probable VITT, and 14 possible VITT). Median age was 40 years...
Clinical Neurology and Neuroscience
HGPPS (horizontal gaze palsy with progressive scoliosis) presents in early childhood ages and one... more HGPPS (horizontal gaze palsy with progressive scoliosis) presents in early childhood ages and one of the cardinal manifestations of the syndrome, progressive scoliosis, is the main disabling feature which usually seeks for orthopedic correction surgeries in early years. Nevertheless, the presence of scoliosis has not been explained yet by the pathogenesis of the disease, the ROBO3 mutation, which is a well-known pathology for gaze palsy by failure of axonal decussation toward the pontomedullary junction. This article highlights a novel case of HGPPS with prominent extrapyramidal findings including torticollis, cervical dystonia and facial spasm along with classic clinical, imaging and genetic correlation. Aiming to investigate the prevalence of extrapyramidal signs in this syndrome, the published cases of HGPPS in the literature have been reviewed in this study. 32% of all HGPPS cases between years of 1975 to 2020 founded to have one or more extrapyramidal features and the dystonia was the most reported sign which even proceed to the presence of scoliosis. Regarding to the fact that the scoliosis could be as a consequence of axial dystonia, its relationship to ROBO3 mutation can be explained by structural and functional changes toward the brainstem and cerebellum, which are involved in this syndrome and known to contribute with the extrapyramidal system. Knowing this possibility, not only could solve the 35-year mystery of scoliosis in the syndrome, but also would be considered as a target of treatment to prevent scoliosis in the future.
Human Vaccines & Immunotherapeutics
Journal of vessels and circulation, Feb 10, 2021
Journal of the Neurological Sciences, Oct 1, 2019
^R esults Among 810 IDD patients, MOG-IgG1 was detected in 133 patients (16.4%): ON in 86(65%) of... more ^R esults Among 810 IDD patients, MOG-IgG1 was detected in 133 patients (16.4%): ON in 86(65%) of whom 38(33%) were recurrent; isolated TM in 26(19.5%) of whom 16(56%) were longitudinally extensive lesions; ADEM in 26(19.5%). Thirty-four patients (25.5%) fulfilled revised NMOSD diagnostic criteria. Eighty-eight percent received methylprednisolone alone or with subsequent plasma exchange or IVIG for acute attacks. Maintenance oral immunosuppressants were used in 63(45%). Relapsing disease was seen in 40% and annualized relapse rate was 0.36 with the median disease duration of 6 years. Eighty-seven percent of patients are currently walking unsupported, 51% had normal vision, 42% had mild visual impairment, and 7% had blindness in one eye but none in both. None had coexistent AQP4-IgG. Conclusions MOG-IgG-associated disorders account for one-sixth of IDDs in Sri Lankan patients. The most common phenotype is isolated ON followed by TM and ADEM. Relapsing disease was seen in almost half of such patients. The majority of patients had good outcomes.
Journal of the Neurological Sciences, Oct 1, 2019
Conclusion This study shows that tenecteplase before thrombectomy was associated with a high inci... more Conclusion This study shows that tenecteplase before thrombectomy was associated with a high incidence of reperfusion and appears to be effective in thrombolysis among patients with ischemic stroke.
Since the beginning of worldwide vaccination against coronavirus disease 2019 (COVID-19), studies... more Since the beginning of worldwide vaccination against coronavirus disease 2019 (COVID-19), studies have reported a possible association between vaccination and Guillain-Barré syndrome (GBS). In this regard, we conducted a systematic review assessing different demographic, clinical, and neurophysiological aspects of patients with GBS following immunization with COVID-19 vaccines. A comprehensive search of PubMed, Web of Science, Scopus, and Google Scholar was performed. Articles in English between January 2020 and November 2021 were included. Data on demographics, clinical characteristics, vaccines information, treatment approaches, and outcomes were extracted. The data of a total of 88 patients out of 41 studies was included. The mean age of patients was 58.7 ± 16.6 years and 55 cases (62.5%) were male. AstraZeneca was the most-reported vaccine associated with GBS with 52 cases (59.1%) followed by Pfizer with 20 cases (22.7%). GBS occurred after the first dose of vaccination in 70 ca...
A growing number of studies indicate a broad range of neurological manifestations, including seiz... more A growing number of studies indicate a broad range of neurological manifestations, including seizures, occur in patients with COVID-19 infection. We report a 29-yers old female with status epilepticus and positive SARS-CoV-2 in the cerebrospinal fluid. Our findings support previous reports suggesting seizure as a possible symptom of COVID-19 infection.
Annals of Medicine and Surgery, 2022