Jaydip Ray Chaudhuri; Kandadai Rukmini Mridula; Matapathi Umamahesh; Alluri Swathi; Banda Balaraju; Venkata Chandrasekher Srinivasarao Bandaru
Volume 12, Issue 3 , September 2013, , Pages 92-97
Abstract
Background: Stroke is a heterogeneous disease with several risk factors. High sensitivity C-reactive protein (hsCRP) is a marker for cardiovascular and cerebrovascular diseases. Recent studies have shown that high hsCRP level is a risk factor for ischemic stroke. The objective of our study was to investigate ...
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Background: Stroke is a heterogeneous disease with several risk factors. High sensitivity C-reactive protein (hsCRP) is a marker for cardiovascular and cerebrovascular diseases. Recent studies have shown that high hsCRP level is a risk factor for ischemic stroke. The objective of our study was to investigate the association of high hsCRP (> 3 mg/L) levels with ischemic stroke and its subtypes in Indian patients.Methods: We recruited 210 consecutive acute stroke patients and 150 age and sex matched controls. Stroke patients were admitted within 72 hours of onset, at Yashoda Hospital, Hyderabad, India. The study period was from January 2011 to December 2012. All patients underwent tests as per standard protocol for stroke workup. Serum hsCRP level was assessed in all stroke patients and controls on the day of admission.Results:The mean hsCRP was significantly higher in stroke patients (3.8 ± 2.5) than controls (1.8 ± 1.5) (P < 0.001). High hsCRP had higher frequency in stroke patients 130 (61.9%) compared to controls 10 (6.6%), P < 0.001. High hsCRP level was more prevalent in the stroke subtypes of cardioembolic stroke (83.3%) and large artery atherosclerosis (72%). High hsCRP level was significantly associated with hypercholesterolemia (P = 0.001), age (P = 0.01), and mortality (0.04). After adjustment of regression analysis it was observed that high level hsCRP is independently associated with acute ischemic stroke (Odds 4.5; 95% CI: 2.5-12.2); especially the stroke subtypes of cardioembolic stroke, (odds ratio 3.4, 95% CI: 1.9-10.5) and large artery atherosclerosis (odds ratio 2.1, 95% CI: 1.5-3.8).Conclusion:High hsCRP level is strongly associated with and an independent predictor of acute ischemic stroke. The association was found in all ischemic stroke subtypes.
Samaneh Aalami Harandi; Mansoureh Togha; Azadeh Sadatnaseri; S Hamed Hosseini; Soodeh Razeghi Jahromi
Volume 12, Issue 3 , September 2013, , Pages 98-101
Abstract
Background: Migraine with aura (MA) has been identified as a risk factor for cardiovascular disease. Previous observation has also found higher prevalence of cardiovascular risk factors in migraineurs without aura (MO), but the results have been conflicting. The present study was conducted to assess ...
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Background: Migraine with aura (MA) has been identified as a risk factor for cardiovascular disease. Previous observation has also found higher prevalence of cardiovascular risk factors in migraineurs without aura (MO), but the results have been conflicting. The present study was conducted to assess the association between cardiovascular risk factors and migraine without aura among Iranians.Methods: In our study the prevalence of cardiovascular risk factors, including hypertension, hyperglycemia, dyslipidemia, obesity, cigarette smoking, and family history of early coronary artery disease, were studied in 347 migraineurs without aura and 267 non-migraineurs. The odds ratio (ORs) with 95% confidence interval (95% CI) was used to assess the strength of the association.Results:Patients with migraine without aura were at an increased risk of developing hypertension (ORadj = 1.9; P = 0.029), but there was no difference in other cardiovascular risk profiles, including hyperglycemia, dyslipidemia, obesity, cigarette smoking, and family history of early coronary artery disease.Conclusion: Our study revealed that the prevalence of hypertension was higher in migraineurs without aura in comparison with non-migraineurs. Therefore, physicians are supposed to be more vigilant in examining these patients and take care not to prescribe medications that may provoke hypertension.
Hosein Shamshiri; Mohammad Reza Eshraghian; Nastaran Ameli; Shahriar Nafissi
Volume 12, Issue 3 , September 2013, , Pages 102-105
Abstract
Background: As a disease of motor nervous system (motor neuron disease), amyotrophic lateral sclerosis (ALS) has a great impact on several aspects of quality of life (QoL). Generic questionnaires of QoL do not address all the especial features of ALS and therefore translation ...
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Background: As a disease of motor nervous system (motor neuron disease), amyotrophic lateral sclerosis (ALS) has a great impact on several aspects of quality of life (QoL). Generic questionnaires of QoL do not address all the especial features of ALS and therefore translation and validation of disease specific questionnaires such as Amyotrophic Lateral Sclerosis Assessment Questionnaire 40-item (ALSAQ-40) is necessary for assessment of patients with different languages. The aim of this study was to review the validation of the Persian version of the ALSAQ-40.Methods: Meticulously translated ALSAQ-40 was completed by 21 ALS patients. Internal reliability was evaluated using Cronbach’s alpha coefficient and item- total correlation was also used to evaluate the correlation of each question with total score.Validity was evaluated through comparison with Amyotrophic Lateral Sclerosis Functional Rating Scale-revised (ALSFRS-r)and the 36-Itemhort Form Health Survey (SF-36). Results: Cronbach’s alpha coe<cient was 0.91-0.96 for different scales of the ALSAQ-40. All the 40 questions of the questionnaire had correlation greater than 0.5. Correlation coefficient of all the related scales of the Persian version of ALSAQ-40, SF-36 and ALSFRS-r was greater than 0.59 with P value < 0.001.Conclusion: Measures of the Cronbach’s alpha coefficient and item-total correlation demonstrated reliability and consistency of the questionnaire, and correlation coefficients confirmed the validity of different items in the questionnaire. This study showed that the Persian version of the ALSAQ-40 is a reliable and valid questionnaire for the evaluation of QoL in ALS patients with Persian language.
Farhad Assarzadegan; Mostafa Asadollahi; Omid Hesami; Omid Aryani; Behnam Mansouri; Nahid Beladi Moghadam
Volume 12, Issue 3 , September 2013, , Pages 106-110
Abstract
Mild (140 to 159/90 to 99 mmHg) or moderate (160 to 179/100 to 109 mmHg) chronic arterial hypertension does not appear to cause headache. Whether moderate hypertension predisposes patients to headache at all remains controversial, but there is little evidence that it does. Ambulatory blood pressure monitoring ...
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Mild (140 to 159/90 to 99 mmHg) or moderate (160 to 179/100 to 109 mmHg) chronic arterial hypertension does not appear to cause headache. Whether moderate hypertension predisposes patients to headache at all remains controversial, but there is little evidence that it does. Ambulatory blood pressure monitoring in patients with mild and moderate hypertension has shown no convincing relationship between blood pressure fluctuations over a 24-hour period and presence or absence of headache. However, headaches are associated to various disorders that lead to abrupt, severe, and paroxysmal elevations in blood pressure. In this paper, the secondary headaches attributed to acute crises of hypertension and the criteria for diagnosing each of them have been reviewed. These are headaches attributed to pheochromocytoma, hypertensive crisis without encephalopathy, hypertensive encephalopathy, pre-eclampsia, eclampsia, and acute pressure response to exogenous agents.
Anahid Safari; Farhad Emadi; Elham Jamali; Afshin Borhani-Haghighi
Volume 12, Issue 3 , September 2013, , Pages 111-113
Abstract
A 50 year-old man was referred with history of acute ataxia and lower extremity paresthesia 10 days after general anesthesia with nitrous oxide. Cervical MRI showed long hypersignal lesion in posterior segment of the cord. Blood analysis revealed vitamin B12 deficiency. Nitrous oxide-induced myelopathy ...
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A 50 year-old man was referred with history of acute ataxia and lower extremity paresthesia 10 days after general anesthesia with nitrous oxide. Cervical MRI showed long hypersignal lesion in posterior segment of the cord. Blood analysis revealed vitamin B12 deficiency. Nitrous oxide-induced myelopathy should be considered in patients who develop acute neurological manifestation after general anesthesia. It is recommended for physicians to think about symptoms and signs of B12 deficiency when evaluating patients in postoperative visits.
Masoud Mehrpour; Mohammad Reza Motamed; Mahboubeh Aghaei; Zahra Badi
Volume 12, Issue 3 , September 2013, , Pages 114-116
Abstract
Stroke is an important cause of disability and death worldwide, with the majority of strokes occurring in older people. Thrombolysis with recombinant tissue plasminogen activator (r-TPA) is the approved treatment for acute ischemic stroke. A major concern of physicians, who treat acute ischemic stroke ...
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Stroke is an important cause of disability and death worldwide, with the majority of strokes occurring in older people. Thrombolysis with recombinant tissue plasminogen activator (r-TPA) is the approved treatment for acute ischemic stroke. A major concern of physicians, who treat acute ischemic stroke with recombinant tissue plasminogen activator (r-TPA,) is the risk of intracerebral hemorrhage. However, other adverse reactions, including anaphylaxis and angioedema, can also occur. Here we report an interesting soft tissue reaction to intravenous r-TPA in an 80 year-old male who was treated for acute ischemic stroke.
Abdorreza Naser Moghadasi; Razieh Aghakhani; Mahsa Owji; Mansoureh Togha
Volume 12, Issue 3 , September 2013, , Pages 117-118
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Mansoureh Togha; Abdorreza Naser Moghadasi
Volume 12, Issue 3 , September 2013, , Pages 119-120
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Vahidreza Ostovan; Ghaemeh Nabaei; Akbar Soltanzadeh
Volume 12, Issue 3 , September 2013, , Pages 121-123
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Hamidreza Hatamian; Elham Bidabadi; Seyed Mohammad Seyed Saadat; Niloufar Seyed Saadat; Ehsan Kazemnezhad; Hamed Ramezani; Babak Bakhshayesh
Volume 12, Issue 2 , June 2013, , Pages 41-46
Abstract
Background: Although the precise etiology of multiple sclerosis (MS) is unknown, it seems that both genetic and environmental factors are important. Recent studies suggest that low serum vitamin D levels are important environmental factor in MS. The aim of this study was to compare the serum levels of ...
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Background: Although the precise etiology of multiple sclerosis (MS) is unknown, it seems that both genetic and environmental factors are important. Recent studies suggest that low serum vitamin D levels are important environmental factor in MS. The aim of this study was to compare the serum levels of vitamin D between MS patients and healthy subjects, and to determine its association with disability in MS patients.Methods: In this cross-sectional study, a total of 52 patients with MS were randomly recruited and matched for age and sex with 52 healthy subjects. Demographic characteristics and serum vitamin D levels for both groups, as well as duration of disease Expanded Disability Status Scale (EDSS) for MS patients were evaluated. Statistical analysis was performed by independent samples t-test and multiple linear regression analysis.Results: The mean serum vitamin D levels were 26.5 ± 16.3 ng/ml in MS patients vs. 37.1 ±19.7 in healthy subjects (P = 0.003). A linear regression analysis showed no significant association between vitamin D levels and EDSS score of patients with MS (P = 0.345), after adjusting for the covariates.Conclusion:Our findings did not suggest a protective association for serum vitamin D levels against disability in MS patients.
Mohammad Yazdchi; Zahra Ghasemi; Hanieh Moshayedi; Reza Rikhtegar; Somayeh Mostafayi; Hale Mikailee; Safa Najmi
Volume 12, Issue 2 , June 2013, , Pages 47-50
Abstract
Background: This study evaluated the efficacy of focal intramuscular injection of botulinum (BoNT) toxin type A in comparison with oral tizanidine (TZD) in treatment of post-stroke upper limb spasticity.Methods: This was a double-blinded randomized clinical trial that recruited 68 patients with post-stroke ...
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Background: This study evaluated the efficacy of focal intramuscular injection of botulinum (BoNT) toxin type A in comparison with oral tizanidine (TZD) in treatment of post-stroke upper limb spasticity.Methods: This was a double-blinded randomized clinical trial that recruited 68 patients with post-stroke upper limb spasticity. Thirty-four patients received BoNT (Dysport(®)) injections in affected muscles of upper limb at the baseline and week 12. Thirty-four patients were treated with tizanidine (Sirdalude) by gradual increase in dosage of 2mg/week to reach maximum 24mg at week 12. Modified Ashworth Scale (MAS) and Action Research Arm Test (ARAT) were evaluated at the baseline, week 12 and week 24 for all the participants.Results: The mean score of MAS reduced from 3.32 and 3.13 at baseline to 1.79 and 1.56 at week 24 on elbow and wrist joints, respectively (P < 0.01). However, there were only reductions from 2.79 and 2.77 to 2.32 and 2.31 (P < 0.001) in TZD group. ARAT increased from 1.79 to 10.97 (P < 0.001) in BoNT group. ARAT increased from 11.08 to 11.35 in TZD group (P = 0.026).Conclusion: BoNT injection was safe and effective in reducing post-stroke upper extremity spasticity in comparison with TZD.
Rana Sorkhabi; Somaiyeh Mostafaei; Mohammadhosein Ahoor; Mahnaz Talebi
Volume 12, Issue 2 , June 2013, , Pages 51-55
Abstract
Background: Headache is one of the most disturbing symptoms with common neurological signs. Variations in optic nerve perfusion quality or retinal microcirculation may end up in ganglion cell damage in patients with migraine.Methods: Sixty patients diagnosed with migraine and thirty normal individuals ...
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Background: Headache is one of the most disturbing symptoms with common neurological signs. Variations in optic nerve perfusion quality or retinal microcirculation may end up in ganglion cell damage in patients with migraine.Methods: Sixty patients diagnosed with migraine and thirty normal individuals were evaluated in groups including migraine with aura, migraine without aura and controls. Retinal nerve fiber layer (RNFL) thickness was measured using stratus optical coherence tomography (OCT™) and then was compared in case and control groups.Results: RNFL thickness was only significantly thinner in nasal quadrant in migraineurs compared to the control group. Other parameters showed no difference between the two groups and besides there was no statistically difference between the two migraine subgroups.Conclusion: Given the significant difference in nasal quadrant RNFL thickness between the migraineurs and normal individuals, we might be able to defend the retinal blood flow decrease theory in migraine; however, multicentre studies with larger samples seem mandatory.
Mehdi Moghaddasi; Mansoureh Mamarabadi; Mahboubeh Aghaii
Volume 12, Issue 2 , June 2013, , Pages 56-59
Abstract
Background: Vitamin D is an important factor responsible for many physiologic functions. Vitamin D deficiency is associated with increased risk of neurodegenerative disease. The level of vitamin D in Iranian patients with Parkinson's disease and its relationship with severity of symptoms and signs were ...
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Background: Vitamin D is an important factor responsible for many physiologic functions. Vitamin D deficiency is associated with increased risk of neurodegenerative disease. The level of vitamin D in Iranian patients with Parkinson's disease and its relationship with severity of symptoms and signs were evaluated in this study.Methods: Eighty-three patients with Parkinson's disease (PD) were recruited using simple non-random sampling. 25-hydroxyvitamin D [25(OH)D3] was measured by Electrochemiluminescence immunoassay (ECLIA). Serum level of calcium and phosphorus was measured to exclude other endocrine disorders.Results: The mean 25(OH)D3 concentration was lower in the PD population than in the normal group. Lower levels of 25(OH)D3 were associated with more severe postural instability and abnormal posture. There was no significant association between levels of 25(OH)D3 and severity of other symptoms of parkinsonism.Conclusion: This analysis showed that serum 25(OH)D levels are lower in PD patients in comparison with normal range. In addition, there was a significant association between the presences of freezing, postural instability and abnormal postures with lower levels of 25(OH)D.
Elham Eftekhari; Masoud Etemadifar; Ali Ebrahimi; Shahrzad Baradaran
Volume 12, Issue 2 , June 2013, , Pages 60-65
Abstract
Background: Hormones can play a significant role in the pathogenesis of multiple sclerosis (MS). The aim of this study was to compare levels of ghrelin, leptin, and testosterone hormones of MS patients with healthy subjects, and assess the relationship between levels of peptide hormone and sex hormones ...
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Background: Hormones can play a significant role in the pathogenesis of multiple sclerosis (MS). The aim of this study was to compare levels of ghrelin, leptin, and testosterone hormones of MS patients with healthy subjects, and assess the relationship between levels of peptide hormone and sex hormones in MS patients.Methods: 35 MS patients with definite relapsing remitting multiple sclerosis (RRMS) (male = 9, female = 26) and 13 healthy subjects (male = 4, female = 9) were enrolled in the study. Levels of serum ghrelin, leptin, and testosterone hormones were measured in this study. ANOVA and Pearson correlation were used for data analysis (P < 0.05).Results:The female and male participants of the patient group were compared with the healthy group. No significant differences were found in serum of leptin, ghrelin, testosterone, ghrelin/leptin, and testosterone/leptin (P < 0.05). Spearman correlation coefficient showed that leptin had a significant negative correlation with the variability of testosterone (r = -1.00) in the healthy male group. Moreover, leptin had a significant positive correlation with the variability of BMI (r = 0.68) and weight (r = 0.59), at the 0.01 level (2-tailed), in the female patient group. In addition, in the healthy male group, ghrelin had a significant negative correlation with the variability of weight (r = -1.00).Conclusion:According to the results, there was no significant difference between peptide and sex hormones of MS patients and healthy persons. Furthermore, there was no significant relationship between peptide and sex hormones of MS patients and healthy persons.
Vahid-Reza Ostovan; Askar Ghorbani
Volume 12, Issue 2 , June 2013, , Pages 66-68
Abstract
Various neurological complications occur in primary or secondary antiphospholipid syndrome (APS) consisting of cerebrovascular attacks, ocular events, dementia, seizure, chorea, and transverse myelopathy that are all related to the titer of antiphospholipid antibodies (aPL). We report a patient with ...
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Various neurological complications occur in primary or secondary antiphospholipid syndrome (APS) consisting of cerebrovascular attacks, ocular events, dementia, seizure, chorea, and transverse myelopathy that are all related to the titer of antiphospholipid antibodies (aPL). We report a patient with chorea and retinal vessel occlusion as manifestations of systemic lupus erythematosus (SLE) and APS. A 27-year-old man presented with progressive visual field defect and decreases visual acuity of right eye (OD) as well as involuntary movements in both hands and slurred speech. Investigations led to the diagnosis of SLE and APS. Anticoagulant and immunosuppressant was started for him. As his condition improved, the prednisolone was gradually tapered. This is the first case report of concomitant retinal vessel occlusion and chorea in SLE and APS.
Farhad Assarzadegan; Elaheh Ehsanpour; Behnam Hosseini; Nahid Beladi-Moghadam; Behnam Mansouri; Omid Hesami
Volume 12, Issue 2 , June 2013, , Pages 69-71
Abstract
Superficial siderosis (SS) is a rare disease which affects people in all ages and both sexes, but three times more in men. Pathological etiology is deposition of hemosiderin (a product of the breakdown of blood) in leptomeninges, subpial layer, ependymal surface and other parts of central nervous system ...
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Superficial siderosis (SS) is a rare disease which affects people in all ages and both sexes, but three times more in men. Pathological etiology is deposition of hemosiderin (a product of the breakdown of blood) in leptomeninges, subpial layer, ependymal surface and other parts of central nervous system (CNS) and typically leads to neurological dysfunction and progressive irreversible signs and symptoms. We present a 33-year-old man with complete deafness in left ear, partial hearing loss in right ear, gait imbalance, bilateral frontotemporal throbbing headache and anosmia resulted from superficial siderosis.
Kavian Ghandehari
Volume 12, Issue 2 , June 2013, , Pages 72-74
Abstract
Standard protocols should be established for treating eligible stroke patients with tissue plasminogen activator (TPA) (recommendation class I, level of evidence B). The Iranian standard protocol of Intravenous Thrombolysis with recombinant Tissue Plasminogen Activator (IVTTPA) is the best possible and ...
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Standard protocols should be established for treating eligible stroke patients with tissue plasminogen activator (TPA) (recommendation class I, level of evidence B). The Iranian standard protocol of Intravenous Thrombolysis with recombinant Tissue Plasminogen Activator (IVTTPA) is the best possible and easy to use method for performing intravenous thrombolysis in Iran. This protocol overcomes problems and limitations of IVTTPA in Iran. The protocol achieves the best selection criteria and assessment method of IVTTPA for our residents and neurologists. This protocol was provided in Persian language and could be easily downloaded from Google site by writing Thrombolysis and Iran in Persian.
Abdorreza Naser Moghadasi; Mahsa Owji
Volume 12, Issue 2 , June 2013, , Pages 75-76
Abstract
Dream should be considered as a kind of cognitive ability that is formed parallel to other cognitive capabilities like language. On the other hand, multiple sclerosis (MS) is a complex disease that can involve different aspects of our cognition. Therefore, MS may influence patients' dreams. In fact, ...
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Dream should be considered as a kind of cognitive ability that is formed parallel to other cognitive capabilities like language. On the other hand, multiple sclerosis (MS) is a complex disease that can involve different aspects of our cognition. Therefore, MS may influence patients' dreams. In fact, we do not know what the importance of dream is in MS, but further studies may introduce dream and dreaming as a sign of improvement or progression in MS disease.
Ali Okhovat
Volume 12, Issue 2 , June 2013, , Pages 77-79
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Somayeh Baghizadeh; Mohammad Ali Sahraian; Nahid Beladimoghadam
Volume 12, Issue 1 , March 2013, , Pages 1-8
Abstract
Background: The clinical course of multiple sclerosis (MS) evolves over many years. Its prognosis is highly variable among affected individuals, i.e. while some suffer from early severe disabilities, others remain ambulatory and functional for many years. We used Multiple Sclerosis Severity Score (MSSS) ...
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Background: The clinical course of multiple sclerosis (MS) evolves over many years. Its prognosis is highly variable among affected individuals, i.e. while some suffer from early severe disabilities, others remain ambulatory and functional for many years. We used Multiple Sclerosis Severity Score (MSSS) and the new classification for MS severity Herbert et al. introduced in 2006 according to MSSS, to investigate some clinical and demographic factors as potential indicators of disease severity in in MS.Methods:During a six-month period, patients with definite MS according to the revised McDonald's criteria who referred to three neurology and MS clinics in Tehran (Iran) were included in the study. All patients were interviewed and examined by a neurology resident who had been trained for employing the Expanded Disability Status Scale (EDSS). For each patient, MSSS was determined by using EDSS and disease duration.Results: Overall, 338 (266 female and 72 male) patients were enrolled. Among demographic features, gender, younger age at onset, positive family history, and parental consanguinity were not associated with disease severity. Education was weakly associated with disease severity. Among clinical factors, presenting symptoms such as poly-symptomatic attacks, walking difficulty, and upper and lower extremity dysfunction were associated with more disability while presentation with optic neuritis had better prognosis. Complete recovery after the first attack, longer interval between the first and second attacks, lower number of symptoms at presentation, shorter duration of attacks, and relapsing-remitting course were associated with less disability and better prognosis. These results were noticed in ordinal logistic regression. However when multiple logistic regression was performed, the strongest determinant of disease severity was disease course with odds ratio (OR) = 49.12 for secondary progressive course and OR = 53.25 for primary progressive (± relapse) course. Walking difficulty as the presenting symptom had a borderline association with disease severity (OR = 2.31; P = 0.055). Increased number of onset symptoms was associated (but not significantly) with more severe disease.Conclusion: Early prediction of disease severity by demographic and clinical features is currently impossible. We need to determine stronger predictors, possibly a combination of demographic, clinical, biomarkers, and imaging findings.
Mehdi Moghaddasi; Mahbubeh Aghaei
Volume 12, Issue 1 , March 2013, , Pages 9-14
Abstract
Background: We compared bone mineral density (BMD) in patients with relapsing-remitting multiple sclerosis (RRMS) on interferon with that of patients with relapsing-remitting multiple sclerosis (RRMS) who were not receiving interferon and healthy age- and sex-matched controls.Methods:Overall, 30 patients ...
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Background: We compared bone mineral density (BMD) in patients with relapsing-remitting multiple sclerosis (RRMS) on interferon with that of patients with relapsing-remitting multiple sclerosis (RRMS) who were not receiving interferon and healthy age- and sex-matched controls.Methods:Overall, 30 patients with RRMS on interferon (treated patients), 30 patients with RRMS but not receiving interferon (untreated patients), and 30 healthy controls were enrolled. The subjects were matched for age, sex, body mass index, physical activity and nutritional habits (as possible), duration of illness, frequency of attacks, and the amount of corticosteroid therapy. BMD was measured at the lumbar spine and proximal femur. The results of dual-energy X-ray absorptiometry were expressed as BMD (g/cm(2)), Z-scores, and T-scores.Results:Osteopenia in patients with RRMS was 61.7% in proximal femur and 53.3% in lumbar spine (vs. 53.3% and 40% in healthy controls, respectively). There was an inverse relationship between Expanded Disability Status Scale scores and lumbar and femoral BDM in the patients. In treated patients, there was an inverse relationship between the duration of interferon therapy and lumbar and femoral BDM. In untreated patients, there was a similar relation between the duration of the illness and BMD. Moreover, inverse relationships existed between the frequency of attacks and lumbar and femoral BDM in both treated and untreated groups. However, this association was only significant in the untreated group.Conclusion:Patients with MS showed reduced BMD in comparison with healthy controls. This reduction was related to the frequency of attacks. We also found lower BMD in untreated patients compared to interferon-treated patients.
Anahid Safari; Afshin Borhani-Haghighi; Seyed Taghi Heydari; Kamran Bagheri Lankarani
Volume 12, Issue 1 , March 2013, , Pages 15-18
Abstract
Background:Guillain-Barre syndrome (GBS) is an acute immune-mediated peripheral neuropathy usually after an incident. This study was performed to investigate the basic epidemiologic features of GBS in south of Iran.Methods:We studied consecutive patients with GBS in Nemazi Hospital of Shiraz, southern ...
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Background:Guillain-Barre syndrome (GBS) is an acute immune-mediated peripheral neuropathy usually after an incident. This study was performed to investigate the basic epidemiologic features of GBS in south of Iran.Methods:We studied consecutive patients with GBS in Nemazi Hospital of Shiraz, southern Iran. Demographic characteristics of the subjects, i.e. age, sex, and length of hospital stay were extracted. Information regarding yearly admissions for the entire hospital was also gathered. The prevalence of GBS per 10,000 hospital admissions was calculated and stratified by sex and year. Yearly prevalence was compared using the odds ratio (OR) and 95% confidence intervals (CI).Results:From January 2000 to December 2009, 389 (232 males and 157 females) patients with GBS were admitted in our center. The mean age of patients was 29.8 ± 23.0 years and their mean length of hospital stay was 12.9 ± 11.6 days. The overall mortality rate was 6%. The ratio of admissions due to GBS to the total admissions was significantly higher in 2009, the year of an influenza A (H1N1) virus pandemic.Conclusion:There appears to be an increase in the incidence of GBS in Shiraz. This is in parallel with the increasing trend of some other autoimmune diseases.
Azin Ayatollahi; Mohammad Reza Mohajeri-Tehrani; Shahriar Nafissi
Volume 12, Issue 1 , March 2013, , Pages 19-22
Abstract
Background: Multiple sclerosis (MS) is a demyelinating disease which can cause many disabilities for the patient. Recent data suggests that MS patients have higher risk for osteoporosis. This study was performed to investigate if the osteoporosis prevalence is higher in MS patients and to determine the ...
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Background: Multiple sclerosis (MS) is a demyelinating disease which can cause many disabilities for the patient. Recent data suggests that MS patients have higher risk for osteoporosis. This study was performed to investigate if the osteoporosis prevalence is higher in MS patients and to determine the possible factors affecting bone mineral density (BMD).Methods:51 definite relapsing-remitting MS patients according to McDonald's criteria (45 females, 6 males aged between 20 and 50 years) participated in this study. The control group included 407 females aged from 20 to 49 years; they were healthy and had no history of the diseases affecting bone metabolism. Femoral and lumbar BMD were measured by Dual Energy X-ray Absorptiometry (DXA). The disability of MS patients was evaluated by Expanded Disability Status Scale (EDSS).Results:The patient's quality of life was evaluated by the validated Persian version of multiple sclerosis impact scale (MSIS-29).Patients' mean age was 36 ± 3.3 years and their mean disease duration was 8.7 ± 1.7 years. The mean EDSS score and the mean body mass index (BMI) of the patients were 3 ± 0.9 and 23.5 ± 2.3 kg/m(2), respectively. 29% of the patients had never been treated by ß-interferon and 6% of them had not received glucocorticoids (GCs) pulses since their MS had been diagnosed. 26% of the patients had a history of fracture.18% of our patients were osteoporotic and 43% of them were osteopenic. Femoral BMD was significantly lower among MS patients than age matched controls (P < 0.001), but lumbar BMD showed no difference. There was no correlation between administration of GCs pulses, interferon and BMD; however, we found a significant correlation between EDSS score, quality of life (QoL), disease duration and BMD of both site.Conclusion:As a result of this study, bone loss inevitably occurs in MS patients.The major factor of BMD loss is immobility. Osteoporosis should be managed as part of MS patients' treatment protocols.
Soodeh Razeghi Jahromi; Maryam Abolhasani; Alipasha Meysamie; Mansoureh Togha
Volume 12, Issue 1 , March 2013, , Pages 23-27
Abstract
Background: Obesity seems to be associated to migraine headache. Increase in body fat, especially in gluteofemoral region, elevates adiponectin and leptin secretion which in turn impair inflammatory processes that could be contributing to migraine risk. This study was designed to assess the relationship ...
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Background: Obesity seems to be associated to migraine headache. Increase in body fat, especially in gluteofemoral region, elevates adiponectin and leptin secretion which in turn impair inflammatory processes that could be contributing to migraine risk. This study was designed to assess the relationship between body composition and risk of migraine for the first time.Methods:In this cross-sectional study, 1510 middle-aged women who were visited in a weight reduction clinic of university were recruited. Migraine was diagnosed with HIS criteria. Body composition parameters including total fat mass (FATM), total fat free mass (FFM), truncal fat mass (TFATM), and truncal fat free mass (TFFM) was assessed using bioelectric impedance. We further assessed cardiovascular risk factors and smoking as confounding factors. To determine the real association between different variables and risk of migraine, the associations were adjusted by multivariate logistic regression analysis.Results:Elevation in fasting blood sugar, total cholesterol, LDL cholesterol, FFM, TFFM, and waist-to-hip ratio increased the risk of migraine. When the associations were adjusted for other factors, only the association between migraine and FFM remained statistically significant.Conclusion:Lower FFM increased the risk of migraine in overweight and obese individuals. In the other words, higher fat free mass could be a protective factor for migraine.
Mahnaz Khajepour; Alireza Ghazizadeh Ehsayei; Hossein Salehi; Mansour Raygani; Darioush Eliaspour
Volume 12, Issue 1 , March 2013, , Pages 28-29
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