MS patients were one of the first populations vaccinated in Iran. To date, the most used vaccine brand on Iranian MS patients is Sinopharm COVID-19 vaccine. Here is the first study on the adverse ...events after the first dose of Sinopharm vaccine on 583 Iranian MS patients. A Google form link was sent to MS patients through social networks, between May 1, 2021 and May 22, 2021. No serious adverse event was reported. At least one complaint (mostly transient) was reported by 350 (60%) of vaccine recipients. Constitutional symptoms (malaise, fatigue, fever, shivering, & generalized body pain) (51%) and headache (9%) were the most reported complaints. We found a relation between gender and prior infection with COVID-19 and reported symptoms (p value less than 0.05). Only five recipients (0.9%) reported MS relapse after vaccination. MS worsening was a minor incident related to fever.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Multiple sclerosis (MS) can result in significant mental and physical symptoms, specially muscle weakness, abnormal walking mechanics, balance problems, spasticity, fatigue, cognitive impairment and ...depression. Patients with MS frequently decrease physical activity due to the fear from worsening the symptoms and this can result in reconditioning. Physicians now believe that regular exercise training is a potential solution for limiting the reconditioning process and achieving an optimal level of patient activities, functions and many physical and mental symptoms without any concern about triggering the onset or exacerbation of disease symptoms or relapse.
Appropriate exercise can cause noteworthy and important improvements in different areas of cardio respiratory fitness (Aerobic fitness), muscle strength, flexibility, balance, fatigue, cognition, quality of life and respiratory function in MS patients. Aerobic exercise training with low to moderate intensity can result in the improvement of aerobic fitness and reduction of fatigue in MS patients affected by mild or moderate disability. MS patients can positively adapt to resistance training which may result in improved fatigue and ambulation. Flexibility exercises such as stretching the muscles may diminish spasticity and prevent future painful contractions. Balance exercises have beneficial effects on fall rates and better balance. Some general guidelines exist for exercise recommendation in the MS population. The individualized exercise program should be designed to address a patient's chief complaint, improve strength, endurance, balance, coordination, fatigue and so on. An exercise staircase model has been proposed for exercise prescription and progression for a broad spectrum of MS patients.
Exercise should be considered as a safe and effective means of rehabilitation in MS patients. Existing evidence shows that a supervised and individualized exercise program may improve fitness, functional capacity and quality of life as well as modifiable impairments in MS patients.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
To investigate the association between serum 25-hydroxyvitamin D levels and its effect on adverse clinical outcomes, and parameters of immune function and mortality due to a SARS-CoV-2 infection.
The ...hospital data of 235 patients infected with COVID-19 were analyzed.
Based on CDC criteria, among our study patients, 74% had severe COVID-19 infection and 32.8% were vitamin D sufficient. After adjusting for confounding factors, there was a significant association between vitamin D sufficiency and reduction in clinical severity, inpatient mortality serum levels of C-reactive protein (CRP) and an increase in lymphocyte percentage. Only 9.7% of patients older than 40 years who were vitamin D sufficient succumbed to the infection compared to 20% who had a circulating level of 25(OH)D< 30 ng/ml. The significant reduction in serum CRP, an inflammatory marker, along with increased lymphocytes percentage suggest that vitamin D sufficiency also may help modulate the immune response possibly by reducing risk for cytokine storm in response to this viral infection.
Therefore, it is recommended that improving vitamin D status in the general population and in particular hospitalized patients has a potential benefit in reducing the severity of morbidities and mortality associated with acquiring COVID-19.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The epidemiological characteristics of multiple sclerosis (MS) have been investigated in various studies, which have revealed that the prevalence of MS varies across countries. The present study was ...conducted to investigate the longitudinal prevalence of MS in Tehran, Iran.
The present population-based study was conducted in Tehran, the capital of Iran from 1999 to 2018 based on the annual report data provided by the Iranian MS Society (IMSS) registry system. The age-standardized and crude prevalence were estimated using population data presented by the Statistical Centre of Iran.
A total of 21,580 MS cases were registered and included in the analysis. Among the participant patients, 24.99% (5393) and 75.01% (16,187) of cases were male and female, respectively. The mean age of MS onset was 28.8 years (S.D: 8.7). The age-standardized prevalence (ASP) of MS increased from 73.7 (95%CI: 72.1-75.2) per 100,000 people in 2006 to 137.6 (95% CI: 135.7-139.5) per 100,000 people in 2018. The ASP of MS in 2018 was estimated to be 67.9 (95%CI: 66.0-69.8) and 207.3 (95%CI: 204.0-210.7) per 100,000 people among males and females, respectively. The age-standardized female-to-male ratio of MS ranged from 3.7 (in 2010) to 2.06 (in 2017).
The findings of this study suggested that the prevalence of MS in Tehran province is relatively high, and the occurrence of the disease is more common in the age groups under 40 years as compared with older-aged groups. In line with reports provided for various regions of the world, the prevalence of MS was higher among women. Similarly, the findings of this study revealed that the female-to-male ratio was 2.14 in 2018.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Multiple sclerosis (MS) is one of the most common neurological disorders and a leading cause of nontraumatic disability in young adults in many countries. Recent reports from the Middle East and ...North Africa have suggested a moderate to high risk of MS in these countries.
A literature search was performed in August 2014 in MEDLINE, EMBASE, and IMEMR to retrieve original population-based studies on MS epidemiology in the Middle East and North African countries published between 1st January 1985 and 1st August 2014. We designed search strategies using the key words: MS, prevalence, incidence, and epidemiology. According to the inclusion criteria, 52 studies were included in this systematic review.
McDonald's criteria were the most widely used diagnostic criteria in the studies. Most studies were conducted in single hospital-based centers with a defined catchment area. The female/male ratio ranged from 0.8 in Oman to 4.3 in Saudi Arabia. MS prevalence ranged from 14.77/100,000 population in Kuwait (2000) to 101.4/100,000 in Turkey (2006). The overall MS prevalence in the region was 51.52/100,000. The mean age at disease onset ranged from 25.2 years in Kuwait to 32.5 years in Northeastern Iran, with an overall estimate of 28.54 years.
Recent advances in MS registries will allow nation-wide studies and temporal comparisons between countries, provided that age- and sex-standardized estimates are available.
Oxidative stress plays a crucial role in the pathogenesis of multiple sclerosis (MS). Melatonin has a central role in the modulation of oxidative stress pathways. We aimed to investigate the effect ...of melatonin on mRNA expression and activity of sirtuin1 (SIRT1) and its target genes, manganese superoxide dismutase (MnSOD), and catalase in peripheral blood mononuclear cells (PBMCs) from MS patients and healthy subjects.
This study was performed on 12 patients with relapsing–remitting MS (RRMS) and 14 age- and sex-matched healthy subjects. PBMCs were isolated and treated with pharmacological concentration of melatonin (1mM) for 12h. Gene expression was evaluated by real time-PCR. SIRT1 activity in PBMCs was measured using a fluorometric assay. MnSOD and catalase activities in PBMCs were determined by colorimetric assays. Plasma total antioxidant capacity was measured using the ferric reducing ability of plasma assay.
Melatonin significantly increased activities and mRNA levels of SIRT1 and catalase in both patients and healthy subjects, whereas melatonin treatment caused a pronounced increase in MnSOD mRNA expression and activity only in patients. In MS patients, SIRT1 activity did not correlate with catalase and MnSOD activities before melatonin treatment, while a significant correlation was observed between SIRT1 activity and catalase activity in PBMCs of patients after melatonin treatment.
It appears that the antioxidant status is affected in PBMCs from MS patients and melatonin could improve impaired antioxidant defense in MS through upregulation of SIRT1, MnSOD and catalase, which might be important in MS management.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Multiple sclerosis (MS) is a central nervous system (CNS) degenerative disorder which is caused by a targeted autoimmune‐mediated attack on myelin proteins. Previously, mesenchymal stem cells were ...considered as a novel and successful treatment of MS. One of the underlying mechanisms behind their immunomodulatory function is the release of extracellular vesicles, particularly exosomes. In this study, we aimed to evaluate the suppressive efficacy of MSCs and their exosomes on the proliferation of peripheral mononuclear blood cells (PBMC) in relapsing‐remitting MS (RRMS) patients and healthy subjects. To do, mesenchymal stem cells were derived from human umbilical cord tissues and used for exosome isolation through ultracentrifugation. Suppressive function of MSCs and MSC‐derived exosomes was examined in a coculture with CFSE‐labelled PBMCs in vitro. PBMC proliferation of the patients and healthy individuals was measured using flow cytometry. We first demonstrated that proliferation of PBMCs decreased in the presence of MSCs and suppression was more efficient by MSC‐derived exosomes, with a minimum alloreaction rate. However, suppression capacity of MSCs and their exosomes significantly decreased during extensive sub‐culturing. The present study showed that MSC‐derived exosomes as an effective cell‐free therapy could prevent proliferation of PBMCs. However, further evaluations are need to move towards a functional approach that can be translated to the clinic.
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DOBA, FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, SIK, UILJ, UKNU, UL, UM, UPUK
Objectives: When a married family member suffers from multiple sclerosis (MS), the collective physical and psychosocial well-being of the family is impacted and much of the burden is on the healthier ...spouse. The purpose of the present study was to determine the contribution of psychosocial support from spouses, friends, and others in overall family functioning in respect of Iranian patients with MS, considering the mediating role of spiritual experiences and moral foundations. Methods: Spouses of patients with MS were chosen through the judgmental sampling method. The research instruments comprised the Family Assessment Device, Social Support Appraisals Scale, Daily Spiritual Experience Scale, and Moral Foundations Questionnaire. Data analysis was done through the path analysis technique. Results: The subjects comprised 220 spouses of MS patients. We found a significant relationship between family support path and overall functioning mediated by the variable 'spiritual experiences', the root mean square error of approximation (RMSEA) value being < 0.001. Similarly, the relationship between spiritual experiences and moral foundations had a significant effect on overall family functioning (RMSEA < 0.001). After eliminating insignificant relationships and estimating fit indicators, the modified (adjusted) model indicated goodness of fit with data. Conclusions: This study found, for the first time in the Iranian community, a significant effect of family support focused on spouses of MS patients compared to the support from friends and others, with regard to family functioning. The mediating roles of spiritual experiences and moral foundations were confirmed. Further studies are suggested to delve into the role of family support for MS patients in developing countries.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Background: Multiple sclerosis (MS) is a chronic and potentially progressive demyelinating disease of the central nervous system. The incidence and prevalence rate of the disease has been increasing ...globally, especially in females.Methods: In this cross-sectional population-based study based on Iranian MS Society data (1989-2016), we aimed to present most recent age-standardized incidence and prevalence rate of MS, female to male ratio, mean onset age, and prevalence of positive family history of MS alongside with their time trend via Joinpoint regression analysis in 27 years. Additionally, a linear regression model was used for evaluating the association of onset age with sex and family history in patients.Results: In 18,061 registered cases: female to male ratio was generally 3.06:1, showing a general decreasing trend. The mean onset age of the disease was 28.50 ± 8.61 with a general increasing trend. 12.52% of the cases had at least a positive any-degree family history of MS, exhibiting a weak increasing trend. The age-standardized incidence and prevalence rate was 1.8 (95% CI: 1.3, 7.2) and 116 (95% CI: 96, 139) per 100000 populations, respectively, both presenting a significant increasing trend, however, incidence rate ended in plateaued and finally decreasing trend. Finally, onset age was predicted to be lower in females and subjects with positive family history of MS.Conclusion: Tehran is among MS high-risk areas with increasing trends in prevalence and increasing followed by plateaued incidence rates indicating necessity of extra investigations of the underlying reasons and health system preparedness for further health care requirements of MS patients.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
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