Abstract Background Vitamin D has immunomodulatory effects in multiple sclerosis (MS). Vitamin D acts through various mechanisms such as secretion of cytokines. Interleukin-17 (IL-17) is a critical ...interleukin in inflammatory response in MS. Objective This study assessed the effect of oral high dose vitamin D intake on IL-17 levels in MS patients in a double blind randomized clinical trial. Methods 94 patients with a diagnosis of relapsing remitting multiple sclerosis (RRMS) were randomized to two groups. One group received 50,000 IU vitamin D3 every five days for 12 weeks. The other group was given placebo. Both groups received interferon-β (IFN-β) treatment. Serum levels of IL-17 were measured at the beginning of the study and after 12 weeks. Results IL-17 serum levels were 56.75 ± 28.72 pg/ml and 30.31 ± 75.85 pg/ml in the intervention and placebo group at the beginning of the study, respectively (Median ± IQR, p = 0.338). After 12 weeks, IL-17 levels were 58.93 ± 67.93 pg/ml and 46.13 ± 94.70 pg/ml in the intervention and placebo group, respectively (Median ± IQR, p = 0.960). The multiple linear regression analysis indicated that the consumption of vitamin D3 was positively and significantly associated with the logarithm of IL-17 measures (β = 1.719; p = 0.002 and R2 = 0.91), adjusted by EDSS scores. Conclusion IL-17 levels showed significant change in RRMS patients after receiving high dose vitamin D3 for 12 weeks.
To evaluate seizure characteristic among multiple sclerosis patients with coexistent seizure activity compared to control group.
This study is a cross-sectional study which was conducted by reviewing ...the clinical records of patients with definite diagnosis of MS according to McDonald's criteria from March 2007 to June 2011, who referred to the MS clinic of the university.
A total of 920 patients with a diagnosis of MS were identified, among whom 29 patients (3.15%) with seizure activity (case) due to MS with the mean age of 32.6 ± 6.23 years were analyzed. Also, fifty MS patients without any seizure occurrence with the mean age of 33.7 ± 7.4 years were used as our control group. In case group, seizure was general tonic clonic in 23 patients (79.3%), complex partial in four (13.8%), and simple partial in two (5.9%). The 26 available interictal EEGs in MS patients showed abnormal EEG pattern in 22 (84.6%) of them, including focal epileptic form discharge or focal slowing in 10 (38.5%), generalized discharge (spike-wave, polyspike, or general paroxysmal fast activity) in 10 (38.5%), and general slowing activity in 10 record (38.5%). MRI reviews of the 26 available brain MRIs showed subcortical white mater lesions in 22 (84.6%) of patients with seizure. All MRIs were performed within one month after the first seizure episode. Amongst 48 available MRIs in our control group, 91.7% (44 cases) showed periventricular lesions and in 8.3% (4 cases) subcortical white matter lesions were reported.
The result of this study demonstrated the higher rate of subcortical whit matter lesion in MS patients with seizure occurrence compared to control group.
Carotid body tumor (CBT) is paraganglioma and mainly found in the carotid bifurcation. The manifestations of the tumor are variable; in most cases, it presents as a non-symptomatic slow-growing mass, ...rarely compression of carotid body induces bradycardia and hypotension and repeated syncope, prolonged syncope can cause convulsion. Convulsive syncope occurred in 0.03% of patients with syncope. In this paper, we report three cases with CBT and convulsive syncope for which surgery was done and patients did not experience syncope again.
Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune, rare demyelinating disease of the central nervous system characterized by recurrent attacks which usually involve optic nerves and ...spinal cord. Although the most common symotoms are myelitis and optic neuritis, it can be presented as cerebral syndromes mainly those related to the brain stem and diencephalon . Since NMOSD is a rare disease and the epidemiological data on this disorder is still insufficient, the establishment of registry and long-term follow up studies are needed to assess the disease course and behavior over a period of time.
We stablished an electronic registry system for NMOSD patients in the MS center of Kashani hospital, Isfahan, Iran, since spring 2016. Every patient suspected for NMOSD and documented in our database was included in a follow up study to monitor their disease course and progression. Anti AQP4 antibody and Anti MOG antibody were checked for all patients in a unique lab by cell based assay method. Demographic data and clinical characteristics such as family history, comorbidities,education, number of relapses, presentation signs and radiological findings were recorded. Moreove, relapses, treatment change, triggers, and COVID-19 infection were documented. We investigated the effect of the COVID19 pandemic and vaccination on NMOSD patients.
This study included 173 cases with definite diagnosis of NMOSD, and 56 ones were seropositive for AQP4 Ab. 142 were females of which 46 were in the seropositive group. Their mean age was 40.02±11.11 years (45.78±12.88 in AQP4Ab positive group). The mean of age at disease onset was about 30.16±11.90 years. The mean time of follow up was 55.84±18.94 months until today. In 76 patients, there were LETM in the first cervical MRI. 123 patients revealedbabnormality in the first brain MRI. 27 patients had hypothyroidism as the most common comorbidity. 36 cases reported positive family history of multiple sclerosis and also 4 had a family history of NMOSD.
The mean age of onset did not differ between seropositive and seronegative group but it was higher than MS patients. Brain MRI showed abnormality in NMOSD patients. Female/male was 4.4/1 which is lower than other studies.
Background: Few studies have attempted to delineate the clinical profile of multiple Sclerosis (MS) among people of Asia. This study sought to identify the characteristics of early-onset Multiple ...Sclerosis (EOMS) comparison to adult-onset form (AOMS) in Isfahan, IRAN. Methods: This prospective study was conducted on 104 youths with multiple sclerosis beginning before the age of 16 years and 123 patients with adult-onset multiple sclerosis. Patients were observed for a mean period of 5 years. The common presenting symptoms, MRI finding, course of disease and disability score were compared between the two groups. Results: The mean onset age of disease in youths and adults were 14 ± 1.9 and 27.7 ± 8.06 years, respectively. Female/male ratio was 4.47:1 in EOMS and 3.92:1 in AOMS, this ratio was 7:1 in early childhood MS (≤ 10 year). The most common presenting symptom was optic neuritis in the EOMS group and paresthesia in AOMS. Optic neuritis was common in AOMS too, but brainstem/cerebellar signs were more common in EOMS than AOMS. Seizure occurred more frequently in EOMS than in the AOMS group (12.6% vs. 1.6%, respectively, p < 0.001). MRI showed that brainstem plaques were more prevalent in the EOMS compared with the AOMS group. Conclusions: It was concluded that early-onset MS does not significantly differ from adult form in terms of major clinical manifestation and course of disease, however Seizure is more common in EOMS, and brainstem and cerebellar symptoms as presenting symptom are more common.
There is a broad variation in reported frequencies of seizure in multiple sclerosis (MS). In this study, the seizure and its characteristics analyzed among a large group of patients with MS.
We ...reviewed the medical records of all definite MS patients referred to the MS Clinic of Kashani hospital, Isfahan, Iran, between 2007 and 2011.
Altogether, 34 cases with seizure activity identified among the 920 definite MS subjects (3.69%). Five excluded due to the other probable etiologies rather than MS. In the remained 29 patients (3.15%), the type of seizure was mostly generalized (79.3%); interictal electroencephalography showed an abnormal pattern in 84.6%, brain magnetic resonance imaging revealed subcortical white mater lesions in 84.6% of patients. The mean duration of MS onsets was 8.17 years and the mean interval between MS onset and the first seizure occurrence was 3.7 years. In general, response to antiepileptic treatment was excellent.
Seizures can occur at any stage during the course of MS, but it is more common during the early stages.
Speed of word retrieval in multiple sclerosis Khatoonabadi, Ahmad Reza; Nejad, Vahid Shaygan; Dadgar, Hooshang ...
Journal of research in medical sciences,
04/2013, Letnik:
18, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Multiple sclerosis (MS) is a common inflammatory - degenerative disease of myelin sheet of central nervous system that affects more young people. These patients show some degrees of cognition ...problems such as memory and processing disorders. The aim of this study was to evaluate the speed processing ability by word finding assessment in three categories include fruits, animals and objects in MS patients.
This study carried out as case-control and descriptive-analytic on 47 MS patients and 29 healthy controls. We measured the reaction time (RT) in three stages. Each stage includes 25 words (animals, fruits and objects words with high familiarity) that were presented randomly. In each stage, the subject should press a key when recognized the target category. Collected data analyzed with repeated measure ANOVA, two-way ANOVA test, and independent-samples t-test.
MS patients in comparison to normal healthy subjects show delay in speed of processing in which there was significant difference between MS patients and control subjects in mean reaction time in all three categories (P < 0.001).
The speed of processing is impaired in MS patients. Consequently, more evaluation and planning treatment programs based of speed processing for memory in these patients are necessary for them because of the role of memory in daily activities of life.
Dysphagia, as a common finding in Parkinson’s disease (PD) patients, was estimated to be present in 80–95% of this population during different stages of the disease. The Swallowing Disturbance ...Questionnaire (SDQ) was created as a self-rated dysphagia screening tool in PD. According to the guidelines for cross-cultural adaptation, Persian version of this questionnaire (SDQ-P) was developed. 59 Persian patients (39 men and 20 women) participated in the study. They responded to the SDQ-P and underwent videofluoroscopic swallowing study (VFSS). Aspiration during VFSS was compared with questionnaire results for each individual. Cronbach’s alpha coefficient for the questionnaire was 0.86 and based on SDQ-P 15 patients (25.4%) were dysphagic, while 10 patients (16.9%) showed aspiration during VFSS. SDQ-P sensitivity and specificity in predicting aspiration were 96.7 and 91.2%; therefore, the SDQ-P could be a prognostic tool for aspiration. The positive predictive value (PPV), the negative predictive value (NPV), and the pre- and posttest probabilities of aspiration were 0.67, 1, 16.9%, and 66.7%, respectively. In summary, this study demonstrated the reliability and also the feasibility of SDQ-P for screening of aspiration in Iranian patients with PD. Further evaluation of SDQ-P in larger subject population would be suggested.
The metabolic syndrome has known as an independent risk factor of stroke. The occurrence of this syndrome is due to genetic factors and lifestyle. This study was performed on the frequency of ...metabolic syndrome prevalence in ischemic stroke patients compare to control.
one hundred ischemic stroke patients and 100 controls (with the same age and sex) were evaluated for this study.
62% of patient and 34% of controls had metabolic syndrome criteria according to National Cholesterol Education Program (NCEP) {OR: 3.2; 95% CI (1.9-9.7), P=0.001} Prevalence of metabolic syndrome in women was more than men (52% vs. 44%) {OR: 0.72; 95% CI (0.4, 1.3)}. Beside of metabolic syndrome, prevalence of metabolic syndrome components was significantly higher in stroke patients compare to controls.
metabolic syndrome prevalence are more common in stroke patients compare to controls, but it should be noticed that the controls are in a risk of future stroke so they need special treatment to prevent it.
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