Neuromyelitis optica spectrum disease characteristics in Isfahan, Iran: A cross-sectional study.

BACKGROUND: Neuromyelitis optica spectrum disease (NMOSD) is a severe autoimmune demyelinating disorder of the central nervous system that throughout epidemiological data, it has not been completely determined. The aim of this study was to assess characteristics of NMOSD patients in Isfahan as one of the most prevalent cities for multiple sclerosis in Iran. MATERIALS AND METHODS: Forty-five patients diagnosed as neuromyelitis optica (NMO) disease through 5 years enrolled in this study. Demographics and characteristics of disease such as Expanded Disability Status Scale (EDSS) score, disease duration, clinical symptoms, laboratory data, and magnetic resonance imaging findings (including T1, T2, and flair protocols) were recorded. NMO-immunoglobulin G serology assay was done in all of the patients by ELISA test. RESULTS: Female to male ratio was 5.4:1. The mean age of disease onset was 29.8 ± 11.2 years. NMO antibody was positive in 24.4% of patients. The presenting symptoms were optic neuritis (55.5%), transverse myelitis (40%), and brainstem symptoms (4.5%). The interval between the first and second attack was 19.28 ± 31.27 months (range: 1 month to 17 years). The mean EDSS score of the patients was 2.8 ± 2.25. Frequency of long-extending cervical plaque was higher among men than women (85.7% vs. 57.9%). CONCLUSION: Based on this study, the mean age of NMOSD onset among Isfahan population was considerably lower than other studies, and there was higher frequency of long-extending cervical lesion among male patients which needs more consideration in further studies.

Evaluation of neural gene expression in serum treated embryonic stem cells in Alzheimer's patients.

BACKGROUND: Previous studies confirmed that neural gene expression in embryonic stem cells (ESC) could influence by chemical compounds through stimulating apoptotic pathway. We aimed to use ESCs-derived neural cells by embryoid body formation as an in vitro model for determination of neural gene expression changes in groups that treated by sera from Alzheimer's patients and compare with healthy individuals. MATERIALS AND METHODS: ESC line which was derived from the C57BL/6 mouse strain was used throughout this study. ESC-derived neural cells were treated with serum from Alzheimer's patient and healthy individual. Neural gene expression was assessed in both groups by quantitative real-time polymerase chain reaction analysis. The data was analyzed by SPSS Software (version 18). RESULTS: Morphologically, the reducing in neurite out-growth was observed in neural cells in group, which treated by serum from Alzheimer's patient, while neurite growth was natural in appearance in control group. Microtubule-associated protein 2 and glial fibrillary acidic protein expression significantly reduced in the Alzheimer's patient group compared with the control group. Nestin expression did not significantly differ among the groups. CONCLUSION: Neural gene expression could be reduced in serum treated ESC in Alzheimer's patients.

Effect of disease duration on personality type in multiple sclerosis patients and healthy individual.

BACKGROUND: Multiple sclerosis may have profound emotional consequences. The relation between psychological and physical factors could lead patients toward unforeseen disease. This study focuses on multiple sclerosis (MS) disease duration on personality type A and B in relation to individuals' behaviors. MATERIALS AND METHODS: This descriptive-analytical study was conducted in Isfahan Alzahra hospital in 2013. Three hundred MS patients and 100 healthy individuals were determined. The distributed questionnaires related to MS patients and considering the descriptive statistics such as demographic variables. Data were analyzed by SPSS software (version 18) based on Chi-square test and independent T-test. RESULTS: Disease duration varied between 1 to 38 years: 30% (1-4 years), 38% (5-10 years), 20% (10-20 years), and 12% (more than 20 years). Significant relationship was observed between disease duration and tendency to type A (higher stress). This relation was positive and significant in Relapsing Remitting MS patients; but negative correlation was seen in Secondary Progressive MS patients. These patients tended to type B (lower stress) when disease duration increased. CONCLUSIONS: Individuals with disease duration of one year and less than one year tend to type A personality, while patients with increment of disease duration have tendency to type B.

The relationship between residents' interest to their specialty field and their level of anxiety.

INTRODUCTION: Studies showed that lack of interest in the field of study in the 1(st) year of residency could create stress and then causing psychological problems like anxiety. The purpose of this study was the evaluation of relationship between interest to the specialized field of study and the level of medical residents' anxiety in 2010. MATERIALS AND METHODS: This study was a cross-sectional study. The statistical population of this study was the medical residents (1(st)-4(th) year) from the Universities of Medical Sciences of Isfahan, Gilan, Sanandaj and Kashan (370 residents). They were selected by stratified sampling method proportional to size and were included in this study. Data was collected by using the researcher-made questionnaire of demographic characteristics, the questionnaire about the field of study selection and Zung anxiety self-assessment standard questionnaire. The findings were analyzed by using the SPSS statistical software version 16, descriptive and analytical tests (t-test, one-way ANOVA and Pearson). The significance level was considered as P ≤ 0.05. RESULTS: The results showed that more than 92% of the surveyed residents did not have anxiety and were in the normal group. There was a significant correlation between the specialized field of interest and anxiety scores of the residents (P < 0.05). In particular, the following cases had a direct effect on interest rates and anxiety in residents: the amount of time for visiting and patient care, job stress, time for personal affairs, the ability to predict the agenda and job security. CONCLUSIONS: The relationship between various factors and anxiety level was corroborated that the residents' interest and success in studying was the result of their choices and management plans to eliminate barriers for the selection of the field and the favorite city by the officials and planners.

Correlation of midkine serum level with pro- and anti-inflamatory cytokines in multiple sclerosis.

BACKGROUND: Midkine (MK) is a heparin-binding growth factor with promoting effects in inflammatory responses through enhancing leukocytes migration. OBJECTIVE: To study the correlation between MK serum levels and concentration of inflammatory cytokines in Multiple Sclerosis (MS) patients. METHODS: We evaluated the MK level and its relationship with inflammatory cytokines (IL-17 and IL-23) and anti-inflammatory ones (IL-10 and TGF-ß) in multiple sclerosis (MS) patients. The serum concentrations of MK and cytokines were assessed by ELISA in 32 MS patients in comparison with 32 healthy subjects. RESULTS: Our data showed that the MK concentration in MS patients is lower than healthy controls (341.15 ± 40.71 Pg/ml vs. 620.15 ± 98.61 Pg/ml, respectively, p=0.015). We also observed a significant decrease in IL-10, IL-23, and TGF-ß cytokine levels in MS patients. There was a significant correlation between MK and IL-23 concentrations in our study (r = +0.829, p≤ 0.001). CONCLUSION: These results confirm a role for MK in inflammatory reactions in MS.

Application and preventive maintenance of neurology medical equipment in isfahan alzahra hospital.

BACKGROUND: Nowadays Medical equipment plays an important role in the treatment and in the medical education. Using outdated preventive maintenance (PM) system may cause problems in the cutting edge medical equipment, Nervous system disease's equipment (In diagnosis and treatment) which are crucial for every medical center. Based on above facts we focused on nervous system treat units' equipment and informed the supervisors and their colleagues about the latest equipment maintenance status and promoted methodical and correct method to be used for medical equipment maintenance. METHODS: This research is an analytical descriptive and has been done on the base information from a particular time to past. We gathered our required information of 2009 from Alzahra Medical Center. We divided this research info 2 main phases. In the first phase, we picked out Neurosurgery and Neourology diseases medical equipment (diagnosis and therapy equipment) and in the second phase, we need to implement a methodical PM for every equipment. RESULTS: Research has shown that there are 19nervous system equipment in Alzahra Medical center, categorized in diagnostic (13 pcs), therapeutic (4 pcs) and diagnostic-therapeutic (2 pcs). As we declare in methods part of this research, we categorized medical equipment in Food and Drug Administration (FDA) segmentation. Capital-scarce equipment: Magnetic resonance imaging, Eco Doppler, Kamalaarak ultrasonic surgical aspirator, Stereotactic, computed tomography-scan, euroendoscope/vital-scarce equipment: Coblation, Sonoco, vaterjet/scarce equipment: Transcranial color Doppler, electroencephalogram, electromyography, surgical microscope. CONCLUSIONS: Survey of application and preventive maintenance of neurology medical equipment in Isfahan Alzahra hospital show there is no P.M system. Implementing a complete P.M system for this medical center is crucial to preventing cause problems for these medical equipment and decreasing maintenance costs and gaining uptime. Researchers of this article have tried to provide PM, use of texts, web and experts.

Is anti-cyclic citrullinated Peptide antibody a good value biomarker for Alzheimer disease?

BACKGROUND: Alzheimer's disease (AD) is one of the most important neurodegenerative disorder. Anti-cyclic citrullinated peptide (anti-CCP) may all be involved in the development of vascular disease such as AD. The aim of this study is detection of seropositivity for anti-CCP antibody in AD patients. METHODS: In our study, 30 patients with AD and 29 healthy controls (age and-sex matched) were recruited. Homocysteine and anti-CCP was measured by spectrophotometrically and immunoassay. RESULTS: Mean ± SE anti-CCP was higher significantly between AD (13.6 ± 3) and healthy subjects (4.8 ± 0.2) (P = 0.006). In the patients, anti-CCP serum level was in high range (32.1%) of abnormal levels, but there was no significant difference in serum homocysteine in AD patients compared with controls. There is no correlation between anti-CCP and homocysteine levels in AD patients (P = 0.75), but between age and anti-CCP level observed a significantly correlation (P = 0.04). CONCLUSIONS: It needs more studies to clarify confirmation the role of anti-CCP antibody production in AD patients.

Investigating the anxiety level in Iranian medical residents in 2010-2011.

BACKGROUND: University entrance is accompanied by major changes in social relationship, rules, and expectations that lead to psychological disorders in susceptible students. The goal of this research is to study the anxiety rate in Iranian medical residents in 2010-2011. METHODS: This study is a cross-sectional, descriptive study. It contains 370 medical residents from the 1(st) year to the 4(th) year of medical universities in Isfahan, Gilan, Zahedan, Sanandaj, and Kashan. The stratified sampling method proportionate to volume of participants is used in this study. The information is collected based on researchers' questioners and Zung self-rating anxiety scale and analyzed with the use of spss software version 16, addition to descriptive and analytic tests (Pearson, one-way analysis of variance, t-test). Meaningful level is regarded as P ≤ 0.05. RESULTS: The study showed that more than 92% of residents participated in the study did not demonstrate anxiety. Among 370 subjects 5.5% presented with mild symptoms of anxiety and no one had symptom of severe anxiety. A meaningful statistical relationship was observed between anxiety and sex, major of study and the city of study (P < 0.05). The results showed a positive meaningful relationship between the number of visits and the score of anxiety. On average the number of night floats were two in 1 week and the number of patient visit was 19 in the past 24 h. A meaningful statistical relationship between anxiety score and number of patient visits was observed. CONCLUSIONS: The anxiety rate in medical students in this study compared to the findings of previous studies reveled very low anxiety in medical residents. The low rate of anxiety could be attributed to the sense of job security and the hope for a better future among residents. The high percentage of anxiolytics abuse and absence of anxiety producing factors among residents in addition to inaccurate response to the questionnaire may all contribute to the low rate of anxiety in this study.