Association between multiple sclerosis and dietary patterns based on the traditional concept of food nature: a case-control study in Iran.

INTRODUCTION: It remains a matter of debate whether traditional concepts regarding the nature of food affect the development and progression of multiple sclerosis (MS).To date, there are limited studies that have investigated the association between MS and dietary patterns based on the categories of food nature (hot, cold, or balanced) defined in traditional medicine. METHOD: This case-control study was conducted from October 2019 to February 2020. In total, 60 patients diagnosed with MS within the preceding 6 months and referred to our neurology outpatient clinic were included in our case group. The control group included 180 patients who were referred to the same center for general or orthopedic surgery. Dietary intake was assessed in both groups through a reliable and valid semi-quantitative food frequency questionnaire. Data were assessed using principal component analysis. RESULTS: The mean age of the participants was 44.9 ± 17.33 years. The analysis showed that four food patterns were distinguished (eigenvalue > 1), namely "additives and cold-natured foods", "hot and balanced foods and nuts", "dairy and legumes", and "hot and balanced starches". These food patterns explained 57.8% of the total variance. After adjusting all confounding factors, individuals in the highest quartile and medium quartile of "additives and cold-natured foods" had an elevated MS risk compared with the lowest quartile (OR = 7.21, 95%CI = 2.01-12.38 and OR = 3.37, 95%CI = 1.02-11.35, respectively). Furthermore, individuals in the highest quartile of the "hot and balanced foods and nuts" group were protected against MS compared with its lowest quartile (OR = 0.28, 95%CI = 0.08-0.90). Moreover, a protective effect against MS was seen in the highest quartile of the "hot and balanced starches" group relative to its lowest quartile (OR = 0.34, 95%CI = 0.12-0.98). No significant association was found between "dairy and legumes" and the risk of MS. CONCLUSION: This study revealed that dietary patterns based on the traditional concept of food nature might be associated with the risk of developing MS. This represents the first work in this area, so further research is recommended.

Large-vessel stenosis in the patients with ischemic stroke in Iran: Prevalence, pattern, and risk factors.

BACKGROUND: Large artery disease (LAD) is a common cause of stroke, but a little is known regarding its role in Iranian stroke patients. The current study investigates the prevalence and risk factors for cervicocephalic arterial stenosis in the patients with ischemic stroke using digital subtraction angiography (DSA). METHODS: This was a prospective cross-sectional study performed in hospitals affiliated to Shiraz University of Medical Sciences from March 2011 to March 2013. Patients with ischemic stroke underwent noninvasive vascular and cardiac investigations to find the etiology of the stroke. Patients suspected of having large artery stenosis underwent DSA. The severity of the stenosis was calculated according to the North American Symptomatic Carotid Endarterectomy (NASCET) and Warfarin-Aspirin Symptomatic Intracranial Disease (WASID) Trial criteria. The presence of cigarette smoking, hyperlipidemia, hypertension, and diabetes mellitus were documented for all subjects. RESULTS: A total of 3703 stroke patients were identified. Of them, 342 patients (62.3%, male) underwent DSA for LAD. The mean age at the time of angiography was 66.7±10.3 years. Extracranial and intracranial arteries were involved in 305 (89.2%) and 162 (47.4%), respectively. And 301 patients (88%) had anterior circulation and 128 patients (37.4%) had posterior circulation involvement. Diabetes mellitus but not age, sex, hypertension, hyperlipidemia, or smoking was significantly associated with intracranial involvement. (P = 0.002). CONCLUSION: It can be concluded that the distribution of the large arterial atherosclerotic disease in Iran is similar to that seen in North America and Europe. Intracranial stenosis was more prevalent in diabetic patients.

Physical injuries in patients with epilepsy and their associated risk factors.

OBJECTIVES: To determine the frequency, nature, and risk factors associated with physical injuries in patients with epilepsy. METHODS: In this retrospective cohort study, patients 18years of age and older with active epilepsy for at least 1year were included. A questionnaire (including age, gender, education, type of epilepsy, seizure frequency, having aura, drug compliance, polypharmacy, comorbidity, type and place of injury) was completed from patients and healthy individuals. Statistical analyses were performed using multiple logistic regression and Chi-square tests. RESULTS: 264 patients with epilepsy and 289 healthy participants were studied. Among patients, 8.7% reported severe injuries and 44.3% had mild injuries. Most patients reported soft tissue injuries, followed by dental injury, burn, and head injury. Severe injuries were 2.9 times more frequent among patients having generalized tonic-clonic seizures (GTCS) compared to healthy control; this was not statistically significant (P=0.07). No patient reported having severe injuries due to SPS, myoclonic or absence seizures. Mild injuries were 10.3 times more frequent among those with GTCS compared to healthy control (P=0.001). The relative risk for having injury in patients compared to control group was 3.42 (95% confidence interval: 2.50-4.69). Injury was significantly related to having GTCSs, illiteracy, having fall with seizures, comorbidity and having uncontrolled seizures. CONCLUSION: Physical injuries are common in patients with epilepsy; however most of these injuries are mild. Severe injuries rarely occur in patients with seizures other than GTCS.