genetic study of celiac disease in patients with multiple sclerosis in comparison with celiac patients and healthy controls

Background: Studies have reported the controversial association between multiple sclerosis [MS] and celiac disease [CD]. Thus, we aimed to conduct a case control study on patients with MS, CD, and controls to investigate CD in patients with MS by means of comparing CD genetic markers in patients with MS and controls. We also evaluated serological markers in patients with MS

Materials and Methods: This is a case control study conducted on 60 patients with MS, 140 patients with CD, and 151 healthy controls in 2015 in Tehran, Iran. HLA typing was done to identify the carriers of the DQB1*02, DQB1*0301, DQA1*05, or DQA1*0201 alleles for HLA-DQ2, DQB1*0302, or DQA1*03 for HLA-DQ8. All data were analyzed using SPSS software [version 23, IBM Corp]. Serological markers including anti-gliadin antibodies [AGA] [IgA, IgG], anti-tissue trans glutaminase antibodies [Anti tTG] [IgA, IgG], anti-endomysial antibody [EMA] [IgA, IgG], and total IgA were assessed in MS group by enzyme immunoassays

Results: The data of 60 patients with MS [26.7% male, mean age = 34.83 years], 140 patients with CD [33.6% male, mean age = 38.37 years] and 151 controls [48.3% male, mean age = 40.43 years] were analyzed. The results of serological markers were not positive in any of the patients with MS. The prevalence of IgA deficiency [IgA

Conclusion: Our results did not show any correlation between MS and CD, which was similar to other studies

Implication of mauk nursing intervention model on coping strategies of stroke survivors

Objective: Stroke is a major event in one's life, and patients will inevitably require the use of coping strategies in order to try to reestablish acceptable life equilibrium. Due to the extensive role that nurses can be active members in the patient's rehabilitation plan, the Mauk model is a model that focuses on stroke patients. For each stage of this model, Mauk has developed appropriate rehabilitation nursing interventions. This study aimed to analyze the effect of implementation of the Mauk nursing rehabilitation model [Agonizing phase, Fantasy phase, Realizing phase] on the coping strategies of stroke patients

Methods: This study is a quasi-experimental one-group pre-test - post-test study. The interventions are identified and coping strategies for patients based on the Mauk model have been trained. Convenience sampling has been done in Imam Khomeini hospital and Tabassom rehabilitation center in 1392. Data collection instruments included a demographic questionnaire and a coping strategies questionnaire for stroke patients. The educational program was implemented in sessions of 45 minutes. The patients' coping strategies, before and after training, were assessed. Data was statistically analyzed using descriptive and inferential tests in SPSS software 16

Results: The mean score for coping strategies before intervention was 111.42 +/- 11.71, and after intervention was 102.14 +/- 12.45 [P<0.05]. The physical, mental and social dimensions in the coping strategies showed significant differences before and after intervention

Discussion: Using the rehabilitation program interventions for effectively dealing with stress, changing and unpredictable behavior patterns in chronic patients is an important component of the treatment protocol, and helps deliver an increase in coping strategies for stroke patients

Diagnostic accuracy of ultrasonography and radiography in detection of pulmonary contusion; a systematic review and meta-analysis

Ultrasonography is currently being used as one of the diagnostic modalities in various medical emergencies for screening of trauma patients. The diagnostic value of this modality in detection of traumatic chest injuries has been evaluated by several studies but its diagnostic accuracy in diagnosis of pulmonary contusion is a matter of discussion. Therefore, the present study aimed to determine the diagnostic accuracy of ultrasonography and radiography in detection of pulmonary contusion through a systematic review and meta-analysis. An extended systematic search was performed by two reviewers in databases of Medline, EMBASE, ISI Web of Knowledge, Scopus, Cochrane Library, and ProQuest. They extracted the data and assessed the quality of the studies. After summarization of data into true positive, false positive, true negative, and false negative meta-analysis was carried out via a mixed-effects binary regression model. Further subgroup analysis was performed due to a significant heterogeneity between the studies. 12 studies were included in this meta-analysis [1681 chest trauma patients, 76% male]. Pooled sensitivity of ultrasonography in detection of pulmonary contusion was 0.92 [95% CI: 0.81-0.96; I2= 95.81, p<0.001] and its pooled specificity was calculated to be 0.89 [95% CI: 0.85-0.93; I2 = 67.29, p<0.001] while these figures for chest radiography were 0.44 [95% CI: 0.32-0.58; I2= 87.52, p<0.001] and 0.98 [95% CI: 0.88-1.0; I2= 95.22, p<0.001], respectively. Subgroup analysis showed that the sources of heterogeneity between the studies were sampling method, operator, frequency of the transducer, and sample size. Ultrasonography was found to be a better screening tool in detection of pulmonary contusion. Moreover, an ultrasonography performed by a radiologist / intensivist with 1-5MHz probe has a higher diagnostic value in identifying pulmonary contusions

Granulocyte Colony-Stimulating Factor for Amyotrophic Lateral Sclerosis: A Randomized, Double-Blind, Placebo-Controlled Study of Iranian Patients

BACKGROUND AND PURPOSE: The aim of this study was to determine the efficacy and tolerability of granulocyte colony-stimulating factor (G-CSF) in subjects with amyotrophic lateral sclerosis (ALS). METHODS: Forty subjects with ALS were randomly assigned to two groups, which received either subcutaneous G-CSF (5 microg/kg/q12h) or placebo for 5 days. The subjects were then followed up for 3 months using the ALS Functional Rating Scale-Revised (ALSFRS-R), manual muscle testing, ALS Assessment Questionnaire-40, and nerve conduction studies. CD34+/CD133+ cell count and monocyte chemoattractant protein-1 (MCP-1) levels were evaluated at baseline. RESULTS: The rate of disease progression did not differ significantly between the two groups. The reduction in ALSFRS-R scores was greater in female subjects in the G-CSF group than in their counterparts in the placebo group. There was a trend toward a positive correlation between baseline CSF MCP-1 levels and the change in ALSFRS-R scores in both groups (Spearman's rho=0.370, p=0.070). CONCLUSIONS: With the protocol implemented in this study, G-CSF is not a promising option for the treatment of ALS. Furthermore, it may accelerate disease progression in females.

Relationship between sleep quality and quality of life in patients with multiple sclerosis

Impaired quality of life [QOL] is an issue considered in patients with multiple sclerosis [MS]. There are limited studies evaluated poor sleep and impaired QOL in these cases. The aim of this study was to evaluate quality of sleep and poor sleep in Iranian patients with MS and the relationship between Pittsburgh Sleep Quality Index [PSQI] score and QOL subscales. One-hundred and fourteen cases with definite MS due to MC Donald criteria enrolled who referred to MS clinic of Sina and Imam Hospitals were enrolled. Patients asked to fill valid and reliable Persian versions of PSQI and MSQOL-54 questionnaires. Demographic data [sex, age], duration of the disease, education level and marital status were extracted from patients medical files. After neurological examination, Kurtzke Expanded Disability Status Scale [EDSS] was assessed. Ninety-one [79.8%] patients were female and 23 [20.2%] were male. Mean age and EDSS was 34.7 +/- 9.6 years and 2.3 [median: 1.5]. Mean PSQI score and overall QOL score were 4.5 and 57. Sixty-seven cases were good sleepers [PSQI 5]. Except five subscales, all others were significantly different between good and poor sleepers. There was significant positive correlation between PSQI score and EDSS [r = 0.24, P < 0.001] and negative correlation between EDSS and physical and mental health [r = -0.48, P < 0.001, r = -0.43, P < 0.001]. EDSS and total PSQI score were independent predictors of physical and mental health composites. Sleep quality as a factor which affecting QOL should be considered and evaluated properly in MS patients