Switching from injectable to other Disease Modifying Therapies may improve sexual dysfunction in people with Multiple Sclerosis.

BACKGROUND: Multiple Sclerosis (MS) a central nervous system autoimmune disorder, mainly affecting young adults and more prevalent among women, can lead to sexual dysfunction (SD) among both males and females with MS. Female sexual dysfunction can be defined as dyspareunia, a lack of sexual desire, disorders in the arousal and orgasm phases, and sexual pain disorders. The purpose of this study is to investigate the changes in sexual function among females with MS whose treatment was switched from first-line injectable medications to other agents after a six-month duration. And assess the changes in all three domains of SD. METHODS: In this longitudinal study females diagnosed with MS, aged between 18 and 50 years old, and were candidates for switching their treatment from interferon beta-1a (intra-muscular and subcutaneous), and Glatiramer Acetate (GA), to Fingolimod, Dimethyl Fumarate (DMF), or Natalizumab (NTZ) due to patients' convenience and tolerability and adverse events were included. "Multiple Sclerosis Intimacy and Sexuality Questionnaire-19" was used to evaluate the SD changes before and six months after the new treatment initiation. Statistical analysis was conducted using SPSS V.24 software. Histograms and the Shapiro-Wilk test were used to assess the normality of the variables; due to the non-normal distribution of quantitative variables (except for age), the Wilcoxon signed-rank test was used to compare the scores, before and six months after the medication change. The level of significance was considered less than 0.05. RESULTS: Out of 107 female participants (average age: 35.09 ± 5.61), The mean of overall MSISQ-19 scores, before and six months after the medication change were not significant (p-value = 0.091). However, considering the subdomains, the medication changes only affected the tertiary subdomain of MSISQ-19 (p-value = 0.017). Still, the scores of other subdomains did not change significantly (p-value = 0.761 for primary SD and 0.479 for secondary SD). Also, there wasn't any significant difference between EDSS before and after the medication change (p-value = 0.461). CONCLUSIONS: To our knowledge, this was the first study, assessing the effect of MS medication change on the improvement of SD among patients. According to the results of the presented cross-sectional study, we found that during a six-month period, the tertiary subdomain of MSISQ-19 symptoms improved significantly, while the changes in other SD domains were not significant.

Perceived social support, coping strategies, anxiety and depression among women with breast cancer: Evaluation of a mediation model.

PURPOSE: Depression and anxiety are now considered as common adverse reactions to cancer. Prior research has shown that social support and functional coping strategies alleviate depressive and anxious symptoms of cancer patients but the exact relationship between social support and coping strategies in amelioration of the symptoms is yet to be elaborated. METHODS: The current study examined the relationship between social support, coping strategies and depressive-anxious symptomatology and explored the possible role of coping strategies in mediating the relationship between social support, depression and anxiety in Iranian breast cancer patients (N = 221). Anxiety and depressive symptoms were measured using the Depression-Anxiety-Stress (DASS-21) scale, social support was measured using the Medical Outcome Survey, Social Support Scale (MOSS-SSS), and coping strategies were measured using the brief COPE. RESULTS: All of the social support subscales were negatively correlated with depression and anxiety. Most of the coping strategies were negatively correlated with depressive-anxious symptoms. When controlling for covariates, mediation analysis revealed that active coping, positive reframing and acceptance partially mediated the association of social support of different types with depression. Positive reframing also partially mediated the relationship of the total social support and positive social interactions with anxiety. CONCLUSIONS: High levels of social support may relieve depressive and anxious symptoms of breast cancer patients through functional coping. The management of breast cancer patients should also focus on providing patients with social support and educating them on the practice of functional coping strategies.

Evaluation of the rate of COVID-19 infection, hospitalization and death among Iranian patients with multiple sclerosis.

BACKGROUND: COVID-19 is increasingly expanding all over the world. People who have an underlying disease or taking immunosuppressive drugs are generally more likely to be infected than the others. Multiple sclerosis (MS) patients may also be at risk of the disease and its complications depending on the medication they are taking. In this study, we evaluated a large population of patients with MS with different disease modifying drugs to show if any of them increases the risk. In addition, this study evaluates the incidence of COVID-19 in patients with MS, the rate of hospitalization or death in these patients. METHOD: This study was performed at the MS Clinic of Sina Hospital. All patients were contacted and their demographic characteristics were recorded. They were then asked about their COVID-19 symptoms. Patients with these symptoms were further evaluated. The documents were reviewed by treating neurologist and MS nurses to be sure about diagnosis of COVID19. The positive polymerase chain reaction (PCR) result or compatible lung computed tomography (CT) scan was acceptable for COVID-19 diagnosis. RESULTS: 4647 patients answered the phone contact. Of these, 68 were infected with the COVID-19. The rate of hospitalization was 25% which is far more than general population. Two patients died from COVID-19. Rituximab was associated with increase rate of COVID-19 infection but not with hospitalization rate. There was no significant correlation between use of other drugs and rate of infection. CONCLUSION: This study revealed that the incidence of COVID-19 in MS patients is not more than general population, but the risk of hospitalization in these patients is higher than estimated for the disease. This highlights the importance of communicating to patients the severity of COVID-19 and the importance of risk reduction behaviors like social distancing and mask use.