فهرست مطالب
Current Journal of Neurology
Volume:16 Issue: 1, Winter 2017
- تاریخ انتشار: 1396/01/24
- تعداد عناوین: 11
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Page 1BackgroundThis study was performed to compare the effects of low dose interferon beta-1 (IFN-β-1) (CinnoVex, 30 mcg) and high dose IFN-β-1 (REBIF, 44 mcg) on the reduction of the number and size of plaques in magnetic resonance imaging (MRI) in patients with multiple sclerosis (MS).MethodsThis historical cohort study, which was performed in 2014 in Sanandaj (western part of Iran). 43 MS patients in two groups were investigated. The first group, which included 19 patients, was treated using high dose IFN (44 mcg) and the second group, which was consisted of 24 patients, was treated using low dose IFN (30 mcg). Patients data were collected and analyzed by the Stata version 11 software; the analyses were performed using statistical t-test, chi-square test, Fisher test, and logistic regression.ResultsBoth drugs were effective in controlling active demyelinating plaque and in preventing plaque activation (P = 0.633). The impact of both drugs in the reduction of the number and size of plaques was evaluated. Based on the results of the MRI, high dose IFN therapy was more effective than the low dose IFN drugs and had a better performance in terms of reducing the number of plaques and in stop-and-recovery (P = 0.039), as well as in reducing the plaque size (P = 0.050).ConclusionThe high dose IFN therapy was more effective than the low dose IFN therapy in reducing the number and size of brain plaques in patients with relapsing-remitting MS (RRMS).Keywords: Multiple Sclerosis, High Dose Interferon, Low Dose Interferon, Magnetic Resonance Imaging
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Page 26BackgroundEvidence-based medicine (EBM) is a current practice in medicine to produce clinical practice guidelines from well-designed, randomized, controlled trials. We studied knowledge, attitude, and practice of EBM of neurologists who participated in the Iranian congress of neurology.MethodsA self-administered anonymous questionnaire was distributed and filled by neurologists.ResultsA total of 200 neurologists were randomly sampled and with response rate of 56%. 33.9% of responder had previously participated in EBM courses. The average total knowledge score was 4.05 ± 0.80 out of a maximum possible score of 5.0. Textbooks were still the most favorite source of knowledge for our neurologists. A lack of time was the highest, and motivation the least mentioned barrier in using EBM.ConclusionOverall, the Iranian neurologist had acceptable knowledge and attitude toward EBM and had same similar as found in other studies.Keywords: Evidence-Based Medicine, Knowledge, Attitude, Neurologist, Iran
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Page 30BackgroundActivated protein C (APC) inactivates factor V (FV) by cleavage of its heavy chain at Arg306, Arg506, Arg679, and Lys994. Mutational changes, which abolish APC cleavage sites, may predispose thrombosis by altering the inactivation process of FV. FV Leiden (FVL) (Arg506Glu) has been demonstrated as a strong risk factor for thrombosis. In the current study, we have studied whether mutations in the cleavage sites of FV for APC, not due to FVL, would have a role in presenting APC resistance (APCR) and initiation of a cerebral thrombotic event.MethodsA group of 22 patients with a history of cerebral venous thrombosis (CVT), who were not carriers of FVL enrolled in the study. The patients who had conditions associated with acquired APCR were excluded from the study. APCR test was performed on the remaining 16 patients, which showed APCR in 4 plasma samples. DNA sequencing was performed on four exons of FV of APCR patients, encoding Arg306, Arg506, Arg679, and Lys994.ResultsMutations were not found within nucleotides encoding the cleavage sites; neither was found within their close upstream and downstream sequences.ConclusionOur results show that polymorphisms affecting cleavage sites of FV other than Arg506Glu it would be less likely to be the basis for APCR and its increased thrombosis susceptibility. In addition, it emphasizes on the importance of screening for APCR in the patients diagnosed with CVT.Keywords: Cerebral Venous Thrombosis_Factor V_Activated Protein C Resistance_Cleavage Sites
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Page 34There has been a global rising trend in recent years in the incidence of multiple sclerosis (MS). Despite being an MS low-risk region, this disease has also been recently on the rise in the Middle East. As part of the Middle East, Iran has not been spared either; however, the cause of this dramatic increase remains to be discovered. This study reviews possible reasons for this increase in Iran. Although many factors such as the increased rate of smoking, lifestyle changes, modernization, and contact with toxic solvents can be proposed as reasons for this sudden rise in the prevalence of MS in Iran, these factors cannot be taken as definite causes and further studies are required to prove their impact.Keywords: Multiple Sclerosis, Causality, Prevalence, Incidence, Environmental Factors, Iran