فهرست مطالب gholamreza shamsaei

Recent research shows that most of the patients with multiple sclerosis (MS) have cognitive-like disorders. Due to the beneficial effects of atomoxetine on improving cognition in limited animal and human surveys, the aim of the present study was to investigate the effect of the atomoxetine on improving cognitive disorders of MS. This study was a parallel, randomized clinical trial, designed to investigate the effect of atomoxetine drug on the improvement of cognitive impairment (CI) in MS, from April 2021 to March 2022. According to the inclusion and exclusion criteria, a total of 52 participants were involved in the study and then randomly divided in two groups of 26. Experimental group was treated with atomoxetine and the control group was treated with placebo. The Minimal Assessment of Cognitive Function in Multiple Sclerosis (MACFIMS) test was performed for assessment at the beginning and after 3 months. The California Verbal Learning Test (CVLT), the CVLT-delay, the Brief Visuospatial Memory Test-Revised (BVMT-R), and the Symbol Digit Modalities Test (SDMT) were used to evaluate the CI and changes following medication. Finally, data were analyzed by SPSS software at significance level of 0.05. The mean age of patients in the experimental group was 37.7 ± 8.5 and in the placebo group was 37.8 ± 7.6 (P = 0.32). The results showed significant changes in cognitive levels before and after the use of atomoxetine and also in comparison to the placebo group (P < 0.05). This study showed that atomoxetine improved the cognitive domains after administration compared to placebo.

Amyotrophic lateral sclerosis (ALS) is an uncommon and aggressive neurodegenerative disorder that influences the lower and upper motor neurons. There are low eligible drugs for ALS treatment; in this regard, supplemental and replacement treatments are essential. There are relative studies in the field of mesenchymal stromal cells (MSCs) therapy in ALS, but the different methods, differently used medium, and difference in follow-up periods affect the outcome treatment.

The current survey is a single-center, phase I clinical trial to evaluating the efficacy and safety of autologous bone marrow (BM)-derived MSCs through intrathecal administration in ALS patients. MNCs were isolated from BM specimens and cultured. The clinical outcome was evaluated based Revised Amyotrophic Lateral Sclerosis Functional Rating (ALSFRS-R) Scale.

Each patient received 15 ± 3 × 106 cells through subarachnoid space. No adverse events (AEs) were detected. Just one patient experienced a mild headache after injection. Following injection, no new intradural cerebrospinal pathology transplant-related was observed. None of the patients’ pathologic disruptions following transplantation were detected by magnetic resonance imaging (MRI). The additional analyses have shown the average rate of ALSFRS-R score and forced vital capacity (FVC) reduction have decreased during 10 months following MSCs transplantation versus the pretreatment period, from -5.4 ± 2.3 to -2 ± 3.08 ALSFRS-R points/period (P = 0.014) and -12.6 ± 5.22% to -4.8 ± 14.72%/period (P < 0.001), respectively.

These results have shown that autologous MSCs transplantation reduces the disease’s progression and has favorable safety.

Guillain-Barre Syndrome (GBS) is an autoimmune acute inflammatory demyelinating polyneuropathy usually elicited by an upper respiratory tract infection. Several studies reported GBS associated with Coronavirus Disease 2019 (COVID-19) infection. In this study, we described nine GBS patients following the COVID-19 vaccine.

In this study, nine patients were introduced from six referral centers for neuromuscular disorders in Iran between April 8 and June 20, 2021. Four patients received the Sputnik V, three patients received the Sinopharm, and two cases received the AstraZeneca vaccine. All patients were diagnosed with GBS evidenced by nerve conduction studies and/or cerebrospinal fluid analysis.

The median age of the patients was 54.22 years (ranged 26-87 years), and seven patients were male. The patients were treated with Intravenous Immunoglobulin (IVIg) or Plasma Exchange (PLEX). All patients were discharged with some improvements.

The link between the COVID-19 vaccine and GBS is not well understood. Given the prevalence of GBS over the population, this association may be coincidental; therefore, more studies are needed to investigate a causal relationship.

Alteplase is a thrombolytic drug that is produced by recombinant DNA technology. Tissue plasminogen activator enzymewhich converts plasminogen to the active form of plasmin is also produced by the same technology; it causes fibrinolysis and clot dissolution. This study aimed to compare the efficacy and complications of Alteplase injection in patients with acute ischemicstroke (AIS(during the first 3hours and 3-4.5hours after the onset of symptoms.

In this study, patients with AIS who were referred to Golestan Hospital of Ahvaz city during 2018-2019 were selected. Information was collected by a checklist.

The results showed that the mean Modified Rankin Scale(mRS)for 3 months and 6 months (p-value: 0.91 for 3months and p-value: 0.80 for 6months) and National Institutes of Health Stroke Scale(NIHSS)(p-value: 0.21) were not significantly different between both groups; statistically, no significant relationship was observed between them. The incidence of complications after treatment was almost similar, in both groups.

Finally, it was concluded that complications and efficacy of rt-PA (Alteplase) injection were not statistically different, between the two groups under study.

Chemotherapy-induced neuropathy is one of the most severe complications of cancer drug therapies causing a number of problems for patients and making treatment limitation decisions problematic. One of the most important drugs used in breast cancer chemotherapy regimens, Taxol is considered as the most common cause of neuropathy in such cases. The aim of this study was to evaluate the effect of vitamin E on reducing the Taxol-induced neuropathy development among patients with breast cancer.
The randomized clinical trial (RCT) included 70 patients with breast cancer who received Taxol chemotherapy regimens. They were assigned to one of the two groups: a group without vitamin E feeding (Group I) and a group with vitamin E treatment at a daily dose of 400 IU bid (Group II). Electrophysiological testing of all patients was performed before starting medications and again 3 months post-treatment. The data were compared between the groups.
Vitamin E feeding had no significant effect on amplitude, latency, and CV of tibial and peroneal nerves (P > 0.05), while the delta amplitude of sural nerve was significantly lower among patients taking vitamin E supplements (P = 0.007).
We suggest the inhibitory effect of vitamin E on the progression of Taxol-induced neuropathy, by slowing the speed of progression, among breast cancer patients by improving the function of the nervous system.

Acute ischemic stroke is one of the most common causes of death worldwide with one new case being diagnosed every five seconds. The mortality rate and permanent disability are very high and the current treatment still needs to improve to a large extent. Minocycline drug, a derivative of tetracycline, is an anti-inflammatory and anti-apoptotic protection of neurons, the role of which has been studied recently in recovery from nerve degenerative diseases, especially stroke. This study aimed at evaluating the effect of minocycline in the recovery of patients with a history of stroke.
In this randomized clinical trial, 42 patients with ischemic stroke were divided to 2 groups: receiving minocycline 200 mg for 5 days and receiving the placebo. Aspirin was prescribed to all patients. Clinical assessment before and 90 days after the intervention was performed by the National institutes of health stroke scale score (NIHSS).
A total of 36 patients completed the study. The number of females in the case and control groups was 55.5% and 51.1%, respectively. In the case group, NIHSS decreased from 9.55 to 6.1 and in the control group, it decreased from 10.2 to 7.33, which was statistically significant. Although the NIHSS decreased in patients taking minocycline more than the control group, this difference was not statistically significant.
According to the findings of this study, it seems that minocycline could be used as a complementary therapy in patients with ischemic stroke. However, these results need to be confirmed by further studies in this field.

The present study is carried out to make a comparison between two pharmacological (heparin) and physical (compression stockings) in the prevention of deep vein thrombosis in lower limb of the patients suffered from acute stroke. In this investigation as a clinical trial, the effectiveness of the above methods on 100 patients with the stroke was compared in two groups of 50 persons. Three patients in physical group and two patients in pharmacological group got deep vein thrombosis that showed no significant difference between two groups. In spite of no significant relationship and due to less incurrence of thrombosis in heparin group, it is more reasonable to use pharmacological methods.

Diabetes mellitus is one of the most common endocrine diseases with micro-vascular complications and is a common cause of polyneuropathy. We studied the effect of enalapril on electrophysiologic criteria and clinical symptoms of patients with type II diabetes and sensory neuropathy. A double blind study was conducted on 45 Patients with type II diabetes and neuropathy. They were normotensive and randomly divided into case and control groups. The case group received oral enalapril 2.5 mg twice a day for 3 months. The control group received placebo. We evaluated the changes in symptoms and electrophysiologic findings. In case group distal latency of peroneal (p=0.01), tibial (p=0.2), ulnar motor (p<0.001), ulnar sensory (p<0.001), median sensory (p<0.001), and median motor nerves (p=0.004) decreased.Amplitude of peroneal (p=0.01), tibial (p=0.01), ulnar motor (p<0.001), ulnar sensory (p<0.001), median sensory (p<0.001) and median motor nerves (p<0.001) increased. Electrophysioloic test of peroneal n. (p=0.01), tibial n. (p=0.01), ulnar motor n. (p<0.001), ulnar sensory n. (p<0.001), median sensory n. (p<0.001) and median motor n. (p<0.001) increased. We did not get any result about sural sensory potential at the beginning and the end of the study. Neuropathy symptom score was also decreased. (p=0.16) In case group electrophysiologic criteria of peroneal, tibial, median sensory and motor, and ulnar sensory and motor nerves showed significant improvement. But no significant changes were found in clinical symptoms.