The characterization of oxaliplatin-induced peripheral neuropathy using electromyography in gastrointestinal cancer patients

Oxaliplatin-induced peripheral neuropathy (OIPN) is a common dose-dependent chemotherapy complication in gastrointestinal cancer (GIC). This side effect may restrict therapeutic dose elevation of oxaliplatin. Here, OIPN frequency and determinants of neuropathy appearance in oxaliplatin-treated GIC patients. A total of 102 GIC patients who underwent chemotherapy with fluorouracil, folinic acid and oxaliplatin (FOLFOX4) regimen participated in this longitudinal study. Electromyography (EMG) was accomplished for ulnar, radial, sural, peroneal nerves and superficial peroneal nerve (SPN) before, 3, and 6 months after treatment. National Cancer Institute-Common Toxicity Criteria V.3 and clinical version of the Total Neuropathy Score were used for the neuropathy diagnosis at six months after treatment onset. Of all entered patients, twelve people discontinued this study, and five patients passed away. About 85 patients remained three and six months after chemotherapy onset. Approximately 95% of patients three months after chemotherapy demonstrated OIPN manifestations. Finally, data for 81 patients having neuropathy were analyzed. Mean age of patient 64.0±10.9 years. There were about 3.7%, 30.9%, 63% grade III, II, I of neuropathy, respectively. Interestingly, a significant decrease in action potential (AP) amplitude of SPN, sural and radial nerves but not ulnar and peroneal was observed after treatment onset. However, only the ulnar nerve indicated a substantial deceleration of nerve conduction. Age, sex, weight, past medical diseases, smoking and acute neuropathy were not significantly associated with OIPN. The occurrence of OIPN is detectable by electrophysiological changes of SPN, radial, and sural nerves at three and six months after starting chemotherapy with the FOLFOX4 regimen

Migraine headache in Multiple Sclerosis. Is more frequent among MS patients?

Objectives. Multiple sclerosis (MS) is a chronic disease of the central nervous system that is associated with inflammation, demyelination of neurons and gliosis. There are different reports about the association between migraine and MS. Taking note of headaches experienced by people with MS and providing appropriate treatment can help enhance their quality of life. We aimed to determine the frequency of migraine headache in MS patients. Materials and methods. This was a descriptive cross-sectional study, conducted in 2020 among 125 MS patients referred to neurology clinic of Poursina Hospital or registered in Guilan MS Registry System and 125 controls with minor head trauma in Rasht. After obtaining written consent, all the subjects were asked to fulfil a checklist about their demographics, MS and headache characteristics by phone call. Outcomes. In this study 96 RRMS, 19 PPMS and 10 SPMS patients participated among which frequency of mild, moderate and severe disability was 74.4%, 22.4% and 3.2%, respectively. The frequency of migraine in MS patients was significantly higher than the control group [28.8% (n=36) vs. 12.8% (n=16) p=0.002]. After adjusting the confounding factors a significant relationship was found between MS and migraine (OR: 2.76, p = 0.004). Conclusions. MS patients experience migraine headaches approximately twice the general population

COVID-19 Infection and Seropositivity in Multiple Sclerosis Patients in Guilan in 2021

Background: Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system. COVID-19 has presented a significant challenge to the care providers of patients with MS. Objectives: The present study aimed to investigate the frequency of COVID-19 infection and its seropositivity in MS patients in Guilan, Iran, in 2021. Materials & Methods: In this analytical-cross-sectional study, all patients with relapsing-remitting MS registered in the Guilan MS Association with an expanded disability status scale of less than 5 who were referred for evaluation participated in the study. Information related to the clinical and serological symptoms of COVID-19 infection, changes in drug use, and the occurrence of new attacks were collected. Serological results of COVID-19 (IgG) among them were registered. Results: In total, 260 patients with MS (78.8% women, and 21.2% men) with a Mean±SD age of 38.7±9.9 years, and a Mean±SD duration of MS of 8.9±4.9 years were investigated. The most commonly used drugs were Dimethyl fumarate, Interferon, and Rituximab, respectively. Thirty-three patients (12.6%) had a clinical COVID-19 infection, of which 32 people had a mild and only one had a critical infection. Eight patients (1.3%) had positive COVID-19 IgG tests. No significant relationship was found between the COVID-19 infection with the type of medication, medication change, clinical attack of MS, and co-morbidities (P>0.05). Conclusion: A few patients had positive COVID-19 IgG tests and clinical COVID-19 infection. The vast majority had mild disease, and the clinical attack was not related to COVID-19 infection

The Relationship between Fatigue and Psychological Symptoms in Patients with Gastrointestinal Cancer

Background: Cancer can lead to fatigue and the manifestation of psychological symptoms in patients, including depression, anxiety, and stress. Objectives: The aim of this study was to investigate the relationship between fatigue and psychological symptoms in patients with gastrointestinal cancer. Materials and Methods: The study had a descriptive, cross-sectional design. We assessed levels of fatigue and the psychological health of 70 patients with gastrointestinal cancer who had been referred to the cancer institute in Tehran, Iran in 2014.We used the Rhoten Fatigue Scale to assess patients’ levels of fatigue and the Depression Anxiety Stress Scale (DASS-21) to assess their psychological symptoms. We performed a correlation analysis and stepwise multiple linear regression to compare the relationship between fatigue and psychological symptoms in the cancer patients. Results: There was a significant relationship between psychological symptoms, including depression, stress, and anxiety and fatigue in patients with gastrointestinal cancer (p<0.05). Conclusion: Our study results demonstrate that the severity of fatigue is related to the extent of psychological symptoms (depression, anxiety, and stress) in patients with cancer. A patient’s depression and anxiety predicts the fatigue

The Effect of Core Stability Exercise Program on the Balance of Patients with Multiple Sclerosis

Background: Multiple sclerosis (MS) is a chronic disease characterized by degradation of the central nervous system myelin which may impair the balance of patients. Core Stability Exercises have been the focus of attention for repairing the stability of some patients.   Objectives: To assess the effect of core stability exercise on the balance of patients with multiple sclerosis. Materials and Methods: In this quasi-experimental (pretest-posttest study with no control group), 15 MS patients have been selected according to convenient sampling and Expanded Disability Status Score (EDSS) of less than 4.5. Participants performed core stability program according to the Jeffreys protocol (2002) at 9 O'clock in the morning over 8 weeks in summer 2015. Static (in second) and dynamic (in centimeter) balances were measured using modified stork and modified star (Y) tests respectively. Data were analyzed in SPSS-16 using Kolmogorov-Smirnov test to ensure normal distribution of data, and paired t-test to compare mean values before and after exercise program as they have normal distribution.  Results: Mean and standard deviation of static balance were 3.56±1.81 and 11.17±6.36 in pretest and posttest in the dominant foot, and 3.67±1.89 and 9.42±2.94 in the non-dominant foot, respectively. The sum of the 3 measurements in Y balance was 256.01±32.68 and 340.68±38.33 in pretest and posttest in the dominant foot, and 262.35±42.49 and 344.55±47.25, respectively, in the non-dominant foot (p≤0.05). Conclusion: The core stability exercise program positively and significantly improved static and dynamic balance of patients with multiple sclerosis

The Effectiveness of Yoga Therapy in Reducing Anxiety, Stress and Depression in Women with Multiple Sclerosis

Background: Multiple sclerosis (MS) is a progressive chronic neurologic disorder which topically causes the destruction and inflammation of the myelin sheath in the brain and the spinal cord. It also affects the patient's emotions and can be treated using complementary medicine. Objectives: The present study was conducted to investigate the effectiveness of yoga therapy in reducing anxiety, stress and depression in MS patients. Materials and Methods: The present experimental case-control study was conducted using a pretest-posttest approach. The statistical population comprised female MS patients in Rasht, Iran in 2016, 30 of whom were randomly assigned to the control and experimental groups. The experimental group underwent yoga therapy for three months. The two groups completed the depression anxiety stress scale (DASS-21). All the data obtained were analyzed in SPSS-21. p<0.05 was set as the level of statistical significance. Results: The repeated measures ANOVA showed that yoga therapy significantly reduces anxiety, stress and depression in MS patients (p<0.05 for all). Conclusion: The results of the present study revealed that yoga therapy can be widely used as an effective and efficient method to improve the symptoms of anxiety, stress and depression in MS patients. This method can prevent the increasing debilitation in MS patients and help them improve their mood and overcome their anxiety

The Effectiveness of Yoga Therapy in Increasing the Self-Efficacy of Women With MS

Background: Multiple Sclerosis (MS) is chronic and debilitating neurological disease which occurs between the ages of 20 and 40 years. Myelin degradation is common in certain areas such as the optic nerve, brain stem, and cerebellum, which causes problems such as imbalance, inability to perform daily tasks, and ultimately affects and reduces the self-efficacy of the affected individuals. Objectives: The purpose of this study was to investigate the effectiveness of yoga therapy in increasing the self-efficacy of women with MS living in Rasht, Iran. Materials & Methods: This research is an applied experimental study with pre-test and post-test design with control group. The statistical population included MS female patients in Rasht City who were members of the MS Society up to 2016. A total of 30 people were selected randomly and divided into control and experimental groups. The experimental group received yoga therapy for 3 months. Two groups completed the Multiple Sclerosis Self-efficacy Scale (MSSS) before and after the intervention. All data were analyzed by repeated measures analysis of variance (group factor analyzed with two levels of yoga therapy in a group and control manner, and time factor analyzed with three levels of pre-test, post-test and follow-up) in SPSS V. 21. Results: Analysis of variance by measurement method and analysis of the variance of 2 in 3 mixture (group agent with two levels of yoga therapy in a group and control manner, and time factor with three levels of pre-test, post-test and follow-up) with a significant level of P<0.05 showed that yoga therapy is effective in increasing the self-efficacy of patients with MS. Conclusion: Yoga therapy is effective in increasing the self-efficacy of MS patients and can be used as a supplementary therapy to improve condition of these patients and increase their self-efficacy

A Comparative Study of Five Personality Factors among Employed and Unemployed People

Background: Professional identity is a part of human identity and career has a beneficial impact on psychological health. The importance of personality in job achievement has also been increasingly concerned in economics. Objective: To compare the Big Five personality factors between employed and unemployed persons. Materials and Methods: This study was an applied cross sectional analytic descriptive research of a comparative type which was conducted from January 2012 to March 2012. The sample size was thirty in each group of employed and unemployed subjects, chosen randomly from male population of a city in the North of Iran with purposive sampling method. Age and education level of subjects were controlled according to labor market conditions. For collecting data, the NEO inventory was used five factors of personality can be assessed by which. The data were analyzed by SPSS software version 19 through descriptive and inferential statistics using independent t-test. Results: A total of thirty employed and 30 unemployed men in the age range of 20-50 years participated in the study. The neuroticism score was higher in unemployed persons (p = 0.001). The openness score resulted in no significant difference between employed and unemployed people (p = 0.96). The scores of extroversion, agreeableness and conscientiousness were significantly higher among employed people rather the unemployed ones (p = 0.01, 0.001 and 0.01, respectively). Conclusion: Personality traits except openness have significant relationship with employment, neuroticism may have a negative relationship, and the other personality traits maybe in the positive relationships with employment

A Survey about the Temporal Pattern of Stroke Occurrence

Background: Temporal variation of stroke onset is suggested in some studies contained somewhat varieties. It is proposed that some predisposing changes occur in some ascertained times consequently resulted in stroke occurrence in some special times. Objective: To determine the circadian and circaseptan variation of stroke onset. Materials and Methods: This cross sectional study was conducted from March 2012 to February 2013 in an academic hospital in the North of Iran. All patients with acute onset of neurological symptoms were enrolled in the study after being diagnosed as a stroke patient. The diagnosis was made by a neurologist using brain imaging. Age, gender, history of diabetes and hypertension, time and date of stroke onset were recorded for all patients. The data were analysed using Chi-square test in SPSS software version19. Results: A total of eight hundred sixty-nine patients with mean age of 67.5±12.4 years (55.6% women 44.4% men) were admitted during one year study. Eighty-five percent of stroke cases were ischemic in nature and the others were hemorrhagic type. Distribution of cases during a day was not uniform (p < 0.0001). The peak of stroke onset occurred in the mornings (7-9 a.m.) followed by a second peak in the evenings (7-9 p.m.). In addition, the distribution of cases during the week was also not uniform (p < 0.016). Conclusion: Stroke occurrence has a diurnal variation probably resulted from circadian physiologic changes. Although there is a circaseptan variation in the times of stroke record, it seemingly isn’t related to physiologic changes