Development of rheumatoid arthritis during treatment of multiple sclerosis with interferon beta 1-a. Coincidence of two conditions or a complication of treatment: A case report

AbstractCoexistence of multiple sclerosis (MS) with other autoimmune diseases has been attributed to common background genetic or environmental factors. This study presents development of rheumatoid arthritis (RA) during treatment of MS. The MS was confirmed by the Mc Donald criteria and the diagnosis of RA was confirmed by the ACR/EULAR criteria. A 35years old women with 9years of MS who was receiving interferon beta 1-a (INF) for 7years and who did not respond to conventional therapy of RA over 8months developed clinical manifestations of RA. But a rapid response was observed after discontinuation of INF. These findings suggest a possible contribution of INF in the development of RA

The Findings of Transcranial Doppler Ultrasonography in Patients with Ischemic Stroke

Background: Stroke is a multifactorial disorder, the most common cause being arterial occlusion. Transcranial Doppler Ultrasonography (TCD) is a common non-invasive method available for assessment the arterial blood flow of the brain. Objective: Assessment the hemodynamic parameters of cerebral arteries, using TCD device in patients suffering ischemic stroke. Materials and Methods: This descriptive cross-sectional study was conducted on patients with ischemic stroke in 2014 in Iran after being approved by ethics committee of Researches and Technology Vice-chancellorship of Guilan University of Medical Sciences. After obtaining informed consent, all patients underwent TCD. Demographic details and TCD findings were recorded. Data were analysed in SPSS software 21 using independent t-test, Chi-square, and Fisher's exact tests. The descriptive results were presented as mean ± SD and frequency. Results: A total of 102 patients (69 men and 33 women) with ischemic stroke and mean age of 63.72 ± 12.64 years participated in this study. Among 49.02% of patients at least one hemodynamic abnormality was diagnosed. Small Vessel Disease (SVD), extracranial stenosis (ECS) and intracranial stenosis (ICS) were found in 29.41%, 20.59% and 11.76% of patients respectively. Abnormal Pulsatility Index (PI), Peak Systolic Velocity (PSV) and Mean Blood Flow Velocity (Vm) were reported in 32.25%, 20.59% and 9.8% of them respectively. A significant relationship was found between PSV parameter and also presence of ECS and gender (p = 0.047). Moreover, SVD and abnormal PI were found significantly related to age (p = 0.002). Conclusion: TCD results showed almost half of the patients with ischemic stroke were found to have at least one hemodynamic abnormality