Multiple sclerosis and fecundity: a study of anti-mullerian hormone level in Egyptian patients

Abstract Background Multiple sclerosis (MS) is a neurological disease that affects people aged 20–40 years on average. It classically affects young females of reproductive age. The prevalence of MS for females to males has increased markedly in recent years (from 2.3 to 3.5:1). Females with MS seem to use infertility treatments more frequently and fecundity could be affected years before making an MS diagnosis. The anti-Müllerian hormone (AMH) level is the strongest marker of ovarian reserve. Although recent studies suggest that patients with MS have lower ovarian reserve, there is no definite data to conclude that females with MS suffer from impaired fertility. This study aimed to investigate fertility and fecundity among female patients with MS by assessing AMH level. This study included 100 patients with MS and 60 healthy controls (HC). Both groups were assessed for AMH levels, activities of daily living (ADL) were assessed using the Kurtzke Expanded Disability Status Scale (EDSS) and the reproductive history of both groups was assessed via a self-administered questionnaire. Results AMH levels among the HCs (0.34–2 ng/ml with a mean of 1.03 ± 0.41 ng/ml) were significantly higher than in patients with MS (0.15–2 ng/ml with a mean of 0.68 ± 0.31 ng/ml). The use of disease-modifying therapies (DMT) was the only predictor of below normal AMH among patients, but there was no significant correlation with age, duration of disease or type of DMT. Conclusions Levels of AMH were significantly lower in MS patients than in healthy controls

Complementary and alternative medicine in epilepsy: A global survey of physicians’ opinions

Purpose: To investigate the opinions of physicians on the use of complementary and alternative medicine (CAM) in patients with epilepsy (PWE) worldwide. Methods: Online survey addressed to neurologists and psychiatrists from different countries. Results: Totally, 1112 physicians from 25 countries (different world region: Europe, North America, South America, Middle-East, Africa, Former Soviet Union Republics) participated; 804 (72.3%) believed that CAM might be helpful in PWE. The most commonly endorsed CAM included meditation (41%) and yoga (39%). Female sex, psychiatry specialization, and working in North and South America were associated with the belief that CAM is helpful in PWE. Two-hundred and forty five out of 1098 participants (22.3%) used/prescribed CAM to PWE; among them, 174 (71%) people perceived CAM to be less effective and 114 (46.5%) people found CAM to be safer than conventional antiseizure medications (ASMs). The most common reasons to prescribe CAM for PWE were: to satisfy the patient (49.9%), dissatisfaction with the efficacy (35.6%), and dissatisfaction with the adverse effects (31.2%) of conventional therapies. Conclusion: Although the evidence supporting the use of CAM for the treatment of epilepsy is extremely sparse, most physicians worldwide believe that it could be integrated with the use of conventional ASMs, at least in some patients. High-quality controlled trials are warranted to provide robust evidence on the usefulness of CAM options in PWE.Fil: Asadi Pooya, Ali A.. Thomas Jefferson University; Estados UnidosFil: Brigo, Francesco. Hospital of Merano; ItaliaFil: Lattanzi, Simona. Università Politecnica Delle Marche; ItaliaFil: Karakis, Ioannis. University of Emory; Estados UnidosFil: Asadollahi, Marjan. Shahid Beheshti University Of Medical Sciences; IránFil: Trinka, Eugen. Paracelsus Medical University; Austria. Centre for Cognitive Neuroscience; AustriaFil: Talaat El Ghoneimy, Lobna. Cairo University; EgiptoFil: Pretorius, Chrisma. Stellenbosch University; SudáfricaFil: Contreras, Guilca. Hospital Metropolitano; EcuadorFil: Daza Restrepo, Anilu. La Trinidad Medical Center; VenezuelaFil: Valente, Kette. Universidade de Sao Paulo; BrasilFil: D`alessio, Luciana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Biología Celular y Neurociencia "Prof. Eduardo de Robertis". Universidad de Buenos Aires. Facultad de Medicina. Instituto de Biología Celular y Neurociencia; Argentina. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic; ArgentinaFil: Turuspekova, Saule T.. Asfendiyarov Kazakh National Medical University; KazajistánFil: Aljandeel, Ghaieb. Medical City; IraqFil: Khachatryan, Samson. National Institute Of Health; ArmeniaFil: Ashkanani, Abdulaziz. Ahmadi Hospital; KuwaitFil: Tomson, Torbjörn. Karolinska Huddinge Hospital. Karolinska Institutet; SueciaFil: Kutlubaev, Mansur. Bashkir State Medical University; RusiaFil: Guekht, Alla. Pirogov Russian National Research Medical University; RusiaFil: Alsaadi, Taoufik. American Center for Psychiatry and Neurology; Emiratos Arabes UnidosFil: Calle Lopez, Yamile. Universidad de Antioquia; ColombiaFil: Mesraoua, Boulenouar. Weill Cornell Medical College; Qatar. Hamad Medical Corporation; QatarFil: Ríos Pohl, Loreto. Clinica Integral de Epilepsia Infanto-Juvenil; ChileFil: Al-Asmi, Abdullah. Sultan Qaboos University; OmánFil: Villanueva, Vicente. Hospital Universitario y Politécnico La Fe; EspañaFil: Igwe, Stanley C.. Alex Ekwueme Federal University Teaching Hospital; NigeriaFil: Kissani, Najib. Cadi Ayyad University; MarruecosFil: Jusupova, Asel. Kyrgyz State Medical Academy; Kirguistá