Balo's concentric sclerosis (BCS) is considered a variant of multiple sclerosis characterized by concentric lamella of alternating demyelinated and partially myelinated tissues. It is a rare and a relatively acute condition. Attacks may proceed rapidly over weeks or months, typically without remission, like Marburg's variant, resulting in death or severe disability. However, the majority of cases have a more benign, self-limiting course with spontaneous remission. Magnetic resonance imaging is a primary imaging modality in the diagnosis of BCS. Treatment with intense immunosuppression may be indicated in patients with more aggressive form. New reports reveal more evidence regarding the pathophysiology and treatment strategies.
Due to severe pain and anxiety in burn patients, especially in procedures such as physiotherapy, and because of the adverse effects of pain on the outcome of physiotherapy, application of adjunctive methods are necessary for achieving pain relief. Right now, no certain method of pain reduction is available. This study evaluated the efficacy of hypnotherapy in reducing pain and anxiety in burn patients through a randomized clinical trial. From amongst women hospitalized in a burn unit, 44 patients were selected and divided into intervention and control groups. The intervention group underwent four hypnotherapy sessions and the control group remained without any hypnotherapy intervention. Procedural pain and anxiety related to physiotherapy were evaluated with Visual Analogue Scale (VAS) contemporaneously in both groups. The degree of pain and anxiety caused by physiotherapy decreased significantly in the intervention group, as compared to the control group (P < 0.001). Hypnosis is recommended as a complementary method in burns physiotherapy.
Epilepsy has garnered increased public health focus because patients who suffer from epilepsy experience pronounced and persistent health and socioeconomic disparities despite treatment and care advances. The epidemiology of epilepsy is diverse in different countries and regions. This nationwide population-based cross-sectional study was conducted to determine the life time prevalence and health related factors of epilepsy for the first time in Iran through a two-phase door-to-door survey method. In phase I, a screening for epilepsy was performed on 68,035 people. Then in phase II, after the neurological evaluation of participants and reviewing medical records, 1130 subjects with epilepsy was confirmed. The life time prevalence of epilepsy was achieved to be 16.6 per 1000 people (95% CI 15.4–17.8) with the average age onset 19.1 ± 21.1 (active prevalence 9.5 per 1000 people). Focal seizure (59.3%), generalized epilepsy (38%) and unknown types of epilepsy (2.7%) were detected among participants. The overall life time prevalence of febrile convulsion was 4.1 per 1000 people. The frequency of attacks per year and per month were 3.0 ± 1.6 and 0.5 ± 0.1, respectively. Age-specific life time prevalence was highest among the age group of 15–19 years old [32.7 per 1000 persons (95% CI 29.1–36.8)] and it was higher in male (53.8%) than female (46.2%) participants. Our results showed that the life time prevalence of epilepsy in Iran is higher than worldwide average.
Background: Despite recent developments in intensive care for patients with Traumatic brain injury (TBI), the long-term neurological disabilities still exist. MLC901 is Traditional Chinese Medicine and has shown some neuroprotective and neuro regenerative benefits after brain injury in previous animal and human studies and may provide a new therapeutic approach in the treatment of TBI. Accordingly, we conducted this pilot, randomized, double-masked, placebo-controlled study to investigate the efficacy of MLC901 in patients with moderate to severe TBI. Materials and Methods:Patients with a diagnosis of moderate to severe TBI were enrolled. Subjects were randomly assigned to receive either MLC901 or placebo capsules three times per day over 6 months. Evaluation of patients was carried out at baseline, 3 rd month and 6 th month follow-after injury. Modified Rankin Scale (mRS) and Glasgow outcome scale (GOS) were used to examine patients. Efficacy was evaluated by comparing these two scores between the 2 groups at follow-up visits.Results: Eighty-one patients complete 6 months follow up. There was no significant difference between two study groups regarding the demographic features, interval between injury and start of intervention and length of ICU stay. However, functional outcome scales of GOS, MRS at 3 rd and 6 th month post-injury were significantly better in MLC901 group compared to placebo (p<0.05). Conclusion:MLC901 has shown promising efficacy in patients suffering from moderate to severe TBI.
Background: The purpose of this study was to systematically review the prevalence of class 1 integrons, antibiotic resistance pattern in Pseudomonas aeruginosa (P. aeruginosa) isolated from clinical samples other than burn samples. Methods: The Web of Science, PubMed, Scopus, and Science Direct databases were searched using keywords based on the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. The cross-sectional studies published from 1st January 2000 until 1st January 2019 were included which addressed the prevalence of class 1 integrons and antibiotic-resistance in P. aeruginosa isolated from clinical samples other than burn samples. Meta-analysis was conducted using Comprehensive Meta-Analysis (CMA) software. The random-effects model, Cochran’s Q and I2 tests were applied for statistical analyses. Results: Eight articles met the eligibility standards for including in the present meta-analysis. The combined prevalence of class 1 integrons in P. aeruginosa isolated from clinical samples other than burn samples was reported by 40% (95% CI:26.1-55.8%). The pooled prevalence of Multi-Drug Resistant (MDR) P. aeruginosa isolates was 70.1%. The highest prevalence of combined antibiotic resistance was related to carbenicillin with a resistance rate of 79.9%. In general, 6 (75%) out of the 8 included studies showed the correlation between the presence of class 1 integrons and antibiotic resistance. Conclusion: Regarding the correlation between the presence of integrons and the high antibiotic resistance reported by studies included in the present review, there is the need for preventive measures to prevent the spread of resistance by integrons and transferring to other micro-organisms
Background: MLC601 and MLC901 showed neuroprotective and neuroregenerative properties and positive results in the treatment of dementia and cognitive impairment. This study aimed to investigate the long-term benefits of monotherapy with MLC601 and MLC901 in patients with Alzheimer's disease (AD). Methods: In this study, patients with AD, diagnosed by DSM-IV criteria, were enrolled. Patients have received MLC601 for four years, and their regimen has changed to MLC901 for another four years. Recruited patients were followed to assess the efficacy and safety first of MLC601 and MLC901. Mini-Mental State Examination (MMSE) and Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) were used to assess cognitive function. Safety was evaluated by monitoring adverse events (AEs) and abnormal findings in physical examinations or lab tests. Results: At the end of the trial, the changes in the mean (±SD) MMSE and ADAS-cog scores were 5.1 (3.09) and 12.5 (10.89), respectively. Both scores showed a significant change in repeated measure analysis, with the ADAS-cog score indicating a higher change than the MMSE score (P<0.001). Conclusion: For more than eight years, we studied monotherapy with NeuroAid (MLC601, MLC901) in patients with AD. The study contributes further to the long-term safety and efficacy data of MLC in patients with AD. Trial Registration
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