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Study design: A randomized, double-blind, placebo-controlled clinical trial. Objective: To assess the effect of alpha-lipoic acid (ALA) supplementation on IL-6, hs-CRP, FBS, anthropometric indices, food intake and blood pressure in male patients with chronic spinal cord injury (SCI). Setting: Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Methods: Fifty-eight men with chronic SCI participated in the study. Participants were divided in two groups: one group received 600 mg of supplemental ALA (n = 28) and the other group received placebo (n = 30) for 12 weeks. At the beginning and end of the study, biochemical parameters, anthropometric indices, blood pressure and dietary intakes were measured. Dietary intake was measured using N4 software, and statistical analyses were carried out using SPSS16. Results: No significant reduction was found in IL-6 (P = 0.97) and hs-CRP levels (P = 0.23). There was significant reduction in fasting blood sugar (P = 0.001), body weight (P = 0.001), BMI (P = 0.001), waist circumference (P = 0.001) and blood pressure (P = 0.001). Dietary intake was significantly reduced, including fat (P = 0.001), carbohydrate (P = 0.001), protein (P = 0.002) and energy intakes (P = 0.001). Conclusion: Lipoic acid supplementation had no significant effect on the measured inflammatory markers but it reduces fasting blood sugar, anthropometric parameters, food intake and blood pressure in men with chronic SCI. Spinal Cord (2015) 53, 621-624; doi:10.1038/sc.2015.35; published online 10 March 2015 INTRODUCTION Alpha-lipoic acid (ALA) or thiocitic acid is an eight-carbon, sulfurcontaining compound. It functions as a cofactor in the multienzyme complexes that catalyze the oxidative decarboxylation of α-keto acids. 1 There is general agreement about the antioxidant properties of ALA, which is thought to work by scavenging free radicals directly, chelating metallic ions, increasing intracellular glutathione and activating endogenous antioxidant systems. 2,3 ALA's antioxidant properties are thought to inhibit the deleterious mechanisms associated with inflammation; however, a number of studies suggest contradictory effects for ALA on inflammatory markers such as IL-6 and C-reactive protein (CRP). [4][5][6] Apart from the antioxidant properties of ALA, it is found to increase nitric oxide synthesis through which endothelial function is probably improved. 7 In addition, ALA reduces body weight and changes other anthropometric indices by suppressing appetite and increasing metabolism. [8][9][10][11][12] Spinal cord injury (SCI) is a devastating condition and entails considerable burden on the individual and society. 13,14 Persons with chronic SCI are at increased risk for obesity, cardiovascular disease, hypertension, diabetes, dyslipidemia and systemic inflammation [15][16][17][18][19] because of changes in their lifestyle, body composition and fat mass. 20 However, these complications may be preventable and treatable. 21 Studying the effect of ALA on cardiovascular risk factors and ...

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Objectives:We evaluate the level of anxiety and depression among patients with spinal cord injury (SCI) in relation with their religious coping and spiritual health. Setting: Brain and Spinal Cord Injury Repair Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Methods: A sample of patients with SCI participated in this cross-sectional study. They completed a sociodemographic questionnaire, the Hospital Anxiety and Depression Scale, the Brief Religious Coping Questionnaire and the Spiritual Well-being Scale. Then, the association between anxiety, depression and independent variables was examined. Results: In all, 213 patients with SCI were studied. Of these, 64 (30%) have had anxiety and 32 (15%) have had depression. Multiple logistic regression analyses revealed that gender (odds ratio (OR) for female = 3.34, 95% confidence interval (CI) = 1.31-8.51, P = 0.011), employment (OR for unemployed = 5.71, 95% CI = 1.17-27.78, P = 0.031), negative religious coping (OR = 1.15, 95% CI = 1.04-1.28, P = 0.006) and existential spiritual well-being (OR = 0.93, 95% CI = 0.89-0.97, P = 0.003) were significant contributing factors to anxiety (Table 3), whereas negative religious coping (OR = 1.21, 95% CI = 1.06-1.37, P = 0.004) and existential spiritual well-being (OR = 0.90, 95% CI = 0.84-0.96, P = 0.001) were significant contributing factors to depression. Conclusion: The findings indicated that depression and anxiety are two psychologically important side effects after SCI. The findings also indicated that religion and spiritual well-being have a moderating role on occurrence of depression and anxiety.

MVA was the most common cause for TSCI. The elderly subjects were less frequent among our patients than more developed countries. The high rate of unemployment and divorce in our cases deserves special consideration.

PurposeThe aim of this study was to introduce and implement a noninvasive method to derive the carotid artery pressure waveform directly by processing diagnostic sonograms of the carotid artery.MethodsUltrasound image sequences of 20 healthy male subjects (age, 36±9 years) were recorded during three cardiac cycles. The internal diameter and blood velocity waveforms were extracted from consecutive sonograms over the cardiac cycles by using custom analysis programs written in MATLAB. Finally, the application of a mathematical equation resulted in time changes of the arterial pressure. The resulting pressures were calibrated using the mean and the diastolic pressure of the radial artery.ResultsA good correlation was found between the mean carotid blood pressure obtained from the ultrasound image processing and the mean radial blood pressure obtained using a standard digital sphygmomanometer (R=0.91). The mean absolute difference between the carotid calibrated pulse pressures and those measured clinically was -1.333±6.548 mm Hg.ConclusionThe results of this study suggest that consecutive sonograms of the carotid artery can be used for estimating a blood pressure waveform. We believe that our results promote a noninvasive technique for clinical applications that overcomes the reproducibility problems of common carotid artery tonometry with technical and anatomical causes.

Objectives: We assess the prevalence of sexual dysfunction in patients with spinal cord injury (SCI), compare sexual function and sexual distress between female patients with SCI and gender-matched healthy controls, and address risk factors associated with sexual dysfunction among Iranian female patients with SCI. Setting: Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. Methods: Eligible Iranian female patients with SCI were included in this cross-sectional study. They were asked to provide sociodemographic information, and complete the Female Sexual Function Index, Hospital Anxiety and Depression Scale and Female Sexual Distress Scale-Revised questionnaire. Results: Of the 105 patients participated in this study, the average age was 41.0 (s.d. ¼ 10.1) years. Women with SCI reported significantly higher levels of sexual dysfunction compared with normal controls. Approximately, 88% of SCI patients reported at least one type of sexual dysfunction, whereas only 37% of healthy controls reported sexual dysfunction. Lack of vaginal lubrication was reported more frequent in SCI patients compared with controls. Women with SCI reported a significantly higher level of sexual distress compared with healthy women. Sexual dysfunction was observed to be significantly higher in older patients, those with less education, patients with complete lesions, those with sexual distress and patients who were anxious and depressed. Conclusion: Sexual dysfunction is highly prevalent among Iranian women with SCI. Sexual dysfunction is associated with age, education, symptoms of depression and anxiety and level of injury. Sexual counseling during the rehabilitation period may help to prevent sexual dysfunction following SCI.