BackgroundThe aim of present study was to determine disease-related and psychological risk factors for sexual dysfunction in women with multiple sclerosis (MS).MethodsThis was a clinical-based study conducted from September 2009 to June 2010 in Tehran, Iran. A consecutive sample of female patients with MS was recruited from an outpatient clinic. The Female Sexual Function Index (FSFI) was used to evaluate sexual function. In addition neurological impairment was measured using the Kurtzke Expanded Disability Status Scale (EDSS), and depression was assessed using the Beck Depression Inventory-II (BDI-II). Univariate and multiple logistic regression analyses were performed in order to examine the association between sexual dysfunction and independent variables.ResultsIn all, 226 women participated in the study. Of these, 125 women (55.3%) met the criteria for sexual dysfunction. The mean age of participants was 35.7 years (SD = 8.07). The results obtained from multiple logistic regression analysis indicated that the disease duration (OR for the disease duration of equal or greater than 9 years = 3.13, %95 CI = 1.29-7.57, P = 0.01), the disease course (OR for secondary progressive MS = 3.96, %95 CI = 1.55-10.10, P = 0.004) and the BDI score (OR = 1.11, %95 CI = 1.07-1.16, P < 0.001) were significant factors contributing to sexual dysfunction in these patients.ConclusionsThe findings from this study indicated that the duration and severity of the disease in addition to depression were the most significant factors that contributed to sexual dysfunction in women with multiple sclerosis. The burden of disease and sexual dysfunction suggests the need for further attention to this patient population.

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Introduction The Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19) was designed to assess the perceived influence of multiple sclerosis (MS) symptoms on sexual activity and satisfaction. Aims This study aimed to translate and validate the MSISQ-19 in women with MS in Iran. Methods The translation of the original questionnaire was carried out in accordance with a standard forward–backward procedure. Then, a sample of 226 married women with MS completed the questionnaire. Reliability was estimated using Cronbach's alpha coefficient. Concurrent validity was assessed by comparison with the Female Sexual Function Index (FSFI), the Expanded Disability Status Scale (EDSS), and the Beck Depression Inventory-II (BDI-II). The factor structure of the questionnaire was extracted by performing exploratory factor analyses. All patients underwent a full neurologic examination. Main Outcome Measures MSISQ-19 score was the main outcome measure. Results The mean age of participants was 35.77 years (SD = 8.07), with mean disease duration of 1.84 years (SD = 0.79). Cronbach's alpha coefficient was 0.90 for total MSISQ-19 score, with values of 0.85, 0.90, and 0.78 for the subscales assessing primary, secondary, and tertiary sexual dysfunction, respectively. The principal component analysis indicated a three-factor solution, similar to that found in the original validation study, that explained 63.0% of the total variance for women with MS. Scores on the MSISQ-19 and its subscales correlated with scores on the FSFI, EDSS, and BDI-II (all P &lt; 0.01). Conclusion In general, the findings suggest that the MSISQ-19 is a reliable and valid measure of sexual function among Iranian women with MS. However, further studies are needed to establish psychometric properties for male MS patients in Iran.

Background Patients with multiple sclerosis (MS) especially those with younger age experience an alteration in physiological and emotional lifestyle that can affect intimacy and sexuality . The aim of this study was to determine demographic and disease related determinants of intimacy and sexuality in young women with MS. Methods This was a cross sectional study carried out in Tehran, Iran. A convenience sample of young women aged ≤35 years old with MS attending to outpatient clinics in a teaching hospital affiliated to Tehran University of Medical Sciences was entered into the study. The Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19) was used to evaluate how the disease influences sexual function and satisfaction in these patients. Multivariable analysis using hierarchical method was performed to identify variables that are associated with intimacy and sexuality. Results In total 117 young women with confirmed diagnosis of MS were included in the study. Participants mean was 25.7 (SD = 8.07) years. A multivariable hierarchical regression analysis was performed using demographic variables entered in step one, relevant neurological variables in step two, and psychological variables in step three. Furthermore, we loaded antidepressant use in the last step. Overall, the seven variables accounted for 39% of total variance observed for the MSISQ score ( P < 0.001). At step one the demographic variables accounted for 13% of the variance in the MSISQ score ( P < 0.001). At step two the inclusion of relevant neurological variables increased the R 2 significantly and explained 27% of variance for the MSISQ (P < 0.001). However in the third step the inclusion of psychological factors increased R 2 significantly (adjusted R 2 increased to 0.39, P < 0.001). Conclusions The findings indicated that psychological, disease-related and demographic factors (education and employment status) contributed to intimacy and sexuality in young women with multiple sclerosis. Appropriate interventions, especially psychological interventions, appear to be essential immediately following a definite MS diagnosis in young women.

BackgroundMultiple sclerosis is increasingly becoming a major health problem among women worldwide. The aim of the present study was to estimate prevalence of depression in women with multiple sclerosis and also to identify risk factors contributing to its development.MethodsThis was a cross-sectional study of depression in a sample of 226 women with multiple sclerosis. The sample was recruited from an outpatient clinic in Tehran, Iran. Depression was assessed using the Beck Depression Inventory-II (BDI-II). Univariate and multiple logistic regression analyses were performed to examine the association between depression and independent variables.ResultsOverall, 91 women (40.2 %) had moderate to severe depression. The mean age of participants was 35.7 years (SD = 8.07). The results obtained from multiple logistic regression analysis showed that the disease course (OR for relapsing–remitting MS = 2.36, % 95 CI = 1.14–5.53, P = 0.46), the expanded disability status scale (OR for score of 5–8 = 4.88, % 95 CI = 2.51–11.06, P < 0.001) and employment status (OR for housewife = 4.75, % 95 CI = 1.55–14.58, P = 0.006) were significant contributing factors to depression in patients with multiple sclerosis.ConclusionsThe findings suggest that depression in patients with multiple sclerosis is multi-factorial and very much dependent to physical and social conditions of patients. The recognition of such conditions might help clinicians to manage patients more effectively.

IntroductionTricuspid valve (TV) has a complex anatomy causing some difficulties in echocardiographic evaluation. In this study, we sought to assess the geometry of TV in patients with functional tricuspid regurgitation (TR) by the implementation of 2‐ and 3‐dimennsional (2D and 3D) echocardiography.MethodsIn a case–control study, the geometrical features of TV were evaluated in forty patients with functional TR using echocardiographic examinations, and those data compared with twenty‐five age‐ and sex‐matched healthy individuals.ResultsThe mean age of patients was 50 ± 12 years, and 75% were female. All echocardiographic features of TV geometry were significantly greater in TR compared to control group. The 3D evaluation of TV annulus showed that the annulus shape was more circular in the TR compared to the control group. When compared patients with moderate and severe TR, there was a significant difference between groups regarding the size of the TV septolateral annulus diameter (3.5 ± 0.4 vs 3.9 ± 0.7 cm; P = .048), and the angle between mitral valve and TV annuluses (12.5 ± 4.3 vs 17 ± 9º; P = .048). Tenting areas measured by 2D echocardiography and obtained by TomTec software were significantly greater in severe TR compared to moderate TR group. The diameter of TV by 2D echocardiography was significantly higher in atrial fibrillation than that in sinus rhythm group among patients with TR.ConclusionsThe implementation of 3D echocardiography is useful in the determination of TV geometry in patients with functional TR. The accurate evaluation of anatomical features of TV might provide valuable tools in the evaluation of patients with functional TR.

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