Background: There are reports that stress-related disorders are increasing during coronavirus disease 2019 (COVID-19) pandemic. Patients with Multiple Sclerosis (MS) are at higher risk of developing psychiatric disorders, which result in worsening of their disability. There are concerns about the mental health of MS patients during this pandemic. Objective: We aimed to evaluate the prevalence of anxiety, depression, and levels of fear about Corona in MS patients during the COVID-19 pandemic. Materials and methods: This was a cross-sectional study on MS patients who were admitted to the MS clinics affiliated with Isfahan University of medical sciences from May to June 2020. Anxiety and depression were evaluated according to the Hospital Anxiety and Depression Scale (HADS). The Corona Fear Questionnaire developed by Ahorsu et al. was applied to evaluate the state of fear about COVID-19. Chi-square tests were used to compare depression and anxiety between different groups, Kruskal-Wallis was used for fear scores, Spearman correlation coefficient was also reported for correlations. Results: 410 MS patients with a mean age of 38.6 years (±10.35) were enrolled in the study. Among those patients who answered the HADS questionnaire completely (n=399, n=388, for anxiety and depression subscales respectively) the prevalence of anxiety and depression were 31.2% (n=128) and 39.3% (n=161), respectively. There was no significant relationship between anxiety and depression with any of the following variables: sex, marital status, history of drug abuse, smoking, duration of taking psychiatric medication, being tested for COVID-19, being quarantined. Regarding fear about COVID-19, patients with depression or anxiety showed higher scores on the fear questionnaire (p-value=0.03, p-value=0.008 respectively). Conclusions: The prevalence of anxiety and depression in MS patients was higher than previously reported. Fear about COVID-19 was correlated with anxiety and depression. Multicenter studies are required to develop specific recommendations for screening mental health problems in MS patients during COVID pandemic.

Background: For decades, static stretching has been the standard benchmark for training programs, because it has been shown to increase flexibility compared with other methods of stretching. Objective: The current study investigated and compared the effects of active dynamic stretching and passive static stretching on hamstring tightness. Methods: For this experiment, 64 female students were enrolled and randomly assigned to active dynamic or passive static stretching groups (n=32 each). The first and second experimental groups were trained with repetitive dynamic stretching and static stretching exercises, respectively. Exercises were performed 10 times per limb, 3 times per day, 5 days per week for 4 weeks. Hamstring muscle length measurements were repeated in weeks 2 and 4. Statistical analysis of the results was performed by t-test and repeated measures ANOVA using SPSS 15. Results: Both experimental groups showed significant improvements in the active knee extension range of motion during the intervention (P<0.001). However, active stretching showed better results and had a greater effect on range of motion in comparison with static stretching. Conclusion: Active dynamic training can be considered a suitable method for increasing the flexibility of the hamstring muscle and, consequently, reducing the complications and problems associated with hamstring tightness.

Background End-stage renal disease (ESRD) is serious global public health challenge in many developing countries. Treatment of ESRD is carried out through renal replacement therapy like peritoneal dialysis (PD). Depression is the most common mood disorder which has a strong impact on the quality of life in patients with ESRD. Little is known about the prevalence and risk factors of depression in peritoneal dialysis patients. Method and materials A multicenter cross-sectional study was conducted on 164 adult ESRD patients undergoing peritoneal dialysis for at least three months who referred to the peritoneal dialysis centers of Al-Zahra, Noor & Ali Asghar hospitals, Isfahan, Iran from May to August 2019. Beck Depression Inventory Second Edition questionnaire was used to measure the symptoms of depression and its severity. Results 43.5% of patients had some levels of depression. Assessing the association of depression with demographic and PD-related factors showed that there was no significant difference regarding age, BMI, dialysis adequacy and residual kidney function, dialysis frequency, type of dialysis solution used, disease duration, and age at the start of dialysis. Ordinal logistics regression analysis showed significant association between depression severity categories and gender (OR = 0.397, CI: 0.160–0.985, p = 0.046), marital status (OR = 2.983, CI: 1.180–7.541, p = 0.021), having a separate room for dialysis (OR = 2.511, CI: 1.108–5.692, p = 0.027). Conclusion As our findings have revealed 43.5% of our participants suffered from mild-to-severe depression, we suggest careful attention and routine evaluation for depression in PD patients, especially women and single patients and those who have low socioeconomic status.

Objective: The aim was to compare dental and skeletal indices in panoramic radiography between patients undergoing haemodialysis, peritoneal dialysis and age- and sex-matched control group. Methods: In this comparative cross-sectional study, quantitative Indices including Antegonial Index (AI), Mental Index (MI), Panoramic Mandibular Index (PMI) and qualitative indices including Mandibular Cortical Index (MCI) and Trabecular Pattern (TP) were evaluated in panoramic images of 32 haemodialysis patients, 14 patients under peritoneal dialysis and 52 healthy individuals. The images were also investigated for pulp canal calcification, pulp stones, soft tissue calcification, changes in or loss of lamina dura, radiolucencies associated with brown tumour and ridge resorption. The indices were compared between the three groups and were investigated for association with the patients’ blood test parameters and their diseases causing chronic renal failure (CRF). Intraobserver agreement for the 2-week interval of assessment was calculated for the indices. Results MI (p = 0.574) and PMI (p = 0.100) were not significantly different, but AI (p = 0.01), MCI (p < 0.001) and TP (p = 0.002) were significantly different between the two case groups and the control group. The prevalence of pulp calcification (p = 0.03) and ridge resorption (p = 0.005) was higher in the haemodialysis group. Soft tissue calcification (p = 0.85) and lamina dura changes (p = 0.9) showed no significant difference. Brown tumours were observed in only one case in the haemodialysis group. Conclusions: AI, MCI and TP showed a reduction in mineral density of the cortical and trabecular bone in CRF patients and more severely in patients under haemodialysis than those under peritoneal dialysis.

Background: The efficacy and quality of hemodialysis (HD) are closely related to the dialyzer characteristics. Objectives: This study aimed to determine the efficacy and complications of modified polyethersulfone (m-PES) -1.5 hollow fiber filters in comparison to conventional filters during HD. Methods: This non-inferiority crossover randomized clinical trial was performed in adult dialysis units at three HD centers within May 2019 to March 2020. The patients were randomly enrolled in two groups. Group A was first put on HD for six sessions with a low or high flux smart flux filter (m-PES-1.5 hollow fiber), which was made in Italy by Medica S.P.A. Group. Group B was hemodialyzed with a corresponding low or high flux filter made in Iran by Meditechsys Company. After a two-week clearance phase, the patients were dialyzed for six sessions with the opposite filter of the first six sessions. Laboratory variables, such as blood urea nitrogen and creatinine, were measured. Kt/V (i.e., a measurement of HD efficacy) and urea reduction ratio (URR) were calculated. Additionally, blood pressure was monitored. Results: A total of 40 patients were entered into the final analysis. No matter which filter was used, no statistically significant differences were observed in URR, creatinine, Kt/V, and blood pressure at different times during dialysis between the two types of filters. Packaging problems (P < 0.001) and blood clotting (P = 0.009) were two more frequent complications in the m-PES group. Conclusions: This study showed that smart flux m-PES-1.5 hollow fiber filters are similar to Meditechsys Company filters.