Uncontrolled seizures are a commonly encountered problem, especially at epilepsy clinics and one should consider all possible reasons for these uncontrolled seizures. The mainstay for making a correct diagnosis is a detailed clinical history.
The present study was performed to investigate the effects of dimethylfumarate (DMF) and methylhydrogen fumarate (MHF) on the cytokine pattern of peripheral blood mononuclear cells (PBMCs) of multiple sclerosis (MS) patients. The PBMCs from patients and healthy controls were stimulated with myelin basic protein (MBP) or phytohemagglutinin (PHA) and cultured in the presence of DMF and MHF. The percentage of CD4+IL-4+ and CD4+IFN-γ+ cells was determined by means of intracellular cytokine staining. CD4+IL-4+ cells were significantly increased in the presence of DMF and MHF when PBMCs were stimulated by MBP (P < 0.003). The same significant result was obtained by PHA stimulation (P < 0.049). In terms of CD4+IFN-γ+ cells, the percentage of cells did not significantly differ between the cultures stimulated with MBP or PHA in the presence and absence of the drugs. Results of MBP stimulation in control group also showed a significant increase in CD4+IL-4+ cells in the presence of DMF and MHF. In comparison between patient and control groups, no statistically significant changes were observed. In conclusion, both DMF and MHF effectively increased IL-4 production, whereas they did not significantly change IFN-γ level, indicating the role of these drugs in increasing the production of beneficial cytokines such as IL-4.
BackgroundCerebral venous sinus thrombosis (CVST) is a frequent cause of cerebrovascular disease in Iran.ObjectivesIn this study, we report cumulative data of published Iranian studies in a systematic manner with critically appraisal and presenting future directions.Materials and MethodsThe authors systematically searched the ISI web of knowledge, Pubmed, Scopus, EBESCO and iranmedex for keywords attributed to cerebral venous sinus thrombosis. The methodological and demographic characteristics, etiology, site of involvement and clinical manifestations of the patients with CVST were investigated.ResultsSeven eligible series with 465 patients were found. Age of the patients were between 29.5-43.8 in these series. The ratio of Female to male was 2.79. The Mortality rate was 11.4%. Oral contraceptive pills the single most common risk factor in the all series(40-71% of female patients). Headache(80-97%), sensori/motor deficits(39-64%) and seizure(20-62%) were the most common clinical presentations. Hemorrhagic transformation was seen in 11-58% of the patients. All included studies have substantial shortcomings. Majority of the studies were retrospective and only one study was population based. Despite the ethnic heterogeneity in Iran, none of these studies reported ethnic information. Detailed methodology was missing in all studies. The extent of investigation for hematologicalor neoplastic disorders was not clear methods. Only one study reported a subgroup with multifactorialetiology. Neither Barthel index nor modified Rankin scale were reported in any studies. The mortality was reported only in the three studies. The analysis of prognostic factors was not done in any study.ConclusionsTo overcome theses hortcomings, more well-structured epidemiologic studies should be conducted in Iran as a CVST-raising country.
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