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To date, there are no reports studying the rate of amyotrophic lateral sclerosis (ALS) in relatives of multiple sclerosis (MS) patients and vice versa. This study was designed to look into this issue using two population-based databases of MS and ALS in Isfahan province of Iran. We have searched for any first, second or third degree familial kinship between the Isfahan MS Society database and Isfahan ALS population. We compared the rate of ALS among the population of first degree relatives of MS patients, with the crude prevalence of ALS in the general population of Isfahan. On the other hand, a reverse analysis was carried out to compare the prevalence of MS in Isfahan with its rate amongst the first degree relatives of ALS patients. We found 10 families among which five had first degree kinship. The rate of the diseases was significantly higher in both comparisons among the family members (p < 0.00001) and an odds ratios of more than 67 in both calculations showed a several-fold increase of ALS occurrence in the first degree relatives of MS patients and vice versa. In our study relatives of MS patients were significantly more prone to ALS and vice versa. This could give clues about the common features that the two disease share. Both diseases have an environmental and genetic component and these results mostly point toward genetic similarities.

Objectives: Environmental factors, such as different infections, have proposed to be involved in the pathogenesis of multiple sclerosis (MS). This study aimed to the evaluate mycoplasma pneumonia seropositivity, as a common cause of community-acquired pneumonia in patients with relapsing-remitting multiple sclerosis (RRMS)., Methodology: Using ELISA method, IgM and IgG antibodies to Mycoplasma pneumoniae were determined in 130 patients with relapsing-remitting multiple sclerosis (85 Remitted and 45 Relapsed) and 50 sex- and age-matched controls. The groups were compared using Kruskal-Wallis test at the significant level of p < 0.05., Results: The median [interquartile range] titer of IgG in remitted multiple sclerosis group was 65.3 [51.1-75.2] RU/ml versus 64 [52.6-71.4] RU/ml in relapsed group and 57.5 [29.2-74.3] RU/ml in control group (p = 0.442). There was not any significant difference between the groups base on median titer of IgM too (p = 0.446). The median [interquartile range] titer of Mycoplasma pneumoniae (MPn) IgG in women was 69.2 [56.4-77.4] RU/ml in remitted patients versus 63.85 [52.45-71.25] RU/ml in relapsed patients and 55.2 [29.17-72.75] RU/ml in controls (p = 0.022). Post hoc analysis demonstrated significant difference between remitted patients and controls (p = 0.002). There was not any significant difference between men in the groups (p = 0.7)., Conclusions: Mycoplasma seroposivity in relapsing-remitting multiple sclerosis was not significantly different in various phases of activity of disease compare to controls; but in women, seroposivity of Mycoplasma antibodies were more than controls.

Background: The aim of this study was to evaluate the protective effect of melatonin on ischemia-reperfusion syndrome., Methods: Thirty-three adult male Wistar albino rats were randomized into three experimental groups of 11: Group C --control group with no ischemia or reperfusion. Groups I/R and I/R + M had 2.5 hours of ischemia and of two hours of reperfusion by means of clamping of the common femoral artery. All the animals received maintenance fluid with intraperitoneal (i.p) normal saline following general anesthesia. The animals of Group I/R + M were treated with i.p Melatonin (10 mg/kg) five minutes before reperfusion. At the end of reperfusion, samples were taken for histological evaluation and biochemical analysis. Parameters studied were biopsies of the soleus muscle, level of lactate, creatine phosphokinase (CPK), lactate dehydrogenase (LDH), sodium, potassium (K), calcium (Ca) and arterial blood gasometry., Results: In I/R group, the levels of K, CPK increased dramatically contrast with groups C and IR+M (P < 0.05). A significant decrease in HCO3 was found in I/R Group in comparison with Group IR+M and Group C (P < 0.001). In Group IR+M, lactate level decreased dramatically compared to other groups (P < 0.001). Histological injury in I/R + M was found to be less than in I/R group (P < 0.05). There was no significant difference in PO2, pH, carbon dioxide, partial pressure of oxygen, Na, LDH, Ca and P in three groups (P > 0.05). Histological change in the group C and group M didn't differ significantly, but the difference in group I/R was significant compared to group C and IR+M (P < 0.05)., Conclusion: We suggest that melatonin has protective effect against I/R syndrome in blood and skeletal muscle and may reduce the morbidity following revascularization surgery in vascular trauma.

Background: The association between epicardial fat and coronary in-stent restenosis has not been evaluated. The objective of the present study was to evaluate the relationship of echocardiographic epicardial fat thickness (EFT) with restenosis in drug eluting stents (DES)., Methods: In this study, 117 patients who underwent coronary angiography due to recurrent clinical symptoms or findings of non-invasive cardiac tests one year after stent implantation were selected. According to angiographic results, they were divided into two groups, 65 patients with in-stent restenosis (case group) and 52 patients without such finding (control group). EFT was measured perpendicularly on the free wall of the right ventricle at the end of systole in two echocardiographic views (parasternal short and long axis) at least in three cardiac cycles. The average of obtained values was determined and recorded as EFT. Furthermore, the history of hypertension, smoking and diabetes, age and sex were investigated and body mass index (BMI) of each patient was also calculated., Results: There were no significant differences in the baseline characteristics (P=0.812). Patients with in-stent restenosis did not have statistically significant difference (4.6±1.8 mm) in EFT compared to subjects with patent stents (4.5±1.8 mm; P=0.88). The above results were also confirmed using multiple linear regressions. No significant correlation was found between EFT and other clinical variables (P >0.05)., Conclusion: In this selected population, the risk of restenosis was not correlated with epicardial fat thickness. Future studies for determining the role of epicardial fat in development of in-stent restenosis are warranted.

Background: Chronic hemodialysis patients frequently require vascular access through central venous catheters (CVCs). The most significant complication of these catheters is infection. This risk can be lowered by the use of an antibiotic-Heparin lock. This study focuses on hemodialysis patients using Tunneled-cuffed catheters (TCC), to assess the rate of catheter-related infections (CRI) in catheter-restricted filling with Cefotaxime and Heparin in end stage renal disease patients., Methods: A double-blind randomized study was conducted to compare 5000 U/ml Heparin plus10 mg/ml cefotaxime (CE/HS) as catheter-lock solutions, with Heparin (5000 U/ml) alone. A total of 30 patients with end-stage renal disease and different etiologies, were enrolled for chronic hemodialysis with permanent catheters from December 2009 to March 2010. These patients were randomly assigned to two groups of 15 members. Blood samples were collected for culture, sensitivity, and colony count, from the catheter lumen and the peripheral vein. CRI was considered as the end point., Results: The rate of CRI was significantly lower in the cefotaxime group versus control group (p < 0.001). No exit site infection was occurred in both groups. Infection-free survival rates at 180 days were 100% for the CE/HS group, and 56% for the HS group., Conclusions: Antibiotic lock therapy using cefotaxime reduces the risk of CRI in hemodialysis patients.

Background: Obstructive lung disease is a growing health problem, especially in developed countries. This study aimed to compare Impulse Osillometry System (IOS) and Spirometry for evaluation of Chronic Obstructive Pulmonary Disease and asthma., Materials and Methods: The study groups contained 87 healthy people, 87 asthmatic patients and 56 COPD patients. Spirometry (FVC, FEV1, FEV1/FVC) and IOS (R5, R20, X5) measurements were performed for all the healthy subjects and patients. The results of IOS were compared with spirometric results., Results: Significant differences were detected among the 3 groups (control, COPD and asthma) in terms of all the spirometric parameters (FVC, FEV1, FEV1/FVC) and some parameters of IOS (R5,R20,X5) measurements (p<0.05). Among COPD patients, sensitivity for X5 (the best value of IOS measurements in the COPD group) was 76%. Also, in asthmatic patients, sensitivity for R20 (the best value of IOS measurements in the asthma group) was 77%. We found a correlation between R5, R20 and X5 with FEV1 in asthmatic patients, but only R5 had this correlation with FEV1 in COPD patients., Conclusion: We concluded that IOS can be an alternative for spirometry in the diagnosis of obstructive lung disease in patients with minimal cooperation. R5 can represent COPD severity.

Background: This study was designed to evaluate the wound healing effects of kiwifruit in the treatment of second-degree burn wounds in rats., Methods: Sixty rats were each randomly assigned to 1 of 3 groups. A deep second-degree burn was created on the lateral flank of each rat with a standard burning procedure in the form of applying a heated plaque. In the control group (group C; n = 20) burns were dressed with Vaseline sterile gauze after normal saline irrigation. In group S (n = 20), the lesions were treated with silver sulfadiazine cream after normal saline irrigation. In the third group (group K; n = 20), the burn wounds were dressed with kiwifruit. The dressings were changed twice a day in all groups. The response to treatments was assessed histologically at day 21 postburn and microbiologically on days 7 and 21. Macroscopic evaluation was performed every day to determine wound closure rate, measure burn wound area, and investigate macroscopic edema, hyperemia, and epithelialization. Histopathologic evaluation included monitoring of epithelialization, vascularization, granulation tissue formation, and inflammatory cell response., Results: On day 21, the wounds in the group K healed completely in comparison to other groups (P < .0001). There was significant reduction in wound area size in the group K in all evaluation days as compared with groups S and C (P < .0001). Microscopic evaluation revealed a high grade of neovascularization in group K lesions in contrast with groups S and C (P < .0001). Wound infection was dramatically less common in the group K compared with the other 2 groups (P < .05)., Conclusion: We suggest that the dramatic antibacterial, debridement, wound contracture, and angiogenic effect of kiwifruit induced a significant wound healing in burn ulcers and might be useful in treating chronic ulcers, such as bedsores., (Copyright © 2010 Elsevier Inc. All rights reserved.)

Objectives: To evaluate the effect of Donepezil on cerebral blood flow velocity using non-invasive transcranial Doppler (TCD) sonography., Methods: This clinical trial was carried out in the Department of Neurology, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran from March 2008 to July 2009, on Alzheimer's disease (AD) patients in 2 groups of case and control, each consisting of 11 patients. The case group who received Donepezil medication was examined by TCD before (baseline), after 4 weeks of oral treatment with 5 mg per day Donepezil, and a further 4 weeks of 10mg per day Donepezil, orally. The control group comprised AD patients who did not receive any medications, and were examined by TCD only once. Peak systolic (PSV), end-diastolic (EDV), and mean flow (MFV) velocities of the posterior cerebral artery (PCA) and the middle cerebral artery (MCA) was assessed by TCD. Also, mini-mental state examination (MMSE) was carried out., Results: There were no significant differences between the case and control groups, in terms of age and gender. In the case group, the mean MMSE score reached 20.2 +/- 2.8 from a baseline value of 15.8 +/- 3.3 after 4 weeks of oral treatment with 5 mg/d Donepezil, and reached 20.6 +/- 3.9 after 4 more weeks at 10 mg/d Donepezil. In the MCA, the difference in PSV and MFV values after 4 weeks of treatment with 10 mg/d Donepezil was statistically significant compared with the baseline values. In PCA, the values of MFV and EDV after 4 weeks of treatment with 10 mg/d Donepezil were statistically significant in comparison with the baseline value., Conclusion: Donepezil (10 mg/d) increased cerebral blood flow velocity and MMSE score in our AD patients, but more extensive trials are recommended.