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Background and Objective: Multiple sclerosis (MS) is a chronic, progressive and degenerative myelin sheath of the central nervous system. Manifestation and side effect of this disease drastically impress patient’s body image and destruct self concept. The objective of the implementation of this study was to evaluate the effect of Orem self- care program on multiple sclerosis patients’ self concept. Materials and Methods: This quesi-experimental study was done on 34 MS patients referred to Ayatollah Kashani hospital in Shahrekord – Iran, during 2008. The patients were selected by convenience sampling. 8 sessions educational program based on patients needs and Orem self care frame work during 3 months were carried out and with self reporting sheets program was pursued. After 3 months self concept questionnaire completed and data were analyzed by using SPSS-11.5 software and paired T, will kakson and kruskal wallis tests. Results: Mean of self concept, prior and post intervention was 60.67+-4.20, 118.26+-3.53, respectively (P<0.05). No significant correlation was found between age, gender, educational level, marriage status, number of children, occupation, level of income, duration of outbreak, times of hospitalized with self esteem. Conclusion: This study showed that self care program based on the Orem frame work has positive effects on self esteem in multiple sclerosis patients. Therefore this program is recommended in MS patients.

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Background and Objective: Multiple sclerosis is one of demyelinating disorder of CNS that is an uncommon cause of the sensorineural hearing loss. This study was done to determine the hearing loss in multiple sclerosis patients.

Materials and Methods: This case-control study was performed on 60 (44 women, 16 men) multiple sclerosis patients and 38 (27 women, 11 men) normal subjects by pure tone audiometery, otoacustic emissions and auditory brainstem responses in Gilan provine, Iran during 2010-11. Data was analyzed by using SPSS-17, Chi-Square and Fischer tests.

Results: 12.5% of case and 3.9% of the control ears had abnormal pure tone audiometery (P<0.05). The frequencies of abnormal HF-pure tone audiometery and two modalities of otoacustic emission did not show any significant differences in two groups. Abnormal autidory brainstem response of ears were observed in 20% and 9.2% of cases and controls, respectively (P<0.05). 20% of case and 9.2% of the control ears had abnormal auditory brainstem response (P<0.05). The absolute latencies of waves I, II and V had not significant differences between two groups. Inter peak latencies of I-III and III-V waves were observed in 10% and 11.7% in cases ears and 1.3% and zero percent in controls, respecticely. 6.7% of cases and 2.6% of control ears had retrocochlear abnormality.

Conclusion: Hearing loss detected by pure tone audiometery and auditory brainstem response is more common in multiple sclerosis compared to normal population.

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Background and Objective: Multiple Sclerosis is one of the most common and disabling neurological disease. Recent studies reported the possible role of serum uric acid in the pathogenesis of multiple sclerosis. This study was done to examine the role of serum uric acid in patients with multiple sclerosis. Materials and Methods: This case - control study was carried out on 70 multiple sclerosis patients as cases and 70 healthy subjects as controls in teaching hospital in Rafsanjan, Iran during 2010. The two groups were matched in age and gender. The serum uric acid level of subjects in case and control groups was measured by enzymatic colorimetric method. Data were analyzed using SPSS-17 and student t-test. Results: The mean serum uric acid level in cases and controls was 3.871±1.193 mg/dl and 4.171±1.39 mg/dl, respectively, this difference was not significant. Also, there was not significant relationship between serum uric acid level and gender in multiple sclerosis patients. Conclusion: This study indicated that the serum uric acid level is not changed in multiple sclerosis patients compared to controls.

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Background and Objective: Although multiple sclerosis is a disease affecting white matter of brain and spinal cord, but involvement of basal ganglions in some studies demonstrated a decrease in T2 sequence signals. This study was done to assess signal intensity of basal ganglions in T2 magnetic resonance imaging (MRI) in multiple sclerosis Materials and Methods: This case – control study was done on 30 multiple sclerosis patients and 30 controls in Imam Reza hospital, Kermanshah, Iran, during 2010. MRI images of multiple sclerosis of patients and control group were matched according to age and sex. The basal ganglia signals were identified based on involvement areas, number of plaques, and brain atrophy in T2 and flair sequences. Data were analyzed using SPSS-16, Chi-Square, Fisher exact test and independent t-tests. Results: Among the case group, 10 patients (33.3%) demonstrated low signals in right thalamus and 14 patients (46.7%) in left thalamus, which was statistically significant compared with control group (P<0.001). The presence of plaques in right and left globus pallidus was observed in 4 (13.3%) and 7 patients (23.3%) respectively. The presence of plaques in right and left thalamus was observed in 10 patients (33.3%) and 14 patients (46.7%) respectively, which was significant compared with control group (P<0.001). The presence of brain atrophy was observed in 18 patients (60%) in case groups and in one patient (3.3%) in control group (P<0.001). Conclusion: This study indicated that reduction of T2 signals in thalamus is a valuable finding in multiple sclerosis patients and it may facilitate the diagnosis of multiple sclerosis.

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Background and Objective: Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease, leading to progressive disability, reduces daily activity and function and emerges with a wide range of physical symptoms. This study was done to determine the effect of relaxation on the physical symptoms in women with Multiple Sclerosis. Methods: In this clinical trial study, 50 patients with MS were randomly divided into relaxation and control groups. In the interventional group, Jacobson and Benson method was performed for 4 weeks, twice a week for 40 minutes and patients in the control group were received only care and routine medical treatment. Data was collected via fatigue severity scale (FSS), numerical rating scale (NRS) before, immediately after and two months after intervention. Results: The mean severity of fatigue score, before, immediately and two months after the intervention were not the same and time trends was effective on severity of fatigue score (P<0.05). The mean of fatigue score were significantly reduced in intervention group (immediately and two months after intervention) in compared to pre-intervention. The mean severity of pain score ,before, immediately and two months after the intervention were not the same and time trends was effective on mean severity of pain score (P<0.05). The mean intensity of pain score over time in the relaxation group non-significantly reduced in compared to the control group. Conclusion: Relaxation technique is effective as a low-cost, safe and easy method to reduce fatigue and pain in patients with MS.

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Background and Objective: Multiple sclerosis (MS) is one of the most common diseases in the central nervous system, caused by damage to myelin sheath. This study was done to compare the effect of eight weeks of core stabilization, theraband resistance and combined training on functional endurance and postural control in male patients with MS. Methods: In this quasi-experimental study, 40 male patients with MS were non- randomly divided into three experimental and one control groups (each group, n = 10, age range 25 to 35 years, BMI between 20 and 25, and physical disability scale of 1 to 5.4). Core stabilization, theraband resistance and combined training, balance berg test and 6-minute walk test were performed in order to exercise protocols. Results: Capacity movement and postural control were significantly improved in experimental groups in comparison with control group (P<0.05). The most variability was related to the combination of training program. Conclusion: Eight weeks of core stabilization, theraband resistance and combined training improves functional endurance and postural control in men with MS.

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Background and Objective: Multiple sclerosis (MS) is the most common progressive neurologic disorder among young adults. This disease leads to lesions regarded to as demylinating plaques which are scattered in the white matter of CNS hence create various neurological problems. This study was done to evaluate the effect of 8 weeks selective training program with instructions focus of internal and external attention on statical balance of MS patients. Methods: In this quasi-experimental study, 23 MS patients were non-randomly divided into, two interventional and one control groups. Training program for two interventional were carried out in 8 weeks, three sessions per week, and each session lasted about one hour. Pre and post test to evaluate the fall risk of subjects using Biodex system was performed in three groups. Results: Statical balance was significantly improved in the two interventional compared to control group (P<0.05). Conclusion: The training program with instructions focus of internal and external attention significantly improves statical balance of MS patients.

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Multiple sclerosis (MS) is a chronic inflammatory immune-mediated disease of the central nervous system. Despite extensive investigations, many aspects of etiology and pathophysiology remain unclear. In multiple sclerosis patients, immune system reacts against autologous proteins in the myelin membrane. Most evidences support the hypothesis that both genetic and environmental factors contribute to disease development. But after the failure of genetic findings to explain the reason for the unequal incidence of MS in identical twins, investigators focused further on environmental factors such as vitamin D deficiency, smoking, living in different latitudes and perhaps the most importantly the role of viruses in people whom are genetically susceptible to MS. There is increasing evidence that viruses may play important role in MS pathogenesis following environmental triggers. Recently, studies focused on the role of herpes virus family, especially Epstein-Barr virus, human herpes virus 6 (HHV-6) and Varicella Zoster virus, as the virus is prevalent in society. This review mainly focused on the identification of important viruses with key role in MS the mechanism behind pathogenesis and describes the animal models of MS. The results of researches are shown strong evidence of the virus or antibodies to viral components in active plaques in MS affected patients, but still cannot be stated with certainty that one or more specific viruses are simultaneously trigger the disease. Further studies are required to prove the pathogenesis of viruses in MS.

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Multiple sclerosis (MS) is a chronic and multiphasic autoimmune disease which affecting the nervous system. Recently, neurotrophic factor secreting cells have been proposed as one of the best sources for cell therapy in MS disease. Therefore, this review study was done with aimed to introduce neurotrophic factor secreting cells and the role of neurotrophic factors in the treatment of MS. The present study, based on the Systematic Review and using multiple sclerosis, neurotrophin and cell therapy keywords, 98 articles were searched from various databases including Pubmed, SID, Springer, SinceDirect Magiran, Web of Sciences and the Google Scholar. After removing irrelevant and repetitive articles, 50 articles were selected. The results of these studies showed that cell-based therapies in MS have been designed with the aim of replacing destroyed cells or with the goal of neuronal support using neural growth factors. Neurotrophic factors secreting cells with the ability to migrate to neurological lesions and secretion of neurotrophic factors can play a major role in supporting neural tissue and preventing its destruction. These factors, through tyrosine kinase receptors, have a variety of effects on the development and proper functioning of neurons. On conclusion, neurotrophic factor secreting cells due to the secretion of a wide range of neural growth factors which required for neural development might be one of the ideal cell sources for cell-based therapy in MS disease.

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Background and Objective: Multiple Sclerosis (MS) is a neurologic necrotic and chronic illness that causes by demyelination in CNS. One of the common clinical symptoms in MS is cognitive disorders. The most common cognitive defects in patients with MS are reduction of memory and information processing rate hippocampus functions in brain are memory and learning. This study was done to determine the function mechanism of memory discover by study on hippocampus. Nowadays tendency of herbal therapy is increased because of drug's side effects. This study's purpose that is from experimental typ effect of compaind extract of Portulaca olerace, Urtica dioica and Boswellia serrata on memory and number of neurons in CA1 area of hippocampus in induced multiple sclerosis rats.
Methods: In this experimental study 30 male adult rats were randomly allocated into control group, sham group (salin injection), (MS + salin) group, (MS + mixture extract, dose of 200 mg/kg), (MS + mixture extract, dose of 400 mg/kg). MS model was induced by intra hippocampal injection a single dose of ethidium bromide (0.01% ethidium bromide sulotion in 0.9% salin) and in 3 microlitre volume with 1 microlitre in minute rate intraperitoneally. Compaind extract of Portulaca olerace, Urtica dioica and Boswellia serrata were injected as the treatment for 21 days. The shuttle box test was used for evaluation of memory. Dissector method was used for neural density in CA1 of hippocampus. Histopathology method was used for evaluation of the alteration of cells.
Results: Neural density in MS induced group was singnificantly reduced in comparison with control and sham groups (P<0.05). Neural density was singnificantly increased in treatment groups in comparison with MS induced group (P<0.05). Histological results showed that induction of MS caused the disrution of neuron cells in compare to controls, but intraperitonal injection of compaind extract cause neurogenesis in tertment groups. Memory in MS induced group was singnificantly reduced in comparison with control and sham groups (P<0.05), but memory was singnificantly increased in treatment groups in comparison with MS induced group (P<0.05).
Conclusion: Compaind extract of Portulaca olerace, Urtica dioica and Boswellia serrata with dosages of 200 and 400 mg/kg/bw due to neurogenesis and amilioration can effective in memory recovery and neural necrosis in MS disease.

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Background and Objective: Multiple sclerosis (MS) is the most common disabling neurological disease which leads to nerve conduction velocity (NCV) reduction and finally reduction of functional abilities. This study was executed to determine the effect of six weeks resistance training on NCV, strength, balance and walking speed in Multiple Sclerosis patients.
Methods: In this quasi-experimental study, 23 MS patients were nonrandomly divided to control (n=10) and resistance training (n=13) groups. Two days before and after training program, NCV, strength, balance and 25 foot walking tests was executed. Resistance training protocol was included tree sessions per week for six weeks and intensity of training was 55% of 1RM.
Results: Six weeks of lower body resistance training significantly increased nerve conduction velocity (NCV) (P<0.05), strength (P<0.05), balance (P<0.05) and walking speed (P<0.05) in MS patients.
Conclusion: Controlled resistance training can improve Multiple Sclerosis patient’s nerve conduction velocity which finally can lead to improve functional abilities, such as strength, balance and walking speed.

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Background and Objective: Multiple sclerosis (MS) is one of the most common diseases of the central nervous system. MS is more common among women. Gait pattern dysfunction is a relevant symptom in these patients. This study was conducted to compare the electromyography activity of selected lower extremity muscles and the ellipse area of center of pressure during unplanned gait termination in female patients with multiple sclerosis and healthy individuals.
Methods: This case-control study was performed on 10 female patients with MS (classified based on the EDSS scale) and 10 healthy subjects matched for height, age and weight. Electromyography activity of rectus femoris (RF), vastus medialis (VM), vastus lateralis (VL), biceps femoris (BF), semitendinosus (SM), gastrocnemius medius (GM) and tibialis anterior (TA) and center of pressure (CoP) recorded using foot pressure system during unplanned gait termination. Subjects were instructed to stop, as soon as possible, in response to an auditory cue delivered when the heel strike phase accidentally.
Results: Vastus Lateralis muscle activity was significantly higher in able-bodied group than patients (P<0.05), whereas in the patient group gastrocnemius medius muscle activity increased significantly (P<0.05). Also, the ellipse area of center of pressure significantly reduced in MS group in compered to able-bodied group (P<0.05).
Conclusion: Increased gastrocnemius medius muscle activity in MS patients may be due to their attempt to slow down the displacement of the center of mass to limit the tibia forward translation consequently, attempting to control balance as a strategy to limit the ellipse area of center of pressure to prevent fall.

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Background and Objective: Multiple sclerosis (MS) is one of the most common progressive neurological diseases affecting the motor pathways leading to muscle fatigue. This study was done to evaluate the effect of eight weeks of aquatic exercises on fatigue, balance and functional training in male patients with multiple sclerosis.
Methods: This clinical trial study was done on 15 men with multiple sclerosis in Zahedan, south-east of Iran. The subjects selected by available and purposeful sampling method participated in research. After primary screening and reconnaissance person of bona fide, subjects randomly divided into intervention group (n=8) with average age 42.62±6.67 height 171.87±2.47 weight 69.62±12.39 and control group (n=7) with average age 30.28±7.11, height 171.57±8.05 weight 66.68±17.26. During study the patients used and follow medicinal drugs according to prescription. Subjects in interventional group were received aquatic exercises program. Aquatic exercises program consisted of 8 weeks, 3 sessions per week. The level of fatigue, balance and functional movement respectively evaluated with fatigue assessment battery for MS, Y balance and side hop jump tests.
Results: The mean of functional movement was significantly increased in interventional group in comparison with controls (P<0.05). The mean of fatigue was significantly reduced in interventional group compared to controls (P<0.05).
Conclusion: Eight weeks of aquatic exercises improves functional movement and reduce fatigue in male patients with multiple sclerosis.

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Background and Objective: Multiple sclerosis (MS) is a common neurological disease that increases oxidative stress and causes immune system disorders. Curcumin is the active component of turmeric with anti-inflammatory properties. This study was conducted to determine the effects of curcumin on cortisol, catalase, and nerve growth factor (NGF) expression in an animal model of MS.
Methods: This experimental study was conducted on 30 female Wistar rats. Experimental autoimmune encephalomyelitis (EAE) was chosen as an experimental model of MS. The rats were divided into 3 groups of 10, including a healthy control group, an affected group, and a group treated with curcumin. The disease was induced by immunization of rats with homogenized guinea pig spinal cord and Freund's complete adjuvant. Then, the immunized animals were allocated into two equal groups. Treatment with curcumin (100 mg/kg daily) was started 12 days after the immunization when the rats showed the first symptoms of neurologic disability. The treatment was continued until day 24 post-immunization. Simultaneously, the EAE group received the medicine solvent (distilled water). Finally, the rats' weights as well as cortisol, catalase, and NGF levels were measured in the study groups.
Results: Curcumin significantly increased the level of cortisol to a level equal to that of healthy rats (P<0.05). It also significantly increased the expression of NGF and reduced the amount of catalase in the affected rats (P<0.05). The curcumin administration significantly increased the overall weight of rats with MS but had no significant effect on the spleen weight of the treated rats.
Conclusion: Curcumin can be beneficial for treating EAE by reducing the destructive effects of oxidative damage and increasing NGF.
 

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Background and Objective: Multiple sclerosis (MS) is an autoimmune disease that targets the central nervous system. Various studies have shown that several factors influence this disease’s occurrence and prevent its progress. Multiple studies have shown that several factors affect this disease’s occurrence and prevent its progress. Helicobacter pylori can be mentioned among these factors. This study was conducted to determine Helicobacter pylori infection in MS patients and healthy individuals.
Methods: This case-control study was conducted on 100 patients with MS (mean age: 36.99±9.87 years) and 100 healthy subjects (mean age: 38.05±11.38 years) in Golestan province, north of Iran during 2021. The case group included eighty relapsing-remitting cases and twenty secondary progressive cases. Blood samples were taken from both groups, and after separating the serum using the ELISA test, anti-Helicobacter pylori antibody (IgG) was detected by determining the antibody titer.
Results: Helicobacter pylori IgG in the MS and control groups was 21% and 44%, respectively (P<0.05). The mean concentration of IgG in the case group was significantly lower than the control group (13.48±10.83 versus 19.78±16.14 AU/ml). The percentage of positive cases of IgG antibody against Helicobacter pylori in the relapsing-remitting and secondary progressive group of patients with MS was determined as 21.2% and 20%, respectively, and the difference between these two groups was not statistically significant.
Conclusion: The history of Helicobacter pylori infection is less than two times in patients with MS compared to healthy people probably indicate the protective role of this bacterium against this disease.

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Background and Objective: Physical disability caused by multiple sclerosis (MS) increases MS patients' need for support from others. Medication adherence is one of the main success factors in the treatment of chronic diseases, which is influenced by various factors. This study aimed to determine the relationship between perceived social support and medication adherence in patients with MS.
Methods: This descriptive-analytical study was conducted on 110 patients (70 women and 40 men) aged 39±9 years with MS who visited the 2 medical training centers of Isfahan University of Medical Sciences (Kashani and Al-Zahra), Isfahan, Iran during 2021. After sampling by the systematic random method, the data were collected by interviews and using Zimmet's Perceived Social Support Scale (MSPSS) and the Morisky Medication Adherence Scale (MMAS-8).
Results: The mean and standard deviation of the scores of medication adherence and perceived social support were 6.10±1.72 and 62.83±14.97, respectively. According to the Pearson correlation coefficient, perceived social support did not show any significant relationship with medication adherence (r=0.185, P=0.053). Perceived social support showed a statistically significant relationship with income satisfaction (F=4.54, P=0.01), the pattern of clinical course (F=2.95, P=0.03), difficulty in accessing medical care (t=-2.29, P=0.02), and clinical symptoms, including motor (t=-3.72, P=0.001), balance (t=-3.23, P=0.002), and urinary disorders (t=-2.53, P=0.01).
Conclusion: Perceived social support in patients with MS did not cause medication adherence.

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Background and Objective: Demyelinating lesions, widespread tissue damage, and neuronal connectivity impairments in white matter are associated with reduced cognitive decline in multiple sclerosis (MS) patients. These findings are particularly prominent in the corpus callosum of the brain. Interleukin-10 (IL-10) is an anti-inflammatory cytokine secreted by regulatory T cells (Tregs) with anti-inflammatory properties and can inhibit the production of pro-inflammatory cytokines produced by macrophages and T cells. IL-6 is a multifunctional cytokine involved in the immune system of autoimmune diseases. The IL-6 gene consists of 5 exons, 4 introns, and a proximal promoter region located on the 7p21 chromosomal locus in humans. This study aimed to determine the effects of IL-10 (-1082/-819) and IL-6 (-174) gene polymorphisms on corpus callosum changes in women with MS.
Methods: This case-control study was conducted on 40 women with MS aged 20-40 years referring to Golestan and Kowsar Magnetic Resonance Imaging (MRI) centers in Gorgan and 20 women without MS, autoimmune or inflammatory diseases over 40 years during 2015. Ten mL of blood was taken from the subjects for genotyping. Additionally, DNA extraction was performed using the phenol-chloroform method, and DNA genotyping was performed using the sequence specific primer-polymerase chain reaction (SSP-PCR) method. Brain MRI images of the subjects were employed to measure the corpus callosum and to investigate the relationship with the investigated polymorphisms.
Results: After performing the tests and obtaining different IL-6, IL-10 (-819), and IL-10 (-1082) genotypes, no significant statistical correlation was observed between IL genotypes in the case and control groups. Additionally, no significant correlation was observed between the different IL-6, IL-10 (-819), and IL-10 (-1082) genotypes and changes in the size of different parts of the corpus callosum, including rostrum width, splenium width, body width, the ratio of body length to anteroposterior length, and the ratio of body length to maximum height between the case and control groups. Reductions in the variables of rostrum width, splenium width, body width, the ratio of body width to anteroposterior length, and the ratio of body width to maximum height were significant in both case and control groups (P<0.05). Only the reduction in splenium width was significantly associated with the occurrence of MS (P<0.009, odds ratio [OR]=2.35, 95% confidence interval [CI]=4.51-1.22).
Conclusion: There was no relationship between the morphometric changes of reduced corpus callosum and the changes in IL-6, IL-10 (-819), and IL-10 (-1082) genotypes in patients with MS.