جستجوی مقالات مرتبط با کلیدواژه « مولتیپل اسکلروزیس » در نشریات گروه « پزشکی »

Multiple Sclerosis (MS) is the most common neurodegenerative disorder in young adults, and there is fear and concern about exercise among MS patients. The present study was designed to explain the barriers and strategies for performing exercise from the perspective of patients with MS.

This study was conducted using the content analysis research method. Fourteen patients with MS referred to the Arak MS Society were interviewed by three nurses and one physician. A total of 18 in-depth individual interviews were conducted in this study. The method of data collection was semi-structured interviews. Purposeful sampling was performed, and data saturation was achieved. All interviews were analyzed using a qualitative method.

In this study, 77.78% of the participants were women, and 61.11% were married. The mean age was 34.52±5.6 years. The duration of the disease varied from 2 to 10 years. The findings of this study can be categorized into two general themes: barriers to exercise (including individual, environmental, and socio-cultural factors) and strategies for institutionalizing exercise for these patients.

The findings of this study can assist authorities in identifying the specific issues faced by patients with MS and their barriers to exercise.

Multiple sclerosis (MS) is a relatively common neurological disorder that often affects young women. The current study aimed to assess the effect of expressive writing on the sexual and marital satisfaction of women with MS.

This randomized clinical trial was conducted to assess the sexual and marital satisfaction of 104 married women aged 18-45 years with MS referred to a selected specialized clinic in Tehran in 2022. The inclusion criteria entailed having minimal literacy, no use of psychotropic drugs, lack of other chronic diseases other than MS, and no pregnancy or breastfeeding. Sampling was performed consecutively, and samples were allocated to two groups based on the table of random numbers. The intervention group did writing at home at least once a week for four weeks. The personal characteristic questionnaire, Larson's sexual satisfaction, and Enrich's marital satisfaction questionnaire were used for data collection. The data were analyzed using SPSS software (version 21), and a p-value less than 0.05 was considered statistically significant.

The two groups were homogenous in terms of all examined personal characteristics. The results of this study demonstrated that performing expressive writing at home at least once a week for four weeks caused a significant increase in sexual satisfaction scores (P=0.01) and marital satisfaction (P<0.001).

As evidenced by the obtained results, expressive writing can improve sexual and marital satisfaction in women with MS.

This study aims to assess several medical malpractice cases and the punishment of imprisonment or non-imprisonment of  Multiple Sclerosis (MS) patients, to investigate the legal processes of dealing with medical malpractice cases of this category of patients and provide criteria for determining the tolerance of punishment of imprisonment or non-imprisonment for them which will reduce malpractice in the process of diagnosis and treatment and also increase the awareness of the medical community.

Case Report:

 Regarding the issue of medical malpractice, the cases of two women were investigated, in the first case, medical malpractice was proved due to not using the correct diagnostic process, and in the second case, medical malpractice was not  proved due to the use of the correct diagnostic process despite the incorrect diagnosis. Regarding the issue of tolerating imprisonment or non-imprisonment punishment, the cases of two criminals were also assessed, and after evaluating the severity of the disease, it was found that the first case which is imprisonment punishment was tolerable and the second case which is non-imprisonment punishment was found to be intolerable.

Failure to diagnose MS disease on time and subsequent mistakes in the treatment plan will lead to filing a complaint against the attending physician, therefore, the use of correct diagnostic processes and management of complications of treatment plans are emphasized. A series of specific criteria were presented to create a uniform procedure in the issuance of medical expert opinions regarding the case of serving the tolerance of punishment imprisonment, or non-imprisonment regarding the patient's condition.

Multiple sclerosis is a demyelinating disease of the central nervous system. This disease is one of the most common neurological diseases in humans and is the most debilitating disease of young people. In this regard, the aim of this research was to evaluate the effectiveness of treatment based on lived experiences of social stigma on the Mental Toughness of multiple sclerosis patients in Isfahan city.

Methods and Materials: 

The research method was a pre-test and post-test with a control group and a one-month follow-up. The statistical population of the research was all patients with multiple sclerosis who referred to the neurologist's office in Isfahan city in 2019. The society was informed that 30 patients with MS were selected by available sampling and randomly divided into two treatment groups based on lived experiences of social stigma and the control group (15 people in each group). The subjects underwent 8 weekly 90-minute sessions. The treatment was based on the lived experiences of social stigma and the control group did not receive any treatment. The data in this research was collected by the mental toughness questionnaire (MTQ48) (Clough et al., 2007) in three stages: pre-test, post-test and follow-up and were analyzed using variance analysis with repeated measurements in SPSS software version 22.

The results of mixed variance analysis with repeated measurements showed that the treatment based on the lived experiences of social stigma has created a Pnificant difference in the inter-group stage (P<0/05).

The results of mixed variance analysis with repeated measurement showed that the treatment based on the lived experiences of social stigma has created a Pnificant difference in the post-test stage compared to the follow-up and the pre-test (P<0/05).

Treatment based on lived experiences of social stigma has increased mental toughness in people with multiple sclerosis. Therefore, these results are recommended for clinical experts and health care workers

MS is an autoimmune, inflammatory disease with demyelination and astrogliosis of the central nervous system that affects the brain and spinal cord. Its prevalence in women is three times that of men.

This study was conducted on 42 male and female rats with an approximate weight of 300-350 grams in Shahid Chamran Faculty of Veterinary Medicine, Ahvaz. Material: The male sham group (received normal saline), the female sham group (received normal saline), the male MS group and the female MS group were divided. In order to inject ethidium bromide in the MS groups using a microinjector, rats were Ketamine (80 mg/kg) and xylazine (5 mg/kg) were anesthetized, 0.02% ethidium bromide and 20microliter normal saline were injected using a Hamilton syringe.

The results of this study showed that the inflammation and degeneration of nerve cells increased in the MS groups, and this inflammation and degeneration was more in males, and the level of MBP expression in the MS group was reduced compared to other groups, which compared The two genders of this reduction in expression were almost the same, and the amount of GFAP expression in the MS group was increased compared to the other groups, which was higher in the female gender when comparing the two genders.

MS causes a decrease in the amount of myelin basic protein and an increase in the astrogliosis factor, which leads to the destruction of the myelin sheath and astrocytes and causes sensory and motor disabilities in people with MS.

Multiple sclerosis (MS) is a progressive inflammatory disease in which inflammatory markers play an effective role in the development of this disease. In contrast, exercise training may lead to improved chronic inflammation. However, the effect of exercise training on inflammatory markers is not clearly understood. Therefore, the purpose of this meta-analysis is to investigate the effect of exercise training on IL-6, TNF-α, and IL-10 as well as CRP in patients with MS.

A comprehensive search was conducted in the three principal databases of PubMed, Web of Science, and Scopus for English and Persian articles published until December 22, 2022. To determine the effect sizes of the effect of exercise training on inflammatory markers IL-6, IL-10, TNF-α, and CRP, standardized mean difference (SMD) and 95% confidence intervals (CIs) were calculated.

Sixteen studies involving 687 patients with MS were included in the meta-analysis. Exercise training resulted in a significant decrease in levels of IL-6 [P = 0.002, (CI: -0.14 to 0.65: -0.40)] and CRP [P = 0.02 -0.04 to 0.70 CI: -0.37], but did not lead a significant effect on the levels of TNF-α [P = 0.20, (0.14 to 0.68 CI: -) -0.27] and IL -10 [P = 0.94, (0.43 to 0.40 CI: -0.15)].

Exercise training may lead to improvement of chronic inflammation status by reducing IL-6 and CRP in patients with MS. Therefore, prescribing regular exercise may be a suitable approach for disease management in patients with MS.

The present study was conducted to compare the effectiveness of meaning therapy and education based on acceptance and commitment to the resilience and quality of life of patients with multiple sclerosis.

The research method was semi-experimental with a pre-test and post-test design with a control group and a one-month follow-up. The statistical population of this research included all the patients with multiple sclerosis in Arak City in 2021, which were selected as an available sampling of 45 patients and randomly assigned to 3 groups of 15 people (two experimental groups and one control group) meaning therapy, therapy group based on commitment and acceptance and the control group were replaced. The measurement tools in this research were the Connor-Davidson Resilience Questionnaire (2003) and the World Health Organization Quality of Life (1998). The experimental groups were respectively subjected to meaningful therapy and education based on acceptance and commitment for 14 sessions of 45 minutes, and the control group received the usual treatment. Statistical data analysis was done using the analysis of covariance method and SPSS version 23 software.

The findings showed that after the intervention, both treatment methods improved resilience and quality of life compared to the control group, and the treatment results were maintained in the follow-up period (p<0.001); However, there was no significant difference between the two treatment methods in improving resilience and quality of life (p<0.001).

Based on the research results, it can be concluded that meaning therapy and education, which are based on acceptance and commitment, along with other treatment methods, are effective intervention techniques for enhancing the resilience and quality of life in patients with multiple sclerosis.

In recent years, artificial intelligence (AI) techniques are rapidly becoming clinical practices such as diagnosis and prognosis processes, treatment effectiveness evaluation, and disease monitoring. Previous studies have shown interesting results regarding the diagnostic efficiency of artificial intelligence methods in differentiating patients with multiple sclerosis (MS) from healthy individuals or other demyelinating diseases. There is a lack of a comprehensive systematic review on the role of AI in MS diagnosis. Our aim was to conduct a systematic review to document the performance of artificial intelligence in MS diagnosis. In this study, we conducted a comprehensive and systematic search using the PubMed database. All original studies that focused on deep learning or artificial intelligence to analyze methods aimed at diagnosing MS using MRI images were included in our study.

For this review, we searched PubMed for studies on the application of artificial intelligence in MS using MRI images published in English during the period 2010-2023. The search strategy was based on the words Mesh and their combinations. All studies were reviewed, but only the most relevant ones were used in this review.

Artificial intelligence, using deep learning methods, can predict the incidence of MS and its complications based on the risk factors of the disease and reduces the cost and time spent for various medical tests. Artificial intelligence makes this possible by extracting information and performing the necessary processing using methods such as CNN.

MS diagnosis based on new markers and artificial intelligence is a growing field of research with MRI images. All these results show that with advances in artificial intelligence, the way MS patients are monitored and diagnosed can change. However, several challenges remain, including better understanding of information selected by AI algorithms, appropriate multicenter and longitudinal validation of results, and practical aspects related to hardware and software integration. In general, the critical importance of human supervision to optimize and fully utilize the potential of artificial intelligence approaches cannot be ignored.

Multiple sclerosis (MS) is the most common demyelinating disease of the central nervous system and the second cause of disability in adults. The exact cause and pathogenic mechanisms behind this disease have not been yet understood. Besides T cells, B cells play a role in MS pathogenesis which has received less attention.

In the current study, the expression of long non-coding RNAs and four genes of the B cell receptor signaling pathway (CR2, BLK, BLNK, and RASGRP3) were investigated in the GSE21942 microarray dataset. Then, miRNAs targeting these genes and lncRNAs were predicted using miRWalk and DIANA-LncBase databases. Finally, the ceRNA network was constructed using desired genes, lncRNAs, and predicted miRNAs.

Seven differentially expressed lncRNAs were identified that all had high expression in MS patients compared with control subjects. Moreover, the expression levels of desired genes (CR2, BLK, BLNK, and RASGRP3) were upregulated in MS patients. Finally, the ceRNA network including one lncRNA (MALAT1), two predicted miRNAs (hsa-miR-92a-3p and hsa-miR-548a-3p), and three genes (CR2, RASGRP3, and BLK) was constructed. In this network, hsa-miR-92a-3p and hsa-miR-548a-3p target CR2, RASGRP3, and BLK genes, and MALAT1 constrains the effect of these miRNAs on desired genes through sponging them.

The constructed ceRNA network can be considered a novel mechanism of MS pathogenesis and may play a key role in MS development and progression by influencing the B cell receptor signaling pathway. Furthermore, each of the components of this network can be considered a potential therapeutic target.

The aim of this study was to determine the effectiveness of acceptance and commitment-based therapy (ACT) on pain anxiety and sleep quality in elderly women with multiple sclerosis.

This study was semi-experimental with a pretest-posttest & follow-up control group design. The statistical population of the study consisted of all elderly women with MS in Tabriz city in 2023. After meeting the criteria for entering and exiting the research, 30 person were selected by the purposeful sampling method and randomly divided into two groups (15 people each). The members of the experimental group received CFT in 8 sessions of 1.5 hours; but the control group did not receive any treatment. Analysis of findings through repeated measures analysis of variance test.

In the pretest, mean and standard deviation of the ACT for pain anxiety (76.00±4.22) and for sleep quality (17.67±2.49), and in the control group for pain anxiety (77.73±4.66) and for sleep quality (17.00±1.73) (P>0.05). The results showed that ACT is effective on pain anxiety (70.93±3.95) and sleep quality (14.53±2.38) of elderly women with multiple sclerosis (p<0.001). In the follow-up phase, the effect of treatment on the pain anxiety and sleep quality was lasting (p<0.001).

Based on the findings of this research, it can be concluded that acceptance and commitment-based therapy has reduced pain anxiety and increased sleep quality in elderly women with multiple sclerosis.

The aim of this study was to determine the effectiveness of compassion-focused therapy (CFT) on sleep quality & intensity pain of women with multiple sclerosis.

This study was semi-experimental with a pretest-posttest & follow up control group design. Thirty people with inclusion criteria were selected by purposive sampling method from all women with MS in Tabriz in 2023 who were members of the multiple sclerosis Association of this city. In total, 30 person meeting the inclusion criteria were selected by purposeful sampling, and The were randomly divided into the intervention and control groups (15 people each). The measurement tools were Pittsburgh sleep quality and McGill pain intensity questionnaires. The members of the experimental group received CFT in 8 sessions of 1.5 hours; but the control group did not receive any treatment. Analysis of findings through repeated measures analysis of variance test.

In the pretest, mean and standard deviation of the CFT for sleep quality (17.67±2.49) and for intensity pain (46.73±4.52), and in the control group for sleep quality (17.00±1.73) and for intensity pain (45.87±3.94) (P>0.05). CFT compared to the control group the sleep quality (14.33±2.28) and intensity pain (42.00±5.09) of women with multiple sclerosis increased and decreased respectively in the post-test (p<0.001). In the follow-up phase, the effect of treatment on the sleep quality and intensity pain was lasting (p<0.001).

Based on the findings of this research, it can be concluded that compassion-focused therapy has increased sleep quality and reduced the intensity pain of women with multiple sclerosis.

Programmed cell death-1 (PD-1) is one of the important co-inhibitory receptors in maintaining tolerance and inhibiting the proliferation and activity of activated immune cells. PD-1: PD-L pathway enhances regulatory T cells proliferation and inhibition of autoreactive T cells and regulates central and peripheral tolerance. This pathway has affected various aspects of the immune system and is of particular importance in a variety of diseases, such as autoimmune diseases. Multiple sclerosis (MS) and Neuromyelitis Optica (NMO) are neurological disorders characterized by inflammation, demyelination by the immune system, and axonal and neuronal damage in the CNS. The clinical manifestations of NMO are very similar to MS and lead to a misdiagnosis. Therefore, the existence of specific diagnostic markers is of particular importance for correct diagnosis. Here, we examined the expression of the PD-1 gene in 40 MS patients, 20 NMO patients, and 15 healthy individuals. Thus, after RNA extraction from human blood and cDNA synthesis, gene expression of PD-1 was investigated using quantitative real-time PCR technique. The results show that the PD-1 mRNA expression in the peripheral blood of the MS group was significantly increased in comparison to that of the NMO group and healthy group (p= 0.0008, p= 0.0024, respectively). However, there was no significant difference in PD-1 mRNA expression between the NMO group and the healthy group.

Multiple sclerosis (MS) is one of the most common causes of disability in neurological diseases, especially in the age of 20-40 years. Many factors caused by the disease have a significant impact on the quality of life the MS patients. The purpose of this study was to investigate the demographic factors including age, gender, occupation, marital status, education level, duration of disease, and the type of disease. Also, it was to survey the factors caused by the disease. such as the severity of depression, disability, cognition, and pain which all can affected the quality of life.

This non-experimental and cross-sectional study was conducted on 82 cases with multiple sclerosis (53 people with relapse-recovery type and 29 people with secondary progressive type) in a simple, non-randomized manner in the age group of 25-60 years. In order to investigate the relationship between variables and the factors affecting the quality of life, Pearson and Spearman correlation tests and multiple regression tests were used, considering the alpha level to be equal to 0.05.

The results of multiple regression demonstrated that all the above factors had a high correlation with the physical and psychological conditions of the MS patients' quality of life, with a correlation coefficient of 0.89 and 0.85, respectively. Moreover, depression severity and disability level were the most important influencing factors in determining the physical condition of the MS patients' quality of life, with the standard beta coefficient of -0.48 and -0.35, respectively. The only effective factor in the psychological state of the MS patients' quality of life was the depression severity (with a standard beta coefficient of -0.67).

The severity of depression is a critical and effective factor in the quality of life of people with multiple sclerosis

Urinary incontinence is very common in multiple sclerosis patients, which affects various aspects of relationships and quality of life. The aim of this narrative review is to collect approved methods of physiotherapy treatments which are effective in healing urinary incontinence in these patients.

In this study, investigations conducted from 1997 to 2023 regarding urinary incontinence physiotherapy for patients with multiple sclerosis were reviewed. A search was made in different databases of Google Scholar, PubMed and Science Direct for retrieving English articles using the keywords urinary incontinence, rehabilitation, physiotherapy, multiple sclerosis. Out of 40 retrieved articles, 23 articles were reviewed that properly considered the design, evaluation of the results and complications of the treatment and the existence of the control group.

The review of various studies showed that the strengthening and electrical stimulation of the pelvic floor muscles, the use of biofeedback electromyography, sacral magnetic stimulation and transcranial magnetic stimulation, skin stimulation of the posterior tibial nerve are effective treatments without side effects for patients with multiple sclerosis.

Physiotherapy with different exercise methods and electrotherapy heal urinary incontinence and improve quality of life in multiple sclerosis patients, and the combination of treatments has a greater effect.

The transmission of data in nervous system is affected by multiple sclerosis. This can cause problems for cognitive abilities and executive functions. Cognitive rehabilitations can improve these abilities. We investigated the effectiveness of Captain’s Log rehabilitation software on cognitive flexibility of patients with multiple sclerosis in Tehran.

The present study was an intervention type with a pre-test and post-test design. At the descriptive level, the mean and standard deviation were used. In the inferential part, the normality test of data (Kolmogorov-Smirnov test), the homogeneity of the regression slope and Levine's test were applied to check the equality of the variance of the dependent variable. Univariate analysis of covariance (ANCOVA) was used to check the effect of the intervention on the post-test scores. The sample statistical population included 30 patients with multiple sclerosis in the year 2021-2022 in Tehran, who were selected by the purposive convenience sampling method and randomly placed into two groups of fifteen people as control and intervention groups. Subjects completed the standard Cognitive Flexibility Questionnaire (CFI) by Dennis and Vander Wal to measure cognitive flexibility.

Captain’s Log cognitive rehabilitation software directly affected cognitive flexibility (p<0.001). The eta squared effect size 0.363 indicated that the effect of Captain’s Log on the flexibility of the subjects is 36.3%.

According to the results, the effectiveness of cognitive rehabilitation on patients with cognitive disorders is clear. It is suggested to use Captain’s Log cognitive rehabilitation software in welfare centers

Multiple sclerosis (MS) is a neurological disease in which the myelin lining the central nervous system is damaged. The complex nature of the disease making the diagnosis more difficult for the patient to face. This study explored the experiences of facilitators and barriers adjustment to MS by Iranian patients.

This study was conducted by using descriptive phenomenological approach. The participants included 14 patients (8 women and 6 men) referred to Rafideh Hospital in Tehran. The participants were selected by purposive sampling and maximum variety. Data collection continued through semi-structured interviews until theoretical saturation. The duration of the interviews was between 30-60 minutes. Data analysis was done with MAXQDA software and using the 7-step descriptive collaizzi,s method continuously and simultaneously with data collection. In order to check the robustness of the results, Lincoln and Goba criteria of validity, reliability, transferability and verifiability were used.

The 5 main themes related to facilitators of adaptation that emerged included religious strategies, receive emotional and professional support, search and find information, psychological coping strategies, and life style (and 18 subcategories). Also the three main themes related to barrier of adaptation that emerged included health-related, patient-related and social-related barriers (and 8 subcategories).

These themes represent the perceived characteristics, facilitators and barriers of adaptation to Multiple Sclerosis by patients. Therefore, it is necessary to design or implement therapeutic interventions based on these findings by psychologists and counselors for patients to reduce psychological problems.

 Brain morphology using quantitative data is one of the most important research topics in neuroscience. There is little documentation about the anatomical changes in the demyelinated mouse brain. On the other hand, the differences between the changes applied due to demyelination in both genders have not been studied. Therefore, the present study was conducted with the aim of investigating the morphometric aspects of the brain of demyelinated male rats along with evaluating the changes in their behavioral patterns.Multiple sclerosis (MS) is a chronic autoimmune disease of the central nervous system (CNS) that affects different areas such as the brain, spinal cord, and optic nerve. The disease is characterized by active plaques containing cytokine-secreting T lymphocytes (1, 2).Nerve demyelination following acute CNS inflammation leads to neurological disability characterized by temporary remission and recurrence or a chronic advanced stage. One of the complications of the disease is cognitive disorders that have been reported in 40-60% of cases and occur in the early or even late stages of the disease (3, 4).MS-related cognitive impairment is often characterized by a relative decrease in neurophysiological function in assessing short-term memory processing speed, attention, spatial visual abilities, and executive function (5, 6).These disorders affect the course of life of individuals and are diagnosed in clinical evaluation to some extent imperceptibly but have not been studied morphometrically. So far, MRI findings have been used to examine the association between structural damage and cognitive impairment. Studies have shown that atrophy of various structures in the gray matter of the brain, such as the cerebral cortex, causes neurological disability (6, 7).Specifically, atrophy of some areas of the cortex, especially the hippocampus, is associated with dysfunction of the cognitive process in the early stages of the disease, while changes in white matter volume did not play a role in the development of these cognitive disorders (8, 9).In one study, imaging findings from patients with Parkinson's showed that the hippocampus and amygdala were atrophied, and this atrophy was concentrated in the cephalic areas of the hippocampus. This dementia has not been observed (10).Also, in patients with Alzheimer's disease, a decrease in the total volume of the fornix and mammals is directly related to cognitive disorders (11).On the other hand, in another study, the findings of people with brain trauma indicated that a reduction in the volume of the hippocampus, fornix and carpus callosum is also seen in the lesion-free group (12).The corpus callosum is the main structure of white matter in the brain that connects the right and left hemispheres. This structure is damaged in MS and its damage causes complex and cognitive disorders. AlonKalron's findings also show that MS reduces the volume of the hippocampus, amygdala and thalamus. Findings of scientists such as Audoin, Wadhwa and Benear also show the role of hippocampus and phoenix in memory and learning (13-15).Given that none of the studies has so far examined the relationship between the histological and anatomical structure of the brain and its function, this study attempts to macroscopically, microscopically and horny areas of the hippocampus and fornix. Study a function in the male rat demilinase model.

 This study was performed on 21 male rats weighing approximately 300-350 g in ShahidChamran Veterinary School of Ahvaz. First, in order to adapt the rats to the environment, they were kept at 23 ± 23 ° C for one week, and the dark-light cycle was maintained for 12 hours without water and food restrictions. All stages of the test were performed according to the instructions of the Committee on Ethics of Working with Laboratory Animals, Faculty of Veterinary Medicine, ShahidChamran University of Ahvaz (EE / 99.3.02.55591 / scu.ac.ir: Code of Ethics). The mice were then randomly divided into three groups of seven consisting of the first group: healthy, the second group: normal saline recipient and the third group: ethidium bromide recipient.For stereotaxic surgery and injection of ethidium bromide using a microinjector, mice were anesthetized with ketamine (80mg / kg) and xylazine (5mg / kg) and the hair on the skull was shaved and then in the midline of the head from the frontal to the oxy. The sagittal shear palate was created to determine the injection site according to the coordinates of the Paxinos atlas (anterior-posterior 0.46, internal-external 1 and dorsal-abdominal 2.2). In the final stage, injection of ethidium bromide 0.02% and normal saline at the rate of 20 μl was performed using a Hamilton syringe in the specified area in mice in the injury group and normal saline, respectively (16). Modified Neurological Severity Scores (MNSS) method was used to check balance. This test consists of several parts that are measured in the balance test of several parameters، Also, in order to investigate the type and manner of animal movement in ethidium bromide, normal saline and healthy rats, footprint test was used. Morris water maze test was used to check the level of spatial learning of the animal،At the end of the twelfth week, the tested groups were anesthetized by intraperitoneal injection of ketamine and xylazine, and after perfusion (with normal saline solution and 4% paraformaldehyde), the animal's head was separated and the brain was removed without damage. After brain extraction, their length and width were measured using a digital caliper and their weight was measured using a digital scale. Then, the weight and volume of the hippocampus region were measured, and the demyelination and nerve cell survival indices in the brain tissue were measured using Siloxal Fast Blue and Cresyl Violet staining in the hippocampus and fornix.

 The results obtained from the balance test showed balance and motor dysfunction in the affected group, which was statistically significant (P <0.05). The results of the Morris water maze test in 5 days (4 days of learning and one day of testing) show that the healthy and saline groups found the platform in less time than the demyelination group. On the other hand, the mean brain indices, The hippocampus and fornix were less in the injury group compared to the healthy and saline groups (P <0.05). Fast blue lux staining also showed severe myelin damage in the ethidium bromide group and also increased the number of damaged nerve cells (dark cell) in curzil violet staining (P <0.05).

 Cerebral demyelination reduces the volume of the hippocampus and fornix in the brain of male rats and also increases the number of damaged cells in direct relation to memory loss and balance. These people can also develop cognitive and behavioral disorders that will negatively affect their daily lives.

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.

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).

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).

Perceived social support in patients with MS did not cause medication adherence.

The aim of this study was to evaluate the impact of a course dynamic neuromuscular stabilization (DNS) training program on balance and ankle proprioception in female patients with MS.

For this study, 24 people were selected who were divided into control (Number: 12 people, Age: 45.50 ± 3.06 years, Height: 1.66 ± 0.02 m, Weight: 58.08 ± 3.05 kg, BMI: 20.99 ± 1.04 Kg/m2, EDSS: 2.05 ± 0.75) and training (Number: 12 people, Age: 43.91 ± 2.84 years, Height: 1.65 ± 0.03 m, Weight: 56.91 ± 4.73 kg, BMI: 20.75 ± 1.17 Kg/m2, EDSS: 1.91 ± 0.51) groups. In this study, static balance was evaluated by Sharpen Romberg test and dynamic balance was evaluated by Timed Up and Go test. Also, ankle proprioception was evaluated in two positions dorsiflexion and plantar-flexion with a goniometer. At the end of the evaluations, the training group performed the exercises for 6 weeks (3 sessions per week). The control group also engaged in their daily activities during this period. Assessments were performed again after the exercises. In this study, Shapiro–Wilk test was used to check the normality of the data. Analysis of covariance and paired t-test, Yu Mann-Whitney and Wilcoxon were also used to analyze the effect of exercise on variables and differences between groups. SPSS24 software was also used to analyze the data in this study.

The results of this study showed that the dynamic neuromuscular stabilization exercise program had a significant effect on improving static balance with open eyes (P=0.001) and (P=0.001), dynamic balance (P=0.001) and proprioception the foot is in dorsiflexion (P=0.01) and plantar flexion position (P=0.001). Also, the results of comparison between the two groups showed a significant difference between the two groups (P≤0.05).

Based on the results of using this exercise program, it is recommended to the therapists involved with these patients.