Association of vitamin D metabolite levels with relapse rate and disability in multiple sclerosis

Multiple sclerosis is an inflammatory demyelinating disease of the central system. It estimated to affect more than 2.5 million people worldwide. It is the most common non-traumatic cause of disability in young adults. Although the cause of multiple sclerosis remains undetermined, number of risk factors for MS have been identified and they can loosely be put into one of two categories; genetic or environmental components. Epidemiologic studies have suggested there is an increase in incidence and prevalence of MS with increasing latitude north and south of the equator. Latitude has implicate vitamin D status as a determinant of risk. To study the association of vitamin D level with relapse rate and disability in patients with relapsing remitting multiple sclerosis in Iraq. Thirty patients [6 males and 24 females] with relapsing remission multiple sclerosis [RRMS], their age range from 16 to 45 years, recruited from MS clinic of neurology department of Baghdad teaching hospital in the medical city in Baghdad and twenty five completely healthy controls [6 males and 19 females] from general population and their age range from 20 to 40 years were enrolled in this study in the period from April 2011 to the end January 2012. The present study shows low vitamin D levels for both patient with RRMS and control group. There is significantly lower 25[OH]D level in patients with relapse compared with patients without relapse in the last 6 weeks. Also we found higher expanded disability status scale [EDSS] in patients with relapse compared with patients without relapse in the last 6 weeks. Lastly, we didn't find any correlation between vitamin D level and EDSS in patients group study. We concluded from this study that there is low circulating level of 25[OH]D in RRMS patients, especially during relapses. Also there is no effect of vit D on disability

Assessment of nitrosative oxidative stress in patients with middle cerebral artery occlusion

To assess serum levels of nitric oxide and peroxynitrite in patients presenting with cerebral infarction resulting from middle cerebral artery occlusion, at 48 hours from stroke onset. We conducted the study in the Department of Pharmacology and in cooperation with Al-Yarmouk Teaching Hospital and the Department of Medicine, College of Medicine, Al-Mustansiriya University, Baghdad, Iraq from October 2003 to May 2004. Twenty patients presented with neurological deficits of middle cerebral artery occlusion, and we also enrolled 20 healthy individuals to serve as a control group. We obtained venous blood samples from each patient after 48 hours of stroke onset and each healthy individual. We determined the serum level of nitric oxide as well as peroxynitrite. Serum nitric oxide and peroxynitrite were significantly [p<0.001] higher in patients [103.9 +/- 40.2 micro mol and 2.7 +/- 0.6 micro mol] than in healthy individuals [53.3 +/- 20.7 micro mol and 2.3 +/- 0.2 micro mol]. The formation of peroxynitrite directly correlated with nitric oxide in healthy individuals [r=0.84], and patients [r=0.514]. Serum intermediate nitrogen species; nitric oxide and peroxynitrite were significantly increased after 48 hours of stroke onset in patients with middle cerebral artery occlusion. The rate of peroxynitrite formation from nitric oxide was slightly increased

Outcome of Thymectomy in Patients with Myasthenia Gravis

Myasthenia Gravis is a neuromuscular disorder characterized by weakness and fatigability of skeletal muscles. Thymectomy is now beneficial even for non-thymomatous patients. The aim of this paper is to evaluate the role of thymectomy as on the treatment options for myasthenia gravis. Thirty patients underwent thymectomy in the period from April 1999 through to July 2000. They were collected from different teaching hospitals in Baghdad, Iraq. All these cases were studied conventionally including history, physical and neurological examination in addition to investigations with particular emphasis on connective tissue screen and thyroid function test. The age in this study ranged between 17-55 years. The preoperative duration ranged between 2-20 months and the postoperative follow up period ranged between 6 months-14 years. The most favorable results were obtained in patients without thymoma with short duration. Early thymectomy carries the best results in Myasthenia Gravis and every effort should be made to shorten the preoperative duration for both thymomatous and nonthymomatous patients. Patients with symptoms can be better controlled with anticholinesterase drugs than patients using steroid and cytotoxic drugs. Thymectomy is beneficial for most patients with Myasthenia Gravis and especially in those with benign folicular hyperplasia