[Comparison of neurolysis and nerve resection in treatment refractory of meralgia paresthetica]

Meralgia paresthetica [MP] is due to lateral femoral cutaneous nerve [LFCN] involvement; if it is left either unattended miss treated it can be followed by significant disabilities. This study was done to compare the neurolysis and nerve resection in treatment refractory of Meralgia paresthetica. This descriptive - comparative study was carried out on 14 patients [7 males and 7 females] afflicted with Meralgia paresthetica and resisted to therapeutical regiment in Poorsina hospital in Rasht, North of Iran during 2001-08. The patients were selected non-randomly and neurolysis were gone under either neurolysis or nerve resection surgery with 18-month follow-up. All 5 patients with neurolysis operation were found to have the recurrent symptoms. None of the patient operated with nerve resection demonstrated the clinical manifestation of the recurrent symptoms, following 18 month follow-up. The success rate of neurolysis and nerve resection were determined to be 3% and 98.8% respectively. Six women and three men are LFCN-resected; a woman and four men treated with neurolysis. The mean age and the disease onset length were 64.6% +/- 9.8 year and 18 +/- 11 months, respectively. Nerve resection method is suggested in patients with Meralgia paresthetica resisted to therapeutical treatment

[Fatigue in multiple sclerosis and its relationship to clinical status]

Multiple Sclerosis [MS] is the leading cause of permanent disability in young adults. Iran is considered a high risk zone for MS and its incidence has risen in recent years. Fatigue is a common and disabling symptom in MS and its timely diagnosis and treatment can markedly improve the quality of life in the affected patients. There is a considerable heterogeneity in the results of most reported studies on the prevalence of fatigue in MS and its contributing factors. Most of them did not pay attention specifically to the role of clinical parameters in the prevalence and severity of fatigue. To determine the relative frequency of fatigue in MS patients and the link between fatigue and clinical status. In this cross-sectional study, 167 patients with definite relapsing MS, according to McDonald 2005 criteria, filled the questionnaires containing items on demographic data and main clinical symptoms of MS [visual, sensory, motor, balance, and sphincteric] and Fatigue Severity Scale [FSS]. Then, they were examined to determine Expanded Disability Status Scale [EDSS] score. In 167 patients, 43 [25.7%] were male and 124 [74.3%] were female. Mean age, fatigue severity according to FSS and EDSS score were 32.34, 39.49, and 1.96, respectively. Relative frequency of fatigue was 60.5%. In univariate analysis, a significant correlation was found between fatigue severity and age, EDSS score, pyramidal involvement, imbalance, visual and sphincter involvement, however, in multivariate analysis a significant correlation was only found with EDSS score and age. Fatigue is a frequent symptom in the patients with MS. It is a heterogenous symptom with numerous etiologies; however, the clinical status of the patients can greatly help predict its occurrence. It seems that EDSS score is an efficient and sufficient clinical indicator of fatigue severity

[Hearing loss in multiple sclerosis patients]

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

Comparing the effect of intramuscular injection of pethidine and diclofenac suppository in relief of pain following laminectomy surgery

Pain, particularly after surgery, can create a variety of side effects including delay in wound healing. Different drugs such as pethidine and non-steroidal anti-inflammatory drugs are used for relieving patient's pain after surgery. The purpose of this research was to compare effect of pethidine vs. diclofenac suppository in relief of pain after laminectomy. A total of 100 patients who underwent laminectomy entered this study. They were divided into pethidine and diclofenac groups. The patients' pain score was measured with visual analog scale [VAS] method. The mean pain score 24 hours after surgery was 2.8 +/- 2.0 in pethidine group and 4.46 +/- 2.30 in diclofenac group. There was a significant statistical difference between pain score after surgery in two groups [P < 0.05]. Nausea was the most common side effect observed in pethidine group [20%] and epigastric pain was the most common one in diclofenac group [18%]. There wasn't any statistical significant difference between side effects in these two groups. It seems that pethidine injection is more effective than diclofenac suppository in relieving pain after laminectomy