Explaining the individual challenges of women affected by neuromyelitis optica and multiple sclerosis: A comparative content analysis Study.

INTRODUCTION: Multiple Sclerosis (MS) and Neuro-Myelitis Optica spectrum disorder (NMOSD) are an autoimmune condition. Both of them have unexpected and acute relapses. The aim of this qualitative study was explaining the individual problems experienced of women affected by NMOSD and MS. METHOD: Sixteen NMOSD patients and eighteen MS patients completed a face to face deep semi-structured interview. Participants were recruited from the MS ward in Sina hospital. After typing the interview, the data were analyzed using conventional content analysis, as recommended by Graneheim and Lundman (2005). Data analysis is managed with MAXQDA2018 software. RESULTS: In this study, a common theme for both disease groups was identified as "challenges arising from personal problems". The categories are named after each other and have many similarities, which in the NMOSD group include four categories including: "From uncertainty to the perception of threat", "Living with limitations", "Active coping until normalization" and "Facilitators of personal problems" appeared. In the group of patients with MS, five categories emerged: "perceived threat", living at a bottleneck, trying to deal with negative experiences, "facilitators of personal problems" and "problems related to physical rehabilitation". CONCLUSION: This qualitative study showed that the individual problems of the two groups of NMOSD and MS patients are somewhat similar. Also in the present study, people with MS need longer-term rehabilitation care than people with NMOSD, which should be considered and examined, a need that was less seen in people with NMOSD. The unpredictability of relapse in NMOSD and MS can have a profound effect on the daily lives of these people. Therefore, knowing the health and life problems of patients with NMOSD/MS can help health care teams to improve the quality of patient care.

Multiple sclerosis projection in Tehran, Iran using Bayesian structural time series.

BACKGROUND: The prevalence of Multiple Sclerosis (MS) has been increasing worldwide and the highest prevalence ratio among Asian countries was reported in Iran. This study aims to estimate the increase in MS occurrence during more than three decades in Tehran and forecast the future condition of the disease using time series approaches for the next ten years. METHODS: The cross-sectional study was conducted from 1999 to 2019 based on records of MS cases from Iranian MS Society (IMSS) registry system. The prevalence was estimated using population data presented by the Statistical Centre of Iran. Through Bayesian Structural Time Series (BSTS) model, we want to predict the prevalence of familial and sporadic MS in the next ten years. . RESULTS: Among 22,421 cases with MS, 16,831 (75.1 %) were female and 5589 (24.9 %) were male. Female to male ratio was 3.0:1 and the number of familial MS cases were 2982 (13.3 %) of subjects. Female gender was less responsible for higher rate of MS in familial definition (beta = 0.020) in comparison to sporadic cases (beta = 0.034). Forecasting by BSTS revealed an increase in MS prevalence for the next ten years so that the prevalence rate for total, familial and sporadic MS respectively begins with 189.50 (183.94-195.14), 25.69 (24.97-26.45) and 163.74(159.06-168.57) in 2020 and ends with 220.84 (171.48-266.92), 30.79 (24.16-37.15), and 189.33(146.97-230.19) in 2029. CONCLUSIONS: According to the findings, MS prevalence increased during three decades and it will increase over the next ten years. Tehran province is one of the regions with highest MS prevalence in Asia. The results of present study indicated that females are at higher risk for MS than males in both sporadic and familial MS.

Prevalence and Associated Risk Factors of Hyperglycemia and Diabetes Mellitus Among HIV Positive Patients in Tehran, Iran.

BACKGROUND: The introduction of Antiretroviral Therapy (ART) has resulted in the emergence of some metabolic complications including hyperglycemia and diabetes mellitus among HIV positive patients. The aim of this study was to investigate the prevalence of hyperglycemia, diabetes mellitus and their associated risk factors in HIV positive patients. METHODS: This cross-sectional study was conducted on HIV positive patients who visited Voluntary Counseling and Testing (VCT) center of Imam Khomeini Hospital, Tehran, Iran (2004-2013). Medical records of patients were reviewed retrospectively. A logistic regression model was applied for analysis of the association between glycemic status and relevant risk factors. RESULTS: Out of 480 patients who were included in this study, 267 (55.6%) had hyperglycemia, including 28 (5.8%) with diabetes mellitus and 239 (49.8%) with pre-diabetes. The higher frequency of hyperglycemia, was found to be significantly associated with older age (OR for patients ˃40 years old, 2.260; 95% CI, 1.491, 3.247), male gender (OR, 1.555; 95% CI, 1.047, 2.311), higher Body Mass Index (OR for patients with BMI˃25 Kg/m², 1.706; 95% CI, 1.149, 2.531) and prolonged duration of HIV infection (OR for patients with duration of HIV infection ≥60 months, 2.027; 95% CI, 1.372, 2.992). CONCLUSION: Hyperglycemia, especially pre-diabetes, is highly frequent among Iranian people living with HIV. Male gender, older age, prolonged duration of HIV infection, and higher BMI were associated with a higher prevalence of hyperglycemia. Hence, it is important to screen all HIV infected patients at the time of diagnosis and then periodically for hyperglycemia.

Factors associated with menopausal age in Iranian women: Tehran Lipid and Glucose Study.

AIM: Menopause, considered a special event in a woman's life, has a wide age range, 40-60 years, and there is no consensus regarding the factors influencing it. We aimed to assess factors affecting the menopausal age in a population of women participants of the Tehran Lipid and Glucose Study. MATERIAL AND METHODS: For the present study, 1114 women were selected from among participants of the Tehran Lipid and Glucose Study. Following implementation of our inclusion criteria, their reproductive histories and demographic background as well as anthropometric parameters were assessed, and ordinal regression analysis was conducted using spss version 15. RESULTS: The mean estimated age at menopause ± standard deviation was 49.6 ± 4.5 years. Menopausal age was considerably lower among women with a history of smoking (P = 0.05), and it increased with increasing age of menarche (P = 0.04) and number of children (P = 0.05). There was no significant correlation between the mean age of menopause and the educational level and anthropometric parameters. CONCLUSION: The smoking status, parity and the age of menarche are the influencing factors of age at menopause among the Iranian population.