Assessment of health-related quality of life in patients with multiple sclerosis living in the Fars province of Iran

Aim:The aim of this study is to determine the health-related quality of life(HRQoL)among patients with multiple sclerosis(MS)living in the Fars province of Iran.Methods:A total of 100 patients with clinically definite MS who were referred to a clinic affiliated with Shiraz University of Medical Sciences were eligible to participate in this study.The HRQoL was evaluated using a Persian version of the Medical Outcomes software.Data were analyzed using descriptive statistics,MANOVA,ANOVA and an independent t-test.Results:Patient variables in this sample included the following:80%of the participants were female,68%of the participants were married,30%of the participants had completed primary school,38%of the participants had completed high school and 32%of the participants attained a university degree.No significant difference among HRQoL scores attributable to these variables were observed among participants in this study.The overall mean scores for the physical and mental components of the HRQoL were 59.48±24.63 and 49.26±23.15,respectively.The paired t-test showed that when compared with a normal sample,the patients in this study had mental component scores of the HRQoL that were significantly lower than physical component scores(t=5.72,df=99,P<0.001).Conclusion:The HRQoL scores among patients with MS are significantly lower than those among members of the healthy population,especially with respect to the mental component of the test.Therefore,close consideration of mental and physical problems and appropriate management of MS can improve quality of life in these patients.

Transient mutism following neuroendoscopy in children: report of two cases

Background:Since the introduction of neuro-endoscopy by Walter Dandy and his colleagues in the early 1920's,several efforts has been made to improve this tool for treatment of hydrocephalus,brain tumors,arachnoid cysts,etc and has largely substituted craniotomy procedures.Several complications such as CSF leakage,intraventicular hemorrhage,infectious complications and transient and permanent psycho-neurologic deficits have been reported for neuro-endoscopic procedures in children.Here in,two cases of transient murism following neuroendoscopy in children were reported,with special focus on pathophysiology,management and clinical course.Knowledge about the possible complications of a procedures,empowers the pediatric neurosurgeon with the ability to avoid them and also to successfully handle them once they take place.Case presentation:We report two patients who underwent neuro-endoscopy,first for treatment of arachnoid cyst via cystoventriculostomy and second for endoscopic third ventriculostomy(E-rV) to treat hydrocephalus.Both children developed apathy and mutism following the procedure.However,this condition was transient and both children improved after a course of 5-6 days with conservative management.Conclusions:Mutism following neuro-endoscopic procedures in children may result from excessive traction on paraventricular white matter and disruption of fronto-subcortical circuits.It can be avoided with less intra-procedural dilation of venricles and less traction on white matter tracts with choosing a more accurate trajectory.However,this condition is transient and spontaneous resolution wil ensue in several days wth conservative management.