scholarly journals Expanded access to multiple sclerosis teleneurology care following the COVID-19 pandemic

2021 ◽  
Vol 7 (1) ◽  
pp. 205521732199746
Author(s):  
Marisa P McGinley ◽  
Shauna Gales ◽  
William Rowles ◽  
Zhini Wang ◽  
Wan-Yu Hsu ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cross Sectional Study ◽  
Care Quality ◽  
Group Differences ◽  
Cross Sectional ◽  
Median Distance ◽  
Chi Squared ◽  
Remote Care ◽  
Perception Of Care ◽  
Disability Level

Background Teleneurology for multiple sclerosis (MS) care was considered feasible, but utilization was limited. Objective To describe how the existing teleneurology populations at two academic MS Centers changed during the COVID-19 pandemic. Methods In this cross-sectional study, we captured all in-person and teleneurology visits at two academic MS Centers between January 2019 and April 2020. We compared group differences between the Centers, and COVID-related changes using T-, chi-squared Kruskal-Wallis and Fisher exact tests. Results 2268 patients completed 2579 teleneurology visits (mean age 48.3 ± 13.3 years, 72.9% female). Pre-COVID, the Centers’ teleneurology populations were similar for age, sex, MS type, and disability level (all p > 0.1), but differed for race (96.5% vs 80.7% white, p ≤ 0.001), MS treatment (49.1% vs 32.1% infusible, p ≤ 0.001), and median distance from Center (72 vs 186 miles, p ≤ 0.001). Post-COVID, both Centers’ teleneurology populations had more black (12.7% vs 4.37%, p ≤ 0.001) and local (median 34.5 vs 102 miles, p ≤ 0.001) patients. Conclusion Teleneurology visits in 2019 reflected the organizational and local teleneurology reimbursement patterns of our Centers. Our post-COVID-19 changes illustrate the potential for payors and policy to change disparities in access to, or utilization of, remote care. Patients’ perception of care quality and value following this shift warrants study.

scholarly journals SARS-CoV-2 infection among patients with multiple sclerosis; A cross-sectional study

2020 ◽  
Author(s):  
Mahnaz Bayat ◽  
Alireza Fayyazpoor ◽  
Afshin Borhani Haghighi ◽  
Daniyal Salehi ◽  
Hossein Molavi Vardanjan ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Fars Province ◽  
Rt Pcr ◽  
Positive Real ◽  
Cross Sectional ◽  
Polymerase Chain ◽  
Group 5 ◽  
Disability Level

AbstractBackgroundNeurological disability associated with multiple sclerosis and immunosuppressive or immunomodulatory therapy which is administered for it may increases the risk of SARS-CoV-2 infection and its morbidity/mortality.ObjectiveIn this study, we evaluated the infection rate and the severity of SARS-CoV-2 infection in patients with multiple sclerosis (MS)MethodsOne thousand and three hundred and sixty one MS patients from Fars province, south of Iran, were interviewed by phone from April 3 to June 20, 2020. Basic demographic data, information about MS disease and any symptoms or laboratory results relevant to COVID-19 were gathered and reviewed by treating neurologist and MS nurses. SPSS version 22 was used for data analysis.Results68 (5%) of MS patients were suspected cases and 8 (0.58%) of all patients with positive real-time reverse transcription polymerase chain reaction (RT-PCR) or chest CT were in the confirmed group. 5 cases of the confirmed group needed hospitalization. Two patients died while both of them had PPMS and were taking rituximab. The frequency rate of suspected cases with RRMS was 57 (87.7%), followed by PPMS 5 (7.7%) and CIS 2(3.1%). In the confirmed group 37.5% had RRMS, 50% had PPMS, 25% use corticosteroid drug, and 50% were on rituximab. 62.5% of confirmed cases had high disability level and need assistance to walk. 36.8% of suspected and 25% of the confirmed cases were on IFN-β1; eventually all of them recovered well from COVID-19 infection.ConclusionThe present study showed that rate of developing COVID-19 in MS patients are similar to the general population and the frequency of PPMS phenotype, rituximab therapy and corticosteroid therapy were higher in the confirmed group.

scholarly journals Economic sanctions against Iran as an important factor in threatening the health of patients with multiple sclerosis

2021 ◽  
Author(s):  
Mohammad Ali Sahraian ◽  
Abdorreza Naser Moghadas ◽  
Sharareh Eskandarieh
Keyword(s):  
Multiple Sclerosis ◽  
Health Care ◽  
Stress Level ◽  
Health Care Services ◽  
Health Care Quality ◽  
Economic Sanctions ◽  
Cross Sectional Study ◽  
Care Quality ◽  
Cross Sectional ◽  
Care Services

Background: After intensified economic sanctions against Iran, decreased welfare of patients were more recognizable. The present study was aimed at identifying the challenges and stress level experienced by patients with multiple sclerosis (MS) regarding treatment and health care services in 2018-2019 after strengthening of economic sanctions against Iran. Methods: A cross-sectional study was conducted on MS patients in Tehran, Iran. A structured questionnaire was designed to measure the main variables addressing the challenges and stress level of MS patients with respect to receiving care and treatment services. Results: In total, 1039 MS patients were enrolled into the study. Among the patients who answered yes to the questions, 873 (85.8%) and 837 (86%) were concerned about medicine unavailability and supply and purchase of internationally branded medicine, respectively. Moreover, 671 (70.3%) subjects were concerned about replacing their medicines with cheaper alternatives due to financial problems and 427 (41.4%) were unwilling to continue their treatment due to the economic burden of MS. In total, 795 (82%) were concerned about the effectiveness of Iranian drugs in comparison with internationally branded drugs. Generally, 970 (93.53%) subjects had experienced increased current living costs and 711 had experienced (68.82%) reduced nutrition quality, which (OR: 2.68; 95% CI: 1.99, 3.60) was significantly higher among subjects who had an income of less than or equal to 250 US$ per month. Conclusion: The sanctions can impose greater stress and hardship on patients due to the unavailability and costs of medicines. Iran should manage health care quality and provide services to prevent the adverse effects of sanctions on MS patients and guarantee patients’ right to receive well-established medication and health services.  

scholarly journals Parturients Perception of Care Providers Attitude Towards Women During Labour And Delivery In Southwest Cameroon

2021 ◽  
Author(s):  
Clovis Achassi Tankeng ◽  
Gregory Halle-Ekane ◽  
Alfred Awa Mokom ◽  
Yannick Lechedem Ngunyi ◽  
André Gaetan Simo Wambo ◽  
...  
Keyword(s):  
Cross Sectional Study ◽  
Disrespect And Abuse ◽  
Care Providers ◽  
Cross Sectional ◽  
Disrespectful Care ◽  
Chi Squared ◽  
Bivariate Logistic Regression ◽  
Perception Of Care ◽  
Regional Hospitals ◽  
Fundal Pressure

Abstract Background: The period of labour and childbirth for women is a delicate moment and predisposes them to disrespectful care which has been reported in many countries. In Cameroon, data which could help in formulating policies to modify these attitudes is rare.Objectives: To assess parturients’ perception on the respect and disrespect of women by care providers as well as determining the prevalence, types and predisposing factors of physical and verbal abuse during labour and delivery, in the Buea and Limbe Regional hospitals, Cameroon. Methods: It was a hospital based cross-sectional study carried out in Buea and Limbe Regional hospitals from February 15th to April 20th 2021. It involved parturients aged between 15 and 45 in their first eight weeks post-delivery. Data was collected using a structured questionnaire, and the collected data was entered into and analyzed with SPSS version 25. Dependent variables were dichotomized and a bivariate logistic regression model was fitted to obtain the determinants of mistreatments during labour and delivery, while Chi-squared test was used to establish association between socio-demographic characteristics and care categories. A P-value <0.05 was considered statistically significant. Results: We sampled 274 parturients aged between 15 and 42 (mean=26.69yrs and SD= + 5.34). Sixty-nine (25.18%) of the respondents reported at least a physical and/or verbal mistreatment. The most common physical and verbal mistreatments were abdominal fundal pressure to facilitate expulsion and scolding. Muslims were more likely to report insult. Parturients perceived both respectful and disrespectful forms of care.Conclusion: Disrespectful care during labour and delivery may not be uncommon in our country as suggested by the findings in this study. There is need for development of interventions to address the drivers of disrespect and abuse which will encourage clients’ future facility utilization. More studies are needed in other areas of the country to support this evidence.

Brief Overview and Experience of Visual Evoked Potential of First 67 cases at Referral Neuroscience Hospital in Bangladesh

2020 ◽  
Vol 6 (2) ◽  
pp. 74-77
Author(s):  
Mohammad Enayet Hussain ◽  
Bithi Debnath ◽  
AFM Al Masum Khan ◽  
Md Ferdous Mian ◽  
Md Nahidul Islam ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Optic Neuritis ◽  
Clinical Diagnosis ◽  
Optic Neuropathy ◽  
Cross Sectional Study ◽  
P Value ◽  
Pattern Reversal ◽  
Cross Sectional ◽  
The Mean ◽  
Visual Evoked

Background: The visual evoked potentials (VEP) is a valuable tool to document occult lesions of the central visual channels especially within the optic nerve. Objectives: The purpose of the present study was to observe the findings of first few cases of VEP done in the neurophysiology department of the National Institute of Neurosciences (NINS), Dhaka, Bangladesh. Methodology: This cross-sectional study was conducted in the Department of Neurophysiology at the National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from September 2017 to March 2020. All patients referred to the Neurophysiology Department of NINS for VEP were included. Pattern reversal VEPs were done using standard protocol set by International Federation of Clinical Neurophysiology (IFCN). Results: The mean age of the study population was 30.70 (±12.11) years (6-68 years) with 31 (46.3%) male and 36 (53.7%) female patients. The mean duration of illness was 8.71 (±1.78) months (3 days- 120 months). Most common presenting symptom was blurring of vision (37.3%) and dimness of vision (32.8%). Patterned VEP revealed mixed type (both demyelinating and axonal) of abnormality in most cases [29(43.35)]. The most common clinical diagnosis was multiple sclerosis (29.85%) and optic neuropathy (26.87%). In the clinically suspected cases of multiple sclerosis, optic neuropathy and optic neuritis most of the cases of VEP were abnormal and the p value is 0.04 in optic neuropathy and optic neuritis. Conclusion: The commonest presentation of the patients in this series were blurring of vision and dimness of vision. The most common clinical diagnosis for which VEP was asked for, was optic neuritis and multiple sclerosis. Most abnormalities were of mixed pattern (demyelinating and axonal). Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 74-77

Multiple Sclerosis: Treadmill Versus Cycle Ergometry Maximal Exercise Test Responses

2020 ◽  
Vol 9 (3) ◽  
pp. 113-117
Author(s):  
Garett Griffith ◽  
Badeia Saed ◽  
Tracy Baynard
Keyword(s):  
Multiple Sclerosis ◽  
Aerobic Capacity ◽  
Work Capacity ◽  
Cross Sectional Study ◽  
Cycle Ergometer ◽  
Cycle Ergometry ◽  
Cross Sectional ◽  
Complete Test ◽  
Peak Aerobic Capacity ◽  
Predicted Values

ABSTRACT Background: Multiple sclerosis (MS) is an autoimmune disease that impacts the central nervous system. MS generally results in decreased mobility and work capacity. Our objective was to determine exercise testing responses on both a treadmill and cycle ergometer among individuals with MS who were able to ambulate freely. Methods: Twenty-six individuals with MS participated in a cross-sectional study (44 ± 11 years; body mass index 26.8 ± 6.2 kg·m−2; expanded disability scale score 3.1 ± 0.9), with 24 individuals with complete test data for both treadmill and cycle ergometry tests. Peak aerobic capacity (VO2peak) for both treadmill and cycle ergometry tests were measured with indirect calorimetry. Results: Participants safely completed both treadmill and cycle ergometry tests, and treadmill testing yielded higher values (26.7 ± 6.4 mL·kg−1·min−1) compared with cycle ergometry (23.7 ± 5.7 mL·kg−1·min−1), with values ~12% greater for treadmill. When comparing tests to their respected predicted values within modality, treadmill tests were 8% lower and cycle ergometry tests were 10% lower than predicted. Conclusions: While peak aerobic capacity was very low for this population, treadmill tests were still higher than cycle ergometry data, with this difference between modes being similar to that observed in healthy adult populations. Additional research is required to determine if these findings are impacted by participation in physical activity or regular exercise.

scholarly journals Kinematic Analysis of Lower Limb Joint Asymmetry during Gait in People with Multiple Sclerosis

Symmetry ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 598
Author(s):  
Massimiliano Pau ◽  
Bruno Leban ◽  
Michela Deidda ◽  
Federica Putzolu ◽  
Micaela Porta ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Lower Limb ◽  
Sagittal Plane ◽  
Cross Sectional Study ◽  
Camera Motion ◽  
Cross Sectional ◽  
Temporal Parameters ◽  
Wide Range ◽  
Edss Score ◽  
Spatio Temporal

The majority of people with Multiple Sclerosis (pwMS), report lower limb motor dysfunctions, which may relevantly affect postural control, gait and a wide range of activities of daily living. While it is quite common to observe a different impact of the disease on the two limbs (i.e., one of them is more affected), less clear are the effects of such asymmetry on gait performance. The present retrospective cross-sectional study aimed to characterize the magnitude of interlimb asymmetry in pwMS, particularly as regards the joint kinematics, using parameters derived from angle-angle diagrams. To this end, we analyzed gait patterns of 101 pwMS (55 women, 46 men, mean age 46.3, average Expanded Disability Status Scale (EDSS) score 3.5, range 1–6.5) and 81 unaffected individuals age- and sex-matched who underwent 3D computerized gait analysis carried out using an eight-camera motion capture system. Spatio-temporal parameters and kinematics in the sagittal plane at hip, knee and ankle joints were considered for the analysis. The angular trends of left and right sides were processed to build synchronized angle–angle diagrams (cyclograms) for each joint, and symmetry was assessed by computing several geometrical features such as area, orientation and Trend Symmetry. Based on cyclogram orientation and Trend Symmetry, the results show that pwMS exhibit significantly greater asymmetry in all three joints with respect to unaffected individuals. In particular, orientation values were as follows: 5.1 of pwMS vs. 1.6 of unaffected individuals at hip joint, 7.0 vs. 1.5 at knee and 6.4 vs. 3.0 at ankle (p < 0.001 in all cases), while for Trend Symmetry we obtained at hip 1.7 of pwMS vs. 0.3 of unaffected individuals, 4.2 vs. 0.5 at knee and 8.5 vs. 1.5 at ankle (p < 0.001 in all cases). Moreover, the same parameters were sensitive enough to discriminate individuals of different disability levels. With few exceptions, all the calculated symmetry parameters were found significantly correlated with the main spatio-temporal parameters of gait and the EDSS score. In particular, large correlations were detected between Trend Symmetry and gait speed (with rho values in the range of –0.58 to –0.63 depending on the considered joint, p < 0.001) and between Trend Symmetry and EDSS score (rho = 0.62 to 0.69, p < 0.001). Such results suggest not only that MS is associated with significantly marked interlimb asymmetry during gait but also that such asymmetry worsens as the disease progresses and that it has a relevant impact on gait performances.

scholarly journals Nutritional status of multiple sclerosis (MS) patients attending Kasr Alainy MS unit: an exploratory cross-sectional study

2021 ◽  
Vol 96 (1) ◽  
Author(s):  
Zeinab E. Afifi ◽  
Rania I. Shehata ◽  
Asmaa F. El Sayed ◽  
El Sayed M. Hammad ◽  
Marwa R. Salem
Keyword(s):  
Multiple Sclerosis ◽  
Nutritional Status ◽  
Dietary Habits ◽  
Care Service ◽  
Structured Interview ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Level Measurement ◽  
Impact Scale

Abstract Background Nutrition was claimed to be a factor in MS causation, course, complications, and management. Several studies were conducted to assess the nutritional status of MS patients; however, few studies were conducted to assess this problem in Egypt. Therefore, the purpose of the current study was to assess the nutritional status of a sample of MS patients. Methods The researchers conducted an exploratory cross-sectional study among 76 relapsing-remitting MS (RRMS) patients attending Kasr Alainy Multiple Sclerosis Unit (KAMSU) from October 2018 to January 2019 to assess the nutritional status of a sample of MS patients. Data were collected using a structured interview questionnaire including an inquiry about the socioeconomic status, and nutritional status using anthropometric measurements, patient-generated subjective global assessment (PG-SGA), semi-quantitative food frequency questionnaires (SQFFQ), and hemoglobin level measurement. Assessment of fatigue was done using the Modified Fatigue Impact Scale 5-items version. Results The mean age of the study participants was 30 ± 6 years. The disease duration ranged from 2 to 264 months. Malnutrition was prevalent among 67.1% (27.6 % overweight, 36.8% obese, and 2.6% underweight). Half of the investigated patients were anemic. According to the PG-SGA, more than half of the studied patients (53.9%) were classified as moderately or suspected malnourished. The unhealthy dietary habits such as taking only a few meals, junk food intake and skipping breakfast were observed in considerable proportions of the group. The SQFFQ revealed overconsumption of energy and fat, and less than acceptable consumption of dietary fibers by most of the studied patients. Conclusions Overweight, obesity, anemia, and unhealthy dietary habits were prevalent among the RRMS patients attending the KAMSU. Nutrition care service is extremely needed for this group of patients.

scholarly journals The pattern of thyroiditis in multiple sclerosis: a cross-sectional study in a tertiary care hospital in Egypt

2020 ◽  
Vol 32 (1) ◽  
Author(s):  
Nearmeen M. Rashad ◽  
Marwa G. Amer ◽  
Waleed M. Reda Ashour ◽  
Hassan M. Hassanin
Keyword(s):  
Multiple Sclerosis ◽  
Interferon Beta ◽  
Demyelinating Disease ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cmv Infection ◽  
Cross Sectional ◽  
Disease Modifying Drugs

Abstract Background Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system with varied clinical features. Disease-modifying drugs (DMDs) of MS associated with different types of thyroiditis. In this cross-sectional study, we aimed to assess the prevalence of thyroid dysfunction in MS and to investigate the association between DMDs and the risk of thyroiditis in MS. A cross-sectional study included 100 patients with relapsing-remitting multiple sclerosis (RRMS) in relapse, and the diagnosed was according to revised McDonald’s criteria 2010. Results Our results revealed that the prevalence of thyroiditis was 40%; autoimmune (34%) and infective (6%) among patients with RRMS in relapse and cerebellar symptoms were significantly higher in patients with thyroiditis compared to patients without thyroiditis. Regarding the association between DMDs and thyroiditis, the prevalence of patients treated with interferon-beta-1b was higher in MS patients with thyroiditis compared to MS patients without thyroiditis. However, the prevalence of patients treated with interferon-beta-1a was lower in MS patients with thyroiditis compared to MS patients without thyroiditis. In addition, we found CMV infection was more common in patients treated by interferon beta-1b and candida infection was common in patients treated by fingolimod. Conclusions Thyroiditis is commonly observed in patients with RRMS in relapse and higher prevalence of patients treated with interferon-beta-1b which is commonly associated with thyroiditis and CMV infection; however, candida thyroid infection was common in MS patients treated by fingolimod.

scholarly journals Quality of Life Prior and in the Course of the COVID-19 Pandemic: A Nationwide Cross-Sectional Study with Brazilian Dietitians

2021 ◽  
Vol 18 (5) ◽  
pp. 2712
Author(s):  
Raquel Adjafre da Costa Matos ◽  
Rita de Cassia Coelho de Almeida Akutsu ◽  
Renata Puppin Zandonadi ◽  
Raquel Braz Assunção Botelho
Keyword(s):  
Quality Of Life ◽  
Psychological Health ◽  
Social Relationship ◽  
Healthcare Professionals ◽  
Life Quality ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Chi Squared

Dietitians as healthcare professionals could decrease their quality of life during the SARS-COV-2 pandemic period; therefore, this study aimed to compare Brazilian dietitians’ perceptions of quality of life before and during the pandemic. This nationwide cross-sectional research aimed to evaluate Brazilian dietitians’ quality of life before and in the course of the COVID-19 pandemic, using a previously validated self-administered instrument WHO-QOL-BREF in Brazilian-Portuguese. The questionnaire was composed of 26 items (four domains) to evaluate life quality (physical, psychological, social relationship, and environment). The questionnaire also presented some sociodemographic variables and three questions about the COVID-19 pandemic. It was applied using GoogleForms® platform (Google LLC, Mountain View, CA, USA). For the statistical analysis of data, Paired T-test, Chi-squared test, and Analysis of Variance were used. A total of 1290 Brazilian dietitians replied to the instrument. Comparing quality of life (QoL) before SARS-COV-2 (3.83 ± 0.59) and during the pandemic (3.36 ± 0.66), data was statistically different. Comparing prior and in the course of the COVID-19 pandemic, all variables and domains presented statistical differences (better before the pandemic period). Among Brazilian dietitians, the psychological health domain was the most affected. The Sars-Cov-2 pandemic negatively impacted the QoL of Brazilian dietitians since health professionals face changes in their lives because of work.

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