Number Of Multiple Sclerosis Cases Research Articles

Current trends and prospects of multiple sclerosis research in Arab countries.

Multiple sclerosis is a complex and intractable neurological disease associated with substantial morbidity, healthcare utilization, management cost, and loss of productivity. There has been an alarming increase in the number of multiple sclerosis cases in Arab countries in recent years, which has spurred an increase in local research. To analyse the multiple sclerosis research profile in Arab countries. A total of 781 publications focusing on multiple sclerosis research in Arab countries from 1983 to 2021 were extracted from the Web of Science database and analysed using bibliometric techniques. Publication on multiple sclerosis research increased sharply in the last decade, globally and in the Arab countries. However, Arab countries have only contributed 0.8% of the overall number of publications. Keyword pattern analysis showed that magnetic resonance imaging, optical coherence tomography, expanded disability status, demyelination, and epidemiology were the major themes of multiple sclerosis research in Arab countries. Case-control, cohort, and descriptive studies were the most prevalent study designs. However, there was a notable paucity of meta-analyses, randomized controlled trials, and clinical trials. Arab countries can improve their regional expertise and add a wealth of knowledge to global multiple sclerosis resources by diversifying their current research initiatives, and tracking recent advances in pathogenesis, diagnosis, and management of multiple sclerosis.

The Critical Role of Imaging in Primary Progressive Multiple Sclerosis

BACKGROUND: Multiple sclerosis (MS) is an autoimmune-related neurological disorder as a result of chronic inflammation and demyelination which affect the central nervous system. The number of MS cases in Indonesia is about 1–5/100.000 people. This disease causes disability and requires immense treatment costs. One of the MS subtypes is primary progressive which is marked by the decline of neurological functions since the disease onset, without any period of relapse attacks.
 CASE REPORT: A 59-year-old female came with complaints on spinning dizziness, accompanied by vomiting and waddling for the past month before hospital administration. Based on physical examination, we found multiple cranial nerve palsies on the cranial nerve III, IV, V, VI, and VII on the left side. Initially, it suspected as an intracranial lesion in the cerebellopontine angle. However, brain computed tomography scan showed a normal result. Brain magnetic resonance imaging (MRI) was conducted and we found multiple lesions on the supratentorial and infratentorial region. The second patient was a 24-year-old female complained about waddling gait for the past year, which grew heavier. Based on physical examination, we found a cerebellar sign on the left side, cerebellar ataxia, paraparesis of lower extremity, and paresthesia. Brain MRI with contrast displayed white matter periventricular and infratentorial lesion.
 CONCLUSION: In both cases, radiological imaging examination, which was MRI with contrast, was beneficial in the establishment of patient’s diagnosis, which made therapeutic management suitable as needed.

Association and linkage of definite multiple sclerosis with HLA and the potential protective role of Helicobacter pylori infection among Egyptians

Background: Multiple sclerosis (MS) is the most common chronic inflammatory demyelinating disease of the central nervous system. The linkage of multiple sclerosis to the Human Leukocyte Antigen (HLA) has been known a few decades ago. Some investigators have shown a relationship between H. pylori infection and Multiple sclerosis development. However, this relationship is still controversial. Objectives: This study was designed to detect the linkage between HLA-DRB1 types and Multiple Sclerosis development, clinical presentation and course, and to try solving the controversy of the role of H. pylori infection in Multiple Sclerosis. Methods: This study was carried out on 130 Egyptian individuals at the Neurology department of Mansoura University Hospital in 20122015. Group I included 80 definite relapsing remittent MS patients and Group II included 50 healthy control people. Both patients and control groups were subjected to HLA-DRB1 typing using the INNOLiPA HLA-DRB1 Plus kit. Correlation of HLA-DRB1 type to clinical presentation and course of the disease was tested. Both study groups were subjected to H. pylori CagA and VacA IgG detection in their sera by qualitative immunoassay. All statistical analyses were performed using SPSS version 16.0. Results: Data pooled from this study showed that number of MS cases with HLA-DRB1 * 1, 4 &7 is statistically significantly higher than it was in the control group (P=0.01, P=0.049 and P=0.02 respectively). The number of control individuals with HLA-DRB1 * 15g &11 types was statistically significantly higher than it was in MS patients (P=0.003 and P 0.05). Conclusion: Carriers of HLA-DRB1 * 1, 4 &7 are at higher risk to develop MS, HLA-DRB1 * 15g &11 exhibit a protective role against the development of Multiple Sclerosis. H. pylori infection may have a controversial causative relation to Multiple Sclerosis development.

Prevalencia de esclerosis múltiple en Ecuador

Introduction Multiple sclerosis (MS) is less frequent in areas near to the Equator, while the incidence and prevalence rises with increasing distance from this particular area, determining a clear north to south gradient. During the last decade several published reports provide recent data on the prevalence in Latin America. The main objective of this article is to report prevalence data in the three largest cities of Ecuador, a South American Country located on Latitude zero North-South. Methods In order to determine the prevalence and other epidemiological variables we conducted a cross-sectional, observational study in the three largest cities of Ecuador. Based on capture and recapture methodology we identified patients with MS who received medical care in the 12 state and private hospitals and in the Ecuadorian Foundation of Multiple Sclerosis (FUNDEM-Quito). The main inclusion criteria to determine the diagnosis of MS was based on the criteria proposed by Poser. For the relative and absolute frequencies calculation, as well as the 95% confidence interval, the EpiInfo 6.01 and EpiDat 3.1. programs were used. Results A total of 159 patients were identified in the three largest cities included in the study. In Quito, the capital city: 5.05/100,000 inhabitants (95% CI, 4.03-6.03), Guayaquil, on the coast: 2.26/100,000 inhabitants (95% CI, 1.62-2.91) and Cuenca in the south: 0.75/100,000 inhabitants (95% CI, 0.024-0.175). Conclusions Ecuador is a low prevalence country although we believe it is possible that the number of MS cases is underestimated since this is not a population based study. We believe that more studies should be carried out on general populations where the disease has been seldom reported or as non-existent. Important exogenous factors may be involved in the pathogenesis of MS in Ecuador.

Ocular pathology in multiple sclerosis: retinal atrophy and inflammation irrespective of disease duration.

There has been growing interest in the use of retinal imaging for tracking disease progression in multiple sclerosis. However, systematic and detailed pathological descriptions of retinal tissue in multiple sclerosis are lacking. Graded, histological evaluations on eyes from 82 patients with multiple sclerosis and 10 subjects with other neurological diseases, with immunohistochemistry on a subset, were performed and correlated with clinical and pathological findings. Multiple sclerosis cases demonstrated evidence of retinal atrophy and inflammation even in late-stage disease. Retinal ganglion cell loss was significant and remaining neurons appeared shrunken and were partially engulfed by human leukocyte antigen-DR positive cells with the phenotype of microglia in samples subjected to immunohistochemistry. Neurofilament staining revealed variable but prominent degrees of axonal loss and injury. Neuronal loss was noted in the inner nuclear layer with focal reduction in cell density. Foamy-appearing human leukocyte antigen-DR positive cells were evident near vessels and periphlebitis was found in a small but significant number of multiple sclerosis cases. Glial fibrillary acidic protein staining showed extensive astrocyte hypertrophy and proliferation with prominent gliosis in multiple sclerosis cases. Frequent but previously unreported abnormalities in the iris were documented in the majority of chronic multiple sclerosis cases. The injury to both iris and retina could be seen at all stages of disease. Severity of retinal atrophy was correlated with overall brain weight at time of autopsy (P = 0.04) and a trend for increased atrophy was seen with longer disease duration (P = 0.13). This study provides the first large-scale pathological description of retinas in multiple sclerosis, including patients with different subtypes of disease at all stages, and with variable clinical severity. Changes were seen not only in the retinal nerve fibre layer and ganglion cell layer, but also in the inner nuclear layer, suggesting that retinal injury is more widespread than previously appreciated. Furthermore, the human retina is devoid of myelin, but inflammation was demonstrated to be prominent in multiple sclerosis and to persist in the retina at late stages of disease. The prominent gliosis and inflammation surrounding vessels of the inner retina could potentially impact optical coherence tomography evaluations in multiple sclerosis-as standard techniques exploit presumed differences in tissue reflectivity and utilize automated edge detection algorithms to judge axon loss in the nerve fibre layer. Deciphering the relationships between the different types of retinal pathology may aid us in understanding the factors that drive both inflammation and tissue atrophy in multiple sclerosis.

Prevalence of multiple sclerosis in Ecuador

Introduction Multiple sclerosis (MS) is less frequent in areas near the Equator, while the incidence and prevalence rises with increasing distance from this particular area, determining a clear north to south gradient. During the last decade several published reports provide recent data on the prevalence in Latin America. The main objective of this article is to report prevalence data in the three largest cities of Ecuador, a South American Country located on Latitude zero North-South. Methods In order to determine the prevalence and other epidemiological variables we conducted a cross-sectional, observational study in the three largest cities of Ecuador. Based on capture and recapture methodology we identified patients with MS who received medical care in the 12 state and private hospitals and in the Ecuadorian Foundation of Multiple Sclerosis (FUNDEM-Quito). The main inclusion criteria to determine the diagnosis of MS was based on the criteria proposed by Poser. For the relative and absolute frequencies calculation, as well as the 95% confidence interval, the EpiInfo 6.01 and EpiDat 3.1 programs were used. Results A total of 159 patients were identified in the three largest cities included in the study. In Quito, the capital city: 5.05/100,000 inhabitants (95% CI, 4.03–6.03), Guayaquil, on the coast: 2.26/100,000 inhabitants (95% CI, 1.62–2.91) and Cuenca in the south: 0.75/100,000 inhabitants (95% CI, 0.024–0.175). Conclusions Ecuador is a low prevalence country although we believe it is possible that the number of MS cases is underestimated since this is not a population based study. We believe that more studies should be carried out on general populations where the disease has been seldom reported or as non-existent. Important exogenous factors may be involved in the pathogenesis of MS in Ecuador.

Multiple sclerosis in children under 10 years of age

Despite the consistent amount of information accumulated in recent years on multiple sclerosis (MS) in childhood, many clinicians still view this condition as an exclusively young adult-onset disease and do not consider that it may occur and manifest even during infancy and pre-school age, suggesting that the number of MS cases in the paediatric age group may have been underestimated. Thus, the need to have practical parameters for therapeutic, counselling and educational purposes in such settings as caring for patients whose onset of disease is at very early ages may increasingly arise for practising clinicians. In addition, the clinical and radiographic criteria for the diagnosis of MS have not been validated in a paediatric MS population; accordingly, inclusion age at onset (such as for research purposes) is generally over 10 years. To highlight the peculiarities that characterise MS when it begins at this young age we have reviewed the literature and summarised our preliminary results with the national registry of the Italian Society of Paediatric Neurology (SINP) Study Group on Childhood MS in the group of MS patients with the earliest onset of disease (i.e., <10 years of age).