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women of childbearing age are at higher risk for developing Neuromyelitis Optica Spectrum Disorder (NMOSD). Post-onset pregnancy is believed to affect and be affected by NMOSD. This study aimed to assess the effect of pregnancy on the development and course of NMOSD.All women from the patient registry of the neurology outpatient clinic in Tehran, Iran, who were diagnosed with NMOSD without any comorbidity were enrolled in this survey. Retrospectively, the participants' reproductive history was collected, and the association of pregnancy-related factors with the age of onset, attack rate, and disability status was sought.The age at first attack was significantly higher in patients with prior pregnancy (P 0.001). To eliminate the immortal time bias, the researchers assessed the effect of pregnancy as a time-varying exposure in the time-dependent Cox model, which indicated that pregnancy did not alter the time of developing NMOSD (Hazard Ratio=0.91, P = 0.741). However, more than one-fourth of patients with pregnancy before NMOSD onset had their first attack within the year of delivery. In addition, younger age at disease onset was accompanied by a shorter interval between the first pregnancy and first attack (Spearman's rho=0.826, P 0.001).NMOSD onset or prognosis seemed not to be affected by pregnancy before the disease onset. However, in women with early disease onset, pregnancy might be a trigger for the development of NMOSD.

Background Sleep disturbances are common in neuromyelitis optica spectrum disorder (NMOSD) and have a great impact on patients’ quality of life. According to a report, there is a 64% prevalence of poor sleep quality in NMOSD patients. Therefore, this study was done to evaluate the effect of sleep disturbances on NMOSD acute exacerbations. Materials and Methods This case-control study was conducted at Sina Hospital in 2019. A total of 60 patients with NMOSD diagnosis were enrolled in the study (30 patients were in the remission phase while 30 patients were hospitalized due to acute attacks). Sleep disorders were evaluated in both groups. Sleep quality was assessed during the last month using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Data were analyzed by SPSS software version 21. Results Among 60 patients who were evaluated in both the control and attack groups, 86.7% were female. The duration of the disease was 68.23 ± 42.89 months in the control group and 69.83 ± 6.90 in the attack group. The mean age of patients was 34.15 years old. Sleep quality was unfavorable in 30% and 56% of patients in control and attack groups, respectively. There were significant differences between the two groups in sleep latency, habitual sleep efficiency, sleep duration, and sleep disturbance. Conclusion The present study revealed that there was a significant difference in sleep quality between controls and attack patients and could show a direct relationship between sleep disorders and NMOSD attacks.

Neurotrauma (NT) is one of the common causes of mortality and morbidity. Investigating the role of people who had an impact on the development of knowledge of NT is reasonable. Our aim is to investigate the role of Bizhan Aarabi, professor of Neurosurgery, on the knowledge development in NT. Accordingly, we searched the Scopus database for Bizhan Aarabi on August 8, 2020 and selected papers with at least 10 citations, investigating his impact on NT and details of his publications. He has published 168 papers including original articles, reviews, conference papers, letters, and editorials according to the Scopus databases. There are 112 papers with 10 or more citations. Thirty-eight out of 112 papers (33.9%) were in the first and the highest rank journal: 29 in Neurosurgery and 9 in the Journal of Neurotrauma. Twenty-four papers have the level of evidence (LOE) of "1". Bizhan Arabi developed knowledge in NT especially in the cervical spine/spinal cord trauma and brain injury and his publications are references for spine/neurosurgeons.

Neuromyelitis optica spectrum disorder (NMOSD) is known as an autoimmune astrocytopathic disorder involving central nervous system (CNS). The aim of this study was to compare Emotional Intelligence (EI) score between NMOSD patients and healthy individuals, and to find out the possible effect of this disease on EI.A total of 45 NMOSD participants and 48 healthy individuals were enrolled in this study. Demographic information (e.g., gender and age) of all participants as well as their level of education, and data on the patients' duration of disease were collected. EI of each participant was assessed using Persian version of Emotional Quotient inventory (EQ-i) questionnaire.The mean total EI score was significantly different between the participants and controls (322±36.7 vs 338±31.5, p value0.03). Compared to controls, patients had a poor performance in 4 of 15 EI subscales including emotional self-awareness (21.29±3.6 vs 22.85±3, p value0.03), optimism (22.4±4 vs 24.1±3.1, p value0.03), self-regard (22.7±4.6 vs 24.5±3.4, p value0.04), and impulse control (16.9±6.5 vs 19.5±5.5, p value0.05). No difference was found between anti-aquaporin-4 antibody (AQP4-IgG) positive and AQP4-IgG negative patients regarding EI score or its subscale scores, except for self-actualization (p value0.05).Our study showed that EI could be regarded as a tool for understanding emotions, thoughts, and behavior of NMOSD patients. It was implied that taking therapeutic steps could improve the performance of NMOSD patients with EI impairment in social life.

Projection of mortality rates is essential for policy making and planning of health services. Premature mortality, as an important index, commonly refers to deaths occurring before 70 years of age. This study was conducted to estimate the trend of premature deaths from 2006-2015 and to project premature deaths for the 2016-2030 period.We used national mortality data collected by the Ministry of Health and Medical Education's Deputy of Health, and population data from the Statistical Center of Iran. Mortality and population data were categorized based on sex and 5-year age groups. The Bayesian hierarchical model was used to project future premature mortality rates through 2030.Age-standardized all-cause premature mortality declines from 414.3 per 100000 persons in 2010 to 300.3 per 100000 persons in 2030 (27.5%) for men, and from 230.6 per 100000 persons in 2010 to 197.2 per 100000 persons in 2030 (14.5%) for women. In all age groups, the percent reduction of premature mortality was greater for men than women.Overall, it is projected that premature mortality will witness a declining trend in both sexes in Iran. Accordingly, we would expect to achieve less than a third reduction in premature mortality by 2030, which is one of the Sustainable Development Goals.

Background A large number of multiple sclerosis [MS] patients suffer from cognitive dysfunction affecting their routine life in family and society. Investigating modifiable factors for cognition decline and controlling them, could improve the quality of life in MS patients. Therefore, the present study was aimed to evaluate the association between lipid profile components and cognition in MS patients. Methods A cross-sectional study was conducted on 50 Relapsing-Remitting MS (RRMS) patients referred to Sina hospital, Tehran, Iran. The definite diagnosis of MS was done based on the revised McDonald criteria. Data on demographic and clinical data of patients were obtained. 5 cc blood samples were taken from all subjects after 10-hour night fasting, and lipid profile components including LDL, HDL, triglyceride, and total cholesterol were evaluated. The Persian version of the Minimal Assessment of Cognitive Functions in MS [MACFIMS] battery was administered to assess the cognitive function. Spearman and Pearson correlation tests were applied to investigate the correlation between lipid profile components and MACFIMS subtests or clinical features of MS patients. Results The mean age of subjects was equal to 32.26 years old, and 85% of them were women. There was no significant correlation between MACFIMS subtests results with disease duration, patient's disability according to Expanded Disability Status Scale (EDSS), annual attack rate, and disease-modifying drug onset year (P value >0.05). A significant inverse correlation was found between greater serum total cholesterol and lower scores of Symbol Digit Modalities subtest [SDMT] (P value 0.02; r: −0.31), the Delis–Kaplan Executive Function System [DKEFS] sorting (P value 0.01; r: −0.34) and DKEFS-descriptive (P value 0.04; r: −0.28) subtests. This significant inverse correlation was also found in terms of the correlation between higher serum LDL and impairment in the case of DKEFS-sorting score (P value 0.05; r: −0.27), and DKEFS-descriptive score (P value 0.05; r: −0.27). No significant correlation was found in case of serum HDL or triglyceride and MACFIMS subtests (P value >0.05). Discussion Our findings proposed a possible correlation between the increased serum LDL cholesterol, serum total cholesterol and cognitive dysfunction among MS patients.