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Background: The C-reactive protein (CRP) level, as an early prognostic factor of functional outcome after stroke, may be of clinical importance. The aim of this study was to determine the prognostic value of CRP on functional outcome and death in stroke patients. Methods: This prospective study was conducted from 2015 to2016 in Hamadan province, Iran. Patients with both ischemic and hemorrhagic stroke who were admitted in the first 12 hours were enrolled. The clinical characteristics of the patients were recorded at time of admission as well as on the fourth and the 90th day after stroke. Blood sample was taken and CRP levels were measured at time of admission. Results: From 186 admitted patients, 155 patients remained in this study for analysis. Mean time between stroke onset and admission was 4.42 hours. Mean level of CRP was 20.03 mg/L. CRP levels in 68 patients (43.8%) were 7 mg/L or above. Prevalence of diabetes (P = 0.001), angina pectoris (P = 0.001), death (P = 0.001), pneumonia (P = 0.004), and DVT (P = 0.002) was significantly higher among patients with CRP levels ≥7 mg/L than patients with CRP levels <7 mg/L. A CRP level ≥7 was associated with poor clinical outcome, including the National Institutes of Health Stroke Scale (NIHSS) ≥13 (P = 0.001) as well as modified Rankin Scale (mRS) >2 (P = 0.004) and Barthel Index (BI) <70 on the first (0.047, 0.001), fourth (0.005, 0.001), and 90th day (0.001, 0.001), respectively. Conclusion: Our findings indicated that elevated CRP levels in the very early phase of both ischemic and hemorrhagic stroke were associated with poor clinical outcomes and prognosis. [ABSTRACT FROM AUTHOR]

Migraine is considered to be a polygenic multifactorial disease with various environmental and genetic etiologies. Tumor necrosis factor-alpha (TNF-α), a potent immunomodulator and pro-inflammatory cytokine, has been implicated in many pathological processes in brain. The hypothesis of this study was that migraine without aura (MWA) might be associated with TNF-α (-308) polymorphism, resulting in increased TNF-α production. Genotyping was performed on DNA extracted from peripheral leukocytes by PCR–SSP method in 221 patients with WMA and 183 healthy control subjects from Iranian population. The results showed that the frequency of −308 A variant allele was higher in MWA than in the control group (40.6% versus 22.3%, OR 3.73, 95% CI 2.4–5.82, p < 0.0001). TNF-α GA heterozygous genotype, high producer, was significantly more prevalent in patients with MWA than controls (74% versus 44.7%, p < 0.0001) whilst the low producer GG homozygous genotype was less frequent in patients compared with controls (22.4% versus 55.3%, p < 0.0001). The logistic regression analysis showed a significant association for TNF-α (−308A) female allele carriers with MWA at reproductive ages (OR 2.56; 95% CI, 1.57–4.16, p < 0.0001) when compared with their matched control subjects. In conclusion, this study demonstrates an association of tumor necrosis factor-alpha (-308A) carriage with MWA, suggesting that carrying a high responder TNF-alpha-308A allele may be a genetic factor in increasing the susceptibility to develop MWA. [ABSTRACT FROM AUTHOR]

Multiple sclerosis (MS) is the most common inflammatory demyelinating disease in the central nervous system. It is one of the major causes of disability in young adults. Early diagnosis and treatment of this disease could decrease later disability and additional costs. In this cross-sectional analytical study, a total of 351 patients were selected from among the multiple sclerosis patients that went to MS clinic or neurologic clinic in 1990-2016. Data were collected and analysed by SPSS v16. This study was conducted on 82.6% females and 17.4% males. Family history of MS was positive in 12.8% of cases. Mean time of onset of symptoms till first medical visit was 3.25 months. Mean time from first medical visit to diagnosis was 14.98 months. Mean time from onset of symptoms till diagnosis was 18.01 months and the mean time from onset of symptoms till initiation of treatment was 18.73 months. Also, 29.3% of cases had delay in first medical visit and 42.2% of cases had delay in diagnosis of MS more than 6 weeks from first medical visit. Overall, delay in first medical visit and diagnosis of MS has decreased over the years. However, there is still delay in diagnosis of MS. Factors associated with delay are low education, male gender, living in rural areas, primary progressive MS, age at MS diagnosis and first clinical symptoms.