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Objectives: We investigated the therapeutic effect of transcranial direct current stimulation (tDCS) combined with routine physiotherapy on the neurological and upper limb motor function in ischemic stroke patients with hemiplegia., Methods: In a Randomized double-blind controlled trial study, 52 eligible stroke patients were assigned to real tDCS receiving bihemispheric electrical current with 1.5 mA for 30 minutes over the primary motor cortex, and sham tDCS with a current intensity of 0.5 mA for 30 seconds. Both groups received routine physiotherapy, 5 sessions per week for two weeks. The National Institute of Health Stroke Scale (NIHSS) and the Medical Research Council Scale for Muscle Strength were used to assess the neurological and upper limb motor functions, respectively., Results: Both therapeutic approaches begot a significant improvement in upper limb motor function and neurological impairment at the last session of therapy and follow-up study. However, the treatment-induced neurological amelioration at the last session of therapy in real tDCS was significantly more than sham, especially in those identified as female and under 60 years old., Conclusions: A gender and age-specific protocol of real tDCS combined with routine physiotherapy might be beneficial to improve neurological impairment but not upper limb motor dysfunction after stroke., Competing Interests: Conflict of interest statement: All authors declare that they have no conflict of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Introduction: Headache is an illness with high prevalence and adverse effects on quality of life. As oral or dental problems such as pain can trigger or aggravate it, we aimed to investigate and compare oral and dental health status in patients affected with chronic headaches and healthy individuals., Methods: The present case-control study included 60 patients with chronic headaches (case) and 60 healthy individuals (control) in Rasht, Iran. The demographic characteristics and clinical examinations, including decayed/missing/filled teeth (DMF-T) and community periodontal index of treatment needs (CPITN) indices, as well as bruxism, frequency of tooth brushing and flossing, and maxillary and mandibular tooth wear were recorded in a checklist. Data analysis was performed using the IBM SPSS version 28 at a significance level of 0.05., Results: The case group consisted of 25 men (41.7%) and 35 women (58.3%) with an average age of 32.55 ± 6.62 years, while the control group had 27 men (45%) and 33 women (55%) with an average age of 30.95 ± 6.33 years. The study groups were not significantly different in bruxism, frequency of tooth brushing and flossing, DMFT, CPTIN, and maxillary and mandibular tooth wear., Conclusion: It seems that chronic headaches do not significantly affect the oral and dental health of the sufferers. Moreover, it appears that these patients are well aware of the role of oral and dental hygiene in triggering or aggravating the episodes of headaches., (© 2024. The Author(s).)

Objectives: The role of combined presence of vitamin D deficiency and other risk factors of stroke in ischemic cerebrovascular accident (CVA) development in Iranian adults has been unclear, so far. The association of vitamin D status at admission with ischemic CVA severity and outcome in this community is not yet well elucidated. This study aimed to clarify these ambiguities., Methods: In a cross-sectional study 104 hospitalized ischemic CVA patients and 104 healthy controls participated. The serum level of 25 (OH) D3 and baseline biochemical parameters were measured in ischemic patients within the first 24 h of admission, as well as healthy controls. The severity of CVA and clinical outcome were assessed using National Institutes Health Stroke Scale and Modified Rankin Scale, respectively. Data were analyzed using the Chi-square test, independent t-test, and multiple logistic regression., Results: There was a significant difference between patients and controls regarding the presence of vitamin D3 deficiency, hypertension, smoking, and baseline level of LDL and FBS. Vitamin D3 deficiency boosted the risk of ischemic in males and those having family history of CVA. A low serum level of 25 (OH) D3 was associated with more severity and poor outcome of CVA. The CVA severity, vitamin D3 deficiency, and hypertension were predictors of poor outcome., Conclusions: The study highlights the increased risk of ischemia in Iranians by cooccurrence of vitamin D3 deficiency and other risk factors of CVA. Clinical significance of vitamin D3 deficiency control may be suggested in those at risk of CVA and functional poor outcomes., (© 2022 Wiley Periodicals LLC.)

Purpose: Paying attention to the factors affecting the psychological well-being of people with multiple sclerosis (PwMS) is of particular importance, hence the present study investigated the relationship between self-compassion and psychological well-being with the mediating role of resilience., Methods: This cross-sectional study was performed using an online survey in a sample of 410 PwMS registered with the Guilan MS Society (GMSS) of Iran. The study was conducted in 2021. A demographic questionnaire, Ryff 's Psychological Well-Being Scales (PWB), the Connor-Davidson Resilience Scale (CD-RISC), and the Self Compassion Scale Short Form (SCS-SF) were used to collect data. Data analysis was performed using structural equation modeling., Results: The model and data were sensibly in agreement. Moreover, bootstrap results showed that all direct path coefficients were significant ( t ≥ 1.96). The direct effects of self-compassion and resilience on psychological well-being were significant, with standardized coefficients of 0.69 and 0.21. In addition resilience, with a coefficient of 0.73, was associated with psychological well-being. Furthermore, the indirect effect of self-compassion on psychological well-being with the mediating role of resilience was also confirmed ( p ≤ 0.05)., Conclusions: In particular, a higher self-compassion score predicts greater resilience, which is correlated with greater psychological well-being. These findings underscore the need to target the psychological well-being of PwMS through resilience to help them cope with living with chronic conditions., Competing Interests: Absent., (Copyright © 2022 Institute of Psychiatry and Neurology.)