Background and purposeTopiramate (TPM) is a sulfa-derivative monosaccharide that is used mainly for treating epilepsy and preventing migraine. Within the gamut of side effects attributable to this drug, ophthalmologic manifestations are of crucial importance. In this study, for the first time, the aim was to provide a systematic literature review regarding this issue.MethodsFor the time period 1996–2011, a PubMed search was made for the studies concerning the adverse/beneficial effects of TPM on vision. Overall, 404 citations out of a total of 2756 TPM-related studies were examined for relevance.ResultsA total of 74 relevant studies were reviewed, 65 of which comprise small observational studies describing the ophthalmic side effects of TPM in 84 patients. Of these patients, 66 were affected by ciliochoroidal effusion syndrome as the cardinal ocular side effect of TPM (17 cases of myopic shift and 49 cases of angle closure glaucoma). A comprehensive statistical analysis is provided on these 66 subjects. Other rare side effects of TPM on the vision were also reviewed, including massive choroidal effusion, ocular inflammatory reactions, visual field defects, probable effects on retina, cornea, and sclera, and neuroophthalmologic complications. In addition, a framework is provided to classify these results.DiscussionDue to the expanding spectrum of indications for the administration of TPM, neurologists and psychiatrists should be aware of its diverse ocular side effects. In conclusion, ocular complications following this drug should be taken seriously and be subjected to ophthalmic counseling.

Background: There is a wide variation in the prevalence of multiple sclerosis (MS) in different geographical regions and the epidemiology of MS in Iran has been a major topic of concern during the last decade. Several population-based studies have shown a sharp increase in the prevalence and incidence of MS in this region. In this study, for the first time, the aim was to provide a comprehensive review regarding the incidence and prevalence of MS across Iran. Methods: A comprehensive literature search was performed using PubMed, Embase, and Web of Science. We also did a manual search of reference lists from primary articles and relevant reviews. Databases of ongoing research and unpublished literature were also searched. Results: A total of 22 relevant studies were reviewed and 11 studies met the inclusion criteria. Incidence data were found in 5 studies and ranged from 0.68 to 9.1/100,000 per year in the Iranian population. Prevalence was reported in all studies and ranged from 5.3 to 74.28/100,000 with the higher prevalence among females (female/male ratio ranged from 1.8 to 3.6). The most prevalent subtype of MS was the relapsing-remitting form (65.8-87.8%). The sensory disturbance was the most initial presentation. Conclusion: The incidence and prevalence of MS in Iran has been increasing rapidly, especially in females. Future research should focus on determining the epidemiological features of MS in the neglected provinces with different ethnicities. Such an effort along with further research towards improvement of data on previously studied areas can enable a field to be opened up to identify the patterns of MS in varied genetic backgrounds and environments of Iran.

SSD cream reduced the severity of radiation-induced skin injury compared with general skin care alone. Further studies in patients with other types of cancer and also comparing SSD cream with other topical agents are warranted.

This study indicates that 3-month ginseng treatment can reduce fatigue and has a significant positive effect on quality of life. Ginseng is probably a good candidate for the relief of MS-related fatigue. Further studies are needed to shed light on the efficacy of ginseng in this field.

This study demonstrated that both low-dose topiramate and propranolol could significantly reduce migraine headache frequency, intensity, and duration. However, compared with propranolol, low-dose topiramate showed better results.