Background: During the COVID-19 pandemic, besides the most prevalent respiratory and systemic symptoms, some neurological symptoms such as acute hemorrhagic necrotizing encephalopathy and myelitis associated with COVID-19 have been reported. It is suspected that COVID-19 involves different body systems via interaction with the ACE-2 (angiotensin-converting enzyme 2) receptor. As ACE2 is expressed on the surface of central nervous system cells, including the brain and spine, these kinds of manifestations are inevitable. Clinical Presentation and Intervention: Here we report a case of COVID-19 associated with acute myelitis in an infected patient in the north of Iran during the pandemic of COVID-19. He presented with paraparesis and urinary incontinence. Unfortunately, he did not respond to anti-inflammatory treatment. Conclusion: Para/Post Infectious myelitis could be a complication of COVID-19 infection.

Iron overload may contribute to brain damage that involves delayed brain atrophy, edema, and neuronal cell death as well as unfavorable outcome following ischemic stroke and intracerebral hemorrhage (ICH). This prospective study was performed to determine the association of serum ferritin level, an iron storage protein, with perihematoma edema (PHE) growth as well as in-hospital mortality and long-term clinical outcome of patients with ICH. Data was collected from patients with ICH from February 2011 to April 2012. Demographic and clinical data were recorded and serum ferritin was measured on admission. Brain CT scan was performed on admission and 72 hours later. Volume of hematoma and PHE was calculated using ABC/2 formula. Functional outcome was assessed using modified Rankin Scale. A total of 63 patients were included in this study, of those 11 (17.5%) patients died during the first 72 hours of admission. There was a significant correlation between PHE growth during first 72 hours of hospitalization and serum ferritin (P<0.001) as well as history of diabetes mellitus (P<0.001). PHE growth during the first 72-hours of hospitalization and baseline hematoma volume were both predictors of in-hospital mortality and poor outcome (P=0.026 and P=0.035, respectively). These results indicate the role of iron overload in the development of PHE following ICH. However, it seems that serum ferritin level is not directly associated with in-hospital mortality and long-term functional outcome.

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Depression is a frequent symptom in multiple sclerosis (MS) which has a negative impact on quality of life and cognitive status. The purpose of this study was to determine the prevalence and associated factors of depression, and status of antidepressant use in Iranian MS patients. One-hundred and sixty patients with definite MS were included. Demographic and clinical characteristics were recorded. Fatigue and depression were evaluated using the fatigue severity scale and Beck depression inventory-II. Cognitive performance and disability were examined by mini-mental status examination and expanded disability status scale. Multiple logistic regressions were used to determine the associated factors of depression and antidepressant use. The prevalence of depression and severe depression was 59.4 and 18.1 %, respectively. However, only 21.1 % of patients were on antidepressant treatment, while the prevalence of unrecognized/untreated depression was found to be as high as 44.1 %. Multivariable analysis showed that fatigue (P < 0.0001, OR = 5.98, 95 % CI = 2.9-12.3) and older age (P = 0.027, OR = 2.24, 95 % CI = 1.09-4.6) were associated with depression in MS patient. A significant association was found between fatigue and antidepressant use (P = 0.001, OR = 6.81, 95 % CI = 2.26-20.48). Our findings demonstrate that depression is significantly associated with fatigue and older age, regardless of other factors. Moreover, despite the high prevalence of depression in MS, most patients do not receive adequate treatment.

Background: Self-management is the most important component in the treatment of chronic diseases, including multiple sclerosis (MS). The Bishop and Frain Multiple Sclerosis Self-Management Scale–Revised (MSSM-R) is one of the valid tools available for self-management assessment. The purpose of this study was to evaluate the psychometric properties of the MSSM-R in Iranian people with MS. Methods: This cross-sectional study was conducted in 2018 in the 1600 people with MS in Guilan Province, Iran. In this study, 250 people were selected by convenience sampling. The reliability of the Persian version of this scale was examined by internal consistency and test-retest methods, and validity evidence was evaluated using confirmatory factor analysis. Results: The MSSM-R had acceptable face and content validity. Confirmatory factor analysis results showed that 24 items on this scale have factor loadings in five subscales. Other results showed the internal consistency, as measured by Cronbach α and test-retest reliability, for the MSSM-R overall (α = 0.85, r = 0.77) and for the following subscales: Healthcare Provider Relationship and Communication (α = 0.83, r = 0.70), Treatment Adherence/Barriers (α = 0.70, r = 0.71), Social/Family Support (α = 0.79, r = 0.85), MS Knowledge and Information (α = 0.89, r = 0.72), and Health Maintenance Behavior (α = 0.77, r = 0.75). Conclusions: This study provides evidence of the validity and reliability of the MSSM-R. To further ensure its psychometric properties, additional studies with this scale are suggested.