Background and Objectives: More than 50% of multiple sclerosis (MS) patients suffer from urinary disorders. Exercise therapy is one of the first lines of treatment for urinary disorders in people with MS. This study evaluated the effectiveness of pelvic floor muscle exercise at home on quality of life (QoL) and fatigue in MS women with urinary disorders. Methods: A randomized, double-blinded, controlled trial was conducted. Thirty women with relapsing and remitting urinary incontinence participated for eight weeks (daily) in this study. The participants were randomly divided into intervention (n=15) and control groups (n=15). The participants of the intervention group received common medicines and specific exercises for the pelvic floor. The control group used only conventional drugs during the study. Results: The results showed significant differences in all variables related to fatigue and QoL in the intervention group (P<0.05). But no significant difference was found in any of the variables related to fatigue and QoL in the control group (P>0.05). However, in the intervention group, significant differences were found in the total score of the QoL and the three subgroups (bothered, worry, and restricted) (P<0.05). In addition, the results showed a significant difference in the cognitive, physical, and psycho-social subgroups in the fatigue questionnaire (P<0.05). The fatigue scores and QoL in the intervention group compared to the control group showed a significant difference (P<0.05). Conclusion: It seems that pelvic floor exercises at home reduce fatigue and improve QoL in women with MS with urinary incontinence. Although the total score of fatigue between the two groups was not significant, the results in the intervention group showed significant results and it seems that by controlling the intervening factors, a significant difference can be observed in the total score of fatigue between the two groups. Therefore, we demonstrated that pelvic floor muscle exercises in women suffering from urinary incontinence improve urinary incontinence and reduce fatigue, and improve the QoL.

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(2.5 vs 2.41 l) between patient with positive or borderline HCT and patients with negative HCT. SNIP was lower in those who were positive or borderline than those who were negative (median 28.5 vs 43 cmH 2 O). Conclusions Patients with NMD and respiratory muscle weakness are prone to develop hypoxia irrespective of their baseline oxygen saturation, FEV 1 and FVC. SNIP may be better at predicting the risk of hypoxia during air travel.

We read an interesting article by Manomaivat and colleagues about the correlation between hepatitis C virus (HCV) infection and oral lichen planus (OLP) in your journal. 1 The World Health Organization planned to eliminate viral hepatitis by 2030, and one important step for this elimination is finding infected people. 2,3 According to the global prevalence of HCV (1%), the widespread screening seems not to be cost-effective. This screening is recommended in people with a greater risk of being infected. 2 The prevalence of HCV in OLP patients was nine times higher than the control group and approximately 18 times higher than the general population of Thailand. 1 Thus, OLP patients are a special group for HCV screening and case finding to eliminate viral hepatitis in Thailand. This issue could be mentioned in local HCV elimination guidelines of Thailand. More studies in other countries are needed to evaluate the importance of screening OLP patients to find unknown HCV-infected people. In addition, local protocols are needed for following up these HCV-infected patients for additional diagnostic tests (eg polymerase chain reaction, genotyping and fibro scan) and linking them to treatment.Manomaivat and colleagues evaluated alcohol drinking, smoking, intravenous drug use, and betel nut chewing as potential risk factors for HCV infection. Previous studies mentioned tattooing, 4 nonintravenous drug use, 5 history of imprisonment, 6 high-risk sexual behavior, and other risk factors for increasing the risk of HCV infection compared to the general population. 2 We suggest that Manomaivat and colleagues control their results for these known risk factors, so they can evaluate the parallel effects of these cofactors on HCV infection. More data are needed to make a decision about the importance of HCV screening in OLP patients. O RCI DHamidreza Karimi-Sari

Fine-needle aspiration (FNA) biopsy has become a standard first-line diagnostic procedure for palpable and nonpalpable nodules of the thyroid gland. Six cytologic diagnostic categories have recently been proposed to unify the terminology that is linked to proper clinical management. We report a case of follicular neoplasm diagnosed on FNA specimen that had a very artistic appearance of the microfollicle formation on both Diff-Quik and Papanicolaou-stained slides.