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      Prevalence, dimensions, and predictor factors of sexual dysfunction in women of Iran Multiple Sclerosis Society: a cross-sectional study

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          Epidemiology of multiple sclerosis in Iran: A systematic review and meta-analysis

          Background Multiple sclerosis (MS) is one of the most common neurological disorders and is one of the main causes of disability. The prevalence and incidence of MS in Iran is reported to range from 5.3 to 89/ 100,000and 7 to 148.1/ 100,000, respectively. There are no systematic and meta-analysis studies on MS in Iran. Therefore, this study was conducted to investigate the prevalence and incidence of MS in Iran using meta-analysis. Method A systematic review of the present study focused on MS epidemiology in Iran based on PRISMA guidelines for systematic review and meta-analysis. We searched eight international databases including Scopus, PubMed, Science Direct, Cochrane Library, Web of Science, EMBASE, PsycINFO, Google Scholar search engine and six Persian databases for peer-reviewed studies published without time limit until May 2018. Data were analyzed using Comprehensive meta-analysis ver. 2 software. The review protocol has been registered in PROSPERO with ID: CRD42018114491. Results According to searching on different databases, 39 (15%) articles finalized. The prevalence of MS in Iran was estimated 29.3/ 100,000 (95%CI: 25.6–33.5) based on random effects model. The prevalence of MS in men and women was estimated to be 16.5/ 100,000 (95%CI: 13.7–23.4) and 44.8/ 100,000 (95%CI: 36.3–61.6), respectively. The incidence of MS in Iran was estimated to be 3.4/ 100,000 (95%CI: 1.8–6.2) based on random effects model. The incidence of MS in men was estimated to be 16.5/ 100,000 (95%CI: 13.7–23.4) and the incidence of MS in women was 44.8/ 100,000 (95%CI: 36.3–61.6). The meta-regression model for prevalence and incidence of MS was significantly higher in terms of year of study (p<0.001). Conclusions The results of this study can provide a general picture of MS epidemiology in Iran. The current meta-analysis showed that the prevalence and incidence of MS in Iran is high and is rising over time.
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            The impact of sexual dysfunction on the quality of life measured by MSQoL-54 in patients with multiple sclerosis.

            Sexual dysfunction (SD) is a common but often overlooked symptom in multiple sclerosis (MS). The aim of this study was to estimate the frequency, type, and intensity of SD in our patients with MS and to investigate its influence on all the domains of quality of life. The study population comprised a cohort of 109 patients with MS (McDonald's criteria, 2001). SD was quantified by a Szasz sexual functioning scale. Health-related quality of life was measured by a disease-specific instrument MSQoL-54 (Serbian version). The presence of at least one symptom of SD was found in about 84% of the men and in 85% of the women. The main complaints in women were reduced libido, difficulties in achieving orgasm, and decreased vaginal lubrication; in men, the main complaints were reduced libido, incomplete erections, and premature ejaculation. In women, statistically significant negative correlations between the presence and level of SD and quality of life domains were reached for all subscales (P < 0.01), except for the Pain subscale (P = 0.112). In men, negative correlations were also observed for all domains, but they were statistically significant for physical health, physical role limitations, social function, health distress, sexual function, and sexual function satisfaction (P < 0.01). We found that the presence of all the analyzed types of sexual problems statistically significantly lowered scores on the sexual function and the sexual function satisfaction subscales in both men and women (P < 0.01). The most prominent impact on both domains was observed for the total loss of erection in men and for anorgasmia in women. Our results reveal that frequent occurrence of SD in MS patients prominently affects all aspects of their quality of life.
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              Sexual dysfunction ın multiple sclerosis: gender differences.

              To assess the frequency and nature of sexual dysfunction in multiple sclerosis (MS) patients and to investigate the relationships of SD with clinical, demographic and psychosocial factors by comparing MS patients with and without SD. Eighty-nine patients were included, 45 males and 44 females, aging an average of 37.4 ± 8.6 years (range:21-56). We applied Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ-19) and Arizona Sexual Experiences Scale (ASEX) to all patients. Disability was evaluated with the expanded disability status scale (EDSS). 60.7% (n=54) of patients reported SD according to MSISQ scores. Women exhibited significantly higher MSISQ scores than men (42.6 ± 12.9 and 36.6 ± 13.3, respectively; P=0.034). Women (7.9%) also reported to experience sexual arousal difficulties significantly more than men (1.1%) (P=0.024) according to ASEX. The patients were classified into three MSISQ-19 subscales, Primary, Secondary and Tertiary SD. The most common reported dimension of SD was secondary (32.5%, n=41). In this dimension of SD, patients mostly complained of pain-burning, memory-concentration problems and bowel symptoms. A significant relationship was found between Secondary SD and both EDSS score and disease duration (r=0.34 p=0.001 and r=0.21 p=0.042, respectively). Tertiary SD was also associated with EDSS score (r=0.23 p=0.03). Sexual Dysfunction, a frequent problem for MS patients, is associated with gender. Women reported more SD than men. Secondary SD symptoms were the most common complaints for both men and women. Nonetheless women had more secondary SD symptoms than men. The emotional dimension of SD is related with disability. Copyright © 2012 Elsevier B.V. All rights reserved.
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                Author and article information

                Journal
                Neurological Sciences
                Neurol Sci
                Springer Science and Business Media LLC
                1590-1874
                1590-3478
                May 2020
                January 2 2020
                May 2020
                : 41
                : 5
                : 1105-1113
                Article
                10.1007/s10072-019-04222-6
                31897948
                8834931d-bf64-4a90-8243-84c0bf597a23
                © 2020

                http://www.springer.com/tdm

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