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Introduction & Objective: Asthma is the commonest cause of being admitted in hospital and missing school among children. It is the commonest chronic disease among them as well. Although the disease may cause a lot of deaths and financial loss , it is preventable . Findings have revealed the various contributions of environmental factors to the incidence of asthma.This study is an attempt to recognize some influential factors in the incidence and recurrent of asthma among children aged between 6 months to 6 years in Yasuj. Materials & Methods: It is of cross- sectional descriptive analytical type of study carried out with two groups, each of which consisting of 90 children .The first group, the healthy ones, was taken as control group and the second, with asthma ,taken as case group . Enough care was taken in selecting uniform members in control group. Afterwards, questionnaires were prepared and filled by pediatricians when visiting the children in health centers. The collected data were analyzed using SPSS. Results: This study showed a significant relationship between smoking , background of allergy within the immediate family members and development of asthma. However there was no significant relationship found between the educational status of parents, breast feeding in the first six months and the incidence of asthma. Conclusion: Bearing in mind the contribution of smoking within the family to the development of asthma in family members with genetic susceptibility to the disease , the need for educational cultural programs encouraging the reduction of smoking within families particularly in enclosed spaces like homes is urgent and should be satisfied .

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Introduction & Objective: Transurethral resection of prostate (TURP) is the operation most frequently performed in urology. In view of the morbidity associated with this procedure, research has been conducted to propose an endoscopic alternative to TURP. Using of high energy laser is the most promising method in these cases. In this study, we evaluated the effect of home made KTP laser on re-sected prostate adenoma after open prostatectomy. Materials & Methods: 40 patients complaining of symptomatic BPH were treated by open prostatectomy. These 40 prostates were divided in to two parts. One part was sent for pathology assessment (group A) and the other part was sent to KTP laser room in the same hospital (group B). The prostates in group B were divided into 4 groups (1, 2, 3, 4), each with 10 prostate tissue. In groups 1, 2, 3 and 4, prostate lobes underwent laser ablation in one, two three and four stage. In any stage, KTP laser, 5 watts for 15 seconds, was used. All of prostate ablated with laser were sent to pathology for evaluation of tissue ablation capacity and deep tissue penetration. The study in all of stages was blinded for pathologist. Results: Mean age of participants was 73.25±6.8 years and mean level of PSA was 3.65±2.1 ng/dl. In both groups, with every stage laser, we have 1 to 2 mm tissue ablation associated with prostate type. In pathologic examination, we have 0-2 mm tissue destruction with disappearance of cells' nuclei, basophilia of stroma and damaged tissue (cutter like effect). Findings were compatible with burn effect. Conclusion: Pathologic findings proved, in the ex vivo investigation, that KTP laser offers a good tissue ablation capacity and minimal microscopic tissue damage. The risk of capsule perforation is very low. This procedure is safe and effective in which bladder outlet obstruction symptoms will be quickly relieves and has a low rate of complications. Moreover KTP laser has much cost effectiveness, although we need further studies on live prostatic tissues

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ABSTRACT: Introduction & Objective: Transitional cell carcinoma of renal pelvis presenting with brain metastases is a very rare case which should be diagnosed and treated in order to prevent further damages. Case: We report a rare case, who had presented with a constellation of neurological symptoms (due to multiple brain metastases), but without any urological symptoms. During evaluation of patient, we found transitional cell carcinoma (TCC) of left renal pelvis, for which palliative radical nephroureterectomy was performed . Conclusion: Although transitional cell carcinoma of renal pelvis presenting with brain metastases is a very rare case, but the patient was managed with gamma knife stereotactic radiosurgery for the metastatic lesions. Afterward he received four cycles of paclitaxel and carboplatin chemotherapy. The patient is alive with stable disease at 32- months’ follow-up.

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Introduction & objective: Unilateral Twin Ectopic Pregnancy is very rare and only 100 cases have been reported till now. Bilateral Twin Ectopic pregnancy is the rarest type of Dizigotic twin pregnancy. We have reported a case of Bilateral Twin ectopic pregnancy with live simultaneous IIntra Uterine Pregnancy that its prevalence is unclear. We didn’t find any similar cases in the literature. Case: The patient was a 34-year-old woman with intermittent crampic pain in both abdominal lower quadrants for 2 days. The patient had a history of abortion and also a secondary infertility and HMG Injection. The ultra-sonography showed a 12 week pregnancy uterus with bilateral ovarian cyst where one of them was ruptured and a large amount of fluid in pelvic cavity was seen. Therefore, a decision was made for surgery. During operation, two much dilated non ruptured area in left falopian tube and two ectopic pregnancies in the right fallopian tube were seen which one of them was ruptured. Conclusion: Considering the ectopic pregnancy, when encountering women in reproductive age, is necessary and any pregnant woman with abdominal pain must be considered for.

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Abstract Background & aim: One of the main genetic factors of infertility is the deletions in the chromosome Y. Accordingly this study was conducted to determine the frequency of microdeletion of AZF region in infertile men of Isfahan, Iran. Methods: In this case-control study, 100 infertile men referred to the Infertility Center of Isfahan and 100 fertile men as controls were randomly selected. Genomic DNA was extracted from their blood and amplified by sequence tagged sites-polymerase chain reaction (STS-PCR) method. The presence of microdeletion in AZF locus was diagnosed. Results: No AZFa, AZFb or AZFc deletions were found in the control group. Microdeletions were observed in one patient in AZFb region, eight patients in AZFc region and two patients in AZFa region. Conclusion: The incidence of Yq microdeletions in Iranian population is similar to the international frequency. Our data agree with other studies regarding microdeletions of AZFc, but for microdeletions of AZFa (2%) our results show smaller frequency and differ significantly with many studies. Key words: Infertility, Y chromosome, Microdeletion

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Abstract Background & aim: Vitrification is a simple and ultra rapid technique for the conservation of fertility. Improving pregnancy rate associate with the use of cryopreserved oocytes would be an important advanced in human assisted reproductive technology (ART). The purpose of this study was to evaluate survival, oocytes maturation and embryo development to the blastocyst stage after vitrification of oocytes germinal vesicle-stage and multi stage Methods: In the present experimental study, germinal vesicle oocytes with or without cumulus cells were transferred to vitrification solution containing 30% (v/v) ethylene glycol, 18% (w/v) Ficoll-70, and 0.3 M sucrose, either by single step or in a step-wise way. After vitrification and storage in liquid nitrogen, the oocytes were thawed and washed twice in culture medium TCM119, and then subjected to in vitro maturation, fertilization, and culture. Data analysis was performed by using One-way variance and Tukey tests. Results: Oocytes survival, metaphase 2 stage oocyte maturation, fertilization and embryo formed blastocyst in vitrification methods multistage were significantly higher than the single step procedure (P<0/05) Conclusion: The Germinal vesicle stage oocytes vitrified with cumulus cells and stepwise procedure had positive effect on the survival, maturation and developmental rate on blastocyst compared to oocytes without cumulus cell and single step procedure. Key words: Germinal Vesicle Oocyte, Blastocyst, Vitrification, Ethylene glycol

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Abstract Background & aim: Multiple sclerosis is a chronic neurological disease that depression has been found in more than 40% of its patients and by several sub-clinical markers associated with disease the opportunity will appearance. Aim of this present study was investigation depression and multiple sclerosis sub-clinical markers. Methods: In this analytical cross-sectional study, 162 patients with multiple sclerosis were selected by consecutive sampling and using the clinical and demographic variables inventory, Depression, Anxiety and Stress Scale, Short Form Health Survey questionnaire, Fatigue Severity Scale along with identical analog-spring balance were examined. The data were analyzed by pearson correlation coefficient, one way analysis of variance, Tukey's test and stepwise multiple regression. Results: Patients with 3 or more times the number of relapses and hospitalizations experienced, received significantly more depression scores than patients with lower frequent relapse and hospitalization. In addition, sub-clinical markers of the disease together could explain 30% of the shared variance of depression. Overall in final step limitations due to physical problems, fatigue and bodily pain could significantly predicts depression scores in patients (P <0.0001). Conclusion: This study highlighted the impact of multiple sclerosis sub-clinical markers in depression of patients. Hence, is requirement that identified key predictors of this research be considered as possible risk factors in development of depression associated with multiple sclerosis and used for the regular management of the disease. Key words: Multiple Sclerosis, Depression, Fatigue, Pain

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Introduction & aim: With respect to the outbreak probability of dangerous infections among the patients, the water sources of dentistry units were taken into consideration, in view of microbial contamination. The objective of this study was to assess of pathogenic organisms of the water used in the dentistry units of Yasuj city. Methods: In this research 120 samples of water from poir and turbine of units (before and after flushing) and two samples of urban water were collected. Sampling was performed on the first weekday (48 hours after the units were switched off) and mid week(16 hours after the units were switched off) before starting work. The samples were cultured on EMB Agar and Blood Agar and incubated at 37oC for purification for Gram positive or Gram negative bacteria and it was identifying with biochemical diagnostic test .Also the samples were counted by standard plate count . Results: The average count of bacteria before flushing in Poir on the first weekday was 5360CFU/L and turbine was 2800 CFU/L and count of bacteria after flushing in Poir on the first weekday was 1040 CFU/L and turbine was 1020 CFU/L .While this result for midweek day : The average count of bacteria before flushing in Poir was 3220 CFU/L and turbine was 2720CFU/L and count of bacteria after flushing in Poir was 1772 CFU/L and turbine was 980 CFU/L . Several samples of before and after flushing were contaminated with E.coli, Pseudomonas ,Proteus, Kelebsiella ,gram positive bacilli ,Streptococci, Staphylococci , Diplo cocci and Yeast. Conclusion: According to the result of this study the contamination rate of the unit’s water was high and it’s rate reduced after flushing. The patients saliva causes water unit contamination and it constitutes biofilm in pipe of unit . Existence of E.coli shows the contamination of water to sewage and staphylococcus explains contamination due to return of the patient’s saliva into suctions. dental units waterlines showed bacterial contamination which was eliminated after flushing.

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Background & aim: Breast cancer is the most common cancer among women and one of the factors threatening the health of women worldwide. Leptin is a 16 kD glycoprotein hormone produced predominantly by white adipose tissue. Leptin binds to receptors in the hypothalamus and plays a key role in regulation of metabolism. Both leptin and leptin receptor have recently been implicated in processes and progress leading to breast cancer initiation. The aim of this study was to identify if there is association between leptin and pathological indexes in patients with breast cancer Methods: 45women with breast cancer were enrolled. Serum leptin levels of patients were measured by the ELISA method. Pathological information such as stage of the breast cancer, Hormonal receptor (ER, PR) and Her2 status in these patients were determined. Result: Results revealed that the patients who were in stage one and two, the mean serum leptin level was (34.18±21.22 ng/ml) And patients who were in stage three and four, the mean serum leptin level was (32.21±21/93 ng/ml). Also the mean serum leptin levels in patients whose receptor status of ER, PR and HER2 positive were (35.90±23.55, 35.74±23.91and 37.02±24.25ng/ml), respectively. The Patients whose receptor status of ER, PR and HER2 negative were 26.64±13.13, 28.17±14.26and31.32±19.9ng/ml respectively. No significant association was found between leptin leveland stage of the breast cancer, hormonal receptor (ER, PR) and Her2 status in Patients with Breast cancer(p>0.05). Conclusions: In this study, no association was found between serum leptin level and pathological indices in women with Breast cancer in Yasuj, Iran.

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Background and Aim: Many problems are associated with infertility diagnosis, especially for women. Resiliency is one of the strategies which may reduce psychological distress of infertile women. The aim of current research was to study the effectiveness of existential psychotherapy in increasing the resiliency of infertile women. Method: The design of the present study was a semi-experimental research with pretest and posttest with control group. Statistical population consisted of all infertile women of Dehdasht, Iran, in the summer of 2014. Samples were selected at first by available sampling method and after completing resiliency questionnaire, and obtaining score for enter to research, were placement using random sampling method in two experimental and control groups (N = 8 per group). The experimental group participated in 8 sessions of group counseling based on existential approach and control group received no intervention. The gathered data were analyzed using covariance analysis. Results: The results showed that significant differences between the pre-test and post-test scores of the experimental group existed. This difference was significant at the level of 0.01. Therefore, it seemed that existential psychotherapy increased the resiliency of infertile women. Conclusion: The results revealed that existential psychotherapy increased resiliency of infertile women and interventions based on this approach will lead to the improvement of the mental health.

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Background & aim: Due to increased public interest in the use of herbal medicine, their efficacy and safety evaluation have become important. In some studies, Pistacia atlantica leave (PAL) extract suggested as a hypoglycemic agent. However, there is no study about its effects on diabetic nephropathy. Therefore, the present work was conducted to evaluate the effects of aqueous extract of PAL on some biochemical and pathological aspects related to renal function in diabetic rats.

Methods: In the present experimental study, 40 severe diabetes male Wistar rats (180-200 gr) with STZ and eight healthy rats at the same age were equally divided into 6 groups and followed for a period of thirty days as the oral treatment respectively. Diabetic groups I ,II and III received 100, 200 and 400 mg/kg of PAL extracts, diabetic group IV received 50 mg/kg Captopril and diabetic group  V and healthy group received saline 0.9% as control groups. Finally, fasting blood glucose (FBG), Urine volume and 24 h urine total protein (UTP), blood nitrogen urea (BUN) and plasma creatinine (Cr) were assessed biochemically and also qualitative renal histomorphological alterations were assessed pathologically. Data were analyzed using one-way ANOVA and Tukey post hoc test.

Results: In diabetic control group the FBS (383.5 ± 118.33), BUN (27.17± 2.86), Cr (1.3 ± 0.45), Urine volume (24.66± 5.10) and UTP (25.67 ± 1.51) of groups 1-5 significantly increased in comparison whit normal control group (p<0.0001 each). In addition:  severe glomerolosclerosis, mesangial matrix expansion and tuft-capsule adhesion were observed in diabetic rats. Unlike captopril, which could significantly reduce the mean level of urea nitrogen (p <0.001; 12.5 ± 2.81), creatinine (p=0.034; 0.97±0.14) and protein (p=0.002: 13.66 ± 3.48) compared with diabetic controls the histology of the group was evaluate and confirmed its moderator effects,

Conclusion: The results clearly demonstrate that PAL did not have any beneficial effects on diabetic nephropathy in rats.

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Abstract


Background and aim: Organophosphate insecticide diazinon is used in agriculture and may affect fertility of men due to the production of free radicals. Because of the antioxidant properties of black currant compounds, the effect of hydroalcoholic extract of black currant on spermatogenesis in diazinon-induced toxicity in male rats was investigated.

Methods: In the present experimental study, 30 adult male Wistar rats were divided into six groups: control group without sham, corn oil and saline without intervention; the positive control group received Diazinon poison at a concentration of 16 mg / kg. Experimental 1 and 2 respectively received diazinon poison (16 mg / kg) and black and white extract (100 mg / kg) and 200 mg / kg (3 mg / kg) extract, respectively. They received 3 extracts of black currant with a concentration of 200 mg / kg. All treatments were carried out for 2 months in gavage. After 2 months sperm parameters, number, mobility, life and morphology were investigated. Similarly, testicular tissue was stained with Hematoxylin Eosin for evaluation of spermatogenesis after cutting. Data were analyzed by one-way ANOVA and Tukey's post hoc test.

Results: Diazinon with a concentration of 16 mg / kg caused a significant decrease in the number and motility of the sperm in comparison to the sham group (p <0.01) (p <0.001), but significantly altered sperm motility and morphology compared to the group Did not have you The group that received diazinon and extract of black currant with two concentrations of 100 and 200 mg / kg compared to diazinon group showed a significant increase in the number of sperms (p <0.01) (p <0.001), but blackheads caused a significant change Sperm motility was not present in the presence of diazinone. Histological examination showed that the number of primary spermatocyte cells and spermatid in the diazinone group compared to sham group decreased significantly (p <0.05). However, the number of spermatogonia cells, primary spermatocytes and spermatid in experimental groups 1 and 2 showed a significant increase compared to diazinon group (p <0.05). In the experimental group 3, the extract increased the number of sperm in comparison with the sham group (p <0.05), but did not change the testicular tissue.

Conclusion: The results indicated that black currant extract had a protective effect on testicular tissue and could increase spermatogonia, spermatocyte, spermatid and sperm count in diazinon-induced toxicity but did not affect sperm motility.
 
 
 

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Background & Aim: Nutritional literacy is the capacity of people to gain, understand and evaluate nutritional information for proper nutrition decision making. This research has been designed and implemented to measure the nutritional literacy of primary school teachers in Yasuj

 

Methods: This cross-sectional study was performed on two parts of the nationalization of the Nutrition Literacy Instrument developed in Turkey, as well as nutritional literacy assessment in elementary school teachers in Yasuj. The selected instrument was localized using translate translation method and receiving and applying opinions of nutritionists specialist on the structure and content of the questionnaire, and then ensuring its reliability for use in Iranian society. Nutritional literacy data were collected from a group of 110 elementary teachers in Yasouj who were selected by multi-stage cluster sampling through a self-administered questionnaire and then analyzed by descriptive and analytical statistics.

 

Results: The localized nutritional literacy tool had 35 items and the Cronbach's alpha coefficient was 0.73. Mean and standard deviation of teacher's score from the nutritional literacy tool was 27.14 ± 3.2, which indicated that 22.7% of teachers had inadequate nutritional literacy. Teachers with fewer years of work and higher education had a higher level of nutritional literacy. The lowest percentages of responses were related to the skill of determining food units, doing calculations and reading food labels.

 

Conclusions: Majority of the teachers studied had sufficient nutritional literacy, but defect in three parts of the skill of determining food units, doing calculations and reading food labels indicates the need to pay attention to these components in the design and implementation of nutrition improvement programs.

 

 

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Background & Aim: Therapeutic schemas model emphasizes the role of early maladaptive schemas in psychological disorders. The aim of this study was to determine the effectiveness of schema therapy on the severity of depression and suicidal thoughts in patients with depressive disorder.

Methods: This research was a semi experimental study using pre-test and post-test with control group. among all patients with treatment resistance depression visited in Naft and Sadooghi hospital of Tehran, 30 patients were selected through inclusion-exclusion criteria and availability sampling method then randomly were assigned into two equal experimental (15 persons) and control (15 persons)  groups. Experimental group experienced 12 weeks of schema therapy, while control group were just followed. Beck depression inventory (BDI-II) and Beck suicide scale ideation (BSSI) were used in pre-test and post-test as the. Data were analyzed by Mancova via SPSS software.
 
Results: The results of this study showed that the mean scores of depression and suicidal ideation decreased significantly in the experimental group in the post test compared to the control group (p <0.0001). In other words, schema therapy sessions reduced the severity of depression and suicidal thoughts in patients with depression resistant to treatment.


Conclusion: The results indicate that schema therapy can be used as an effective intervention to reduce the severity of depression and suicidal thoughts in people with depressive disorder. Therefore, it is suggested that psychologists and psychiatrists use a therapeutic schema to reduce the psychological problems of people with depressive disorder.


 

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Background & aim:  MYH7 and MYH7β genes play important roles in cardiac function. Endurance activity, on the other hand, challenges the structure and function of the heart. The aim of the present study was to determine and evaluate the effect of 14 weeks of endurance training on MYH7 and MYH7β gene expression and left ventricular structural changes in male Wistar rats.
 
Methods: In the present experimental research, 14 rats weighing 113±20gr under controlled conditions (temperature, light and dark cycle, free access to food and water) were retained. After exposure (231±24g), they were randomly divided into control (7) and experimental (7) groups. The experimental group completed a program (30 m/min, 50 min/session, 6 sessions/week for 14 weeks) on the treadmill and then anesthetized and described 48 hours after the last training session with the control group. Then their hearts and their left ventricles were removed and MYH7 and MYH7β gene expression levels were measured using Real time-PCR. Data were analyzed using independent and dependent t-tests.
Results: The results of the present study indicated that cardiac weight gain and MYH7 and MYH7β gene expression were increased in the exercise group, meaning that endurance exercise significantly increased the heart to body weight ratio in the experimental group compared to the control group. Expression of MYH7 and MYH7β genes was not significantly higher in the experimental group (p = 0.005) (p = 0.001). 
 
Conclusion: It seemed that the endurance training induced remodeling which was indicated by hypertrophy and it coincided with increasing of MYH7 and MYH7b genes expression. This may be part of an improvement in cardiac function due to exercise activity due to increased expression of these genes
 

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Background & aim: Indoor air contains a wide variety of bioaerosols. The presence of bioaerosols in the air can affect human health. Transmission of bioaerosols may cause nosocomial infections that affect all health, economic and social aspects of one's life. Therefore, the aim of the present study was to determine the density and type of bioaerosols in the air of Imam Sajjad Hospital of Yasuj.
 
Methods: the present cross-sectional descriptive study was conducted in 4 sections in different classes of Imam Sajjad Hospital of Yasuj. 240 specimens were sampled by active sampling method using a Quik Tic Pump 30 sampler at a flow rate of 28.3 liters per minute for 2 consecutive months for 4 consecutive months from August to November 2015 on tryptic agar medium and Saber-dextrose agar were collected for bacteria and fungi, respectively. The specimens were incubated for 48 hours at 37°C for bacterial culture and 70 to 120 hours incubated at 25-27 ° C for the fungi. It was reported in CFU/ m^{3 for} each bioaerosols. Data were analyzed using statistical tests.
 
Results: The results indicated that Staphylococcus bacteria (76.57%), Bacillus (79.36%), Nocardia (23.4%), Micrococcus (0.68%), Streptococcus (0.38), Corynebacterium (0.12%) and Enterococcus (0.04%) were the most frequent to the lowest percentage, respectively. The highest and lowest number of fungi observed in Imam Sajjad Hospital of Yasuj and their prevalence were Rhizopus (39.71%), Penicillium (32.47%), Yeast (18.57%), and Alternaria (3.69%), respectively.), Ascoliolaris (0.67%), Cladosporium (0.43%), and Trichophagygomes (0.23%). The highest bacterial contamination in postnatal care was 531.14 CFU/ m³and the least contamination in postnatal care was in fungal bioaerosols of 114.47 CFU/ m³ of air. The mean air pollution of the studied sections for bacterial and fungal bioaerosols was 24 and 125.78 CFU/ m³, respectively.
 
Conclusion: According to the obtained results, microbial quality of air in Imam Sajjad Hospital was not desirable. High density of patients, hospital staff and patient companions in wards, lack of proper ventilation in hospital can affect bio-aerosol density in the hospital.
 
 

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Background & aim: Concurrent stunting with overweight" is one of the consequences of nutritional transition, which has worsened the outcomes more than overweight itself. The aim of this study was to determine the trend of anthropometric indices in primary to high school students in Eslam Abad-e Gharb city, Iran.
 
Methods: The present analytical-comparative study was conducted in 2017 in the city of Islamabad-e-Gharb, and students from 16 high schools were randomly selected and surveyed by cluster sampling. High school metrics were measured in the same year. Elementary school information was collected through school student files. In this study, "short stature at the same time with overweight" was defined as "z-score equal to + 1 and above BMI for age and z-score equal to 1- and less" height for age "based on simultaneous placement. Collected data was analyzed using Fisher and Chi-square statistical tests.
 
Results: In the present study, out of 731 people, 350(47.9%) were girls and 381 (52.1%) were boys. The prevalence of short stature at the same time with overweight in primary school was 0.55%(4 people) and in high school was 3.83% (28 people), which was significant from primary school to high school among all students studied (p=0.001). In short, the index was not significant in girls (p=0.001), but not significant in boys (p = 0.506).
 
Conclusion: The prevalence of short stature has been on the rise with overweight students (especially girls) from elementary school to high school.
 
 
 

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Abstract:
Background & aim: Fingolimod was the first oral drug in the treatment of multiple sclerosis in its recurrent form, which was approved in 2013 in Iran and has made patients better tolerant to treatment. The aim of the present study was to evaluate the efficacy and pharmacological side effects of Fingolimod in the follow-up of 3-year-old patients with multiple sclerosis.
 
Methods: The present study was a clinical trial. The study population included 28 patients with RRMS disease referred to the clinic of Imam Reza (AS) Hospital in Kermanshah. The patients took one oral capsule of Fingolimod daily for 36 months, and in the three-month period for 36 months after the onset of Fingolimod in terms of recurrence, progression of disability, and possible side effects of the drug were examined and they were followed up. After a period of 36 months, 28 patients were analyzed and 7 (2 due to medication, 1 due to immigration and 4 due to disability) were dropped out of the study. The EDSS questionnaire was completed for patients in each care period. Data were analyzed using Colomogram Smirnov, Kay Do and Variance analysis statistics.
Results: The mean age was 23.67±7.31 and the mean duration of the disease was 6.89±3.47 years. The mean frequency of recurrence of MS before the intervention was 1.94±1.28 and in the first year after the intervention, it was 0.37±0.68, in the second year 0.5±0.63 and in the third year it was reduced 0.32±0.47. 88.9% patients had not progress in EDSS, 75% had no recurrence and 58.2% had no new lesions or an increase in the size of the lesions on MRI II. The frequency of GAD lesions was significantly reduced after the intervention (p=0.03). White blood cells had a decreasing trend in patients (p=0.0001) and two patients were discontinued due to leukopenia and increased liver enzymes, and no severe complication was reported in other patients.
 
Conclusion: Fingolimod was a suitable alternative for the treatment of RRMS. In addition to the high efficacy, relatively acceptable side effects of the study with a larger sample size are essential for a more informed assessment of the benefits and risks of this drug for recurrence.