Hospital Practices and Research

Abstract Background: Multiple Sclerosis (MS) is the most common demyelinating inflammatory disease of the central nervous system. Rituximab is an anti-CD20 monoclonal antibody used as a primary drug for MS; however, it can cause injection and post-consumption side effects.
Objectives: This study aimed to determine the side effects of rituximab in patients with Multiple Sclerosis.
Methods: This descriptive-analytical study focused on MS patients who had received Rituximab and regularly visited Isfahan Multiple Sclerosis clinics in 2021. These patients had received at least two doses of Rituximab (1000 mg), and their symptoms and examinations were documented during face-to-face visits using checklists. The data were analyzed using SPSS version 22.
Results: In this study, 150 patients with MS participated. The number of attacks (more than one) before and after using Rituximab was 22% and 4.7%, respectively. The mean EDSS score among them before and after Rituximab was 3.53 ± 1.30 and 3.66 ± 1.51. 68.7% of the patients showed infusion side effects, such as a sore throat and dyspnea. Moreover, post-consumption side effects included muscle spasm, weight gain, arthralgia, and edema of the extremities.
Conclusion: The mean EDSS score before and after using Rituximab showed a slight increase, indicating no significant effects on improving dysfunctions, but the attack rate was reduced.

Abstract Background: Iatrogenic dural tear is a relatively common complication in lumbar spine surgery; however, little information exists about the frequency of this condition and its complications in our country.
Objectives: This study aimed to assess the frequency of dural tear and its complications in lumbar spine surgery.
Methods: This cross-sectional descriptive study was conducted on 884 patients who underwent lumbar spine surgery and were referred to Kashani and Alzahra hospitals from 2020 to 2021. Information including age, gender, type of surgery, duration of surgery, duration of hospitalization, number of hospitalizations, need for a second surgery, number of previous surgeries, complications of surgery, involved vertebrae, and underlying diseases were extracted from the checklist.
Results: Among 884 patients who underwent lumbar spine surgery, iatrogenic dural tear was observed in 62 patients (7%). Fever, headache, and wound site complications were observed in 8 (12.9%), 22 (35.5%), and 4 patients (6.5%), respectively. Moreover, the duration of surgery in the total group and the dural tear group was 195 ± 76.2 and 204.13 ± 71.69 minutes, respectively. The duration of hospitalization in the total group and the dural tear group was 3.10 ± 1.3 and 4.08 ± 2.68 days, respectively. Laminectomy was performed in 24.09% and 24.2% of patients in these two groups, respectively.
Conclusion: According to the findings of this study, the frequency of dural tear was 7%, which may be affected by several factors, including age, duration of surgery and hospitalization, underlying disease, smoking, and history of previous surgery.