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Multiple Sclerosis

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Dr.RAJEEV KASHYAP
Dr.RAJEEV KASHYAP
Health & Medicine
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Multiple Sclerosis Group Presentation Clin 213-50 Humber College Clin 213-50 Humber College Downloaded from www.jama.com
Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
Overview ,[object Object],Clin 213-50 Humber College
Multiple Sclerosis - Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object]
History of Multiple Sclerosis ,[object Object],[object Object],Clin 213-50 Humber College
Multiple Sclerosis - Epidemiology ,[object Object],[object Object],[object Object],[object Object]
World Distribution of MS Clin 213-50 Humber College
Multiple Sclerosis - Types ,[object Object],[object Object],[object Object],[object Object],[object Object]
Multiple Sclerosis - Types ,[object Object],[object Object],[object Object],[object Object]
Multiple Sclerosis - Types ,[object Object],[object Object],[object Object],[object Object]
Multiple Sclerosis - Types ,[object Object],[object Object],[object Object],[object Object]
Multiple Sclerosis - Types ,[object Object],[object Object],[object Object],[object Object]
Multiple Sclerosis Signs and Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
Multiple Sclerosis Signs and Symptoms ,[object Object],[object Object]
Factors Contributing for MS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Multiple Sclerosis - Causes ,[object Object],[object Object],[object Object]
Multiple Sclerosis - Diagnosis ,[object Object],[object Object],[object Object]
Possible v/s Definite MS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
MRI as Surrogate marker of disease process in MS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
Multiple Sclerosis - Diagnosis ,[object Object],[object Object],[object Object],[object Object]
How Does it work? Clin 213-50 Humber College
Demyelination of Nerve Fibers in MS Clin 213-50 Humber College The destruction of the myelin sheath leads to impaired communication between nerve cells and neurological symptoms such as abnormal sensations, vision problems , and weakness
Mode of Action ,[object Object],Clin 213-50 Humber College
How Autoimmune response cause MS Clin 213-50 Humber College
Pathophysiology ,[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
Clinical Tools for MS Diagnosis Schumacher Clinical Criteria -1965 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
Clinical Tools for MS Diagnosis Poser Criteria for the 1983 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
Clinical Tools for MS Diagnosis McDonald Criteria Clin 213-50 Humber College
Clinical Tools for MS Diagnosis Expanded Disability Status Scale ,[object Object],[object Object]
Clinical Tools for MS Diagnosis EDSS - Issues ,[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Tools for MS Diagnosis EDSS - Issues ,[object Object],[object Object],[object Object]
Clinical Tools for MS Diagnosis Multiple Sclerosis Functional Composite ,[object Object],[object Object]
Clinical Tools for MS Diagnosis Multiple Sclerosis Functional Composite ,[object Object],[object Object]
Treatment of Multiple Sclerosis ,[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
Treatments available in Canada ,[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
Alternative Treatments ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
Medications used for MS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
Current Treatments Clin 213-50 Humber College ,[object Object],[object Object],[object Object],[object Object],[object Object]
Current Treatments Clin 213-50 Humber College ,[object Object],[object Object],[object Object]
C urrent treatments cont’d: Disease Modifying Drugs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
Current Treatments cont’d: INTRAMUSCULAR INTERFERON BETA-1aTHERAPY ( LAWRENCE,D. JACOBS et al, SEPTEMBER28, 2000) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Current Treatments cont’d: Alemtuzumab ,[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
Antidepressants Efficacy Trial Michael A. Posternak, M.D. et al, (Am J Psychiatry 2002; 159:191 – 200) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Safety and Efficacy Issues ,[object Object],[object Object],[object Object]
A Randomized, Placebo-Controlled Trial of Natalizumab for Relapsing Multiple Sclerosis ,[object Object],[object Object]
Nataluzimab: marketing withdrawal pending evaluation ,[object Object],[object Object],[object Object],[object Object]
Multiple Sclerosis and Epstein-Barr Virus Ref: Lynn I. Levin, PhD, MPH et al, JAMA . 2003;289(12):1533-1536 (doi:10.1001/jama.289.12.1533) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Research Themes for Multiple Sclerosis ,[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
Focus on current trends ,[object Object],[object Object],[object Object]
Hookworms In MS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
Stem Cells in Multiple Sclerosis ,[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
Stem Cells in Multiple Sclerosis ,[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
Stem Cells in Multiple Sclerosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
Stem Cells in Multiple Sclerosis ,[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
Stem Cells in Multiple Sclerosis ,[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
Stem Cells in Multiple Sclerosis ,[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
Stem Cells in Multiple Sclerosis ,[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
Stem Cells in Multiple Sclerosis ,[object Object],[object Object],[object Object],Clin 213-50 Humber College
Stem Cells in Multiple Sclerosis ,[object Object],[object Object],Clin 213-50 Humber College
Stem Cells in Multiple Sclerosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
Stem Cells in Multiple Sclerosis ,[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
Stem Cells in Multiple Sclerosis ,[object Object],[object Object],[object Object],Clin 213-50 Humber College
Stem Cells in Multiple Sclerosis ,[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
Stem Cells in Multiple Sclerosis ,[object Object],[object Object],[object Object],Clin 213-50 Humber College
Stem Cells in Multiple Sclerosis ,[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
Stem Cells in Multiple Sclerosis ,[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College
Stem Cells in Multiple Sclerosis ,[object Object],[object Object],[object Object],Clin 213-50 Humber College
Stem Cells in Multiple Sclerosis ,[object Object],[object Object],[object Object],Clin 213-50 Humber College
Stem Cells in Multiple Sclerosis ,[object Object],[object Object],Clin 213-50 Humber College
Stem Cells in Multiple Sclerosis ,[object Object],Clin 213-50 Humber College
Stem Cells in Multiple Sclerosis ,[object Object],[object Object],Clin 213-50 Humber College
Stem Cells in Multiple Sclerosis ,[object Object],Clin 213-50 Humber College
Vitamin D – the basics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Sources of Vitamin D ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Vitamin D and Multiple sclerosis ,[object Object],[object Object]
1. High prevalence of vitamin D deficiency and reduced bone mass in multiple sclerosis J. Nieves, F. Cosman, J. Herbert, V. Shen and R. Lindsay ,[object Object],[object Object],[object Object]
Neives et. Al cont’d ,[object Object]
Neives et. Al cont’d (Results) ,[object Object]
 
Neives et al. cont’d ,[object Object]
Cytokine Profile in Patients with Multiple Sclerosis Following Vitamin D Supplementation. B.D. Mahon, S. A. Gordon, J. Cruz, F. Cosman, and M.T. Cantorna ,[object Object]
Cytokine Profile in Patients with Multiple Sclerosis Following Vitamin D Supplementation. B.D. Mahon, S. A. Gordon, J. Cruz, F. Cosman, and M.T. Cantorna ,[object Object],[object Object]
Cytokine Profile in Patients with Multiple Sclerosis Following Vitamin D Supplementation. B.D. Mahon, S. A. Gordon, J. Cruz, F. Cosman, and M.T. Cantorna ,[object Object],[object Object],[object Object]
Cytokine Profile in Patients with Multiple Sclerosis Following Vitamin D Supplementation. B.D. Mahon, S. A. Gordon, J. Cruz, F. Cosman, and M.T. Cantorna ,[object Object]
Cytokine Profile in Patients with Multiple Sclerosis Following Vitamin D Supplementation. B.D. Mahon, S. A. Gordon, J. Cruz, F. Cosman, and M.T. Cantorna
Conclusion (vitamin D) ,[object Object],[object Object],[object Object]
Issues with Trial Design: ,[object Object],[object Object]
Issues with Trial Design Cont’d: ,[object Object],[object Object]
Issues with Trial Design Cont’d: ,[object Object],[object Object],[object Object],[object Object]
Ethical Considerations: ,[object Object],[object Object],[object Object],[object Object]
Guidelines 2001: ,[object Object],[object Object],[object Object]
Six terms for Placebo-Controlled Trials ,[object Object],[object Object],[object Object]
Six terms for Placebo-Controlled Trials Cont’d ,[object Object],[object Object],[object Object]
Informed Consent ,[object Object],[object Object]
Conclusion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Reference ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Clin 213-50 Humber College

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Multiple Sclerosis

  • 1. Multiple Sclerosis Group Presentation Clin 213-50 Humber College Clin 213-50 Humber College Downloaded from www.jama.com
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  • 7. World Distribution of MS Clin 213-50 Humber College
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  • 21. How Does it work? Clin 213-50 Humber College
  • 22. Demyelination of Nerve Fibers in MS Clin 213-50 Humber College The destruction of the myelin sheath leads to impaired communication between nerve cells and neurological symptoms such as abnormal sensations, vision problems , and weakness
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  • 24. How Autoimmune response cause MS Clin 213-50 Humber College
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  • 28. Clinical Tools for MS Diagnosis McDonald Criteria Clin 213-50 Humber College
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  • 85. Cytokine Profile in Patients with Multiple Sclerosis Following Vitamin D Supplementation. B.D. Mahon, S. A. Gordon, J. Cruz, F. Cosman, and M.T. Cantorna
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