Contents lists available at ScienceDirect Multiple Sclerosis and Related Disorders journal homepage: www.elsevier.com/locate/msard Demographic and clinical profile of Multiple Sclerosis in Kashmir: A short report Insha Zahoor a, ⁎ , Ravouf Asimi b,1 , Ehtishamul Haq a,1 , Irfan Yousuf Wani b a Department of Biotechnology, University of Kashmir, Srinagar J & K 190006, India b Department of Neurology, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar J & K 190011, India ARTICLE INFO Keywords: Multiple sclerosis Profile India Kashmir Clinical Demographic ABSTRACT Background: Multiple sclerosis (MS) is a chronic autoimmune and inflammatory disease of the central nervous system (CNS). There have been only few population/hospital based studies on MS in India, and at the same time there is no data on its profile in Kashmir. Methods: A total of 41 MS patients diagnosed on the basis of 2010 Revised Mc Donald criteria were enrolled in this study from Kashmir region of India. Clinical, demographic, radiological and biochemical parameters were analyzed for most of the patients. Results: Male to female ratio was found to be 1:3.1 with mean age at the time of analysis 32.26 ± 7.54 (range 18–48) years. The mean disease duration was found to be 3.2 ± 3.6 years. The most common course was relapsing-remitting (RR) present in 87.80% of cases followed by secondary progressive (SP) in 9.76% and primary progressive (PP) in 2.44%. Numbness, weakness of limbs, prickling and tingling sensations, muscle stiffness, and visual disturbances were most common manifestations. Condition of bilateral internuclear ophthalmoplegia (INO) and vertigo was rarely observed. Oligoclonal bands (OCB) were present in cerebrospinal fluid (CSF) of majority of the patients. Symptomatic and steroidal treatment mode was given to majority of the patients (92.68%) and only 7.32% patients were given disease modifying drug. Conclusion: This is the first preliminary report on MS profile in Kashmir. The high prevalence of female patients and RR course of MS, low prevalence of progressive cases, predominance of OCB positive cases, insignificant family history in all cases, predominance of cases with low socio-economic status, and high rate of less educated and unemployed cases are the most important findings. By and large MS pattern in Kashmir was found to be relatively similar to West and rest of the Asia. Larger comprehensive studies are mandatory to completely understand MS pattern in Kashmir. There is utmost requirement to maintain a local MS registry in Kashmir so as to get an idea about the actual number of persons suffering from the disease and compare the data with other regions of India. 1. Introduction Multiple sclerosis (MS) is a chronic autoimmune, inflammatory, and demyelinating disease of the central nervous system (CNS) mediated by an inappropriate immune response within the body against the insulating myelin sheath. Its prevalence shows variance across the globe, however, it is well known that MS is highly prevalent in European populations (Compston and Coles, 2008). Despite few studies on MS in some parts of India (Bhatia et al., 1996; Pandit et al., 1993; Singhal and Wadia, 1975), there has been no report on its profile and prevalence from Kashmir region. Kashmir valley represents the northern most region of India, located in its North Western Himalayan belt. It is one of the divisions of Jammu & Kashmir State, having distinct temperate climate and comes under low-risk zone for MS http://dx.doi.org/10.1016/j.msard.2017.02.018 Received 16 December 2016; Received in revised form 1 February 2017; Accepted 23 February 2017 ⁎ Correspondence to: Women Scientist DST-WOS 'A' Project, Department of Biotechnology, Ground Floor, Science Block, University of Kashmir, Hazratbal, Srinagar J & K 190006, India. 1 Both authors contributed equally. E-mail addresses: inshazahoor11@gmail.com (I. Zahoor), ravoufasimi@yahoo.co.in (R. Asimi), haq@kashmiruniversity.ac.in (E. Haq), drirfanyousuf@gmail.com (I. Yousuf Wani). Abbreviations: CNS, central nervous system; CSF, cerebrospinal fluid; EDSS, expanded disability status scale; IEC, Institutional Ethics Committee; INO, internuclear opthalmoplegia; IPD, In Patient Department; MRI, magnetic resonance imaging; MS, multiple sclerosis; MSIF, Multiple Sclerosis International Federation; NMOSD, neuromyelitis optica spectrum disorder; OCB, oligoclonal bands; OPD, Out Patient Department; PP, primary progressive; RR, relapsing-remitting; SD, standard deviation; SKIMS, Sher-I-Kashmir Institute of Medical Sciences; SP, secondary progressive; WHO, World Health Organization Multiple Sclerosis and Related Disorders 13 (2017) 103–106 2211-0348/ © 2017 Elsevier B.V. All rights reserved. MARK