Relationship between serum level of vitamin-D3 and Expanded Disability Status Scale (EDSS) changes before and 8 weeks after methylprednisolone pulse therapy in multiple sclerosis (MS) patients

INTERVENTION: Amp vitamin‐D3 ,chemical formulation active vitamin‐D3 (calciteriol) , 300000 IU / day and single dose, intramuscular, made in Osva Pharmaceutical company in Islamic Republic Of Iran, not having generic name. In 20 patients with low levels of vitamin D 3 whom are selected based on random numbers table , on the last day of 5 days pulse therapy , vitamin D 3 ampule will be injected. They will be examined based on EDSS changes 8 weeks after pulse therapy. In 20 patients with low levels of vitamin D 3 whom are selected based on random numbers table , on the last day of 5 days pulse therapy , vitamin D 3 ampule will not be injected. They will be examined based on EDSS changes 8 weeks after pulse therapy. In 20 patients with sufficient levels of vitamin D 3, therapy will not be given. They will be examined based on EDSS changes 8 weeks after pulse therapy. Intervention 1: Amp vitamin‐D3 ,chemical formulation active vitamin‐D3 (calciteriol) , 300000 IU / day and single dose, intramuscular, made in Osva Pharmaceutical company in Islamic Republic Of Iran, not having generic name. Intervention 2: In 20 patients with low levels of vitamin D 3 whom are selected based on random numbers table , on the last day of 5 days pulse therapy , vitamin D 3 ampule will not be injected. They will be examined based on EDSS changes 8 weeks after pulse therapy. Intervention 3: In 20 patients with sufficient levels of vitamin D 3, therapy will not be given. They will be examined based on EDSS changes 8 weeks after pulse therapy. Intervention 4: In 20 patients with low levels of vitamin D 3 whom are selected based on random numbers table , on the last day of 5 days pulse therapy , vitamin D 3 ampule will be injected. They will be examined based on EDSS changes 8 weeks after pulse therapy. Treatment ‐ Drugs CONDITION: Disseminated Multiple Sclerosis Multiple Sclerosis. ; Disseminated Multiple Sclerosis PRIMARY OUTCOME: The rate of recovery after attack. Timepoint: Before intervention and two months after intervention. Method of measurement: Physical examination done by neurologist and using Expanded Disability Status Scale (EDSS). SECONDARY OUTCOME: Expanded Disability Status Scale (EDSS). Timepoint: Before intervention and two months after intervention. Method of measurement: Physical examination done by neurologist based on revised Mc‐Donald (2010). Serum level of 25‐hydroxy vitamin‐D3. Timepoint: Before intervention and two months after intervention. Method of measurement: Blood test. INCLUSION CRITERIA: INCLUSION CRITERIA: 1‐ Patients with multiple sclerosis based on McDonalds Criteria. 2‐ Patients type relapsing‐remitting (RRMS). 3‐EDSS less than 5 before attack. 4‐Less than 5 years after MS diagnosis. 5‐Less than 5 attacks in the duration of MS diagnosis. Exclusion criteria: 1‐ Association with any diseases such as liver diseases, renal diseases, bone marrow disfunction, sarcoidosis, renal stone,hypercalcemia. 2‐pregnancy or breast feeding. 3‐Using drugs such as hydrochlorothiazide, phenytoin, barbiturate, digital.