 We used to be KRUPPs fatigue severity scale. The survey has nine questions as following: 1 my motivation is lower, when I am fatigued 2 exercise brings on my fatigue 3 I am easily fatigued 4 fatigue interferes with my physical functioning 5 fatigue causes frequent problems for me 6 my fatigue prevents sustained physical functioning 7 fatigue interferes with carrying out certain duties and responsibilities 8 fatigue is among my 3 most disabling symptoms 9 fatigue interferes with my work, family, or social life. All subjects scored each question on a 7-point scale 1 strongly disagree to 4 neither disagree nor agree to 7 strongly agree. All fatigue severity scale calculated and collected by one research nurse C.W.K in the Department of Internal Medicine. 