[Effects of topiramate in the prevention of drug resistant migraine headache]

Migraine is the most common cause of headache. The aim of the present study was to evaluate the effects of topiramate [TPM] in the prevention of drug-resistant migraine headache. This is a double-blind clinical trial conducted on 70 patients between ages 15 to 45 years referred to the Bu Ali Sina Hospital in Sari with a history of migraine attacks based on International Headache Society criteria for a period of more than one years with a minimum incidence of 1 to 6 attacks per month. The drug rate performance was assessed by response rate to treatment, mean changes in the number and severity of migraine attacks compare with the placebo group for 3 months. Collected data were analyzed using analysis of variance [ANOVA], Newman-Keuls and Spearman's Coefficient Rank Correlation as the post hoc tests. GRAPHPAD software was used for analysis of the data. 66 of 70 patients completed the study. The mean age of the patients was 30.33 +/- 7.9 years. A significant reduction in the severity and frequency of migraine attacks was seen in all months [P<0.0001] for topiramate treated group in compare to placebo group. Responder rate for patients treated with TPM was significantly higher than placebo group [64.6%, P<0.0001] in the 3 rd month of the treatment side effects of treatment were transient and well tolerated. Low dose of TPM showed significant efficacy in prevention of migraine attacks within the first, second, and third month of treatment. Low dose of TPM seems to be a good therapeutic option for the patients with refractory migraine

Quality of life among multiple Sclerosis patients

MS is one of the progressive and chronic demyelinative disorders involving active members of society. The study of quality of life in these patients could decrease relieve some disabilities and promotes residual abilities to maximal levels. Regarding relatively high prevalence of MS in Mazandaran province, this study was designed to measure the quality of life in Multiple sclerosis patients living in Mazandaran Province. In this discriptive study, the community of research included members of Mazandaran Multiple Sclerosis Association [MMSA]. The census sampling method was used. The volunteers [101 patients] were assessed from october 2005 to March 2006. Assessment tool for data collection was standard questionnaire SF-36. This questionnaire consists of 36 questions and its validity has already been determined in many countries including Iran and it has high reliability [alpha chronbach 0.77-0.90]. Clinical manifestations and the severity of the disease were evaluated with history and physical examination taken by Neurologist and using EDSS criteria. The results showed that 76% of the patients were females and 26% were males. The age range was 18-60 years [mean age 33.27 +/- 8.31]. The emergence of disease was at age 12-54 years [mean age 27.12 +/- 8.03]. About%7 of the patients had positive family history of multiple sclerosis. The mean score [based on 100] of general health, physical health, mental health, vivacity, social health, and physical pain were, respectively, 41.34 +/- 10.22, 54.75 +/- 30.25, 53.25 +/- 22.03, 54.75 +/- 24.44, 56.62 +/- 20.96, and 35.75 +/- 31.68.. In this study, the quality of life was relatively good in all aspects. This may be due to mildness of disease in majority of the patients, low age at time of disease emergence and shorter duration of disease