ABSTRACT
Background: statins, widely used cholesterol-lowering agents, have also been demonstrated to have anti-inflammatory and immunomdulatory effects
Objective: to evaluate the effects of atorvastatin in combination with Interferon-[beta] in the treatment of multiple sclerosis [MS] in a randomized controlled clinical trial
Methods: multiple sclerosis patients were randomized independently, in a double blind design, into one of two treatment groups. Control group [n=45] received 30 [micro]g/week interferon [beta]-1a via intra-muscular injection. Atorvastatin-treated group [n=50] received interferon [beta]-1a similar to control group in addition to atorvastatin [40 mg/day] for 18-months. All clinical and immunological variables were measured at the baseline and at the end of the study
Results: there was no significant difference between the two groups in the expanded disability status scale scores and the number of gadolinium-enhancing lesions during the 18-month treatment period. After 18 months, the levels of interleukin [IL]-4, IL-10, transforming growth factor-[beta] and serum ferric reducing antioxidant power in the atorvastatin treatment group were significantly higher than the control group. Levels of IL-17, TNF-[alpha] and lymphocyte proliferation in the atorvastatin treatment group were significantly lower than the control group
Conclusion: although combined atorvastatin and interferon-[beta] do not change the clinical course of MS, atorvastatin might have beneficial effects in MS treatment possibly through inducing anti-inflammatory responses
ABSTRACT
Background and Objectives: Diarrhea is one of the most common complications of antibiotic usage. And clostridium difficile is the most common cause of Antibiotic-Associated Diarrhea [AAD]. This study was aimed to investigate the infection with Clostridium Difficile Toxin [CDT] and Clostridium Difficile-Associated Diarrhea [CDAD] among hospitalized patients
Materials and Methods: This cross-sectional descriptive study was conducted on 195 patients admitted to different wards of Valiasr Hospital in Arak, Iran in the summer of 2013, by simple random sampling and considering inclusion and exclusion criteria. Demographic and clinical information of the patients was recorded using questionnaires
Results: Among 195 patients, the prevalence positive toxin and CDAD were calculated as 14.4% and 4.1%, respectively. Incidence of CDAD had a significant relationship with antibiotic consumption history [p<0.05]. Though the prevalence of positive toxin cases was more in female patients [p=0.001] and having significant relationship with diarrhea [p=0.036], no other significant relationship was found between the age, the type of hospital wards, the reason for hospitalization and antibiotic use with the results of CDT test
Conclusion: The CDT infection and CDAD were highly frequent in the hospital under our study. Therefore, it is suggested to implement care programs to decrease prevalence of the toxin of this organism in the patients admitted to hospitals and the related CDAD
ABSTRACT
Background & Objective: Stroke is one of the common leading causes of morbidity and mortality worldwide. Diabetes is one of the modifi able risk factors of stroke which is related to a higher mortality and a poorer outcome. We aimed to evaluate the protective effect of Insulin versus glibenclamide on the improvement of neurological and functional outcomes of hemorrhagic stroke. Methods: The present single blind clinical trial was conducted on 100 patients with stroke and diabetes who had referred to Neurology Emergency Department of Vali-e-Asr hospital, Arak, Iran. The patients were categorized into two groups according to the glucose control treatment before stroke. Without any randomization, glibenclamide was used in 45 patients, while others (55 ones) received insulin. National Institute of Health Stroke Scale (NIHSS) and modifi ed Rankin scale (MRS) systems were used for evaluating the neurological and functional outcomes. Results: Hemiparesis was the most common sign of the patients. The mean of changes in NIHSS and MRS scores of the two groups were -29.69±21.4 and -17.24±21, respectively. Although Insulin group had a higher decrease in NIHSS and MRS scores, no signifi cant difference was found between the two groups. Both treatment methods had a signifi cant decreasing effect on NIHSS and MRS scores (p<0.001). Conclusion: Patients treated with both glibenclamide and insulin had similar decrease in their one week NIHSS and MRS scores with no signifi cant difference in the two treatment groups.
ABSTRACT
Migraine is classified into two groups of vascular and chronic headaches. Also, iron anemia is the most common type of anemia among women who are in the productive age in the world. This study was done to investigate the relationship between the vascular headaches and the iron deficiency anemia and to see the effect of iron deficiency tablets administration on the treatment of these headaches in women who are in the productive age. In this quasi-control clinical trial study, 50 women in the productive age - who had iron deficiency anemia and vascular headaches and were referred to the neurological clinic of Vali-e-Asr hospital, Arak, Iran were included. The patients were treated with ferrous sulfate tablets for three months. For verifying the treatment, the patients' hemoglobin was monitored after one month, and in case of any significant increase in this value, the patients were excluded from the study. The number of headache attacks and the number of analgesic used before, through, and three month after the beginning of the administration of ferrous sulfate were noted for all the patients. The mean number of the headaches attacks one month before the treatment, during the treatment and three months after the treatment were 19.6 +/- 28, 14.2 +/- 11.2, and 13.3 +/- 16.1, respectively [p < 0.0001]. In addition, the mean number of used analgesics before the treatment, during the treatment, and three months after the treatment were 30.1 +/- 14.1, 14.3 +/- 11.2, and 13.1 +/- 16.1, respectively [p < 0.0001]. It seems that using iron tablets can be useful in treatment of vascular headaches. Moreover, it has a beneficial effect on patients suffering from iron deficiency anemia with headaches