Efficacy and safety of pregabalin for chronic neuropathic pain: A meta-analysis

@#To assess the efficacy and safety of pregabalin during short-term treatment in adults with neuropathic pain. We searched the PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and Clinical Trials databases. Twelve eligible articles were finally selected. Efficacy outcomes included change in Daily Pain Rating Scale score (DPRS; 0 = ‘no pain’ to 10 = ‘worst possible pain’) and sleep interference score (0 = ‘pain does not interfere with sleep’ to 10 = ‘completely interferes’). Safety was based on adverse events, serious adverse events (SAEs) and the incidence of treatment emergent adverse events (TEAEs) .The authors used the Cochrane Collaboration’s Risk of Bias Tool to assess the risk of bias in included trials. Review Manager 5.3 was used for all statistical analyses. Data from 12 articles including 3,169 patients (pregabalin, n = 1,677; placebo, n =1,492) were analyzed. Mean changes in the daily pain rating scale score [MD=-0.65, 95%CI(-0.88,-0.41), P<0.001] and daily sleep interference score in patients that received pregabalin were compared to those that received placebo [MD=-0.81, 95%CI(-1.16,-0.46), P<0.001]. The incidence of any TEAE was significantly increased in patients that received pregabalin [OR=1.70, 95%CI (1.44,2.01), P<0.001]. Serious adverse events (SAEs) rate in the pregabalin group was higher than the placebo group [OR=2.09, 95%CI (1.49,2.93), P<0.001], while there was no significant difference in the incidence rate of discontinuation [OR=1.29, 95%CI (0.79,2.11), P = 0.31]. Comparative results revealed pregabalin (150-600 mg/day) significantly reduced the symptoms of neuropathic pain in adults and its safety was acceptable

The efficacy and safety of Chai Hu Shu Gan San as an adjuvant drug for selective serotonin reuptake inhibitors in the treatment of post-stroke depression: A meta-analysis

@#Post-stroke depression often seriously affects the prognosis and quality of life of patients and many clinical trials had shown that Chai Hu Shu Gan San (柴胡疏肝散) combined with selective serotonin reuptake inhibitors (SSRIs) had good efficacy and minor side effects. We aimed to conduct this metaanalysis to evaluate the efficacy and safety of Chai Hu Shu Gan San as an adjuvant drug for SSRI in treating post-stroke depression. We searched PubMed, EMBASE, Cochrane Library, Wanfang, China Biology Medicine disc (CBM), Chongqing VIP, and CNKI (China National Knowledge Infrastructure) from their date of foundation to December 15, 2018. Literature screening, data extraction and quality assessment were conducted by two authors independently. The data synthesis and analysis were performed by using Review Manager (RevMan) 5.3 software and sensitivity analysis was conducted to assess the robustness of the results. Finally, a total of 22 articles were included. The meta-analysis confirmed the advantages of the combination of SSRI and Chai Hu Shu Gan San, mainly from four aspects: the Hamilton Depression (HAMD) scale score (MD=3.66; 95% DI=2.33-4.98; p<0.001), the Modified Edinburgh Scandinavian Stroke Scale (MESSS) score (MD=4.87; 95% CI=2.32-7.43; p<0.001), the efficacy rate (OR=3.50; 95% CI =2.61-4.69; p<0.001) and the incidence of adverse reactions (OR=0.28; 95% CI=0.17-0.46; p<0.001). No significant publication bias was observed, and sensitivity analysis suggested a good stability of the results. According to the present evidence, we concluded that Chai Hu Shu Gan Sa

Toxoplasmosis presenting with multiple cranial nerve palsies and cavernous sinusitis: A case report

@#Toxoplasmosis is a worldwide zoonosis caused by an intracellular protozoan parasite, Toxoplasma gondii. We report here a diabetic patient who was diagnosed as toxoplasmosis with multiple cranial nerve palsies and cavernous sinusitis. A 37-year-old male presented with an 11-day history of gingival pain, one day history of ptosis and diplopia. He has been having diabetes mellitus for 6 years, and has a history of contact with cats. After admission, his symptoms worsened with right 3rd to 7th cranial nerve palsies. The brain magnetic resonance imaging (MRI) showed cavernous sinusitis in the right sellar region. Serology for toxoplasma was positive for IgM and negative IgG. The patient was treated with oral clindamycin (900 mg/day) and dexamethasone (15 mg/day). The right visual acuity and lid-conjunctival swelling improved after 3 days. At follow-up after a month, the movement of the right eye significantly improved. This case demonstrate the rare occurrence of multiple cranial nerve (3rd to 7th) palsies from toxoplasmosis cavernous sinusitis, which is a potentially treatable condition.