Dietary Intake of Thiamine in Migraine Patients and Healthy Subjects: a Case-Control Study

The migraine headache is a disease related to the neurovascular system, which affects 10%–20% of people, worldwide. Recent evidences suggested a relation between thiamine status and migraine headaches. The current study was undertaken to assess dietary intake of the thiamine in migraine patients and to evaluate its association with the frequency of migraine attacks. In a case-control design, the current study was performed on 50 migraine patients and 50 healthy people, 20–60 years old in Isfahan, Iran, in 2017. Information about dietary intake was collected by Food frequency questionnaire and analyzed using the Nutritionist version 4 (N4) software (Tinuviel Software). Information about the history of disease was collected by demographic questionnaire. Analysis of covariance and independent t-test were used for data analysis and p value less than 0.05 was considered significant. Mean age, weight, height, and body mass index of participants were 35.1 ± 9.8 years, 65.3 ± 10.4 kg, 162.5 ± 8.4 cm, and 24.7 ± 4.0 kg/m², respectively. Dietary intake of thiamine among the migraine patients was lower than that in the healthy participants (p < 0.001). Migraine patients with the high frequency attacks had significantly lower intake of thiamine compared with moderate frequency attacks group (p = 0.010), however, it was not significant after adjusting for energy intake (p = 0.410, p = 0.240). Dietary intake of thiamine in migraine patients was not significantly different in comparing with healthy subjects. In addition, no significant correlation between thiamine intake and the frequency of migraine attacks was observed.

comparative assessment the efficacy of intravenous infusion of sodium valproate and phenytoin in the treatment of status epilepticus

Status epilepticus [SE] is a type of persistent lasting seizure with high mortality and morbidity. Numerous medications are suggested for the treatment of SE, two of which are sodium valproate and phenytoin. The purpose of this study is to conduct a comparison between the efficiencies of intravenous sodium valproate and phenytoin in the treatment of this type of epilepsy. This is a clinical trial study conducted on SE-suffering patients admitted to the emergency departments of Al-Zahra and Ayatollah Kashani Medical Centers of Isfahan in 2009 and 2010. The patients were randomly assigned into two groups and taken under treatment, separately by intravenous infusion sodium valproate and phenytoin. No significant difference was observed between the two groups [at P = 0.06]. In terms of incidence of the clinical complications, the incidence of clinical complications in the two groups was significantly different [at P = 0.03]. Based on the findings the efficiency of sodium valproate is larger than that of the phenytoin, and thus, the treatment by sodium valproate is preferred over the treatment by phenytoin

Quality of sleep in patients with Parkinson's disease

Parkinson's disease [PD] is a progressive neurodegenerative disorder causing motor and non-motor symptoms. The latter are common and include autonomic dysfunction, cognitive impairment, and sleep difficulties. Many of the non-motor aspects of PD such as sleep disturbance are more common and significantly affect the day-to-day activities of patients and their quality of life. The most important aim of this study was to evaluate the sleep quality in patients with PD. This case-control study was performed on patients with PD referred to the Neurology Clinic of our teaching hospital in 2011. Thirty-four patients with PD and 34 healthy people as control group were enrolled in this study. Sleep quality of patients and control was evaluated by Parkinson's disease sleep scale [PDSS] questionnaire. PDSS is a reliable and valid tool to measure sleep disorders in PD. The mean total PDSS score in patient group was 55.29 [SD = 26.92] indicating moderate to severe sleep disturbances whereas, the mean total score in control group was 20.34 [SD = 10.65]. Difference between the two groups' mean scores was significant [P < 0.05]. Our study demonstrated that patients with PD experienced poorer nocturnal sleep quality than the control group

Preliminary evaluations related to the ranges of hematological and biochemical variables in hospitalized patients with stroke

According to the international reports, brain stroke is the main reason of death and disability. In ischemic stroke, early and precise classification of patients who may profit from conflicting finest therapeutic interference is necessary if enhanced effects in terms of survival are to be talented. Due to uncomplicated, easy performance, and inexpensive method the aim of this preliminary study was to investigate changes related to biochemical and hematological variables in patients with stroke. A cross-sectional study located at the neurology ward of the Ayatolah Kashani and Alzahra Hospitals' [conducted to Isfahan Neurosciences Research Center] was carried out on fifty patients [females; n = 20 and males; n = 30] between April 1, 2012 and September 31, 2012. The data from subjects' records were taken for analyzing variables. The statistical analysis of d-base was performed using [SPSS] for windows. Analysis of available data showed that with a mean of 182.4 mg/dl, blood sugar [BS] ranged from 75 to 300 mg/dl [n = 15/50]. The changes in hemoglobin [Hgb] [mean 4.6 g/dl, n = 27/50], platelet [mean 210, 653/mm[3], n = 26/50] and lymphocyte [Lymph] [mean 37, n = 26/50] seems to be significant. The mean age of females was 76 years [ranged 46-93 years]. The mean age of males was 70 years [ranged 31-90 years]. Information related to previous drug history was available only in 24 patients. In 5 out of 22 cases ischemic heart disease [IHD] were positive. In 8 out of 29 cases, diabetes mellitus was positive. In 5 out of 28 cases, hypertension [HTN] was positive. In the four patients both IHD and HTN were positive. Any considerable alter in patients' biochemical and hematological figures [BS, Hgb, Plt and Lymph] may necessitate further attention related to inter- and intra-individual variability in clinical supervision and drug's assortment. Therefore, success in treatment could be achieved by the close management of clinical, biochemical, hematological, and pharmacological manifestation. To reduce disability, mortality, and morbidity in Iranian stroke population further clinical studies are needed to correlate drugs and laboratory markers to associated clinical events in order

Pizotifen in migraine prevention: A comparison with sodium valproate

Background & Objective: Pizotifen is an alternative option for prophylactic treatment of migraine headache. This study aims to compare the effi cacy and safety of pizotifen with sodium valproate; one of the most-widely used drugs in migraine prevention. Methods: This was a single blind, randomized, parallel-group study. After a 4-week baseline evaluation, patients with episodic migraine were randomly assigned to get either sodium valproate or pizotifen for a period of 12 weeks. Patients were asked to fi ll a headache diary through the study. Headache characteristics and the possible side effects were evaluated throughout and at the end of trial. Results: Forty two patients aged 20 to 49 were recruited to the study. With both drugs, the frequency, intensity and duration of headaches were signifi cantly reduced (p < 0.05). Except for headache duration, pizotifen was signifi cantly superior to sodium valproate in the headache parameters assessed. Total reported side effects were initially higher in patients who received pizotifen (37 vs. 22; P= 0.038); however, persistent side effects were lower for pizotifen (6 vs. 10; P= 0.22). Conclusions: The results of this study suggest that pizotifen is a safe and effective drug in migraine prevention.

Comparison of botulinum toxin type-A and divalproex sodium for prevention of chronic and episodic migraine

Background & Objective: There is a need for a more effective and better tolerated prophylactic treatment of migraine. This study aims to compare the effi cacy of botulinum toxin type-A (Dysport) and divalproex sodium (divalproex) as prophylactic treatment in patients with episodic or chronic migraine. Methods: This was a randomized, cross-over, single-center clinical trial. Participants were randomly divided into two treatment groups. Two phases of intervention were arranged (each for three months). In the fi rst phase, patients received either Dysport (125 units) or divalproex (200 mg bid for three months). The patients were left for a three months washout period, and then the treatment agents were swapped in the second stage. The response to each treatment was assessed at the end of each phase. Results: With divalproex, the frequency, intensity and duration of headache, as well as analgesic consumption were signifi cantly reduced (p<0.05) in both episodic and chronic patients. However, Dysport demonstrated signifi cant effi cacy only in patients with episodic migraine. In chronic migraine, Dysport only showed a non signifi cant trend to benefi t in these parameters, with exception of headache intensity,where it resulted in signifi cant improvement from baseline. Divalproex was signifi cantly superior to Dysport, in terms of headache frequency and intensity in patients with episodic migraine. Conclusions: Both Dysport and divalproex are effective prophylactic therapies for patients with episodic migraine. Divalproex but not Dysport was signifi cantly effective for chronic migraine.

Isaac's syndrome associated with CIDP and pregnancy

Neuromyotonia with all its synonyms is a disorder of peripheral nerve hyperexcitability characterized by regular or irregular myokymia, muscle cramps and stiffness, delayed muscle relaxation after contraction, and hyperhidrosis associated with well-described spontaneous electromyographic features. Herein, we report clinical and electrodiagnostic findings of a pregnant woman with neuromyotonia who also suffered from chronic inflammatory demyelinating polyneuropathy. We treated the patient with plasma exchange, 50 mL/kg [twice weekly, for six weeks]. After two weeks of treatment, cramps and stiffness were substantially reduced. After four weeks, she looked normal with a relatively smooth gait. After eight weeks, the patient was entirely well with no cramps or stiffness. Repeat EMG showed no myokymic discharges. After four months she was in good health and the plasma exchanges and only visited the patient regularly. One year later, we repeated a five-day course of plasma exchange to overcome mild recurrence of myokymia in her thighs. Now, after four years, she is healthy without any disability or problem. The patient's child has been healthy throughout without any evidence of neuromyotonia

Headache in multiple sclerosis

Multiple Sclerosis [MS] is a common neurological disease in young adults with variable clinical symptoms and signs. Many of MS patients experience headache. This study was done to evaluate the prevalence of headache in MS patients. This descriptive cross-sectional study was carried out in MS clinics affiliated to Isfahan university of Medical Sciences in the first six months of 1380. For each patient a questionnaire was filled according to history and examination, and the data was analyzed by SPSS program. From 100 patients, 67% had headache and 86.6% of them were women.Tension headache in 47.7% and migraine headache in 34.3% was reported of 100 patients, 23 of them had migraine headache, 36 patients had history of headache before the onset of MS, whom in 52.8% severity of headache was increased. of patients 10.4% had headache at the onset of MS and in 6.8% headache was the first symptom of MS. The neurological signs and symptoms were presented after headache. According to this study different types of headaches are common in MS and the migraine type is more common than in general population

Evaluation of the effect of donepezil on cerebral blood flow velocity in Alzheimer's disease

To evaluate the effect of Donepezil on cerebral blood flow velocity using non-invasive transcranial Doppler [TCD] sonography. This clinical trial was carried out in the Department of Neurology, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran from March 2008 to July 2009, on Alzheimer's disease [AD] patients in 2 groups of case and control, each consisting of 11 patients. The case group who received Donepezil medication was examined by TCD before [baseline], after 4 weeks of oral treatment with 5mg per day Donepezil, and a further 4 weeks of 10mg per day Donepezil, orally. The control group comprised AD patients who did not receive any medications, and were examined by TCD only once. Peak systolic [PSV], end-diastolic [EDV], and mean flow [MFV] velocities of the posterior cerebral artery [PCA] and the middle cerebral artery [MCA] was assessed by TCD. Also, mini-mental state examination [MMSE] was carried out. There were no significant differences between the case and control groups, in terms of age and gender. In the case group, the mean MMSE score reached 20.2 +/- 2.8 from a baseline value of 15.8 +/- 3.3 after 4 weeks of oral treatment with 5mg/d Donepezil, and reached 20.6 +/- 3.9 after 4 more weeks at 10mg/d Donepezil. In the MCA, the difference in PSV and MFV values after 4 weeks of treatment with 10mg/d Donepezil was statistically significant compared with the baseline values. In PCA, the values of MFV and EDV after 4 weeks of treatment with 10mg/d Donepezil were statistically significant in comparison with the baseline value. Donepezil [10mg/d] increased cerebral blood flow velocity and MMSE score in our AD patients, but more extensive trials are recommended

Orthostatic hypotension in Iranian patients with Parkinson's disease

To prospectively investigate the prevalence and clinical relevance of orthostatic hypotension [OH] in Parkinson"s disease [PD] in Isfahan, Iran. We investigated 150 consecutive patients with PD [42 women, 108 men] in Al-Zahra Hospital, Isfahan, Iran from January 2002 to January 2004. Blood pressure was measured first in a supine position following a rest of at least 10 minutes, and then after 3 minutes of active standing. Data concerning the age, gender, duration of disease, and drug consumption were recorded in a questionnaire. Orthostatic hypotension in PD is more frequent in women, patients taking a higher dose of levodopa, in higher age groups, and patients with longer duration of the disease, however, a statistically significant difference was seen in the female group and patients taking a higher dose of levodopa. Orthostatic hypotension is mainly related to PD pathology and the clinical relevance of OH to gender, age, and disease duration may be due to the natural course for progression of human autonomic dysfunction during life. Higher doses of levodopa may increase the risk of OH

Peripheral neuropathy in type 2 diabetes mellitus in Isfahan, Iran: prevalence and risk factors

To estimate the prevalence and risk factors of peripheral neuropathy [PN] in people with type 2 diabetes mellitus. 810 patients with type 2 diabetes [289 male and 521 female] from Isfahan Endocrinology and Metabolism Research Centre outpatient clinics, Iran, were examined. Part of the examination included an assessment of neurological function including neuropathic symptoms and physical signs, and nerve conduction velocity. The prevalence of PN was 75.1% [95% confidence interval [CI] 72.1, 78.0]. Peripheral neuropathy was associated with age, proteinuria, and duration of diabetes, insulin-treatment, and presence of retinopathy and ischaemic heart disease [IHD]. The age-adjusted prevalence rate of PN was 78% higher among patients with IHD, 64% higher among patients with any retinopathy, 66% higher among insulin-treated type 2 diabetes, and greater with duration of diabetes. Using a stepwise binary logistic regression model, age, duration of diabetes and proteinuria were significant independent predictors of PN. PN is a common complication in this population of Iranian type 2 diabetic patients. It increases with age, duration of diabetes and proteinuria