Intravenous dexamethasone versus morphine in relieving of acute migraine headache.

Inflammation is thought to play a significant role in the underlying pathophysiology of migraine headaches which could be controlled by corticosteroids. The present study was conducted to determine and compare the pain relieving effect of dexamethasone versus morphine on patients with acute migraine headache. During this double blinded clinical trial study, 190 patients who met the International Headache Society definition of acute migraine headache were evaluated at emergency department of Tabriz Imam Reza Hospital. After giving informed consent, patients were randomly enrolled into two groups: Receiving either 8 mg dexamethasone (group A) or 0.1 mg kg(-1) morphine (group B) intravenously. Severity of the headache was determined using Visual Analog Scale (VAS) scoring method at baseline (VAS-A), 10 min (VAS-B), 60 min (VAS-C) and 24 h (VAS-D) after intervention. The mean age of patients was 44.17 +/- 16.20 years, 61.57% male and 38.43% female. The mean of VAS-A and VAS-B scores was not statistically different between two groups (p = 0.236 and p = 0.481), but the mean of VAS-C and VAS-D scores in the group A were significantly lower than the group B (p = 0.017, p = 0.010). In long-term (1 h and 24 h after administration), dexamethasone reduces the severity of acute migrant headache more than morphine.

Clinical, electrodiagnostic and pedobarographic assessments of leprotic patients with trans-tibial amputation.

The aim of present study was to investigate clinical, electrodiagnostic and pedobarographic findings of non-amputee limb in chronic leprotic patients with unilateral trans-tibial amputation to determine neuropathy and plantar foot pressure in non-amputee limb. During the present prospective cross-sectional study, 10 chronic leprotic patients with unilateral trans-tibial amputation were evaluated. The study was conducted in Tabriz Bababaghi and Imam Reza Hospitals at summer of 2008. Sensory nerve conduction (SNAP) and Compound Motor Action Potentials (CMAP) studies were performed in association with pedobarographic assessment. No reliable response was detected from tested sensory and motor nerves, except a very low amplitude finding in deep preoneal nerve of one patient. In comparing with healthy group, static total plantar area, dynamic total plantar area, static rarefoot peak pressure and dynamic rarefoot peak pressure were lower in leprotic patients (p = 0.047, p = 0.004, p = 0.029 and p < 0.001), while static forefoot peak pressure and dynamic forefoot peak pressure were higher in these patients (p = 0.011 and p = 0.031). All of leprotic patients with unilateral trans-tibial amputation suffered from severe neuropathy. Also, these patients have high plantar pressure under the forefoot. Collectively, severe neuropathy and abnormal plantar foot pressure expose in non-amputee foot expose leprotic patients to the higher risk of secondary amputation.