The effect of vitamin D supplementation on the brain mapping and behavioral performance of children with ADHD: a double-blinded randomized controlled trials.

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is one of the common neurodevelopmental diseases that are accompanied with EEG pattern changes and Low levels of 25-hydroxyvitamin D [25(OH)D]. Neurofeedback provides a feedback signal to alleviate brain wave abnormalities and offers an alternative therapy for ADHD. This study aimed to investigate the concomitant effects of Vitamin D3 supplementation and Neurofeedback on children with ADHD. METHOD: This study was implemented on children with an established diagnosis of ADHD who received multisession Neurofeedback therapy. The intervention and control groups received 50000 IU vitamin D3 capsules and placebo respectively once a week for 2 months. The background rhythm was measured using quantitative EEG both before and at the end duration of the therapy. RESULTS: All of the vitamin D3 treated children showed a significant increase in the 25(OH)D (46 ± 18, 28 ± 10 (ng/ml), p = 0.001) and serum calcium level (9.5 ± 0.5, 9.8 ± 0.3 (mg/dl), p = 0.003) compared to the baseline. There were a statistically significant decrease in the treatment group about theta relative power, theta/beta, and theta/alpha power ratios within two eyes conditions (p = 0.004). All the changes were significant within eye open state in the treatment group (2.4 ± 1.2, 1.7 ± 0.5, p = 0.01). There is a significant relationship between Connors scores and some brain waves improvement (in relative theta (r = 0.998) and theta-to-beta power difference score (r = 0.56) (p < 0.001). CONCLUSION: Concomitant use of vitamin D3 supplementation and neurofeedback, increases the serum level of this vitamin and reveal favorable electrophysiological results in children with ADHD.Trial registration: Iranian Registry of Clinical Trials identifier: IRCT20200922048802N1..

Comparison of the Effect of Chlordiazepoxide and Transcranial Alternating Current Stimulation on Blood Potassium Loss Due to Preoperative Anxiety.

PURPOSE: This study evaluated and compared the effect of chlordiazepoxide and transcranial alternating current stimulation (tACS) on changes in blood potassium levels caused by preoperative anxiety. DESIGN: This randomized, double-blind placebo control study was performed on 100 patients undergoing surgery with the American Society of Anesthesiologists physical status (ASA I) who went through surgery for the first time. METHODS: Patients were classified into four groups of real or sham tACS, chlordiazepoxide, and placebo. The Amsterdam Preoperative Anxiety information Scale (APAIS) and serum potassium levels were used to collect data. The results were analyzed using the Kolmogorov-Smirnov tests, independent t test, Pearson correlation, and χ2 test. FINDINGS: There was no baseline difference between the groups. A significant difference was found between real tACS and the chlordiazepoxide group in plasma potassium level (P = .017). CONCLUSIONS: The results showed that real tACS was more effective than chlordiazepoxide in preventing the decrease of plasma potassium level in the preoperative period. Assessing the efficacy of the other types of brain electrical interventions is suggested for future studies.

Effect of vitamin D supplementation on brain waves, behavioral performance, nitric oxide, malondialdehyde, and high-sensitivity C-reactive protein in children with attention deficit/hyperactivity disorder: study protocol for a randomized clinical trial.

BACKGROUND: Attention deficit/hyperactivity disorder (ADHD) is the most common chronic mental and behavioral disorder among children. Some studies showed the lower levels of vitamin D in patients with ADHD compared with the healthy people. Few clinical trials were conducted in this field. The present study will be performed to examine the effect of vitamin D supplementation in children with ADHD. METHODS: We will conduct a double-blind, randomized controlled clinical trial to investigate the effect of vitamin D supplementation on brain waves, behavioral performance, serum nitric oxide, malondialdehyde, and high-sensitivity C-reactive protein in 50 patients with ADHD. The intervention group will receive one capsule 50,000 IU vitamin D every week, for 8 weeks. The control group will receive one placebo capsule containing 1000 mg olive oil every week. Electroencephalography will be performed for 10 min using Brain Master Discovery from 19 scalp sites both before the first intervention and the 10 sessions of the therapy. The artifact-free periods of 1-min electroencephalography data will be analyzed for quantitative electroencephalography measures. DISCUSSION: For the first time, this clinical trial will evaluate the effect of vitamin D supplementation on brain waves, serum nitric oxide, malondialdehyde, and high-sensitivity C-reactive protein in patients with ADHD. The results of the present clinical trial will provide a better vision about the vitamin D efficacy in patients with ADHD. TRIAL REGISTRATION: Registered on 5 November 2020 at Iranian Registry of Clinical Trials with code number IRCT20200922048802N1 ( https://www.irct.ir/trial/51410 ).

Androgens' Role in Severity and Mortality Rates of COVID-19.

By the end of December 2019 new corona virus began to spread from Wuhan, China and caused a worldwide pandemic. COVID-19 deaths and prevalence represented sex discrepant patterns with higher rate of deaths and infection in males than females which could be justified by androgen-mediated mechanisms. This review aimed to assess the role of androgens in COVID-19 severity and mortality. Androgens increase expressions of Type II transmembrane Serine Protease (TMPRSS2) and Angiotensin Converting Enzyme 2 (ACE2), which both facilitate new corona virus entry into host cell and their expression is higher in young males than females. According to observational studies, prevalence of COVID-19 infections and deaths was more in androgenic alopecic patients than patients without androgenic alopecia. The COVID-19 mortality rates in aged men (>60 years) were substantially higher than aged females and even young males caused by high inflammatory activities such as cytokine storm due to hypogonadism in this population. Use of anti-androgen and TMPRSS2 inhibitor drugs considerably modified COVID-19 symptoms. Androgen deprivation therapy also improved COVID-19 symptoms in prostate cancer: overall the role of androgens in severity of COVID-19 and its associated mortality seemed to be very important. So, more studies in variety of populations are required to define the absolute role of androgens.

Impact of Transcranial Direct Current Stimulation on Ultra-Rapid Opioid Detoxification Outcome.

Introduction: The persistence of post-detoxification problems in drug addiction is one of the disadvantages of the ultra-rapid opioid detoxification (UROD) method. Transcranial direct current stimulation (tDCS) has been introduced in experimental addiction treatment for some years. Results of pilot studies suggest that it might be a promising method for addiction treatment. This study explores the adjunctive application of tDCS during treating opiate addiction with the UROD approach. Methods: This double-blind, sham-controlled clinical trial was carried out on patients with substance abuse admitted to the Bahman Clinic of Yazd City in Iran (from March to September 2014). Forty participants were randomly allocated to treatment and control groups. Two sessions of tDCS (real or sham) over dorsolateral prefrontal cortices (DLPFC) were applied, accompanied by UROD. Withdrawal symptoms and craving were assessed by the drug desire questionnaire and objective opiate withdrawal scale before UROD and for the 24-hour interval after. Results: Transcranial direct current stimulation optimized the opiate addiction treatment through craving and withdrawal syndrome alleviation. Conclusion: The study results indicate that prefrontal tDCS may promote the efficacy of the UROD method in opioid addiction.

The relationship between spiritual well-being and happiness among healthcare students: Application of the spiritual health questionnaire for the Iranian population.

OBJECTIVES: To investigate the relationship between spiritual well-being (SWB) and happiness in a sample of Iranian healthcare students, considering a culturally-adapted and a context-based measure of SWB. METHODS: In this descriptive-correlational study, 343 Muslim students of Qom University of Medical Science are studied from October 2017 to March 2018. Data collection tools were the culturally-adapted spiritual well-being scale (SWBS), the spiritual health questionnaire for the Iranian population (SHQ), and the Persian version of Oxford happiness inventory (OHI). RESULTS: Total scores of SWBS, SHQ, and OHI were in moderate (68.42 ± 12.76), high (193.74 ± 24.26), and moderate (37.95 ± 14.56) levels, respectively. Happiness had a significant positive correlation with all domains of SWBS and SHQ. Moreover, a significant proportion of happiness was determined by SWBS and SHQ. Also, some domains of SWBS and SHQ showed a significant correlation with age, gender, marital status, and academic major. CONCLUSION: There was a significant correlation between happiness and SWB, measured by SWBS and SHQ. Hence, it seems that both SWBS and SHQ are sufficiently sensitive to assess the relationship between happiness and SWB.

Effect of Oral Clonidine on Shoulder Tip Pain and Hemodynamic Response After Laparoscopic Cholecystectomy: A Randomized Double Blind Study.

BACKGROUND: Shoulder tip pain is a common problem after laparoscopic cholecystectomy. There are a few clinical trial studies on the effect of clonidine on post laparoscopic shoulder pain (PLSP). This study aimed at evaluating the effect of oral clonidine on PLSP in semi-sitting position and post-operative hemodynamic response of patients undergoing LC surgery. METHODS: This randomized controlled clinical trial was conducted on 60 patients, who were candidates for elective laparoscopic cholecystectomy surgery under general anesthesia, and were randomly allocated to clonidine and placebo groups. Patients in the clonidine group received 0.2 mg oral, 90 minutes prior to induction. Patients in the placebo group received vitamin C tablets during the same time. Postoperative pain intensity was assessed, using a visual analog scale at the emergence from anesthesia, 4 and 8 hours after the operation by an anesthetist, who was blinded to the patient group. Mean arterial blood pressure and heart rate were recorded before clonidine administration and in post-operative period. RESULTS: The mean age was 36.85 ± 10.93 years and the mean Body Mass was 26.34 ± 3.46 kg/m2. Two groups were not comparable with respect to occurrence of PLSP (P = 0.739). There was a significant difference in intensity of PLSP between the 2 groups at emergence from anesthesia (P = 0.012), 4 and 8 hours after the operation (P = 0.001) between 2 groups. The clonidine group showed a larger reduction of pain intensity at these phases. The result of independent t test indicated significant differences in the MABP value between the 2 groups at the time of emergence from anesthesia (P = 0.031). The clonidine group demonstrated a lower MABP level at this time. CONCLUSIONS: Oral clonidine is not effective in preventing the PLSP. However, it alleviates PLSP intensity in the patient under LC procedure on the first post-operative hours.

Cognitive Behavioral Development in Children Following Maternal Postpartum Depression: A Review Article.

Mothers' constitute is a very important part of infants' social environment and mediate their experience with the surrounding world. Postpartum depression, which is considered one of the most common and important psychiatric disorders, affects 10-15% of mothers, its causes are different. By investigating various sources, some effects of this disorder have been observed on the cognitive development of children, particularly among boys, such as language, intelligence quotient (IQ), and behavioral problems. Thus, it is imperative to study the effects of postpartum depression on children's growth and development and to identify methods of reducing these effects. This review indicates that postpartum depression in mothers reduces children's cognitive performance. The adverse effects of postpartum depression on children's development seem to be mediated by the mother's interpersonal behavior and the infant gender. The review of previous studies shows that postpartum depression reduces children's cognitive performance by impairing maternal mental and behavioral care.