Lavender essential oil has been used as an anxiolytic drug, a mood stabilizer, a sedative, spasmolytic, antihypertensive, antimicrobial, analgesic agent as well as a wound healing accelerator. We ...have studied for the first time the efficacy of lavender essential oil inhalation for the treatment of migraine in a placebo-controlled clinical trial.
Forty-seven patients with definite diagnosis of migraine headache were divided into cases and controls. Cases inhaled lavender essential oil for 15 min, whereas the control group used liquid paraffin for the same time period. Patients were asked to record their headache severity and associated symptoms in 30-min intervals for a total of 2 h. We matched the two groups for key confounding factors.
The mean reduction of headache severity in cases was 3.6 ± 2.8 based on Visual Analogue Scale score. The reduction was 1.6 ± 1.6 in controls. This difference between the controls and cases was statistically significant with p < 0.0001. From 129 headache attacks in cases, 92 responded entirely or partially to lavender. In the control group, 32 out of 68 recorded headache attacks responded to placebo. The percentage of responders was significantly higher in the lavender group than the placebo group (p = 0.001).
The present study suggests that inhalation of lavender essential oil may be an effective and safe treatment modality in acute management of migraine headaches.
Cerebral Venous Sinus Thrombosis (CVST), a complex and infrequent cerebrovascular disorder characterized by the formation of clots within the cerebral venous sinuses, occurs as a result of multiple ...risk factors and casualties, and its epidemiological picture should be investigated.
This descriptive study was conducted retrospectively on patients with a final diagnosis of cerebral vein thrombosis, who were referred to the emergency room of Ghaem Hospital (Mashhad, Iran) between 2009 and 2019. The study included all patients with cerebral vein thrombosis who were older than 18 years. Clinical symptoms and causes were documented and contrasted according to demographics.
During the 10 years of this study, 749 cases of cerebral vein thrombosis were observed, with women accounting for the majority (72.8%). The most prevalent symptom was headache (554 cases; 74.0%), followed by seizures (23.1%), blurred vision (16.0%), nausea (7.5%), vomiting (6.9%), double nose (4.9%), and dizziness (3.3%). There was no significant difference in the frequency of symptoms between the two genders (
<0.05). The most commonly identified risk factors were OCP (110 cases; 14.7%), followed by infection (103 cases; 13.8%), malignancies (78 cases; 10.4%), and fasting (15 cases; 2.0%). There was no significant difference in risk factors between the two genders, with the exception that all cases of fasting were in women, and the differences were significant (
=0.015). The most common site of involvement according to Magnetic Resonance Venography (MRV) was the upper sagittal sinus (427 cases; 57.0%). There was no significant difference in terms of the site of the conflict between the two genders (
<0.05).
The findings of the present study showed that deep vein thrombosis occurred mainly in women and manifested itself mostly as a headache. Moreover, the upper sagittal sinus was the most common site of involvement.
There is controversial evidence about the effect of cerebellar low-frequency stimulation in patients with essential tremor (ET).
In this study we assessed safety and effectiveness of 1 Hz ...(low-frequency) cerebellar repetitive transcranial magnetic stimulation (rTMS) on tremor severity in patients with essential tremor in a sham-controlled crossover trial.
A total of 23 patients assigned into two groups to receive either sham (n = 10) or rTMS (n = 13) treatment, with crossing over after a two-month washout period. Intervention consisted of 900 pulses of 1 Hz rTMS at 90% resting motor threshold or the same protocol of sham stimulation over each cerebellar hemisphere for 5 consecutive days. Tremor severity was assessed by Fahn-Tolosa-Marin (FTM) scale at baseline and at days 5, 12 and 30 after intervention. The FTM consists of 3 subscales including tremor severity rating, performance of motor tasks, and functional disability. Carry-over and treatment effects were analyzed using independent samples t-test.
There was no significant improvement in the total FTM scores in rTMS compared to the sham stimulation on day 5 (p = 0.132), day 12 (p = 0.574), or day 30 (p = 0.382). Similarly, FTM subscales, including tremor severity rating, motor tasks, and functional disability did not improve significantly after rTMS treatment. Mild headache and local pain were the most frequent adverse events.
Although cerebellar rTMS seems to have acceptable safety when used in ET patients, this study could not prove any efficacy for it in reduction of tremor in these patients. Larger studies are needed to evaluate efficacy of this therapeutic intervention and to provide evidence about the optimal stimulation parameters.
•Noninvasive brain stimulation is an underexplored option in treatment of ET.•Multiple sessions of cerebellar low frequency rTMS is satisfactorily safe.•Cerebellar low frequency rTMS did not improve essential tremor.•Larger well-designed trials are needed to evaluate efficacy of this intervention.
Background: Headache is one of the most common forms of medical complaints with numerous underlying causes and many patterns of presentation. The first step for starting the treatment is the ...recognition stage. In this article, the problem of primary and secondary headache diagnosis is considered, and we evaluate the use of intelligence techniques and soft computing in order to predict the diagnosis of common headaches. Methods: A fuzzy expert-based system for the diagnosis of common headaches by Learning-From-Examples (LFE) algorithm is presented, in which Mamdani model was used in fuzzy inference engine using Max-Min as Or-And operators, and the Centroid method was used as defuzzification technique. In addition, this article has analyzed common headache using two classification techniques, and headache diagnosis based on a support vector machine (SVM) and multilayer perceptron (MLP)-based method has been proposed. The classifiers were used to recognize the four types of common headache, namely migraine, tension, headaches as a result of infection, and headaches as a result of increased intra cranial presser. Results: By using a dataset obtained from 190 patients, suffering from primary and secondary headaches, who were enrolled from a medical center located in Mashhad, the diagnostic fuzzy system was trained by LFE algorithm, and on an average, 123 pieces of If-Then rules were produced for fuzzy system, and it was observed that the system had the ability of correct recognition by a rate of 85%. Using the headache diagnostic system by MLP- and SVM-based decision support system, the accuracy of classification into four types improved by 88% when using the MLP and by 90% with the SVM classifier. The performance of all methods is evaluated using classification accuracy, precision, sensitivity, and specificity. Conclusion: As the linguistic rules may be incomplete when human experts express their knowledge, and according to the proximity of common headache symptoms and importance of early diagnosis, the LFE training algorithm is more effective than human expert system. Favorable results obtained by the implementation and evaluation of the suggested medical decision support system based on the MLP and SVM show that intelligence techniques can be very useful for the recognition of common headaches with similar symptoms.
This study was designed to compare object relations and anger control between MS patients and normal individuals.
The present study was a cross-sectional case-control study with two groups: the case ...group (patients with MS) and the control group (normal controls without MS). 80 patients and 80 healthy individuals were selected according to the inclusion and exclusion criteria using a simple random sampling method. The research's data collection tool was a three-part questionnaire consisting of demographic information, the Bell Object Relations and the Reality Testing Inventory (BORRTI) and the State-Trait Anger Expression Inventory 2 (STAXI-2). The data were analyzed by the SPSS software version 26 using descriptive and analytical statistics (stepwise regression).
The results showed that in terms of object relations, there was no significant difference between the two groups except in alienation of relations (P = 0.035). The results also showed that in general, there was no statistically significant difference between the anger index of the group of MS patients and the normal controls. However, 12.8% of MS patients were significantly different in state of anger, trait anger and anger control compared to normal individuals. This difference was especially higher in angry temperament (P = 0.025) and the anger expression-in (P = 0.04).
Although patients with MS were not significantly different from healthy individuals in terms of intrapsychic and interpersonal functions in the context of object relations and anger management, it seems that more complex and multifaceted explanations lie in the results that need further research.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Introduction: Fingolimod is the first confirmed oral immune-modulator to treat Relapsing-Remitting Multiple Sclerosis (RRMS). This study aimed to investigate the safety and efficacy of fingolimod ...therapy in Iranian patients with RRMS. Methods: In our trial, 50 patients resistant to conventional interferon therapy were assigned to receive fingolimod 0.5 mg per day for 12 months. The number of Dadolinium (Gd)-enhanced lesions, enlarged T2 lesions, and relapses over 12 months were considered as endpoints and compared to baseline. Liver biochemical evaluations and lymphocyte count were done at baseline and in months 3, 6, and 12 of the study. Patients were also monitored for possible cardiovascular events within the first 24 h and other side effects routinely. Results: Among the patients who completed the trial, the number of Gd-enhanced and enlarged T2 lesions over 12 months significantly decreased (P=0.03 and P<0.001, respectively). The proportion of relapse-free patients was higher compared to the onset of fingolimod administration. There were no significant alterations in the Expanded Disability Status Scale (EDSS) scores. A slight, transient increase was recorded in liver enzymes among the participants. Lymphocyte count reduced by 61% at month 1 and displayed a gradual increase until month 12. No bradycardia and macular edema were recorded. Conclusion: These findings indicate an effective first-line fingolimod therapy for the first time in Iranian patients with RRMS. The decrease in the number of new attacks and the amelioration of MRI lesions were the benefits of fingolimod therapy, suggesting that it is preferred to other medicines to treat RRMS in Iran.
HTLV-1 associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a neuroinflammatory disorder associated with HTLV-1. Cytokines and inflammatory mediators have a major role in forming ...inflammation in HAM/TSP patients. This study aimed to measure the levels of IL-32, a proinflammatory cytokine associated with autoinflammatory disorders, and also cyclooxygenase -2 (COX-2) as a key mediator of inflammatory pathways in HAM/TSP patients and HTLV-1 asymptomatic carriers (ACs).
Peripheral blood monocyte cells (PBMCs) were isolated from HAM/TSP patients, ACs, and healthy controls (HCs), and DNA and RNA were extracted to evaluate HTLV-1 proviral load (PVL) and expression of IL-32 and COX-2, using real-time PCR. Serum levels of IL-32 were determined by using an ELISA assay.
The expression level of IL-32 was significantly higher in ACs compared with HAM/TSP patients and HCs (
<0.0001 and
>0.05, respectively). There were no statistically significant differences in the expression levels of Cox-2 and protein levels of IL-32 between the study groups. HTLV-1 PVL was higher in HAM/TSP patients compared with ACs.
Results showed increased mRNA levels of IL-32 in ACs. Since HTLV-1 PVL in ACs is lower than in HAM/TSP patients, it could be concluded that IL-32 might be an HTLV-1 inhibitor that seems to control virus replication. Despite the difference in IL-32 mRNA levels between study groups, no statistically significant differences were observed in IL-32 serum levels. Also, there were no significant differences in COX-2 expression.
Purpose: This study aimed to determine if the use of gabapentin is more efficacious than a stabilization splint with regard to the intensity of masseter muscle contractions and/or sleep quality for ...patients experiencing sleep bruxism (SB).
Materials and Methods: Twenty patients with SB participated in this clinical study. They were randomly divided into two treatment groups: stabilization splint group (n = 10) and gabapentin group (n = 10). The first polysomnographic examination was performed before the beginning of the experiment for all the participants. At the end of a 2‐month period of stabilization splint therapy or gabapentin usage, a second polysomnographic recording was made.
Results: Statistically significant reductions in the number of SB episodes per hour and per night, bruxism time index, total duration of SB episodes per night and number of SB episodes in stages NR I and NR II (p < 0.05) were observed in both groups after treatment. Both treatments significantly reduced the mean intensity of masseter muscle contractions during SB episodes. Moreover, the participants treated with gabapentin showed a significant improvement in total sleep time, slow wave sleep (stage III), and sleep efficiency (p < 0.05).
Conclusions: Gabapentin could be an effective treatment modality in SBs, especially in those with poor sleep quality.
Background: The migraine headache is a kind of most populated headache which its prevalence rate is so high. The first step for starting the treatment is the recognition stage. In addition, the fuzzy ...logic has good power for describing enigmatic and imprecise aspects; so, this tool could be used for the system modeling. This research aimed to recognize the migraine via using fuzzy logic and systems. Methods: A fuzzy expert system for diagnosis of migraine via Learning from Examples (LFE) algorithm was presented. Mamdani model was used in fuzzy inference engine using Max-Min as Or-And operators and Centroid method was used as defuzzification technique. Findings: Using the data of 148 patients, the migraine diagnostic system was trained by LFE algorithm and in average, 80 pieces of If-Then rules were produced for fuzzy system. The accuracy, precision, sensitivity, and specificity of the system were 97%, 80%, 70%, and 94%, respectively. Using the migraine diagnostic system by human experts, it was proved that the system had the ability of correct recognition by the rate of 81%. Conclusion: As the linguistic rules may be incomplete when human expert express their knowledge and according to importance of early diagnosis and favorable results, the LFE training algorithm is more effective than human experts system for recognition of migraine headache.
Multiple Sclerosis (MS), a myelin- targeting autoimmune disease of CNS, targets cognitive abilities in patients. The degree of this dysfunction would be different from one patient to another ...regarding their disease duration, age, EDSS, and lesion location in brain networks. The cognitive impairment will impact patients’ life adversely. Therefore, the present cross-sectional study aimed to evaluate the verbal episodic memory performance in Iranian Relapsing- Remitting Multiple Sclerosis (RRMS) patients and their healthy counterparts. Due to the susceptibility of women to MS, 35 female patients and 35 age, gender, and education-matched healthy controls were selected based on convenient sampling. The MS patients with Expanded Disability Status Scale (EDSS) scores ≤ 6 were recruited. The Montreal Cognitive Assessment (MoCA) and the California Verbal Learning Test (CVLT-II) were used for screening participants’ cognitive and verbal episodic memory function respectively. MoCA test (Persian version) was used to screen the participants for their cognitive function due to the higher sensitivity of the MoCA to the Mini-Mental State Exam (MMSE) for measuring cognitive function in individuals with MS. CVLT-II assess attention, learning strategies, recall accuracy and consistency, proactive and retroactive interference, recall errors, and recognition. The results revealed that MS patients were significantly impaired in the short and long-term recall as well as recognition list compared to their healthy counterparts. The findings showed that Multiple sclerosis has an adverse impact on verbal episodic memory performance.
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