Search

Background: There is no definite recommendation for melatonin supplementation in episodic migraine. This study aimed to evaluate the effect of melatonin on reducing the frequency and severity of migraine attacks.Methods: This randomized, double-blind clinical trial was conducted at Golestan Hospital of Ahvaz, Iran, in 2021. A total of 60 patients with episodic migraine were randomly assigned into 2 groups of receiving 3 mg melatonin (intervention group; n=30) or the same dose of placebo (control group; n=30) along with baseline therapy (propranolol 20 mg, BID) for two months. The attack frequency, attack duration, attack severity (based on VAS), the number of analgesic intakes, drug complications, Migraine Disability Assessment score (MIDAS), and Pittsburgh sleep quality index (PSQI) were evaluated at baseline and in the first, second, third, and fourth months of follow-up. The independent t test, chi-square, and analysis of variance (ANOVA) with repeated measures were used to compare variables between the two groups. Results: In both groups, the frequency, duration, and severity of attacks, taking analgesics, MIDAS, and PSQI scores during follow-up decreased significantly (P0.999).Conclusion: Our study shows that melatonin was more efficacious than the placebo in the reduction of frequency and duration of migraine attacks. It was equally safe as the placebo and might be effective in the preventive treatment of episodic migraine in adults.Trial registration number: IRCT20190107042264N5.

Background: Stroke is the third main cause of death and chronic disabilities in adults, which requires finding neuroprotective drugs to reduce its mortality and morbidity. Objectives: To determine the efficacy of magnesium sulfate as an adjunctive neuroprotective agent in patients with stroke. Materials & Methods: This randomized double-blind clinical trial recruited 120 patients with acute ischemic stroke in the middle cerebral artery territory presenting to Ahvaz Golestan Hospital from 2015 to 2016. The patients were randomly assigned into two groups. The first group received 4 grams bolus intravenous magnesium sulfate and then 16 grams/24 hours for 5 consecutive days. The second group received normal saline as placebo. Functional disability was assessed on admission and at the end of the first and third months after stroke by modified National Institutes of Health Stroke Scale (mNIHSS) and modified Rankin Scale Score (mRSS). Qualitative variables were compared using chi-square test in SPSS V. 16. Results: The results showed that difference of the mean mNIHSS, before (P=0.596) and one (P=0.512) and three (P=0.664) months after the treatment was not statistically significant between magnesium and placebo groups. Also it was true for mRSS before (P=0.669) and three month (P= 0.878) after the treatment. Conclusion: IV magnesium sulfate probably did not have significant positive effects on the outcome of patients with acute middle cerebral artery infarction. Studies on larger populations are recommended to show its possible effects.

Background: Optic neuritis is an inflammation of the optic nerve. Because of importance of vision for human, management of optic neuritis is an important issue in neurology. Objectives: This study aimed at assessing the effect of oral steroid treatment after intravenous (IV) methylprednisolone therapy on demyelinating optic neuritis. Materials & Methods: 60 Patients with first episode of acute demyelinating optic neuritis who referred to a neurology clinic in an academic hospital in south-west of Iran in 2015-2016 included in this randomized double-blind clinical trial study (No: IRCT2015102724735N1). They were divided into two groups with (A) and without (B) tapering oral steroid treatment after IV methylprednisolone. Visual acuity and color vision were measured before treatment, before oral tapering, 1 and 3 months after treatment. Independent t-test in SPSS software version 20 was used to analyze the data. P0.05).Frequency of color vision abnormality in groups A and B were at baseline (53.3% vs. 56.6%) (P=0.796), before oral tapering (43.3% vs. 30%, P=0.284), 1 month after treatment (23.3% vs. 30%, P=0.559), 3 months after treatment (0% vs. 23%, P=0.011). Conclusion: Oral steroid treatment after IV methylprednisolone pulse therapy improves color vision after 3 months in patients with demyelinating optic neuritis but has no effect on visual acuity.

Botulism is one of the most important foodborne diseases and is caused by Clostridium botulinum toxin. The main manifestations are flaccid muscle paralysis and cranial nerve palsies. Botulism is an essential health problem because of its high mortality. The diagnosis of botulism, especially in sporadic cases, is a medical challenge and a high clinical suspicion is necessary for early recognition. So, every physician should be familiar with its signs and symptoms for early detection and treatment. We describe a family with dysphasia and acute paralysis after the ingestion of locally made cheese. The clinical presentations of the 1st patient were similar to myasthenic crisis and she, therefore, received plasma exchange. After the appearance of similar symptoms in the other family members, they were treated with polyvalent botulinum antitoxin and diagnosis was confirmed by toxicology and detection of serotype A botulinum toxin in cheese and stool samples. Uncommon clinical presentations and unusual sources of botulinum toxin should be kept in mind because of the importance of early diagnosis and treatment.