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Acute poisoning with organophosphorus cholinesterase inhibitors (OPs), such as OP nerve agents and pesticides, can cause life threatening cholinergic crisis and status epilepticus (SE). Survivors often experience significant morbidity, including brain injury, acquired epilepsy, and cognitive deficits. Current medical countermeasures for acute OP poisoning include a benzodiazepine to mitigate seizures. Diazepam was long the benzodiazepine included in autoinjectors used to treat OP-induced seizures, but it is now being replaced in many guidelines by midazolam, which terminates seizures more quickly, particularly when administered intramuscularly. While a direct correlation between seizure duration and the extent of brain injury has been widely reported, there are limited data comparing the neuroprotective efficacy of diazepam versus midazolam following acute OP intoxication. To address this data gap, we used non-invasive imaging techniques to longitudinally quantify neuropathology in a rat model of acute intoxication with the OP diisopropylfluorophosphate (DFP) with and without post-exposure intervention with diazepam or midazolam. Magnetic resonance imaging (MRI) was used to monitor neuropathology and brain atrophy, while positron emission tomography (PET) with a radiotracer targeting translocator protein (TSPO) was utilized to assess neuroinflammation. Animals were scanned at 3, 7, 28, 65, 91, and 168 days post-DFP and imaging metrics were quantitated for the hippocampus, amygdala, piriform cortex, thalamus, cerebral cortex and lateral ventricles. In the DFP-intoxicated rat, neuroinflammation persisted for the duration of the study coincident with progressive atrophy and ongoing tissue remodeling. Benzodiazepines attenuated neuropathology in a region-dependent manner, but neither benzodiazepine was effective in attenuating long-term neuroinflammation as detected by TSPO PET. Diffusion MRI and TSPO PET metrics were highly correlated with seizure severity, and early MRI and PET metrics were positively correlated with long-term brain atrophy. Collectively, these results suggest that anti-seizure therapy alone is insufficient to prevent long-lasting neuroinflammation and tissue remodeling.

OBJECTIVES: Long-term benzodiazepine use is common despite known risks. In the original Eliminating Medications Through Patient Ownership of End Results (EMPOWER) Study set in Canada, patient education led to increased rates of benzodiazepine cessation. We aimed to determine the effectiveness of implementing an adapted EMPOWER quality improvement (QI) initiative in a US-based healthcare system. DESIGN: We used a pre-post design with a non-randomised control group. SETTING: A network of primary care clinics. PARTICIPANTS: Patients with ≥60 days supply of benzodiazepines in 6 months and ≥1 risk factor (≥65 years of age, a concurrent high-risk medication prescribed or a diazepam equivalent daily dose ≥10) were eligible. INTERVENTION: In March 2022, we engaged 22 primary care physicians (PCPs), and 308 of their patients were mailed an educational brochure, physician letter and flyer detailing benzodiazepine risks; the control group included 4 PCPs and 291 of their patients. PRIMARY AND SECONDARY MEASURES: The primary measure was benzodiazepine cessation by 9 months. We used logistic regression and a generalised estimating equations approach to control for clustering by PCP, adjusting for demographics, frailty, number of risk factors, and diagnoses of arthritis, depression, diabetes, falls, and pain. RESULTS: Patients in the intervention and control groups were comparable across most covariates; however, a greater proportion of intervention patients had pain-related diagnoses and depression. By 9 months, 26% of intervention patients (81 of 308) had discontinued benzodiazepines, compared with 17% (49 of 291) of control patients. Intervention patients had 1.73 greater odds of benzodiazepine discontinuation compared with controls (95% CI: 1.09, 2.75, p=0.02). The unadjusted number needed to treat was 10.5 (95% CI: 6.30, 34.92) and the absolute risk reduction was 0.095 (95% CI: 0.03 to 0.16). CONCLUSIONS: Results from this non-randomised QI initiative indicate that patient education programmes using the EMPOWER brochures have the potential to promote cessation of benzodiazepines in primary care.

Worrying about perceived threats is a hallmark of multiple psychological disorders including anxiety. This concern about future events is particularly important when an individual is faced with an approach-avoidance conflict. Potential goals to approach are known to be represented in the dorsal hippocampus during theta cycles. Similarly, important information that is distant from the animal's position is represented during hippocampal high-synchrony events (HSEs), which coincide with sharp-wave ripples (SWRs). It is likely that potential future threats may be similarly represented. We examined how threats and rewards were represented within the hippocampus during approach-avoidance conflicts in rats faced with a predator-like robot guarding a food reward. We found decoding of the pseudo-predator's location during HSEs when hesitating in the nest and during theta prior to retreating as the rats approached the pseudo-predator. After the first attack, we observed new place fields appearing at the location of the robot (not the location the rat was when attacked). The anxiolytic diazepam reduced anxiety-like behavior and altered hippocampal local field potentials (LFPs), including reducing SWRs, suggesting that one potential mechanism of diazepam's actions may be through altered representations of imagined threat. These results suggest that hippocampal representation of potential threats could be an important mechanism that underlies worry and a potential target for anxiolytics. Worry is a key component of anxiety, and is often characterized by imagination of a negative outcome. This study found that when a rat is attacked by a robot, hippocampal place fields develop to represent the robot. When the rat shows anxiety-like behaviors, it imagines the robot's location, presumably worrying about the imminent danger. [ABSTRACT FROM AUTHOR]

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Background: Cerebral blood flow normally places a limit on the magnitude of brain vascular permeability (P) that can be measured in vivo. At normal cerebral blood flow, this limit falls at the lower end of lipophilicity for most FDA-approved CNS drugs. In this study, we report on two methods that can be used to overcome this limitation and measure brain vascular permeability values that are up to ~1000 times higher using the in situ brain perfusion technique. Methods: Rat brain was perfused with physiological saline at increased flow rate and in the presence of various concentrations of plasma protein, serum albumin or alpha-acid glycoprotein. Plasma protein was added to the saline perfusion fluid to lower extraction into the measurable range using the Crone Renkin "diffusion-flow" equation to calculate brain PoS. Results: Cerebrovascular Po was determined for 125 solutes, of which 78 showed little or no evidence of active efflux transport. Fifty of the solutes were in the lipophilicity zone (Log Poct 1–5) of most FDA-approved CNS drugs. Care was taken to ensure the integrity of the brain vasculature during perfusion and to measure flow accurately using markers that had been verified for the flow rates. The results showed a linear relationship between Log Po and Log Poct over ~10 orders of magnitude with values for diazepam, estradiol, testosterone, and other agents that exceed prior published values by fivefold to 200-fold. Conclusions: The results show that brain vascular permeability can be measured directly in vivo for highly lipophilic solutes and the PS values obtained match reasonably with that predicted by the Crone-Renkin flow diffusion equation with care taken to validate the accuracy for the component measurements and with no need to invoke "enhanced" or "induced" dissociation. [ABSTRACT FROM AUTHOR]

The 14N nuclear quadrupole resonance (NQR) spectra of two common benzodiazepines, Diazepam and Lorazepam, have been recorded using cross relaxation double resonance. Benzodiazepines are characterized by a fused diazepine and benzene ring and act as central nervous system depressants or tranquilizers. Each compound has two distinct nitrogen atoms in their molecular structure. Both nitrogen atoms of diazepam have similar asymmetry parameters. However, the imine nitrogen of diazepam has a slightly higher quadrupole coupling constant (χ) than its tertiary amide nitrogen. The 14N NQR signals of lorazepam suggests that there is more than one form present in the solid. The imine nitrogen shows similar frequencies and NQR parameters to that of diazepam. However, the frequencies assigned to the secondary amide nitrogen result in a lower χ and a relatively higher asymmetry parameter (η) than the amide nitrogen of diazepam. This has been attributed to hydrogen bonding of the amide proton in lorazepam. Ab-initio and DFT calculations have been performed to support the assignments. [ABSTRACT FROM AUTHOR]

Medical emergencies, though rare, may occur unpredictably in a dental office during or after dental procedures. It may occur accidentally or subsequent to systemic problems of patients. These series of clinical events entail instantaneous management to evade any potential consequences. Basic life support measures require sufficient knowledge, expertise, skills, and equipment. Several medications and equipment are necessary to be available for immediate reach in any dental office. Health authorities of different countries usually propose these lists to dental practitioners. However, the best emergency kit is the one, which is arranged and maintained by the dentists based on their needs and easily accessible for immediate use. Considering the importance of this subject and the results yielded from the regular visits of the Dental Supervision Department (Vice Chancellor for treatment of Shiraz University of Medical Sciences) to the dental centers of Shiraz in the spring and summer of 2023, we decided to recall the importance of emergency medicines and equipment through a brief communication. [ABSTRACT FROM AUTHOR]

Background: Posterior fossa syndrome (PFS), also known as cerebellar mutism syndrome, occurs in about 25% of pediatric patients undergoing resection of a posterior cranial fossa medulloblastoma. It is characterized primarily by mutism or reduced/impaired speech and may include variable symptoms such as motor dysfunction (apraxia, ataxia, hypotonia), supranuclear cranial nerve palsies, neurocognitive changes, and emotional lability. Long-term multidisciplinary rehabilitation is typically required, with recovery taking approximately six months, though many children experience long-term residual deficits. Neuropathic pain associated with PFS is rarely reported in pediatric patients, and evidence for its management is limited. Methods: This case report describes a 10-year-old boy who developed PFS following incomplete resection of a medulloblastoma. Clinical presentation included mutism, irritability, emotional lability, sleep disturbances, and neuropathic pain localized at the C5 level. The patient was treated with a combination of gabapentin, diazepam, and baclofen. Results: The combined pharmacological approach resulted in successful management of the patient's neuropathic pain and other symptoms associated with PFS, improving his overall condition. Conclusions: This case highlights the potential effectiveness of a multimodal pharmacological regimen for treating neuropathic pain and associated symptoms in pediatric patients with PFS. Further research is needed to explore optimal treatment strategies for this rare but challenging complication. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Although prompt treatment of status epilepticus is standard of care, the effect of timing of rescue therapy administration for seizure clusters in epilepsy remains unknown. Seizure clusters are a rare but clinically important condition, and benzodiazepines are the cornerstone rescue therapy for seizure clusters in epilepsy. We characterized temporal patterns from a large dataset of treated seizure clusters in the safety study of diazepam nasal spray. METHODS: This post hoc analysis used timing data of treated seizure clusters recorded by care partners and patients in seizure diaries during a 1-year safety study. Data analysis used time from seizure start to administration of diazepam. RESULTS: From 4466 observations, 3225 had data meeting criteria for analysis. Overall, median times from seizure start to dose administration, dose administration to seizure termination, and total seizure duration were 2, 3, and 7 min, respectively. In seizure clusters treated in

Introduction: Children with cerebral palsy (CP) demonstrate poor hand function due to spasticity in the flexors muscles of the upper limbs. Impairment of the upper limb function can impact on self-care abilities, activities of daily living, education, leisure activities and vocational outcomes. Oral baclofen and diazepam are commonly used as antispastic agents in patients where generalised reduction in tone is desired. There are no studies comparing the effect of diazepam and baclofen on hand function in spastic CP. Materials and Methods: A total of 61 spastic CP children were enrolled in a single-blinded randomised prospective study. Diazepam and baclofen were given in weekly incremental doses. Spasticity reduction was measured by Modified Ashworth Scale (MAS) and hand function by prehensile activities. Results: In the diazepam group, the baseline MAS score was 1.95 ± 0.4 and it was 1.83 ± 0.64 in the baclofen group. A statistically significant (P < 0.001) improvement in the mean MAS score compared to baseline (MAS score: diazepam 1.62 ± 0.40 and 1.40 ± 0.36 and baclofen 1.56 ± 0.59 and 1.30 ± 0.48, respectively) was seen in both the groups at the 1st and 3rd months. Inter-group comparison showed no significant difference. Improvement in hand function was found to be significant only after 3 months. Conclusion: Spasticity reduction contributed to improvement in hand functions in both the groups after 3 months. Both the drugs have a similar effect in terms of spasticity reduction and hand function improvement.

Medicinal plants Melissa officinalis (M. officinalis), Atropa belladonna (A. belladonna), and Artemisia siberia (A. siberia) have been widely used in traditional medicine in Iran and other countries due to their numerous ethno-pharmacological effects. Therefore, the purpose of this research was to compare the sedative and pre-anesthetic effects of, M. officinali, A. belladonna, A. siberia and diazepam in rats. For this purpose, during an experimental study, 150 female Wistar rats which were allocated into different experimental groups received intra-peritoneal injections of 150, 300 and 450 mg per kilogram of A. belladonna extract, 50, 200 and 350 mg per kilogram of M. officinalis extract, 100, 200 and 400 mg per kilogram of A. siberia extract, 1.2 mg per kilogram of the drug diazepam and equal volumes of the chemical substance dimethyl sulfoxide as placebo. The obtained results showed a significant increase in the duration of sleep induced by ketamine, as well as a significant increase in the treatment groups with higher doses of the extract (pA. belladonna, A. siberia, and M. officinalis plant extracts respectively. According to the results, extracts of A. belladonna, A. siberia, and M. officinalis have significant sedative and pre-anesthetic effects.

Introduction Methods Results Discussion and Conclusions ‘Street’ benzodiazepines (BZD) are structurally and pharmacologically related to BZDs licensed for human use. In this study we investigated how street BZDs contribute to overall BZD use and death prevalences in England, Wales and Northern Ireland.Data were analysed from deaths reported to the National Programme on Substance Use Mortality with post‐mortem BZD detections (1999–2021), BZDs seized from music festivals (2017–2021) and drug samples with BZD detections submitted to Welsh Emerging Drugs and Identification of Novel Substances (WEDINOS) (2017–2021).About 14,837 deaths with BZD detections were identified, with polydrug use evident in 99.3% of cases (n = 14,733/14,837). Deaths following BZD use increased by over 200% from 2010 (n = 556) to 2020 (n = 1245). Most BZD detections were of those available via NHS prescription (96.2%), although in most cases (61.9%) the BZD—majority diazepam (77.3% of detections)—had been illicitly sourced. While street BZD deaths represented only 8.5% of overall BZD deaths, street BZD deaths increased by over 1200% between 2015 (n = 26) and 2020 (n = 326). There were increasing proportions of street BZD deaths in each geographical region but was more marked in Northern Ireland. The proportion of individual BZDs seized at music festivals and submitted to WEDINOS largely reflected that of individual BZDs detected in deaths.While deaths following street BZD use are increasing, most BZDs detected in deaths were prescribable BZDs that were often illicitly sourced. The types of BZD detected in post‐mortem samples, festival seizures and WEDINOS submissions has evolved over time to reflect changes in BZD prevalence on the illicit drug market. [ABSTRACT FROM AUTHOR]

Alcohol is the most consumed and abused psychoactive drug globally, but the molecular mechanisms driving alcohol action and its associated behaviors in the brain remain enigmatic. Here, we have discovered a transmembrane protein TMEM132B that is a GABA A receptor (GABA A R) auxiliary subunit. Functionally, TMEM132B promotes GABA A R expression at the cell surface, slows receptor deactivation, and enhances the allosteric effects of alcohol on the receptor. In TMEM132B knockout (KO) mice or TMEM132B I499A knockin (KI) mice in which the TMEM132B-GABA A R interaction is specifically abolished, GABAergic transmission is decreased and alcohol-induced potentiation of GABA A R-mediated currents is diminished in hippocampal neurons. Behaviorally, the anxiolytic and sedative/hypnotic effects of alcohol are markedly reduced, and compulsive, binge-like alcohol consumption is significantly increased. Taken together, these data reveal a GABA A R auxiliary subunit, identify the TMEM132B-GABA A R complex as a major alcohol target in the brain, and provide mechanistic insights into alcohol-related behaviors. [Display omitted] • Single-pass transmembrane protein TMEM132B is a GABA A R auxiliary subunit • TMEM132B promotes GABA A R expression at the cell surface and slows receptor deactivation • TMEM132B enhances the allosteric effects of alcohol on various GABA A Rs • Genetic inactivation of TMEM132B in mice alters alcohol-related behaviors Identification of TMEM132B as a GABA A R auxiliary subunit that modulates alcohol action in the brain at both the molecular and behavioral levels. [ABSTRACT FROM AUTHOR]

This investigation aimed to evaluate the antidepressant, anxiolytic, and antioxidant effects of Piper aduncum essential oil from northern Peru. The essential oils were obtained through hydro-distillation using a modified Clevenger-type apparatus. The chromatography-mass spectrometry (GC-MS) was used to assess the chemical composition. Behavioral assays in mice were used to evaluate the antidepressant and anxiolytic effects. In addition, the antioxidant capacity was performed through DPPH, ABTS, and FRAP assays. The GC-MS analysis revealed that linalool (29.16%), bicyclogermacrene (13.32%), nerolidol (12.38%), and ß-caryophyllene (10.76%) were the principal components. The results demonstrated significant antidepressant and anxiolytic effects comparable to fluoxetine and diazepam, with statistical differences between all groups (p<0.005). The IC50 values for the DPPH, ABTS, and FRAP assays were 5.9±0.08, 0.20±0.06, and 109.5±1.3, respectively. Consequently, Piper aduncum essential oil exhibits antidepressant and anxiolytic-like effects and modest antioxidant properties compared to the controls. [ABSTRACT FROM AUTHOR]

Introduction: Study comparatively evaluated the effect of metoprolol (intravenous followed by oral) treatment along with control drug (isosorbide dinitrate and diazepam) in a prospective randomized control trial manner. Here, patients were stratified according to age, infarct size, infarction type and type of ventricular arrhythmias before administrations of drug intravenous and oral metoprolol and others for total 70 patients. All patients were studied up to 365 days here and no death recorded in metoprolol therapy while 37% death occurred in control drug group. Thus, sufficient improvement in reduction of cardiac deaths recorded via metoprolol as compared to (Control) isosorbide dinitrate and diazepam (37%). Not only is that improvement in the reduction of chest pain, better controlled heart rate with reduction in the incidence of post-infarction arrhythmias, controlled systolic blood pressure, better reduction and limitation of infarct size, better electrocardiographic findings and reduced serum CPK-MB value also been recorded. In conclusion early administration of metoprolol and treatment in AMI improves the health (cardiac) status of patients suffering from myocardial infarction and thereby, significant reduction in death rate, reinfarction did not occur in metoprolol treated group as compared to 17.1% cases had reinfarction in control group. [ABSTRACT FROM AUTHOR]

Objectives: To study the pharmacological interactions between agmatine and gamma aminobutyric acid (GABA) modulatory agents in the regulation of anxiety-like behavior in rats. Materials and methods: Male Wistar rats were treated drugs per se or in combination and 15 min after last injection were subjected to elevated plus-maze (EPM) test. Anxiety-like behavior was evaluated by measuring behavioral conventional readout, open arm activity (duration and/or entries) for 5-minute duration. Results: Acute intra-central amygdala (CeA) injection of agmatine (0.1-0.6 μmol/site/rat), muscimol (0.25-1 nmol/site/rat), diazepam (5-20 μg/site/rat) and allopregnanolone (2-8 μg/site/rat) increased open arm entries of the rats in EPM suggesting anxiolytic effect in dose dependent manner. Moreover, the anxiolytic effect at subeffective dose of agmatine (0.1 μmol/site/rat) was potentiated by subeffective dose of muscimol (0.25 nmol/site/rat), diazepam (5 μg/site/rat) and allopregnanolone (4 μg/site/rat). Whereas, pretreatment with GABAA receptor antagonist, bicuculline (10 ng/site/rat) blocked the anxiolytic effect of agmatine and its synergistic effect of agmatine plus muscimol. Similarly, benzodiazepine (BZD) receptor antagonist, flumazenil (15 μg/site/rat) and GABA allosteric modulator antagonist, RO 15-45 13 (10 μg/site/rat) reduced the anxiolytic effect of agmatine, given alone and with diazepam and allopregnanolone, respectively. Conclusion: These results indicated that anxiolytic effect of agmatine is medicated via GABAergic mechanisms, probably conciliated by the GABAA receptor subtypes. Modulation of interplay between agmatine and GABAA receptor activity might be a pertinent solution for the regulation of anxiety. [ABSTRACT FROM AUTHOR]

The potential of semiconducting, corrugated graphene, grown on silicon carbide, as an active element in chemosensors is studied in the present work. For this purpose, the adsorption of benzene, diazepam and 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on the material's surface was modeled. According to the graphene sheet bending and adsorbate–adsorbent distances, the heterostructure favors the ligands in the order of diazepam < benzene < TCDD. The apparent ambiguity in the results for diazepam is easy to explain. The abundance of lone pairs and π-electrons compensates for the low-symmetry, non-planar, far from optimal (adsorption-wise) geometry. The maximum band gap change in the heterostructure, caused by adsorption, is 0.02 eV. Intermolecular binding does not alter the HOMO–LUMO difference in benzene and TCDD by more than 0.01 eV. The completely planar molecules are not expected to undergo significant geometrical changes; hence, the alteration in their frontier orbitals is also minimal. The adsorption of diazepam, however, causes significant changes in the projected density of states of both structures in the complex. In conclusion, corrugated graphene is applicable as an active material in selective chemosensors for non-planar aromatic molecules. [ABSTRACT FROM AUTHOR]

Introduction: Datura stramonium poisoning, resulting from the ingestion of seeds, leaves, or flowers of Datura stramonium, is a severe condition with significant risks, particularly for young children. Most documented cases of Datura stramonium poisoning in the literature involve teenagers who intentionally ingest the plant to induce hallucinogenic and euphoric experiences. This report presents a rare instance of unintentional Datura stramonium poisoning in a 3year-old Ethiopian toddler. Case presentation: He presented with symptoms consistent with anticholinergic toxidrome, including altered mental status, agitation, seizures, dilated pupils, and tachycardia. Laboratory tests, including complete blood count, liver function test, renal function test, electrolyte levels and cerebrospinal fluid analysis were normal. Results of blood toxicology screen were negative. Timely recognition and supportive care lead to a positive outcome. Conclusion: Through this report, we aim to add to the limited body of literature on Datura stramonium poisoning in toddlers and offer insights into its clinical course and management in paediatric patients. [ABSTRACT FROM AUTHOR]

Anxiety is a natural response to stress, characterized by feelings of worry, fear, or unease. The current research was conducted to investigate the anxiolytic effect of indirubin (IND) in different behavioral paradigms in Swiss albino mice. To observe the animal's behavioural response to assess anxiolytic activity, different tests were performed, such as the open‐field (square cross, grooming, and rearing), swing, dark‐light, and hole cross tests. The experimental mice were administered IND (5 and 10 mg/kg, p.o.), where diazepam (DZP) and vehicle were used as positive and negative controls, respectively. In addition, a combination treatment (DZP+IND‐10) was provided to the animals to determine the modulatory effect of IND on DZP. Molecular docking approach was also conducted to determine the binding energy of IND with the GABAA receptor (α2 and α3 subunits) and pharmacokinetics were also estimated. The findings revealed that IND dose‐dependently significantly (p<0.05) reduced the animal's movement exerting calming behavior like DZP. IND also demonstrated the highest docking score (−7.7 kcal/mol) against the α3 subunit, while DZP showed a lower docking value (−6.4 kcal/mol) than IND. The ADMET analysis revealed that IND has proper drug‐likeness and pharmacokinetic characteristics. In conclusion, IND exerted anxiolytic effects through GABAergic Pathways. [ABSTRACT FROM AUTHOR]

A rapid and effective method utilizing ultrasonic assisted-dispersive solid-phase microextraction coupled with gas chromatography/mass spectrometry (GC/MS) was developed for the determination of lorazepam and diazepam in biological and aqueous samples. A modified nanocrystalline cellulose-based sorbent was prepared and applied for the microextraction of the analytes. The extraction efficiency of the sorbents prepared using self-assembled N-(2-aminoethyl)-3-aminopropyltrimethoxysilane, including cellulose nanostructure and modified nanocrystalline cellulose, was compared. The modified cellulose nanostructure was characterized using thermogravimetric analysis (TGA), energy dispersive X-ray (EDX), and Fourier transform infrared spectroscopy (FTIR). Additionally, the study investigated the effects of relevant factors on the extraction/desorption performance, including extraction time, ionic strength, and the type and volume of the desorption solvent. The method achieved limits of detection of 1 ng mL−1 and 3 ng mL−1 and quantification limits of 4 ng mL−1 and 10 ng mL−1 for lorazepam and diazepam, respectively. Furthermore, the developed method demonstrated good repeatability with relative standard deviations of 4% and 6% (n = 5) for the spiked analyte aqueous solutions at 50 ng mL−1. The method also exhibited high linearity (R > 0.9996) in the range from 10 to 1000 ng mL−1. [ABSTRACT FROM AUTHOR]

Purpose: This retrospective multicenter cohort study aimed to investigate the impact of diazepam administration during embryo transfer on reproductive outcomes, focusing primarily on the live birth rate. Secondary outcomes included the positive beta-hCG rate, clinical pregnancy rate, miscarriage rate, ectopic pregnancy rate, and preterm birth rate. Methods: Data from 5607 embryo transfers, encompassing 465 cases with diazepam administration, were retrospectively analyzed. The study included single blastocyst transfers from 12 clinics in Portugal and Spain between January 2015 and December 2022. Results: Comparison of reproductive outcomes between patients receiving diazepam and those who did not showed no statistically significant differences. Positive beta-hCG rates (60.8% non-diazepam vs. 60.4% diazepam, p = 0.92, adjusted p = 0.32) and clinical pregnancy rates (45.6% non-diazepam vs. 46.2% diazepam, p = 0.81, adjusted p = 0.11) were comparable. Miscarriage rates (11.0% diazepam vs. 9.3% non-diazepam, p = 0.25, adjusted p = 0.26) and ectopic pregnancy rates (0.9% diazepam vs. 0.1% non-diazepam, p = 0.1, adjusted p = 0.20) were similar. Live birth rates (36.3% non-diazepam vs. 35.3% diazepam, p = 0.69, adjusted p = 0.82) and prematurity rates (0.3% non-diazepam vs. 0% diazepam, p > 0.99, adjusted p = 0.99) also exhibited no statistically significant differences. Conclusions: Based on the results, diazepam administration during embryo transfer did not show a discernible impact on reproductive outcomes, including live birth rates, suggesting its limited effectiveness in enhancing success. [ABSTRACT FROM AUTHOR]

Background: Anxiety transcends a natural emotion, evolving into a pathological condition with the potential to trigger cascading cardiovascular and psychiatric disorders. Although conventional allopathic medicine offers treatment options, concerns regarding their side effects and long-term efficacy remain prevalent. Medicinal plants contain natural compounds that may be promising sources of therapeutic drugs. Aims and Objectives: This study aims to compare the anxiolytic potential of ethanolic and aqueous extracts of Ocimum sanctum (OS). The growing appeal of plant-based therapies for anxiety stems from perceived advantages in safety and tolerability compared to synthetic drugs. Materials and Methods: The anxiolytic activity of aqueous and ethanolic extract of OS is evaluated with an elevated plus maze test. A total of 36 Wistar albino rats (150-200 g) were used and randomly divided into six groups of six animals each. The effects of the test drug at different doses, 100 and 200 mg/kg, were compared with the standard anxiolytic drug diazepam at 2 mg/kg body weight and the control group using distilled water at 0.5 mL/kg body weight. Results: The behavioral changes suggested reduced anxiety and openarm exploration in plus-maze indicates reduced anxiety in animals treated with OS extracts. The changes are significantly (P < 0.001) comparable with the standard drug diazepam. Conclusion: The ethanolic extracts of OS are more significant than aqueous extracts for evaluating anti-anxiety activity in a dose-dependent manner. In addition, ethanolic extracts are more likely to contain a wider range of bioactive compounds, which are thought to be responsible for the anti-anxiety effects of OS. [ABSTRACT FROM AUTHOR]

Background: Traditionally, extracts of Passiflora mollisima leaves are used as anxiolytics, but the existing metabolites are unknown. Objectives: To identify by UHPLC-ESI-MS/MS some of the metabolites and the anxiolytic activity of the leaf extract. Materials and Methods: The extract was subject to UHPLC-ESI-MS/MS analysis and administered intraperitoneally (VIP) to 4 groups of mice: G1: white group 0.1mL of saline solution, G2: positive control group 1mg Kg¯¹ of diazepam and to treatment groups, namely, G3 50 mg Kg¯¹ and G4 100 mg Kg¯¹ and anxiety levels were evaluated with the light/dark transition test for mice. Results: Six flavone C-glycosides were tentatively identified, namely vicenin 2, lucenin 2, schaftoside, orientin, vitexin, and glucopyranosyl methyl luteolin. Lower levels of anxiety were observed in animals of groups G3 and G4 based on the number of transitions, with a mean of 11±2 and 21±2, respectively, compared to G1, which was 2±1 (p

Epilepsia partialis continua (EPC) without intracranial abnormalities is a rare presentation in patients with human immunodeficiency virus (HIV) infection. In our case report, the patient presented with left-sided clonic-myoclonic seizures that were resistant to initial anti-seizure treatment. This condition is classified as EPC. Lesions that could be linked to episodes of EPC were not evident on magnetic resonance imaging. Electroencephalography showed right-sided centroparietal epileptiform activity. After blood testing, the patient was diagnosed with HIV. Dual antiseizure medications were administered, leading to seizure cessation after three days. [ABSTRACT FROM AUTHOR]

Background: Persisting and uncontrollable vomiting in adolescence can indicate several disorders, from self-limiting diseases to life-threatening conditions. Case Report: Herein, we present the case of an adolescent boy with two previous hospitalizations for persistent vomiting with abdominal pain who showed no improvement after ondansetron and omeprazole treatment. Both episodes were characterized by emesis, abdominal discomfort/pain with normal physical examination, and normal radiography and blood analysis. The patient reported relief following a hot water bath. During the second episode, a urinary drug test was performed, which was positive for cannabinoids. Subsequently, he confessed to frequent cannabinoid use during the past two years. Discussion: Cannabinoid hyperemesis syndrome is characterized by cycles of severe persistent nausea and recurrent vomiting associated with abdominal pain in the setting of chronic cannabis use. Physicians should be aware of and fully consider this differential diagnosis due to the rise in cannabis use worldwide. [ABSTRACT FROM AUTHOR]