Journal of Advances in Medical and Biomedical Research
Volume:29 Issue: 136, Sep-Oct 2021

Evidence about the effect of theophylline and gabapentin on post-spinal headache is rare. Therefore, in this study, we compared the effect of gabapentin and theophylline on post-spinal headache after cesarean section.

We conducted a double-blind randomized clinical trial on 120 pregnant women, who underwent spinal anesthesia due to cesarean section; they had experienced post-spinal headache. They were randomly assigned to the study groups, including gabapentin and theophylline groups.The gabapentin group received 400 mg of gabapentin, every eight hours for 24 hours. The theophylline group also received 200 mg theophylline, every eight hours for 24 hours. The visual analog scale (VAS) score was compared between the two groups before the intervention and 8, 16 and 24 hours after the intervention. Statistical analysis was done using Studentchr('39')s t-test. P-value less than 5% was considered as significant.

There was not any significant difference between the two groups in regards of VAS score, before the intervention and 8 and 16 hours after the intervention; the significant lower VAS score was reported by the theophylline group, 24 hours after the intervention (0.7±1.79 vs. 2.23±2.58, P=0.014). Reductions in the VAS score during 8 hours (3.14 vs. 2.67), 16 hours (4.7 vs. 3.47) and 24 hours (5.5 vs. 3.8) were compared after the intervention; it was higher in the post-intervention compared to the pre-intervention in the theophylline group.

The present clinical trial study showed that reduction in the VAS score was significantly higher in the theophylline group compared to the gabapentin group, only within 24 hours. Both gabapentin and theophylline were effective against post-spinal headache, but Theophylline was more effective on pain relief within 24 hours.

Dyskinesia is a debilitating complication of Parkinsonchr('39')s disease (PD), which appears due to some known risk factors. The effect of diabetes and high plasma glucose on the manifestation of dyskinesia has been evaluated in just a few previous reports. The current study aimed to assess the mentioned correlation.

 In this case-control study, 88 patients with PD were enrolled and categorized into two equal groups of diabetic and non-diabetic patients. They were selected from the movement disorder clinic in Rasoul Akram Hospital, Tehran, Iran. Patients were evaluated regarding the presence of dyskinesia and its characteristics, besides the assessment of other clinical parameters. 

 The prevalence of dyskinesia in diabetics, compared to non-diabetics, showed a higher rate (P=0.033). Baseline parameter equality was confirmed to exclude the confounding bias effect. Simultaneous involvement of upper and lower extremities (right after drug intake) was the most prevalent sign of dyskensia in diabetic patients with PD.

 The comorbidity of PD and diabetes showed a higher prevalence of levodopa-induced dyskinesia (LID) in PD; this result was obtained based on homogeneity of the two groups in manners of age, disease, treatment duration and the dosage of levodopa.

Stroke is the second leading cause of mortality and the third leading cause of morbidity worldwide. This study aimed to examine the spatial-temporal distribution of stroke in rural districts, Zanjan Province, Iran.

This cross-sectional study was conducted at Zanjan University of Medical Sciences (ZUMS). Patients with a discharge diagnosis of stroke (the ICD-10 code of I64), hospitalized during 2012-2019 at ZUMS hospitals, were selected as the study sample. Spatial statistical tools, autocorrelation Moran’s I, high-low clustering analysis, and hot spot analysis were used for spatial data analysis. ArcGIS 10.7, R 3.6.0, and RStudio 1.2.1335 software packages were used to analyze the data.

During 2012-2019, 8404 stroke cases were hospitalized at ZUMS hospitals, with an incidence of 697 patients per 100 000 people. Men had a higher rate of stroke incidence (52.06%) compared with women (47.94%). The mean age of patients was 69.3±14.7 years; the mean length of stay was 158.8±270 hours. In the study area, 4 significantly hot spot areas and 4 low-high outliers of stroke were found.

This study showed a high incidence of stroke in Zanjan Province, Iran, from 2012 to 2019. Identifying high-risk areas of stroke is a warning to healthcare authorities and policymakers to focus on major risk factors. It can help to figure out the possible causes of stroke and implement prevention programs to reduce stroke incidence in these areas.

Today, obesity is one of the most important health problems in the world. The purpose of this study was to determine the effects of caffeine and high fat diet on expression of PGC1-α, Fndc-5 and UCP-1 genes in male Wistar rats.

To study the aim of this survey, 40 male Wistar rats were divided into four equal groups (n=10 in each group), including: 1) control, 2) high fat diet (HFD), 3) caffeine and 4) high fat diet and caffeine (HFD+caffeine) groups. Oral gavage of caffeine was performed in a dose of 6 mg/kg body weight. PGC1-α and Fndc-5 mRNA of muscles, and UCP-1 mRNA of subcutaneous fatty tissue were measured using real-time polymerase chain reaction (qPCR). One-way ANOVA test was used to analyze the data.

The results of the present study showed that caffeine prevented overweight and increased PGC1-α, Fndc-5 and UCP-1 gene expression in the caffeine group. There were no significant differences in target genes expression, between the HFD+caffeine and the control group.

Based on our results, caffeine is a preventive factor for obesity. It can increase the converting process of white adipose tissue to the brown.

 Hypothyroidism leads to an increased risk of overweight and obesity. This study examined the effect of weight gain caused by hypothyroidism on maternal health (hypertension, gestational diabetes, and miscarriage) for the first time.

This case-control study consisted of 123 pregnant women with clinical hypothyroidism and 242 non-hypothyroid pregnant women as the control group. National guidelines were used to diagnose hypothyroidism in the first trimester. Body mass index (BMI), thyroid-stimulating hormone level, as well as systolic and diastolic blood pressure (BP) were measured. Moreover, fasting blood sugar was assessed during 24-28 weeks of gestation. Data were analyzed by the Chi-square, Student’s t-distribution, and logistic regression using the SPSS19 software.

 We found a significant relationship between BMI and hypothyroidism in pregnant women (P<0.001). Systolic and diastolic BP in the case group were higher in women with BMI≥25 (P=0.017 and P=0.002). Furthermore, diastolic BP had a significant impact on abortion (P=0.018). The rate of abortion increases by 1.042 with 1 mmHg elevation in diastolic BP in pregnant women if the variables maternal age, hypothyroidism, and overweight are constant.

 According to the results of the present study, weight gain in women with hypothyroidism can affect the risk of high diastolic BP and abortion.

Both duloxetine (DLX) and transcutaneous electrical nerve stimulation (TENS) are recommended as safe and effective treatments for diabetic peripheral neuropathic pain. However, these methods have not been compared. This study aimed to compare the efficacy of treatment by DLX and TENS in diabetic neuropathy pain relief.

This survey was performed on 60 eligible diabetic patients randomly divided into two groups of DLX (20, 40, and 60 mg/day for weeks 1, 2, and 3-12, respectively), and TENS (20 min,80 HZ, 50 Amp, 0.2 ms Square pulses 2-3 times sensory threshold). The participants were evaluated according to the numerical rating scale (NRS) after four and twelve weeks of treatment. Moreover, adverse drug reactions were documented during the study period.

Baseline demographic data had no significant difference between the two groups (P≥0.05). The average NRS scores were significantly lower in the DLX group in both measurement times. At the end of weeks four (P=0.01) and 12 (P=0.001), the trend of changes was significant from baseline to the third month (P=0.0001). No patient in the TENS group reported any side effects, while 18% did in the DLX group.

We found that both DLX and TENS were effective and safe for the management of painful diabetic neuropathy. The DLX seemed to be better, compared to TENS. However, in some conditions, such as drug intolerance or contraindication for medications, TENS could be a proper intervention.

The frontal sinus is regarded as one of the human paranasal sinuses located in the frontal bone as a triangular-shaped cavity, which originates as separated space from the anterior ethmoid cells. Computed Tomography (CT) is a completely non-destructive technique that uses a high density of contrast to identify the air inside any bony sinus with soft tissue demarcated by air within a particular nasal cavity. This study aimed to measure the anteroposterior length, width, and height of frontal sinus in different age groups of both genders with axial, coronal, and sagittal CT scans, as well as identifying the pneumatization of that sinus according to the extent represented by CT scans.

A prospective study was conducted on a random sample of 250 subjects attending the Radiology Section of both Baghdad Medical City and Salah Al-Deen Teaching Hospitals from February 2019 to January 2020. Different age and gender groups from these individuals underwent measurement of the anteroposterior length, width, and height of frontal paranasal sinus in axial, sagittal, and coronal CT scans.

The frontal air cells belonged to the anterior group including four types and one medial group with a prevalence of 37.6%, 18%, 16.8%, 6.8%, and 20.8%, respectively, through a series of CT scan sections. The mean values of frontal sinus length, width, and height for males were 19.8±8.7 mm, 32.8±8.7 mm, and 29.7±8.8 mm, respectively; and for females were 14.9±8.3 mm, 25.4±9.2 mm, and 22.5±9.2 mm, respectively.

A high incidence of frontal sinus cell types and supraorbital cells suggested the superioposterior partition of frontal sinus which tends to demonstrate more pneumatization than other partitions.

 The behavior of COVID-19, clinical symptoms, and mortality rate are not the same in different regions. Due to lack of knowledge about the cited issues, we aimed to investigate the clinical symptoms, case fatality rate, and some risk factors of COVID-19.

This longitudinal study was started from the late February 2020 and lasted to the mid-July 2020 in Jiroft, Kerman province, Iran. The course of the disease, clinical signs and symptoms, underlying diseases, patientschr('39') exposure history, travel history, adherence to health instructions, and the fatality rate of the disease were evaluated in the patients. The descriptive statistics and frequency were analyzed in different groups using IBM SPSS statistics version 20.

In this study, 2977 definitive cases of COVID-19 were detected using RT-PCR test. The frequent clinical symptoms were fever (45.2%), body aches and bruises (38.8%), and cough (36.4%), respectively. The fatality rate of the disease was 4%. Evaluation of the patients’ exposure history showed that almost 50% of the cases had no exposure. Among the studied individuals, 33% had the history of exposure to a definite COVID-19 case.

Personal hygiene, social distancing, and use of face mask are of great importance in reducing the disease morbidity and mortality. Public awareness about COVID-19 should also be increased, especially in the elderly individuals with the history of underlying and chronic diseases.