fariborz khorvash

Migraine is characterized by frequent attacks of debilitating headaches, often accompanied by sensory and motor disturbances. Although the clinical manifestations of migraine are influenced by diet, the relationship between food groups such as legumes and nuts with migraine has not been identified. The present study was conducted to compare the consumption of legumes and nuts among patients with migraine and healthy individuals and to investigate the relationship between their consumption and migraine.

This study included 140 patients with migraine and 230 age-matched healthy individuals. Food intake was assessed using a semi-quantitative food frequency questionnaire (FFQ). The characteristics of migraine headaches and the headache daily result (HDR) were also evaluated using the visual analogue scale (VAS).

Patients with migraine consumed fewer legumes, not nuts. After adjusting for potential confounders, patients with the highest tertile legume intake were found to have a 2.9 times higher risk of severe migraines [odds ratio (OR): 2.90, 95% confidence interval (CI): 1.03-8.16] and a 65% reduced chance of experiencing recurrent migraines (OR: 0.35, 95% CI: 0.13-0.97). Patients who consumed more nuts had a 63% reduced likelihood of experiencing long-term headaches (OR: 0.37, 95% CI: 0.14-0.99) and a 69% reduced risk of HDR.

Our findings indicated that higher consumption of legumes was associated with increased intensity and decreased frequency of migraine attacks.

Migraine headaches are one of the psychosomatic disorders that severely impair patients' quality of life and general functioning by mediating psychological problems. The aim of this study was to investigate the mediating role of pain intensity in the relationship between psychosomatic components on quality of life in these patients.

Methods and Materials:

 In this cross-sectional study, 250 patients with migraine were selected based on inclusion and exclusion criteria among people with migraine referred to the Pain and Neurology Clinic affiliated to Isfahan Medical Sciences in 2020 through available sampling. In the appropriate psychological situation, after justifying the goals of the research, the World Health Organization Quality of Life Questionnaire (SF-26), Von Korff’s Pain Intensity Scale (PIS) and also the Diagnostic criteria for psychosomatic research Questionnaire (DCPR) were completed.

The results showed that there was no significant correlation between pain intensity and other variables and only psychosomatic components had a significant negative correlation with quality of life dimensions and Also, in the path analysis model, no significant direct and indirect relationship was found between psychosomatic components and pain intensity with different dimensions of quality of life, although the proposed path analysis model showed a good fit.

The findings of this study suggest the development of psychological intervention packages based on the explanatory model for the correction of Alexithymia, irritable mood, health anxiety and type A behavior in order to improve the quality of life of migraine patients.

Increased body mass index (BMI) seems to be a risk factor for migraine attacks. Cinnamon has anti-inflammatory, neuroprotective, and anti-obesity effects. This study aimed to assess the effects of cinnamon on anthropometric indices and headache-related disability of patients with migraine.

This study was conducted as a randomized, double-blind, placebo-controlled trial involving 50 migraine patients. Patients were randomized to receive either 600 mg cinnamon powder or placebo capsules for two months. Height, body weight (BW), waist circumference (WC), and hip circumference (HC) were measured.Furthermore, Minimal or Infrequent Disability (MIDAS) and Headache Daily Result (HDR) Questionnaires were recorded.

At the end of the treatment period, BW and BMI did not change in the intervention group; however, both factors were significantly increased in the placebo group (p=0.001). The change of WC, HDR and MIDAS was significantly different between the intervention and placebo groups (p<0.001). Furthermore, HC and WHR significantly decreased (p=0.001).

Cinnamon seems to have beneficial effects on anthropometric indices and headache disability of migraine patients.

Cerebrovascular diseases comprise a significant portion of neurological disorders related to coronavirus disease 2019 (COVID-19). We evaluated the clinical and imaging characteristics of a cohort of COVID-19 patients with stroke and also identified patients with watershed infarcts.

In this cross-sectional study, seventy-three COVID-19 patients with ischemic stroke were included between October 2020 and January 2021. Patients were evaluated based on the following clinical and imaging features: severity of COVID-19 (critical/non-critical), stroke type, presence/absence of clinical suspicion of stroke, medical risk factors, Fazekas scale, atherothrombosis, small vessel disease, cardiac pathology, other causes, and dissection (ASCOD) criteria classification, and presence or absence of watershed infarction. Clinical outcomes were assessed based on Modified Rankin Scale (MRS) and mortality.

Most cases of ischemic stroke were due to undetermined etiology (52.1%) and cardioembolism (32.9%). In terms of imaging pattern, 17 (23.0%) patients had watershed infarction. Watershed infarction was associated with the clinically non-suspicious category [odds ratio (OR) = 4.67, P = 0.007] and death after discharge (OR = 7.1, P = 0.003). Patients with watershed infarction had a higher odds of having high Fazekas score (OR = 5.17, P = 0.007) which was also shown by the logistic regression model (adjusted OR = 6.87, P = 0.030). Thirty-one (42%) patients were clinically non-suspected for ischemic stroke. Critical COVID-19 was more common among patients with watershed infarct and clinically non-suspicious patients (P = 0.020 and P = 0.005, respectively). Patients with chronic kidney disease (CKD) were more prone to having stroke with watershed pattern (P = 0.020).

Watershed infarct is one of the most common patterns of ischemic stroke in patients with COVID-19, for which clinicians should maintain a high index of suspicion in patients with critical COVID-19 without obvious clinical symptoms of stroke.

Structural planning is essential for the management of constipation in stroke patients. The current study aims to determine the impact of a care plan on the frequency of new‑onset constipation following stroke.Materials and Methods: This clinical trial was conducted on 132 stroke patients (two groups of 66) in three phases (pre‑intervention, during discharge, 1 month after discharge). Clients were randomly assigned to blocks based on gender, type of stroke, and age. The care plan according to the nursing process was conducted. Data collection tools included a demographic–clinical information questionnaire, Rome IV criteria (diagnosis of constipation), and Bristol scale (consistency of stool). Data were analyzed using the Chi‑square, McNemar, Wilcoxon, Analysis of Variance (ANOVA), and a general estimated model.

The prevalence of new‑onset constipation following stroke in the control group decreased from 66 (100%) at admission to 39 (67.20%) at discharge and in the intervention group from 66 cases (100%) to 18 cases (34%) (p </em>= 0.001), but it was not significant at follow‑up (p </em>= 0.16). The trend of frequency of constipation from admission to follow‑up was generally significant in the intervention group (p </em>= 0.03) vs the control group (p </em>= 0.21). The difference in the mean number of cases of constipation was statistically significant (2.89) 2.10) control group vs 1.58 (1.65) intervention group, p </em>< 0.001).

A significant impact of the care plan was observed from admission to discharge, but further follow‑up was required with more client‑side collaboration. Therefore, the present care plan is recommended in the hospital and home care.

Migraine is one of the most common diseases. Curcumin with anti-oxidative and anti-neuroinflammatory properties might have beneficial effects in migraine patients. This study will be conducted to evaluate the effects of a phytosomal preparation of curcumin on clinical signs, oxidative stress, and inflammatory parameters in patients with migraine. This is a randomized, double-blind, placebo-controlled, clinical trial in which, 60 patients with migraine will be assigned to receive a daily dose of 250 mg of phytosomal curcumin for 8 weeks (intervention group) or 250 mg maltodextrin as a placebo for the same duration (control group). Before and after the study, frequency, duration, and severity of the attacks, quality of life and sleep, mood status, high-sensitivity C-reactive protein (hs-CRP), Nitric Oxide (NO), and oxidative stress factors will be measured. It seems that phytosomal formulation of curcumin (a solid dispersion preparation of curcumin with phosphatidylserine) with high bioavailability, can cross the blood-brain barrier (BBB) and result in decreased neuroinflammation, oxidative stress, and neurotoxicity. This way, phytosomal curcumin might lead to reduction of headaches and other complications of migraine and increase the quality of life of patients with migraine.

Migraine is a chronic headache manifested with attacks. Here we aimed to evaluate and compare the efficacy of 15?point Dysport injection with 31?point Xeomin injections.

This is a randomized clinical trial performed in 2020–2021 in Isfahan on patients with refractory chronic migraine. A total number of 60 patients entered the study. The pain of patients was also determined using headache impact test (HIT) questionnaire. Patients were randomized into two groups: Group 1 underwent 31?point Xeomin injection and Group 2  nderwent 1 vial of Dysport injection into 15 points of the scalp.

Our study revealed that the data regarding aura, nausea, vomit,  hotosensitivity, sensitivity to sounds and smells did not change  ignificantly between two groups compared to the beginning of the study. Frequency, duration, intensity of headaches, and the mean HIT score of all patients improved significantly within 3 months after interventions. Comparing both groups showed no significant differences (P > 0.05). HIT score was decreased from 21.26 ± 3.58 before intervention to 15.51 ± 4.58 after 3 months in Group 1 and 22.23 ± 2.59–10.33 ± 2.26 in Group 2. In both groups, these changes were statistically significant (P < 0.001). Although we found more decrease of HIT score in Group 2 comparing with Group 1 (10.33 ± 2.26 vs. 15.51 ± 4.58), this difference was notstatistically significant (P = 0.12).

Although Xeomin and Dysport injections are both effective and reduced pain in patients with chronic migraine, our new technique is probably better than the standard technique. Because the injection points are halved, increase patients comfort and reduce overall cost.

Neurological manifestations of coronavirus disease 2019 (COVID‑19) have been highlighted. COVID‑19 potentially increases the risk of thromboembolism. We aimed to compare patients with COVID‑19 with and without new‑onset acute ischemic stroke (AIS).

In this single‑center retrospective case–control study, demographics, clinical characteristics, laboratory findings, and clinical outcomes were compared between 51 patients with both COVID‑19 and AIS (group A) and 160 patients with COVID‑19 and without AIS (group B).

Patients in group A were significantly older, more likely to present with critical COVID‑19 (P = 0.004), had higher rates of admission in the intensive care unit (P < 0.001), more duration of hospitalization (P < 0.001), and higher in‑hospital mortality (P < 0.001). At the time of hospitalization, O2 saturation (P = 0.011), PH (P = 0.04), and HCO3 (P = 0.005) were lower in group A. White blood cell count (P = 0.002), neutrophil count (P < 0.001), neutrophil‑lymphocyte ratio (P = 0.001), D‑Dimer (P < 0.001), blood urea nitrogen (BUN) ( P < 0.001), and BUN/Cr ratio (P < 0.001) were significantly higher in patients with AIS.

Stroke in COVID‑19 is multifactorial. In addition to conventional risk factors of ischemic stroke (age and cardiovascular risk factors), we found that patients with more severe COVID‑19 are more prone to ischemic stroke. Furthermore, leukocyte count, neutrophil count, neutrophil‑lymphocyte ratio, D‑Dimer, BUN, and BUN/Cr ratio were higher in patients with AIS following COVID‑19 infection.

Migraine is a neurologic disorder with wide global spread. Quality of life (QOL) and dietary factors are important parameters in migraine management. The aim of this study was to evaluate the relationship of mood status, QOL, and dietary intake with migraine symptoms among women with migraine.

This cross-sectional study was conducted on 143 women with migraine aged 20–40 years who were randomly selected from two clinics in Isfahan, Iran. Data were collected using the Food Frequency Questionnaire for Assessing Dietary Patterns, a visual analogue scale for migraine headaches, the Migraine-Specific Quality of Life Questionnaire, and the Depression Anxiety Stress Scale. The serum level of calcitonin gene-related peptide (CGRP) was also measured.

Participants’ age and number of sleeping hours per 24 hours had significant relationship with migraine severity, depression and anxiety had significant relationship with migraine severity and the duration of migraine attacks, and QOL had significant relationship with migraine severity and the duration and frequency of migraine attacks. Daily intake of riboflavin also had significant relationship with frequency of migraine attacks, while daily intake of water had significant relationship with migraine severity (P < 0.05). However, serum level of CGRP had no significant relationship with migraine (P > 0.05). The relationships of vitamin D and magnesium intake with depression were also significant (P < 0.05).

Serum level of CGRP has no significant relationship with migraine attacks, while depression, anxiety, QOL, and magnesium and vitamin D intake have significant relationship with migraine attacks.

Migraine headaches are one of the psychosomatic disorders that severely impair patients' quality of life and general functioning by mediating psychological problems. The aim of this study was to investigate the mediating role of pain anxiety in the relationship between psychosomatic components on quality of life in these patients.

In this cross-sectional study, using available sampling method, 250 patients with migraine were selected based on inclusion and exclusion criteria among people with migraine referred to the Pain and Neurology Clinic affiliated to Isfahan Medical Sciences, Isfahan, Iran, in year 2020. In the appropriate psychological situation, after justifying the goals of the research, the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), McCracken Pain Anxiety Questionnaire (PASS-20) and also the Diagnostic Criteria for Psychosomatic Research Questionnaire (DCPR) were completed.

There was a negative correlation between the components of psychosomatic and pain anxiety with the dimensions of quality of life. Moreover, there was an indirect relation between the components of psychosomatic with the dimensions of quality of life, a direct relation between pain anxiety and the dimensions of quality of life. Besides, the proposed model of path analysis of variables had a good fit.

The findings of this study explain the contribution of some underlying psychological factors in the occurrence and persistence of headache. Moreover, this study suggests the development of psychological intervention packages based on an explanatory model to improve the quality of life of patients with migraine.

Oxidative stress-induced mitochondrial damage is the main event in acquired brain injuries (ABI). This study aimed to evaluate the effects of melatonin, a mitochondria-targeted antioxidant, on mitochondrial and brain injury markers, and the clinical outcomes of patients with ABI.

In this randomized controlled trial, intensive care unit (ICU) or neurology patients with ABI (n=60) received melatonin (21 mg/day) or placebo tablets, within the first 72 hours of injury onset for five days. As a primary endpoint, serum levels of malondialdehyde (MDA), S100B and C-reactive protein (CRP) were compared at baseline, and after five days’ intervention. Secondary endpoints included assessment of Glasgow Coma Scale and Sequential Organ Failure Assessment (at the end of day 5), Rancho Los Amigos Revised Scale and modified Rankin Scale (at the end of month 3), the duration of mechanical ventilation, the lengths of ICU and hospital stays, and in-hospital and three-month mortality.

There were no significant effects of melatonin on the primary and secondary outcomes. However, the subgroup analysis showed a significant reduction in S100B in patients with non-traumatic brain injuries, receiving melatonin versus placebo (p: 0.016).

This study showed that melatonin supplementation in the early phase of brain injury had no significant effects on the injury markers and clinical outcomes of patients with ABI. However, it reduced the level of S100B in the non-traumatic subgroup. Further larger-scale studies are needed to determine the effects of melatonin on the ABI and its subgroups.

Anticoagulation therapy following cerebral vein thrombosis (CVT) can improve mortality and morbidity. Vitamin K antagonists are currently the routine oral anticoagulant used for CVT; while by introduction of rivaroxaban, a direct factor Xa inhibitor, the attentions have been deviated toward novel agents, but the evidence is not strong. The current study is aimed to compare the efficacy and safety of rivaroxaban versus warfarin for anticoagulation therapy of CVT. The current randomized clinical trial has been conducted on 50 patients with CVT among which, 25 ones were randomly allocated to rivaroxaban treatment (20 mg per day for three months) and remained 25 ones to warfarin treatment [adjusted based on international normalized ratio (INR) of 2-3]. The Modified Rankin Scale (mRS) and clinical investigations, including the incidence of seizure, papilledema, intra/extra-cranial bleeding, blurred vision, headache, nausea and vomiting, and death were evaluated at discharge time and within 3 and 6 months following CVT incidence; eventually, two groups were compared. Comparison of mRS scores between the groups revealed significant differences in none of the interval assessments, at the time of admission (P = 0.510), within three months (P = 0.630), and within six months (P = 0.990), while both of the approaches led to significant decrease in mRS scores following both of the treatments (P < 0.001). The comparison of drug-related adverse effects showed insignificant difference between warfarin versus rivaroxaban (P > 0.050). Based on this study, rivaroxaban is an efficacious agent for the treatment of CVT without remarkable adverse effects.

The impacts of new-onset constipation outcomes in stroke clients have remained unclear. It seems helpful to update the structure planning with nursing-led intervention. 

The current study aimed to present a protocol and methods of Caspian Nursing Process Projects in new-onset constipation by nursing-led intervention considering the experts’ point of view.

The current multi-stage evolutionary study describes the protocol and methods of Caspian Nursing Process Projects, which were conducted on stroke constipation, such as new-onset constipation. The study was conducted in several phases, including searching for scientific sources, formal-content validity, RAND and Delphi methods, and changes made at the Delphi stage and the experts’ panel. We selected 21 studies published between January 2004 and December 2019 in the Cochran database, Medline, Science Direct, PubMed, Elsevier, and Scopus. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and AGREE II (The Appraisal of Guidelines for Research & Evaluation) were used to evaluate the articles and guidelines.

After considering the inclusion and exclusion criteria, 14 articles and guidelines were entered. Most of the authorities were 16 men (72.7%), 11 cases had MD degrees (50%), and 4 (18.2%) were neurologists. Regarding the priority, the highest agreement was found on patient and companion education (98%) and the lowest on disability in daily activity (75.6%). In terms of benefits, patient education again achieved the highest agreement with 97.2%, and use of the Bartel index with 73.6% obtained the lowest agreement. Regarding the applicability, registration, and reporting, the water and electrolyte impairment and educational booklet obtained the highest agreement with 93.6%.

All recommendations had reached over 70% agreement in all four areas of the initial draft, and some care should be taken only by stroke nurses or critical care nursing. The study results can be used for developing national guidelines or criteria.

Migraine is a prevalent health condition associated with significant pain and disability. Neurogenic inflammation has a key role in migraine pathophysiology. Curcumin is a well‑known herb compound with anti‑inflammatory function. This study was aimed to evaluate the effects of curcumin supplementation on clinical features, as well as on serum levels of calcitonine gene‑related peptide (CGRP) and interleukin‑6 (IL‑6).

This randomized double‑blind placebo‑controlled clinical trial was carried out on 44 women with migraine, receiving either 500 mg curcumin twice a day or placebo supplements for 8 weeks. Serum CGRP and IL‑6 concentration, and clinical symptoms including headache severity, duration and frequency were measured at the baseline and end of study.

After 8‑week intervention, compared with placebo, curcumin supplementation led to significand reduction in CGRP (P < 0.001), IL‑6 (P = 0.041), severity (P = 0.001), and duration of headache ( P = 0.007). Headache frequency showed marginal improvement in curcumin group, compared to controls ( P = 0.052). Within‑analysis indicated significant decrease in CGRP and severity (P < 0.001), frequency ( P = 0.014) and duration ( P = 0.003) and no significant decrease in IL‑6 (P = 0.454), compared to baseline in curcumin group. There were no significant changes in body mass index (BMI), weight, percent body fat (PBF), and percent body muscle (PBM) between the two groups.

Curcumin supplementation improved the pro‑inflammatory markers and clinical features of migraine headaches and that could be contributed to could be to its anti‑inflammatory properties.

Because of the unwanted effects of the patient’s migraine headaches and the role of excitement and stress in the development and exacerbation of headaches, migraine headaches are psychosomatic disorders that affect the patients’ psychological lives. The present study aimed to investigate the effectiveness of Compassion-Focused Therapy (CFT) for improving emotional control and reducing the severity of pain in patients with migraines.

A total of 30 patients with migraines referred to Isfahan Al-Zahra Hospital, Isfahan City, Iran, were selected and randomly divided into experimental and control groups. The research instruments included the Emotion Control Questionnaire (ECQ), von Korff’s questionnaire for grading the severity of chronic pain, and the Migraine Disability Assessment (MIDAS) questionnaire. The experimental group received eight 90-min sessions of CFT, and both groups took the post-test after finishing the training sessions. Analysis of the data involved both descriptive and inferential statistics, including mean, standard deviation, Multivariate Analysis of Covariance (MANCOVA), and Analysis of Covariance (ANCOVA). 

The results showed that the training based on CFT had a significant effect on improving emotional control and its subscales (F=21.81; P<0.01), as well as reducing pain severity in the patients (F=17.21; P<0.01). 

Therefore, in treating migraine patients, CFT can be a useful supplementary approach along with medications.

Prevalence of migraine is reported at 14.7% and 14% around the world and Iran, respectively. Zinc deficiency is recognized as one of the nutritional problems worldwide. People with migraines have lower levels of zinc, as compared to healthy individuals. The present study aimed to determine the effect of zinc supplementation on symptoms and C-Reactive Protein as a sensitive marker of inflammation among patients with migraine.

This double-blinded randomized clinical study was conducted on 80 patients with migraine in Isfahan, Iran, in 2016. Participants were randomly assigned to the intervention and control groups. The patients in the intervention and control groups received one daily dose of 220 mg zinc sulfate (50 mg zinc) and a placebo (starch) for 8 weeks. The symptoms of migraine attacks, including the severity of headache, frequency and duration of headache, headache diary result (HDR), and C-Reactive Protein (CRP) levels were measured for each patient at baseline and at the end of the trial.

At the commencement of the study, there was no significant difference between the two groups regarding migraine symptoms. In addition, the intervention decreased the severity (P=0.048), frequency (P = 0.026), and headache diary result (HDR) (P=0.02), as compared to the placebo. Nonetheless, the two groups were significantly different regarding the mean duration of headache attacks (P=0.092).

As evidenced by the obtained results, zinc supplementation for 8 weeks may be an effective treatment for migraine symptoms.

A randomized, double-blind, placebo-controlled clinical trial was performed to assess the effect of omega-3supplementation(3g/day) on atherosclerosis progression by measuring carotid intima-media thickness (cIMT) in hemodialysis (HD) patients.

A total of 54 HD patients were randomized into two groups: Intervention group (n = 27), in which patients were given 3 g/day omega-3 for 6 months and placebo group (n = 27), in which patients received placebo using the same administration protocol. All patients underwent a carotid artery ultrasound scan to measure cIMT at baseline and at 6 months.

cIMT decreased significantly in omega‑3 group (0.79 ± 0.21 mm at baseline vs. 0.65 ± 0.18 mm at 6 months, P < 0.001). On the other hand, a nonsignificant increase in cIMT was seen in placebo group (0.75 ± 0.17 mm at baseline vs. 0.79 ± 0.17 mm at 6 months, P = 0.12). Moreover, cIMT was statistically significantly different between omega-3 and placebo groups at 6 months (P < 0.001). After 6 months, a statistically significant increase was observed in high‑density lipoprotein level in omega‑3 group compared to placebo group (P = 0.03). Urea reduction ratio was also statistically significantly higher in omega‑3 than placebo group at 6 months (P = 0.03). No significant difference was observed in terms of other variables between the two groups.

These data suggested that omega-3 supplementation plays a protective role in the progression of atherosclerosis in HD patients.

Stroke causes physiologic functional changes such as vascular resistance and arterial remodeling. This study aimed to explore the effects of 3‑month regular home‑based exercise rehabilitation on brachial flow‑mediated dilation (FMD), daily physical activity, and upper and lower extremity sensorimotor of the acute ischemic stroke patients.

This randomized control trial was done from August 2017 to September 2018. Patients with unilateral ischemic stroke were recruited from inpatient wards at an educational hospital. Patients were randomly assigned to the home‑based rehabilitation program (intervention group) or usual care (control group). Fugl‑Meyer upper and lower extremity sensorimotor score and Barthel score were evaluated in both the groups before and 3 months after baseline assessment. Furthermore, brachial artery vasomotor reactivity (FMD) hemiparetic arm assessed vascular health. The intervention group received home‑based rehabilitation exercise program for 3 months. The control group did not receive home‑based rehabilitation program and incentive telephone call. All data were collected and analyzed by SPSS software (version 20) and appropriate statistical tests.

Forty ischemic stroke patients (twenty in the intervention group and twenty in the control group) were examined. Results showed that Barthel score and Fugl‑Meyer upper and lower extremity score and FMD in the intervention group were significantly higher than the control group after 3‑month home‑based exercise rehabilitation (P < 0/001).

Twelve‑week regular home‑based exercise training was well tolerated by the intervention group. After this period, improvements were reported in brachial FMD as well as daily physical activity and upper and lower extremity functional capacity.

Inflammation is defined as body tissues response to harmful stimuli. Obesity‑related inflammation leads to increased risk chronic diseases including diabetic polyneuropathy (DPN). The present study was performed to determine association between body mass index (BMI) and inflammatory markers including erythrocyte sedimentation rate (ESR) and C‑reactive protein (CRP) in DPN patients.

In this cross‑sectional study, 200 DPN patients with a mean (SD) of age 58.76 (9.53) years were selected. All patients completed the questionnaire including demographic data and chronic disease history. In addition, anthropometric measures and clinical laboratory tests were taken. Multivariate linear regression was used to detect the association between BMI, CRP, and ESR levels.

BMI was associated with increase in ESR and CRP levels (β‑ESR = 4.67, P < 0.001 and β‑CRP = 0.71, P < 0.001). Also, this association remained after adjustment for other different variables.

These findings indicate that higher BMI is related to increase inflammatory markers including CRP and ESR in DPN patients. Therapies for DPN and reducing inflammation should target the weight loss among obese patients

Among patients with diabetic polyneuropathy, the status of folic acid, homocysteine, and nerve conduction studies (NCS) variations has been associated with methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms. The objective of the present study is to assess B9 vitamin supplementation associated with MTHRF C677T polymorphism can be effective on NCS variations in patients. This study is a randomized, double‑blind, placebo‑controlled study. Patients were randomly allocated to either intervention (1 mg of folic acid, n = 40) or placebo (n = 40) groups based on parallel group design. Blood samples were taken to determine the serum levels of folic acid and homocysteine. The NCS data were collected for the assessment of diabetic neuropathy. Genotyping was performed for C677T polymorphism of the MTHFR gene. Four months after intervention, patients significantly observed change of serum folic acid and homocysteine levels based on C677T genotypes in the MTHFR gene. The amplitude of sensory peroneal nerve between intervention and placebo groups with CC genotype was significantly different (2.8 ± 1.6 vs. 1.9 ± 1.1). However, peak latency and amplitude of sensory sural nerve between CC (3.8 ± 1.8 vs. 4.0 ± 1.5 for peak latency and 3.5 ± 1.0 vs. 2.5 ± 1.0 for amplitude; and CT + TT genotypes (3.7 ± 1.7 vs. 3.9 ± 1.3 for peak latency and 3.2 ± 1.0 vs. 2.3 ± 1.1 for amplitude) were significant. Furthermore, significant difference for variables of motor tibial nerve and motor peroneal nerve amplitude was observed in different groups of MTHFR C677T genotypes (5.4 ± 2.9 vs. 4.6 ± 3.2 for onset‑latency of tibial nerve between CC genotype; 4.8 ± 2.8 vs. 4.6 ± 3.2 for onset‑latency of tibial nerve between CT + TT genotype; 0.6 ± 0.2 vs. 0.3 ± 0.1 for amplitude of tibial nerve between CC genotype; 0.5 ± 0.3 vs. 0.3 ± 0.2 for amplitude of tibial nerve between CT + TT genotype; 26.0 ± 13.3 vs. 23.2 ± 13.4 for velocity of tibial nerve between CC genotype; 26.0 ± 13.7 vs. 23.1 ± 9.6 for velocity of tibial nerve between CT + TT genotype; 1.6 ± 1.0 vs. 0.9 ± 0.7 for amplitude of peroneal nerve between CC genotype; 1.4 ± 0.7 vs. 0.9 ± 0.5 for amplitude of peroneal nerve between CT + TT genotype). The study determined that MTHFR C677T polymorphism effects the efficacy of folic acid supplementation on serum folic acid, homocysteine levels and some NCS parameters in diabetic polyneuropathy patients.

Patients who experienced transient ischemic attack (TIA) are at high‑risk for cardiovascular events. This study aims to evaluate diagnostic value of carotid artery intima‑media thickness (CIMT) and ABCD2 score for predicting cardiovascular events in long‑term follow‑up
after TIA. We prospectively included sixty patients with TIA who admitted to hospital from March 2016 to August 2016. Duplex ultrasonography of internal carotid arteries was performed. ABCD2 scores were evaluated for each patient. At a median follow‑up of 20 months, patients were asked about new cardiovascular events. We used IBM SPSS software version 22.0 with Chi‑squared,
t‑test, ANOVA, receiver operating characteristic, and area under the curve (AUC) analysis for our work. Sensitivity and negative predictive value of the combined score (ABCD2+CIMT) was the highest (96.3% and 90.9%, respectively), and the specifcity and positive predictive value of the CIMT were the highest (57.5% and 63.1%, respectively) to predict cardiovascular events in long‑term. Compared to ABCD2 score, CIMT proved to be more accurate to predict cardiovascular events in long‑term follow‑ups (AUC = 0.736 vs. AUC = 0.640). However, adding CIMT value to ABCD2 score was even better (AUC = 0.750). Therefore, CIMT measurement in the ABCD2 score after TIA enables prediction of long‑term cardiovascular events.

Prostaglandin I2 receptor plays a major physiologic role in the relaxation of arterial smooth muscle and vasodilation and possibly during migraine attacks. Therefore, in this study, the coding and noncoding exons and exon-intron boundaries of Prostaglandin I2 receptor gene were examined in patients with migraine headache and healthy controls and the potential effects of identified single nucleotide variations were evaluated using direct PCR-sequencing and in silico analysis.
In this study, the peripheral blood samples of 50 patients and 50 controls were examined to find any mutation in coding and noncoding exons and exon-intron boundaries of PTGIR gene. DNA was extracted and all the samples were amplified by polymerase chain reaction (PCR) and sequenced.
In this study, the patients had a mean age of 35.235 ± 10.99 years (range, 9–60 yrs.), and female to male ratio was 4:1 in this group. The controls had a mean age of 35.058 ± 11.116 years (range, 8–59 yrs.), and female to male ratio was 3.7:1.3 in this group. Two patients had mutations in exon 2. The first mutation was located in exon 2 (at amino acid position 251) of PTGIR gene at nucleotide position c.866A > T, a synonymous variant described previously in the database. The second mutation was located in exon 2 c.867G > A, which is a missense variant. Sequence analysis revealed high occurrence of previously reported intronic variants mostly in a homozygous statue.
The data supported the hypothesis that mutations in PTGIR gene, particularly the mutation we described, should be considered even in cases of migraine. The presence of this mutation in patients with family history raises important issues regarding genetic counselling.

Stroke as a devastating condition is one of the major causes of death worldwide. It is accountable for long time disability with high personal and social cost in adults. There are several risk factors for stroke such as diabetes and hypertension. Alpha‑lipoic acid (ALA) as an antioxidant can be a risk modifer in these patients. We designed this trial to scrutinize the possible effects of ALA consumption on some cardiovascular risk factors in patients experienced stroke.
In this randomized, double‑blind, placebo‑controlled clinical trial, 67 patients experienced stroke were randomly allocated into two groups (taking a 600 mg ALA supplement or placebo daily for 12 weeks).
Fasting blood sugar (FBS), fasting insulin and systolic (SBP), and diastolic blood pressure (DBP) were measured before and after intervention in this study. Statistical analyses were performed using SPSS version 16 (SPSS Inc., Chicago, IL, USA) software.
Primary features were similar in the intervention and placebo groups (P > 0.05). After the intervention period, SBP (P Results of this trial indicated that 12 weeks supplementation with 600 mg ALA has benefcial effects on SBP, DBP, and FBS but has no effect on insulin level.

Radicular pain is one of the most common forms of chronic pain in the world, which has challenges about effective medical therapy. The aim of this study was to evaluate the effect of pregabalin (PGB) and metformin (Met) on subacute and chronic radiculopathy.

This double‑blind prospective clinical trial was performed on 71 patients with subacute and chronic cervical and lumbosacral radiculopathy. Group A was treated with PGB 75 mg daily while Group B was treated with PGB 75 mg daily and Met 500 mg daily for 3 months. Finally, the pain score in both groups was evaluated based on visual analog scale (VAS) and numerical scale pain.

The results showed a significant reduction in VAS and pain severity in both groups but this reduction in the terms of VAS (47.79% vs. 46.48%, P = 0.125) and pain severity (47.1% vs. 39.2%, P = 0.264) was more in treated patients with PGB and Met as compared to PGB group while total pain experience (53.5% vs. 49.1%, P = 0.464) and interference with daily function (57.1% vs. 50.61%, P = 0.726) were more in patients treated with PGB alone.

Our results showed that PGB and PGB + Met reduced pain intensity and interference with daily function while we did not observe significant differences between two groups. PGB alone would have the potentiality to become a simple and economic means to decrease radicular pain.

Parkinson’s disease (PD) is the second most common neurodegenerative disorder. Its worldwide incidence rate varies between 18 and 418 cases per 100000 annually. This cross-sectional study was carried out with the aim to identify the clinical characteristics and demographic features of a huge number of patients with PD in Isfahan, Iran.

The study was conducted on 987 patients with PD in Isfahan city and checklists were used to evaluate the demographic features and clinical characteristics of the patients.

The mean age of the patients at the time of sampling was 65.40 ± 11.90 years. The study results indicated that the rate of PD among men with 67.3% was twice that of women with 32.7%. The mean duration of the disease was 4.91 ± 4.60 years.

This study showed a considerable rate of PD among the individuals in Isfahan city. In addition, the incidence ratio of men to women was more than the previous studies.