scholarly journals Suppression of Menstrual-Related Migraine Attack Severity Using Pyridoxine, Thiamine, and Cyanocobalamin: A Quasi-Experimental Within-Subject Design

2020 ◽  
Vol 7 (3) ◽  
Author(s):  
Mansoureh Togha ◽  
Reza Rahmanzadeh ◽  
Shiva Nematgorgani ◽  
Zahra Yari ◽  
Soodeh Razeghi Jahromi ◽  
...  

Background: B-group vitamins can potentially contribute to migraine prophylaxis through various mechanisms. We conducted a quasi-experimental study to assess the efficacy and tolerability of a combination of vitamins B1, B6, and B12 (Neurobion) for prophylaxis of menstruation-related migraine attacks. Methods: Women diagnosed with menstrual-related migraine, both chronic and episodic headaches, were enrolled. The patients began Neurobion therapy one week before the menstruation cycle, and repeated the injection for three consecutive months; each ampoule contained 100 mg of vitamins B1 and B6 as well as 1000 μg of vitamin B12. Neurobion was used as an add-on therapy for patients receiving the same prophylactic therapy during the last two months before the start of the study. The outcome parameter examined the severity of menstrual-related migraine attacks on a 10-point visual analog scale (VAS). Results: Three hundred eighty-three patients (169 with chronic migraine and 214 with episodic migraine) were included in the final analysis. The patients received treatment with a combination of vitamins B1, B6, and B12 with positive results. The mean intensity of menstrual-related migraine attacks was reduced from 6.7 on the 10-point VAS to 3.2 (P < 0.001) in patients with chronic migraine. The mean severity of menstrual-related migraine attacks was also reduced from 7.2 to 3.7 in patients with episodic migraine (P < 0.001). There was no significant difference in the reduction of headache severity between the two groups of migraineurs (P = 0.985). Conclusions: Neurotropic vitamins, including pyridoxine, thiamine, and cyanocobalamin yielded significant reductions in the severity of menstrual-related migraine attacks. Neurobion as a combination of vitamins B1, B6, and B12 appears to be well-tolerated and beneficial as an adjuvant in treatment and prophylaxis of menstrual-related migraine attacks. Further large-scale trials with long-term follow-up will be required to confirm our results.

2021 ◽  
Vol 11 ◽  
Author(s):  
Young Dong Yu ◽  
Young Hwii Ko ◽  
Jong Wook Kim ◽  
Seung Il Jung ◽  
Seok Ho Kang ◽  
...  

AimThis study evaluated the prognosis and survival predictors for bladder urachal carcinoma (UC), based on large scale multicenter cohort with long term follow-up database.MethodsA total 203 patients with bladder UC treated at 19 hospitals were enrolled. Clinical parameters on carcinoma presentation, diagnosis, and therapeutic methods were reviewed for the primary cancer and for all subsequent recurrences. The stage of UC was stratified by Mayo and Sheldon pathological staging system. Oncological outcomes and the possible clinicopathological parameters associated with survival outcomes were investigated.ResultsThe mean age of the patients was 54.2 years. Among the total of 203 patients, stages I, II, III, and IV (Mayo stage) were 48 (23.8%), 108 (53.5%), 23 (11.4%), and 23 (11.4%), respectively. Gross hematuria and bladder irritation symptoms were the two most common initial symptoms. The mean follow-up period was 65 months, and 5-year overall survival rates (OS), cancer-specific survival rates (CSS), and recurrence-free survival rates (RFS) were 88.3, 83.1, and 63.9%, respectively. For the patients with Mayo stage ≥III, OS, CSS, and RFS were significantly decreased to 38.0, 35.2, and 28.4%, respectively. The higher pathological stage (Mayo stage ≥III, Sheldon stage ≥IIIc), positive surgical margin (PSM), and positive lymphovascular invasion (PLM) were independent predictors of shorter OS, CSS, and RFS.ConclusionThe pathological stage, PSM, and PLM were significantly associated with the survival of UC patients, emphasizing an importance of the complete surgical resection of tumor lesion.


2011 ◽  
Vol 39 (02) ◽  
pp. 261-269 ◽  
Author(s):  
Rong Liu ◽  
Xiao-Jun Teng ◽  
Jiang-Fu He ◽  
Shao-Shu Xiao ◽  
Zhi-Bing Yuan ◽  
...  

The article evaluates the long-term follow-up results of PSE using Bletilla striata (BS) particles for hypersplenism in cirrhosis, as compared to PSE using gelfoam particles. Fifty-nine patients with cirrhosis-induced hypersplenism were treated with PSE. The patients were randomly assigned into two groups: gelfoam group, which includes 32 patients using gelfoam particles as the embolic material, and BS group, which includes 27 patients using BS particles. The peripheral blood cell counts and parameters for complications associated with PSE were measured during the follow-up. The mean values of leukocyte and thrombocyte, but not hemoglobin, were significantly increased after PSE (p < 0.01) in both groups. The values of leukocyte and thrombocyte during the long-term follow-up were significantly improved in BS group than that in gelfoam group (both p < 0.01). The frequency of bleeding episodes from esophageal varices in both groups was significantly reduced after PSE (both p < 0.01), but the post-PSE bleeding episodes showed no remarkable differences between the two groups (p = 0.084). Post-embolization syndrome consisted mainly of fever, nausea and vomiting, and abdominal pain in the two groups. The incidence of grade II to III abdominal pain in BS group (82.8%, 27/33) was significantly higher than in gelfoam group (57.9%, 33/57) (p = 0.020). The mean survival time was 61.5 ± 9.1 (median 60, 1–157) months in gelfoam group and 63.4 ± 9.9 (median 52, 0–161) months in BS group, which showed no significant difference (p = 0.930).In conclusion, BS particles could be used as the embolic material in PSE. Compared to gelfoam used in PSE, BS can achieve even better efficacy in alleviating hypersplenism. It provides a long-term effect on the hematological parameters, bleeding from esophageal varices and good palliation, and improved clinical status contributing to symptomatic control.


2021 ◽  
Author(s):  
Tarek Gharib ◽  
Ibrahim Abdelal ◽  
Adel Elatreisy ◽  
Elsayed Salih ◽  
Ahmed Sebaey

Abstract Objective: To evaluate effectiveness and safety of a 5mg tadalafil daily treatment for men with erectile dysfunction (ED) and premature ejaculation (PE) and assessment of long-term follow up by persistence of improvement 2 years after stoppage of tadalafil.Materials and Methods: The study included 160 patients diagnosed with erectile dysfunction from April 2018 to June 2020. All were evaluated using the international index of erectile function questionnaire-5 (IIEF-5) to evaluate ED and intravaginal ejaculatory latency time (IELT) for PE. Patients subdivided into two equal groups. I included 80 patients treated with tadalafil 5 mg daily for 3 months, and group II included 80 patients treated with a placebo for same period. After 3 months treatment and 2 years later after stoppage of tadalafil, all patients were assessed for ED and PE using the same questionnaires. Results: The mean IELT and IIEF pretreatment were 37±11.24 s and 13.2±4.2 respectively for group I, while in group II was 35.98±10.8 s and 13.12±4.11, respectively. After 3 months of treatment, the mean value of IELT in group I showed a highly significant improvement from 37±11.24 sec to 120.5±47.37 sec (p-value < 0.001), but for group II, the mean values of IELT showed no significant improvement from baseline 35.98±10.8 to endpoint 39.43±13.6 ( p-value > 0.05). As regarding the IIEF, there was a highly significant improvement from baseline 13.2±4.2 to endpoint 20.45±4.5 in group I (p-value < 0.001) while there was no significant difference in group II from baseline 13.12±4.11 to endpoint 15±4.84 (p-value > 0.05) . 2 years later after stoppage of tadalafil , 75 patients from group I complete follow up and there was significant improvement in IELT and IIEF form base line (37±11.24) (13.2±4.2) to endpoint (98±18.3) (19.1±2.3) respectively but less than the results after 3 months treatment.ConclusionDaily Tadalafil 5 mg was effective, tolerable, and safe treatment for patients suffering from ED and PE. Long-term follow up after 2 years declared persistence of significant improvement.


2015 ◽  
Vol 7 (12) ◽  
pp. 15
Author(s):  
Gunnar Bengtsson

<p>Toxic metals are mobilized on a large scale in modern society. Many of those metals end up in sewage sludge. The objective of this review was to elucidate the threat to groundwater due to a few metals lost from tilled sludge amended soils. It is sometimes suggested that these metals are immobilized in the topsoil and do not move downward. In contrast, dozens of long term field studies around the world indicate that penetration depths for metals increase with time since deposition.</p><p>Such studies were examined in depth in the current analysis. An equation was developed for calculation of long term mean metal penetration rates into the topsoil for copper and silver. The equation is valid for about a century but not much longer. The mean depths of a basic set of 11 cases from studies over 4 years to 100 years were predicted with a standard deviation of 11%. A typical penetration rate was 3 mm per year. There was no significant difference in penetration rate between several cations. Extremely large amendments were associated with larger penetration rates.</p><p>When metals have traversed the topsoil, the groundwater will be contaminated. The European Groundwater Pollution Directive stipulates that pesticide levels should be kept below 0.1 µg/l. When sludge is applied to agricultural soil, this level may by far be exceeded for many metals, even if strict limitations are applied to the metal contents of the sludge. This calls for careful assessment of the groundwater consequences of sludge amendment.</p><p>Extensive supplementary material provides many detailed tables, texts and references.</p>


2016 ◽  
Vol 49 (02) ◽  
pp. 214-219 ◽  
Author(s):  
Mohamed Makboul ◽  
Mahmoud S. Abdelhamid ◽  
Ghada S. Al-Attar

ABSTRACT Background: Surgery for hypertrophied breasts represents a challenge for plastic surgeons. The search for a good post-surgical cosmetic breast has led to the development of many techniques. Objectives for reduction mammoplasty are to achieve elevated, symmetrical breasts, a round shape, good projection, small cicatrices that are not very perceptible, and a lasting result. Patients and Methods: This study was carried out on sixty cases who had done reduction mammoplasty from January 2009 to December 2014. All patients were examined and were asked for late post-operative results and overall patients’ satisfaction. Results: Long-term projection and contour of the breast were more satisfactory among patients who had superomedial pedicle with a statistically significant difference. No statistically significant difference was observed between patients underwent either superomedial or inferior pedicle reduction mammoplasty with regard to breast shape symmetry, nipple symmetry and sensation. The mean score for satisfaction was higher among patients who underwent superomedial pedicle rather than the inferior pedicle method. Conclusion: The superomedial pedicle shows better long-term cosmetic results.


2021 ◽  
pp. 1-10
Author(s):  
Richard Voldřich ◽  
David Netuka ◽  
František Charvát ◽  
Vladimír Beneš

OBJECTIVE The natural course of dural arteriovenous fistulas (DAVFs) is unfavorable. Transarterial embolization with Onyx is currently the therapeutic method of choice, although the long-term stability of Onyx has been questioned. The literature reports a significant difference in the recurrence rate after complete DAVF occlusion and lacks larger series with long-term follow-up. The authors present the largest series to date with a long-term follow-up to determine the stability of Onyx, prospectively comparing magnetic resonance angiography (MRA) and digital subtraction angiography (DSA) as follow-up diagnostic methods. METHODS Demographics, clinical symptomatology, length of follow-up, diagnostic methods, and angiographic findings of DAVFs were recorded and retrospectively evaluated in 112 patients. A prospective group of 15 patients with more than 5 years of follow-up after complete DAVF occlusion was established. All 15 patients in the prospective group underwent a clinical examination and MRA; 10 of these patients also underwent DSA. The recurrences and the correlation between the two diagnostic methods were evaluated. RESULTS Among the 112 patients, 71 were men and 41 were women, with an average age of 60 years. Intracranial hemorrhage (40%) was the most common clinical presentation of DAVF. At the last follow-up, 73% of the patients experienced clinical improvement, 21% remained unchanged, and 6% worsened. Overall, 87.5% of the DAVFs were occluded entirely with endovascular treatment, and 93% of the DAVFs were classified as cured at the last follow-up (i.e., completely embolized DAVFs and DAVFs that thrombosed spontaneously or after Gamma Knife surgery). Two recurrences of DAVFs were recorded in the entire series. Both were first diagnosed by MRA and confirmed with DSA. The mean follow-up was 27.7 months. In the prospective group, a small asymptomatic recurrence was diagnosed. The mean follow-up of the prospective group was 96 months. CONCLUSIONS Onyx is a stable embolic material, although recurrence of seemingly completely occluded DAVFs may develop because of postembolization hemodynamic changes that accentuate primarily graphically absent residual fistula. These residuals can be diagnosed with MRA at follow-up. The authors’ data suggest that MRA could be sufficient as the follow-up diagnostic method after complete DAVF occlusion with Onyx. However, larger prospective studies on this topic are needed.


Author(s):  
Soniya Mahajan ◽  
Mani Kalaivani ◽  
Gomathy Sethuraman ◽  
Binod Kumar Khaitan ◽  
Kaushal Kumar Verma ◽  
...  

Background: There are few studies on basal cell carcinoma (BCC) from India. Long-term follow-up is available in only one study and the aesthetic outcome of treatment has not been evaluated in Indian patients. Aims: In this retrospective study on BCC, we compared treatment failure, recurrence rates and aesthetic outcomes on long-term follow-up between surgical excision and repair, and nonsurgical and ablative treatments. Methods: Records of patients with BCC treated in the dermatologic surgery clinic over the past 10 years were analyzed. Patients with histopathologically confirmed BCC who could be contacted were evaluated for recurrence, treatment failure, overall satisfaction and aesthetic outcomes by global aesthetic improvement scale. Results: Out of 98 patients, 72 were contactable. Four patients received both nonsurgical and ablative treatments and surgical excision and repair sequentially and were excluded. The mean age of patients was 57.9 ± 15.8 years (24–90 years) and the male: female ratio was 1.6:1. The most common site involved was the face (72.1%) followed by trunk and scalp, and the most common type of BCC was the pigmented superficial type (33.8%), followed by the pigmented noduloulcerative type (16.2%). There was no significant difference between the groups in the number of high-risk cases. The mean follow-up period was 37.1 ± 31.4 (range, 4–120) months. Fifty one patients were treated with surgical excision and repair, and 17 with nonsurgical and ablative treatments (9-imiquimod, 5-cryotherapy, 4-radiotherapy). Treatment failure was seen in 5 (7.4%) patients, all in the nonsurgical and ablative treatments group (P = 0.0006). Recurrence was seen in 2 (2.9%) patients, both in the surgical excision and repair group (P > 0.05). Mean patient satisfaction was significantly higher with surgical excision and repair, though there was no significant difference in the Global Aesthetic Improvement Scale between the groups. Limitations: The sample size was low. Only telephonic and pictorial assessments were done where the patient could not come for follow-up. Conclusions: Surgical excision and repair was associated with better outcomes than nonsurgical and ablative treatments. Treatment failures and adverse events were high with nonsurgical and ablative treatments. The recurrence rate was low.


2021 ◽  
Vol 10 (7) ◽  
pp. 1336
Author(s):  
Toshifumi Takahashi ◽  
Shinya Somiya ◽  
Katsuhiro Ito ◽  
Toru Kanno ◽  
Yoshihito Higashi ◽  
...  

Introduction: Cystine stone development is relatively uncommon among patients with urolithiasis, and most studies have reported only on small sample sizes and short follow-up periods. We evaluated clinical courses and treatment outcomes of patients with cystine stones with long-term follow-up at our center. Methods: We retrospectively analyzed 22 patients diagnosed with cystine stones between January 1989 and May 2019. Results: The median follow-up was 160 (range 6–340) months, and the median patient age at diagnosis was 46 (range 12–82) years. All patients underwent surgical interventions at the first visit (4 extracorporeal shockwave lithotripsy, 5 ureteroscopy, and 13 percutaneous nephrolithotripsy). The median number of stone events and surgical interventions per year was 0.45 (range 0–2.6) and 0.19 (range 0–1.3) after initial surgical intervention. The median time to stone events and surgical intervention was 2 years and 3.25 years, respectively. There was a significant difference in time to stone events and second surgical intervention when patients were divided at 50 years of age at diagnosis (p = 0.02, 0.04, respectively). Conclusions: Only age at a diagnosis under 50 was significantly associated with recurrent stone events and intervention. Adequate follow-up and treatment are needed to manage patients with cystine stones safely.


2021 ◽  
pp. 1357633X2110241
Author(s):  
Zari Doaltabadi ◽  
Leila Amiri-Farahani ◽  
Seyedeh Batool Hasanpoor-Azghady ◽  
Shima Haghani

Introduction The spouse has a special role in promoting the health of mothers and infants during pregnancy, childbirth, and postpartum. Women's health during pregnancy requires the participation and cooperation of their spouses. Therefore, this study was conducted to determine the effect of face-to-face and virtual prenatal care training of spouses on the pregnancy experience and fear of childbirth of primiparous women. Methods This is a quasi-experimental clinical trial that was conducted on primiparous pregnant women referring to three prenatal clinics in Tehran, Iran. Sampling was done by available method and pregnant women were divided into three groups of face-to-face training ( n = 35), virtual training ( n = 35), and control ( n = 33). The content of training program in the virtual and face-to-face groups was similar and included; nutrition during pregnancy, emotional support, fetal growth and development, advantages and disadvantages of vaginal delivery, planning for delivery, infant care, and danger signs for infants, which were presented in four sessions. The samples in the control group did not receive any training. In the 18th and 20th weeks of pregnancy, the demographic information form, pregnancy experience scale, and version A of the Wijma delivery expectancy/experience questionnaires were completed, and once again in the 37th and 38th weeks of pregnancy, the pregnancy experience scale and version A of the Wijma delivery expectancy/experience questionnaires were completed. Results There was a statistically significant difference in the mean score of pregnancy experience after the intervention between the face-to-face training and control groups ( p = 0.001). There was a statistically significant difference in the mean score of uplifts between the two groups of face-to-face training and control ( p = 0.01), and also between virtual training and control groups ( p = 0.02). There was a statistically significant difference between the two groups of face-to-face training and control in terms of and hassles score after the intervention ( p = 0.04). There was a statistically significant difference between the two groups of face-to-face training and control ( p = 0.02) and also between virtual training and control ( p = 0.04) in terms of the mean score of fear of childbirth after the intervention. Conclusion The results of this study showed that teaching prenatal care to spouses of primiparous women by face-to-face and virtual methods can be a useful intervention in improving the pregnancy experience and reducing the fear of childbirth among primiparous women.


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