Helicobacter pylori infection in migraine headache: a true association or an innocent bystander?

Much concern was directed towards the relationship between migraine and Helicobacter pylori (H. pylori) infection. Some researchers reported a strong association. Meanwhile, others have indicated totally negative results. The aim of this work was to clarify the association between migraine headaches and both H. pylori infection and Gastrointestinal (GIT) symptoms and to study their impact on the frequency and severity of migraine headache attacks.This is a case control study conducted on 77 migraine patients and 77 healthy controls. History was taken from the included patients regarding the frequency of migraine headache attacks/month and GIT symptoms including dyspepsia, flatulence, weight loss, and epigastric pain. Migraine Disability Assessment Test (MIDAS) and Visual Analogue Scale (VAS) were used for assessment of migraine severity. Helicobacter pylori was detected in the stool of the included patients and controls.There was a significantly higher prevalence of infection with H. pylori in migraine patients [77.9% (n = 60)] than control group [50.6% (n = 39)] (P-value˂ 0.001, Odds ratio= 3.439, 95% CI =1.708 - 6.923). The prevalence of dyspepsia, flatulence, and epigastric pain. was significantly higher in migraine patients in comparison to control group (P-value= 0.003, 0.017, 0.006 respectively). There was no effect of infection with H. pylori or presence of GIT symptoms on frequency of migraine attacks, MIDAS or VAS scores.GIT symptoms and H. pylori infection are more prevalent in patients with migraine compared to controls, however, they might not have an impact on the frequency or severity of migraine headache attacks.

Zinc deficiency correlates with severity of diabetic polyneuropathy.

OBJECTIVES: There are controversies about the role of zinc in the development of both types 1 and 2 diabetes. The aim of this study was to assess serum zinc level in diabetic patients with and without peripheral neuropathy in comparison to healthy controls and to explore the possible relationship between serum zinc level and severity of peripheral neuropathy. METHODS: This case control study was conducted on 120 subjects: 40 patients fulfilled the criteria for diagnosis of probable diabetic polyneuropathy (DPN), 40 diabetic patients without polyneuropathy (N-DPN) and 40 healthy controls. DPN patients were submitted to clinical assessment of diabetic neuropathy using neuropathy symptom and change (NSC) scale, Michigan Neuropathy Screening Instrument Physical Assessment (MNSI) scale and electrophysiological assessment using nerve conduction study. Zinc serum level was measured in all subjects included in this study using direct colorimetric test method. RESULTS: Diabetic patients with and without neuropathy were found to have significantly lower mean values of serum zinc than healthy controls (p = .025,  .03 respectively). There is a statistically significant negative correlation between zinc serum level and hemoglobin A1C (HA1C) (p ˂ .001), NSC score (p = .001) and MNSI score (p = .003) in DPN group. There were also statistically significant correlations between zinc serum level and nerve conduction study values. CONCLUSION: Zinc deficiency significantly correlates with the severity of DPN and glycemic control.

Evaluating optic nerve diameter as a possible biomarker for disability in patients with multiple sclerosis.

BACKGROUND AND PURPOSE: The development of new biomarkers for multiple sclerosis (MS) is of paramount importance to improve our ability to predict disease progression and disability. The aim of this study was to evaluate the potential role of the optic nerve diameter (OND) measured by ultrasonography as a biomarker of early disability in patients with relapsing-remitting multiple sclerosis (RRMS). METHODS: Forty-nine RRMS patients, 23 with a history of optic neuritis (MS-ON) and 26 without a history of optic neuritis (MS N-ON), and 50 age- and sex-matched healthy control subjects were included in the study. The OND and optic nerve sheath diameter (ONSD) were measured by transorbital sonography (TOS), and the retinal nerve fibre layer (RNFL) and ganglion cell complex (GCC) thicknesses were measured by optical coherence tomography (OCT) using the Optovue RTVue™ system (Optovue, Inc., Fremont, CA, USA). RESULTS: There was no significant difference between the patient (whether ON or N-ON eyes) and control groups in either the OND (p=0.979) or the ONSD (p=0.911). However, patients with an expanded disability status scale (EDSS) score >2 had a significantly lower OND and RNFL thicknesses (p=0.014, p=0.010 respectively) than patients with an EDSS score ≤2. Statistical logistic regression revealed that OND was an independent predictor of EDSS>2 (p=0.044, OR =0.000, 95% CI=0.000-0.589). CONCLUSION: The OND, as measured by ultrasonography, could be potentially used as a biomarker for the detection of early disability in RRMS patients.