Serum concentration of magnesium as an independent risk factor in migraine attacks: a matched case-control study and review of the literature.

There is controversy over the role of magnesium in the etiology of migraine headaches. We aimed to evaluate and compare serum levels of magnesium between healthy individuals and those with migraine headaches during migraine attacks and between attacks to evaluate the role of magnesium in the etiology of migraine headaches. Forty patients with migraine headaches and 40 healthy individuals were enrolled in this matched case-control study. Malnutrition, digestive system disorders, history of smoking, drug abuse, and history of medications use were recorded at baseline. The pain scores of patients were measured and recorded based on a 10 cm visual analog scale. Subsequently, blood samples were collected at 8-10 in the morning to determine serum levels of magnesium. Analysis of variance, χ-test, and conditional logistic regression were used for data analysis. There were no significant differences in demographic data between the two groups. There were significant differences in magnesium serum levels between the three groups (1.09±0.2 mg/dl during migraine headaches; 1.95±0.3 mg/dl between the attacks; and 1.3±0.4 mh/dl in the control group; P<0.0001). Odds of acute migraine headaches increased 35.3 times (odds ratio=35.3; 95% confidence interval: 12.4-95.2; P=0.001) when serum levels of magnesium reached below the normal level. The odds in patients who are not in the acute attack phase were 6.9 folds higher (odds ratio=6.9; 95% confidence interval: 1.3-2.1; P=0.02). The serum level of magnesium is an independent factor for migraine headaches and patients with migraine have lower serum levels of magnesium during the migraine attacks and between the attacks compared with healthy individuals.

Patient-Controlled Transdermal Fentanyl Versus Intravenous Morphine Pump After Spine Surgery.

Patient-controlled analgesia (PCA) is regularly used to manage pain following major surgery. The fentanyl hydrochloride iontophoretic transdermal system (ITS) was developed to overcome some of the limitations of intravenous (IV) PCA. The small, self-adhesive, needle-free disposable system is applied to the skin on the upper arm or chest and is controlled by patients clicking a button on the device. The authors identified patients who were underwent spinal surgery from 2 prior multicenter, randomized studies and analyzed their data. Of the 1296 patients in the original trials, 170 underwent spine surgery procedures: 90 were randomized to the fentanyl ITS (40 mcg/activation) and 80 to IV PCA morphine (1 mg/dose). More patients treated with the fentanyl ITS rated their method of pain control as "excellent" across all time points, but differences did not reach statistical significance. However, investigators' ratings of "excellent" satisfaction with study treatment were significantly higher for the fentanyl ITS. Discontinuation rates and overall adverse event rates were similar between groups. The only significant difference was that patients treated with the fentanyl ITS had a higher rate of application site reactions than infusion site reactions in the IV PCA morphine group; the reactions were typically mild-to-moderate erythema that resolved shortly after removal of the fentanyl ITS device and did not require further treatment. Ratings of satisfaction with pain control method were consistently higher for the fentanyl ITS than the IV PCA morphine. The 2 groups had a similar safety profile. These results suggest that the fentanyl ITS appears to be a safe, efficacious alternative to IV PCA in spine surgery patients.

Gender differences in prevalence of musculoskeletal disorders among the rice farmers of West Bengal, India.

BACKGROUND: Musculoskeletal disorder is one of the major health hazards among the rice farmers. Both men and women rice farmers have been shown to experience elevated risks of prevalence of work-related musculoskeletal disorders (WMSD). OBJECTIVE: To estimate the different ergonomic risk factors associated with rice farming identify potential gender differences and the prevalence of musculoskeletal disorders (MSDs) among the rice farmers. PARTICIPANTS: Rice farmers - 110 men and 110 women were selected from the villages of West Bengal, India. METHODS: Modified Nordic Questionnaires were administered to assess the prevalence of MSDs. Detailed posture analysis was performed along with the administration of the Body-part Discomfort Scale. Objective measurements of physiological parameters and lung function values were also recorded. RESULTS: From this study it was revealed that the most subjects (99%) suffered discomfort at different parts of the body especially at low back (93.8%), shoulder (60.9%), hand (53.6%) and knee (80.9%) due to awkward posture (99%) and excessive repetitive task (95%) for a prolonged period of time. Both group of rice farmers suffered maximum discomfort feeling during digging (87.7%), showing seeds (82.7%), harvesting (90.9%) and carrying crops (99%) activities. The farmers also suffered from severe physiological and thermal stress which hampered their other daily activities. CONCLUSIONS: The study conclude that women farmers felt significantly (p< 0.001) higher discomfort feeling than men rice farmers due to perform numerous household activities which further enhanced their discomfort feeling in their different body parts.