Comparison the Effects of Gabapentin and Oxazepam on Sleep Quality, Anxiety, and Pain in Unstable Angina Patients Admitted to Coronary Care Unit of Hazrat Rasool Akram Hospital.

Background: This study aimed to compare the efficacy of gabapentin and oxazepam on sleep quality, the severity of anxiety, and pain level in patients admitted to the coronary care unit (CCU). Materials and Methods: This double-blind randomized clinical trial was done on the patients with unstable angina (UA) admitted to the CCU of Hazrat Rasool Akram Hospital in Tehran. A total of 56 patients were entered the study and randomly divided into two groups of 26. The first group was given a gabapentin capsule at a dose of 300-1200 mg/day, and the second group was given 10-20 mg of oxazepam tablets per day until hospitalization in the CCU. On the first and 4th days of hospitalization, Groningen sleep quality score (GSQS), Beck Anxiety Inventory, and severity of pain experienced by Visual Analogue Scale were recorded, and the mean frequency of chest pains was calculated in 24 h during the first 4 days. The amount of drug (morphine) prescription in CCU also compared between the two groups. Results: There was no significant difference in GSQS scores between both groups. The mean score of Beck's anxiety scale did not differ significantly between the two groups. However, the incidence of chest pain was significantly lower in the gabapentin-receiving group than in the oxazepam-receiving group (<0.001). The days that the patients experienced chest pain were significantly less in the gabapentin-receiving group than in the oxazepam-receiving group (<0.001). Conclusion: The results of our study showed that gabapentin compared to oxazepam could significantly reduce chest pain in patients with UA.

Kleine-Levin Syndrome in an 8-Year-Old Girl with Autistic Disorder: Does Autism Account a Primary or Secondary Cause?

Objective Kleine-Levin syndrome (KLS) is a rare disorder with an unknown etiology. Autism spectrum disorder is characterized by various degrees of impairment in social communication, repetitive behavior and restricted interests. Only four patients of KLS with autistic spectrum disorder (ASD) have been reported so far. This report presents an 8-year-old girl with history of autistic disorder and epilepsy that superimposed KLS. Because of the rarity of KLS and related studies did not address whether autism accounts for a primary or secondary cause, the area required attention further studies.

Neighbourhood air quality and snoring in school-aged children.

The prevalence of habitual snoring has been extensively explored in paediatric populations. Although exposure to cigarette smoke increases the risk of habitual snoring in a dose-dependent fashion, the potential contribution of air quality to habitual snoring remains unclear. 6000 questionnaires were distributed to 6- to 12-year-old children attending public schools in five distinct neighbourhoods within the city of Tehran, Iran, that were preselected based on air quality measures. Habitual snoring was defined as loud snoring ≥3 nights per week. Information regarding clinical and family-related habitual snoring risk factors was also obtained. Descriptive statistics followed by adjusted risk assessments were conducted. Among the 4322 (72%) completed datasets, the prevalence of habitual snoring was 11.6%. Partition of habitual snoring rates according to neighbourhood air quality characteristics revealed significantly higher habitual snoring frequencies among children residing in neighbourhoods with greatest pollution (24.5% and 12.1% in South and Central neighbourhoods versus 7.0% and 7.7% in North and East neighbourhoods, respectively). The regional variance in habitual snoring was primarily accounted for by an integrated measure of air quality, even after controlling for other risk factors. Environmental air quality emerges as a significant and potentially modifiable contributor to the risk for developing habitual snoring during childhood.

Prevalence of Parasomnia in School aged Children in Tehran.

OBJECTIVES: Parasomnias can create sleep disruption; in this article we assessed parasomnias in school-aged children in Tehran. METHODS: In spring 2005, a total of 6000 sleep questionnaires were distributed to school-aged children in 5 districts of Tehran (Iran). A modified Pediatrics sleep questionnaire with 34 questions was used. RESULTS: Parasomnias varied from 0.5% to 5.7% among the subjects as follows: 2.7% sleep talking, 0.5% sleepwalking, 5.7% bruxism, 2.3% enuresis, and nightmare 4%. A group of children showed parasomnias occasionally- this was 13.1% for sleep talking, 1.4% for sleepwalking, 10.6% for bruxism, 3.1% for enuresis and 18.4% for nightmares. CONCLUSION: A high proportion of children starting school suffer from sleep problems. In many cases this is a temporary, developmentally related phenomenon, but in 6% of the children the disorder is more serious and may be connected with various stress factors and further behavioral disturbances.

A comparative study of the components of sleep quality in medical outpatients.

Background. Almost any medical illness that causes significant pain or discomfort may negatively affect the quality of sleep. Moreover sleep disorders may coexist with medical disorders in people of all ages. Measuring sleep dysfunction is an area of active research, but few studies examined subjective ratings of sleep quality in medical patients Method. A total of 250 medical patients with various somatic complaints who attended the ENT, internal, neurology, orthopaedics and urology clinics participated in this study. The patients completed the Pittsburgh Sleep Quality Index (PSQI) which measures the quality of sleep in seven major domains and helps discriminate between individuals who experience poor sleep versus individuals who sleep well. A score ≥6 is considered as a significant sleep disturbance. Results. The PSQI score of the patients from all selected clinics were higher than the reported cut-off point (Mean = 8, SD = 3.42). Significant differences were found in sleep duration (component 3) and sleep disturbances (component 5) between clinics. Pain and worry were the major causes of sleep disturbances reported by the majority of the patients. Conclusion. Sleep disturbances in medically ill patients require careful evaluation for proper treatment that will alleviate the sleep problem without exacerbating concomitant illnesses. Essentially any condition that causes pain or discomfort may cause insomnia and must be considered in the overall treatment plan.