ABSTRACT
BACKGROUND: Social changes due to urbanism, acculturation, and fading of values have led to some challenges in family relationships, including domestic elder abuse. This study was conducted to determine elder abuse status in Yazd, Iran. METHODS: This cross-sectional study was conducted on 250 elderly people over 60 years in Yazd in 2014-2015. Clustered random sampling was used to recruit the participants from 10 clusters in Yazd (25 individuals from each cluster). The data were gathered by the 49-item,Iranian Domestic Elder Abuse Questionnaire which was filled out through private interviews with the participants. RESULTS: Mean score of elder abuse was 11.84 (SD: 12.70) of total 100. Of the participants,79.6% (95% CI: 74.5-84.6) experienced at least one type of abuse. Emotional neglect was the most reported abuse and physical abuse was the least reported. Abuse score was associated with age, education level, living status, and insurance status of elders. Further, those who reported history of gastrointestinal problems, dyslipidemia, respiratory diseases, sleep disorders, audiovisual problems, joints pain, hypertension, dental/oral problems, cardiovascular disease,urinary incontinence and disability, reported a statistically significant higher abuse score. CONCLUSION: Despite overall low rate of domestic elder abuse, its high prevalence indicates that some interventions are necessary to decrease domestic elder abuse. Emotional neglect of elders should be addressed more than other abuse types.
ABSTRACT
BACKGROUND: Multiple sclerosis (MS) is a central nervous system disorder with periods of recurrence and recovery. Mitoxantrone has been approved for secondary progressive MS (SPMS) treatment but data lacks the role of corticosteroid pulse therapy in SPMS. OBJECTIVES: To evaluate the role of corticosteroid pulse therapy in patients with SPMS receiving mitoxantrone. PATIENTS AND METHODS: A double blind randomized controlled clinical trial was performed on 71 patients with SPMS referred to Shahid Sadoughi Hospital (Yazd, Iran) for receiving mitoxantrone in two groups. The first group (35 patients) received 20 mg mitoxantrone plus 500 mg methylprednisolone monthly for six months. The second group (36 patients) received the same dosage of mitoxantrone plus 100 CC of 5% dextrose water monthly for six months. Expanded disability status scale (EDSS), MRI plaques in both groups before and after the treatment completion and six months after the end of trial were compared together. RESULTS: 28 men and 43 women enrolled in the study. MRI plaques number reduced in groups significantly (2.29 vs. 2.17) without significant difference between the groups (P = 0.782). Six months after trial completion, plaques number increased in groups without significantly difference (0.72 vs. 0.77, P = 0.611). The mean value of EDSS showed significant reduction at the end of treatment in groups (0.79 and 0.53) without significant difference between the groups (P = 0.953). Six months after trial completion, EDSS increased in groups without significant difference (0.35 vs. 0.43, P = 0.624). CONCLUSIONS: Corticosteroid pulse therapy in SPMS was effective in inflammatory process, but could not postpone or decline the neurodegenerative process and besides the imposing side effects could not result in significant improvement in EDSS and MRI plaques number in long term.
ABSTRACT
BACKGROUND: Migraine headache is a prevalent periodical and neurological impairment that is associated with functional disorders. Regarding the side effects of available medications, research is continuing in an effort to identify new, effective pharmaceutical regimens with limited side effects. OBJECTIVE: The aim of this study was to compare the effectiveness of vitamin B2 versus sodium valproate in migraine prophylaxis. METHODS: This was a single-blind clinical trial conducted on 90 migraine patients in two parallel groups. The first group underwent vitamin B2 treatment (400 mg/day) for three months, and the second group was treated with sodium valproate (500 mg/day). The patients were examined at the beginning of the study and 4, 8, and 12 weeks later. After the administration of the drugs in both groups, we recorded the duration of migraine pain, the frequency of migraine episodes, and the severity of the headaches. Potential complications of this study that were measured were weight gain, dizziness, and gastrointestinal problems. RESULTS: The findings showed that the frequency, median duration per month, and severity of the headaches decreased in both groups, but the difference between them was not significant (p > 0.05). However, there were significantly fewer side effects in vitamin B2 group (p = 0.005). CONCLUSION: Sodium valproate and vitamin B2 have similar effects on the reduction of migraine attacks, but vitamin B2 had fewer complications and fewer adverse effects; therefore, vitamin B2 can be administered to patients who are prohibited from taking sodium valproate or who have adverse side effects when they take it.
ABSTRACT
BACKGROUND: Sodium valproate (SV) has been approved for migraine prophylaxis and its intravenous form is used to treat acute migraine attacks. We compared the efficacy and safety of intravenous SV and subcutaneous Sumatriptan in managing acute migraine attacks. METHODS: This double-blind randomized clinical trial divided 90 patients into two groups: one group received 400 mg of intravenous SV and the second group received 6 mg of subcutaneous Sumatriptan. Headache severity before treatment and half an hour, one hour, and two hours after treatment was measured based on the VNRS in the groups. Associated symptoms, i.e., photophobia, phonophobia, nausea, and vomiting, were assayed on admission and 2 hours after treatment. Side effects of the drugs were checked 2 hours after injection. Obtained data from the groups were compared. RESULTS: In both groups, pain decrement at the mentioned time points was significant (P<0.001), but had no significant difference (P>0.05), indicating the similar effect of both drugs on pain improvement. In the SV group, photophobia, phonophobia, nausea, and vomiting were improved significantly, while in the Sumatriptan group, only photophobia and vomiting were decreased significantly, indicating the advantage of SV in improving the associated symptoms. Nausea, vomiting, facial paresthesia, and hypotension were more significantly frequent in the Sumatriptan group than in the SV group (P<0.05). CONCLUSION: Intravenous SV (400 mg) was as effective as subcutaneous Sumatriptan in the treatment of acute migraine attacks, but with more improvement in associated symptoms and with fewer side effects. TRIAL REGISTRATION NUMBER: IRCT201108025943N4.