Association of DRD2, DRD4 and COMT genes variants and their gene-gene interactions with antipsychotic treatment response in patients with schizophrenia.

Antipsychotic drugs are the first line of treatment in schizophrenia; although antipsychotic responses indicate a wide interindividual variety in patients with schizophrenia. This study aimed to investigate the association between four polymorphisms in DRD2, DRD4 and COMT genes and their gene-gene interactions with antipsychotic treatment response in patients with schizophrenia. A total of 101 patients with schizophrenia were recruited and stratified in treatment responder and treatment resistant groups based on the published criteria of resistant to treatment using PANSS. Clinical and demographic factors were analyzed. Genomic DNA was extracted from whole blood and genotyping for the four polymorphisms were done by ARMS-PCR, PCR-RFLP and gap-PCR. Gene-gene interactions were analyzed by logistic regression. In case of DRD2 A-241G, G allele was significantly associated with resistant to treatment. Regarding DRD4 120-bp duplication, 240/240 genotype was significantly associated with resistant to treatment comparing to other genotypes in a dominant model. The genotype combination of DRD4 240/240 and COMT Val/Val was significantly associated with treatment resistant. Among DRD2 AA genotype, COMT met allele carriers which also had a 120 bp allele of DRD4 had a significantly better response to antipsychotics. Moreover, analysis of clinical and demographic factors demonstrated a significantly longer duration of hospitalization and higher chlorpromazine-equivalent daily dose in resistant to treatment patients. Discovering the polymorphisms which effect treatment response to antipsychotics will provide the possibility of genetic screening before starting an antipsychotic treatment which enhances the chance of responding to antipsychotics and decreases drugs side effects and costs.

The effect of vitamin D and calcium supplementation on inflammatory biomarkers, estradiol levels and severity of symptoms in women with postpartum depression: a randomized double-blind clinical trial.

Objectives: Postpartum depression (PPD) is a major depressive disorder. Vitamin D deficiency may play a role in PPD pathogenesis. This study was designed to determine the effect of vitamin D and calcium supplementation on the severity of symptoms and some related inflammatory biomarkers in women with PPD.Materials and Methods: Eighty-one women with a PPD score >12 participated in this study. A total of 27 patients were randomly assigned into three groups (1:1:1 ratio) to receive either 50,000 IU vitamin D3 fortnightly + 500 mg calcium carbonate daily; or 50,000 IU vitamin D3 fortnightly + placebo of calcium carbonate daily, or placebo of vitamin D3 fortnightly + placebo of calcium carbonate daily (placebo group) for 8 weeks. At the baseline and end of the study, the severity score of PPD, levels of 25-hydroxy vitamin D, calcium, tumor necrosis factor-alpha (TNFα), interleukin 6 (IL6) and estradiol were measured.Results: The PPD score had more reduction in the vitamin D + calcium and vitamin D + calcium placebo groups than that of the placebo group (-1.7 ± 3.44, -4.16 ± 5.90 and 0.25 ± 2.81, respectively; p = 0.008). The effect of vitamin D on the PPD score was larger when vitamin D was given alone than given together with calcium (p = 0.042 and p = 0.004, respectively). No significant differences in estradiol, IL6 and TNFα were observed between the three groups.Discussion: Vitamin D may be effective in improving the clinical symptoms of PPD; however, the mechanism of the effect might not entirely operate through inflammatory and/or hormonal changes.

Prostatic irradiation-induced sexual dysfunction: A review and multidisciplinary guide to management in the radical radiotherapy era (Part III on Psychosexual Therapy and the Masculine Self-Esteem).

Psychological morbidity, sexuality, and health/system information have been identified as the highest areas of support needs in patients undergoing management of their prostate cancer (PCa). Management of a patient's sexual function prior to, during and after PCa radiotherapy requires multidisciplinary coordination of care between radiation oncologists, urologists, dermatologists, pharmacists, and psychiatrists. The finale of this three-part review provides a framework for clinicians to better understand the role of mental healthcare providers in the management of sexual toxicities associated with prostatic radiotherapy. The authors recommend that patients be referred for psychological evaluation and possibly to individual, couples or group general or cognitive behavioral sex therapy at the time of their PCa diagnosis, for a more specialized focus on management of sexual toxicities and sexual recovery. The importance and implications of the masculine self-esteem, sexual orientation, gender identification, cultural expectations, relationship status and patient education are reviewed. Well-informed patients tend to have a better quality of life outcomes compared to patients that take on a passive role in their cancer management.

Prevalence of internet addiction among medical students: a study from Southwestern Iran.

OBJECTIVE: In today's world, despite the numerous benefits, increasing demand for computer technology and the influence of widespread internet technology, many people, especially students, have faced impaired mental health and social relationships resulting from internet addiction; therefore, with regard to the contradictory results of preceding studies in the field of internet addiction, this study was designed to determine the prevalence of internet addiction in students of Ahvaz Jundishapur University of Medical Sciences. METHODS: This descriptive study was conducted on all students of Ahvaz Jundishapur University of Medical Sciences. For data collection questionnaire and demographic profile of internet addiction test was used. RESULTS: The results showed that internet addiction is common among university students (t = 23.286, p < 0.001). Internet addiction is significantly different between males and females and more prevalent in the male users (t = 4.351, p = 0.001). The prevalence of internet addiction in various categories was 1.6% normal, 47.4% mild, 38.1% moderate, and 12.9% severe. Our analysis also showed a significantly higher proportion of senior students with severe internet addiction (16.4%) compared to junior students (χ2 = 30.964; p < 0.001). CONCLUSION: Based on the findings of this study it can be concluded that there is a considerable internet addiction in medical students, and to prevent risks and complications, health considerations and proper treatments seem to be necessary.

Memantine Augmentation Improves Symptoms in Serotonin Reuptake Inhibitor-Refractory Obsessive-Compulsive Disorder: A Randomized Controlled Trial.

INTRODUCTION: There is a large body of evidence on the clinical benefits of augmentation therapy with glutamate-modulating agents, such as memantine in reducing OCD symptoms. METHODS: A double-blind, placebo-controlled trial was conducted on SRIrefractory OCD patients. Thirty-two patients were randomized to receive either 20 mg/day memantine or placebo augmentation and were visited at baseline and every 4 weeks for 12 weeks. Results were measured using the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). RESULTS: The Y-BOCS total score was significantly reduced in the memantine group at the end of weeks 8 and 12, while no improvement was observed in the placebo group throughout the trial. A reduction of 40.9% in the mean Y-BOCS total score by week 12 in the memantine group resulted in 73.3% of patients achieving treatment response. The findings showed that a time to effect of 8 weeks was necessary to observe significant improvement in OCD symptoms, while treatment response was only seen after 12 weeks of memantine augmentation. DISCUSSION: Memantine is an effective and well-tolerated augmentation in severe OCD patients refractory to SRI monotherapy.

Which came first, the risk of migraine or the risk of asthma? A systematic review.

OBJECTIVES: We conducted this review to systematically assess the association and risk of the migraine in the patient with asthma and vice versa. METHODS: We systematically searched publishes articles indexed in PubMed, Scopus, Cochrane library, PsycINFO, CINAHL, ISI Web of Science, Science Direct from inception, and Embase databases until June 2017. The quality assessment of the involved studies was done using the Newcastle-Ottawa Scale (NOS). RESULTS: Eight studies with 389,573 participants were reviewed and selected for data extraction. Among the selected studies, 5 were reported the association between migraine with asthma risk, and the rest three studies reported the risk of asthma in patient with migraine compared to non-moraine individuals. Odds ratio (OR) of migraine for patient with asthma as compared with non-asthmatic individuals was 1.62 (95% CI 1.43-1.82). Data pooling using a random-effect model showed that migraine was associated with a significant increased risk of asthma (relative risk (RR): 1.56; 95% CI: 1.51-1.60; p < .00001). Besides, sub-group and sensitivity analyses supported the positive association between asthma and migraine, and risk of asthma in migraine patients. CONCLUSION: Now it is unknown if control of the asthma will impact the severity of migraines or vice versa, but it is necessary to perform more research to further explain the mechanisms through which asthma increases the frequency of migraine or vice versa. If two conditions linked, once an individual undergo better control of asthma symptoms, might the excruciating migraine ease, too.

Comparison of Toxoplasmosis in Narcotic Drug-addicted and Healthy Persons in the Southwest of Iran; A Case-control Study.

INTRODUCTION: Toxoplasmosis and narcotic drug addiction are endemic in various regions of Iran. These drugs can provide situations for infections by disrupting the immune system. The current case-control study was designed to determine the prevalence of toxoplasmosis in narcotic drugaddicted persons in comparison with healthy subjects using serology and molecular techniques in the southwest of Iran. METHODS: A total of 201 subjects (including 101 individuals with drug addiction and 100 control participants) were randomly selected. Chronic and acute toxoplasmosis was detected using the enzymelinked immunosorbent assay (ELISA) IgG avidity. T. gondii immunoglobulin G (IgG) and immunoglobulin M (IgM) were also determined by the ELISA. Moreover, the presence of T. gondii in blood samples was diagnosed using the nested-polymerase chain reaction (Nested-PCR). RESULTS: For T. gondii IgG, 17 (17.0%) of 100 and 39 (38.6%) of 101 cases were diagnosed in the control participants and drug-addicted people, respectively [P=0.001, OR=3.071, CI= (1.591-5.929)]. Moreover, 16 (15.8) and 5 (5.0%) cases were positive for the B1 gene in the drug-addicted patients and controls by the nested-PCR technique, respectively [P=0.019, OR=3.576, CI= (1.257-10.179)]. However, no significant differences were found between the opium (n=64) and crystal methamphetamine (n=37) groups in terms of T. gondii IgG and IgM antibodies and the presence of the parasite in the blood (P>0.05). CONCLUSION: The present results demonstrated that the outbreak of the infection was more frequent in narcotic drug-addicted persons than the controls using serology and molecular techniques.

Comparison of psychological disorders during and after pregnancies caused by assisted reproductive treatments and spontaneous pregnancies.

INTRODUCTION: Mental disorders during pregnancy are one of the major public health problems because of its effect on both mother and child, but the prevalence of psychiatric disorders in infertile women is largely unknown to compare psychiatric disorders during and after pregnancies with assisted reproductive therapies (ART) and spontaneous pregnancies. METHODS: This cross-sectional study was conducted on pregnant women referring to midwifery centers in Ahvaz City in 2022. Pregnant women were included in two groups of either pregnancy caused by ART (n= 84) or spontaneous pregnancy (n= 256). The Symptom Checklist-90-R (SCL90-R) was used to assess psychiatric disorders during and after pregnancies. RESULTS: A high percentage of women with spontaneous pregnancy (74.6%) and ART (91.7%) had some degree of psychological disorders. The severity of psychological disorders in both groups was higher during pregnancy than after pregnancy (P<0.001). The intensity of various psychological disorders during and after pregnancy in the ART pregnancy group was significantly higher than the control group (P<0.001). An increased risk of psychiatric disorders during pregnancy was associated with the history of psychiatric disorders [odd ratio (OR): 12.393; P= 0.022], family history of psychiatric disorders (OR:26.168; P<0.001), history of infertility (OR: 19.00; P<0.001), primary infertility (OR: 12.714; P=0.004), infertility duration more than three years (OR: 43.424; P<0.001), and frequency of embryo transfer (OR: 18.939; P=0.045). CONCLUSION: Psychiatric disorders were prevalent among pregnant women in the study area especially in pregnant women with ART. Regular screening programs for mental health problem should be included in an antenatal care service especially in this high-risk group.

Relationship between health literacy and generalized anxiety disorder during the COVID-19 pandemic in Khuzestan province, Iran.

Introduction: During the COVID-19 pandemic, many changes occurred in various cultural, social, and economic fields, leading to the creation of psychological effects, especially anxiety, in the community. Fear and anxiety about emerging diseases (COVID-19) and less participation in preventive behaviors reduce individual resistance and ultimately lower one's quality of life. Therefore, we aimed to investigate the relationship between health literacy and generalized anxiety disorder during the COVID-19 pandemic in Khuzestan province, Iran. Methods: This was a descriptive-analytical (cross-sectional) study conducted among participants aged 18-65 in Khuzestan province during the years 2020-2021 through online sampling. Due to the prevalence of COVID-19 and the impossibility of face-to-face communication, the questionnaire was designed on the Porseline Survey website and the questionnaire link was provided to participants through WhatsApp and Telegram. The data collection tool includes the Iranian Health Literacy Questionnaire, which includes 33 items, and the Generalized Anxiety Disorder-7 scale, which has 7 items based on a Likert scale. Data analysis was performed using STATA14 software and descriptive and analytical statistical tests at a significant level less than 0.05. Results: The mean (standard deviation) score for health literacy was 52.9 ± 9.3 and for generalized anxiety disorder was 5.2 ± 3.1. A significant negative correlation was found between the mean of anxiety disorder and health literacy (p < 0.05). The frequency of health literacy in individuals included 427 (37.8%) with inadequate health literacy, 628 (55.6%) with marginal health literacy, and 75 (6.6%) with sufficient health literacy. There was a statistically significant difference between the mean of generalized anxiety disorder among individuals with different levels of health literacy (p < 0.05). Conclusion: As the level of health literacy increases, the prevalence of generalized anxiety disorder caused by fear of COVID-19 decreases. Therefore, increasing awareness and health literacy about this virus, its transmission, and prevention methods is very effective in managing anxiety and stress caused by COVID-19. Paying attention to the issue of health literacy and generalized anxiety disorder, and promoting preventive behaviors can be effective tools for planners, health officials, and policymakers to promote health literacy for any type of disease.

Effects of aripiprazole augmentation in treatment-resistant obsessive-compulsive disorder (a double blind clinical trial).

BACKGROUND: Obsessive-compulsive disorder (OCD) is a chronic disorder with unknown etiology. Failure in OCD treatmentcompulsive is common and finding effective augmentations in treatment of OCD will benefit patients. Antipsychotic augmentation is a common strategy for treatment resistant OCD. This trial evaluated the efficacy of adding aripiprazole in patients whose OCD was insufficiently responsive to an adequate SSRI treatment. METHODS: Thirty-nine adult outpatients, who met the DSM-IV-TR criteria for OCD and had treatment resistant OCD were evaluated in a double-blind randomized clinical trial. The patients received either aripiprazole 10 mg/day or placebo, for 12 weeks. Data were analyzed using intention-to-treat analysis with last observation carried forward. All statistical tests were two-sided, and were considered statistically significant at P < 0.05. RESULTS: A significant reduction in total scores of Y-BOCS (P < 0.0001) was found in the aripiprazole group. Aripiprazole was generally well tolerated. There was no significant difference between the two groups in terms of observed side effects. CONCLUSION: Results of the present study indicate that aripiprazole could be an effective augmentation medicine in treatment resistant OCD.

Relationship Between Mental Health and Death Anxiety During COVID-19 Pandemic in Dental Staff and Students: A Cross-Sectional Study.

Objective: We aimed to determine the mental health and death anxiety among dental staff and students in school of dentistry during COVID-19 pandemic. Methods: It was a cross-sectional study among students (n = 300) and staff (n = 60) in School of dentistry in Ahvaz University of Medical Sciences during 2020. The instruments were a demographic questionnaire, Death Anxiety Scale, and Kessler Questionnaire. Data was analyze by using SPSS version 22, in all tests, the significance level was set at <0.05. Results: The mean age of dental students and personnel was 23.96 and 40.08 years, respectively. The mean scores of death anxiety were higher in dental staff (8.53) than students (6.02) and the mean scores of mental health status were higher in students (14.78) than personnel (9.18). This indicates that death anxiety was higher in Dental staff, while students were in better mental health status. The correlation coefficient between death anxiety and mental health status was 0.366 among students (p < 0.001), while it was 0.429 among dental staff (p < 0.001), showing a medium relationship between death anxiety and mental health in both groups. Conclusion: The overall findings represent a significant but contradictory relationship between mental health status and death anxiety among dental staff and students during the prevalence of COVID-19 pandemic. This suggests the impact of confounding factors in this area, which can be studied by future researchers and policy makers to design health promotion interventions.

Assessment of the diagnostic performance of two new tools versus routine screening instruments for bipolar disorder: a meta-analysis.

OBJECTIVE: The present meta-analysis was conducted to determine the diagnostic accuracy of the bipolarity index (BI) and Rapid Mode Screener (RMS) as compared with the Bipolar Spectrum Diagnostic Scale (BSDS), the Hypomania Checklist (HCL-32), and the Mood Disorder Questionnaire (MDQ) in people with bipolar disorder (BD). METHODS: We systematically searched five databases using standard search terms, and relevant articles published between May 1990 and November 30, 2021 were collected and reviewed. RESULTS: Ninety-three original studies were included (n=62,291). At the recommended cutoffs for the BI, HCL-32, BSDS, MDQ, and RMS, the pooled sensitivities were 0.82, 0.75, 0.71, 0.71, and 0.78, respectively, while the corresponding pooled specificities were 0.73, 0.63, 0.73, 0.77, and 0.72, respectively. However, there was evidence that the accuracy of the BI was superior to that of the other tests, with a relative diagnostic odds ratio (RDOR) of 1.22 (0.98-1.52, p < 0.0001). The RMS was significantly more accurate than the other tests, with an RDOR (95%CI) of 0.79 (0.67-0.92, p < 0.0001) for the detection of BD type I (BD-I). However, there was evidence that the accuracy of the MDQ was superior to that of the other tests, with an RDOR of 1.93 (0.89-2.79, p = 0.0019), for the detection of BD type II (BD-II). CONCLUSION: The psychometric properties of two new instruments, the BI and RMS, in people with BD were consistent with considerably higher diagnostic accuracy than the HCL-32, BSDS, and MDQ. However, a positive screening should be confirmed by a clinical diagnostic evaluation for BD.

Toxoplasmosis in Treatment-Resistant Obsessive-Compulsive Disorder Patients.

BACKGROUND AND OBJECTIVES: The current study was done to evaluate the relationship between T. gondii and obsessive-compulsive disorder (OCD) as well as prevalence rate of toxoplasmosis in treatment-resistant patients with OCD in comparison with treatment-sensitive patients with OCD. METHODS: A total of 180 subjects were selected, including 90 patients with OCD and 90 control participants. Immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies against T. gondii were measured by the enzyme-linked immunosorbent assay (ELISA) technique. Detection of acute and chronic toxoplasmosis was carried out using the ELISA IgG avidity. In addition, the presence of this parasite in blood was detected using the nested-polymerase chain reaction (PCR) method. RESULTS: Regarding T. gondii IgG antibodies 42 (46.7%) and 17 (18.9%) cases were detected in the patients and controls, respectively (P = 0.000). Also, 16 (17.8%) and 5 (5.6%) cases were positive for B1 gene in patients and controls, respectively (P = 0.018). The antibodies were found to be related to risk of OCD [OR (95% CI) = 3.71 (1.88-7.30); P < 0.001]. Moreover, out of 90 patients, 35 and 55 cases were resistant and sensitive to treatment, respectively, so that 24 (68.6%) out of 35 and 18 (32.7%) out of 55 were positive for the antibodies (P = 0.01) as well as 11 (31.4%) out of 35 and 5 (9.1%) out of 55 were positive for B1 gene (P = 0.010). The antibodies were also associated with risk of resistance to treatment in patients with OCD [OR (95% CI) = 3.81 (1.42-10.17); P = 0.008]. CONCLUSION: Our findings showed that toxoplasmosis was more frequent in patients with OCD than the control group. In addition, prevalence rate of toxoplasmosis in treatment-resistant patients with OCD was significantly more than that in treatment-sensitive patients with OCD.

A preliminary randomized double-blind clinical trial on the efficacy of celecoxib as an adjunct in the treatment of obsessive-compulsive disorder.

Obsessive-compulsive disorder is a common neuropsychiatric condition. Although a variety of pharmaceutical agents is available for its treatment, psychiatrists have found that many patients cannot tolerate the side effects, do not respond to treatment adequately, and may finally discontinue their treatment. However, augmentation strategies have been shown to have some benefits in the treatment of OCD. These include reducing both the overall cost of treatment and the side effects. The purpose of this study was to assess the efficacy of celecoxib as an adjuvant agent in the treatment of OCD in an 8-week, double-blind, placebo controlled trial. To this end, 25 patients were assigned to a study group and were given fluoxetine 20mg/day plus celecoxib 400mg/day (200mg BID). The control group included 25 patients who were given fluoxetine 20mg/day plus placebo. Both protocols significantly lowered scores on the Yale-Brown Obsessive-Compulsive Scale over the trial period. The combination of fluoxetine and celecoxib decreased the symptoms of obsessions and compulsions significantly more than fluoxetine plus placebo. The results of this study suggest that celecoxib can be an effective adjuvant agent in the management of patients with OCD; therefore, anti-inflammatory therapies should be further investigated.

Experimental Therapeutic Strategies in Epilepsies Using Anti-Seizure Medications.

Epilepsies are among the most common neurological problems. The disease burden in patients with epilepsy is significantly high, and epilepsy has a huge negative impact on patients' quality of life with epilepsy and their families. Anti-seizure medications are the mainstay treatment in patients with epilepsy, and around 70% of patients will ultimately control with a combination of at least two appropriately selected anti-seizure medications. However, in one-third of patients, seizures are resistant to drugs, and other measures will be needed. The primary goal in using experimental therapeutic medication strategies in patients with epilepsy is to prevent recurrent seizures and reduce the rate of traumatic events that may occur during seizures. So far, various treatments using medications have been offered for patients with epilepsies, which have been classified according to the type of epilepsy, the effectiveness of the medications, and the adverse effects. Medications such as Levetiracetam, valproic acid, and lamotrigine are at the forefront of these patients' treatment. Epilepsy surgery, neuro-stimulation, and the ketogenic diet are the main measures in patients with medication-resistant epilepsies. In this paper, we will review the therapeutic approach using anti-seizure medications in patients with epilepsy. However, it should be noted that some of these patients still do not respond to existing treatments; therefore, the limited ability of current therapies has fueled research efforts for the development of novel treatment strategies. Thus, it seems that in addition to surgical measures, we should look for more specific agents that have less adverse events and have a greater effect in stopping seizures.

The Effect of Virtual Reality on Emotional Response and Symptoms Provocation in Patients With OCD: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis aimed to evaluate the effectiveness of virtual reality (VR)-based technology on emotional response and symptoms in patients with obsessive-compulsive disorder (OCD). We systematically searched major electronic databases, including PubMed/Medline, Scopus, Embase, ISI Web of Science, PsycINFO, and Cochrane central, up to April 14, 2021, with no data or language limits. We performed reference, related articles, and citation searches to find additional articles. We included original articles comparing and studying VR-based technology in patients with OCD against the control group. We observed that VR significantly increases in anxiety (SMD = 2.92; 95% CI 1.89-3.94, p < 0.0001; I 2 = 95%), disgust (SMD = 2.52; 95% CI 1.36-3.68, p < 0.0001; I 2 = 95%), urge to wash (SMD = 3.12; 95% CI 1.92-4.32, p < 0.0001; I 2 = 94%), checking time (SMD = 1.06; 95% CI 0.71-1.4, p < 0.0001; I 2 = 44%), number of checking behavior (SMD = 1.45; 95% CI 0.06-2.83, p = 0.04; I 2 = 93%), and uncertainty (SMD = 2.59; 95% CI 0.90-4.27, p = 0.003; I 2 = 70%) in OCD patients compared with healthy controls using a random-effect model. This meta-analysis found that this environment has a moderate enhancement in emotional response and symptoms test scores of patients with OCD. However, our findings should be generalized with caution due to the lack of standardized methods and high heterogeneity among included evidence. The appropriate mode of integrating VR-based technology for patients with OCD requires more exploration.

Does atorvastatin have augmentative effects with sodium valproate in prevention of migraine with aura attacks? A triple-blind controlled clinical trial.

BACKGROUND: Migraine is a painful and disabling nervous disorder which negatively affects the quality of life. Migraineurs may suffer from a generalized vasomotor dysfunction. Statins improve vasomotor and vascular function, with their pleiotropic effects. We aimed to assess efficacy and safety of adding Atorvastatin to prophylactic regimen in better control of migraine with aura. METHODS: This triple-blind controlled clinical trial was on 68 patients with migraine with aura. An interval of at least 1 month was given to evaluate vitamin D3 level and eligibility. In patients with vitamin D3 deficiency, the correction with vitamin D supplementation was provided. The patients were randomly assigned to receive atorvastatin 20 mg plus sodium valproate 500 mg or placebo plus sodium valproate 500 mg once a day for 2 months. The patients were evaluated based for the number of attacks and pain severity based on Visual Analogue Scale. RESULTS: There was a significant (p = 0.0001) improvement in severity of pain and number of migraine attacks by adding Atorvastin to the prophylactic regimen of patients with migraine with aura. After controlling for variable parameters, the differences between two arms of the study was yet statistically significant (p = 0.0001). A significant number of participants in intervention group were satisfied by their treatment (p = 0.001) with no remarkable side effects (P = 0.315). CONCLUSIONS: Adding atorvastatin to migraine with aura preventive regimen may help reduce the number of acute attacks and pain severity without causing considerable side effects and led to a better patient satisfaction. TRIAL REGISTRATION: IRCT20180106038242N1 . Registered: 7 February 2018.

The relationship between history of dietary nutrients intakes and incidence of aggressive behavior in adolescent girls: A case-control study.

BACKGROUND & AIMS: Aggressive behavior (AB) progress to a major concern among adolescents. The present study is designed to assess possible association between dietary intake of macronutrient, some micronutrient, cholesterol, and antioxidants with AB in adolescent girls, from age 9-13 years old. MATERIALS AND METHODS: In the case-control study, a total 212 primary school girls between 9 and 13 years of age were divided into two groups (106 with AB and 106 healthy) base on aggression score of the Buss-Perry questionnaire. A 147-item food frequency questionnaire (FFQ) was used to evaluate nutritional intake of subjects. Independent t-test and Mann-Whitney test was used to compare quantitative variables between the two groups according to the normality of data distribution. Chi-square test was used to compare categorical variables between case and control groups. Logistic regression models were used to assess possible association of nutrients intake with AB. RESULTS: The consumption of more simple carbohydrate [odds ratios (OR): 14.53, confidence interval (CI): (13.23, 17.56)] total fat [OR: 13.31, CI: (8.50, 16.47)], SFAs [OR: 11.831, CI: (8.94, 15.36)], TFAs [OR: 9.10, CI: (6.87, 10.12)], and caffeine [OR: 16.26, CI: (14.53, 17.88)] significantly increase the occurrence of aggressive behaviors. Conversely, intake of fiber [OR: 0.997, CI: (0.012, 0.999)], W3 [OR: 0.991, CI: (0.040, 0.999)], and vitamin K [OR: 0.994, CI: (0.990, 0.999)] were marginal associated with reduced odds of AB. CONCLUSIONS: The intake of caffeine, simple carbohydrate, total fat, SFAs, TFAs, could increase the occurrence of AB.

A double-blind, placebo-controlled pilot study of ondansetron for patients with obsessive-compulsive disorder.

OBJECTIVE: To assess the efficacy and tolerability of ondansetron in combination with selective serotonin reuptake inhibitors (SSRIs) in patients with obsessive-compulsive disorder (OCD). METHODS: The study was an 8-week pilot double-blind randomized clinical trial. Forty-two adult outpatients who met the Diagnostic and Statistical Manual, Fourth Edition, Text Revision (DSM-IV-TR) criteria for OCD based on the structured clinical interview participated in the trial. In this study, patients were randomly assigned to receive either ondansetron (4 mg) plus fluoxetine or fluoxetine (20 mg/day) plus placebo. RESULTS: The results showed a significant difference between two groups in the treatment of OCD (based on t-test). There was not any significant difference between the two groups in terms of observed side effects. CONCLUSIONS: The results of this study show that ondansetron has positive effects on obsession and compulsion which start two weeks after the beginning of the treatment.

Statin for Migraine Headache: Is It Worthwhile?

Migraine is a severe primary headache disorder that affects about 12% of the population, and it often occurs along with nausea, vomiting, and extreme sensitivity to light and sound. For patients with migraine, beta-blockers, antidepressants, anticonvulsants, are given as the first line of preventive treatment; alternatives include calcium channel blockers. Not only statins prevent the synthesis of cholesterol biosynthesis but also they have a pleiotropic effect such as antiinflammatory effects, antioxidant property, antiproliferative and immunomodulatory effects, the stability of plaque, normalization of sympathetic outflow, and inhibit of platelet aggregation. Here, we should focus on the evidence that works on the effect of the statins on migraine headaches, especially in patients who do not respond to first-line prevention treatments. The hypothesis may show that statins could be effective in the treatment of patients with migraine. Taken together, some epidemiologic, clinical, and experimental evidence suggest that statin may be a novel and promising candidate. For future treatment or prophylaxis of migraine, we hope that the use of this drug as cholesterol and triglycerides(blood lipids) leads to rebate drugs, as well as to reduce migraine headaches episodes agent to enhance the role of this drug in cure or prevent migraine attacks or recurrence, and finally to improve the patient's quality of life.