Serologic evaluation of cytomegalovirus (CMV), Toxoplasma gondii and Brucella in schizophrenia patients

Background

Infectious agents are considered as a possible cause of schizophrenia. The aim of this study was to evaluate the serum levels of cytomegalovirus (CMV), Toxoplasma gondii and Brucella antibodies in schizophrenia patients compared with the control group.

Methods

This cross-sectional study was performed on 75 patients with schizophrenia who were clinically diagnosed with schizophrenia using the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) by two independent psychiatrists. As the controls, 75 sex and age-matched individuals were selected from orthopedic and surgical wards, who were admitted because of trauma. Anti-Toxoplasma gondii IgG antibody was detected by Abbott's company diagnostic kit. To detect anti-Brucella IgG antibodies, the enzyme-linked immunosorbent assay (ELISA) test with Vircell diagnostic kit was used. Quantitative luminescence (CLIA) method using Abbott diagnostic kit was also used to detect anti-cytomegalovirus IgG antibody (CMV IgG avidity).

Results

There was not any clinically significant differences in the mean value of Toxoplasma, CMV and Brucella IgG antibodies between schizophrenia and control group. However, considering cut-off point for these tests and further analysis with non-parametric tests showed clinically significant difference between two groups at cut-off point 1.1 for anti-Brucella IgG antibody which indicated more positive samples in schizophrenia group (24 out of 75) than control group (12 out of 75) with a p-value less than 0.05 (0.046).

Conclusion

The results of the present study showed no association between toxoplasmosis infection and CMV and schizophrenia. However, there might be a positive correlation between anti-Brucella IgG antibody and schizophrenia.

Cognitive function in methadone maintenance patients compared with abstinent opioid users

BACKGROUND

Opioid is the second most prevalent illicit drug worldwide, whose consumption is very high in Iran, due to Iran's geographical proximity to producing countries. Methadone maintenance therapy is one of the most prevalent and accepted methods of substance abuse treatment. Nevertheless, cognitive disorders have been reported as one of its complications.

AIM

This study was conducted to evaluate cognitive impairment in methadone maintenance patients (MMPs) and to compare it with abstinent opioid users (AOUs).

MATERIALS AND METHODS

This cross-sectional analytical study was performed on 25 MMPs and 25 AOUs. Samples were selected through convenience sampling method whereby a self-made questionnaire was distributed among them to assess demographic information, clinical variables such as methadone and opioid use history, underlying disease and medication history, as well as 13-item Beck depression inventory. Then, they were interviewed using the Montreal Cognitive Assessment (MoCA) questionnaire.

RESULTS

Significant differences were found in MoCA questionnaire total scores (p = 0.018) and orientation to time and place dimension (p = 0.008) between the two groups, with the mean scores being higher in AOU group. Duration of opioid use was the only factor influencing cognitive assessment score in both Groups. (p = 0.029).

CONCLUSION

We suggest monitoring and assessing cognition function in patients receiving methadone especially for those with a long history of opioid use.

Impact of biofeedback therapy for pelvic floor-related constipation to improve sexual function

AIM

The purpose of this study was to investigate the effect of biofeedback therapy on constipation to improve sexual function among the female population with pelvic floor hypertonicity.

BACKGROUND

It appears that pelvic floor disorder could lead to sexual complaints. Unfortunately, there are few data on the correlation between pelvic floor-related constipation and sexual disorders. The biofeedback role as a conservative method in improving the health status in these patients is conflicting.

METHODS

Forty-two eligible women were included in the study. The exclusion criteria were not being sexually active, not having functional constipation according to Rome IV criteria, and having other psychiatric issues, according to DSM4TR criteria. All participants were treated using biofeedback in eight sessions, during two months. Before and after the treatment, they were analyzed by pelvic floor impact questionnaire, pelvic floor Distress Inventory, and Short Scale Personal Experiences Questionnaire (SPE Q).

RESULTS

Biofeedback significantly improved orgasm, arousal, and dyspareunia (respectively P = 0.001, P = 0.001, P = 0.001). However, there was no significant improvement in libido and partner satisfaction domains (respectively P = 0.132, P = 0.341). Significant negative correlations were detected between the age and sexual function. On the other hand, there was no negative relationship between vaginal delivery as well as cesarean delivery and different components of sexual function.

CONCLUSION

It seems the improvement in pelvic floor muscle hypertonicity leads to sexual satisfaction. Nevertheless, more data are required to prove this correlation.

Cutaneous application of menthol 10% solution as an abortive treatment of migraine without aura: a randomised, double-blind, placebo-controlled, crossed-over study

OBJECTIVE

To investigate the efficacy and safety of the cutaneous application of menthol 10% solution for the abortive treatment of migraine.

BACKGROUND

Peppermint and its active ingredient menthol have long been used for the treatment of various pain conditions including headache.

METHODS

This is a randomised, triple-blind, placebo-controlled, crossed-over study conducted in the neurology Clinic of Nemazee Hospital, affiliated with Shiraz University of Medical Sciences, Shiraz, southern Iran, from March 2007 to March 2008. The patients were recruited via local newspaper advertisements. Eligible patients were categorised into two groups and a 10% ethanol solution of menthol (as drug) and 0.5% ethanol solution of menthol (as placebo) were applied to the forehead and temporal area in a crossover design. Pain free, pain relief, sustained pain free and sustained pain relief end-points were measured by questionnaires using a visual analogue scale.

RESULTS

The intent-to-treat population consisted of 35 patients (80% women, 20% men, mean age: 29.6 +/- 6.2) with 118 migraine attacks. In the intent-to-treat population, the menthol solution was statistically superior to the placebo on 2-h pain free (p = 0.001), 2-h pain relief (p = 0.000), sustained pain free and sustained pain relief end-points (p = 0.008). The menthol solution was also more efficacious in the alleviation of nausea and/or vomiting and phonophobia and/or photophobia (p = 0.02). In the per-protocol population, there was significantly higher number of patients who experienced at least one pain free/pain relief after the application of menthol rather than the placebo (p = 0.002). No significant difference was seen between the adverse effects of the drug and the placebo groups (p = 0.13).

CONCLUSION

Menthol solution can be an efficacious, safe and tolerable therapeutic option for the abortive treatment of migraine.

Peritonsillar infiltration with bupivacaine and pethidine for relief of post-tonsillectomy pain: a randomised double-blind study

Previous studies of infiltration of local anaesthetics in children undergoing tonsillectomy resulted in conflicting results. The aim of this study was to evaluate the effect of the peritonsillar injection of bupivacaine and pethidine on postoperative pain in children undergoing snare-dissection tonsillectomy. In a double-blind study, 80 children (aged 7-15 years) were randomly divided into two groups receiving peritonsillar injection of either bupivacaine (1 mg x kg(-1)) and pethidine (1 mg x kg(-1)) in adrenaline 1:200,000 (treatment group) or an equivalent volume of saline (placebo group) pre-operatively. The time needed for first demand of analgesia and analgesic consumption to reduce the visual analogue scale (VAS) for resting throat pain to < or = 30, the VAS for pain on swallowing, drinking liquid and eating a soft diet, incidence of nausea and vomiting, and the need for rescue anti-emetics in the first 24 h after operation were compared in both groups. The combination of bupivacaine and pethidine could significantly decrease the consumption of analgesics for resting pain at 4, 6, 8, 12, and 24 h after operation but did not reduce pain on swallowing, drinking liquid and eating a soft diet. The times to demand of first dose of analgesic and to first oral intake were not significantly different. The overall satisfaction of patients in relation to relief of postoperative pain was not significantly different between the two groups. Although peritonsillar injection of pethidine and bupivacaine in children reduces the analgesic consumption, it does not affect the dynamic pain state in the first 24 h after snare-dissection tonsillectomy.