BackgroundThere are many drugs recommended for pain relief in patients with migraine headache.MethodsIn a prospective double blind randomized clinical trial, 90 patients (age ≥ 18) presenting to Emergency medicine Department with Migraine headache were enrolled in two equal groups. We used intravenous propofol (10 mg every 5–10 minutes to a maximum of 80 mg, slowly) and intravenous dexamethasone (0.15 mg/kg to a maximum of 16 mg, slowly), in group I and II, respectively. Pain explained by patients, based on VAS (Visual Analogue Scale) was recorded at the time of entrance to ED, and after injection. Data were analyzed by paired samples t test, using SPSS 16. P < 0.05 was considered to be statistically significant.ResultsThe mean of reported pain (VAS) was 8 ± 1.52 in propofol group and 8.11 ± 1.31 in dexamethasone group at presenting time (P > 0.05). The VAS in propofol group was obviously decreased to 3.08 ± 1.7, 1.87 ± 1.28 and 1.44 ± 1.63 after 10, 20 and 30 minutes of drug injection, respectively. The VAS in dexamethasone group was 5.13 ± 1.47, 3.73 ± 1.81 and 3.06 ± 2 after 10, 20 and 30 minutes of drug injection, respectively. The mean of reported VAS in propofol group was less than dexamethasone group at the above mentioned times (P < 0.05). The reduction of headache in propofol group, also, was very faster than dexamethasone group (P < 0.05). There were no adverse side effects due to administration of both drugs.ConclusionsIntravenous propofol is an efficacious and safe treatment for patients presenting with Migraine headache to the emergency department.Trial registrationClinical Trials IRCT201008122496N4

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Background The relationship between gut dysbiosis and inflammatory diseases including multiple sclerosis (MS) is presently recognized as an important health issue. It has been established that some bacterial probiotic strains are effective in treating MS. This study will investigate the effect of yeast probiotic Saccharomyces boulardii (SB) supplements on mental health, quality of life, fatigue, pain, and indices of inflammation and oxidative stress in MS patients. Methods/design In this double-blind randomized controlled two-group parallel trial, 50 MS patients who meet the inclusion criteria will be recruited from outpatient settings. They will be randomly allocated to 4 months of daily placebo or the SB probiotic intervention. Blood samples will be taken from each participant at the baseline and after the intervention period to assess inflammation and oxidative stress. The primary endpoint will be the changes in their mental health evaluated by the 28-item General Health Questionnaire. The secondary endpoints include changes in: (1) quality of life, evaluated by the 36-item Short Form Questionnaire, (2) fatigue, evaluated by the Fatigue Severity Scale, (3) pain, evaluated by a visual analogue scale, and (4) serum levels of indices of inflammatory stress (high-sensitivity C-reactive protein) and oxidative stress (malondialdehyde and total antioxidant capacity). Moreover, any adverse events and side effects due to the intervention will be documented. Discussion There is a need to discover safe and practical methods for managing the symptoms of MS. This trial will gather evidence on the effects of a probiotic. Trial registration Iranian Clinical Trial Registry, IRCT20161022030424N1 . Registered on 9 April 2018. Electronic supplementary material The online version of this article (10.1186/s13063-019-3454-9) contains supplementary material, which is available to authorized users.

ObjectivesIn this cross-sectional study among 220 medical students we aimed to determine the nutritional knowledge and attitude of medical students through clinical training courses (externship and internship) of Tabriz University of Medical Sciences, Iran. A nutritional knowledge questionnaire included 51 questions was used to determine the correct, perceived and accuracy of knowledge of the participant in different aspects of nutrition sciences. The nutrition attitude questionnaire included 30 questions. Both questionnaires were confirmed in terms of the validity and reliability for assessing nutritional knowledge and attitude in this sample of Iranian medical students. Nutritional knowledge and attitude were calculated as percentage of correct or appropriate responses.ResultsThe correct knowledge was not significantly different among externs and interns (68.20 ± 7.50% and 67.87 ± 6.04% respectively, p = 0.729). Results showed that most of the participants (49.61% of externs and 57.14% of inters) had a poor nutritional knowledge, significantly varied by age (p = 0.035). The attitude index of the subjects was not significantly different among externs and interns (73.36 ± 9.42% and 74.59 ± 9.20%, p = 0.335). Most students (92.7%) had a very appropriate attitude toward nutrition, significantly varied by sex (p = 0.010). These findings indicate that there are multiple deficiencies in nutrition knowledge of medical students.

Objectives We aim to measure dietary inflammatory index (DII) and its association with functional status, pain intensity and quality of life (QOL) in patients with knee osteoarthritis (KOA). Dietary information from 220 qualified patients with KOA was collected by a 168-item food frequency questionnaire. The functional status, pain intensity and QOL were evaluated by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire, Visual Analogue Scale (VAS) and SF36 questionnaire respectively. Results Linear regression analysis showed that the DII was significantly associated with VAS (p = 0.040; β = 0.151), and physical function (p = 0.039; β = − 0.184), emotional wellbeing (p = 0.048; β = − 0.158) and pain (p = 0.020; β = 0.161) scales and physical health (p = 0.047; β = 0.110) subscale of QOL after adjusting for age, sex, body mass index, and physical activity. There was no significant differences concerning WOMAC across the DII tertiles with and without adjustment to probable confounders (Ptrend = 0.091 and 0.181, respectively). After adjustment, a significantly increased severe pain odds was observed in the highest tertile of DII score in comparison with the lowest tertile (OR tertile 3 vs. 1 = 1.55, 95% CI 1.04–2.31; Ptrend = 0.04).

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Aim: Residual leg pain makes the outcome in lumbar discectomy unfavorable. The aim of this study was to compare gabapentin with placebo in terms of reduced remaining postoperative leg pain and morphine consumption after single level lumbar laminectomy and discectomy.Methods: We conducted a randomized parallel group, doubleblind, placebo-controlled clinical trial. Two hundred and six patients were randomly assigned into 2 groups. Each group received preanesthesia identical capsules containing gabapentin or placebo. Similar anesthesia protocol was performed. One hundred thirty patients were excluded secondarily and a total of 76 patients with residual, but less degree postoperative leg pain remained in the study. Postoperative visual analog scale and morphine consumption via patient-controlled analgesia pumps were recorded and statistically compared at 6-hour intervals for 24 hours.Results: No statistical significance was found between the 2 groups in terms of reduced postoperative leg pain or morphine consumption (P >0/0.05). No clinical evidence to prove synergism between gabapentin and morphine in discectomy patients was found. Conclusions:The results of this clinical trial failed to show that preemptive gabapentin is more effective than placebo with regard to leg pain reduction and morphine consumption during the acute stage after single level lumbar laminectomey and discectomy. However the possibility remains that multiple dose regimens of gabapentin would be beneficial.