Iron accumulation in the brain causes oxidative stress, blood–brain barrier (BBB) breakdown, and neurodegeneration. We examined the preventive effects of acetylated oligopeptides (AOP) from whey protein on iron‐induced hippocampal damage compared to N‐acetyl cysteine (NAC). This 5‐week study used 40 male albino rats. At the start, all rats received 150 mg/kg/day of oral NAC for a week. The 40 animals were then randomly divided into four groups: Group I (control) received a normal diet; Group II (iron overload) received 60 mg/kg/day intraperitoneal iron dextran 5 days a week for 4 weeks; Group III (NAC group) received 150 mg/kg/day NAC and iron dextran; and Group IV (AOP group) received 150 mg/kg/day AOP and iron dextran. Enzyme‐linked immunosorbent assay, spectrophotometry, and qRT‐ PCR were used to measure MMP‐9, tissue inhibitor metalloproteinase‐1 (TIMP‐1), MDA, reduced glutathione (GSH) levels, and nuclear factor erythroid 2‐related factor 2 (Nrf2) and heme oxygenase‐1 (HO‐1) gene expression. Histopathological and immunohistochemical detection of nestin, claudin, caspase, and GFAP was also done. MMP‐9, TIMP‐1, MDA, caspase, and GFAP rose in the iron overload group, while GSH, Nrf2, HO‐1, nestin, and claudin decreased. The NAC and AOP administrations improved iron overload‐induced biochemical and histological alterations. We found that AOP and NAC can protect the brain hippocampus from iron overload, improve BBB disruption, and provide neuroprotection with mostly no significant difference from healthy controls.

ABSTRACT

Background: Chronic migraine [CM] is a severe neurological disorder characterized by pulsating unilateral or bilateral headache episodes. In people with chronic migraine, onabotulinumtoxinA could reduce the frequency and severity of migraines. Patients report that the treatment is well tolerated.

The Aim of The Work: The aim of this study was to evaluate the efficacy of onabotulinumtoxinA injection compared with the efficacy of onabotulinumtoxinA injection in combination with other oral prophylactics.

Materials and Methods: This observational study included one hundred five patients with chronic migraine attending the neurology clinic at Almoosa Specialized Hospital in Saudi Arabia, and was conducted from November 2019 to January 2021. Forty-five patients [42.9%] received an injection of onabotulinumtoxinA alone [group A], and 60 patients [57.1%] received a combined injection of onabotulinum- toxinA plus oral prophylaxis [group B].

Results: The study included 105 patients. The mean age of participants was 41.2 ± 5.7 years and ranged from 35 to 55 years. Seventy women [66.7%] and 35 men [33.3%] were affected. The mean frequency of migraine days showed a significant reduction from 17.6±10.3 days per month to 7.2±4.3 days after treatment in patients receiving onabotulinum toxin-A in combination with oral prophylactic medication, whereas it showed a less significant reduction from 16.4 ± 10.4 days per month to 9.1 ± 2.4 days in patients receiving onabotulinum toxin-A alone. Mean treatment frequency per month and mean duration of migraine attacks per hour were also significantly reduced after treatment in both groups.

Conclusion: Onabotulinum toxin-A toxin injection is highly effective in treating patients with chronic daily migraine, reducing the number and severity of migraine attacks per month and improving the quality of life of migraine patients. However, it is even more effective when combined with other prophylactic medications depending on the patients' concomitant diseases.

ABSTRACT

Background: The diagnosis of lumbar disc herniation is based on clinical history and examination, imaging studies, and electrophysiologic studies. Many factors have been reported as affecting recovery following surgical decompression. Electrophysiological studies has role in the diagnosis and predicting the prognosis of lumbar disc herniation.

Aims and Objectives: To study the prognostic value of the late response (F wave and H reflex) in lumbar disc herniation (L5-S1) treated surgically.

Materials and Methods: The study was conducted from January 2014 to April 2015 on fifty patients presented with lumbar disc herniation (L5-S1) and admitted in the department of spine surgery for surgical decompression. Both preoperative and 3 months postoperative electrophysiological studies were done.

Results: Preoperative F wave were abnormal in 74% of patients while H reflex were abnormal in all patients. 3 months follow up postoperative, 82% of patients had good outcome and improved neurological symptoms and 18% of patients still complaining of low back pain and sciatica. Postoperative F wave results showed 56% of patients had abnormal F wave response while H reflex results showed 52% of patients had abnormal H reflex. There were significant difference between both groups regarding to age, BMI, duration of disease, preoperative F wave and H reflex.

Conclusion: Old age patients with high BMI, long duration of neurological symptoms, absent F wave and H reflex response had unfavorable outcome postoperative.

Abstract

Aim of the study: To assess if the modified Mallampati score (MMS) can predict the presence and the severity of obstructive sleep apnea syndrome (OSA) in a group
of patients who had snoring and witnessed apnea from Al-Azhar university hospitals, Cairo, Egypt and Almoosa Hospital, Alhasa, Saudi Arabia.

Methods: A retrospective study was done for patients who had snoring and witnessed apnea referred to a sleep lab for the diagnosis of OSA by overnight full polysomnogram from January 2017 to November 2020. Apnea-hypopnea index (AHI) was used to categorize the severity of sleep apnea. Age, sex, MMS, body mass
index (BMI), comorbidities, sleep and laboratory parameters were recorded. Also, full Otorhinolaryngological, Neurological and Internal medicine examinations were recorded.

Results: The study was carried out on 350 patients fulfilling the inclusion criteria with a mean age 51.3 ± 14.3 years ranging from 14 to 81 years. More than half of them (58.6%) were males, the mean BMI was 35.1 ± 8.8 kg/m2 and the mean MMS was 4.7 ± 1.6 with about 65% of patients grouped in classes III and IV. OSA
(AHI>5) was diagnosed in 278 (79.4%) patients. Significantly, OSA was more detected among males, those with increased age, BMI, MMS, and those with type 2 diabetes mellitus (T2DM). Further evaluation showed a significant positive correlation between both BMI and MMS with the severity of OSA (ρ =0.23, P<0.001 and
ρ =0.36, P<0.001) respectively.

Conclusion: MMS is a useful tool to predict the presence as well as the severity of OSA in snoring patients. BMI and male gender are independent predictors.

Keywords: Snoring; Modified Mallampati Score; Body Mass Index; Obstructive Sleep Apnea