Comparison of the effect of letrozole alone with letrozole plus n-acetylcysteine on pregnancy rate in patients with polycystic ovarian syndrome: A randomized clinical trial

Objectives: Different drugs are prescribed for the induction of ovulation in patients with polycystic ovary syndrome (PCOS). The aim of this study was to compare the effect of letrozole alone with letrozole plus N-acetyl cysteine (NAC) on the pregnancy rate in patients with PCOS. Materials and Methods: This clinical trial studyincluded317 patients with PCOS in the infertility clinic of Zahedan in 2018. Patients were randomly divided into letrozole and NAC plus letrozole groups. Then, several parameters were evaluated in both groups, including the pregnancy rate, number of follicles larger than 18 mm, endometrial thickness, and the endometrial pattern. Finally, data were analyzed using SPSS 25, and t-test and chi-square tests were used for statistical analysis. Results: The mean age of study participants was 28.5 ± 4.9 years old. The mean duration of infertility in the intervention group was 4.5 ± 3.8 years. The mean anti-Müllerian hormone and the mean endometrial thickness of patients in the intervention group were 4.4± 3.6 ng/mL and 7.6 ± 2.5 mm, respectively. Eventually, the pregnancy rate was 14.6 (n = 23) and 7.5 (n = 12) in the intervention and control groups, respectively (P = 0.046). Conclusions: The results of this search revealed that the number of follicles with the size of 18 mm in the control group was higher compared to the intervention group, but the fertility rate in patients with PCOS receiving letrozole plus N-acetylcysteine was significantly higher. © 2021 The Author(s);

Spinal protein kinase A and phosphorylated extracellular signal-regulated kinase signaling are involved in the antinociceptive effect of phytohormone abscisic acid in rats

Objective: The phytohormone abscisic acid (ABA) as a signaling molecule exists in various types of organisms from early multicellular to animal cells and tissues. It has been demonstrated that ABA has an antinociceptive effect in rodents. The present study was designed to assess the possible role of PKA and phosphorylated ERK (p-ERK) on the antinociceptive effects of intrathecal (i.t.) ABA in male Wistar rats. Methods: The animals were cannulated intrathecally and divided into different experimental groups (n=6�7): Control (no surgery), vehicle (received ABA vehicle), ABA-treated groups (received ABA in doses of 10 or 20 µg/rat), ABA plus H.89 (PKA inhibitor)-treated group which received the inhibitor 15 min prior to the ABA injection. Tail-flick and hot-plate tests were used as acute nociceptive stimulators to assess ABA analgesic effects. p-ERK was evaluated in the dorsal portion of the spinal cord using immunoblotting. Results: Data showed that a microinjection of ABA (10 and 20 µg/rat, i.t.) significantly increased the nociceptive threshold in tail flick and hot plate tests. The application of PKA inhibitor (H.89, 100 nM/rat) significantly inhibited ABA-induced analgesic effects. Expression of p-ERK was significantly decreased in ABA-injected animals, which were not observed in the ABA+H.89-treated group. Conclusions: Overall, i.t. administration of ABA (10 µg/ rat) induced analgesia and p-ERK down-expression likely by involving the PKA-dependent mechanism. © 2020 Associacao Arquivos de Neuro-Psiquiatria. All rights reserved

Overnight response to levetiracetam in Lance–Adams syndrome presenting 3 years after cardiac arrest

Abstract Background Lance–Adams syndrome (LAS), also known as chronic post-hypoxic myoclonus manifests as myoclonic movements of the face, limbs, or trunk following hypoxic brain injury, which may occur during respiratory failure or cardiac arrest. Case presentation We present a case and provide a video of a patient who developed LAS 3 years after experiencing cardiac arrest, presenting with action-induced generalized myoclonus upon standing. The patient exhibited a significant response to levetiracetam. To the best of our knowledge, this is the first reported case of LAS with such a delayed onset following the initial hypoxic event. Conclusion It is crucial for clinicians to be aware of this treatable condition and recognize that its onset may be delayed, occurring years after a hypoxic brain insult. This improved understanding will facilitate prompt diagnosis and effective management of LAS, ultimately enhancing patient outcomes

Traumatic rupture of a skull base dermoid cyst mimicking chronic meningitis

Cranial dermoid cysts are rare, embryologic tumors containing fat, hair, and other ectodermal elements. They occur most frequently in the posterior fossa and are typically diagnosed as incidental findings on brain imaging done for an unrelated reason. Traumatic rupture of a previously unidentified intracranial dermoid cyst can mimic symptoms of post-concussion syndrome and should be ruled out with magnetic resonance imaging (MRI). Surgical intervention after traumatic rupture may not result in complete symptom control due to the persistence of dermoid cyst debris in the subarachnoid space. Here, we present the clinical scenario and radiological features of a ruptured dermoid cyst due to trauma, highlighting a rare complication of a classically benign lesion