Background & Objective: There is a need for a more effective and better tolerated prophylactic treatment of migraine. This study aims to compare the effi cacy of botulinum toxin type-A (Dysport) and divalproex sodium (divalproex) as prophylactic treatment in patients with episodic or chronic migraine. Methods: This was a randomized, cross-over, single-center clinical trial. Participants were randomly divided into two treatment groups. Two phases of intervention were arranged (each for three months). In the fi rst phase, patients received either Dysport (125 units) or divalproex (200 mg bid for three months). The patients were left for a three months washout period, and then the treatment agents were swapped in the second stage. The response to each treatment was assessed at the end of each phase. Results: With divalproex, the frequency, intensity and duration of headache, as well as analgesic consumption were signifi cantly reduced (p<0.05) in both episodic and chronic patients. However, Dysport demonstrated signifi cant effi cacy only in patients with episodic migraine. In chronic migraine, Dysport only showed a non signifi cant trend to benefi t in these parameters, with exception of headache intensity,where it resulted in signifi cant improvement from baseline. Divalproex was signifi cantly superior to Dysport, in terms of headache frequency and intensity in patients with episodic migraine. Conclusions: Both Dysport and divalproex are effective prophylactic therapies for patients with episodic migraine. Divalproex but not Dysport was signifi cantly effective for chronic migraine.

OBJECTIVE: Primary dysmenorrhea occurs in more than 50% of women of reproductive age. This survey evaluated the effects of Menstrugole on the alleviation of primary dysmenorrhea. METHODS: This study was performed in western Iran between August 15 and December 15, 2017, in female students with primary dysmenorrhea. The students were randomly divided into 2 groups and received placebo or a Menstrugole capsule for 3 days in each of 2 menstrual cycles. The visual analog scale was used to assess pain severity. The χ2 test, one-way analysis of variance, and the paired t-test were used for statistical evaluation. RESULTS: We compared the severity of pain between the 2 groups. There was a significant change in the mean pain score during the first (P < 0.001) and second months (P < 0.001) after the use of Menstrugole, compared with that in the placebo group. CONCLUSION: Menstrugole decreased pain severity in female students, and can be considered by health care providers for treatment of primary dysmenorrhea.
Adolescent ; Analgesics ; Dysmenorrhea* ; Female ; Health Personnel ; Humans ; Iran ; Menstrual Cycle ; Visual Analog Scale

OBJECTIVE: Premenstrual syndrome (PMS) affects millions of women and is known as the most important disorder among them. The very aim of the present study was to evaluate the effects of low dose calcium on severity of PMS. METHODS: This study can be considered as a double-blind randomized clinical trial. Female students of Hamadan University of Medical Sciences diagnosed with PMS in 2014 participated in the present study. Sixty-six female students diagnosed with PMS were involved in the experimental and control groups. The participants were randomly assigned into two groups to receive 500 mg of calcium daily or placebo for two months. Severity of PMS was detected by Daily Record of Severity of Problems, which was used to measure symptoms during one menstrual cycle before and two menstrual cycles after the intervention. RESULTS: No signifcant differences were observed in the mean scores of PMS symptoms between calcium and placebo groups before the treatment (P=0.74). However, signifcant differences were noticed between the two intervention groups in the first (P=0.01) and second menstrual cycles (P=0.001) after the intervention. The differences were significant in subgroups of anxiety, depression, emotional changes, water retention, and somatic changes in calcium group compared with placebo group in the menstrual cycle before the intervention and two menstrual cycles after the intervention and among menstrual cycles (0, cycle 1, cycle 2) in calcium group (P=0.01). CONCLUSION: Overall, the results of the present study suggest that treatment with calcium supplements is an effective method for reducing mood disorders during PMS.
Anxiety ; Calcium* ; Depression ; Female ; Humans ; Menstrual Cycle ; Methods ; Mood Disorders ; Premenstrual Syndrome* ; Water

Objective: To assess prevalence of cyclical mastalgia and its main determinants in women who attended in health centers of Hamadan City, Iran. Methods: This case-control study was conducted on 400 women (case: cyclical mastalgia, n = 240; control: without cyclical mastalgia, n = 160) who attended family planning clinic for routine follow-up in health centers. The cluster sampling was used. Information was collected by interviewing and using a standardized validated questionnaire. Severity of mastalgia was assessed through using visual analog scaling. Data processing and statistical analysis were performed by using SPSS 19.0. Results: The results revealed that majority of women (60.0%) experienced cyclical mastalgia. Out of these, 22.5% and 37.5% were mild and moderate-to-severe mastalgia, respectively. No association was revealed in experience of depression and anxiety in mastalgia group. In a multivariable logistic regression model, the increasing age, age of marriage, history of abortion and history of premenstrual syndrome were main determinants of mastalgia, while use of oral contraceptive and regular exercise was associated with lower incidence of mastalgia. Conclusions: Most of women with breast discomfort suffered cyclical mastalgia which severity can be determined by advanced age, age of marriage, history of abortion and history of premenstrual syndrome, but inversely by oral contraceptive use and exercise activity.