Diazepam Group Research Articles

Vaginal diazepam plus transcutaneous electrical nerve stimulation to treat vestibulodynia: A randomized controlled trial

ObjectiveTo assess the effectiveness of vaginal diazepam in addition to transcutaneous electrical nerve stimulation (TENS) in the treatment of vestibulodynia (VBD). Study DesignThis study was a randomized, double-blind, placebo-controlled trial. Forty-two patients with VBD were randomized, 21 underwent diazepam and TENS (diazepam group) and 21 received placebo and TENS (placebo group). Vulvar pain was assessed on a on a 10-cm visual analogue scale (VAS) and dyspareunia according to the Marinoff dyspareunia scale. Vaginal surface electromyography (EMG) and vestibular current perception threshold (CPT) testing were performed at baseline and 60 days after treatment. The primary endpoints included the change in pain and dyspareunia from baseline to 60 days of pain and dyspareunia. The secondary endpoints was the variation in objectivity of pelvic floor muscle (PFM) function and vestibular nerve fiber current perception threshold (CPT). ResultsThe VAS scores for pain from basal values of 7.5 and 7.2 for the diazepam and placebo, respectively, showed significant (p 0.01) decreases from 4.7 to 4.3, but this difference was not statistically significant. The Marinoff dyspareunia scores in the diazepam group showed a significant difference (p 0.05) from values measured in the placebo group. The ability to relax the PFM after contraction (difference between maximal contraction and rest tone) was significantly greater for the diazepam group versus the placebo group (3.8 μv and 2.4 μv, respectively, p 0.01). The CPT values for all of the nerve fibers increased after the treatment, but this increase was significant in the diazepam group only for the values at a 5-Hz stimulation (C fibers) with a change of 47.8% vs 26.9% (p < 0.05). Only two patients reported a mild drowsiness in the diazepam group. ConclusionsThe present study provided indications that vaginal diazepam plus TENS is useful to improve pain and PFM instability in women with VBD.

Taurine Protects from Pentylenetetrazole-Induced Behavioral and Neurochemical Changes in Zebrafish.

Epilepsy is a common neurological disorder characterized by recurrent unprovoked seizures, which culminate in various neurobehavioral and neurochemical changes. Taurine (TAU) is an amino sulfonic acid which acts an endogenous inhibitory neuromodulator. Moreover, TAU displays intrinsic antioxidant activity, contributing to its beneficial actions in the CNS. Here, we evaluated whether TAU pretreatment protects from pentylenetetrazole (PTZ)-induced behavioral alterations and oxidative stress-related parameters in zebrafish brain tissue. Fish were pretreated with 42, 150, and 400mg/L TAU (40min) and further exposed to 10mM PTZ (20min) to analyze the seizure-like behaviors. As a positive control, another group was previously treated with 75μM diazepam (DZP). Afterwards, biochemical experiments were performed. All TAU concentrations tested decreased seizure intensity in the first 150s. Importantly, 150mg/L TAU attenuated seizure-like behavioral scores, decreased seizure intensity, reduced the frequency of clonic-like seizures (score 4), and increased the latency to score 4. TAU (150mg/L) also prevented oxidative stress in PTZ-challenged fish by decreasing lipid peroxidation and protein carbonylation and preventing changes on nonprotein thiol levels. No significant changes were observed in MTT assay and LDH activity. Differently than observed in DZP group, TAU did not affect the overall swimming activity of fish, suggesting different mechanisms of action. Collectively, we show that TAU attenuates PTZ-induced seizure-like behaviors and brain oxidative stress in zebrafish, suggesting the involvement of antioxidant mechanisms in neuroprotection.

Lofexidine versus diazepam for the treatment of opioid withdrawal syndrome: A double-blind randomized clinical trial in Singapore

BackgroundMany individuals leave costly inpatient detoxification programs prematurely because of the severity of withdrawal symptoms experienced. In the absence of opioid-assisted detoxification in Singapore, diazepam is used to manage withdrawal. However since diazepam is addictive, there is a need to explore the effectiveness of alternative medications. Design and proceduresThe study aimed to examine the safety and efficacy of lofexidine, a non-opiate, non-addictive, alpha 2-adrenergic agonist in assisting opioid detoxification in Singapore, using a randomized, double-blind, investigator-initiated placebo-controlled trial comparing lofexidine against diazepam. Opioid dependent patients (n = 111) were randomized to receive a 10-day course of lofexidine (n = 56) or diazepam (n = 55). The primary endpoint was the Objective Opioid Withdrawal Scale (OOWS) score on days 3 and 4 and secondary outcomes were the Short Opioid Withdrawal Scale (SOWS) score, program retention rate, and ratings of opiate craving. Main findingsThe OOWS, SOWS and opiate craving scores were consistently lower in the lofexidine group relative to the diazepam group over the 14-day study period; however no statistically significant differences were found on days 3 and 4 (peak withdrawal). Changes in mean pupil size during peak withdrawal were significantly smaller in the lofexidine group and more participants in the lofexidine group remained in treatment and completed detoxification. ConclusionsLofexidine was at least as effective as diazepam in reducing the opioid withdrawal syndrome and increased treatment retention. In addition to its non-addictive and non-abuse properties, lofexidine has several clinical advantages over diazepam. The use of lofexidine is recommended when opioid-assisted medications are not available.

The study of diazepam, pregabalin and glucose effect on glutamate toxicity: In vitro study

In this study we used pregabalin, diazepam and glucose for evaluating which one are more effective agents against glutamate induced neurotoxicity. After cortex culture preparation glutamate toxicity induced by adding 10-5 mM glutamate to each wells except negative control group. After 10 min different dose of diazepam, pregabalin and glucose were added for 24 h and then 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), Total Antioxidant Status (TAC) and Total oxidant status (TOS) assays were done. Diazepam, dose dependently shows neuroprotective effects and low dose of diazepam did not increase cell viability higher than 80 %. Combination groups only in high dose increased neurons viability. Total Antioxidant capacity of Pregabalin also show correlation with diazepam groups and highest dose of both show nearest value to negative control group. In addition, lowest and highest oxidant level were gained by the negative and positive control groups respectively. Except high dose of combination group, all groups show statically difference in compare with the negative control group P

Comparison of Effectiveness of Topiramate and Diazepam in Preventing Risk of Recurrent Febrile Seizure in Children under Age of 2 Years.

Febrile seizures are the most common type of convulsions. Medicinal prophylaxis is sometimes used for children at high risk of recurrent febrile seizure. In certain circumstances, conventional drugs such as diazepam and phenobarbital cannot be used and the need for alternative medicines is felt. This study compared the effectiveness of topiramate and diazepam in preventing the risk of recurrent febrile seizure in children under 2 yr old. This randomized controlled trial, in Besat Hospital in Hamedan, Iran from 22 Nov 2013 to 22 Nov 2015 (Registered code: IRCT Number: IRCT2015010120527N1), included 54 patients, at risk of recurrent febrile seizure, inhibited from taking phenobarbital. Samples were randomly divided into two groups. The first group received diazepam treatment during fever episodes and the second group received daily dose of topiramate. A one-year follow-up of recurrent febrile seizure and its complications was also conducted. Thirty-four patients (17 patients in each group) completed the one-year course of the trial. Recurrent febrile seizure was not observed in the course of preventive treatment. The prevalence of minor complications was 29.4% in the diazepam group and 48.5% in the topiramate group. No major complication was observed in among the subjects. Topiramate can be recommended for preventing recurrent febrile seizure when the use of frontline medicines is not possible.

Thirty- Versus Ten-Day Diazepam Treatment for Alcohol Detoxification and a Comparison of Drinking Patterns, Craving, and Anxiety for up to 12 Weeks: A "Proof-of-Concept" Open-Label Randomized Controlled Trial.

The aim of this study was to evaluate whether a prolonged detoxification treatment could decrease the relapse rate at 3 months after alcohol cessation in alcohol-dependent individuals through decreasing the levels of postdetoxification craving and anxiety. Twenty-six adult patients with alcohol dependence (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision) who began an outpatient alcohol cessation program with an initial drinking goal of abstinence were enrolled in a 3-month, parallel, randomized (1:1 ratio), controlled, open-label, pilot trial. Participants were randomized to receive a detoxification treatment of diazepam with a duration of 30 (n = 12) or 10 days (n = 14). All participants received BRENDA-based psychotherapy during follow-up. No significant between-group difference in relapse to any drinking was found at 3 months (P = 0.20). However, relapse to any heavy drinking at 3 months and regular drinking or heavy drinking during follow-up were significantly lower in the 30-day diazepam group (P = 0.009, P = 0.049, and P = 0.004, respectively). These differences were corroborated by significant differences in the alcohol-specific biological marker carbohydrate deficient transferrin at 3 months. Participants in the 30-day diazepam group also displayed significantly lower scores for alcohol craving (P = 0.007), self-reported anxiety (P = 0.024), and clinician-assessed anxiety (P = 0.002) throughout the follow-up. No serious adverse event was reported during the study. This study provides an evidence-based rationale for a double-blind, randomized, placebo-controlled trial to confirm the efficacy of such a procedure on short-term and mid-/long-term drinking outcomes after alcohol cessation in alcohol-dependent individuals.

Perbandingan Tingkat Sedasi Klonidin Syrup 2 mcg/kgBB dengan Diazepam Syrup 0.4 mg/kgBB sebagai Premedikasi pada Pasien Anak yang Menjalani Pembedahan dengan General Anestesi

Introduction: Anxiety in children undergoing surgery is characterized by subjective feeling of tension, apprehension,nervousness and worry that may be expressed in various forms. Clonidine, an alpha 2-adrenoceptor agonist, has beenshown to be as a preanesthetic medication in childrens. The current study was designed to investigate the differencesof level sedation clonidine syrup and diazepam syrup as a premedicant in children.Methods: In a randomized, double-blind, controlled clinical trial, 40 children, aged 2-12 yr, undergoing electivesurgery received 2 micrograms/kg clonidine syrup or 0.4 mg/kg diazepam syrup orally. These agents were administered120 min before the estimated time of induction of general anesthesia and noted the children’s level of sedation. Thelevel of sedation were compared among the two groups. PASS &lt;1 demanded rescue intravenous sedation.Result: Clonidine syrup 2 mcg/kgBB provided better quality of sedation after 60 min of premedicant but it wasn’tsignificant(1.8±0.92) and diazepam syrup (0.80±0.89; p&gt;0.05) and number of patients with rescue intravenous diazepamacceptance were same both clonidine group compared to diazepam, there was no significant difference between twogroups, 10% of clonidine group patients, 10 % of diazepam group patients (p&gt;0.05). No clinically significanthypotension or bradycardia was observed after preanesthetic medications of diazepam and clonidine syrup.Discussion: These data indicate that, even in pediatric surgery, the 2 micrograms/kg syrup clonidine is an effectivepremedication. However, the safety and optimal dose of clonidine in this setting remain to be determined.

Anxiety influences attention bias but not flight speed and crush score in beef cattle

Attentional biases towards threatening stimuli are increased when animals are in anxious states. An ability to assess negatively valanced affective states such as anxiety are important as they may be related to poor welfare. Flight speed and crush score are two well established tests of temperament in cattle, but little is known about their relationship with anxiety. This study was conducted to validate an attention bias test as a measure of anxious states in cattle and to determine whether the temperament trait(s) measured by flight speed and crush score tests were associated with anxiety. Thirty six Angus steers received one of the following pharmacological treatments: 1) anxiogenic (increase anxiety; 1-methy-chlorophenylpiperazine; m-CPP), 2) anxiolytic (decrease anxiety; diazepam) or, 3) control (saline). Thirty minutes later the steers were tested for crush score, flight speed and attention bias. The attention bias test involved measuring the response of each animal to the presence of the threat of a dog for 10s after which behavioural responses were recorded for 3min. Steers treated with m-CPP showed increased attention towards the threat (P<0.01), increased vigilance (P<0.01), spent more time with their ears backwards (P=0.022) and had a greater core temperature increase over the test period (P=0.01) compared to the control and diazepam groups. Cattle treated with m-CPP were significantly slower and less likely to eat in the attention bias test, compared to control and diazepam treated groups (P=0.04). The diazepam treatment did not affect any of the measures in the attention bias test (P>0.05). Crush score and flight speed were not affected by treatment (P>0.05). The results suggest that the pharmacologically induced anxiety state may not be related to these traditional tests of temperament. Increased attention towards the threat and differences in behaviours and body temperature during the attention bias test confirm that this test indicates increased anxiety in cattle. Attention bias testing provides promise as a measure of some negatively valanced affective states in cattle.

Research on the Mechanism of Mongolian Medical Warm Acupuncture in Alleviating Insomnia by Increasing the BCL-2/BAX Ratio and Decreasing the Hormones Related to the Central HPA Axis of the Stress Response

Abstract Background Mongolian medical warm acupuncture is efficacious in treatment of insomnia but the mechanism still remains unclear. There is no research on the effect on the changes in expression of mRNA in the receptors of 5HT, DA, 5HT1α, 5HT2α, and DRD2 and the levels of hormones related to the central HPA axis in the stress response. Objective To further explain the mechanism of Mongolian medical warm acupuncture in insomnia treatment and its role in protecting cerebral neurons, elaborate the effect of Mongolian medical warm acupuncture on the changes in expression of 5HT, DA, 5HT1α, and 5HT2α at different sites in the brains of the PCPA-induced insomnia model rats and the levels of hormones related to the central HPA axis in the stress response. Method 72 Wistar rats were randomly divided into blank group, model group, Mongolian medical warm acupuncture group, and diazepam group of 18 each. The rats were intraperitoneally injected with PCPA (400 mg/kg) for 2 consecutive days to induce insomnia. The sleep latency and sleep duration before and after treatment were observed. The content of 5HT in the hypothalamus and hippocampus was measured with the ELISA method. The content of mRNA in the 5HT1A and 5HT2A receptors in the hypothalamus and hippocampus with the qPCR technique. The content of DA in the hypothalamus and corpus striatum was determined with the ELISA method. The content of ELISA in the hypothalamus and the content of ACTH in the serum of the insomnia rats were determined with the ELISA method. The changes in content of the BCL-2 and BAX proteins in the hippocampus were observed with the immunohistochemical method. Result PCPA intraperitoneal injections were able to prolong the sleep latency of the rats and shorten the sleep duration (P&lt;0.05) when compared with the blank group. Mongolian medical warm acupuncture was able to alleviate the tendency of decreasing weight gain arising from insomnia (P&lt;0.05). Mongolian medical warm acupuncture was able to decrease the levels of CRH and ACTH in the hormones related to central HPA axis in the stress response (P=0.017, P=0.015) and alleviate the overexciting state of the HPA axis arising from insomnia. Mongolian medical warm acupuncture group was able to up-regulate the expression of the BCL-2 protein in the hippocampus, down-regulate the expression of the BAX protein, and increase the BCL-2/BAX ratio (P=0.011). Mongolian medical warm acupuncture was able to protect the hippocampal neurons by changing the content of the apoptosis factors (P=0.024). Conclusion Mongolian medical warm acupuncture decreases the levels of CRH and ACTH in the hormone related to the HPA axis, up-regulates the expression of the BCL-2 protein in the hippocampus, and down-regulates the expression of the BAX protein for improving rat insomnia by influencing the expression of 5HT1A and 5HT2A receptors in the hypothalamus and hippocampus.

Comparison of Clomethiazole and Diazepam in the Treatment of Alcohol Withdrawal Syndrome in Clinical Practice

Background: The objective of this retrospective study was to compare the effectivity and tolerability of diazepam and clomethiazole in the treatment of alcohol withdrawal syndrome (AWS) in a large clinical sample. Methods: The data of 566 patients admitted to an intensive care psychiatric unit in Germany (2010-2014) were evaluated. The course of withdrawal was analyzed on a matched sample (n = 152) consisting of a diazepam group (n = 76) and a clomethiazole group (n = 76). Medical assessment was based on a standardized point-based symptom rating scale called AESB (Alkoholentzugssymptom-Bogen), a German modified version of the Revised Clinical Institute Withdrawal Assessment of Alcohol Scale (CIWA-Ar). Results: Although the mean daily symptom reduction did not differ significantly, patients treated with clomethiazole were treated significantly shorter and needed less concomitant antipsychotic medication. Numbers of complications and adverse events did not show significant differences. Conclusion: Both clomethiazole and diazepam were effective and equally safe in the treatment of AWS. Clomethiazole provided a faster withdrawal and required less concomitant antipsychotic medication and therefore might be the more favorable option for patients and physicians. Taken into account the methodological limitations of the study (retrospective design, secondary matching, missing randomization, use of clomethiazole as drug of first choice), further studies are needed to confirm this result.

Anti-anxiety activity of ethanolic extract of Spermacoce hispida leaves in swiss albino mice

Background: The objective of the study was to evaluate the anxiolytic activity of ethanolic extract of Spermacoce hispida (EESH) in swiss albino mice.Methods: Forty eight adult Swiss albino mice weighing 25-30grams were selected. 24 were allocated to Elevated plus maize test and the remaining 24 to Bright and dark box test models. In each model, there were 4 groups. The control group received normal saline (10ml/kg), the standard, Diazepam (1mg/kg) and test groups received ethanolic extract of Spermacoce hispida (100mg/kg, 200mg/kg p.o. respectively) 1h prior to the acute study. In chronic study the drugs were given orally once a day for 10 days and the last dose was given 1h before the experiment. The antianxiety activity of the test drug was evaluated using EPM test and Bright and dark box test experimental models of anxiety. All results were expressed as mean±standard error mean (SEM) and analysed by one-way ANOVA. Post-hoc comparisons were performed by applying Dunnet’s test. P &lt;0.05 was considered statistically significant.Results: Ethanolic extract of Spermacoce hispida significantly increased the duration of time spent and number of entries in open arm in EPM and increased the number of entries into the bright arena, the time spent and the rears in bright arena indicating anxiolytic activity and EESH 200 mg/kg was found to be better than diazepam.Conclusions: The results of the present study suggest that the ethanolic extract of Spermacoce hispida have anxiolytic activity better than Diazepam.

A GAB Aergic anxiolytic-like trait of thymoquinone, possibly via diazepam-co-agonistic pathway

This study evaluated the possible anxiolytic potential of thymoquinone (TQ), a promising component of Nigella sativa oil in male Swiss mice under unstressed and stressed conditions. A short-term physical stress (STPS) was produced by using an electric shaker. A new apparatus named as ‘swing apparatus’ was selected to carry out this study. TQ was tested at doses of 5, 10 and 20 mg/kg. In order to understand possible action mechanism, a GABA receptor agonist and an antagonist were used in this study. As agonist diazepam (DZP), while antagonist flumazenil (FZL) was used at 2 and 2.5 mg/kg doses. Treatments were given intraperitoneally. The brain GABA levels were determined by UV-spectrophotometric method. The results suggest that, TQ dose-dependently exerted a significant (p&lt;0.05) anxiolytic effect in rodents, which was confirmed by the calming effect of the experimental animals in comparison to the vehicles' NC, DZP and FZL groups. An augmentation of the movements of the animals was observed in STPS applied groups. GABA levels in the mouse brain were also found to link with the behavioral activity, where TQ co-treated with DZP augmented the calming effect by decreasing GABA levels, which was reversed by the FZL pre- and post-treated groups, demonstrating possible co-agonistic and antagonistic effects with DZP and FZL, respectively. Therefore, this study suggests an involvement of GABAergic, possibly DZP-co-agonistic anxiolytic-like effect of TQ.

Comparing Hemodynamic Responses to Diazepam, Propofol and Etomidate During Anesthesia Induction in Patients with Left Ventricular Dysfunction Undergoing Coronary Artery Bypass Graft Surgery: a Double-blind, Randomized Clinical Trial

Background:Anesthesia induction is often accompanied by a period of hemodynamic instability, which could be deleterious in patients with coronary artery disease (CAD) and left ventricular dysfunction undergoing coronary artery bypass graft (CABG) surgery. The aim of this study was to compare the hemodynamic responses to propofol, etomidate, and diazepam following anesthesia induction, laryngoscopy and intubation in CABG surgery patients with low ejection fraction (EF).Methods:A double-blind randomized, clinical study was performed on 150 patients with CAD and left ventricular dysfunction (EF≤35%) scheduled for elective CABG surgery with Cardiopulmonary bypass (CPB). Patients were randomly allocated to three groups A, B, and C. These patients received propofol, etomidate or diazepam at induction of anesthesia, respectively. Hemodynamic variables (systolic and diastolic blood pressure [SBP, DBP], mean arterial pressure [MAP] and heart rate [HR]) were measured and recorded at baseline, immediately before laryngoscopy and tracheal intubation and one and three minutes after intubation.Result:One minute after induction and before laryngoscopy, there was a statistically significant decrease from the baseline in SBP, DBP and MAP in all three groups, but these variables in each hemodynamic parameters in diazepam group were less than other two groups (p<0.001). Moreover, the mean HR decreased in patients receiving propofol and etomidate one minute after induction and before laryngoscopy, but did not decreased in the diazepam group (p=0.005).Conclusion:The present study showed that in patients undergoing CABG surgery with low EF, diazepam is more favorable in terms of hemodynamic stability compared to propofol and etomidate and this drug can be used safely for induction of anesthesia in patients with impaired ventricular function.

Curcumin Reverses the Diazepam-Induced Cognitive Impairment by Modulation of Oxidative Stress and ERK 1/2/NF-κB Pathway in Brain.

Oxidative stress and inflammation can be involved in cognitive dysfunction associated with neurodegenerative disorders. Diazepam (DZP) administration has been chosen to simulate the memory impairment. The aim of this study was to evaluate the effects of curcumin (CUR) on spatial cognition, ambulatory activity, and blood and brain oxidative stress levels. The ERK/NF-κB signaling pathway and the histopathological changes in the hippocampus and frontal lobe, in diazepam-treated rats, were also analyzed. The animals were divided into 4 groups: control, carboxymethylcellulose (CMC) + CUR, CMC + DZP, and CUR + CMC + DZP. CUR (150 mg/kg b.w.) was orally administered for 28 days. DZP (2 mg/kg b.w.) was intraperitoneally administered 20 minutes before the behavioral tests (open field test, Y-maze, and elevated plus maze). CUR improved the spontaneous alternation behavior, decreased the oxidative stress levels, both in the blood and in the hippocampus, and downregulated the extracellular signal-regulated kinase (ERK 1/2)/nuclear transcription factor- (NF-) κB/pNF-κB pathway in the hippocampus and the iNOS expression in the hippocampus and frontal lobe of the DZP-treated rats. Histopathologically, no microscopic changes were found. The immunohistochemical signal of iNOS decreased in the DZP and CUR-treated group. Thus, our findings suggest that curcumin administration may improve the cognitive performance and may also have an antioxidant effect.

Effects of diurnal variation and anesthetic agents on intraocular pressure in Syrian hamsters (Mesocricetus auratus).

OBJECTIVE To determine effects of diurnal variation and anesthetic agents on intraocular pressure (IOP) in Syrian hamsters (Mesocricetus auratus). ANIMALS 90 healthy adult Syrian hamsters (45 males and 45 females). PROCEDURES IOP was measured with a rebound tonometer. In phase 1, IOP was measured in all hamsters 3 times during a 24-hour period (7 am, 3 pm, and 11 pm). In phase 2, hamsters were assigned to 5 groups (18 animals [9 males and 9 females]/group). Each group received an anesthetic agent or combination of anesthetic agents (ketamine hydrochloride, xylazine hydrochloride, diazepam, ketamine-diazepam [KD], or ketamine-xylazine [KX] groups) administered via the IP route. The IOP was measured before (time 0 [baseline]) and 10, 30, 60, 90, 120, and 150 minutes after administration of drugs. RESULTS Mean ± SD IOP values were 2.58 ± 0.87 mm Hg, 4.46 ± 1.58 mm Hg, and 5.96 ± 1.23 mm Hg at 7 am, 3 pm, and 11 pm, respectively. Mean baseline IOP was 6.25 ± 0.28 mm Hg, 6.12 ± 0.23 mm Hg, 5.75 ± 0.64 mm Hg, 5.12 ± 1.40 mm Hg, and 4.50 ± 1.30 mm Hg for the ketamine, xylazine, diazepam, KD, and KX groups, respectively. A significant decrease in IOP, compared with baseline IOP, was detected in only the KX group at 30, 60, and 90 minutes after drug administration. CONCLUSIONS AND CLINICAL RELEVANCE Maximum IOP in Syrian hamsters was detected at night. The ketamine-xylazine anesthetic combination significantly decreased IOP in Syrian hamsters.

Diazepam and Meclizine Are Equally Effective in the Treatment of Vertigo: An Emergency Department Randomized Double-Blind Placebo-Controlled Trial

BackgroundVertigo is a debilitating disease that is commonly encountered in the emergency department (ED). Diazepam and meclizine are oral medications that are commonly used to alleviate symptoms. ObjectivesWe sought to determine whether meclizine or diazepam is superior in the treatment of patients with peripheral vertigo in the ED. MethodsWe performed a double-blind clinical trial at a suburban, teaching ED. We randomized a convenience sample of adult patients with acute peripheral vertigo (APV) to diazepam 5 mg or meclizine 25 mg orally. Demographic and historical features were recorded on a standardized data form. Patients recorded their initial level (t0) of vertigo on a 100-mm visual analog scale (VAS) and after 30 min (t30) and 60 min (t60). The primary outcome parameter was the mean change in VAS score from t0 to t60. Differences between groups and 95% confidence intervals were calculated. Our a priori power calculation estimated that a sample size of 20 patients in each group was required to have an 80% power to detect a difference of 20 mm between treatment groups. ResultsThere were 20 patients in the diazepam group and 20 in the meclizine group. The two groups were similar with respect to patient demographics and presenting signs and symptoms. At t60, the mean improvements in the diazepam and meclizine groups were 36 and 40, respectively (difference −4; 95% confidence interval −20 to 12; p = 0.60). ConclusionWe found no difference between oral diazepam and oral meclizine for the treatment of ED patients with acute peripheral vertigo.

Comparison of valerian extract and diazepam on anxiety before orthopedic surgery

Introduction: anxiety has a negative effect on healing and tissue repair and spending too much mental and physical energy during prolonged stress can cause hospitalization and delay in discharge of patients. One method of reducing anxiety is the use of medicinal plants that in this study the effects of valerian root on the anxiety was examined. The aim of this study was to Comparison of valerian extract and diazepam on anxiety before orthopedic surgeryMaterials and Methods: In this double blind clinical trial study, 60 patients 15-60 years old referred to Imam Ali (AS) hospital of Bojnoord were selected as available and were also randomly divided into two groups of 30 individuals. At 21 pm before surgery, group 1 received 10 drops of valerian edible oil and group 2 received diazepam (5 mg) mixed in 50 ml of tap water. The Spielberger questionnaire was used to assess anxiety before intervention and one hour before initiation of surgery was recorded. Data was analyzed using statistical tests . The level of significance was measured 0/05 in this study.Results: In this study, in the valerian group there were 83.8% male and 16.7%% female while diazepam group included 23.3% male and 76.7 females. The Difference score of overt and covert anxiety in valerian group was 10.1±1.0 and 12.4±1.3 and in the diazepam group was 9.3±1.1 and 10.7±.03. Comparison of two groups showed no significant difference .Conclusion: Valerian has a good anti-anxiety and can be a substitute for chemical medicines after enough studies

Abstract PR359

Background & Objectives: Several techniques have been proposed to attenuate the pressor response following laryngoscopy and intubation.Clonidine has been shown to be effective for preoperative sedation, analgesia and perioperative haemodynamic stability. More recently gabapentin has been used for attenuation of pressor response to laryngoscopy and intubation. Primary Objective: To compare the efiicacy, saftey and utility of clonidine and gabapantin in attenuation of pressor response to laryngoscopy and tracheal intubation. Materials & Methods: STUDY DESIGN:Prospective, double-blind, randomized control. Toatal 90 patients, divided in 3 groups of 30 each. Inclusion Criteria: ASA grade I and II patients in the age group 20 to 60 years of both sexes. Study drug was administered as follows on day of surgery - GROUP I – Tab. Diazepam 5 mg at 6:00 am with sips of water. GROUP II – Cap. Gabapentin 900 mg at 6:00 am with sips of water. GROUP III – Tab. Clonidine 0.2 mg at 6:00 am with sips of water. Results: The rise of heart rate was longest in diazepam group and shortest in clonidine group. The pattern of changes in SBP, DBP and MAP were same in all the three groups following laryngoscopy and intubation. Hence the changes in MAP are taken as a reflection of drugs following ‘laryngoscopy and intubation. Both clonidine and gabapentin groups required statistically significant reduced analgesia intraoperatively as compared to diazepam. The attenuation of heart rate was better in gabapentin and clonidine group, as compared to diazepam group. Also the rise of heart rate was longest in diazepam group and shortest in clonidine group. The pattern of changes in SBP, DBP and MAP were same in all the three groups following laryngoscopy and intubation. Hence the changes in MAP are taken as a reflection of drugs following ‘laryngoscopy and intubation. Both clonidine and gabapentin groups required statistically significant reduced analgesia intraoperatively as compared to diazepam. However no such difference was noted between gabapentin and clonidine groups Conclusion: Clonidine was effective in attenuating pressor response (SBP, DBP, MAP) to laryngoscopy and intubation and was better than diazepam but less effective than gabapentine. Patients who were premedicated with clonidine and gabapentin have longer duration of post operative analgesia as compared to diazepam.

Antioxidative and neuroprotective effects of Leea macrophylla methanol root extracts on diazepam-induced memory impairment in amnesic Wistar albino rat

BackgroundA neurological disorder is becoming one of the major health problems worldwide. Synthetic drugs for neurological disorders often produce unwanted effects while traditional plant- derived drugs offer a unique strategy in combating the neurological diseases. This study investigated how the antioxidative properties of Leea macrophylla root extracts integratively help as neuroprotective and antiamnesic in animal model.MethodsLeea macrophylla root methanol extract (LM) was assessed by open field test, hole cross test, elevated plus maze test and thiopental sodium induced sleeping time test for screening neuropharmacological effect on Wistar albino rats using the LM at 100 & 200 mg/kg body weight. Antiamnesic effect of LM was studied on diazepam induced anterograde amnesia in Wistar albino rats. Morris water maze test was performed to evaluate whether the learning and memory of rats are impaired by amnesia produced by diazepam. The antioxidative enzymes superoxide dismutase, catalase, glutathione peroxidase and oxidative biomarkers malondialdehyde, nitric oxide, advanced oxidation protein product from the hippocampus of decapitated animals were measured to assess the antioxidative potential of the extract.ResultsLM was found to show significant (p <0.05) reduction in locomotor activity and increase in the duration of sleeping of animals. Morris water maze test showed that animals treated with LM significantly (p <0.05) decreased the mean escape latency compared to animals in diazepam group. LM was also found to reduce the content of malondialdehyde, nitric oxide and advanced oxidation protein product and to increase the activities of superoxide dismutase, catalase and glutathione peroxidase in hippocampus.ConclusionOur studies suggest that antioxidative capacity of LM in hippocampus may augment the antiamnesic effects in anterograde amnesia.

Enhancement of Pentobarbital-induced Sleep by the Vaporized Essential Oil of Citrus keraji var. kabuchii and its Characteristic Component, γ-Terpinene

Kabuchii (Citrus keraji var. kabuchii hort. ex Tanaka, Rutaceae) is a peculiar Okinawan citrus fruit. Local farmers cultivating various Citrus fruits say that the fragrance of Kabuchii is the most relaxing, but, there are few reports on the biological effects of the essential oil of Kabuchii and its chemical components [1]. In this study, the sedative effects of inhalation of the vaporized Kabuchii essential oil in open field, Rotarod, and pentobarbital sleep tests are compared with diazepam, as a positive control. In the open field test, both Kabuchii essential oil and diazepam decreased the spontaneous motor activity dose-dependently. The reduction in spontaneous motor activity in the 0.3 mg/cage (ca. 0.0278 mg/L) Kabuchii essential oil group was greater than that in the 1 mg/kg diazepam group. In the Rotarod test, Kabuchii did not affect the motor performance, even at the highest dosage tested (3 mg/cage), whereas diazepam decreased it dose- dependently. The effects of the major or characteristic components of Kabuchii, d-limonene, y-terpinene, thymol, and p-cymene, were also evaluated in the- open field and Rotarod tests. y-Terpinene and thymol significantly decreased spontaneous motor activity at a dosage of 0.3 mg/cage, without affecting motor performance. Thus, y-terpinene was estimated to be the main active component. Reduction in spontaneous motor activity by y-terpinene in the open field test was not observed in intranasal zinc sulfate irrigation-induced anosmic mice. In the pentobarbital sleep test, both Kabuchii essential oil and diazepam potentiated pentobarbital-induced loss of the righting reflex (LRR). The LRR duration prolonging effects of both treatments were inhibited by pretreatment with flumazenil, a benzodiazepine receptor antagonist. The LRR latency reducing effect of Kabuchii was not affected by flumazenil, while that of diazepam was suppressed by it. y-Terpinene showed similar potentiating effects on pentobarbital-induced sleep. Thus, vaporized Kabuchii essential oil and its active component, y-terpinene, have sedative effects comparable with diazepam without inducing motor incoordination, which is a well-known side effect of. diazepam.