22 A single 8 mg oral Dexamethasone following intravenous Phenothiazine treatment for migraine attack

did not reduce the rate of recurrent headache in an Australian study.23 A placebo-controlled study was conducted by Fiesseler et al.24 on 173 patients with migraine. The authors did not find a statistically significant therapeutic effect of 10 mg IVDEX in patients with acute migraine headache. The distribution of the relapse patterns was not significantly Inhibitors,research,lifescience,medical different between the two therapeutic groups in the present study (P=0.870). A pooled analysis of seven trials, Akt inhibitor involving 742 patients, suggested a modest but significant benefit in preventing headache recurrence when IVDEX was added to standard antimigraine therapy.25 Friedman et al.26 determined the efficacy of 10 mg IVDEX in a placebo-controlled study in 205 migrainous patients. Their study confirmed that a moderate dose of IVDEX should not be administered routinely

in acute migraine, Inhibitors,research,lifescience,medical although it might be useful for patients with migraine status. Adding 3.5 mg of Prochlorperazine to 20 mg of IVDEX significantly shortened the response time for the abortive therapy of migraine status in one study.27 Elsewhere, the administration of IVDEX decreased the incidence of severe recurrent headache following the treatment of migraine attack,14 whereas it had no preventive effect on the recurrence of migraine in another study.28 Inhibitors,research,lifescience,medical The distribution of pain-free response was not significantly different between the IVVP and IVDEX groups of our patients (P=0.704). A meta-analysis of the effects of single-dose IVDEX, by comparison with a placebo, showed that IVDEX and placebo provided similar acute pain reduction; nevertheless, IVDEX was significantly more Inhibitors,research,lifescience,medical effective than the placebo in reducing headache recurrence within 72 hours.29 Another US study included 40 participants with prolonged severe migraine, Inhibitors,research,lifescience,medical who alternatively received either 500 mg IVVP or 10 mg Metoclopramide intramuscularly, followed by one mg Dihydroergotamine. The study reported that IVVP

was similar in effectiveness to Metoclopramide/Dihydroergotamine as abortive therapy for prolonged severe migraine.30 It is deserving of note that although textbooks on headache have mentioned the usefulness of IVVP in the treatment of severe acute migraine,31 further research Tryptophan synthase is required to shed sufficient light on this issue. Conclusion A meticulous review of the literature shows that our study is the only clinical trial to date to compare 16 mg IVDEX with 900 mg IVVP (Orifil) in patients with migraine status. In our study, IVVP (Orifil) was similar to IVDEX as abortive therapy and IVVP (Orifil) appears to offer a safe and well-tolerated abortive treatment. Conflict of Interest: None declared.
Dear Editor, An 8-year-old boy, a known case of T-cell acute lymphoblastic leukemia (ALL), was admitted for an episode of fever and neutropenia.