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Evaluating the Neuroprotective Effect of Melatonin on Patients With Hemorrhagic Stroke Using Serum S100b Protein As a Prognostic Marker Publisher



Sharifnia H1 ; Mojtahedzadeh M2 ; Dianatkhah M3 ; Najafi A1 ; Ahmadi A1 ; Najmeddin F2 ; Dianatkhah M3 ; Alizadeh N5 ; Jafari A6 ; Izadpanah M7 ; Parvin S8 ; Daei M9
Authors
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Authors Affiliations
  1. 1. Department of Anesthesiology and Critical Care, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Clinical Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Clinical Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
  4. 4. Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
  5. 5. Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Department of Clinical Pharmacy, Rasht University of Medical Sciences, Rasht, Iran
  7. 7. Department of Clinical Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  8. 8. Chemical Injuries Research Center, Proteomics Laboratory, Baqiyatollah University of Medical Sciences, Tehran, Iran
  9. 9. Department of Clinical Pharmacy, Alborz University of Medical Sciences, Alborz, Iran

Source: Jundishapur Journal of Natural Pharmaceutical Products Published:2021


Abstract

Background: Intracerebral hemorrhage (ICH) is one of the most debilitating kinds of stroke. Recent evidence shows that the proper initiation of neuroprotective agents might save at risk neurons and improve the outcome. Objectives: The focus of this study is to evaluate the neuroprotective effect of melatonin on patients with hemorrhagic stroke. Methods: Forty adult patients with confirmed nontraumatic ICH, who were admitted to the ICU within 24 hours of the stroke onset were enrolled in this study. Subjects in the melatonin group received 30 mg of melatonin every night for 5 consecutive nights. In order to evaluate the intensity of the neuronal injury, S100B was assessed once on day 1 and, day 5 post ICU admission. Additionally, the length of ICU stay, mortality, and the duration of mechanical ventilation were also recorded. Results: Forty patients completed the study. In both groups the plasma concentrations of S100B decreased after 5 days compared with their baseline values. However, this reduction was more significant in the melatonin compared to the control group (P-value < 0.05). The duration of mechanical ventilation and length of ICU stay was shorter in the melatonin group, and this difference was statistically significant for the length of ICU stay (P-value < 0.05), and marginally significant for the duration of mechanical ventilation (P-value = 0.065). The in-ICU mortality rate of the melatonin group was 15%, almost half of that of the control group (30%). However, this difference was not statistically significant. Conclusions: In conclusion, melatonin can be considered as a harmless and effective nueroprotective agent with some unique features which has made it an appropriate adjunctive medicine for critically ill intubated patients. © 2021, Jundishapur Journal of Natural Pharmaceutical Products. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
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