The solid-state decomposition mechanism followed by the degradation stage of HPPS was Phase boundary controlled mechanism (c) 2008 Wiley, Periodicals, Inc. J Appl Polym Sci 111: 1900-1904, 2009″
“Type 2 diabetes mellitus (T2DM) is a progressive multisystemic disease accompanied by vascular dysfunction and a tremendous increase in cardiovascular mortality.

Numerous adipose-tissue-derived factors and beta cell dysfunction contribute to the increased cardiovascular risk in patients with T2DM. Nowadays, numerous pharmacological interventions are available to lower blood glucose levels in patients with type 2 diabetes. Beside more or less comparable glucose lowering efficacy, some of them have shown limited or probably even unfavorable effects on the cardiovascular system and overall mortality. Recently, incretin-based therapies (GLP-1 receptor agonists and DPP-IV inhibitors) have been AZD9291 mouse introduced in the treatment of T2DM. Beside the effects of GLP-1 on insulin secretion, glucagon secretion, and gastrointestinal motility, recent studies IWR-1-endo datasheet suggested a couple of direct cardiovascular effects of GLP-1-based therapies. The goal of this paper is to provide an overview about the current knowledge of direct GLP-1 effects on endothelial and vascular function and potential consequences on the cardiovascular outcome in patients with T2DM treated with GLP-1 receptor

agonists or DPP-IV inhibitors.”
“The role of new and emerging biomarkers in risk prediction has become a topic of significant interest and controversy in recent times. Currently, available models for risk prediction are reasonably good yet still misclassify a not insignificant portion of the population. The sheer number of new potential risk markers is daunting, and it is difficult to assess the importance of each one over and above the traditional risk factors. Endothelial function is one potential biomarker of risk that has been extensively studied. However, while it

has demonstrated some utility in risk prediction, its use in daily clinical practice is yet to be clearly defined. The present review assesses the prognostic significance Of measures of endothelial function.”
“Background: LCL161 supplier Persistent organic pollutants (POPs), including polychlorinated biphenyls (PCBs) and pesticides bioaccumulate through the food chain and cross the placenta. POPs are developmental toxicants in animals but the epidemiological evidence on pregnancy outcomes is inconsistent. Maternal gestational weight gain has been recently suggested as a key factor explaining the association between PCBs with lower birth weight.

Aims: We examined whether in utero exposure to current low levels of different POPs is associated with fetal growth and gestational age in a mother-child cohort in Crete, Greece (Rhea study), and evaluated specifically whether maternal gestational weight gain may affect this association.

Methods: We included 1117 mothers and their newborns from the Rhea study.

After the death of his uncle in 1512, Copernicus became the personal physician to the subsequent 4 Warmian bishops and his confreres from the Warmian chapter in Frombork. Copernicus practiced medicine not only in diagnosing and taking care of his patients but also in personally preparing the prescribed drugs. He was often consulted (consiglia) from several other cities, including Gdansk, Konigsberg, Lubawa, Elblag and Olsztyn. Rabusertib He also collaborated

and consulted with Jan Benedict Solfa and Laurence Wille, the official Polish royal physicians at the time. During the epidemics of 1519, Copernicus employed sanitary preventive measures by providing several Warmian and Pomeranian towns with an innovative water supply system. Copernicus is well known as a genius in astronomy, but this great Renaissance man was also a mathematician, engineer, soldier, writer, economist and, last but not least, a practicing physician.”
“Total joint arthroplasty remains the most effective treatment

to relieve pain and restore function in damaged and diseased joints; however, less invasive, more functional solutions are necessary for young, active patients who have chondral defects and are at the early stages of selleck kinase inhibitor disease. Unfortunately, attempts at providing such a method have provided variable and often unsatisfactory outcomes. Unicondylar knee replacement, for example, is associated with a markedly higher rate of revision when compared with total knee arthroplasty, and there is a distinct probability of disease progression in the remaining joint compartments. Small metallic caps intended for filling the cartilage defects are commercially

available, AZD9291 order but the clinical follow-up of patients who have undergone this treatment is short. Although not yet in clinical use, synthetic polymeric implant scaffolds, with and without cell-seeding, are also under development. The biomechanical requirements for treating chondral lesions, like those of total knee arthroplasty, are wear and fixation. A lesion-filling implant must carry large joint loads without damaging the opposing tissue. Integration with surrounding cartilage and subchondral bone would enhance load-sharing and load transfer. The challenge of meeting these requirements is difficult, but new forms of computational models and in vitro tests can aid in establishing performance and in rapidly screening possible solutions.”
“Primary cutaneous folliculotropic melanoma has been described rarely, and there are even fewer published cases of folliculotropic metastases. We report a 54-year-old man with history of primary cutaneous melanoma of the right posterior shoulder, Breslow depth of 3.4 mm, with one positive sentinel lymph node, negative full axillary dissection, and no extranodal metastases at initial staging.

Our study has indicated that the prevalence of BKV antibodies in sera from

MS patients is higher than that detected in normal individuals, while levels of antibodies against BKV and JCV are lower in MS patients compared to those of normal subjects.”
“Interfacial effects in sputtered La2/3Sr1/3MnO3 thin films with different capping layers (MgO, LaAlO3, SrTiO3, NdGaO3, and Au) have been locally investigated by means of x-ray absorption spectroscopy and x-ray magnetic circular dichroism at the Mn L-3,L-2-edge. Data were acquired by using the total electron yield detection mode thus guaranteeing maximum sensitivity to the interface. The data show that LaAlO3 capping almost does not modify the bulklike Mn valence at the interface.

In case of SrTiO3 and this website Au, the presence of divalent Mn is detected, selleck compound whereas MgO and NdGaO3 capping lead to an increase of the Mn valence oxidation state. The modification of the nominal Mn valence state leads to depressed surface magnetization. (C) 2011 American Institute of Physics. [doi:10.1063/1.3545814]“
“It remains unclear how the detection of hepatitis B core antibody (anti-HBc) in the absence of hepatitis B surface antigen (HBsAg) and antibody (anti-HBs) should be interpreted and whether all patients with this pattern need to be tested for hepatitis B virus (HBV)-DNA. This study aimed at reassessing the significance of ‘anti-HBc alone’ in unselected sera referred to the clinical laboratory and determining whether significant HBV viraemia can be found in this setting. Of the 6431 patients PD0332991 tested for HBsAg, total anti-HBc and anti-HBs in a Paris hospital over a 1-year period, 362 (5.6%) had ‘anti-HBc alone’ (24.8% of anti-HBc-positive patients). Only 11 of the 362 sera (3.0%) were found to be false positive. One patient was

in the resolving phase of acute hepatitis B. HBV-DNA was detected in 10 of 362 (2.8%) patients, using a commercial standardized assay (threshold: 350 IU/mL). Viral loads exceeded 10(4) copies/mL in 6 of 10 patients. Mutations in the HBsAg immunodominant region were identified in seven of the viraemic patients. HBsAg was detected in only two cases when retested by one of the latest, multivalent assays. Neither human immunodeficiency virus nor hepatitis C virus serostatus distinguished between patients with and without HBV-DNA. In conclusion, ‘anti-HBc alone’ should be considered a risk marker for a so-called ‘false occult’ HBV infection with significant viraemia. Indeed, results in this hospital population indicate that a small proportion of patients with ‘anti-HBc alone’ have high viral loads, revealing the occurrence of infection with HBV mutants that escape detection even by multivalent HBsAg assays.

05) and 14-38% higher in the Surgical group (P < 0.05) compared to Controls. BMD correlated positively with the alpha angle measurements (R-2 = 0.44, P < 0.001).

Conclusion: BMD was elevated in subjects with cam-type deformities, with the severity

of the deformity more correlative than symptom status. Similarities to the symptomatic group suggest that hips with an asymptomatic deformity may already be in early stages of joint degeneration. (C) 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.”
“The phytochemical study of Duguetia moricandiana Mart. (Annonaceae) yielded the isolation of the alkaloid which was identified by spectral analysis as discretamine. The evaluation of antinociceptive activity ZD1839 molecular weight carried out by the acetic acid-induced https://www.selleckchem.com/products/ly3039478.html writhing, formalin and hot plate tests in mice, suggests a potent antinociceptive effect. Discretamine (5, 10 and 20mg kg(-1), i.p.) significantly reduced the number of writhes similarly at all doses tested and the number of paw licks during the first phase of formalin test when compared to control. The effect of discretamine on hot plate response provides a confirmation of its central effect. These

results indicate antinociceptive properties of this alkaloid.”
“Objective: To investigate the association between baseline hip shape and both clinical hip osteoarthritis (OA) and total hip replacement (THR) at CHIR-99021 5-year follow-up.

Design: Individuals from the Cohort Hip and Cohort Knee (CHECK) study, with early symptomatic OA, having standardized anteroposterior pelvic radiographs at baseline and 5-year follow-up (n = 723) were included. Hip shape on the radiographs was assessed using statistical shape modeling (SSM). Hips fulfilling the American College of Rheumatology (ACR) criteria at follow-up were classified as clinical OA. The association between each mode of shape variation and both outcome measures was calculated by Generalized Estimating Equations (GEE).

Results: The included individuals comprised 575 females

and 148 males (mean age 55.9 +/- 5.2 years). At baseline, 8% fulfilled the ACR criteria, 76% had no radiographic hip OA [Kellgren & Lawrence (K&L) = 0] and 24% had doubtful OA (K&L = 1). At follow-up, 147 hips (10.4%) fulfilled the ACR criteria and 35 hips (2.5%) had received THR. Five shape variants (modes) at baseline associated significantly with THR within 5 years. When combined in one GEE model, these shape variants resulted in a predictive power indicated by an area under the curve of 0.81. No shape variants associated with the presence of clinical OA at follow-up.

Conclusion: The shape of the hip as quantified by an SSM has a good predictive value for THR, whereas variation in shape cannot predict clinical OA. Minor shape variants may be used as a radiographic biomarker to predict the future risk of THR. (C) 2013 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

During the period of two years almost 2500 samples of bacterial culture were taken from different pathological laboratories and hospitals in Karachi. Among these 1500 were Gram positive cocci and 1000 samples were identified as Staphylococcus aureus. Life saving antibiotics were taken from

five different groups and by mean of disk diffusion technique antibiogram of Staphylococcus aureus against these antibiotic were determined. During the course of study imipenem showed 11%, amikacin exhibited 58%, cefipime showed 31%, vancomycin and piperacillin/tazobactam displayed 24% resistance against Staphylococcus aureus. Imipenem was found to be most effective against Staphylococcus aureus Resistance to other antibiotics developed Fer-1 NCT-501 cost quickly in Staphylococcus aureus collected from clinical areas where these antimicrobial agents are extensively used.”
“Background. In children, waist-for-height ratio (WHtR) has been proposed to identify subjects at higher risk of cardiovascular diseases. The utility of WHtR to identify children with elevated blood pressure (BP) is unclear. Design. Cross-sectional population-based study of schoolchildren. Methods. Weight, height, waist circumference and BP were measured in all sixth-grade schoolchildren of the

canton de Vaud (Switzerland) in 2005/06. WHtR was computed as waist [cm]/height [cm]. Elevated BP was defined according to sex-, age- and height-specific ALK inhibitor US reference data. The area under the receiver operating characteristic curve (AUC) statistic was computed to compare the ability of body mass index (BMI) z-score and WHtR, alone or in combination, to identify children with elevated BP. Results. 5207 children participated (76% response) [2621 boys, 2586 girls; mean (+/- SD) age, 12.3 +/- 0.5 years; range: 10.1-14.9]. The prevalence of elevated BP was 11%. Mean WHtR was 0.44 +/-

0.05 (range: 0.29-0.77) and 11% had high WHtR (>0.5). BMI z-score and WHtR were strongly correlated (Spearman correlation coefficient r=0.76). Both indices were positively associated with elevated BP. AUCs for elevated BP was relatively low for BMI z-score (0.62) or for WHtR (0.62), and was not substantially improved when both indices were considered together (0.63). Conclusions. The ability of BMI z-score or WHtR to identify children aged 10-14 with elevated BP was weak. Adding WHtR did not confer additional discriminative power to BMI alone. These findings do not support the measurement of WHtR in addition to BMI to identify children with elevated BP.”
“Tako-no-Suidashi ointment (TSO) is an old Japanese over-the-counter drug, used for the drainage of infectious pustular disease, such as furuncles, carbuncles and infectious atheroma, although whether it works well or not is unknown.

Although drug or natural substance therapy may retard the progress of alopecia or prevent future hair loss, it may also accelerate hair loss when the medication is stopped after prolonged use. Conversely, the transplantation of human hair involves taking plugs of natural hair from areas in which occipital hair is growing and transplanting them to bald areas. However, the number of hairs that can be transplanted is limited in that only three such operations can generally

be performed. To overcome such problems, many researchers have attempted to revive hair follicles by culturing hair follicle cells or mesenchymal cells in vitro and then implanting them in the treatment area. (C) 2009 Elsevier B.V. All rights reserved.”
“Background:

The clinical presentation of hepatic artery thrombosis (HAT) post-liver transplantation (LT) varies considerably. Doppler

VDA inhibitor ultrasonography (Doppler US) is the first line investigation, with a diagnostic sensitivity for HAT as high as 92%. Because indocyanine green (ICG) elimination from the blood depends among other factors on the hepatic learn more blood flow, we hypothesized that plasma disappearance rate of indocyanine green (PDR-ICG) can be influenced by the flow in the hepatic artery. Thus, we evaluated the role of PDR-ICG measurement in HAT diagnosis in post-LT patients.

Patients and methods:

Fourteen liver transplant patients with no visible flow in the hepatic artery (Doppler US) were identified. Of the 14, seven patients had HAT confirmed by CT-angiography. The PDR-ICG measurement, an investigation routinely used in our center, was performed in all 14 patients.

Results:

The PDR-ICG in patients with HAT was significantly lower than in patients without HAT (5.8 +/- 4.3 vs. 23.8 +/- 7.4%/min, p = 0.0009). In patients with HAT, after the revascularization, the PDR-ICG value increased (5.8 +/- 4.3 vs. 15.6 +/- 3.5%/min, p = check details 0.006).

Conclusion:

The ICG elimination

may be an adjunct diagnostic tool in the management of patients with suspected HAT following LT.”
“Etch pits created by hydrochloric and phosphoric acid on cleaved CaF(2)(111) are investigated by scanning force microscopy (SFM). A geometric and dimensional analysis of the etch pits reveals two distinctly different types. Type-I etch pits evolve at dislocation defects, are pointed and their size and eccentricity is related to the angle between the dislocation and the surface. Type-II etch pits result from defects below the surface, are flat-bottomed for longer etching times and exhibit a characteristic ratio of depth and edge length depending on the type of etchant. An analysis of etch pit morphology allows an identification of the origin of an etch pit and a characterization of the associated defect structure. (c) 2010 American Institute of Physics. [doi: 10.1063/1.

3% and ICC 0.44 (0-0.77). Variable reproducibility was also reflected in the calculated sample sizes, which ranged from 11 (global Ecc(SAX)) to 156 subjects (segmental Ell(RV)). The reproducibility of LV volumes and function was excellent. There was no diurnal variation in global strain or LV volumetric measurements.

Conclusions: Inter-study reproducibility of CMR-FT

varied between different parameters, as summarized above and was better for global rather than segmental analysis. It was not measurably affected by diurnal variation. CMR-FT may have potential for quantitative wall motion analysis with applications in patient DZNeP solubility dmso management and clinical trials. However, inter-study reproducibility was relatively poor for segmental and long axis analyses of strain, which have yet to be validated, and may benefit from further development.”
“The aim of this study was to evaluate histologically and biomechanically the peri-implant bone healing around implants placed with high torque after a follow-up of 8 and 12 weeks. A total of 12 implants were placed in the lower edge of the mandible of 2 sheep. Entinostat mouse In each sheep, 3 implants

were placed with a low torque (<25 N center dot cm, LT group) as a control, and 3 implants were placed with a high insertion torque (maximum torque, HT group). The sheep were killed after 8 and 12 weeks of healing, and the implants were examined for removal torque, resonance frequency analysis, and histologic analysis.

The mean insertion torque in the LT group was 24

N center dot cm, whereas it was 105.6 N center dot cm in HT. All the implants osseointegrated and histologic analysis showed similar aspects of the peri-implant bone tissue for both groups and both healing times. Mean removal torque values selleck chemical for LT implants were 159.5 and 131.5 N center dot cm after 8 and 12 weeks, respectively, whereas those for the HT were 140 and 120 N center dot cm at 8 and 12 weeks, respectively. Implant stability quotient values were 26.6 and 76 for the LT group and 74 and 76 for the HT group at 8 and 12 weeks, respectively.

It could be concluded that high implant insertion torque does not induce adverse reaction in cortical bone and does not lead to implant failure.”
“Akt proteins are serine/threonine protein kinases that participate in several important intracellular signal transduction cascades. Akt1 and Akt2 are expressed in cardiomyocytes, and both are activated by the action of a variety of growth factors and extracellular ligands. In work with genetically modified mice that had targeted disruption of the genes encoding Akt1 or Akt2, findings showed that Akt1 specifically regulated the physiologic growth of cardiomyocytes that occurred in response to exercise training. In contrast, Akt2 does not regulate physiologic growth but instead regulates glucose metabolism in response to insulin stimulation in cardiomyocytes.

25, 95% CI 1.52-3.31), other digestive problems prepregnancy, younger age, single gestation, and carrying a female fetus. 11% of women with N/V and 47% of women with heartburn used pharmacologic therapy. Infants born to women with heartburn had significantly

higher birth weights (p = 0.03), but gestational age at delivery selleck kinase inhibitor was not significantly different. N/V was not associated with birth weight or gestational age at delivery. 19.7% of women with heartburn during pregnancy reported postpartum heartburn. Conclusions: Heartburn and N/V are common pregnancy symptoms, particularly among women with a history of such symptoms. Neither condition appears to adversely affect the outcome of pregnancy. Pregnancy-related heartburn predisposes to early postpartum heartburn.”
“Purpose: To assess the national trends and comparative effectiveness of the various treatments for pediatric ureteropelvic junction obstruction

(UPJO).

Patients and Methods: Within the Nationwide Inpatient Sample, a weighted estimate of 35,275 pediatric patients (<19 years; 1998-2010) with UPJO underwent open pyeloplasty (OP), laparoscopic pyeloplasty (LP), robot-assisted pyeloplasty AP24534 mouse (RP, >= October 2008) or endopyelotomy (EP). National trends in utilization and comparative effectiveness were evaluated.

Results: Minimally invasive pyeloplasty (RP+LP, MIP) utilization began to increase in 2007; MIP accounted for 16.9% of cases (2008-2010). EP accounted for 1.4% of all cases from 1998 to 2010. On individual multivariate models (relative to OP): (a) no significant differences were noted between groups for intraoperative complications; (b) RP and LP had equivalent learn more risks of postoperative complications developing (vs OP), but EP had a significantly higher risk of postoperative complications; (c) RP and EP had significantly higher risks of necessitating

transfusions; (d) RP, LP, and EP had higher overall risks of greater hospital charges; (e) RP had a lower risk of greater length of stay, while EP had a higher risk (LP and OP were equivalent).

Conclusions: OP continues to be the predominant treatment for patients with UPJO. RP was the most common MIP modality in every age group. Compared with OP patients, RP patients had equivalent risk for intraoperative and postoperative complications, lower risk for greater length-of-stay, but higher risks for transfusions and greater hospital charges. LP patients had higher overall hospital charges, but no mitigating benefits relative to OP. EP fared poorly on most outcomes.”
“Luminescent graphene quantum dots (GQDs) have attracted tremendous attention from the scientists in chemistry, materials science, physics and biology, because of their superiority of good stability, excellent optical and electrochemical properties, resistance to photobleaching and low cytotoxicity. We summarize the recent advances in the preparation and the properties of GQDs and their applications in environmental and biological areas.

This paper presents a structure whose excitation source is just a single magnet. This structure decreases the cost of the previous sensor while retaining its advantages. For example, multiple output signals can be obtained per turn of the shaft by simply adding a corresponding number of wires, without requiring more pick-up coils and magnet pairs. In this study, the dependence of the output voltage on the pick-up coil was measured and the domain wall structure was elucidated by the measurement result. (C) 2011 American Institute of Physics. [doi:10.1063/1.3564948]“
“Using copolymerization functionalization,

poly[3,4-dioctyloxythiophene-alt-2,5-bis(4-vinylphenyl)-1,3,4-oxadiazole] (P3,4DOOTV-OXD) combining electrochemical properties of poly(3,4-dioctyloxythiophene) (P3,4DOOT, donor) and 1,3,4-oxadiazole (OXD, acceptor) was synthesized through Heck reaction and evaluated with (1)H-NMR, FTIR, gel permeation chromatography (GPC), UV-vis spectroscopy,

photoluminescence PF-03084014 mouse (PL), and electroluminescence (EL) spectra. This D/A alternating copolymer, with regio-symmetrical 3,4-dioctyloxythiophene, has good solubility in common organic solvents. The optical properties investigations showed that the band-gap energy of P3,4DOOTV-OXD is 10% higher than that of P3,4DOOT (2.27 eV) at 2.52 eV in solid film. However, the photoluminescence (PL) quantum yield is as high as 57.4%, > two times more than that of homopolymer P3,4DOOT in CHCl(3) solution, and displays bright green-yellow luminescence (518 nm) GSK1120212 molecular weight in solution and yellow (542 nm) in solid film. Cyclic voltammogram indicated that the copolymer has bipolar properties, and the band gap energy (E(g)) calculated based on the cyclic voltammogram is consistent with that

deduced from the absorption spectra at 2.40 eV. By using indium-tin oxide (ITO) as the anode, poly(ethylenedioxythiophene) (PEDOT) QNZ mouse doped with poly(styrenesulfonate) (PSS) as the hole-injection layer, P3,4DOOTV-OXD as the emitter and aluminum (Al) as the cathode, double-layer device with the structure of [ITO/PEDOT: PSS (50 nm)/polymer/Al (130 nm)] shows typical diode characters and exhibit bright yellow electroluminescence (562-552 nm) under the forward bias. (C) 2011 Wiley Periodicals, Inc. J Appl Polym Sci 122: 50-54, 2011″
“To analyze the outcome of solid organ transplantation (SOT) in patients who had undergone allogeneic hematopoietic stem cell transplantation (HSCT), a questionnaire survey was carried out within 107 European Group of Blood and Marrow Transplantation centers. This study covered HSCT between 1984 and 2007 in Europe. Forty-five SOT in 40 patients were reported. Fifteen liver, 15 renal, 13 lung, 1 heart and 1 skin transplantations were performed in 28 centers. Overall survival (OS) of patients after SOT was 78% at 5 years (95% confidence interval [CI], 64% to 92%). OS at 5 years was 100% for renal, 71% (95% CI, 46% to 96%) for liver and 63% (95% CI, 23% to 100%) for lung transplant recipients.

Patients who abused alcohol were younger (p<0.0001) than HCV infected, non-abusive patients. The overall survival rate among patients with alcoholic cirrhosis (Al group), HCV related cirrhosis Fosbretabulin (HCV group), and HCV infected + alcoholic cirrhosis (HCV + Al group), showed no significant differences, although the 10-year cumulative survival rate of Al group was the highest of the three

groups. The HCC development rate of Al group was the lowest. In addition, alcohol abuse decreased the survival rates of HCV group in the early stage with no HCC (p = 0.0028). In conclusion, alcohol abuse might affect the progression of liver damage in HCV infected patients with liver cirrhosis in the early stage, although the influence of alcohol abuse on the long term prognosis seems to be rather small.”
“Headache syndromes often involve occipital and neck symptoms suggesting a functional connectivity between nociceptive trigeminal and cervical afferents. Several studies have suggested that pain relief in migraine and other types of headache can be achieved by local injections of steroids, local anaesthetics or a mixture of both in the area of greater occipital

nerve (GON). Usually greater occipital nerve block (GONB) is performed by using local anaesthetics alone or with steroid. The rationale of performing a GONB for the treatment of chronic headache states is on the anatomical connections between trigeminal and upper cervical Compound C chemical structure sensory fibres at the level of the trigeminal nucleus caudalis. However, the reason for the improvement after GONB in primary headache is unknown. The objective of this study is to determine whether adding triamcinolone to local anaesthetics increased the efficacy of GONB and BMS-777607 purchase trigger point injections (TPIs) for chronic migraine (TM). Patients with TM were randomized to receive GONB and TPIs using

lidocaine 2% and bupivacaine 0.5% + either saline or triamcinolone 40 mg. Particularly, a 10-ml syringe containing 4.5 ml of lidocaine 2%, 4.5 ml of bupivacaine 0.5% and 1 ml of either saline (group A) or triamcinolone 40 mg/ml (group B) was prepared for each patients. Patients were given bilateral GONB and TPIs in the cervical paraspinal and trapezius muscles bilaterally. 2 ml were injected into each GON at the medial third of the distance between the occipital protuberance and the mastoid process. In addition, 0.5 ml was injected into each of the 12 trigger points. The total injected volume was 10 ml. The primary outcome measure was the change in mean headache severity from before injection to 20 min after in the two groups. Secondary outcome measures were the change in mean neck pain, photophobia and phonofobia severity from before injection to 20 min after in the two groups. Patients documented headache and severity of associated symptoms for 4 weeks after injection. Changes in symptom severity were compared between the two groups.