Addiction

Prevalence of New Psychoactive Substances Use

Prevalence of New Psychoactive Substances Use Among Outpatient of Addiction Management Clinic in Assiut University Hospital

All participant will subjected to the following:
Special sheet designed for the study in department of neurology and psychiatry at Assiut University hospital asking about spychoactive substance use regarding to type, amount, duration,cause of use, and cause for stoppage.
Addiction severity index Urinary drug screen

AAEsraa

Princible investigator

Assiut University

Physostigmine 0.02 mg/kg IV bolus (max of 2 mg), which can be repeated at 10 minutes, followed by a 0.02 mg/kg/hr (max of 2 mg/hr) infusion for 4 hours.

Lorazepam 0.05 mg/kg IV bolus (max 2 mg), which can be repeated at 10 minutes if inadequate patient response, followed by a Normal Saline infusion for 4 hours.

Anticholinergics Toxicity

Administration of physostigmine bolus followed by an infusion

Physostigmine

Administration of lorazepam bolus followed by normal saline infusion

Lorazepam

University of Colorado Anschutz Medical Campus, Children's Hospital Colorado

Treatment of Adolescent Antimuscarinic (Anticholinergic) Toxidrome

A Randomized Trial Comparing Physostigmine vs Lorazepam for Treatment of Adolescent Antimuscarinic (Anticholinergic) Toxidrome

Determine the effectiveness of physostigmine as compared with lorazepam for control of antimuscarinic agitation. Richmond Agitation Sedation Scores (RASS) will be compared throughout treatment protocol.

Determine the effectiveness of physostigmine as compared with lorazepam in the reversal of antimuscarinic delirium. Confusion Assessment Method for the ICU (CAM-ICU) scores will be evaluated throughout the study.

Evaluation of clinical antimuscarinic symptoms, along with presence of any adverse effects, during the infusion to report tolerability, safety profile, and effectiveness of the infusion.

University of Colorado, Denver

American Academy of Clinical Toxicology

Poor grade (WFNS IV and V) SAH patients without clinical signs of brain herniation syndrome

Poor grade (WFNS IV and V) SAH patients with clinical signs of brain herniation syndrome

Subarachnoid Hemorrhage

Patients will be clinically assessed whether they present clinical signs of brain herniation syndromes

Clinical assessment

Kantonsspital Aarau

University Hospital Basel

Department of Neurosurgery, University Hospital Bern

Hôpitaux Universitaires de Genève

CHUV Lausanne

Ospedale Regionale di Lugano - Civico e Italiano

Kantonsspital St. Gallen

Universitätsspital Zürich

Impact of Herniation on WFNS Grading in Spontaneous Subarachnoid Hemorrhage - a SWISS SOS Observational Trial

Impact of Herniation on WFNS Grading and Outcome in Spontaneous Subarachnoid Hemorrhage - a SWISS SOS Observational Trial

Comparison of the two scales (calculation); the basis is the mRS at 6 months

University Hospital Inselspital, Berne

Patients will be randomised to a 8 week treatment period with the active drug followed by a 2 week washout period before an 8 week treatment period with placebo.

Patients will be randomised to a 8 week treatment period with the placebo, followed by a 2 week washout period and a further 8 week treatment period with the active drug.

Secondary Progressive Multiple Sclerosis

Primary Progressive Multiple Sclerosis

Fampridine

Placebo

St Vincent's University Hospital

St. Vincents University Hospital

A Double Blind, Randomized, Placebo Controlled, Crossover Study of the Effectiveness of Oral Fampridine in Improving Upper Limb Function in Progressive Multiple Sclerosis

A Phase IV Double Blind, Randomized, Placebo Controlled, Crossover Study of the Effectiveness of Oral Fampridine in Improving Upper Limb Function in Progressive Multiple Sclerosis

An upper limb responder is defined as a patient with both of the two "on treatment" 9-HPT assessments measured in seconds (assessments 4 & 5 or 7 & 8) improving 20% from the average of the baseline assessments (1, 2 & 3).

A secondary measure of upper limb responsiveness will be defined as a 20% improvement in from baseline in the average time taken to complete all seven tasks on the Jebson Taylor Hand Function Test "on treatment" (assessments 4 & 5 or 7 & 8) compared with baseline assessments (assessments 1,2 & 3).

A mobility responder to Fampridine will be defined as a patient with both of the two "on treatment" T25FW assessments (assessments 4 & 5 or 7 & 8) being better than the maximum of any of the four "off treatment" assessments (assessments 1, 2, 3, & 9). Otherwise the patient will be deemed a non-responder.

Upper limb responders as measured by changes in the 9-HPT and/or JTT will be compared to non-responders in relation to the change in the DASH between baseline assessment and end of treatment (week 10 or 20).

Upper limb response will be examined at the end of treatment phase 1 and repeated at the end of the trial by comparing patients receiving active drug with those receiving placebo to assess any placebo effect and allow assessment of any residual beneficial effect on those who receive fampridine in treatment phase 1 and then switch to placebo in treatment phase 2. Response will again be considered as a 20% improvement in the 9HPT in the active treatment group compared with placebo and a 20% improvement from baseline in the time taken to complete all seven tasks in the JTT. See earlier comment

Mobility responders as measured by change in T25FW will be compared to non-responders in relation to the change in the MSWS-12 between baseline assessment and end of treatment (week 10 or 20).

The patients' scores on the SF-36 will be examined in relation to the objective changes (responder/non-responder) in the 9-HPT, JTT and the T25FW.

Upper limb responders as measured by changes in the 9-HPT and/or JTT will be compared to non-responders in relation to the change in the AMSQ between baseline assessment and end of treatment (week 10 or 20).

Compare changes in MSIS-29 between baseline and end of treatment in either upper limb or mobility responders to fampridine.

mydriasis/seizures

Prevalence of New Psychoactive Substances Use

Treatment of Adolescent Antimuscarinic (Anticholinergic) Toxidrome

Impact of Herniation on WFNS Grading in Spontaneous Subarachnoid Hemorrhage - a SWISS SOS Observational Trial

A Double Blind, Randomized, Placebo Controlled, Crossover Study of the Effectiveness of Oral Fampridine in Improving Upper Limb Function in Progressive Multiple Sclerosis

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