scholarly journals D.02 Predictive factors for epilepsy in pediatric patients with Sturge Weber Syndrome

2016 ◽  
Vol 43 (S2) ◽  
pp. S13-S13
Author(s):  
ML Kaseka ◽  
JY Bitton ◽  
P Major
Keyword(s):  
Venous Drainage ◽  
P Value ◽  
Significant Difference ◽  
Weber Syndrome ◽  
Medical Photography ◽  
Patients At Risk ◽  
Sturge Weber Syndrome ◽  
D 02 ◽  
Patients With Epilepsy

Background: Sturge Weber Syndrome (SWS) patients at risk of epilepsy are often not identified before their first seizure which leads to unnecessary follow up of many patients with facial angioma. Methods: The medical photography database of our institution has been reviewed to identify SWS patients followed between 1993 and 2013. Patients with isolated glaucoma were compared to patients with epilepsy regarding the location of the facial angioma, the presence of asymmetrical background activity on EEG done prior epilepsy onset and cerebral imaging. Logistical regression tests and a p-value of 0.05 were used. Results: 21 patients with SWS have been identified. No significant difference was noted when patients were compared based on the laterality of the lesion (p=0.169), or the location of the facial angioma (p = 0.314 to 0.999). Only 2 epileptic patients had digital EEG done prior the onset of epilepsy and only 2 patients with glaucoma had digital EEG done during their follow up. No significant difference was noted between EEG background activities in the two groups (p= 0.514). The presence of venous drainage anomalies (VDA) predicted (p = 0.004) the onset of epilepsy. Conclusions: Cerebral VDA increases the risk of epilepsy in SWS patients. Since they can be detected at birth, they might guide the management.

scholarly journals Clinical pharmacist-led educational tool effect on pediatric patients with epilepsy in Jordan

2021 ◽  
Author(s):  
Suha Jarad ◽  
Amal Akour ◽  
Wael Khreisat ◽  
Afrah El-Shammari
Keyword(s):  
Clinical Pharmacist ◽  
Pediatric Patients ◽  
Controlled Trial ◽  
Intervention Group ◽  
Control Group ◽  
P Value ◽  
Educational Tool ◽  
Significant Difference ◽  
Patients With Epilepsy

Aim: To investigate the effect of a clinical pharmacist-led educational tool on pediatric patients with epilepsy in Jordan. Specifically on the efficacy, safety, adherence to antiepileptic drugs (AEDs), satisfaction with information about AEDs provided to the caregivers, and quality of life (QoL). Methods: This was a randomized controlled trial where pediatric patients were randomly assigned to the intervention (n=41) or the control (n=40) group. 30-minute clinical pharmacist-led educational interview to the parent/caregiver was provided to the intervention group as add-on to standard medical care received by the control group. Efficacy was measured by number of seizure-free patients, while epilepsy specific questionnaires were used to evaluate safety, adherence, satisfaction with information about AEDs and QoL; measured at baseline and after 8-week follow-up. Results: The intervention group had 63.9% seizure free patients at follow up vs. 31.7% at baseline (P-value <0.001), and the control group had 48.6% at follow up vs. 27.5% at baseline (P-value <0.05); with no significant difference between groups (P- value > 0.05). At follow-up, mean pediatric epilepsy side effects questionnaire (PESQ) score was reduced in the intervention group (P-value <0.001), and increased in the control group (P-value <0.001); with no significant difference between groups (P-value=0.08). While the intervention group had a significant higher mean score of adherence (P-value <0.0001), and higher satisfaction with information (P-value <0.0001), and a higher QoL (P-value <0.05). There was a significant positive correlation between satisfaction and adherence (r=0.682, P-value < 0.0001), satisfaction and QoL (r=0.298, P-value < 0.05), adherence and QoL (r=0.323, P-value < 0.01). While, satisfaction and safety, safety and QoL correlated significantly and negatively (r=-0.263, P-value < 0.05 and r=-0.782, P-value < 0.0001, respectively) Conclusion: Clinical pharmacist-led educational tool had a positive outcome on pediatric patients with epilepsy with regard to efficacy, safety, adherence, satisfaction with information about AEDs and QoL.

scholarly journals Radiographic Recurrence of Hallux Valgus Based on Osteotomy Location

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0021
Author(s):  
Andrew Federer ◽  
Travis Dekker ◽  
David Tainter ◽  
Jordan Liles ◽  
Mark Easley ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Weight Bearing ◽  
Surgical Correction ◽  
P Value ◽  
Single Individual ◽  
Hallux Valgus Angle ◽  
Intermetatarsal Angle ◽  
Valgus Angle ◽  
Significant Difference

Category: Bunion Introduction/Purpose: Hallux valgus (HV) is one of the most common deformities of the foot resulting in pain and lifestyle modification of the patient. Recurrence rates of 10-47% have been documented in single individual osteotomy series. Unfortunately, surgical correction and recurrence are often defined as changes related to normal radiographs and not actually as the magnitude of correction lost with follow-up. Currently there have not been studies evaluating the percentage of recurrence of intermetatarsal angle (IMA) and hallux valgus angle (HVA). As there is substantial difference in starting IMA and HVA, as well as amount of surgical correction, our goal was to evaluate the percentage loss of correction over time comparing preoperative, initial postoperative and minimum of 2-year follow up radiographs among three different surgical correction techniques. Methods: This is a retrospective chart review study that examines the weight-bearing radiographic measurements of patients undergoing hallux valgus corrective surgery at a single institution over 5 years. Fifty-three patients were divided into first tarsometatarsal arthrodesis (i.e. Lapidus), mid-diaphyseal osteotomies (i.e. scarf), and distal metatarsal osteotomies (i.e. chevron). The preoperative, initial postoperative, and final follow up weight-bearing radiographs were measured for intermetatarsal angle (IMA) and hallux valgus angle (HVA). Primary outcome was percentage of recurrence of IMA and HVA, with the difference in angles between preoperative and initial postoperative weight-bearing films being considered 100% correction. The percentage of recurrence between initial postoperative and most recent follow up was then calculated (Figure 1A). A one-way analysis of variance (ANOVA) test and post-hoc Tukey-Kramer tests were used to compare preoperative IMA and HVA and percentage recurrence of IMA and HVA at most recent follow up. Results: There was no significant difference between Lapidus (14.3deg) and mid-diaphyseal osteotomies (12.7deg) in preoperative IMA (p-value=0.26). There was a significant difference between Lapidus (-0.3deg) and mid-diaphyseal (2.8deg) osteotomies for degree of hallux valgus recurrence as measured by IMA between initial postoperative films and final 2-year follow up (p-value=0.009). Lapidus procedure showed a greater magnitude decrease in IMA degrees from preoperation to final follow up compared to distal osteotomy (p-value=0.037) and trended toward significance compared to mid-diaphyseal (p-value=0.056). Mid-diaphyseal osteotomies (30%) showed a statistically significant higher percentage of IMA recurrence compared to Lapidus (-11%) (p-value=0.0014) (Figure 1B). When comparing percentage recurrence of HVA, distal osteotomies had a significantly smaller rate of recurrence when compared to the diaphyseal osteotomies (p-value=0.030). Conclusion: Though Lapidus and mid-diaphyseal osteotomies were performed for patients with a similar preoperative IMA, mid-diaphyseal osteotomies had a significantly higher percentage of recurrence at 2-year follow up compared to Lapidus procedures. Moreover, Lapidus procedures trended toward greater overall of IMA correction compared to mid-diaphyseal osteotomies. When either a Lapidus or mid-diaphyseal osteotomy is indicated, a Lapidus procedure may result in decreased rate of radiographic recurrence of hallux valgus at 2 years.

scholarly journals Topical Diltiazem Versus Topical Glyceryl Trinitrate In The Management Of Chronic Anal Fissure

JMS SKIMS ◽  
2014 ◽  
Vol 17 (2) ◽  
pp. 55-58
Author(s):  
Shams Ul Bari ◽  
Ajaz Ahmad Malik ◽  
Khurshid Alam Wani ◽  
Ajaz A Rather
Keyword(s):  
Side Effects ◽  
Anal Fissure ◽  
Chronic Anal Fissure ◽  
P Value ◽  
Double Blind ◽  
Surgical Methods ◽  
Significant Difference ◽  
Topical Glyceryl Trinitrate ◽  
One Year

Background: Chemical sphincterotomy is a novel way for treating patients of chronic anal fissure which avoids the risk of fecal incontinence associated with traditional surgical methods. Aims and objectives: The aim of this study was to compare the results of topical Diltiazem with topical Glyceril trinitrate in the management of chronic anal fissure. Methods: 71 patients in the age group of 15 - 61 years with chronic anal fissure were included in this prospective, randomized, double-blind trial over a period of two years with further follow up for one year. The patients were randomly allocated to either Diltiazem gel 2% (37 patients) or Glyceril trinitrate ointment 0.2% (34 patients) and were asked to use the treatment twice daily for 8 weeks. Each patient was reviewed every two weeks. Symptoms, healing, side effects and recurrence were compared using SPSS version 10 employing X2 test. A p-value below 0.05 was considered statistically significant. Results: Patients who received topical diltiazem (DTZ) showed statistically significant difference than those who were prescribed topical glyceril trinitrate in terms of symptoms, wound healing, side effects ( headaches) and recurrence (p=0.03 and 0.003 respectively). Healing occurred in 34 of 37 (92%) patients treated with Diltiazem after 6 weeks and 27 of 34 (80%) patients treated with Glyceril trinitrate after 8 weeks, which shows a significant difference in favour of Diltiazem (P < 0.001). The rest of the patients did not heal and underwent sphincterotomy (SILS). Headache occurred in all of the patients treated with Glyceril trinitrate but none of the patients treated with Diltiazem. Conclusion: Diltiazem gel was found to be better than Glyceril trinitrate ointment due to significantly higher healing rate and fewer side-effects. JMS 2014;17(2):55-58

scholarly journals Evaluation of ubiquitin C-terminal hydrolase-L1 enzyme levels in patients with epilepsy

2020 ◽  
Vol 78 (7) ◽  
pp. 424-429
Author(s):  
Ibrahim Halil YASAK ◽  
Mustafa YILMAZ ◽  
Murat GÖNEN ◽  
Metin ATESCELIK ◽  
Mehtap GURGER ◽  
...  
Keyword(s):  
Healthy Volunteers ◽  
Epileptic Seizure ◽  
Epileptic Seizures ◽  
Healthy Individuals ◽  
Roc Curve Analysis ◽  
Remission Period ◽  
Significant Difference ◽  
Epileptic Attack ◽  
Patients With Epilepsy

ABSTRACT Objective: Ubiquitin C-terminal Hydrolase-L1 (UCH-L1) enzyme levels were investigated in patients with epilepsy, epileptic seizure, remission period, and healthy individuals. Methods: Three main groups were evaluated, including epileptic seizure, patients with epilepsy in the non-seizure period, and healthy volunteers. The patients having a seizure in the Emergency department or brought by a postictal confusion were included in the epileptic attack group. The patients having a seizure attack or presenting to the Neurology outpatient department for follow up were included in the non-seizure (remission period) group. Results: The UCH-L1 enzyme levels of 160 patients with epilepsy (80 patients with epileptic attack and 80 patients with epilepsy in the non-seizure period) and 100 healthy volunteers were compared. Whereas the UCH-L1 enzyme levels were 8.30 (IQR=6.57‒11.40) ng/mL in all patients with epilepsy, they were detected as 3.90 (IQR=3.31‒7.22) ng/mL in healthy volunteers, and significantly increased in numbers for those with epilepsy (p<0.001). However, whereas the UCH-L1 levels were 8.50 (IQR=6.93‒11.16) ng/mL in the patients with epileptic seizures, they were 8.10 (IQR=6.22‒11.93) ng/mL in the non-seizure period, and no significant difference was detected (p=0.6123). When the UCH-L1 cut-off value was taken as 4.34 mg/mL in Receiver Operating Characteristic (ROC) Curve analysis, the sensitivity and specificity detected were 93.75 and 66.00%, respectively (AUG=0.801; p<0.0001; 95%CI 0.747‒0.848) for patients with epilepsy. Conclusion: Even though UCH-L1 levels significantly increased more in patients with epilepsy than in healthy individuals, there was no difference between epileptic seizure and non-seizure periods.

scholarly journals Effect of platelet rich-fibrin on alveolar osteitis incidence following surgical removal of impacted mandibular third molars: A comparative study

2019 ◽  
Vol 31 (4) ◽  
Author(s):  
Ali S. Abdul Kareem ◽  
Ali H. Al Hussaini
Keyword(s):  
Postoperative Pain ◽  
Control Group ◽  
P Value ◽  
Surgical Removal ◽  
Similar Distribution ◽  
Extraction Socket ◽  
Platelet Rich Fibrin ◽  
Significant Difference ◽  
Alveolar Osteitis

Background: Postoperative morbidity after extraction of the impacted mandibular third molar (IMTM) is inevitable. One of the most common postoperative complication is alveolar osteitis (AO) which is a painful non healed socket. Many researches were attempted to prevent the occurrence of AO by introducing and applying a new materials inside the extraction socket. Platelet rich fibrin (PRF) is a biological complex fibrin matrix where autologous platelets and leucocytes are present, used to enhance tissue healing process and reduce the early adverse effects of the inflammation. Aims: To evaluate the effect of PRF on the incidence of AO. Also to assess PRF effect on pain, swelling, and trismus following the surgical removal of IMTM and compare it with the control group. Materials and methods: This clinical prospective study was conducted from October 2016 to October 2017 at the Department of Oral & Maxillofacial Surgery, College of dentistry/University of Baghdad; and Al-Sadr Specialized Health Center. A total number of 50 IMTMs were surgically removed from 45 patients who met the inclusion criteria (21 males and 24 females) with age ranged from 16-41 years. The cases were divided into two groups: a study group (25 cases) where PRF were placed inside the extraction socket and control group (25 cases) where traditional surgery were performed. AO, trismus and swelling were assessed at the 2nd and 7th postoperative day. Pain scored by numeric rating scale daily by the patients. Results: The study showed that age, gender, side of impaction, oral hygiene condition, impacted tooth classification, surgical difficulty, and the time of procedure in both control and study groups had nearly similar distribution with non- significant difference. At the 1st follow up period: Trismus (P-value = 0.834) and Swelling (P-value = 0.592) were non- significant between the two groups. AO had overall incidence of 4% occurred only in the control group, while the PRF group had no occurrence (0%), but the difference was statistically non significant. Postoperative pain had no significance difference in both groups. At the 2nd follow up period there was no significant difference regarding trismus, swelling, and incidence of AO between both groups. Conclusion: Local application of PRF can reduce the incidence of AO but not to a significant level. PRF had no effect concerning postoperative pain, swelling, and trismus.

scholarly journals Focal cortical dysplasia type IIa underlying epileptogenesis in patients with epilepsy associated with Sturge-Weber syndrome

Epilepsia ◽  
2012 ◽  
Vol 53 (11) ◽  
pp. e184-e188 ◽  
Author(s):  
Nobuya Murakami ◽  
Takato Morioka ◽  
Satoshi O. Suzuki ◽  
Kimiaki Hashiguchi ◽  
Toshiyuki Amano ◽  
...  
Keyword(s):  
Focal Cortical Dysplasia ◽  
Cortical Dysplasia ◽  
Weber Syndrome ◽  
Sturge Weber Syndrome ◽  
Patients With Epilepsy

Effect of a Persian metabolic diet on the functional dyspepsia symptoms in patients with postprandial distress syndrome: a randomized, double-blind clinical trial

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Fereshteh Nouri ◽  
Mohsen Naseri ◽  
Saeed Abdi ◽  
Soghrat Faghihzadeh ◽  
Mehdi Pasalar ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Distress Syndrome ◽  
P Value ◽  
Intervention Period ◽  
Dietary Regimen ◽  
Postprandial Distress Syndrome ◽  
Severity Scores ◽  
Significant Difference ◽  
Persian Medicine

Abstract Objectives Postprandial distress syndrome (PDS) is associated with food indigestion. Efficacy of drugs used against PDS is limited whereas dietary modifications were shown to have important beneficial effects. Traditional Persian Medicine (TPM) sages suggested a dietary regimen known as Persian metabolic diet (PMD) for the management of PDS patients. In this study, the efficacy of PMD in alleviating the symptoms of PDS was explored. Methods This single-center, parallel-group, randomized clinical trial included 56 patients whom were randomly allocated to PMD group (29 participants) and Optional diet (OD) group (27 participants). They were instructed to follow the protocol for two weeks. Using a standard validated questionnaire, all outcomes were evaluated at baseline, end of the intervention period, and end of follow-up time. Results At the end of the intervention period, comparing the changes of severity scores between the groups showed a statistically significant difference in week 2 (p-value<0.001) and week 8 (p-value<0.001) follow-up comparing to the baseline. Similarly, at the end of the follow-up period, epigastric fullness, epigastric discomfort, and bloating were significantly improved in the PMD group (p<0.001). Conclusions This diet prepared based on Persian medicine seems to be effective in relieving the symptoms of patients with PDS.

P1321PLASMATIC OSTEOPONTIN: A PREDICTOR OF VASCULAR ACCESS DYSFUNCTION IN HEMODIALYSIS PATIENTS

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Nirvana Sadaghianloo ◽  
CONTENTI Julie ◽  
Vido Sandor ◽  
Carboni Joseph ◽  
Bonnet Sophie ◽  
...  
Keyword(s):  
Biological Marker ◽  
Duplex Ultrasound ◽  
Hemodialysis Patients ◽  
Control Group ◽  
Strongly Correlated ◽  
Arteriovenous Fistulas ◽  
Significant Difference ◽  
Patients At Risk ◽  
Elisa Technique

Abstract Background and Aims Despite recommendations for a close follow-up of arteriovenous fistulas (AVF), thombosis rate reaches 10% each year. Conventional follow-up modalities remain a burden for hemodialysis patients. We tested the hypothesis that osteopontin (OPN), a pro-inflammatory molecule related to intimal hyperplasia, could be a biological marker of stenosis, and could thereby allow a screening of patients at risk for AVF dysfunction. Method Our prospective study (NCT03270358) compared the rate of plasmatic OPN between patients with a good-functioning AVF (control group, N= 39) and patients who required surgical or endovascular revision of their AVF because of a stenosis (stenosis group, N= 37). Blood samples were taken in the AVF, at the time of AVF cannulation in control patients, and at the time of AVF revision in stenosis patients. For each patient, blood from the contralateral arm was also analyzed as a between-subject control (paired t test). Cardiovascular risk factors, ongoing medications, and OPN rates (ELISA technique) were compared among the groups (uni- and multivariate analysis). The ROC curve determined sensitivity and specificity of the marker for the detection of stenosis. Results Patients' characteristics were similar between the 2 groups (mean age, 70 years; men, 63%; AVF duration; 39 months), apart from diabetes (control group, 33%; stenosis group, 57%; p=0.04). The rate of OPN was similar between the AVF arm and the contralateral arm (p=0.11), but significantly increased in the stenosis group compared to the control group (655 vs. 452 ng/mL, respectively, p=0.02). There was no statistically significant difference in OPN rate for diabetics and non diabetics (two-way ANOVA, p= 0.50). Sensitivity was 89% for a threshold &gt;293ng/mL and specificity was 80% for a threshold &gt;567ng/mL (AUC: 0.70; 95%CI: 0.57-0.81; p=0.004). Patients with an OPN rate ≥293ng/mL and those with an OPN rate ≥567ng/mL had respectively 8.87 and 15.62 higher odds to have a stenosis than patients with an OPN rate &lt;293ng/mL (binomial regression, p&lt;0.01). Conclusion Plasmatic OPN rate in hemodialysis patients can be measured simply, in a blood sample taken at the time of AVF cannulation, and is strongly correlated to the presence of a symptomatic AVF stenosis. This biomarker could help the physician choose which patient need a comprehensive examination of his/her AVF with duplex ultrasound or fistulogram.

Sturge Weber syndrome

2019 ◽  
Vol 16 (2) ◽  
pp. 46-49
Author(s):  
Yam Bahadur Roka
Keyword(s):  
Cerebral Atrophy ◽  
Partial Seizures ◽  
Weber Syndrome ◽  
Daily Dose ◽  
History Of ◽  
Scalp Wound ◽  
Skin Nodules ◽  
Sturge Weber Syndrome ◽  
Neurocutaneous Syndrome

Sturge-weber syndrome is a type of neurocutaneous syndrome/ neurooculo cutaneous/ phakomatoses that is characterized by facial capillary Port Wine stain, leptomeningealangioma and glaucoma with a incidence of 1 per 20-50,000 live births. A case is reported that presented to the outpatient clinic with discharging wound over the left side of his head for a week. On examination he had a large left facial PW stain involving all the divisions of the Trigeminal nerve. Further examination revealed he had history of partial seizures since last 10 years with incomplete and irregular treatment. He also had right sided hemiatrophy of the limbs along with medial gaze deviation of the left eyeball. Skull skiagram was done outside which revealed calcifications in his left hemisphere and CT was then advised for his headache and seizure that revealed Left hemispheric Tram track calcifications along with cerebral atrophy and loss of cortical volume. EEG was unremarkable. He was managed with antibiotics for the scalp wound and discharged with Leveteracetam 1000 mg daily dose and asked to attend eye hospital for the reduced vision. With the PW stain, skin nodules, eye findings and the radiological features he was diagnosed as SWS and counseled for regular follow up, use of anti-epileptic medications, probable side effects and surgery for eye abnormalities.

scholarly journals P1795ASSOCIATION BETWEEN T CELL INFILTRATION IN BIOPSY PROVEN ACUTE T CELL MEDIATED REJECTION AND RESPONSE TO THERAPY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Nooshin Dalili ◽  
Pedram Ahmadpoor ◽  
Behzad Einollahi ◽  
Hamed Azhdari Tehrani
Keyword(s):  
T Cell ◽  
Graft Function ◽  
Stable Condition ◽  
Response To Therapy ◽  
Response To Treatment ◽  
P Value ◽  
Organ Rejection ◽  
Graft Outcome ◽  
Significant Difference

Abstract Background and Aims Renal transplantation is considered as the best replacement therapy for advanced ESRD patients. An allograft rejection happens as a result of post transplant immune reactions, which change the outcome of the organ transplantation. Today a major challenge in the field of transplantation is the identification of easy, reliable and non-invasive markers or methods that being able to predict the probability of organ rejection. One of the possible methods is looking for type of infiltrated cells in tissue obtaining by biopsy stained with specific cellular markers and assesses the infiltration of these cells in different types of rejection. Here the severity of CD3, CD20, Th17 and FOXP3 infiltration in patients with biopsy proven acute cellular rejection was evaluated based on IHC staining, whether these specific infiltrations can show an association with graft outcome or not. Method 50 patients with biopsy proven Acute T Cell Mediated Rejection (ATCMR) recruited. Previous clinical data and 1 year clinical follow up collected. The entire specimen assessed for infiltration of CD3, CD20, FOXP3 Tregs and Th17 with IHC. Patients divided into subgroups: stable graft function versus impaired graft function based on serum creatinine course in one year follow up after rejection therapy and appropriate response to treatment versus failure to response, based on allograft function throughout the course of admission. Results In impaired graft function arm, FOXP3 (7.88 vs. 8.02 with P-value 0.96) and Th17 cells were higher (5.01 vs. 10.2 with P-value 0.24) but with non-significant values. FOXP3/Th17 ratio was higher in stable group (1.4 vs. 1.12 with P-value 0.22). In failure to response to therapy group both FOXP3 (9.95 vs. 6.63 with P-value 0.1) and Th17 (11.3 vs. 8.3 with P-value 0.15) cells were higher. FOXP3/Th17 ratio was higher in proper response group (1.19 vs. 1.15 with P-value 0.8). No significant difference was obtained between CD3 and CD20 infiltration in these two groups. Conclusion Final results showed that Th17 has more important role in predicting the graft outcome and response to treatment and FOXP3 infiltration had a minor part. This may be in controversial with previous facts about the role of FOXP3 cells, which drive the allograft into stable condition.

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