Knowledge and attitudes of driver license applicants and instructors about driving of patients with epilepsy in Burkina Faso

Background Epilepsy is the most common neurological disease in the world. The objective of the study was to determine the knowledge, attitude and practice of driver’s license applicants and instructors in driving schools on epilepsy in Burkina Faso. Method This cross-sectional study was carried out from January 7th to March 7th 2020 in 21 driving schools approved by the National Driver License Authority in the city of Ouagadougou. Fifteen driver applicants and one instructor were selected in each driving school, resulting in a total of 315 driver applicants and 21 instructors in the study. Results The mean age of participants was 29.91 ± 7.63 years. One of the driver applicants included in the study was once experienced a seizure attack. All respondents had heard of epilepsy. The main source of epilepsy information was from family (42.5%). Two hundred and twenty-six respondents (67.3%) had witnessed an epileptic seizure. A majority of participants (55.9%) believed that persons with epilepsy be not permitted to drive a motor vehicle. About 44.0% of participants thought that people with epilepsy should be permitted to drive under certain conditions. One hundred and four (30.9%) participants suggested that people with epilepsy be permitted to drive a light vehicle. One hundred and forty-one (42.0%) suggest to withdraw the driving license for lifetime if a driver had an epileptic seizure attack; while twenty-three (6.8%) participants recommended suspension of driver license for 12 months. Conclusion Efforts should be made to improve awareness and education among license applicants and instructors on the driving by people with epilepsy.

A ROLE OF AYURVEDA IN THE MANAGEMENT OF APASMARA (EPILEPSY): A CASE STUDY

Apasmara (epilepsy) is defined as the apagama (deterioration) of smriti (memory) associated with bibhasta cheshta (seizures) due to derangement of dhi and satwa, mainly related to vata and rajo dosha vitiation, which effects both Sharira (body) and Mana (mind). The present antiepileptic drugs control the seizure attack, but long-term use generates adverse effect at cognitive level and leads to behavioral disorders, hence there is need of safe and effective treatment which not only controls seizure attack but helps to cure the disease. A 44-year-old man approached Kayachikitsa OPD with the complaints of frequent seizure attacks, since from at the age of one and half year with regular oral antiepileptic drugs medications (allopathic), the dose of medications increasing yearly and he was not satisfied with treatment, so he was advised with Panchakarma treatment starting from Deepana, Pachana, Vamana (medicated emesis), Virechana (medicated purgation), Basti (medicated enema), Shirodhara along with palliative treatment. After each treatment it was observed that the patient was satisfied with treatment and the complaints of seizure attack reduced in frequency and duration with improved quality of life. Palliative treatment was advised to continue along with modern medications.

Muliple Sclerosis, Corpus Callosum & Epilepsy

There is a difference in prevalence of Epilepsy in General population & MS patients. Interical Epileptiform Discharges (IED) positivity in EEG is also different in the above two populations. Demyelination slows down the conduction speed of axons and author is proposing that different speed of conduction in adjacent axons can generate re-entrant circuits. If the reentrant circuits involve Corpus callosum (CC) fibers, seizure activities of MS can be triggered. DBS applied to CC can terminate the seizure attack of MS like Vagal Nerve Simulator (VNS) in terminating seizure in general population.

Posterior Fossa Intradiploic Epidermoid Cyst: A Case Report

Epidermoid cysts are rare, benign congenital tumours of ectodermal origin which typically present between the third to fifth decade. These tumours comprise approximately 0.2-1.8% of all intracranial tumours. Though these pearly tumours are potentially curable, subtotal resection may lead to catastrophic complications such as recurrence, granulomatous meningitis and carcinomatous degeneration of cyst wall. We herein report the case of a 36-year-old man who presented with an unusual mixed density posterior fossa epidermoid cyst on imaging studies. Total removal not only cures both tumour and seizure attack in this case but also preserves patient’s neurological function.

LAMA MASA KERJA DAN TINGKAT PENDIDIKAN PERAWAT DENGAN PENANGANAN PERTAMA KEJANG DEMAM PADA ANAK

Abstrak Kejang demam yang berlangsung lama (>15 menit) biasanya disertai apnea sehingga dapat menyebabkan terjadinya kerusakan neuron otak. 2-10% dapat berkembang menjadi epilepsi. Kejang demam pada anak yang satu dengan yang lain tidaklah sama tergantung pada nilai ambang kejang masing-masing. Oleh karena itu, ketika serangan kejang demam terjadi maka harus di tangani secara cepat dan tepat. Tujuan penelitian ini untuk mengetahui hubungan lama masa kerja dan tingkat pendidikan perawat dengan penanganan pertama kejang demam pada anak. Metode penelitian ini menggunakan desain penelitian analitik korelasi, dengan pendekatan retrospektif. Sampel penelitian menggunakan metode total sampling, dan didapatkan sampel dengan jumlah sebanyak 31 responden. Hasil penelitian dengan menggunakan uji spearmen, pada tingkat kemaknaan 95%, signfikan untuk lama masa kerja dengan penanganan pertama kejang demam (nilai p : 0,275 > 0,05) dan signifikan tingkat pendidikan dengan penanganan pertama kejang demam pada anak (nilai p : 0,335 > 0,05). Kesimpulan tidak terdapat hubungan yang signifikan antar lama masa kerja dan tingkat pendidikan perawat dengan penanganan pertama kejang demam pada anak di IGD RSU GMIM Bethesda Tomohon dan RS Bhayangkara TK III Manado.Kata kunci : Lama masa kerja, Tingkat Pendidikan, Penanganan pertama kerjang demamAbstract Febrile seizures that last for more than 15 miutes by usually accompanied apanea so that it can cause damage to brain neurons. 2-10% can develop into epilepsy. Febrile seizures in one child with another are not the same depending on the value of each seizure threshold. Therefore, when a febrile seizure attack occurs, it must be dealt with quickly and appropriately. The purpose of this study was to determine the relationship between length of work and nurse education level with the first treatment of febrile seizures in children. Method uses a correlation analytic research design, with a retrospective approach. The research sample uses a total sampling method, and obtained a sample of 31 respondents. Results of the study used the spearmen test, at a significance level of 95%, were significant for the length of work with the first treatment of febrile seizures (p value : 0.275 > 0.05) and significant levels of education with the first treatment of febrile seizures in children (p value : 0.335 > 0.05). Conclusion there is no significant relationship between the length of work and the education level of nurses with the first treatment of febrile seizures in children in the emergency room GMIM General Hospital Bethesda Tomohon and Hospital Bhayangkara TK III Manado.Keywords : Length of work, Education Level, First handling fever work.

Simultaneous Bilateral Neck of Femur Fracture in a Young Adult with Underlying Metabolic Disturbances

Introduction. Simultaneous bilateral fractures of the femoral neck are considered very rare injuries. Few cases were reported in the literature. Most cases were reported in elderly patients with underlying bone pathology. Case Report. We report a case of a 31-year-old male patient who presented to the emergency department with bilateral hip pain and inability to bear weight after a sudden loss of consciousness and fall while running on a treadmill. The patient had a recent history of anabolic steroids, growth hormone, and other supplements used for bodybuilding. Radiological studies confirmed bilateral neck of femur fracture. Laboratory investigations revealed pan-pituitary axis insufficiency and mild vitamin D deficiency, and his EEG suggested a seizure attack. The patient was treated with three 6.5 mm cannulated cancellous screws on one side and a sliding hip screw on the other side and was followed with strict physical therapy and rehabilitation plan. 6 months from the injury, a radiographic bilateral union achieved with the patient back to his normal daily activity and noncontact sports. Conclusion. We report this rare case of bilateral neck of femur fracture in a young adult after a generalized seizure attack with underlying metabolic disturbances. Ruling out other biological underlying etiologies, early diagnosis and early fracture anatomic reduction and fixation are crucial to decrease potential complications such as avascular necrosis and fracture nonunion.

Prediction of Epileptic Seizures based on Mean Phase Coherence

Around 1-2 % of the world's population suffers from epilepsy and 20 % of that vulnerable mass can't be cured through surgery or medicine. Epileptic seizures often occur unpredictably and may cause serious damage to the patient in adverse situations, for e.g. getting a seizure while driving or crossing a road can be fatal. In such a scenario, a reliable mechanism to predict the onset of seizure beforehand is much desirable. In this study, A reliable real-time technique for prediction of epileptic seizures is presented. Mean Phase Coherence (MPC), as a measure of phase synchronization, is used to predict impending seizures in a multi-channel EEG data. It was found that during the pre-ictal stages, MPC values and thus phase synchronization between various channels was found to drop significantly below the level in a non-ictal EEG signal. The range of the prediction horizon for seizures varied from 4-10 mins and prediction of impending seizure attack is possible for 8 out of 10 test cases.