Efficacy and Safety of Lamotrigine in Lennox - Gastaut Syndrome

ObjectiveThe Lennox-Gastaut syndrome (LGS), one of the most difficult epilepsy syndromes to treat, is characterized by a triad of intractable seizures of various types, a slow (< 2.5-hertz) spike-wave pattern in EEG and mental retardation. The aim of this study was to evaluate the efficacy and safety of lamotrigine as add-on therapy in intractable epilepsy of children with LGS.Materials & MethodsIn a quasi- experimental study, 40 children with LGS referred to the pediatric neurology clinic of Shaheed Sadoughi Hospital in Yazd, between August 2007 and to November 2008, were evaluated.ResultsTwenty-two boys and 18 girls with a mean age of 4.12 ±1.8 years were evaluated. At the end of three months of treatment with lamotrigine, 12 % were seizure free, 52% had> 50% reduction in seizure frequency and 12% had increase in seizures. Means of seizure frequency/per week, before and after treatment were 70 (range 1-180) and 18.6 (range 0-60) respectively, indicating effectiveness of the drug in seizure reduction (P value = 0.003). The drug was effective in 72 % of mixed type seizures, 40 % of generalized tonic-clonic and 33% of drop attack and tonic seizures. Transient side effects were seen in 12.5 % (drowsiness in 3 and ataxia in 2 children). No serious side effects were seen.ConclusionLamotrigine should be considered as an add-on therapy in management of intractable epilepsy in LGS

Evaluation of CSF in 100 Children Admitted With Febrile Seizures

Introduction: Febrile seizure is the most common form of childhood seizures that occurs in 3–4% of them. In the approach for convulsive febrile patients, diagnosis of etiology of fever and exclusion of CNS infection is very important. The purpose of this study was to evaluate CNS infection in 100 CSF samples of children with febrile seizures. Methods: In a descriptive retrospective study, CSF analysis results of 100 children with febrile seizures admitted between March 2002 and August 2004 to Yazd Shaheed Sadoughi Hospital were evaluated. Results: 59 boys and 41 girls with mean age of 1.9±1.67 years were evaluated. Most of the cases (62%) were less than two years old. Febrile seizures were complex in 15% and simple in 85 %. The most common form of seizure was generalized tonic colonic (90%) and URI was the most prevalent etiology of fever. 3 cases had aseptic meningitis while status epilepticus was seen in one of them. No bacterial meningitis was seen. Conclusion: Routine LP in all children with febrile convulsions should be avoided and limited to cases with clinical evidence of CNS infections in history and physical examination. All infants with first simple febrile seizure should be admitted to the hospital for close observation and lumbar puncture must be done if clinical signs of meningitis are present

A 10-year study on the prevalence of cardiovascular affliction among Kawasaki patients in Yazd, Iran

Background: Kawasaki syndrome is considered as the leading cause of cardiovascular disease among children. The aim of the present study was to determine the prevalence of cardiovascular complications among Kawasaki patients of Yazd province. Materials and Methods: In this cross-sectional study, the medical documents of all patients (no = 48) referring to Yazd hospitals with a diagnosis of Kawasaki syndrome (during the march 1996 � march 2006) were reviewed and the related demographic, clinical, paraclinical, echocardiographical and therapeutical data were collected through the questionnaire. The obtained data were analyzed using the Chi�square and t-test statistical tools.Results: Nineteen (39.5) out of the 48 Kawasaki diagnosed patients had cardiovascular affliction (male 63.2). All Cardiovascular afflicted patients had coronary aneurysm and a history of more than 5 days fever, whereas this was the case in 89.7 of non- cardiovascular afflicted . ESR mean in cardiovascular afflicted patients was higher than that in the non-afflicted ones (p = 0.04) . Conclusion: The high affliction of cardiovascular and coronary aneurysm among the Yazd Kawasaki patients is considerable. ESR levels may be helpful in diagnosing the high risk patients for Kawasaki syndrome

Comparison of the Effectiveness of Mellisan Gel and Acyclovir 5% Cream in the Improvement of Recurrent Herpes Labialis

BACKGROUND AND OBJECTIVE: Recurrent herpes labialis is a common infection of the mouth area, caused by herpes simplex virus. This infection appears in the mucus or lip skin and is commonly known as oral herpes. The purpose of this study was to compare the effectiveness of Mellisan gel and acyclovir 5% cream in the improvement of recurrent herpes labialis. METHODS: This double-blind clinical trial was conducted on 60 patients (14 men and 46 women), with the average age of 23.8 years (minimum of 20 and maximum of 32 years) and a prior history of recurrent herpes labialis three times a year. The previously-coded medicines were randomly distributed among patients. The subjects were asked to apply the cream or gel locally on the infected region three times a day, according to the manufacturer's instructions. All patients were examined within one, two, four and seven days after using the cream or gel to determine the changes in pain intensity, size of the ulcer, inflammation and recovery time. IRCT: 13870819144281.  FINDINGS: Mellisan gel and acyclovir cream were not significantly different in reducing the size of the ulcer, inflammation or the associated side-effects. Mellisan gel was accompanied by a significant reduction in pain intensity in patients on the second and fourth days of the examination (p=0.0001 and p=0.02, respectively). Moreover, on the second day, there was a significant difference in recovery (p=0.001). CONCLUSION: The results of this study suggested that Mellisan gel is more effective than acyclovir cream in terms of pain reduction and recovery, whereas no significant difference was observed regarding the size of the ulcer or inflammation. Also, the administration of Mellisan gel and acyclovir cream was associated with no side-effects

Evaluation of Inheritance Pattern in Mentally Retarded Children

Introduction: Mental retardation is one of the most important problems of general health. The purpose of this study was to evaluate inheritance pattern of mentally retarded patients in Yazd city. Methods: In a descriptive cross- sectional study, all medical records and pedigrees of 320 mentally retarded children whose parents had referred for genetic consultation to the Welfare center of Yazd city were reviewed. Results: Of the total, 62.8% of the parents had consanguineous marriage. Mean inbreeding coefficient of offsprings was 0.0713 in third degree related parents versus 0.0156 in non-related parents. Mental retardation was seen in 43.4% of first– degree relatives of children (6.6% of parents and 36.8% of siblings, respectively). Frequency of mental retardation did not differ significantly in both sexes. Pedigree showed inheritance pattern in 43.4% of patients (autosomal recessive, autosomal dominant and x-linked inheritance pattern were seen in 33.75%, 6.9% and 2.8%, respectively), while 37% of patients had no definite inheritance pattern. Abnormal karyotype were seen in 19.4% of patients, 28 of whom(8.75% of all patients) had Down syndrome. The prevalence of autosomal recessive inheritance in patients with consanguineous marriages and non family marriages was 62.8 % and 10%, respectively (P=0. 002). Conclusion: Since multiple cases of mental retardation were seen in families and rate of consanguineous marriage was more in parents of mentally retarded children, genetic counseling in consanguinity marriages and families of mentally retarded children can prevent incidence of mental retardation in these families

Clinical Features, Radiologic Findings and Treatment Outcome in Tuberculous Spondylitis in Yazd, Iran

Introduction: Tuberculosis is a widespread disease which is more common in developing countries .Musculoskeletal tuberculosis constitutes10-15% of cases in underdeveloped countries. The most common site of involvement is vertebrae. Clinical manifestations, location of vertebral involvement and therapy approaches vary between geographic areas. Recognition of specific features of the disease, predominant signs and consequences of common therapies in the region can be useful for physicians and can reduce its complications. Methods: This cross-sectional descriptive case series study included all spinal tuberculosis cases who have been diagnosed in Yazd city between 2001 and 2008. A questionnaire was applied to collect the data about demographic, clinical signs and symptoms, imaging features, medical or surgical therapeutic approaches, complications and outcome of treatment were collected by questionnaire. Analysis was done by SPSS(version 10.5) and p value< 0.05 was taken as significant. Results: Fifty patients were evaluated in this study, the most frequent age group of patients the 40-60 year group, and the least frequent was the group< 20years old. The most common clinical finding in decreasing order was local pain in involved vertebrae, weight loss, sweating and loss of appetite. Location of involved vertebrae was lumbar, thoracic, thoraco-lumbar and cervical. All patients were treated medically and 16 patients required surgical intervention. The study results revealed cure for 42(84%) without any complications. Conclusion: Considering occurrence of this disease in middle age, the most common symptoms and local vertebral pain are influential in earlier diagnosis. They prevent the complications and surgical intervention of spinal tuberculosis

Prevalence of Attention Deficit Hyperactivity Disorder in 6 Year Olds of Yazd City

Introduction: Attention Deficit hyperactivity Disorder (ADHD) is the most common psychiatric disorder in school age children and has a negative effect on the individual’s general functions. The purpose of this study was to estimate the prevalence of ADHD in preschool 6 year old children in Yazd in 2005 and the influence of gender, birth weight, birth order and parental education on ADHD. Methods: 400 preschool children including 200 boys and 200 girls were selected randomly through sampling method and the data of the cross sectional research was collected via compiled questionnaires based on the DSM-IV criteria and interview of parents. Data of this investigation was analyzed and evaluated using SPSS: 11.5 software. Results: The results showed that general prevalence of ADHD was 16/3% and more in boys (19/5%) than girls (13%). Most of the parents of the affected children were illiterate or uneducated. There was no statistically significant relationship between gender, birth weight, order and ADHD frequency. Conclusion: In view of the high prevalence of ADHD among children in Yazd and its undesirable outcome, it is recommended to have a preventive mental health program for screening and treatment

Evaluation of Stages and Mean Age of Onset of Puberty in Boys of Yazd

Introduction: Genetic and health factors along with ethnicity and geographic location are factors that affect the time of puberty onset. The aim of the present study was to evaluate the mean age of onset of puberty and its stages in boys of Yazd. Methods: This cross- sectional study with random clustering sampling method was conducted on 1018 healthy 9-16 years old male students of Yazd. All cases were examined and evaluated for onset and secondary characters of puberty with inspection of the genital region for pubic hair and scrotum and testicular size according to Tanner classification. Results: The mean age of G2 (onset of testicular growth) and PH2 (onset of pubic hairs growth) was 11.57±1.54 and 12.43±1.07 years. The mean age of G5 (final stage of testicular growth) and PH5 (final stage of pubic hairs growth) was 15.43±0.8 and 15.69±1.1 years. The mean BMI in the early stages of puberty (G2) was 16.32±2.02. Conclusion: The mean age of onset of puberty (G2) in boys of Yazd was 11.5 years that is similar to other researches in other countries