MRI Findings in Children with the First Unprovoked Seizure Presenting to the Emergency Department; Does Developmental Delay Suggest the Importance of Brain MRI Evaluation?

Introduction: The first unprovoked seizure (FUS) in children is a convulsive seizure with an unknown cause, which may be due to an underlying neurological disease or a manifestation of epilepsy. Objective: The aim of this study was to evaluate the findings of brain magnetic resonance imaging (MRI) in pediatric patients with FUS, presenting to the emergency department (ED). Methods: In this cross-sectional study, all children with FUS (age: >1month and<14 years), who were referred to the ED of Qaem Hospital, Mashhad, Iran from 2016 to 2019, were investigated. Medical records, brain MRI findings, electroencephalography (EEG) results, and developmental status of children were reviewed retrospectively. Results: The brain MRI findings of 56 children with FUS were reviewed. The mean age of children was 3.92±6.05 years, and the sex distribution was equal. Seventeen (30.4%) patients had abnormal EEG findings, while 13 (23.2%) patients’ had non-specific EEG findings. Neurological examination of 4 (7.1%) children was abnormal. Overall, 6 (10.7%) patients had non-specific abnormal brain MRI findings for seizure, while 3 (5.4%) patients had specific abnormal findings. A significant relationship was observed between the developmental status of children and abnormal MRI findings (P=0.04). However, MRI findings had no significant relationship with EEG or neurological findings (P>0.05). Conclusion: It may be useful to perform brain MRI for children with FUS presenting to ED, especially those who are suspected of developmental disorders

MRI Findings in Children with the First Unprovoked Seizure Presenting to the Emergency Department; Does Developmental Delay Suggest the Importance of Brain MRI Evaluation?

Introduction: The first unprovoked seizure (FUS) in children is a convulsive seizure with an unknown cause, which may be due to an underlying neurological disease or a manifestation of epilepsy. Objective: The aim of this study was to evaluate the findings of brain magnetic resonance imaging (MRI) in pediatric patients with FUS, presenting to the emergency department (ED). Methods: In this cross-sectional study, all children with FUS (age: >1month and<14 years), who were referred to the ED of Qaem Hospital, Mashhad, Iran from 2016 to 2019, were investigated. Medical records, brain MRI findings, electroencephalography (EEG) results, and developmental status of children were reviewed retrospectively. Results: The brain MRI findings of 56 children with FUS were reviewed. The mean age of children was 3.92±6.05 years, and the sex distribution was equal. Seventeen (30.4%) patients had abnormal EEG findings, while 13 (23.2%) patients’ had non-specific EEG findings. Neurological examination of 4 (7.1%) children was abnormal. Overall, 6 (10.7%) patients had non-specific abnormal brain MRI findings for seizure, while 3 (5.4%) patients had specific abnormal findings. A significant relationship was observed between the developmental status of children and abnormal MRI findings (P=0.04). However, MRI findings had no significant relationship with EEG or neurological findings (P>0.05). Conclusion: It may be useful to perform brain MRI for children with FUS presenting to ED, especially those who are suspected of developmental disorders

The Impact of Fasting on Metabolic and Anthropometric Parameters in Type II Diabetic Patients: A Prospective Observational Study

Introduction: Fasting has certain effects on metabolic and anthropometric parameters in diabetic patients. It is therefore, necessary for patients to receive proper instructions about their physical activities, eating habits, blood glucose monitoring and medications. Aim: To investigate the effects of fasting on metabolic and anthropometric indices in type II diabetic patients. Materials and Methods: This prospective observational study was performed during Ramadan 2018. The study population consisted of 40 type II diabetic patients (33 females and 7 males) who wished to fast. They started to follow given instructions on their physical activity, eating habits, blood glucose monitoring, and medications before Ramadan. Anthropometric variables were measured pre and post-Ramadan. Fasting Blood/Plasma Glucose (FBG/FPG), Glucose 2 Hour Postprandial (2h PPG), glycosylated haemoglobin (HbA1c), and the lipids profile were assessed before and after Ramadan. FPG and 2h PPG were also evaluated on the fifteenth day of Ramadan. Data were presented as mean±SD. Paired t-test was employed and a p-value of <0.05 was considered statistically significant. Results: After completion of the study, anthropometric variables of patients, including weight (74.9±12.7 vs. 73.0±13.1 kg, p<0.001), BMI (29.9±5.2 vs. 29.0±5.1 kg/m2 , p=0.042), waist circumference (106.2±11.8 vs. 105.3±11.6 cm, p<0.001), conicity index (9.94±0.96 vs 9.80±0.99, p=0.085), systolic blood pressure (118.5±10.6 vs. 113.8±9.4 mmHg, p=0.018), Diastolic blood pressure (72.0±7.9 vs. 68.3±7.0 mmHg, p=0.02) and FPG (125.1±27.4 vs. 105.2±21.4 mg/dL, p<0.001) decreased significantly. However, serum triglyceride increased significantly (127.5±45.5 vs. 166.5±53.5 mg/dL, p<0.001) after fasting compared to pre-Ramadan measurements. Changes in other variables were not statistically significant. Conclusion: The results of this study indicate that fasting had beneficial effect on fasting blood glucose level and anthropometric parameters in type II diabetic patients