Factors associated with poor discharge status in patients with status epilepticus at Khon Kaen hospital

Piyawan Chiewthanakul,1 Parinya Noppaklao,2 Kittisak Sawanyawisuth,3,4 Somsak Tiamkao3,5 1Department of Medicine, Khon Kaen Hospital, Khon Kaen, Thailand; 2Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 3Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 4Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Khon Kaen, Thailand; 5Integrated Epilepsy Research Group, Khon Kaen University, Khon Kaen, Thailand Background: Status epilepticus (SE) is a serious neurological condition and has high a mortality rate. Data on importance of factors associated with poor outcomes in Asian or Thai populations are limited.Methods: Adult patients diagnosed as SE at Khon Kaen hospital, Thailand from October 1, 2010 to September 30, 2012 were enrolled. Patients were categorized as good or poor outcomes at discharge. Good outcomes were defined by improvement at discharge and absence of neurological deficits, while poor outcomes were defined by: not being improved at discharge; being discharged against advice; death; or presence of a neurological deficit. Clinical factors were compared between both groups.Results: During the study period, there were 211 patients diagnosed as SE. Of those, 130 patients were male (61.61%). The mean age of all patients was 53.28 years. Acute stroke was the most common cause of SE in 33 patients (15.64%). At discharge, there were 91 patients (43.13%) who had poor outcomes. Only initial plasma glucose levels were significantly associated with poor outcomes with an adjusted odds ratio of 1.012 (95% confidence interval of 1.003 and 1.021). Conclusion: Initial plasma glucose is associated with poor discharge status in patients with SE. Keywords: hyperglycemia, outcomes, prognosis, risk factor

Efficacy and motor complications of original and generic levodopa in Parkinson's disease treatment

Narongrit Kasemsap,1 Satrirat Onsanit,2 Piyawan Chiewthanakul,3 Kannikar Kongbunkiat,1 Chonthicha Tanking,1 Nisa Vorasoot,1 Kittisak Sawanyawisuth,1,4 Somsak Tiamkao1,5 1Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, 2Department of Medicine, Udonthani Hospital, Udonthani, 3Department of Medicine, Khon Kaen Hospital, 4Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), 5Neuroscience Research and Development Group (NRDG), Khon Kaen University, Khon Kaen, Thailand Background: In general, a generic drug is considered interchangeable with the original formulated drug. In Parkinson’s disease (PD), generic drug use remains debated. This study was aimed to investigate whether the generic drug was as effective as the original in improving the symptoms of PD and the prevalence of motor complications.Methods: This study was a multicenter cohort study of patients with PD enrolled from three northeast hospitals in Thailand between February 2013 and February 2014. The patients were categorized into original and generic levodopa groups. The clinical characteristics, efficacy, and motor complications were compared between the groups.Results: There were 400 eligible patients. Of these, 327 patients (81.75%) met the study criteria and were classified as the original levodopa group (200 patients, 61.16%) and the generic levodopa group (127 patients, 38.84%). The average age of all patients with PD was 65 years. The duration of PD and the modified Hoehn–Yahr stages were not different between the groups. The total doses of original and generic levodopa-equivalent doses were significantly different (199.97±127.08 versus 305.58±138.27 mg; P-value <0.001) and the actual doses were 198.10±117.92 versus 308.85±139.40 mg (P-value <0.001). Approximately 80% of patients with PD in both groups had good responses (P-value >0.999), but the development of motor complications was significantly greater in the original than in the generic group.Conclusion: Generic levodopa was effective in improving the symptoms of PD. The prevalence of motor complications in the original compound group, at a lower dose of levodopa equivalent, was higher than in the generic group. Keywords: Parkinson’s disease, original, generic, levodopa, efficacy, motor complicatio