Comparing Mental Health of School-Age Children with and without Epilepsy

How to Cite This Article: Shamsaei F, Cheraghi F, Zamani Ghr. Comparing Mental Health of School-Age Children with and without Epilepsy: A Case Control Study. Iran J Child Neurol. Summer 2016; 10(3):35-41. AbstractObjectiveMental health problems frequently occur in children with epilepsy but the diagnosis is frequently missed and therapeutic opportunities are often lost. The aim of this study was to compare mental health statues between school-aged children with epilepsy and the healthy group.Materials & Methods In this case, control study, 120 children aged 6 to 12 years with idiopathic epilepsy and 240 healthy control groups were followed up. Children with epilepsy were enrolled from Iranian Epilepsy Association in 2014. The parent version of Child Symptom Inventory-4 questionnaire was used. Mean comparisons were performed using Student’s t test while effect sizes were estimated by Cohen’s d coefficient. The Chi-Square test was used to assess the difference between frequency distribution of demographic variables in both groups. The significance level was considered less than 0.05.ResultsThere were statistically significant differences between children with epilepsy and control group as for attention deficit hyperactivity disorder, generalized anxiety disorder, major depression, separation anxiety, social phobia, motor and vocal tics and oppositional defiant disorder.ConclusionThe carefully evaluating and prospectively following the psychopathology symptom of children with epilepsy are critical for early identification, prevention and treatment.ReferencesValizadeh L, Barzegar M, Akbarbegloo M, Zamanzadeh V, Rahiminia E, Ferguson CF. The relationship between psychosocial care and attitudes toward illness in adolescents with epilepsy. Epilepsy Behav 2013; 27(1):267-71.Russ SA, Larson K, Halfon N. A national profile of childhood epilepsy and seizure disorder. Pediatrics 2002; 129(2):256-264.Kotsopoulos IA, van Merode T, Kessels FG, de Krom MC, Knottnerus, JA. Systematic review and meta-analysis of incidence studies of epilepsy and unprovoked seizures. Epilepsia 2002; 43(11):402–1409.Sayehmiri K, Tavan H, Sayehmiri F, Mohamadi I, Carson KV. Prevalence of Epilepsy in Iran: A Meta-Analysis and Systematic Review. Iran J Child Neurol 2014; 8(4): 9–17.Salpekar JA, Dunn DW. Psychiatric and psychosocial consequences of pediatric epilepsy. Semin Pediatr Neurol 2007; 14(4): 181-8.Ott D, Siddarth P, Gurbani S, Koh S, Tournay A, Shields WD, Caplan R. Behavioral disorders in pediatric epilepsy: unmet psychiatric need. Epilepsia 2003; 44(4): 591-597.Davies S, Heyman I, Goodman R. A population survey of mental health problems in children with epilepsy. Dev Med Child Neurol 2003; 45(5):292-295.Maia Filho HS, Costa CRM, Gomes MM. Epilepsia e Saúde Mental na Infância. J Epilep Clin Neurophysiol 2006; 12(2):79-88.Gaitatzis A, Carroll K, Majeed A, Sander J. The epidemiology of the comorbidity of epilepsy in the general population. Epilepsia 2004; 45(2):1613-1622.Jones JE, Watson R, Sheth R, Caplan R, Koehn M, Seidenberg M, Hermann B. Psychiatric comorbidity in children with new onset epilepsy. Dev Med Child Neurol 2007; 49(7):493-7.Gadow KD, Sprafkin J. Child symptom inventory-4 Screening and norms manual. Stony Brook, NY: checkmate Plus Ltd, 2002.Dulcan MK, Mina K. Dulcan’s Textbook of Child and Adolescent Psychiatry. 1st ed, American Psychiatric Pub, 2010.Jafari N, Mohammadi MR, Khanbani M, Farid S, Chiti P. Effect of Play Therapy on Behavioral Problems of Maladjusted Preschool Children. Iran J Psychiatry 2011 6(1): 37–42.Hermann B, Jones J, Dabbs K, Allen CA, Sheth R, Fine J, McMillan A, Seidenberg M. The frequency, complications and etiology of ADHD in new onset pediatric epilepsy. Brain 2007; 130(Pt 12):3135-48.Kaner AM. Psychiatric Comorbidity in Children with Epilepsy … or Is It: Epilepsy Comorbidity in Children with Psychiatric Disorders? Epilepsy Curr 2008; 8(1): 10–12.Williams J Steel C, Sharp GB, DelosReyes E, Phillips T, Bates S, Lange B, Griebel ML. Parental anxiety and quality of life in children with epilepsy. Epilepsy Behav 2003; 4(5): 483–486.Stefanello S, Marín-Léon L, Fernandes PT, Li LM, Botega NJ. Depression and anxiety in a community sample with epilepsy in Brazil. Arq Neuropsiquiatria 2011; 69 (2):342-348.Dunn DW, Austin JK, Perkins SM. Prevalence of psychopathology in childhood epilepsy: categorical and dimensional measures. Dev Med Child Neurol 2009; 51(5):364-372.McDermott S, Mani S, Krishnaswami S. A population-based analysis of specific behavior problems associated with childhood seizures. J Epilepsy 1995; 8(2):110–118.Davies S, HeymanI Goodman R. Apopulation survey of mental health problems in children with epilepsy. Dev Med Child Neurol 2003; 45(5):292-295.Parisi R, Moavero R, Verrotti A, Curatolo P. Attention deficit hyperactivity disorder in children with epilepsy. Brain Dev 2010; 32(1):10–16

Comparison of Efficacy and Complication of Alteplase Injection in Acute Ischemic Stroke

Background and Aim: Alteplase is a thrombolytic drug that is produced by recombinant DNA technology. Tissue plasminogen activator enzyme which converts plasminogen to the active form of plasmin is also produced by the same technology; it causes fibrinolysis and clot dissolution. This study aimed to compare the efficacy and complications of Alteplase injection in patients with acute ischemic stroke (AIS( during the first 3 hours and  3-4.5 hours after the onset of symptoms. Methods: In this study, patients with AIS who were referred to Golestan Hospital of Ahvaz city during 2018-2019 were selected. Information was collected by a checklist. Results: The results showed that the mean Modified Rankin Scale (mRS) for 3 months and 6 months (p-value: 0.91 for 3 months and p-value: 0.80 for 6 months) and National Institutes of Health Stroke Scale (NIHSS) (p-value: 0.21) were not significantly different between both groups; statistically, no significant relationship was observed between them. The incidence of complications after treatment was almost similar, in both groups. Conclusion: Finally, it was concluded that complications and efficacy of rt-PA (Alteplase) injection were not statistically different, between the two groups under study. *Corresponding Author: Gholamreza Shamsaei; Email: [email protected]; [email protected] Please cite this article as: Amirazodi E, Shamsaei G, Rafie S, Kashipazha D, Hesam S. Comparison of Efficacy and Complication of Alteplase Injection in Acute Ischemic Stroke. Arch Med Lab Sci. 2021;7:1-6 (e4). https://doi.org/10.22037/amls.v7.3350

The Efficacy and Safety of Intrathecal Autologous Bone Marrow-Derived Mesenchymal Stromal Cells in Amyotrophic Lateral Sclerosis: A Pilot Study

Purpose: Amyotrophic lateral sclerosis (ALS) is an uncommon and aggressive neurodegenerative disorder that influences the lower and upper motor neurons. There are low eligible drugs for ALS treatment; in this regard, supplemental and replacement treatments are essential. There are relative studies in the field of mesenchymal stromal cells (MSCs) therapy in ALS, but the different methods, differently used medium, and difference in follow-up periods affect the outcome treatment. Methods: The current survey is a single-center, phase I clinical trial to evaluating the efficacy and safety of autologous bone marrow (BM)-derived MSCs through intrathecal administration in ALS patients. MNCs were isolated from BM specimens and cultured. The clinical outcome was evaluated based Revised Amyotrophic Lateral Sclerosis Functional Rating (ALSFRS-R) Scale. Results: Each patient received 15±3×106 cells through subarachnoid space. No adverse events (AEs) were detected. Just one patient experienced a mild headache after injection. Following injection, no new intradural cerebrospinal pathology transplant-related was observed. None of the patients’ pathologic disruptions following transplantation were detected by magnetic resonance imaging (MRI). The additional analyses have shown the average rate of ALSFRS-R score and forced vital capacity (FVC) reduction have decreased during 10 months following MSCs transplantation versus the pretreatment period, from -5.4±2.3 to -2±3.08 ALSFRS-R points/period (P=0.014) and -12.6±5.22% to -4.8±14.72%/period (P<0.001), respectively. Conclusion: These results have shown that autologous MSCs transplantation reduces the disease’s progression and has favorable safety. Trial Registration: This study performed as a phase I clinical trial (code IRCT20200828048551N1)

The Effect of In-Hospital Intervention to Reduce Door to Needle Time in Patients Receiving Tissue Plasminogen Activator

Background and Objective: Attempts have been made to confirm the diagnosis of stroke at the earliest stage and to prevent the development of neurological deficits. Tissue plasminogen activator (tPA) plays a logical role in the treatment of acute stroke by converting plasminogen to plasmin, and recent studies have shown that the drug can be injected up to four and a half hours after the onset of symptoms. The present study aimed to evaluate the effect of an in-hospital intervention to reduce door to needle (DTN) time in acute stroke patients. Methods: This epidemiological case-control study was performed on patients with acute ischemic stroke from September to March 2016 (n= 25) (group A) who were treated with tPA according to stroke guidelines. Their basic specifications, DTN and Door to Computed Tomography scan (DTC) time were recorded. Then, from April to August 2017, an intra-hospital recipe for tPA injection was provided by investigating the obstacles and causes of intra-hospital delays. Subsequently, stroke patients receiving tPA from September to March 2017 (n= 23) (group B) were examined, and their DTN and DTC were compared with patients in the first group. Results: The mean DTN and DTC in group A were 67.27 ±28.83 and 30.40 ±10.59 minutes, and in group B, were 45 ±25.98 and 22.17 ±8.50, minutes, respectively, which made a significant difference between the two groups (P=0.005, P=0.006, respectively). The percentage of patients with DTN less than 60 minutes increased from 52% in group A to 95.6% in group B. The percentage of patients with DTC less than 25 minutes decreased from 32% to 69.56% (P&lt;0.001). The percentage of patients with symptomatic cerebral haemorrhage increased from 12% to 8.7% (P&lt;0.001). The percentage of patients with independent ambulatory (mRS: 0-2) at three months after discharge increased from 48% to 56.5% (P=0.003). The mortality rate also decreased from 24% to 13.4% (P&lt;0.001). Conclusion: By resolving the causes of intra-hospital delays and using a proper team program, the mean DTN and DTC of patients receiving tPA were reduced. This decrease in DTN time was accompanied by reduced complications in the form of reduced symptomatic cerebral haemorrhage and mortality and improved prognosis

Neurological manifestations in hospitalized COVID-19 patients: a cross-sectional study

Abstract Background Accumulating evidence on the neurological sequelae of COVID-19 is a serious concern, with patients possibly being at risk of permanent debilitation if not managed appropriately. We aimed to determine the prevalence and pattern of neurological manifestations and diagnostic and therapeutic findings among hospitalized COVID-19 patients consulted with the neurology service for neurological disorders. We conducted a retrospective, observational study at the Golestan Hospital of Ahvaz, Iran, between March 20, 2020, and March 19, 2021. Patients' demographic, clinical, paraclinical, and therapeutic characteristics were extracted from medical records and then subjected to statistical analysis. Results Overall, 6.7% (157/2340) of COVID-19 patients at Golestan Hospital had a neurological disorder. Most of the patients (90/157) were men, and the mean age of patients was 62.91 ± 91 years. A total of 56.68% of patients (89/157) were SARS-CoV-2 RT-PCR positive. The mean chest CT severity score was 8.26 ± 4.4, ranging from 1 to 19. The most common neurologic disorders were cerebrovascular disease (72.6%), encephalopathy (8.9%), and Guillain–Barre syndrome (6.4%). The CSF SARS-CoV-2 PCR test was positive in one patient with Guillain–Barre syndrome. The in-hospital mortality rate was 43.9%. Definite COVID-19, ICU admission, history of stroke and dementia, and comorbidities were associated with an increased mortality risk in these patients. Conclusions Patients with COVID-19 can present with serious neurological disorders such as cerebrovascular disease and impaired consciousness, even without typical COVID-19 symptoms. Close monitoring for neurological symptoms may help improve prognosis in hospitalized COVID-19 patients