A Survey on Awareness, Knowledge, and Attitudes toward Epilepsy in an Urban Community in Turkey

Background and Aim: Epilepsy is one of the most common chronic neurological disorders with a high prevalence. Epileptic people and their family members suffer more from social stigma than the disorder itself. Among various complex reasons knowledge and awareness about epilepsy are the two important factors underlying discriminatory attitudes towards epileptic people. Community pharmacists play a major role in the care of these patients. In this study we mainly aimed to gain insights into the knowledge and awareness of and attitudes (AKA) towards epilepsy both in epileptic and healthy individuals in an urban community. To this end we also aimed at developing a reliable and valid measurement tool to assess AKA levels. Materials and Methods: This study was conducted in 13 community pharmacies with 219 respondents. Factor analysis yielded three clear subscales. Results: It was found that a vast majority of the participants were familiar with epilepsy; yet only 18 of them had detailed information. The community pharmacists were indicated as a main source of information about epilepsy at the same rate to that of physicians. Although most of the respondents knew that epilepsy was not a form of mental illness only about one forth of them knew the real cause. More than half of the respondents supported the epileptics’ socialization in the community. Conclusion: We believe that the questionnaire developed in the study is a promising instrument for determining educational needs and offering guidance to healthcare professionals in developing standardized educational tools and programs.Keywords: Attitude, awareness, community pharmacist, epilepsy, knowledg

Nitric oxide mediated effects of nebivolol in myocardial infarction: the source of nitric oxide

OBJECTIVE: After MI pathological LV remodeling is one of the major causes of death. We previously showed the NO mediated beneficial effects of nebivolol in rat MI model, in this study we aimed to evaluate the NOS related mechanisms in this phenomenon

Chronic Emotional Stress Exposure Increases Infarct Size in Rats: The Role of Oxidative and Nitrosative Damage in Response to Sympathetic Hyperactivity

We investigated the level of sympathetic hyperactivity in response to stress exposure in an acute in myocardial infarction (AMI) model and the contribution of oxidative and nitrosative damage to this phenomenon. Stress was induced by 20-day administration of different emotional stress factors: daylight/darkness exposure, overcrowding, isolation, new hierarchy, tilting the cage and restriction of water or food. AMI was induced surgically, Heart I-ate (HR) and heart rate variability (HRV) measurements were done before and after AMI. Oxidant parameters were measured in heart tissue and cortisol levels were measured in plasma specimens. Compared with the nonstressed group, stress-exposed rats showed sympathetic hyperactivity characterised by increased HR together with decreased HRV. In the stressed group serum corticosterone levels were high both below and after A All. Mean infarct size in the stressed group was significantly larger (44.6 +/- 3.23% and 53.1 +/- 4.52%, respectively; P < 0.05). Increasecl tissue malondialdehyde (MDA) levels (0.63 +/- 0.59 and 1.60 +/- 0.31 nmol/mg protein, respectively: P < 0.05) and decreased superoxide dismutase (SOD) activity and glutathione (GSH) content were seen in stress-exposed rots. Likewise, heart peroxynitrite levels were also high in stress-exposed rats (141.8 +/- 18 nmol/g tissue vs. 164.2 +/- 21 nmol/g tissue). Chronic emotional stress is a deteriorating factor for the induction and prognosis of MI. Exaggerated sympathetic activity may be the major contributing factor. Oxidative and nitrosative damage in response to this sympathetic hyperactivity is the kelp mechanism

THE EFFECT OF AMLODIPINE ON THE MASS AND FUNCTION OF THE LEFT-VENTRICLE IN PATIENTS WITH PRIMARY HYPERTENSION AND LEFT-VENTRICULAR HYPERTROPHY

The aim of this study was to assess the effects of amlodipine in patients with mild-to-moderate primary hypertension and left ventricular hypertrophy. Nineteen patients (6 women, 13 men; mean age, 52 years) with primary hypertension were included in the study and all completed the study. After the 2-week, single-blind placebo phase, 5 mg/d oral amlodipine was initiated. If diastolic blood pressure (DBP) could not be reduced below the target level (less than or equal to 90 mm Hg) after 6 weeks of treatment, the dose of amlodipine was increased to 10 mg/d. Clinical evaluation was performed at weeks 0, 1, 2, 4, 6, 8, 10, 14, 18, 22, and 26, and echocardiography at the end of the placebo phase and at weeks 14 and 26. No significant reduction in blood pressure was recorded during the placebo phase. Systolic and diastolic blood pressures (mean +/- SE) were 163 +/- 20 mm Hg and 102 +/- 5.4 mm Hg, respectively, at the end of the placebo phase; these values were reduced to 139 +/- 19 mm Hg (P < 0.001) and 86 +/- 8 mm Hg (P < 0.001) at week 14. This reduction in blood pressure was maintained until the end of the study. No significant alterations were shown in heart rate during the study. DBP was reduced to less than or equal to 90 mm Hg in 10 (53%) of 19 patients with 5 mg/d and in 6 (32%) of 19 patients with 10 mg/d of amlodipine. Thus an overall therapeutic success of 84% was achieved. Left ventricular mass index (mean +/- SE) was 147 +/- 20 g/m(2) at the end of the placebo phase; it decreased to 129 +/- 20 g/m(2) at week 14 (P < 0.001) and to 123 +/- 19 g/m(2) at week 26 (P < 0.05 for the values at weeks 14 and 26). The mitral early filling flow velocity (wave E) to late filling flow velocity (wave A) ratio was significantly increased 0.7 +/- 0.1 to 0.9 +/- 0.2 at the end of the trial (P < 0.001). Echocardiographic assessment showed no statistically significant changes in left ventricular ejection fraction and cardiac index. It was concluded that amlodipine, given in single daily doses, is an effective antihypertensive agent in patients with primary hypertension, improving left ventricular diastolic function and reducing left ventricular hypertrophy

Non-invasive evaluation of endothelial function in hypertensive elderly patients

Impaired endothelium-dependent vasomotion is a diffuse disease process resulting in abnormal regulation of blood vessel tone and loss of several atheroprotective effects of the normal endothelium. The aim of the present study was to investigate the effects of aging and hypertension on endothelial function. Sixty-six geriatric subjects with ages over 60 (48 hypertensive and 18 healthy) and 40 middle-aged subjects (16 hypertensive and 24 healthy) were included in the study. Systemic vascular endothelial function was evaluated through measuring brachial arterial vasodilation, a physiologic answer to reactive hyperemia occured with increased blood flow in the vessel after transient ischemia (flow-mediated dilation, FMD%), and with carotid artery intima-media thickness (IMT) measurement, using high-resolution ultrasonography. Endothelial independent vasodilation was also measured after administration of sublingual isosorbide dinitrate (isosorbide dinitrate mediated dilation, IDNMD%). FMD% was significantly decreased in elderly and/or hypertensive (HT) patients (geriatric HT: 9.5 +/- 4.7%, geriatric non-HT: 12.7 +/- 5.5%, middle-aged HT: 12.9 +/- 4.3% and middle-aged non-HT: 18.9 +/- 8.1 %) (geriatric HT versus geriatric non-HT (P = 0.02), geriatric HT versus middle-aged HT (P = 0.01), geriatric non-HT versus middle-aged non-HT (P = 0.008)). Both FMD% and IDNMD% were inversely correlated with age, baseline vessel diameter and carotid artery intima-media thickness. FMD% was also inversely correlated with diastolic blood pressure. No correlation was found between FMD% and systolic blood pressure, serum cholesterol and triglyceride levels. Endothelium dependent (EDD) and independent dilatation of large arteries decreased with aging even in the healthy elderly, and FMD further declined in HT elderly patients, indicating that age and hypertension independently impair endothelial function. Positive correlations with age and hypertension, and significant inverse correlation with FMD, makes carotid artery IMT a possible indicator of endothelial function. (C) 2004 Elsevier Ireland Ltd. All rights reserved