Thyroid Gland Volume in Adults with Epilepsy: Relationship to Thyroid hormonal function

Several studies were done investigating thyroid function in patients with epilepsy. However the results of different studies were conflicting or controversial. This study aimed to evaluate thyroid hormonal changes and their relationship to thyroid volume in epileptic adults on long-term treatment with antiepileptic drugs (AEDs). This study included 135 adults with idiopathic epilepsy with mean age of 32.32±4.34years, duration of illness of 10.52±5.08years and on treatment with carbamazepine (CBZ), valproate (VPA) or CBZ+VPA for a mean duration of 8.66±3.32years. The serum levels of free thyroxine (fT4), triiodothyronine (fT3), and thyroid-stimulating hormone (TSH) were assessed. Thyroid volume was measured using ultrasonography. Compared to control subjects, patients had significant lower fT4 (p<0.01) and fT3 (p<0.01) and higher levels of TSH (p<0.0001). All patients with reduced fT4 had reduced fT3 and increased TSH levels. Nearly 26% of the patients had enlargement of the thyroid gland (p<0.001). Patients on polytherapy had more thyroid volume compared to patients on monotherapy (p<0.05) and patients on VPA had more thyroid volume compared to patients on CBZ (p<0.03). All patients were clinically euthyroid. Significant correlations were identified between fT4 concentrations and duration of illness, dose, serum level and duration of AEDs treatment, fT3 and TSH concentrations and between thyroid volume and fT4, fT3 and TSH concentrations. CBZ and VPA as mono- or poly- therapies may cause thyroid hormonal and structural abnormalities. Thyroid enlargement is due to associated subclinical hypothyroidsm. This data have implications suggesting prevention strategies

The Protective Properties of the Strawberry (Fragaria ananassa) against Carbon Tetrachloride-Induced Hepatotoxicity in Rats Mediated by Anti-Apoptotic and Upregulation of Antioxidant Genes Expression Effects

The strawberry (Fragaria ananassa) has been extensively used to treat a wide range of ailments in many cultures. The present study was aimed at evaluating the hepatoprotective effect of strawberry juice on experimentally induced liver injury in rats. To this end, rats were introperitoneally injected with carbon tetrachloride (CCl4) with or without strawberry juice supplementation for 12 weeks and the hepatoprotective effect of strawberry was assessed by measuring serum liver enzyme markers, hepatic tissue redox status and apoptotic markers with various techniques including biochemistry, ELISA, quantitative PCR assays and histochemistry. The hepatoprotective effect of the strawberry was evident by preventing CCl4-induced increase in liver enzymes levels. Determination of oxidative balance showed that strawberry treatment significantly blunted CCl4-induced increase in oxidative stress markers and decrease in enzymatic and non-enzymatic molecules in hepatic tissue. Furthermore, strawberry supplementation enhanced the anti-apoptotic protein, Bcl-2, and restrained the pro-apoptotic proteins Bax and caspase-3 with a marked reduction in collagen areas in hepatic tissue. These findings demonstrated that strawberry (Fragaria ananassa) juice possessed antioxidant, anti-apoptotic and anti-fibrotic properties, probably mediated by the presence of polyphenols and flavonoids compounds

Cardiac autonomic function in patients with myasthenia gravis: analysis of the heart-rate variability in the time-domain

Aim: Myasthenia gravis (MG) is a neuromuscular transmission disorder caused by acetylcholine receptor autoantibodies. Cardiac autonomic dysfunctions were rarely reported in patients with MG. Functional cardiac abnormalities were variable and reported in patients at severe stages of the disease and with thymoma. We investigated cardiac functions in patients with MG using Ambulatory 24-h electrocardiographic Holter-Monitoring.Methods: This study included 20 patients with MG with a mean age of 28.45 ± 8.89 years and duration of illness of 3.52 ± 1.15 years. The standard Holter reports include data for heart-rate, ventricular ectopies (VEs), supraventricular ectopies (SVEs), heart-rate variability (HRV), ST, QT, atrial fibrillation and T-wave alternans.Results: VEs, SVEs and ST-T changes were reported in 55%, 40% and 20% of patients respectively. Compared with healthy subjects (n = 20), HRV components including SDNN, SDANN, SDNN Index, RMS-SD and pNN50 (P = 0.001 for all) were reduced in patients indicating sympathetic and parasympathetic autonomic dysfunctions. HRV abnormalities were reported in 30-60% of patients. No significant correlations were identified between SDNN, RMS-SD, pNN50, and duration of illness.Conclusion: Depressed HRV may be an early manifestation of autonomic neuropathy in patients with MG even in milder stages of the disease. This information is useful in rating disease progression and the efficacy of therapeutic interventions

The effect of epilepsy and antiseizure medications on cardiac autonomic functions in children with epilepsy

Autonomic manifestations have been frequently studied in adults with epilepsy. Here, we evaluated cardiac autonomic (ANS) functions in children with epilepsy in the interictal period and determined the risks for their dysfunctions. This study included 60 patients (boys = 25; girls = 35 age: 14.53 ± 2.54 yrs) and 25 controls. Patients were well-controlled on antiseizure medications (ASMs). The battery of testing included measuring resting heart rate (HR) and blood pressure (BP), 30:15 ratio, HR variability (HRV) response to deep breathing, Valsalva ratio and BP changes in response to standing, isometric exercise and cold. Dizziness was reported in 25%. Autonomic dysfunctions were found in 45% (n = 27). Manifestations included high frequencies of abnormal 30:15 ratio (22%), HRV responses to deep breathing (45%), Valsalava ratio (45%), and BP responses to standing (35%), isometric exercise (27%) and cold (27%), indicating parasympathetic and sympathetic hypofunctions. There were positive correlations between parasympathetic and sympathetic dysfunctions. Logistic analysis showed that the durations of epilepsy and ASMs therapy were associated with ANS dysfunctions [95% CI: 0.895–4.719, p = 0.004]. Parasympathetic and sympathetic autonomic hypofunctions are common in children with epilepsy. This could be due to the depressant effect of sodium channel blocker ASMs on central and/or cardiac autonomic systems.</p