Pregabalin in childhood epilepsy: a clinical trial study

How to Cite This Article: Mollamohammadi M, Tonekaboni SH, Pirzadeh Z, Vahedian M . Pregabalin in Childhood Epilepsy: A Clinical TrialIran J Child Neurol. 2014 Autumn;8(4): 62-65.AbstractObjectiveThe prevalence of active epilepsy is about 0.5–1%, and approximately 70% of patients are cured with first anti-epileptic drugs and the remaining patients need multiple drugs. Pregabalin as an add-on therapy has a postive effect on refractory seizures in adults. To the best of our knowledge, there is no research with this drug in childhood epilepsy. We use pregabalin in children with refractory seizures as an add-on therapy. The objective of this study is to evaluate the effects of pregabalin in the reduction of seizures for refractory epilepsy.Material & MethodsForty patients with refractory seizures who were referred to Mofid Children’s Hospital and Hazrat Masoumeh Hospital were selected. A questionnaire based on patient record forms, demographic data (age, gender,…), type of seizure, clinical signs, EEG record, imaging report, drugs that had been used, drugs currently being used, and the number of seizures before and after Pregabalin treatment was completed. We checked the number of seizures after one and four months.ResultsAfter one month, 26.8% of patients had more than a 50% reduction in seizures and 14.6% of these patients were seizure-free; 12.2% had a 25–50% reduction; and approximately 61% had less than a 25% reduction or no change in seizures.After the fourth month, 34.1% of patients had more than a 50% reduction in seizures and 24.4% of these patients were seizure-free. Additionally, 65.9% of patients had less than 50% reduction in seizures (9.8% between 25–50% and 56.1% less than 25% or without improvement).ConclusionWe recommend Pregabalin as an add-on therapy for refractory seizures (except for myoclonic seizures) for children.ReferencesKwan P., Brodie MJ. Early identification of refractory epilepsy. N Engl J Med 2000;342(5):314-9.Mikati MA. Seizures in childhood. In: Kliegmann RM, Behrman RE, Jenson HB, Stanton BF, editors. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa:Saunders Elsevier. 2011.P.2013-2039.Camfield PR, Camfield CS. Pediatric Epilepsy. In: Swaiman KF, editors. Swaiman`s pediatric neurology: Principles and Practice.7th ed. Edinburgh: Elsevier Saunders; 2012.P 703-710.Piña-Garza EJ. Fenichel’s clinical pediatric neurology. Altered States of Consciousness. 7th ed. Elsevier Saunder. 2013.P.47-75.Austin JK, Smith S, Risinger MW, McNehs AM. Childhood epilepsy and asthma comparison of quality of life. Epilepsia 1994:35(3):608-15.Farvwell JR, Dodrill CB, Batzel LW. Neuropsychological abilities of children with epilepsy. Epilepsia 1985;26(5):395-400.Kotagal P, Rothner AD, Erenberg G, Cruse RP, Wyllie E. Complex partial seizures of childhood onset. Arch Neurol 1987:44(11):1177-80.Miller R, Frame B, Corrigan B, Burger P, Backbrader H, Garofalo EA, et al. Exposure- response analysis of pregabalin add- on treatment of patients with refractory partial seizures. Clin Pharmacol Ther 2003;73(6):491-505.Fink K, Dooley DJ, Meder WP, Suman-Chauhan N, Duffy S, Clusmann H, et al. Inhibition of neuronal ca(2+) influx by gabapentin and pregabalin in the human neocortex. Neuropharmacology 2002;42(2):229-36.Topol A. Pregabalin for epilepsy. New medicines profile 2004 November; (04/12):1-3.Arroyo S, Anhut H, Kugler AR, Lee CM, Knapp LE, Garofalo EA, et al. Pregabalin add-on treatment: a randomized, double-blind, placebo-controlled, doseresponse study in adults with partial seizures. Epilepsia 2004; 45(1):2-7.Beydoun A, Uthman BM, Kugler AR, Greiner MJ, Knapp LE, Garoflo EA. Safely and efficacy of two pregabalin regimens for add-on treatment of partial epilepsy. Neurology 2005;64(3):475-80.French JA, Kugler AR, Robbins JL, Knapp LE, Garoflo EA. Dose-response trial of pregabalin adjunctive therapy in patients with partial seizures. Neurology 2003;60(10):1631-7.Carreno M, Maestro I, Molins A, Donaire A, Falip M, Becerra JL, et al. Pregabalin as add-on therapy for refractory seizures in every day clinical practice. Seizure 2007;16(8):709-12.Jan MM, Zuberi SA, Alsaihati BA. Pregabalin: Preliminary experience in intractable childhood epilepsy. Pediatr Neurol 2008;40(5):347-50.Chisanga E, Manford M. Pregabalin drug information. NHS foundation trust. March 2013.Gil-Nagel A. Zaccara G. Baldinetti F. Leon T. Add-on treatment with pregabalin for partial seizures with or without generalization: pooled data analysis of four randomized placebo-controlled trials. Seizure 2009;18(3):184-92

Surgery of Undescended Testis by Scrotal Approach; Benefits and Limitations

Background: The term of undescended testis refers to the cessation of the natural descending of the testis into the scrotum. Due to the advantages of the scrotal orchiopexy method over inguinal orchiopexy in some studies, we decided to conduct a similar study on children in Hazrat Masoumeh Hospital in Qom in 2016-2019 and we evaluated the effect of scrotal surgery in the treatment of UDT. Material and methods: In this study, among the files of children with palpable UDT between 2016-2019 who were undergone scrotal or inguinal surgery in Hazrat Masoumeh Hospital in Qom, the number of sample files from these files is selected and divided into two groups. One group was undergone traditional inguinal surgery and the other group were under scrotal surgery. Results: The mean operation time for type of incision above the scrotum and in the inguinal region were 8.27 ± 2.51 and 3.14 ± 12.08 minutes, respectively. The highest location in scrotal surgery was 70 (52.67%) in the external ring area and 101 (60.47%) was inguinal canal in inguinal surgery. In the scrotal method in no case and in the inguinal method only one case of secondary UDT was observed. In the scrotal method in no case and in the inguinal method only one case of wound infection was observed. Conclusion: Finally, our study showed that the scrotal method has more advantages than the inguinal method, the only limitation in this method is the location of the testis

The Effect of Religious Care by the Clergyman next to the Patients’ Bedside on their Depression and Anxiety

For downloading the full-text of this article please click here.Background and Objective: The fear of surgery, death, and the debilitating symptoms of the illness make hospitalized patients develop anxiety and depression that may disrupt their performance. Religious care aimed at addressing the religious needs of hospitalized patients can have a significant role in increasing the hospitalized patients’ ability to cope with their illness. Therefore, the researchers aimed to set up a religious-based plan and perform it by the presence of a clergy next to the patients’ bedside and determine its effectiveness on decreasing anxiety and depression of hospitalized patients.Method: In this randomized controlled clinical trial with control group, 142 hospitalized patients were chosen in the form of random sampling in Nekoui hospital of Qom. They were divided into a test and a control group. Then, the demographic questionnaire and the Hospital Anxiety Depression Scale were completed by them. The religious-based plan by the presence of a clergy next to the patients’ bedside was performed in the test group. The two groups were followed after the intervention. All ethical issues were observed in this study and the researchers declared no conflict of interests.Results: In terms of overall score of hospital anxiety and depression, the results of ANCOVA showed a statistically meaningful difference between the two groups after the intervention (F=35.75, P<0.001). Also, the results of paired-samples t-test showed a significant decline in the anxiety and depression of hospitalized patients in the intervention group (P= 0.001). In contrast, no measurable difference was observed in the anxiety and depression scores of patients in the control group (P= 0.10, P= 0.48).Conclusion: The presence of special medical teams like responsible clergies who are familiar with health issues and the provision of religious care can decrease patients’ anxiety and depression. Such a religious intervention also has a significant role in boosting patients’ morale and reducing their woes.For downloading the full-text of this article please click here.Please cite this article as: ShojaeiS, AbbasiM, RahimiT, Vahedian M, FarhadlooR, Movahed E, Parvaresh-MasoudM. The Effect of Religious Care by the Clergyman next to the Patients’ Bedside on their Depression and Anxiety. J Res Relig Health. 2018; 4(3):45-5

The Prevalence and Risk Factors of Metabolic Syndrome in Patients with Hemodialysis

Introduction: Metabolic syndrome is a common disorder that puts patients at high risk for cardiovascular disease (CVD) and mortality. To our knowledge, there is no published study in Pub Med which evaluated both lifestyle and metabolic syndrome in hemodialysis patients. This study aimed to estimate the prevalence of metabolic syndrome and investigate the potential risk factors in hemodialysis patients. Methods: This was a cross-sectional study conducted on 204 patients enrolled conveniently. National Cholesterol Education Program Adult Treatment Panel III criteria considered for Metabolic Syndrome. Demographics, lifestyle, and disease characteristics were gathered. The relationship between metabolic syndrome and its severity with independent variables was investigated through multivariable multivariate logistic and linear regressions. Results: The mean (SD) age was 55 (14) years and 42% were women. 42.6% had metabolic syndrome. Low high-density lipoprotein (HDL), high fasting blood sugar, high blood pressure (BP), increased waist circumference (WC), and high triglyceride were observed in decreasing order of frequency in 54.4%, 44.1%, 38.7%, 33.3% 28.9% of patients, respectively. The logistic regression model revealed significant associations between metabolic syndrome and physical activity (OR=0.85, 95% CI : 0.74-0.97), mood (OR=1.04, 95% CI : 1.002-1.078), age (OR=1.023, 95% CI : 1.001-1.046), and missed work (OR=0.86, 95% CI : 0.76-0.97). The linear regression model revealed significant associations between metabolic syndrome severity score and physical activity (B=-0.12, 95% CI : -0.21-0.02) and sleep quality (B=0.017, 95% CI : 0.001-0.033). Conclusion: Poorer sleep quality, lower physical activity, lower mood status, and older age were associated with higher odds of metabolic syndrome/metabolic syndrome severity score in hemodialysis patients

Assessing sex differential in COVID-19 mortality rate by age and polymerase chain reaction test results: an Iranian multi-center study

Background The aim of this study is to evaluate the sex differential effect in the COVID-19 mortality by different age groups and polymerase chain reaction (PCR) test results. Research design In a multicenter cross-sectional study from 55 hospitals in Tehran, Iran, patients were categorized as positive, negative, and suspected cases. Results A total of 25,481 cases (14,791 males) were included in the study with a mortality rate of 12.0%. The mortality rates in positive, negative, and suspected cases were 20.55%, 9.97%, and 7.31%, respectively. Using a Cox regression model, sex had a significant effect on the hazard of death due to COVID-19 in adult and senior male patients having positive and suspected PCR test results. However, sex was not found as significant factor for mortality in patients with a negative PCR test in different age groups. Conclusions Regardless of other risk factors, we found that the effect of sex on COVID-19 mortality varied significantly in different age groups. Therefore, appropriate strategies should be designed to protect adult and senior males from this deadly infectious disease. Furthermore, owing to the considerable death rate of COVID-19 patients with negative test results, new policies should be launched to increase the accuracy of diagnosis tests

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations

Psychometric Properties of Persian Version of the Ottawa Self-Injury Inventory in Hospitalized Patients

Introduction: Non-Suicidal Self-Injury (NSSI) has high prevalence among the patients with psychiatric disorders. Self-Injury plays an important role in the treatment, prognosis and risk of suicide, which highlights the need for an appropriate tool to assess the nature and psychological functions of NSSI. Therefore, the aim of this study was to determine the psychometric properties of the Persian version of the Ottawa Self-Injury inventory (OSI) in hospitalized patients. Methods: The present study was a psychometric study based on analytical method. The research has been performed on 310 patients with non-suicidal self-injury who have been referred to Nekoei-Hedayati Hospital in Qom City. Sample group completed Persian version of the Ottawa Self-Injury inventory. Data were analyzed using SPSS-16 and Cronbach’s alpha coefficient, Content Validity Index (CVI) and Content Validity Ratio (CVR). Results: The results showed that content validity index in this study was more than 0.75 and content validity ratio for validity of questions was more than 0.79.   The impact score of all items (Except for the tenth question) was higher than 1.5 that confirmed the face validity of inventory. The total Cronbach's alpha coefficient was calculated 0.71. Another result of this study was that 52% of patients reported at least one addictive characteristic. Conclusion: The finding showed that Persian version of Ottawa Self-Injury inventory has appropriate validity (face /content) and reliability in the inpatient population

Work-Related Musculoskeletal Disorders in Truck Drivers and Official Workers

Work-related musculoskeletal disorders (WMSDs) are common among drivers and official workers. Musculoskeletal disorders are frequent causes of absenteeism in many countries. The aim of this study was to determine the prevalence of musculoskeletal disorders and risk factors associated with these symptoms. A total of 346 workers and truck drivers were participated in this case-control study. All the participants were interviewed using a self- administered questionnaire containing demographic data and a Nordic questionnaire about presence site and characteristics of pain. Then the data were gathered, and the prevalence of the mentioned parameters and the relationship between variables in the questionnaire were analyzed statistically. The results of this study revealed that 78.6% out of truck drivers and 55.5% out of official workers had musculoskeletal disorders in on-year and there was a significant difference between two groups in this regard (P<0.001). On the whole, the most common symptoms were neck 47 (27.2%), followed by lumbar pain 42 (24.3%) in truck drivers and knee 63 (36.4%) and lumbar symptom 21 (12.1%) in one-year in official workers. In this study, musculoskeletal disorders showed statistically significant association with work duration, age and BMI (P<0.001). Within the limits of this study, it can be concluded that the musculoskeletal troubles have a high frequency among the drivers and official workers. Both groups usually remain on a prolonged uncomfortable postures and high static muscle load which may imply a risk for development of the troubles