ABSTRACT
Background: Seizure is one of the common causes of childhood hospitalization with significant mortality and morbidity. Current study is to find the etiology of seizure and classify seizure into various types and age groups presenting to tertiary center in Department of pediatrics VCSGGIMS and R Srinagar Pauri, Gharwal, Uttrakhand, India.Methods: This was a hospital based prospective study carried out from 1st Jan. 2014 to 31st Dec 2014. Variables collected were demographics, clinical presentations, laboratory tests, brain imaging studies, electroencephalography, diagnosis and hospital course.Results: A total of 276 patients were admitted for seizures with 172 (62.3%) males and 104 (37.7%) females. Among these patients, 148 (53.5%) presented with fever and 157 (56.8%) of children were less than 5 years of age. Generalized tonic-clonic seizure was the most common seizure type (69.2%) followed by partial (19.2%), absence (2.8%), myoclonus (1.6%) and others (6.9%). Seizure disorder (33.7%), febrile seizures (30%), CNS infections (meningitis 6.1%, encephalitis 6.5% and Tubercular meningitis 1.8%) and neurocysticercosis were other common etiologies. Abnormal brain images were noted in 55 (45.45%) out of 121 patients and most common abnormality was neurocysticercosis 33(12%).Conclusions: Acute episode of seizure is one of the causes for hospitalization. It can be concluded from present study that most of seizures caused by febrile seizures and CNS infections (meningitis and encephalitis, neurocysticercosis) can be managed better with prompt interventions. Children presenting with unprovoked seizure need prolonged follow up with neurophysiologic studies and neuroimaging (CT or MRI) for better understanding of childhood seizure.
ABSTRACT
Diabetes is associated with increased formation of advanced glycation end products (AGEs), which have been implicated in micro and macrovascular complications of diabetes. Our earlier reports showed proangiogenic effect of AGE-bovine serum albumin (BSA). In order to understand the mechanism of AGE-mediated angiogenesis, the possibility of involvement of peroxisome prolifeator activated receptor (PPAR) , a ligand activated transcription factor was examined. The angiogenic effect was studied in chick chorio allantoic membrane (CAM) and by analyzing angiogenic markers in human umbilical vein endothelial cells (HUVECs) in culture. The involvement of PPAR was investigated using synthetic PPAR agonist GW 1929 and antagonist GW 9662 and by RT-PCR. In CAM assay, PPAR antagonist GW 9662 reversed the AGE-induced effect on vascularity. In HUVECs in culture, GW 9662 reversed the effect of AGE-BSA and decreased the expression of CD 31, E-Selectin and VEGF. RT-PCR analysis showed that treatment with AGE-BSA caused upregulation of PPAR mRNA levels. The reversal of the effect of AGE on angiogenesis by treatment with PPAR antagonists and up-regulation of PPAR gene in HUVECs treated with AGE-BSA suggested the possible involvement of PPAR -dependent downstream pathway in mediating the angiogenic effect of AGE.