Efficacy and safety of lamotrigine in lennox - gastaut syndrome

The Lennox-Gastaut syndrome [LGS], one of the most difficult epilepsy syndromes to treat, is characterized by a triad of intractable seizures of various types, a slow [< 2.5-hertz] spike-wave pattern in EEG and mental retardation. The aim of this study was to evaluate the efficacy and safety of lamotrigine as add-on therapy in intractable epilepsy of children with LGS. In a quasi- experimental study, 40 children with LGS referred to the pediatric neurology clinic of Shaheed Sadoughi Hospital in Yazd, between August 2007 and to November 2008, were evaluated. Twenty-two boys and 18 girls with a mean age of 4.12 +/- 1.8 years were evaluated. At the end of three months of treatment with lamotrigine, 12% were seizure free, 52% had> 50% reduction in seizure frequency and 12% had increase in seizures. Means of seizure frequency/per week, before and after treatment were 70 [range 1-180] and 18.6 [range 0-60] respectively, indicating effectiveness of the drug in seizure reduction [P value = 0.003]. The drug was effective in 72% of mixed type seizures, 40% of generalized tonic-clonic and 33% of drop attack and tonic seizures. Transient side effects were seen in 12.5% [drowsiness in 3 and ataxia in 2 children]. No serious side effects were seen. Lamotrigine should be considered as an add-on therapy in management of intractable epilepsy in LGS

Study of the correlation between transcutaneous bilirubin levels [Jh20-1 bilirubinometer] and serum bilirubin levels [laboratory]

Hyperbilirubinemia is a common benign problem in neonates. Nonetheless, if untreated, severe hyperbilirubinemia is potentially neurotoxic. The standard method for diagnosis of hyperbilirubinemia is determination of serum bilirubin levels in the laboratory that requires a blood sample which is both painful and stressful for neonates and entails cost and time. The objective of this study was to study the correlation between transcutaneous bilirubin levels [JH 20-1 bilirobinometer] and serum bilirubin levels. This prospective study was done on 100 jaundiced newborn term infants from March to October, 2006. Initial clinical assessment of jaundice was carried out by a physician [researcher] and simultaneously, blood sample was collected and a JH20-1 bilirubinometer was applied at two sites; forehead and sternum. The study group consisted of 57 boys and 43 girls diagnosed as jaundiced neonates. The mean serum bilirubin and mean transcutaneous bilirubin levels at forehead and sternum were 13.35, 12.95 and 12.46 mg/dl, respectively. The correlation coefficient of bilirubin levels estimated by the bilirubinometer at the forehead and sternum and serum levels were 0.773 and 0.731, respectively. At bilirubin levels higher than 12 mg/dl [cut off point], the bilirubinometer had a decreased sensitivity, but an increased specificity. Transcutaneous bilirubin measurements using JH20-1 bilirubinimeter correlate well with total serum bilirubin levels, but when bilirubin levels are higher than 12mg/dl, sensitivity of the device is reduced and therefore not reliable

Prevalence of attention deficit hyperactivity disorder in 6 year olds of Yazd city

Attention Deficit hyperactivity Disorder [ADHD] is the most common psychiatric disorder in school age children and has a negative effect on the individual's general functions. The purpose of this study was to estimate the prevalence of ADHD in preschool 6 year old children in Yazd in 2005 and the influence of gender, birth weight, birth order and parental education on ADHD. 400 preschool children including 200 boys and 200 girls were selected randomly through sampling method and the data of the cross sectional research was collected via compiled questionnaires based on the DSM-IV criteria and interview of parents. Data of this investigation was analyzed and evaluated using SPSS: 11.5 software. The results showed that general prevalence of ADHD was 16/3% and more in boys [19/5%] than girls [13%]. Most of the parents of the affected children were illiterate or uneducated. There was no statistically significant relationship between gender, birth weight, order and ADHD frequency. In view of the high prevalence of ADHD among children in Yazd and its undesirable outcome, it is recommended to have a preventive mental health program for screening and treatment

Relationship between para clinical findings of first seizure and one year recurrence ra te in children admitted at shaheed Sadoughi hospital-Yazd

Seizure is the most common pediatric neurology problem that occurs in 10% of children. The purpose of this study was to determine the recurrence rate of seizures after one year and its relationship with paraclinical findings of the first attack. In a historical cohort analytic study, 131 children with first seizure admitted to Shaheed Sadoughi Hospital between March 2004 to August 2005 were evaluated for recurrence rate during one year and its relationship with serum levels of sodium, potassium, glucose, calcium, Hb, MCV and PMN during the first attack. 79.4% of cases were in febrile seizure group and 20.6% in first unprovoked seizure group [FUS].Of the total, 27.84% of patients had seizure recurrence [27.9% in febrile and 25.9% in afebrile group]. Mean survival recurrence rate was 10.11 +/- 0.32 SD months [10.25 +/- 0.33 SD months in febrile group and 9.57 +/- 0.83 SD months in FUS]. Survival analysis showed that seizures recurred later in older patients. Younger age and lower Hb levels in the febrile seizure group and lower MCV in the FUS group were associated with an increased risk of recurrence. In this study, anemia and microcytic RBC were risk factors for seizure recurrence. Therefore, more studies should be done so as to decrease seizure recurrence by treating and preventing anemia

Analgesic effects of glucose and water in neonates

Several methods have been used to relieve pain in neonates. The objective of this study was to assess the analgesic effect of 50% glucose and water during hepatitis B vaccination. In this randomized controlled trial, 90 term neonates were studied. Infants were randomly assigned to one of the three equal sized groups. First, heart rates were measured by EKG monitor. Then, 2mL of either 50% glucose or sterile water was administered into the mouths of infants in groups one and two, respectively. No intervention was done for group three. During vaccination until three minutes after, crying of babies was taped. Heart rates were measured during injection until 60 seconds. Mean values of duration of crying for glucose, water, and no intervention groups were 21.1 s, 33.3 s, and 56.9 s, respectively, which were significantly different [P= 0.0003]. Post hoc test revealed substantial differences between groups one and three [P= 0.0001] and between groups two and three [P= 0.006]. However, groups one and two were not statistically different [P= 0.19]. Moreover, heart rate did not rise significantly in any of those groups. Both 50% glucose and water showed analgesic effects in neonates

[Comparing the antipyretic effectiveness of oral and rectal acetaminophen in children]

Introduction: Acetaminophen is the most commonly used drug for temperature reduction in febrile children, which is used orally or rectally. The effectiveness of rectal versus oral Acetaminophen is not well established

Objective: This study is designed to compare the antipyretic effectiveness of rectal acetaminophen dose 15mg/kg to the standard oral dose of 15mg/kg

Materials and Methods: A randomized clinical trial was performed on 60 patients aged 6 months to 6 years with fever>/=39 rectally. The patients were randomly assigned in one of two groups. First 39[degree]c group received 15mg/kg Acetaminophen rectally and the second group received same dose orally and their body temperature was measured one and three hours after Acetaminophen administration

Results: The mean temperature reduction, 60 and 180 minutes after use of acetaminophen were 1.07 +/- 0.16 and 1.74 +/- 0.25

Conclusion: Effectiveness of oral and rectal Acetaminophen with 15mg/kg dose is similar in decreasing children's fever. Standard [15mg/kg] oral and [15mg/kg] rectal acetaminophen has similar antipyretic effectiveness

Comparison of the efficacy of oral [10 and15 mg/kg] and rectal [15 mg/kg] acetaminophen in fever reduction in children

Fever is the most common symptom of patients referring to pediatrics clinics. The first choice for antipyretic medication is acetaminophen with dosage of 10-15 mg/kg every 4-6 hours. We compared the efficacy of oral [10 and 15 mg/kg] and rectal [15 mg/kg] acetaminophen in fever reduction in children. A randomized, controlled trial was performed in 90 patients aged between 6 months and 6 years with fever >/= 39°Celsius. The patients were divided into three groups; Group 1 administerd rectal acetaminophen 15mg/kg, Group 2 oral Acetaminophen 15 mg/kg and Group 3 oral acetaminophen l0mg/kg. The results at the end of the first and third hour were assessed. The rate of temperature reduction at the end of the first and third hour in the group receiving rectal acetaminophen [15mg/kg] was 1.07 +/- 0.16 and 1/74 +/- 0.25, respectively. The rate of temperature at the end of the first and third hour in the group receiving oral acetaminophen [15mg/kg] was 0.98 +/- 0.19 and 1.25 and 1.7 +/- 0.14, respectively. The rate of temperature reduction at the end of the first and third hour in the group receiving oral acetaminophen [10mg/kg] was 0.63 +/- 0.18 and 1.25 +/- 0.22, respectively. There was no significant difference in temperature reduction between the groups receiving oral [15mg/kg] and rectal acetaminophen, but oral acetaminophen [10 mg/kg] was less effective in temperature reduction