Lipid profiles in epileptic children treated with carbamazepine and valporic acid

Epilepsy in children often requires prolonged AED therapy. The aim of this study was to define the effect of treatment with some antiepileptic drugs Carbamazepine [CBZ] and Valporate [VPA] on serum lipid profiles alter nine months of therapy. This study was conducted on forty epileptic children, twenty five cases had generalized tonic - clonic and fifteen cases of partial seizures. There were control group [twenty healthy children] and patient group [forty children] the latter was classified randomly into two subgroups as follows: [1] Carbamazepine subgroups twenty cases] and [2] Valporate subgroup [twenty cases]. Our results revealed that serum total cholesterol, LDL- cholesterol, HDL- cholesterol, triglycerides and VLDL-cholesterol levels were increased alter treatment with CBZ with a statistically significant difference compared to serum levels before treatment, on the other hand these serum lipids levels decreased in patients treated with VPA when compared to their serum levels before treatment with a statistically significant difference. Valporic acid has a favorable effect on serum lipid profile and it may be the preferable antiepileptic drug with regards to the effects of the medication on the lipid metabolism

Cerebral venous thrombosis. Clinical presentation and outcome in a prospective series from Sudan

To describe the presentation and outcome of treatment of cerebral venous thrombosis [CVT] in patients from Sudan, an example of a developing country. In a prospective study, we described the clinical features, risk factors, and outcome of CVT in patients admitted to the National Center for Neurological Diseases, Khartoum, Sudan, the only specialized neurological hospital in the country, during the period from February 2001-October 2006. Patients were referred from other hospitals in the town or from nearby hospitals in Khartoum state. We recruited only adult and adolescent patients aging >/= 15 years. We reviewed 15 patients [12 females and 3 males] with a mean [ +/- SD] age of 33.9 +/- 11.8 years. Headache [n=15], papilledema [n=13], paresis [n=3], and generalized seizures [n=3] were the most common symptoms, and signs encountered. A prothrombotic risk factor was often identified [n=12]. At the time of the first visit namely, 12 weeks after discharge, 7 patients [46.7%] attained complete neurological recovery, 4 [26.7%] developed optic atrophy, and 2 [13.3%] died of pulmonary embolism. The clinical features and risk factors of CVT in Sudan are not different from elsewhere, but the outcome is less favorable. Places with less privileged health service resources, late presentation or delayed accessibility to appropriate diagnostic tools may negatively influence the final outcome

Ataxia telangiectasia: findings from two families in the Sudan

We report herein two families with ataxia telangiectasia. Patients in both families fulfilled the diagnostic criteria and showed unusual presentations that are rarely reported in literature. No patient developed malignancy yet. To the best of our knowledge this is the first report on Ataxia telangiectasia from Sudan

Pott's disease of the spine: findings from Sudan

Spinal tuberculosis is the commonest type of skeletal tuberculosis. It has variable presentations, but commonly presents with backache and weakness of lower limbs. Its prevalence is increasing world wide after the epidemic of HIV. To the best of our knowledge there are no studies addressing the clinical presentation of this disease in Sudan. In this study we included 84 patients with spinal tuberculosis. The study was conducted in two major hospitals in Khartoum in the period from January 2002 to December 2006. Results show males constituted 46 patients [54.8%] and females 38 [45.2%]. Their ages ranged between 16 years and 80 years, the mean age was 44.46 +/- SD 16.99. All patients had pain and or tenderness at the site of the lesion. Paraplegia or paraparesis was reported in 36 patients [42.8%], quadriplegia or quadriparesis in 25 [30%], Sciatica and root weakness in 22 [26.1%] and right brachial monoplegia in one patient. Evidence of active pulmonary tuberculosis was found in 15 patients [17.8%], abdominal tuberculosis in 7 patients [8.3%], lymphatic Tuberculosis in 1 patient [1.2%]. Cervical vertebrae were affected in a total of 26 patients [30.9%], the dorsal in 39 patients [46.4%] and the lumbar in 30 patients [35.7%]. One vertebra was affected in 3 patients [2.57%], 2 adjacent vertebrae in 48 patients [57.14%], 3 vertebrae in 24 patients [28.57%], 4 vertebrae in 4 patients [4.76%], 5 vertebrae in 1 patient [1.19%] and 6 vertebrae in 4 patients [4.76%]. HIV test was negative in all patients. Tuberculin test was positive in 80 patients [95%] and negative in 4 patients [5%]

Osteopetrosis: a rare disease with rare presentations

At least eight types of osteopetrosis have been described in humans. The primary underlying mechanism involved in all forms is the failure of normal osteoclastic bone resorption. Osteopetrosis tarda, the benign adult form, is inherited as an autosomal dominant trait. Patients typically are asymptomatic and have good long-term survival rates because bone marrow failure rarely occurs. A more common and malignant form, osteopetrosis congenita, presents in infancy and results in bone marrow failure caused by complete replacement of the marrow spaces with osteoclasts. Other forms are rare and have variable manifestations. In this communication we report 2 cases on possibly a rare form of osteopetrosis, the intermediate form

Electro-cardiographic detection of the site of totally occluded left anterior descending coronary artery

The goal of this study was to undertake the assessment of the value of ST-segment changes in various ECG leads during evolving acute anterior wall myocardial infarction in predicting the location of left anterior descending coronary artery obstruction by coronary angiography. A total number of 40 patients were enrolled between October 2000 and June 2001. All patients subjected to full history taken, clinical assessment, twelve leads resting ECG serial cardiac enzymes, laboratory tests, echocardiography and coronary angiography. According to angiographic results, patients were classified into: Group A having proximal LAD and group B having mid and/or distal LAD lesion. In this study, the presence of the ST-segment elevation in lead land aVL were greater and more frequent when lesion was in the proximal LAD than when it was in the mid or distal segment. On the other hand, the presence of ST-segment depression in leads II, III and aVF also were greater and more frequent when the lesion was in the proximal LAD than it was in the mid or distal segment. Also, this work demonstrated that STsegment depression in inferior leads II, III and aVF was strongly correlated with ST-segment elevation in leads I and aVL. Also, group A had a significantly higher incidence family history of ischaemic heart disease than group B. This work concluded that patients with proximal LAD lesion had a worsen prognosis than patients with mid or distal LAD lesion

Pulmonary tuberculosis as a cause of recurrent wheezy chest: the value of serologic diagnosis using IgG antibodies to mycobacterium 38 KDa antigen

The protective efficacy of current M. Bovis BCG vaccines is both unpredictable and variable. An enzyme immune-assay to detect IgG antibodies to 38-kDa antigen of M. tuberculosis is a sensitive serological test for those with smear-negative tuberculosis. We investigated 100 randomly selected children [3-10 yr.] with recurrent wheezy chest and 100 age-matched healthy controls for pulmonary TB. Children were subjected to clinical examination including detailed history, chest X-ray, Mantoux tuberculin skin-test, smear staining of gastric aspirates on 3 consecutive mornings, blood collected for erythrocyte sedimentation rate, complete blood count and detection of IgG antibodies to 38 kDa antigen of M. tuberculosis by enzyme immunoassay [EIA] [Omega Diagnostics] were performed. The pediatric TB score of children with wheezy chest [Crofton et al.] was measured and those with score >/= 7 were treated for 6 months. The results of the study revealed that none of the controls had a score > 6 or had circulating antibody to 38 kDa antigen whereas 8/100 of patients with wheezy chest had TB score >/= 7. Multiple logistic regression analysis, excluding factors used for calculating TB score showed that serologic diagnosis to detect circulating anti-38 kDa and age were the most valuable for diagnosing pulmonary TB in this group of children with wheezy chest [Probability of TB = 2.84 [anti-38 kDa] + 0.4 [age in years] - 8.67]. Antituberculous therapy for 6 months successfully abolished wheezes in the 8 cases with TB score >/= 7. In summary the prevalence of pulmonary TB in children with recurrent wheezy chest is considerably large [8%], serologic diagnosis is a very helpful diagnostic tool in addition to the TB score

Purification of superoxide dismutase from human umbilical cord haemolysed blood: a simple and efficient method

Superoxide dlsmutase [SOD] functions as a scavenger of superoxide radical, thus, it protects living organisms. Here we present a simple and efficient SOD purification method from human umbilical cord blood. After chloroform-ethanol treatment, SOD was purified by DEAE sepharose, phenyl-sepharose and HPLC. The purified enzyme has a molecular weight of 150,000 as determined by gel filtration and it appears as a single homogenous band on SDS-PAGE under non reducing and reducing conditions with an apparent molecular weight of 25,000, an indication that the native enzyme is a hexamer. It has a specific activity of 27x10[4] U/ mg protein. The optimum pH is 7.8 with a pi of 6.0 and the optimum temperature is 37.5°C. The enzyme has a Km of 2.7x10[4] and the activity is completely inhibited by 5 mM EDTA, while Cu and Zn regain and enhace the activity when added after EDTA inhibition. This means that this is a Zn-Cu SOD