ABSTRACT
Sickle-cell disease [SCD] is an inherited hemoglobin childhood disorder, frequently complicated by pulmonary hypertension and cardiac involvement. Cardiovascular events and complications are the leading cause of mortality and morbidity in patients with SCD. Tissue Doppler imaging and the myocardial performance index [Tei index], are simple indices for the assessment of the cardiac function. The purpose of this study was to assess the left ventricular function in children with SCD. Sixty-four patients with SCD [mean age = 11.7 +/- 5.5 years] were compared with 50 age matched healthy controls [mean age = 11.2 +/- 5.20 years]. Myocardial wall motion velocities at the lateral mitral annulus and the junction between the medial mitral annulus and the interventricular septum were assessed during systole [Sa], early diastole [Ea], and late diastole [Aa] through a four-chamber view using pulsed Doppler echocardiography. The ejection fraction and shortening fraction were estimated. The Tei index was estimated via tissue Doppler echocardiography. The results showed that Ea and Aa velocity in the mitral annulus and interventricular septum had no difference between the patients and controls [p value > 0.05], and nor was there any difference between the two groups as regards the Tei index, Ea/Aa, ejection fraction, and shortening fraction [p value > 0.05]. Sam wave velocity, however, had a significant difference between the two groups [p value < 0.038]. The Tei index is a sensitive indicator for the cardiac function in chronic diseases and the right ventricular function in some disorders such as SCD
ABSTRACT
There are some controversial studies on effects of anti-epileptic drugs [AEDs] on serum IgG subclasses; however, the role of these medications is still unclear. The aim of this study was evaluation the effects of anti-epileptic drugs on serum concentration of IgG and its subclasses. Serum IgG and IgG subclasses of 61 newly diagnosed epileptic patients were measured at the beginning of monotherapy with carbamazepine, sodium valproate, and phenobarbital, and 6 months later. Measurement of IgG and its subclasses was performed using nephlometry and ELISA techniques, respectively. Reduction of at least one IgG subclass was found in 6 patients 6 months after treatment with AEDs. Among 27 patients receiving carbamazepine, decrease in at least one serum IgG subclass level was found in 5 patients. Among 20 patients using sodium valproate, only one patient showed decrease in IgG2 subclass. None of the 14 patients using phenobarbital revealed significant decrease in IgG subclasses. No infection was seen in the patients with reduction of subclasses. Although in our study, children with selective IgG subclass deficiency were asymptomatic, assessment of serum immunoglobulin levels could be recommended at starting the administration of AEDs and in serial intervals afterward in epileptic patients