ABSTRACT
Background: Epilepsy is a chronic disorder of the brain that affects people of all ages Neuropsychological impairment is an important comorbidity of chronic epilepsy in the majority of children with epilepsy. interictal epileptiform EEG discharges may present as a complicating factor in spite of being seizure free. In a group of children with interictal EEG discharges there is sudden and unexpected decline of school performance as the first symptom of epilepsy
Consequently, accumulating cognitive impairment, and even a decline in IQ scores, is reported in epileptic children with frequent episodes with epileptiform EEG discharges
Aim of the Work: To evaluate the possible relationship between interictal EEG discharge and cognitive function in a sample of Egyptian epileptic children
Patients and Methods: The ethical approval was obtained from the Hospital Ethical Research Committee. Each patient and/or parents entering the study signed an informed consent. This study was conducted on 140 children selected from Epilepsy Outpatient Clinic of Al-Azhar University Hospitals during a period of two years starting from June 2016 untill June 2018. A specialized pediatric neurology sheet was taken. EEG and cognitive assessment of epileptic patients with and without epileptiform EEG discharges using Stanford-Binet intelligence scale and P300 by ERP were performed to each patient two times 3 months in between
Results: we found that patients with frequent IEDs had high mean P300 latency and low IQ when compared to patients with infrequent and normal EEG examination. In addition, the mean p300 latency significantly reduced with rising in IQ [more improvement in cognitive function] after disappearance of IED in some patients
Conclusion: Interictal epileptiform EEG discharge had an additional effect on cognitive function especially if generalized and of high frequency. This effect might be often underestimated and might accumulate, and have a severe cognitive impact. So, treatment of epileptic patients should put in concern reduction or even treatment of IEDs as controlling of these IED lead to improvement of cognition
ABSTRACT
Background: Liberating a patient from ventilator is a continuous process as with any disease condition which starts with recognition of patient being ready to be weaned from ventilator by letting the patient breathe on T-piece and, if successful proceeding to SBT followed by extubation, if it is tolerated well [simple weaning]. Otherwise letting patient on ventilator till next such trial being successful. Difficulty in weaning from mechanical ventilation is one of the most frequently encountered problems in MICU. An estimated 20% of mechanically ventilated patients face failed extuabtion [requiring reintubation within 48 h of extuabtion]
Aim of the study: This study was designed to assess the value of the excursion of diaphragm tested by ultrasonography to predict weaning from mechanical ventilation versus volume associated weaning parameters in medical intensive unit's patients
Patients and Methods: A prospective study was carried out on 30 patients ready for weaning. All patients were divided into two equal groups.Group A [successful weaning group] and Group B [failed weaning group]
Results: Of the entire group of 30 patients, 21 patients [70%] had succeeded extubation and 9 patients [30%] failed. By applying cut-off level 1cm determined in our study the sensitivity and specificity of mean liver and spleen displacement were 95.2% and 88.9% respectively, which is higher than Pi max [85.7% and 77.8%] by cut-off level
Conclusions: The present study concluded that ultrasonographic measurement of liver and spleen displacement during SBT before extubation is a good method for predicting extubation outcome
ABSTRACT
Nasopharyngeal carcinoma is mainly arising from the fossa of Rosenmuller frequently extends to the paranasopharyngeal space, which contains fibrofatty tissue and portions of the third division [V3] of the trigeminal nerve. The aims of this work are to describe the radiological findings of perineural spread in nasopharyngeal carcinoma and to compare the accuracy of MRI and CT in diagnosing perineural metastasis along the cranial nerves. A total of 52 patients diagnosed with nasopharyngeal carcinoma were included in this study. Both computed tomography and magnetic resonance imaging of the head and neck, including the nasopharynx, were performed for all patients. The extent of the trigeminal perineural tumor invasion was evaluated and correlated with neurologic symptoms. All 52 cases of nasopharyngeal carcinoma showed radiologic evidence of perineurai spread. However, clinical signs and symptoms of cranial nerve palsy were only seen in 36.5% [19 of 52] of the patients, leaving 63.5% [33 of 52] of the patients with no signs of nerve paralysis. The most common nerve to be infiltrated is the mandibular nerve in 30.7%. Maxillary nerve [V2], Ophthalmic division [VI] and vidian nerve were involved in 15.4%, 7.7%, 13.5% respectively. Maxillary and mandibular nerves were involved together in 32.7% of the patients. Perineural spread of the cranial nerves especially, trigeminal nerve is one of the most common and important routes in the intracranial extension of nasopharyngeal carcinoma.Clinical and radiologic findings reveal that nasopharyngeal carcinoma has a significant liability for perineural invasion. Neurologic symptoms usually present when the intracranial perineural spread has occurred. MR is the preferred imaging method for the evaluation of nasopharyngeal carcinoma perineural spread
Subject(s)
Humans , Male , Female , Tomography, X-Ray Computed/methods , Magnetic Resonance Imaging/methodsABSTRACT
The present work describes the application of the modified HPLC method for bioequivalence study of Rifampicin generic 300 mg capsules [generic] relative to Rifampicin innovator 300 mg capsules [reference]. A sensitive high pressure liquid chromatographic method for the quantitation of rifampicin in human plasma has been established by using water [pH 2.27]: methanol: acetonitrile [1.5:6:12] as a mobile phase. The method allows the analysis of rifampicin in plasma at concentrations ranging from 0.25 to 20 microg/ml. Linearity and precision of the method were validated by analysis of spiked human samples. Accuracy and precision of the method for rifampicin were found to be acceptable. Peak-area ratios [PAR] were used in the determination of plasma concentrations of the drug using indomethacin as an internal standard. The method is sensitive, therefore useful for routine analysis of large number of biological samples. The bioequivalence was carried out on twenty four healthy male volunteers who received a single dose of the test product, Rifampicin generic 300 mg capsules or, the reference product, Rifampicin innovator, 300 mg capsules, in a randomized balanced two ways cross over design. After dosing, serial blood samples were collected for a period of 24 hours. Pharmacokinetic analysis was performed using noncompartmental method. 90% confidence interval for AUC[0-inf], C[max] of test/reference ratio were found to be within the bioequivalence acceptance range of 80% - 125%. It was concluded that Rifampicin generic 300 mg capsules is bioequivalent to Rifampicin innovator 300 mg capsules