Screening for Behavioural Abnormality Using Strength & Difficulty Questionnaire (SDQ) in Children with Epilepsy

Aims: To estimate the problem of behavioural co morbidity and to determine risk factors associated with epi-lepsy in children. Methods: A prospective observational study using Hindi and Gujarati version of Strength & Difficulty ques-tionnaire (SDQ) was conducted. Children aged 6 to 17 years with epilepsy (CWE) as cases & without epilepsy as controls enrolled. Detailed demographic and clinical data were recorded. The total difficulty score and the subscale scores were compared between two groups. Comparison of the scores were done among the children with epilepsy group also. Results: 52 children in each group were included. Self-reported SDQ used in 76% and parent reported SDQ used in 27% participants. Prevalence of behaviour abnormality was 25% in CWE. (p 0.004). CWE had signifi-cantly higher mean total difficulty score (p<0.001) and mean emotional (p <0.0001) and conduct subscale score (p 0.0024). Children having uncontrolled epilepsy (OR 15, 95% CI 2.9 - 76.3, p 0.0005) and having num-ber of seizures more than 3 (OR 13.33 95% CI 3.4 - 51.04, p 0.0004) were found to be significantly associated with behavioural abnormality. Conclusion: Epileptic children are at more risk of behavioural problem than in normal children, especially emotional problem and conduct problem. Uncontrolled epilepsy and frequency of seizure were significant risk factor for occurrence of behavioural problem.

A short series of rolled tendon arthroplasty in carpo-metacarpal joint arthritis of thumb.

Introduction: Trapezio metacarpal joint arthritis is the commonest of arthritis in hand. It occurs more in females after age of 40 years (post menopausal women). Pain appears in all thumb movements which incapacitates them to do their daily household work. There are various methods of treating this disease like conservative methods including NSAIDS and hot water fomentation; surgical methods like trapeziectomy, stabilizing ligamentoplasty, prosthetic replacement (silicon implats, steffee prosthesis etc, fusion of trapezio metacarpal joint and tapeziectomy with tendon interposition arthroplasty. Non surgical measures forms the first line of treatment with aim of preventing progression of disease, however, surgery becomes an option when symptoms are refractory to nonsurgical methods. Aim: To evaluate the outcomes of trapeziectomy with free rolled tendon palmaris longus interposition arthroplasty for moderate to severe osteoarthritis of trapezio metacarpal joint. Material and methods: We evaluated 10 patients (mean age 50, Eaton Littler stage 3 and 4) who underwent trapeziectomy and palmaris longus interposition arthroplasy for end stage osteoarthritis of thumb carpometacarpal joint. Clinical outcome parameters were determined preoperatively and at 3, 6, and 12 months postoperatively. Results: We have got excellent in 7 cases (9 thumbs), good in 2 cases, poor in 1 case. Conclusion: Rolled tendon arthroplasty using free rolled palmaris longus tendon with trapeziectomy is able to provide high quality results in moderate to severe osteoarthritis of trapezio metacarpal joint.

Fine needle aspiration cytology role in head and neck lesions.

Introduction: Fine Needle Aspiration Cytology (FNAC) is a simple, quick and inexpensive method in the head and neck region. It also affords a practicable and means of rationally planning surgery and causes minimal trauma to the patient and carries no risk of complications. Aim and objectives: The aim of this study was to see the frequency of various pathological conditions detected on FNAC in patients presenting with head and neck swellings and to evaluate the role of FNAC in diagnosis of head and neck swelling. Material and methods: A retrospective study was conducted in Department of Pathology, SMIMER Medical College, Surat from July 2014 to June 2015which included 250 patients with head and neck swellings presenting to Outpatient clinics. Fine Needle Aspiration Diagnosis was correlated with detail of relevant clinical findings and investigation. Results: Maximum incidence was observed in the age group 31-40 years with higher incidence among males. Out of 250 cases, 160 cases of lymph node lesions were diagnosed of which non- specific lymphadenitis was the commonest diagnosis (47%) followed by Tuberculous lymphadentities (25%). 57 cases of thyroid lesions were diagnosed, in which incidence rate of benign thyroid lesions was (84%). 12 cases of salivary gland lesions were found, among which pleomorphic adenoma was common (67%). Conclusion: It was concluded that non-Specific lymphadenitis is the commonest condition in patients presenting with neck swellings. FNAC is a simple, safe and inexpensive tool for the assessment of patients with head and neck swellings. It could differentiate the infective process from neoplastic one and avoids unnecessary surgeries. Thus, FNAC can be recommended as a first line of investigation in the diagnosis of head and neck swellings.

Targeting CYP450 modulation to decrease the risk of induced cataract in the experimental model.

Background: Diabetes is one of the major causes of cataract. Some drugs prescribed for the treatment of diabetes are the modulators of CYP450, which may alter the risk of cataract. Objective: To study the effect of CYP450 modulation in galactosemic cataract. Materials and Methods: Male Sprague-Dawley suckling rats were allotted to four groups (n = 6), as follows: Group 1: Normal control, Group 2: Galactose control, Group 3: CYP450 inhibitor pretreated and Group 4: CYP450 inducer pretreated. Cataract was induced in animals of all groups except group 1 by feeding them galactose (50%), 21 days after parturition. From the eighteenth day of life, CYP450 inhibitor (nifedipine; 8.1 mg/kg) and CYP450 inducer (pioglitazone; 3.8 mg/kg) were given orally to groups 3 and 4, respectively. The maturation pattern of the cataract was observed by an operating microscope, every third day. Biochemical changes in the lenses of all groups, for example, CYP450 activity expressed as µM NADPH oxidized / unit time, alterations in the levels of total proteins, soluble proteins, and reduced glutathione (GSH) following the induction of cataract, were estimated. Results: The microscopic examination of the lenses indicated that CYP450 inhibitor pre-treatment delayed (fourteenth day) the occurrence of cataract, while CYP450 inducer pretreatment demonstrated an early (ninth day) cataract as compared to galactose control rats (twelfth day). A significant decrease and increase in CYP450 activity was observed with the CYP450 inhibitor and inducer pre-treatment, respectively. There was no alteration in the GSH level, but a significant increase in total and soluble protein was found in groups 3 and 4 as compared to group 2. Conclusion: CYP450 may have a role in the initiation of cataract without any effect on the maturation pattern, as revealed by the delayed occurrence of cataract with the CYP450 inhibitor and an early onset of cataract with the CYP450 inducer.

Effect of chronic treatment with hydralazine on various in vitro preparations of rat.

Effect of chronic treatment with hydralazine (40 mg/kg/day) on isolated heart, anococcygeus muscle and myometrial preparations from rats has been studied. The treatment for 6 weeks caused a significant increase in isoprenaline induced positive inotropic response in rat heart. However, isoprenaline induced positive chronotropic effects were not altered significantly by chronic hydralazine treatment. Chronic hydralazine treatment also failed to alter noradrenaline induced contractile effects on rat anococcygeus muscle. However, on myometrial preparations from hydralazine treated rats showed an increase in adrenaline induced relaxations. The results of the present study can be explained on the basis of the effect of hydralazine on adenylate cyclase-cyclic adenosine monophosphate (cAMP).

Nifedipine and blood glucose in normal human volunteers.

The effect of nifedipine, a calcium antagonist on fasting blood glucose level, glucose tolerance, glucose-induced insulin and glucagon secretion was studied in healthy nondiabetic volunteers. Nifedipine 10mg twice daily for four weeks did not affect fasting blood glucose level, glucose tolerance, glucose-induced insulin and glucagon secretion.

A study of some pharmacological actions of carbamazepine and sodium valproate.

Carbamazepine (CA) and sodium valproate (SV) were studied for their actions of central nervous system and neuromuscular junction. CA and SV given ip neither possessed analgesic nor hypothermic activity in rats, nor did they alter the pentobarbitone sleeping time in mice. The drug had no effect on the frog rectus muscle nor did they alter its responses to acetylcholine. Both CA and SV produced a dose related decrease in indirectly evoked contractions of rat diaphragm and cat gastrocnemius muscle without much altering the directly evoked responses. This effect may be due to their local anaesthetic property, which was observed in infiltration test in guinea pigs.

Local anaesthetic activity of some sec-amino-N-(aryl-aralkyl)-ethyl acetamides.

Six basic amides were screened for local anaesthetic activity and compared with procaine and lignocaine. Amongst the basic amides screened, piperidino-N-(alpha-4-ethoxy phenyl- beta-phenyl) ethyl and Diethylamino-N (alpha-4-ethoxy- beta-phenyl) ethyl acetamide were found to be more effective as compared to lignocaine. They were found to be non-irritant, and non-toxic even in high doses.