ABSTRACT
The American Academy of Neurology (AAN) has recently updated its practise advisory on antiseizure medication withdrawal. The recommendations have been formulated for pediatric as well as adult epilepsy, with emphasis on the risk factors for seizure relapse, occurrence of status epilepticus or death on drug withdrawal, and effect on quality of life in both age groups. We herein list the important aspects of the updated recommendations in pediatric epilepsy for the benefit of the general pediatricians. The full update is available at the AAN website.
ABSTRACT
Background: Thyroid diseases and diabetes mellitus, as comorbid condition these together throw a great burden to medicine and humanity. Considering the ever increasing population of diabetics in our country and the significant causal relationship established by current literature, this study was undertaken.Methods: A thorough clinical history regarding diabetes mellitus (onset, duration), any history of long-term illness, any previous thyroid dysfunction, previous history of any kind of drug therapy, whether the patient was on insulin or oral hypoglycaemic drugs was sought. All diabetic patients were evaluated for thyroid dysfunction by testing thyroid profile (T3, T4 and TSH).Results: In the present study, out of the 100 diabetic patients, 18 (18%) patients had thyroid dysfunction and 82 (82%) patients were found to be euthyroid. The prevalence of thyroid dysfunction more in females as compared to males (68.75% vs 31.25%) and highest in the age group of >60 years. The prevalence of thyroid dysfunction found to be more in patients with HbA1C >7 as compared to patients with HbA1C <7. Out of 18 diabetic patients who had thyroid dysfunction, 05 (27.78%) had duration of diabetes >1 - 5 years and 08 (44.44%) had duration of diabetes 6 - 10 years. The prevalence of thyroid dysfunction found to be more in patients who had BMI >30 and patients who were on both oral hypoglycaemic agents and insulin.Conclusions: There is a high prevalence of thyroid disorders in patients of type 2 diabetes mellitus which found to be more in Females, Elderly patients, Patients with uncontrolled diabetes and BMI > 30.
ABSTRACT
Introduction: There are various techniques available for securing limbal conjunctival auto graft in the treatment of primary pterygium. purpose of this study to compare the surgical outcome and cost effectiveness of a new techniqueautologous blood with electrocautery pen and current standard of fibrin glue. Materials and methods: This retrospective study was carried out in 76 patients presented with primarypterygia who underwent pterygium surgery using autologous blood with ecp (36 eyes) and fibrin glue (40 eyes). all patients were followed up post operatively on 1stday, 7thdayand 6th month. during follow up,patients were assessed for graft displacement or loss and comfort. cost of the surgery was also compared. Results: No intraoperative complications occurred in either group. out of 36 patients, 4 graft dislodgements occurred in autologous blood with ecp group on the immediate post-operative day. while none in fibrin glue group. during the 6 months follow-up, 6 eyes in group i (16.7%) and 1 eye in group 2 (2.5%) developed recurrence. Conclusion: Autologous blood with ecp in conjunctival autografting is as effective as fibrin glue in terms of graft adherence and post-operative patient comfort. however, this method is 3 times cost effective than the commercially available fibrin glue.
ABSTRACT
Objective: To study the socio-demographic and psychosocial correlates in patients with conversion disorder presenting with nonepileptic events and discuss its interventional implication. Material and Methods: This cross-sectional descriptive study was carried out in a tertiary care centre of eastern India from September 2008 to February 2009. 151 consecutive patients with conversion disorder satisfying the inclusion and exclusion criteria were selected. They were interviewed using semi-structured socio-demographic profile proforma, Holmes and Rahe stress scale for the exploration of psycho-social stressors. The data were entered on MS excel, analyzed by SPSS-version 16.0. Results: The psychosocial stressors were clearly identified in all patients. Almost ninety five (94.70%, n=143) out of the total 151 subjects had a history of stressors, while in the rest 4.95% no stressors could be established. The commonest stressors were Troubles with in-laws (26.49%), Death of close family member (11.92%) and Increase in argument with significant others (10.59 %). Conclusion: Significantly higher number of the patients presented with the stressor of troubles with in-laws, when assessed on the Holmes and Rahe Social Readjustment Rating Scale. Detection of exact nature of correlates has immense potential for therapeutic as well as preventive field.