ABSTRACT
Abstract: Epilepsy is one of the most common neurological disorders, affecting approximately 50 million people worldwide. Medications are still the most common therapeutic choice for seizure control. In clinical practice anti-epileptic drugs that were licensed before valproate are called traditional antiepileptic drugs while those licensed after valproate are called new generation antiepileptic drugs
Objective: To compare the efficacy of sustained release formulation of valproate and topiramate monotherapy for control of epilepsy in elliptic patients. Study design: Randomized controlled trial. Setting: OPD, Medical Department, Allied hospital Faisalabad. Duration of study: 6 months duration after approval of synopsis from 30-07-2015 to 30-11-2015
Methodology: Patients with definite diagnosis of epilepsy with generalized tonic clonic seizures between 13 to 17 years of both genders were recruited from medical ward and OPD who fulfilled the inclusion were enrolled in the study. After approval from hospital ethical review committee. Informed consent was taken from each participant of the study. Patients were divided randomly into group A and group B using computer generated random number table. Group A was given sustained released formulation of valproate 500mg once a day and titrated up with weekly increments of 250mg/per day up to maximum of 2000mg/day in two divided doses to control seizures. Group B was given topiramate 25mg twice daily and titrated up in increments of 50 mg weekly to control seizures up to a maximum of 800 mg per day in 2 divided doses. Follow up was done by telephonic contact by asking about control of generalized tonic clonic seizures. Data was collected through self-conducted interviews using a standardized proforma. Efficacy was measured in terms of control of seizures
Results: In our study out of 330 cases, 165 in each group, 41.82%[n=69] in group-A and 40%[n=66] group-B were between 13-40 years of age while 58.18%[n=96] in group-A and 60%[n=99] in group-B were between 41-70 years of age ,mean was calculated as 41.79 +/- 10.66 and 42.12 +/- 10.37 years, 61.21%[n=101] in group-A and 54.55%[n=90] in group-B were male while 38.79%[n=64] in group-A and 45.45%[n=75] in group-B were females. Comparison of efficacy in both groups shows that 39.39%[n=65] in group-A AND 25.45%9[n=42] in group-B were treated effectively, p value was calculated as 0.006 showing a significant difference
Conclusion: We concluded that the efficacy of sustained release formulation of valproate is significantly higher when compared topiramate monotherapy for control of epilepsy in epileptic patients
ABSTRACT
Introduction: Chronic obstructive pulmonary disease [COPD] is defined as a disease state characterized by airflow limitation that is not fully reversible. FEV1/FEV6 is a new more reliable spirometric index, which is derived from maneuvers that can be performed more easily and can detect early airway obstruction
Objective: To determine the diagnostic accuracy of FEV1/FEV6 by taking FEV1/FVC as gold standard in the detection of airway obstruction in chronic smokers. Study Design: Cross sectional [Validation] study. Setting: This study was conducted in the Department of Medical Unit-II, Allied Hospital Faisalabad. Duration with Dates: Six months from 01-12-2014 to 31-05-2015
Subjects: A total of 192 patients were enrolled from Medical OPD of Allied Hospital Faisalabad. Every patient was asked to take three practice attempts before actual readings were taken to avoid technical error. The patient was asked to breathe in as deeply as possible and then exhale. The both FEV1/FVC and FEV1/FEV6 were calculated for each patient
Results: The mean age of the patients were 42.1 +/- 8.9 years. There were 152 [79.2%] male and 40 [20.8%] female patients. The sensitivity of FEV1/FEV6 in the detection of airway obstruction was 88%, specificity 94%, positive predictive value 95%, negative predictive value 85% and diagnostic accuracy 91%
Conclusion: It is concluded from this study that FEV1/FEV6 is a sensitive and specific test for the diagnosis of airway obstruction. FEV1/FEV6 can be used as a valid alternative for FEV1/FVC in the diagnosis of airway obstruction