efficacy and safety of zonisamide as an add-on drug in the treatment of Lennox-Gastaut syndrome

The Lennox-Gastaut syndrome [LGS: the triad of intractable seizures of various types, a slow spike-wave pattern in EEG and mental retardation] is one of the most difficult epilepsy syndromes to treat. The aim of this study was to evaluate the efficacy and safety of zonisamide [ZNS] as add-on therapy in seizures of children with LGS. In a quasi-experimental study, seizure frequency and side effects of 40 children with LGS who were referred to the pediatric neurology clinic of Shaheed Sadoughi University of Medical Sciences, Yazd, Iran, between September 2008 and November 2009 and were on ZNS for six months were evaluated. Twenty one boys and 19 girls with a mean age of 6.6 +/- 3.6 years were evaluated. At the end of six months of treatment with ZNS, 25% became seizure free, 25% had >50% reduction in seizure frequency while 35% did not have a notable change in seizure frequency and 15% experienced an increase in seizure frequency. Drug was effective in 62.5% of the myoclonic and generalized tonic-clonic, 50% of the atonic, 43% of the mixed type and 33.4% of the tonic seizures. Transient side effects were seen in 25% of the patients: drowsiness in 10%, hyperthermia in 5% and irritability, fatigue, ataxia and anorexia [each one] in 2.5% of the patients. No serious side effects were reported. ZNS could be considered as an add-on therapy in the management of intractable epilepsy in LGS

Determination of the percentage of blood free leptin hormone in diabetic patients after treatment with metformin

Plasma leptin exists in protein-bound and free forms, which may affect its hormonal bioactivity. The free and bound forms are changed by the body weight. The purpose of this study was to evaluate the effect of metformin on bound and free plasma leptin concentration. Subjects recruited from Yazd Diabetes Research Centre, Yazd University of Medical Sciences. The participants were new cases of obese type 2 diabetes [BMI > 30 kg/ m2]. Fasting bloods samples, before and after one month treatment with motorman collected. These samples used for the purification of free leptin by HPLC method and analysis of other biochemical parameters. The results indicated that, there was no significant difference observed between the free leptin forms before and after the one month treatment [71% +/- 4.2vs 72 +/- 5]. The one month treatment, reduced blood sugar in patients, but at the same time it did not have a reduction effect on the body weight. Therefore, in the free form of hormone after treatment comparing to before treatment it did not make a significant difference. This confirmed other reports which showed that the variation of free leptin depended on the body weight

Gastrointestinal manifestations of patients with Chronic Granulomatous Disease

Chronic Granulomatous Disease [CGD] represents a group of inherited disorders of phagocytic system, manifesting recurrent infections at different sites. The present study was accomplished in order to determine the gastrointestinal manifestations of CGD patients. Fifty-seven patients [38 males and 19 females] with CGD, who had been referred to three immunodeficiency referral centers in Iran, were studied during a 24-year period [1980-2004]. The median age at the time of study was 14.5 years old [1-56 years]. The median onset age of symptoms was 5 months [1 month - 13.75 years], and that of diagnostic age was 5 years [2 months- 54.1 years], with a diagnostic delay of 33 months, on average. Seven patients were presented with acute diarrhea, 3 with oral candidiasis, and 2 with liver abscesses as the first chief complaints. Twenty-four cases [42.1%] had been complicated by gastrointestinal manifestations during their course of the disease. Of those, 12 cases [21.1%] had diarrhea, 7 [12.3%] oral candidiasis, 5 [8.8%] hepatitis, 4 [7.0%] hepatic abscess, and 2 cases [3.5%] gastric outlet obstruction. Also, failure to thrive was detected in 6 patients [10.5%]. Four patients died [7%]. CGD should be excluded in any patient with gastrointestinal manifestations especially chronic diarrhea, hepatic abscess, and gastric outlet obstruction

Effect of ATP-dependent K+ channel openers and blockers on serum concentration of aldosterone in rats

There are many reports for involvement of ATP-sensitive potassium channels in pancreatic, cardiac and vascular smooth muscle cells. This study examined the effect of single doses of K+ channel openers; diazoxide, minoxidil and K+ channel blockers; chlorpropamide, glibenclamide on serum concentration of aldosterone in male rats. Blood samples were obtained 60 minutes after drug treatment and serum aldosterone level was determined by RIA. The basal serum aldosterone was 659.32 +/- 71.48 pg/ml and after diazoxide or minoxidil administration increased to 1188.53 +/- 99.45 pg/ml and 1392.69 +/- 177.83 pg/ml, respectively. Chlorpropamide or glibenclamide treatment did not produce any change in basal serum aldosterone concentration, but in early streptozotocin-induced diabetic rats decreased serum aldosterone level significantly [P<0.001]. Pretreatment with glibenclamide blocked aldosterone response to diazoxide but did not affect aldosterone response to exogenous ACTH to the same extent. Effect of diazoxide in insulin-treated rats was approximately similar to that of normal rats. Comparison of blood glucose concentration determined in normal, insulin treated and diabetic rats after different drug administration showed that there is no correlation between blood glucose level and the responses observed in serum hormone concentration. The results indicate that regulatory processes involved in the secretion of aldosterone are responsive to drugs affecting glibenclamide-sensitive K+ channels