Self-Perceived Seizure Precipitants among Patients with Epilepsy in Middle-Belt of Nigeria

Aim: Patient's perception of seizure precipitant is crucial in epilepsy management; but it is often overlooked by physicians. This may be due to neglect and underestimation of its importance. This study looked at frequency and nature of self-perceived seizure precipitants among patients with epilepsy. Materials and Methods: A close-ended questionnaire-based study. Patients with active epilepsy (=2 attacks/year) were recruited from the neurology clinic of the University of Ilorin Teaching Hospital (UITH); Ilorin. Result: A total of 89 patients participated in the study and of these 41 (46.1) were males. Their median age was 30 (21-52) years and median age at seizure onset was 22 (15-46) years. The median seizure duration was five (2-14) years. More patients (46.1) had less than secondary school education and 12 (13.5) were uneducated. Generalized epilepsy was the predominant (68.6) seizure type. A total of 33 (37.1 subjects had =4 attacks/year; 29 (32.6) had 5-12 attacks/year; and 27 (30.3) 12 attacks/year. A total of 16 (18) subjects did not mention any seizure precipitant; whereas 73 (82.2) reported at least one specific seizure precipitant; of these; 62 (85) patients reported =2 precipitants. Stress (41); inadequate sleep (27); and head trauma (26) were the three leading seizure precipitants mentioned. Subject's age; sex; level of seizure control; and place of abode did not influence reported seizure precipitants. However; the more educated (12 years education) patients significantly reported stress as seizure precipitant (P 0.05). Most (80) patients rightly indicated that antiepileptic drug was the best treatment for their seizure control. Conclusion: The result of this study showed that the leading perceived seizure precipitants among epilepsy patients attending the neurology clinic of UITH were stress; inadequate sleep; head trauma; and demonic attacks and spells

Self-perceived seizure precipitants among patients with epilepsy in Middle-belt of Nigeria.

AIM: Patient's perception of seizure precipitant is crucial in epilepsy management, but it is often overlooked by physicians. This may be due to neglect and underestimation of its importance. This study looked at frequency and nature of self-perceived seizure precipitants among patients with epilepsy. MATERIALS AND METHODS: A close-ended questionnaire-based study. Patients with active epilepsy (≥2 attacks/year) were recruited from the neurology clinic of the University of Ilorin Teaching Hospital (UITH), Ilorin. RESULT: A total of 89 patients participated in the study and of these 41 (46.1%) were males. Their median age was 30 (21-52) years and median age at seizure onset was 22 (15-46) years. The median seizure duration was five (2-14) years. More patients (46.1%) had less than secondary school education and 12 (13.5) were uneducated. Generalized epilepsy was the predominant (68.6%) seizure type. A total of 33 (37.1%) subjects had ≥4 attacks/year, 29 (32.6%) had 5-12 attacks/year, and 27 (30.3%) >12 attacks/year. A total of 16 (18%) subjects did not mention any seizure precipitant, whereas 73 (82.2%) reported at least one specific seizure precipitant; of these, 62 (85%) patients reported ≥2 precipitants. Stress (41%), inadequate sleep (27%), and head trauma (26%) were the three leading seizure precipitants mentioned. Subject's age, sex, level of seizure control, and place of abode did not influence reported seizure precipitants. However, the more educated (>12 years education) patients significantly reported stress as seizure precipitant (P < 0.05). Most (80%) patients rightly indicated that antiepileptic drug was the best treatment for their seizure control. CONCLUSION: The result of this study showed that the leading perceived seizure precipitants among epilepsy patients attending the neurology clinic of UITH were stress, inadequate sleep, head trauma, and demonic attacks and spells.

Phenolic compounds from sandpaper (ficus exasperata) leaf inhibits angiotensin 1 converting enzyme in high cholesterol diet fed rats.

ETHNOPHARMACOLOGICAL RELEVANCE: Sandpaper [Ficus exasperata Vahl (Moraceae)] leaf has been reportedly used in folklore for the management/treatment of cardiovascular diseases with little/or no scientific basis for their action. This study sought to investigate the effect of dietary supplementation of sandpaper leaf on angiotensin-I converting enzyme (ACE) activity in hypercholesterolemia as well as the effect of their phenolic extract on this enzyme in vitro. MATERIALS AND METHODS: The phenolic extract was prepared, then, the inhibitory effect of the leaf extract on ACE was determined in vitro. Thereafter, the effect of dietary supplementation of sandpaper leaf on angiotensin-I converting enzyme (ACE) activity in high cholesterol diet fed rats for 14 days was evaluated as well as some biochemical parameters. RESULTS: The result revealed that under in vitro condition, the phenolic extract inhibited ACE (IC50=14.7µg/mL) in a dose-dependent manner (0-10µg/mL). Feeding high cholesterol diets to rats caused a significant (P<0.05) increase in the ACE activity. However, there was a significant (P<0.05) decrease in the ACE activity as a result of supplementation with the sand paper leaves. Furthermore, there was a significant (P<0.05) increase in the plasma lipid profile with a concomitant increase in malondialdehyde (MDA) content in rat liver and heart tissues. However, supplementing the diet with sandpaper leaf (either 10% or 20%) caused a significant (P<0.05) decrease in the plasma total cholesterol (TC), triglyceride (TG), very low density lipoprotein-cholesterol (VLDL-C), and low-density lipoprotein-cholesterol levels (LDL-C), and in MDA content in the tissues. Conversely, supplementation caused a significant (P<0.05) increase in plasma high-density lipoprotein-cholesterol level when compared with the control diet. Reversed phase HPLC analysis of the extract revealed Quercitrin (43.7mg/g), chlorogenic acid (42.8mg/g) and caffeic acid (33.9mg/g) as the major phenolics in the leaf. CONCLUSION: The inhibition of ACE activity and prevention of hypercholesterolemia by sandpaper leaf could be part of the possible mechanism underlying its anti-hypertensive property which could lay credence to its use in folk medicine. However, these activities may be directly/indirectly attributed to the polyphenolics present.

Inhibition of α-amylase and α-glucosidase activities by ethanolic extract of Telfairia occidentalis (fluted pumpkin) leaf.

OBJECTIVE: To investigate the inhibitory effect of Telfairia occidentalis Hook f. (Curcubitaceae) (T. occidentalis) leaf on key enzyme linked to type-2 diabetes (α - amylase and α - glucosidase) as well as assess the effect of blanching (a commonly practiced food processing technique) of the vegetable on these key enzymes. METHODS: Fresh leaves of T. occidentalis were blanched in hot water for 10 minutes, and the extracts of both the fresh and blanched vegetables were prepared and used for subsequent analysis. The inhibitory effect of the extract on α - amylase and α - glucosidase activities as well as some antioxidant parameter was determined in vitro. RESULTS: The result revealed that unprocessed T. occidentalis leaf reduce Fe(3+) to Fe(2+) and also inhibited α - amylase and α - glucosidase activities in a dose dependent manner. However, blanching of the leafy vegetables caused a significant (P<0.05) increase in the antioxidant properties but decrease their ability to inhibit α - amylase and α - glucosidase activities. CONCLUSIONS: This antioxidant properties and enzyme inhibition could be part of the mechanism by which they are used in the treatment/prevention of type-2 diabetes. However, the blanched vegetable reduces their ability to inhibit both α - amylase and α - glucosidase activity in vitro.