An analysis of breakthrough seizures and related factors in paediatric epilepsy patients.

OBJECTIVE: To determine the frequency of breakthrough seizures among paediatric patients suffering from epilepsy, and factors related to the precipitation of these seizures. METHODS: The cross-sectional study was conducted from July 1, 2018, to July 1, 2020, at the Combined Military Hospital Lahore and the Military Hospital, Rawalpindi, Pakistan, and comprised children of either gender aged 2-12 years diagnosed with any type of epilepsy presenting at the children outpatient department. Diagnosis of epilepsy was established by either a consultant adult neurophysician or a consultant paediatrician. The presence of breakthrough seizures was assessed by obtaining detailed history from the patient and the primary caregiver. Socio-demographic profile, duration of epilepsy and poly-pharmacy were noted. Data was analysed using SPSS 23. RESULTS: Of the 450 subjects, 259(57.6%) were boys and 191(42.4%) were girls. The overall mean age was 6.353±4.732 years. The presence of breakthrough seizures was noted in 227(50.4%) subjects. Children with young age, with low family income, and those in need of poly-pharmacy showed significantly higher odds for breakthrough seizures (p<0.05). CONCLUSIONS: The incidence of breakthrough seizures in epileptic children was high despite the anticonvulsant agents that were previously effective in controlling seizures.

Psychiatric morbidity among informal caregivers of children suffering from intellectual developmental disorders.

OBJECTIVE: To assess the presence of psychiatric morbidity and associated socio-demographic factors among informal caregivers of children suffering from intellectual developmental disorders. METHODS: The analytical cross-sectional study was conducted at the Neurology Department of a tertiary care hospital in Rawalpindi, Pakistan, from January 1, 2018, to December 31, 2019, and comprised informal caregiver of children diagnosed with intellectual developmental disorders presenting at the paediatric or neurology outpatient clinics of the hospital. Intellectual developmental disorder was diagnosed by consultant neurologists or psychiatrists or paediatricians on the basis of International Classification of Diseases-11 criteria. Psychiatric morbidity in the informal caregiver was assessed using the 12-item general health questionnaire. Data was analysed using SPSS 23, and binary logistic regression was applied to assess association. RESULTS: Of the 500 informal caregivers, 323(64.6%) showed psychiatric morbidity. Increasing age and comorbid epilepsy among the patients were significantly related to the presence of psychiatric morbidity among the informal caregivers (p<0.05). CONCLUSIONS: Majority of informal caregivers of children with learning difficulties were found to have psychiatric morbidity.

Association between migraine and Body Mass Index in patients reporting at a military hospital, Rawalpindi.

The objective of this study was to determine the association between Body Mass Index (BMI) and migraine. This prospective study took place from 5th February, 2017 to 5th August, 2017 at a Military Hospital in Rawalpindi. Migraine in subjects was diagnosed according to the ICHD-III criteria by clinicians after taking an informed, written consent from 78 patients and the data was analysed using SPSS 22. Of the 78 patients, 35(44.9%) were males and 43(55.1%) were females. Out of the 78 subjects, 9(11.5%) were underweight, 33(41.0%) were of normal weight, 9(14.10%) were overweight, 19(24.4%) were obese and 7(9.0%) were morbidly obese. The p-value calculated was 0.892 which indicates no significant evidence of any association between BMI and migraine in the survey population reporting at the Rawalpindi Military Hospital. A follow-up study at a national level with much larger sample size will be able to better predict the changing results in our country, because as of now the association between BMI and migraine is debatable.