ABSTRACT
Objective: Childhood stroke is linked to high personal costs for affected children and their families since more than half of the survivors are impaired for a long time, hampering their normal development and lifestyle. Thus, the present study aimed to evaluate the neurological developmental outcomes of children admitted to Namazi hospital, Shiraz, Iran, for ischemic and hemorrhagic stroke with a five-year follow-up. Ma a retrospective cohort study on children admitted to Namazi Hospital due to ischemic and hemorrhagic stroke during the past three years (2012-2015). The information was collected by reviewing the medical records and clinically visiting the patients on follow-up. The SPSS 21.0 software was used for statistical analysis. Materials & Method: This is a retrospective cohort study on children admitted to Namazi hospital due to ischemic and hemorrhagic stroke during past three years (2012-2015). The information was collected by reviewing the medical records and clinically visiting the patients at the time of follow up. The SPSS 21.0 software was used for statistical analysis Settings. Results: The patients' mean age at the time of stroke was 6.87 ± 4.60 years. The mean follow-up period was 3.5 ± 1.64 years. 53.1% of the children (N=17) were diagnosed with hemorrhagic stroke, and 46.9% (N=15) with ischemic stroke. The most frequent symptoms first presented by the study population were a decrease in the level of consciousness (LOC) (40.6%), headaches (37.5 %), and hand/arm/leg weakness (34.4%), respectively. The number of patients in the poor.and severe outcome group was 73.3% in the ischemic and 52.9% in the hemorrhagic group. Conclusion: Hemorrhagic stroke was slightly more frequent than ischemic stroke, and stroke was more frequent in boys. A decrease in LOC and headaches were the most common symptoms upon admission. The left sensorimotor area was the most involved in both ischemic and hemorrhagic groups. In addition, trauma was the most common cause of stroke in this study population.
ABSTRACT
OBJECTIVES: Previous studies in adults with epilepsy revealed a higher prevalence of metabolic syndrome, resulting in cerebrovascular and cardiovascular events. However, there is insufficient data about body composition and metabolic syndrome in children, especially in the Middle Eastern region. We aimed to investigate metabolic syndrome criteria and body composition in ambulatory children with Epilepsy in Southern Iran. MATERIAL & METHODS: Seventy seven epileptic children with an average age of 11.4 ± 3.2 years and their age-gender-matched controls were included in this study. Anthropometric data, lipid profile, blood glucose, and blood pressure were checked. Body composition was also evaluated by Hologic system dual-energy X-ray absorptiometry. RESULTS: The prevalence of metabolic syndrome as well as the fat mass index in patients were higher than the controls, and p values are 0.032 and 0.012, respectively. Moreover, the lean mass with Bone Mineral Content (BMC) index was detected lower than the controls (P= 0.017).Regarding drugs consumption, serum triglyceride and the blood pressure in patients who receiving carbamazepine was higher than the control individuals with P = 0.019, Beta = 0.379 and P = 0.016, Beta = -0.26, respectively. Fat mass index was also higher in patients using sodium valproate (P = 0.031, Beta = 0.238). CONCLUSION: Our study revealed that children with epilepsy are more prone to metabolic syndrome and higher body fat mass. Therefore, early diagnosis and prevention of metabolic syndrome criteria in patients with epilepsy, With performing regular exercise and having a healthy diet should be encouraged in these children.
ABSTRACT
Epilepsy might have adverse effect on bone density due to underlying disease, drugs, vitamin D deficiency, immobilization and malnutrition. We investigated the bone mineral density in ambulatory vitamin-D supplemented children with epilepsy. This case-control study was conducted on 90 epileptic children aged 11.4 ± 3.3 years, and age and gender matched controls in pediatric neurology clinics of Shiraz, in Southern Iran, 2016. Anthropometric measurements, puberty, sun exposure, physical activity and biochemical variables were assessed. Bone mineral density was evaluated by dual-energy X-ray absorptiometry method. Data were analyzed by SPSS.v21. Prevalence of low bone mass in femur was more in patients (27%) than the controls (9%) (P value = 0.002). Age, weight Z score and height Z score were the most significant associated factors on lumbar BMD, BMAD, and femur BMD. Seizure duration and how it responded to anticonvulsants were the most associated factors with both lumbar and femur bone density. Sodium valproate and carbomazepin usage had negative association with lumbar Z score (beta = - 0.216, P = 0.017 and beta = - 0.336, P = 0.027, respectively). We hypothesized that epilepsy per se could affect bone density by an unknown pathophysiology, which was independent from vitamin D deficiency, effects of anticonvulsant and physical activity.
