Psychogenic nonepileptic seizures in children and adolescents: An international cross-cultural study.

PURPOSE: We compared various clinical characteristics of psychogenic nonepileptic seizures (PNES) between young patients from Iran, Saudi Arabia, and Canada, three nations with significantly different socioeconomic and demographic characteristics. This international cross-cultural comparative study may advance our knowledge and understanding of PNES in children and adolescents across the cultures and borders. METHODS: In this retrospective study, we investigated all patients 16 years of age or younger, with PNES admitted to the epilepsy monitoring units at one center in Iran, one center in Saudi Arabia, and one center in Canada. Age, gender, age at seizure onset, seizure semiology, seizure frequency, factors potentially predisposing to PNES, and video-electroencephalography (EEG) recording of all patients were registered routinely and compared between the nations. RESULTS: Fifty-one patients were studied (22 from Iran, 14 from Saudi Arabia, and 15 from Canada). Age at the diagnosis was 13.4 ±â€¯2.2 years (range: 8-16 years), and age at the onset of seizures was 12.3 ±â€¯2.7 years (range: 5-16 years). Demographic and clinical characteristics of and associated factors in the patients among the three nations were not significantly different. Twenty-six (51%) patients were taking antiepileptic drugs at the time of diagnosis; the difference was not statistically significant between the nations (13 patients in Iran, 6 in Saudi Arabia, and 7 patients in Canada; P = 0.5). CONCLUSION: Young patients with PNES across borders and between cultures share more similarities than differences with regard to their demographic and clinical characteristics.

Species-specific kinetics and zonation of hepatic DNA synthesis induced by ligands of PPARalpha.

Peroxisome proliferator-activated receptor alpha (PPARalpha) ligands evoke a profound mitogenic response in rodent liver, and the aim of this study was to characterize the kinetics of induction of DNA synthesis. The CAR ligand, 1,4-bis[2-(3,5-dichoropyridyloxy)]benzene, caused induction of hepatocyte DNA synthesis within 48 h in 129S4/SvJae mice, but the potent PPARalpha ligand, ciprofibrate, induced hepatocyte DNA synthesis only after 3 or 4 days dosing; higher or lower doses did not hasten the DNA synthesis response. This contrasted with the rapid induction (24 h) reported by Styles et al., 1988, Carcinogenesis 9, 1647-1655. C57BL/6 and DBA/2J mice showed significant induction of DNA synthesis after 4, but not 2, days ciprofibrate treatment. Alderley Park and 129S4/SvJae mice dosed with methylclofenapate induced hepatocyte DNA synthesis at 4, but not 2, days after dosing and proved that inconsistency with prior work was not due to a difference in mouse strain or PPARalpha ligand. Ciprofibrate-induced liver DNA synthesis and growth was absent in PPARalpha-null mice and are PPARalpha dependent. In the Fisher344 rat, hepatocyte DNA synthesis was induced at 24 h after dosing, with a second peak at 48 h. Lobular localization of hepatocyte DNA synthesis showed preferential periportal induction of DNA synthesis in rat but panlobular zonation of hepatocyte DNA synthesis in mouse. These results characterize a markedly later hepatic induction of panlobular DNA synthesis by PPARalpha ligands in mouse, compared to rapid induction of periportal DNA synthesis in rat.

Patterns of breastfeeding practice during the first 6 months of life in Saudi Arabia.

OBJECTIVE: To assess the breastfeeding practices in the first 6 months of infants at King Abdulaziz Medical City (KAMC), Riyadh, Kingdom of Saudi Arabia. METHODS: A cross-sectional study was carried out at KAMC in 2005. Infants who attended the primary care centers and well-baby clinic of the hospital for the 6-month's vaccine were included. Mothers were interviewed to collect information on the mothers, infants, and their breastfeeding practice. World Health Organization definitions were used for classification of infant nutrition patterns. RESULTS: Five hundred seventy eight infants were included in this study. The breastfeeding initiation among the sample was 95%. Most mothers supplemented the infants with milk formula (83.4%) or fluids (94%) during the first 6 months. The percent of exclusive breastfeeding was 1.7% and the partial breastfeeding breast milk with formula was the most common type of feeding (78.8%). Lactation duration dropped to 50% at 6 months of age. Factors favoring the milk formula use were introduction of the formula in the first day of life and maternal reasons of inadequate milk. Lactation duration and formula introduction were found to be significantly associated with mothers' parity, working status, and combined contraceptive pill use. CONCLUSION: Prevalence of exclusive breastfeeding was extremely low in our population. Partial breastfeeding was the trend for feeding in the first 6 months of life, which was accompanied with rapid decline in lactation duration.