RESUMO
OBJECTIVE: To evaluate the efficacy of the ketogenic diet in Indian children with uncontrolled epilepsy. STUDY DESIGN: Prospective observational study. SETTING: Hospital based. PATIENTS: 105 children (age 4 months to 18 years) with uncontrolled epilepsy enrolled in the ketogenic diet program over a period of 9 years and followed up for 25.7+/- 20.3 months (median:17 months) on the ketogenic diet. MAIN OUTCOME MEASURES: Reduction in seizure frequency and comparison of improvement in two main groups of epilepsies, namely epileptic encephalopathies and localization related epilepsies. RESULTS: Thirty seven (35%) out of 105 children dropped out of the study and 68 remained on the diet. Thirty nine (37%) achieved 100% control, 23 (22%) achieved between 90 and 99% control, 7 (6.8%) achieved between 75 and 90% control, and 16 (15.2%) achieved between 50 and 75% control. Twenty (19%) achieved less than 50% control. Epileptic encephalopathies had a better response than localization related epilepsies. CONCLUSION: The Indian version of ketogenic diet used is well tolerated and efficacious in controlling difficult-to-control epilepsy in children. Epileptic encephalopathies respond better than localization related epilepsies.
Assuntos
Dieta Cetogênica/métodos , Resistência a Medicamentos , Epilepsia , Adolescente , Criança , Pré-Escolar , Epilepsia/dietoterapia , Epilepsia/tratamento farmacológico , Epilepsia/epidemiologia , Feminino , Humanos , Incidência , Índia/epidemiologia , Lactente , Masculino , Prevalência , Resultado do TratamentoRESUMO
OBJECTIVE: To test couples with three or more consecutive recurrent miscarriages for suitability of the mother for immunization with paternal lymphocytes. SETTING: Regional transfusion centre, patients referred by local obstetricians. PATIENTS AND INTERVENTIONS: Women treated were from 103 couples with > or = 3 consecutive recurrent miscarriages and no more than one live birth. HLA sharing and frequencies were investigated, and contrasted with control data. Patients showed increased sharing versus control (but not in comparison with gene frequencies of the county population). Sixty-eight mothers were finally found suitable and immunized with paternal lymphocytes. OUTCOME MEASURES: Pregnancy and live births. RESULTS: 55/68 conceived, with 30 live births resulting; 8/13 additional successes after repeat (booster) immunization. CONCLUSIONS: This treatment still suffers from the lack of clear criteria for patient selection, and it should be submitted to a prospective controlled double-blind trial.
