scholarly journals COGNITIVE ADVERSE EFFECTS OF LACOSAMIDE IN PATIENTS WITH LOCALIZATION RELATED EPILEPSY - A PROSPECTIVE OBSERVATIONAL STUDY

Author(s):  
Sophia B Modi ◽  
Asha S ◽  
Thomas Iype ◽  
Libu GK ◽  
Reeja Rajan

More than 30% of epilepsy patients remain refractory to pharmacotherapy. Combined administration of AEDs or the application of novel AEDs is a therapeutic option especially when surgical treatment cannot be offered. The newer AEDs offer new mechanisms of action and more favourable safety profiles than the older AEDs. Lacosamide (LCM) is one of the third generation AEDs approved for adjunctive use in partial-onset seizures. Patients with epilepsy frequently experience cognitive dysfunctions. Because antiepileptic drugs (AEDs) are the major therapeutic modality for epilepsy, the adverse effects of AEDs on cognition are important. Objectives: This study was conducted to obtain reliable data on the cognitive adverse effects of lacosamide in Indian population. METHODOLOGY : An open labelled prospective observational study in 22 patients who suffered from localization related epilepsy. Results: Average Initial seizure frequency per month was 3.56 (SD 2.58) and median frequency 2.5 seizures per month. Range being 1-8 per month. At the final followup at 6months, only 2 persons experienced seizure and that too only single episodes. The difference in frequency is statistically significant (Wilcoxon Signed Ranks TestP <0.001). All the pre and post lacosamide cognition scores showed statistically significant positive correlation in this study. Conclusion: Excellent seizure control is observed in patients with refractory localization related epilepsy treated with lacosamide. Also, lacosamide has no serious adverse effects or drug interactions. In this study, it is observed that unlike many AEDs, lacosamide contributed to significant improvement in cognition and can improve the quality of life in such patients.

Author(s):  
Dr. Sophia B Modi, MD ◽  
Dr. Asha S, MD ◽  
Dr. Thomas Iype, MD, MRCP(UK), FRCP(Edin), DM ◽  
Dr. Libu Gnanaseelan Kanakamma, MD ◽  
Mrs. Reeja Rajan, Neuropsychologist

Objectives: This study was conducted to obtain data on the cognitive effects of lacosamide in Indian population. Methodology: An open labelled prospective observational study in 22 patients who suffered from focal epilepsy. Results: All the pre and post lacosamide cognition scores showed statistically significant positive correlation in this study. Average initial seizure frequency per month was 3.56 (SD 2.58) and median frequency 2.5 seizures per month. Range being 1-8 per month. At the final follow-up at 6months, 87.5% of the study subjects had no seizures. In the remaining12.5% of patients, reduction in seizure frequency was observed. The difference in frequency is statistically significant (Wilcoxon Signed Ranks TestP <0.001). Conclusion: Excellent seizure control is observed in patients with refractory focal epilepsy treated with lacosamide. Also, lacosamide has no serious adverse effects or drug interactions. In this study, it is observed that unlike many AEDs, lacosamide contributed to significant improvement in cognition.


2018 ◽  
Vol 88 ◽  
pp. 349-356 ◽  
Author(s):  
Kamil Detyniecki ◽  
Jane O'Bryan ◽  
Tenzin Choezom ◽  
Grzegorz Rak ◽  
Chanthia Ma ◽  
...  

2021 ◽  
Vol 12 (12) ◽  
pp. 44-49
Author(s):  
Appandraj S ◽  
Sivagamasundari V ◽  
Varatharajan Sakthivadivel

Background: The Jigsaw method is a form of cooperative learning, in which students are actively involved in the teaching-learning process that improves the long-term retention of acquired knowledge. Aims and Objectives: The objective of this study was to assess the knowledge acquired by students using the Jigsaw learning method in Internal Medicine. Materials and Methods: A prospective observational study was conducted with 100 students. The acute coronary syndrome was taken for 1 h as a didactic lecture, and a pre-test was conducted. The students were divided into five groups and were put for the intervention “Jigsaw.” The pre- and post-test were conducted, and feedback was collected from the students. Paired t-test was used to perform analysis of pre- and post-test. Feedback evaluation was done by a 5-point Liker scale. P<0.05 was considered statistically significant, and the data were analyzed using CoGuide software. Results: The mean pre-test score was 8.44 ± 2.33 ranged (3–14) and the mean post-test score was 11.03 ± 2.07 (ranged 6–15). The difference of 2.39 (95% CI: 2.19–2.59) increase in marks post-test after the Jigsaw method was statistically significant (P<0.001). The satisfaction level was 50–55% on the Likert scale based on the questionnaire given. There was a significant improvement in the post-test scores of the students after Jigsaw. Conclusion: The Jigsaw method improved knowledge in the short-term by engaging students in group work and motivation to learn. Overall response based on the questionnaire about the Jigsaw method was positive.


2020 ◽  
pp. 60-62
Author(s):  
Narendra Nath Hait ◽  
Brahmarshi Das ◽  
Ratan Chandra Mandal ◽  
Haricharan Roy ◽  
Debarshi Jana

Background: Threatened abortion is till most common cause of early trimester bleeding PV and can be diagnosed and managed by early USG diagnosis. Materials and methods: This was a prospective observational study. Place of the study was Department of Obstetrics and Gynaecology and Department of Radiodiagnosis, Midnapore Medical College and Hospital from January 2019 to June 2020. Eighteen months. Result: When the clinical method to diagnose threatened miscarriage was compared to the sonographic method, it was evident that sonographic method was reliable than the clinical method and the difference was statistically significant. Conclusion: In case of missed miscarriage and complete miscarriage, although the percentage of discrepancy was 100%, on further statistical analysis, the discrepancy was not statistically significant. And the cause behind this was probably inadequate sampling.


2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Amalia Papanikolopoulou ◽  
Nikolaos Syrigos ◽  
Louisa Vini ◽  
Maria Papasavva ◽  
Georgios Lazopoulos ◽  
...  

Author(s):  
Nithya Krishnakumar ◽  
N. K. Bashir ◽  
Girish Raj

<p class="abstract"><strong>Background:</strong> Adenoidectomy is one of the most common surgeries done in children. Over the years many techniques have evolved like powered adenoidectomy, radiofrequency ablation, electro cautery etc. Use of endoscopes has enabled surgeons to perform adenoidectomy under direct vision. The objectives of the study were to compare blood loss of conventional and endoscopic assisted powered adenoidectomy.</p><p class="abstract"><strong>Methods:</strong> In this a prospective observational study of 30 children attending ENT department in MES Medical College was done. In the conventional technique, adenoidectomy was done using St Claire Thomson adenoid curette. In powered adenoidectomy technique, micro debrider was used under guidance of 0<sup>0</sup> nasal endoscope (2.7 mm). Intra operatively blood loss during surgery were looked for and noted in both groups.  </p><p class="abstract"><strong>Results:</strong> In the study of 30 children divided in to 2 groups who are comparable statistically. Average blood loss in patients who underwent CA was 38.53 ml and in patients who underwent EAA was 28.27 ml, with standard deviation of 4.704 and 3.863 respectively. The difference in mean blood loss was 10.26 ml.</p><p class="abstract"><strong>Conclusions:</strong> Endoscopic assisted powered adenoidectomy has lower blood loss as compared to conventional adenoidectomy.</p>


2021 ◽  
Vol 10 (20) ◽  
pp. 1515-1518
Author(s):  
Siri Kandavar ◽  
Sampathila Padmanabha

BACKGROUND Post-operative nausea and vomiting is a complication of general anaesthesia but can also be seen less commonly in regional anaesthesia. The uneasiness and discomfort associated with it can make the post-operative period eventful. We conducted this study to evaluate if sevoflurane and propofol used in maintenance of anaesthesia have any influence on post-operative nausea and vomiting. METHODS We included 64 patients in this prospective observational study who were undergoing elective otorhinolaryngology surgery belonging to American Society of Anaesthesiologist (ASA) PS I and II. After induction of general anaesthesia and endotracheal intubation, Group P received propofol at 100 - 200 mcg / kg / hr and group S received sevoflurane as maintenance anaesthetics agent at 1.5 - 2 %. All the patients were given ondansetron intravenously in the intra-operative period. Anaesthetic agents used for maintenance was stopped at the end of the surgery and patients were extubated and shifted to post-operative care unit. Patients were assessed for any occurrence of post-operative nausea and vomiting after extubation for 24 hours. RESULTS There were 2 (6.25 %) patients in the propofol group and 12 (37.5 %) patients in the sevoflurane group who had post-operative nausea and vomiting in the first hour. The difference in the nausea and vomiting between the groups was statistically significant with (P value of 0.0046) higher incidence in sevoflurane group. All the patients who had nausea and vomiting were treated with dexamethasone. When the patients were reassessed after four hours, five patients had nausea in sevoflurane group after four hours, which was treated with metoclopramide or Ondansetron. After six hours, none of the patients had nausea or vomiting. CONCLUSIONS The incidence of post-operative nausea and vomiting was lesser in the propofol group compared to sevoflurane group. KEY WORDS Post-Operative Nausea and Vomiting, Propofol, Sevoflurane, General Anaesthesia


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