scholarly journals Pulse Methylprednisolone with Oral Prednisolone versus Adrenocorticotropic Hormone in Children with West Syndrome: a Randomized Controlled Trial

2021 ◽  
Vol 11 (2) ◽  
pp. 136-141
Author(s):  
Kanij Fatema ◽  
Mizanur Rahman ◽  
Mohammad Monir Hossain ◽  
Shaheen Akhter ◽  
Dewan Afsana Shomee ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Infantile Spasm ◽  
Total Duration ◽  
Oral Prednisolone ◽  
Epileptic Encephalopathy ◽  
West Syndrome ◽  
Variable Response ◽  
Duration Of Treatment ◽  
Pulse Methylprednisolone ◽  
Methyl Prednisolone

Background and Purpose: West syndrome is an epileptic encephalopathy of infancy. According to guidelines, adrenocorticotrophic hormone (ACTH) is probably effective for the short-term management of infantile spasm, but there is little uniformity in treatment due to variable response. This study has been done to evaluate the efficacy of pulse methylprednisolone as compared to ACTH in children with West syndrome.Methods: Children between 3 months to 24 months with the diagnosis of West syndrome were included and ACTH and pulse methyl prednisolone followed by oral prednisolone were given after randomization. Total duration of treatment was 6 weeks in both groups.Results: Total 87 children were enrolled; 12 patients lost in follow up. Finally, 43 received ACTH and 32 received pulse methylprednisolone. In pulse methylprednisolone group, 28.13% showed 50-80% response, 28.13% showed 80-99% response and 21.87% patients showed 100% response. In ACTH group, 41.86% showed 50-80% response, 25.58% showed 80-99% response and only 3 (6.97%) patients showed 100% response. Methylprednisolone treatment regimen did not cause significant or persistent adverse effects.Conclusions: Pulse methylprednisolone followed by oral prednisolone for 6 weeks is as effective as ACTH. Thus, methylprednisolone therapy can be an important alternative to ACTH.

scholarly journals Single dose intravenous methyl prednisolone versus oral prednisolone in Bell′s palsy: A randomized controlled trial

2015 ◽  
Vol 47 (2) ◽  
pp. 143 ◽  
Author(s):  
RavindraKumar Garg ◽  
ManeeshKumar Singh ◽  
Rajesh Verma ◽  
HardeepSingh Malhotra ◽  
PraveenKumar Sharma ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Single Dose ◽  
Controlled Trial ◽  
Oral Prednisolone ◽  
Randomized Controlled ◽  
Methyl Prednisolone

scholarly journals West syndrome - epileptic encephalopathy at early infancy

2020 ◽  
Vol 11 (4) ◽  
pp. 7492-7494
Author(s):  
Malavika Gopi ◽  
Akshaya Suresh ◽  
Anandu H ◽  
Roshni P R ◽  
Mamatha M R ◽  
...  
Keyword(s):  
Infantile Spasm ◽  
Epileptic Encephalopathy ◽  
Infantile Spasms ◽  
West Syndrome ◽  
Early Infancy ◽  
The West ◽  
Rare Type ◽  
Complete Control ◽  
New Antiepileptic Drugs ◽  
Healthy Infants

West syndrome (WS), synonymously infantile spasm or epileptic spasm, is a rare type of epileptic encephalopathy occurring at early infancy that exists with variable life expectancy. It is the most common form of epileptic encephalopathy. WS presents with spasms marked by extensor or mixed movements with distinct electroencephalogram (EEG) pattern of hypsarrhythmia, flexor and psychomotor arrest. Children with west syndrome always depict abnormal EEG, but sometimes the abnormality is seen only during sleep. The incidence of infantile spasms is found closer to 1 in 2,000 children, that typically begins between 2-12 months of age and peaks between 4-8 months of age. It is observed in otherwise healthy infants and also among infants with abnormal cognitive development. If this spasm happens in older subjects, they are preferably called "epileptic spasms" rather than infantile spasms. The goal for treatment of infantile spasms is to have complete control of spasms. Hormonal therapy with ACTH or vigabatrin is the mainstay of treatment. In spite of the development of new antiepileptic drugs (AEDs), about 35-40% of cases are drug-resistant. Children affected with the west syndrome can be cured, but a successful therapy often depends on the timely diagnosis. This case report is one evidence highlighting the treatment strategy for the west syndrome, and this could be useful for any further study regarding this topic.

The effect of practicing yoga during pregnancy on labor stages length, anxiety and pain: a randomized controlled trial

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Ellahe Mohyadin ◽  
Zohreh Ghorashi ◽  
Zahra Molamomanaei
Keyword(s):  
Controlled Trial ◽  
Intervention Group ◽  
Total Duration ◽  
Measurement Data ◽  
Labor Pain ◽  
Control Group ◽  
Chi Square ◽  
Nulliparous Women ◽  
Two Stages ◽  
And Control

AbstractBackgroundAnxiety and fear of labor pain has led to elevated cesarean section rate in some countries. This study was conducted to investigate the effect of yoga in pregnancy on anxiety, labor pain and length of labor stages.MethodsThis clinical trial study was performed on 84 nulliparous women who were at least 18 years old and were randomly divided into two groups of yoga and control groups. Pregnancy Yoga Program consisting of 6 60-min training sessions was started every 2 weeks from week 26 of pregnancy and continued until 37 weeks of gestation. Anxiety severity at maternal admission to labor was measured by the Spielbergers State-Trait Anxiety Inventory, and labor pain was measured by Visual Analogue Scale (VAS) at dilatation (4–5 cm) and 2 h after the first measurement. Data were analyzed using Chi-Square and t-test.ResultsIntervention group reported less pain at dilatation (4–5 cm) (p=0.001) and 2 h after the first measurement (p=0.001) than the control group. Stat anxiety was also lower in intervention group than the control group (p=0.003) at the entrance to labor room. Subjects in the control group required more induction compared to intervention group (p=0.003). Women in intervention group experienced shorter duration of the first phase of the labor than the control group (p=0.002). Also, the total duration of two stages of labor was shorter in intervention group than the control group (p=0.003).ConclusionsPracticing yoga during pregnancy may reduce women’s anxiety during labor; shorten labor stages, and lower labor pain.

scholarly journals Improving Bereavement Outcomes in Zimbabwe: Results of a Feasibility Cluster Trial of the 9-Cell Bereavement Tool

2021 ◽  
Author(s):  
Barbara Mutedzi ◽  
Kennedy Nkhoma ◽  
Lisa Langhaug ◽  
Jennifer Hunt ◽  
Richard Harding
Keyword(s):  
Controlled Trial ◽  
Qualitative Interviews ◽  
Total Duration ◽  
Cluster Randomized Trial ◽  
Potential Effect ◽  
Cluster Trial ◽  
Process Data ◽  
African Countries ◽  
Training Impact ◽  
Trial Participants

Abstract ContextDespite high mortality rates from both communicable and non-communicable diseases, bereavement studies are under-researched in African countries. The 9-cell bereavement tool was designed to assist individuals to reflect on their feelings in bereavement, and identify resources in families and communities to manage bereavement. This study aimed to determine the feasibility of implementing the 9-cell bereavement tool and recruitment to experimental evaluation. Methods: A feasibility cluster randomized trial with embedded qualitative interviews was conducted in two comparable neighborhoods in Chitungwiza, Zimbabwe. Community leaders identified potential community lay bereavement supporters (interventionists). Each recruited 2-3 recently bereaved community members (trial participants). Following baseline data collection, the communities were randomly allocated to intervention or wait-list control. Self-administered questionnaires were completed at T0 (month 0), T1(3 months) and T2 (6 months). Grief, mental health and social support were assessed. Focus group discussions with selected interventionists described training impact and intervention processes. Quantitative and qualitative analysis were performed. ResultsObjectives were achieved as follows(i) feasibility of recruitment and retention (ii) feasibility of implementing the intervention (iii) determining contamination(iv) completeness of data(v) participants’ views on intervention and mechanisms(vi) estimating potential effect size (vii) determining whether full trial warranted. In line with the aim of the study, the processes of the randomized cluster trial were possible. We successfully conducted the randomized control trial of the 9-cell bereavement tool and successfully recruited study participants. In addition, the 9-cell intervention allowed interventionists to share and learn from their grieving process. All of the above was conducted within the intended timeframe of 3 weeks, with an over recruitment of 112% of interventionists and 43% more trial participants. This means we were able to recruit at least 75% of the suggested sample size; and to retain at least 75% of the trial participants for the total duration of the study. Conclusion The processes of the randomized controlled trial were possible. The 9-cell bereavement intervention was delivered and process data assessed. The study was funded through the BuildCARE fund from the Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation Protocol Registration: http://www.isrctn.com/ISRCTN16484746.Protocol Publication: https://pilotfeasibilitystudies.biomedcentral.com/articles/10.1186/s40814-019-0450-5

scholarly journals Efficacy and safety of Ivermectin and Hydroxychloroquine in patients with severe COVID-19. A randomized controlled trial

2021 ◽  
Author(s):  
Jose Lenin Beltran Gonzalez ◽  
Mario González Gámez ◽  
Emanuel Antonio Mendoza Enciso ◽  
Ramiro Josue Esparza Maldonado ◽  
Daniel Hernández Palacios ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Controlled Trial ◽  
Total Duration ◽  
Severe Respiratory Failure ◽  
Double Blind ◽  
Arterial Blood ◽  
Duration Of Hospitalization ◽  
Group 3 ◽  
Group 2

AbstractBackgroundIn the search for active drugs against COVID-19, the indications of many have been redirected. Ivermectin and Hydroxychloroquine are drugs that inhibit viral replication in vitro and that have been used in several medical centers.ObjectivesThis clinical trial analyzes the efficacy of Ivermectin and Hydroxychloroquine in patients with moderate COVID-19 and in need of hospitalization.MethodsThis a controlled, clinical, randomized, double-blind trial that included patients with COVID-19-induced pneumonia and hospitalization criteria, but no severe respiratory failure. Patients were randomized to one of three groups: Group1-hydroxychloroquine, 400 mg every 12 hours on the first day and subsequently, 200 mg every 12 hours for 4 days, Group 2-ivermectin, 12 mg or 18 mg, according to patient weight and, Group 3-placebo. At inclusion, blood samples for arterial blood gases and biochemical markers associated with a poor prognosis were obtained. The primary outcome was established as the duration of hospitalization until discharge due to patient improvement, the total duration of hospitalization, and the safety outcomes were either respiratory deterioration or death.ResultsDuring the month of August, the admission of patients requiring hospitalization mostly encompassed cases with severe respiratory failure, so we ended the recruitment process and analyzed the data that was available at the time. One hundred and six (106) patients with an average age of 53 yrs. (±16.9) were included, with a greater proportion of males (n=66, 62.2 %). Seventy-two percent (72%) (n= 76) had an associated comorbidity. Ninety percent (90 %) of patients were discharged due to improvement (n=96). The average duration of hospitalization was 6 days (IQR, 3 – 10). No difference in hospitalization duration was found between the treatment groups (Group1: 7 vs Group 2: 6 vs Group 3: 5, p=0.43) nor in respiratory deterioration or death (Group 1: 18 % vs Group 2: 22.2 % vs Group 3: 24.3 %, p =0.83).ConclusionsIn non-critical hospitalized patients with COVID-19 pneumonia, neither ivermectin nor hydroxychloroquine decreases the number of in-hospital days, respiratory deterioration, or deaths.ClinicalTrials identifier NCT04391127

scholarly journals Aetiological aspects of west syndrome

2006 ◽  
Vol 134 (Suppl. 1) ◽  
pp. 45-49
Author(s):  
Borivoj Marjanovic ◽  
Milena Djuric ◽  
Dragan Zamurovic ◽  
Ruzica Kravljanac ◽  
Gordana Vlahovic ◽  
...  
Keyword(s):  
Metabolic Diseases ◽  
Neurological Impairment ◽  
Epileptic Encephalopathy ◽  
Psychomotor Retardation ◽  
West Syndrome ◽  
Clinical Feature ◽  
Perinatal Complications ◽  
Hereditary Metabolic Diseases ◽  
Number Of Patients ◽  
Aetiological Diagnosis

INTRODUCTION. West Syndrome involves epileptic encephalopathy in infants, occurring with an incidence of 5/10000 live births. Its main clinical feature are spasms that occur in clusters, which are associated with an EEG pattern called hypsarrhythmia and psychomotor retardation in most patients. West Syndrome is associated with many underlying conditions and the terms idiopathic, cryptogenic, and symptomatic are used for its aetiological subgroups. OBJECTIVE. The objective of this investigation was to determine the aetiological diagnosis of patients with West Syndrome and to compare the results with other studies. METHOD. In this 34-year longitudinal prospective one-centre study, 404 patients were studied. All patients exhibiting the diagnostic criteria for West Syndrome were investigated by clinical and neurological examination, EEG, ophthalmologic, psychological, metabolic, genetic, as well as neuroradiological methods, according to their particular indications. RESULTS. 36 (8.9%) patients had normal development, in whom infantile spasms occurred without any identifiable underlying cause, forming the idiopathic group. 51 patients (12.6%) with neurological impairment of unknown aetiology formed the cryptogenic group. The greatest number of patients (317 or 78.5%) formed the symptomatic group, in which neurological features and developmental delay preceded the onset of spasms. Disgenetic disorders and hereditary metabolic diseases were aetiological factors 44 (10.8%) patients. Prenatal and perinatal aetiological factors were revealed in one third of the patients (134 or 31%). Postnatal aetiological factors were revealed in 42 (10.2%) patients. In our study, disgenetic disorders were registered less frequently and perinatal complications more frequently than in other studies. CONCLUSION. Our results indicate the possibility of preventing West Syndrome with good quality obstetric and neonatal care, as well as the early prenatal diagnosis of brain malformations. Modern, sophisticated investigation makes the more accurate aetiological diagnosis of West Syndrome possible.

B3GALNT2-Related Dystroglycanopathy: Expansion of the Phenotype with Novel Mutation Associated with Muscle-Eye-Brain Disease, Walker–Warburg Syndrome, Epileptic Encephalopathy-West Syndrome, and Sensorineural Hearing Loss

2018 ◽  
Vol 49 (04) ◽  
pp. 289-295 ◽  
Author(s):  
Muna Al Dhaibani ◽  
Ayman El-Hattab ◽  
Omar Ismayl ◽  
Jehan Suleiman
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Novel Mutation ◽  
Congenital Muscular Dystrophy ◽  
Craniocervical Junction ◽  
Epileptic Encephalopathy ◽  
Brain Disease ◽  
West Syndrome ◽  
Sensorineural Hearing ◽  
Muscle Disease

AbstractMutations in B3GALNT2, encoding a glycosyltransferase enzyme involved in α-dystroglycan glycosylation, have been recently associated with dystroglycanopathy, a well-recognized subtype of congenital muscular dystrophy (CMD). Only a few cases have been reported with B3GALNT2-related dystroglycanopathy with variable severity ranging from mild CMD to severe muscle-eye-brain disease. Here, we describe a child with a novel homozygous nonsense mutation in B3GALNT2. The affected child has severe neurological disease since birth, including muscle disease manifested as hypotonia, muscle weakness, and wasting with elevated creatine kinase, eye disease including microphthalmia and blindness, brain disease with extensive brain malformations including massive hydrocephalus, diffuse cobblestone-lissencephaly, deformed craniocervical junction, and pontocerebellar hypoplasia. The clinical and radiologic findings are compatible with a diagnosis of severe muscle-eye-brain disease and more specifically Walker–Warburg syndrome. A more distinct aspect of the clinical phenotype in this child is the presence of refractory epilepsy in the form of epileptic spasms, epileptic encephalopathy, and West syndrome, as well as sensorineural hearing loss. These findings could expand the phenotype of B3GALNT2-related dystroglycanopathy. In this report, we also provide a detailed review of previously reported cases with B3GALNT2-related dystroglycanopathy and compare them to our reported child. In addition, we study the genotype–phenotype correlation in these cases.

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