scholarly journals SEIZURES WITH ANTI-SEIZURE DRUG

2017 ◽  
Vol 10 (12) ◽  
pp. 3 ◽  
Author(s):  
Keerthana Brattiya ◽  
Bhuvaneshwari K
Keyword(s):  
Status Epilepticus ◽  
Antiepileptic Drugs ◽  
Rare Complication ◽  
Therapeutic Index ◽  
Refractory Status Epilepticus ◽  
World Health ◽  
Metal Ring ◽  
Causality Analysis ◽  
Toxic Reaction ◽  
Health Organization

This case study is to report and explore the etiology of a case of refractory seizures due to overdosage of phenytoin tablets. A case report from the Department of Neurology generated through voluntary adverse drug reaction (ADR)reporting stated phenytoin overdosage leading to refractory status epilepticus which did not respond to any of the antiepileptic drugs. A 33-year-old female patient with the history of consumption 15 tablets of phenytoin and a metal ring as part of a suicidal bid a month ago, presented with unconsciousness, persistent seizures, and gangrene of fingers. Magnetic resonance imaging showed generalized atrophic changes of the cerebrum and cerebellum. Electroencephalogram suggested multifocal onset status epilepticus. The patient did not respond to standard emergency treatment of status epilepticus with known antiepileptic drugs and was treated with thiopentone infusion under mechanical ventilation, which controlled her seizures as long as she was maintained under the infusion. Causality analysis using the World Health Organization scale categorizes this ADR as “possible”, as the patient is a known case of seizure disorder with additional cerebral changes. Hence, the disease could have had an influence over the toxic reaction. To conclude, seizures are a rare complication of phenytoin. Seizures can be prevented by evaluating therapeutic plasma concentration of phenytoin. In this case, the patient was on chronic treatment, and due to intentional toxicity, she progressed to a refractory state of seizures. This could have occurred because of the unique kinetic profile of phenytoin, small therapeutic index, genetic variation in drug metabolizing enzymes, and saturated sodium channels.

FEATURES OF MODERN PHARMACOTHERAPY OF EPILEPTIC STATUS

2021 ◽  
pp. 31-38
Author(s):  
Tokareva N.G. ◽  
Ignatieva O.I.
Keyword(s):  
Status Epilepticus ◽  
Side Effects ◽  
Antiepileptic Drugs ◽  
Refractory Status Epilepticus ◽  
International Standards ◽  
Correct Selection ◽  
Treatment And Prevention ◽  
New Antiepileptic Drugs ◽  
Combined Use ◽  
Special Approach

In the presented review of the literature, the most significant problems of modern pharmacotherapy of status epilepticus are indicated. The urgency of treatment of status epilepticus is confirmed by its frequency and ineffectiveness of traditional drugs (benzodiazepines, hydantoins, barbiturates), which have a number of side effects from the cardiovascular and respiratory systems. In Russian intensive care medicine, treatment of status epilepticus is carried out in accordance with international standards and recommendations. For a number of years, the injectable form of valproate has proven its effectiveness, including in pediatric practice. In comparative studies, phenytoin, valproate and levetiracetam are safe and equally effective in treating status epilepticus. A particular difficulty in therapy is caused by benzodiapine-resistant status epilepticus and refractory, which requires consideration of the possibility of using a combination of antiepileptic drugs. The review of foreign and domestic sources presents the results of clinical studies that allow the use of new antiepileptic drugs, which can effectively stop status epilepticus already in the early stages. New antiepileptic drugs are especially relevant in the treatment of patients refractory to drug treatment. However, treatment with antiepileptic drugs does not always show its effectiveness in refractory and super-refractory status epilepticus, which requires new approaches in complex treatment. The tolerance of drugs and the frequency of side effects are important for patients, since most of them require long-term combined use. Correct selection of antiepileptic drugs increases the level of compliance. A special approach requires the treatment of status epilepticus in the context of palliative care and comorbid pathology. In the treatment and prevention of status epilepticus, surgical treatment and the use of a ketogenic diet can be considered.

scholarly journals Super-refractory status epilepticus in a 29-year-old pregnant female

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110004
Author(s):  
Cinthya Carrasco ◽  
Audra Schwalk ◽  
Byungkwan Hwang ◽  
Kenneth Iwuji ◽  
Ebtesam Islam
Keyword(s):  
Status Epilepticus ◽  
Antiepileptic Drugs ◽  
High Mortality ◽  
Safety Profile ◽  
Seizure Control ◽  
Prolonged Exposure ◽  
Refractory Status Epilepticus ◽  
Pregnant Female ◽  
Mortality And Morbidity ◽  
Refractory Status

Super-refractory status epilepticus is a rare medical and neurological emergency due to the high mortality and morbidity associated with this condition. Furthermore, there is very little data regarding its incidence, etiology, and management in the pregnant population with super-refractory status epilepticus. The treatment of super-refractory status epilepticus during pregnancy is specifically a major challenge as there are limited available therapeutic options due to the well-established teratogenicity of most antiepileptic drugs and the unknown safety profile of some of the anesthetics commonly used for seizure control. We report a case of successfully treated super-refractory status epilepticus in a 29-year-old, 26 weeks pregnant female who after an emergent delivery and prolonged exposure to multiple antiepileptic drugs recovered full neurological function.

scholarly journals Pharmacognostical analysis of different parts of Cyperus rotundus L.

2019 ◽  
Vol 6 (sp1) ◽  
pp. 607-612
Author(s):  
Anand Prakash ◽  
Divya Jain ◽  
Rashmi Tripathi ◽  
` Pracheta
Keyword(s):  
Medicinal Plants ◽  
Herbal Remedy ◽  
Therapeutic Index ◽  
Cyperus Rotundus ◽  
World Health ◽  
Experimental Plant ◽  
Plant Parts ◽  
Soxhlet Apparatus ◽  
Health Organization ◽  
Different Parts

Medicinal plants have been used as chief antidotes for the cure of numerous diseases since time immemorial. To investigate the quality assurance and authentication of medicinal plants, pharmacognostical, physicochemical and preliminary phytochemical studies of the different parts (root, stem and flower) of Cyperus rotundus were carried out. Present study deals with WHO (World Health Organization) recommended methods, fluorescence, phytochemical characteristics for standardization of plant parts by using a soxhlet apparatus in order of increase polarity. The extracts were subjected to qualitative phytochemical screening using standard procedures. Phytochemical investigation led to the revelation of the presence of enormous kinds of primary and secondary metabolite’s as protein, carbohydrate, phenole, flavonoid, alkaloid, terpenoid, and saponin, etc., in trace, moderate and high amount in various extracts of different parts of experimental plant. It was concluded that the plant is rich in phytochemicals with significant pharmacological applications that may supply drugs for modern medicines and can be valuable for the therapeutic index. Information obtained from these studies help in determining the antioxidant capacity and contributes to the predominant group of bioactive components which can be used as markers in the identification and standardization of this plant as a herbal remedy.

scholarly journals INFLAMMATORY MYOFIBROBLASTIC TUMORS IN THE PECULIAR CONTEXT OF THE POSTPARTUM CASE REPORT

2021 ◽  
Vol 9 (03) ◽  
pp. 607-611
Author(s):  
Khalloufi C. ◽  
◽  
Ibnoulkhatib S. ◽  
El Kebir A. ◽  
Karkouri M. ◽  
...  
Keyword(s):  
Case Report ◽  
Cesarean Section ◽  
World Health Organization ◽  
Rare Complication ◽  
Malignant Neoplasm ◽  
World Health ◽  
Pathological Examination ◽  
The World ◽  
Inflammatory Myofibroblastic Tumors ◽  
Health Organization

The debate persists about the inflammatory or tumoral, benign or malignant nature of the Inflammatory myofibroblastic tumors (TMI). Radioclinically, they can mimic a malignant neoplasm, although they are classified as intermediate by the World Health Organization (WHO). The diagnosis is almost always made by pathological examination. The treatment is poorly codified but the management is usually surgical. The removal of these tumors is a challenge when the mass is developed at the expense of or in the vicinity of noble organs. Several therapies have been tested to overcome the limitations of surgery, the results are variable. These tumors rarely affect the digestive tract. We propose the study of a case of myofibroblastic tumor developed at the expense of the omentum, five months after a cesarean section, in order to try to determine if it is a rare complication of the postpartum or a fortuitous combination.

Antiepileptic Drugs

2018 ◽  
Author(s):  
Eelco F. M. Wijdicks ◽  
Sarah L. Clark
Keyword(s):  
Intensive Care Unit ◽  
Decision Making ◽  
Intensive Care ◽  
Status Epilepticus ◽  
Antiepileptic Drugs ◽  
Refractory Status Epilepticus ◽  
Convulsive Status Epilepticus ◽  
Refractory Status ◽  
Focal Status Epilepticus

Patients are often admitted to the neurosciences intensive care unit specifically for the treatment of a series of seizures or focal status epilepticus. Far more urgent is convulsive status epilepticus, which requires multiple intravenously administered antiepileptic drugs. The choices are different when the patient is in status epilepticus and refractoriness is mostly due to pharmacologic resistance. Use of an algorithm for decision making is common in the management of refractory status epilepticus. Antiepileptic drugs often interact with other antiepileptic drugs. This chapter discusses the use of antiepileptic drugs available to treat seizures, recurrent seizures, status epilepticus, and refractory status epilepticus.

scholarly journals Surgical Ciliated Cyst Secondary to Orthognathic Surgery: Report of three cases and review of the literature

2021 ◽  
Author(s):  
Alberto Díez-Montiel ◽  
Armentia ◽  
Raul Antunez-Conde ◽  
Navarro-Cuéllar ◽  
Tousidonis ◽  
...  
Keyword(s):  
Orthognathic Surgery ◽  
Case Reports ◽  
Rare Complication ◽  
World Health ◽  
Lytic Lesion ◽  
Pubmed Database ◽  
Posterior Maxilla ◽  
Delayed Complication ◽  
The Difference ◽  
Health Organization

Abstract Background: Surgical ciliated cysts (SCC) of the maxilla appear as a delayed complication after surgery in the maxillary sinus, midface osteotomies, traumatic tooth extraction, and maxillary fractures. They are defined as a lytic lesion with entrapment of the pseudostratified columnar epithelium.Report of three cases: We present three patients in which after orthognathic surgery a slowly enlarging asymptomatic swelling mass was developed. On CT, all the cases presented lytic expansive lesions in the alveolar ridge. In the three cases, lesions were completely excised, and upon histological examination, ciliated pseudostratified columnar epithelium with goblet cells was found so they were diagnosed as SCC. An exhaustive review of the medical literature was conducted. The PubMed database was searched for PubMed Central (PMC). 44 references were found, reporting 1555 cases: 11 series and 33 case reports, being the largest series from the Asian countries. The mean age was 46.5 years, and more frequently described in male patients. The most frequent form of presentation was as unilateral unilocular cysts in the posterior maxilla. They were described most frequently after a Caldwell-Luc approach. The average latency time was of 19.9 years.Conclusion: SCC is a rare complication after orthognathic surgery, but large series have been published, so maybe it could be interesting to include these cysts in the next Edition of the World Health Organization Classification of the Head and Neck Tumors: Odontogenic and Maxillofacial Bone Tumors, making clear the difference between SCC and mucoceles to avoid future confusions.

scholarly journals Dasatinib-Induced Pulmonary Arterial Hypertension Treated with Upfront Combination Therapy

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Makoto Nishimori ◽  
Tomoyuki Honjo ◽  
Kenji Kaihotsu ◽  
Naohiko Sone ◽  
Sachiko Yoshikawa ◽  
...  
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Combination Therapy ◽  
Arterial Hypertension ◽  
Rare Complication ◽  
Functional Class ◽  
World Health ◽  
First Line Therapy ◽  
Mean Pulmonary Arterial Pressure ◽  
Pulmonary Arterial ◽  
Health Organization

Pulmonary arterial hypertension (PAH) is a rare complication of dasatinib that was approved as a first-line therapy for chronic myelocytic leukemia (CML). A 24-year-old man presenting dyspnea at rest and leg edema was admitted to our hospital. He had been diagnosed with CML and prescribed dasatinib for 4 years. Chest X-ray showed significant bilateral pleural effusion and heart enlargement. Echocardiography revealed interventricular septal compression and elevated peak tricuspid regurgitation pressure gradient of 66.7 mmHg indicating severe pulmonary hypertension. After the other specific diseases to provoke PAH were excluded, he was diagnosed with dasatinib-induced PAH. Despite discontinuation of dasatinib and intravenous administration of diuretic for two weeks, World Health Organization (WHO) functional class was still II and mean pulmonary arterial pressure (PAP) was high at 37 mmHg. Therefore, we administered sildenafil and bosentan together as an upfront combination therapy three weeks after dasatinib discontinuation. Six months later, his symptoms improved to WHO functional class I and mean PAP was decreased to 31 mmHg. Although PAH is a rare complication of dasatinib, symptomatic patients prescribed with dasatinib should have an echocardiogram for PAH screening. Moreover, the upfront combination therapy would be a useful option for symptomatic patients after discontinuation of dasatinib.

scholarly journals Forecasting COVID-19 Confirmed Cases in Major Indian Cities and Their Connectedness with Mobility and Weather-related Parameters

2021 ◽  
pp. 097226292110082
Author(s):  
Aditya Krishna
Keyword(s):  
Air Quality ◽  
Multivariate Time Series ◽  
Weather Conditions ◽  
World Health ◽  
New Delhi ◽  
Causality Analysis ◽  
The People ◽  
Weather Parameters ◽  
Health Organization ◽  
Indian Cities

Coronavirus disease 2019 (COVID-19) outbreak that was declared as a pandemic by the World Health Organization (WHO) on 11 March 2020 has already had severe consequences in all aspects of people’s lives worldwide. The pandemic has affected over 200 countries and has become a major concern. India also faced a stiff challenge in terms of controlling the virus outbreak and through some strict measures such as nationwide lockdown was able to control the further spread of COVID-19 towards the latter part of 2020. Therefore, it is imperative to predict the spread of this virus along with causality analysis of parameters that play a significant role in its spread. The present study employs a series of univariate and multivariate time series forecasting techniques namely MSARIMA, ARMAX and extended VAR models to predict COVID-19 cases in New Delhi, Mumbai and Bengaluru. Besides, providing a robust forecasting performance for COVID-19 cases, the study also deals with finding the causal relationship of the spread of COVID-19 with various mobility and weather parameters. Outcomes of our study establish that the spread of COVID-19 can be associated with mobility and weather parameters apart from the various precautions that are taken by the people to reduce community transmission. However, the type of mobility (residential, retail and workplace) and type of weather conditions (air quality, temperature and humidity) associated with the causality differ with cities. For New Delhi, air quality, residential, retail are the parameters affecting the spread of the COVID-19 cases, whereas masks, temperature, residential and workplace were the significant mobility and weather parameters for Mumbai. In addition, for Bengaluru, the statistically significant causal variables were air quality, masks and residential. Outcomes of this study would help the concerned authorities to predict and contain future COVID-19 spreads in Indian cities efficiently.

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