scholarly journals Cognitive Effects of Lacosamide in Patients with Drug Refractory Focal Epilepsy: A Prospective Observational Study

2021 ◽  
Vol 6 (12) ◽  
pp. 926-934
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
Keyword(s):  
Observational Study ◽  
Seizure Frequency ◽  
Prospective Observational Study ◽  
Indian Population ◽  
Seizure Control ◽  
Focal Epilepsy ◽  
Median Frequency ◽  
Cognitive Effects ◽  
The Difference

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.

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

2021 ◽  
Author(s):  
Sophia B Modi ◽  
Asha S ◽  
Thomas Iype ◽  
Libu GK ◽  
Reeja Rajan
Keyword(s):  
Adverse Effects ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Therapeutic Option ◽  
Therapeutic Modality ◽  
Median Frequency ◽  
Favourable Safety ◽  
The Difference ◽  
Final Followup ◽  
Patients With Epilepsy

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.

scholarly journals Safety of High-Dose Dabigatran in Elderly and Younger Patients with a Low Bleeding Risk: A Prospective Observational Study

Cardiology ◽  
2021 ◽  
pp. 1-5
Author(s):  
Aharon Erez ◽  
Gregory Golovchiner ◽  
Robert Klempfner ◽  
Ehud Kadmon ◽  
Gustavo Ruben Goldenberg ◽  
...  
Keyword(s):  
Observational Study ◽  
Elderly Patients ◽  
Prospective Observational Study ◽  
Bleeding Risk ◽  
The Elderly ◽  
High Dose ◽  
World Population ◽  
Younger Patients ◽  
End Point

<b><i>Introduction:</i></b> In patients with atrial fibrillation (AF) at risk for stroke, dabigatran 150 mg twice a day (DE150) is superior to warfarin for stroke prevention. However, there is paucity of data with respect to bleeding risk at this dose in elderly patients (≥75 years). We aimed to evaluate the safety of DE150 in comparison to warfarin in a real-world population with AF and low bleeding risk (HAS-BLED score ≤2). <b><i>Methods:</i></b> In this prospective observational study, 754 consecutive patients with AF and HAS-BLED score ≤2 were included. We compared outcome of elderly patients (age ≥75 tears) to younger patients (age &#x3c;75 years). The primary end point was the combined incidence of all-cause mortality, stroke, systemic emboli, and major bleeding event during a mean follow-up of 1 year. <b><i>Results:</i></b> There were 230 (30%) elderly patients, 151 patients were treated with warfarin, and 79 were treated with DE150. Fifty-two patients experienced the primary endpoint during the 1-year follow-up. Among the elderly, at 1-year of follow-up, the cumulative event rate of the combined endpoint in the DE150 and warfarin was 8.9 and 15.9% respectively (<i>p</i> = 0.14). After adjustment for age and gender, patients who were treated with DE150 had a nonsignificant difference in the risk for the combined end point as patients treated with warfarin both among the elderly and among the younger population (HR 0.58, 95% C.I = 0.25–1.39 and HR = 1.12, 95% C.I 0.62–2.00, respectively [<i>p</i> for age-group-by-treatment interaction = 0.83). <b><i>Conclusions:</i></b> Our results suggest that Dabigatran 150 mg twice a day can be safely used among elderly AF patients with low bleeding risk.

scholarly journals The role of rehabilitation measures in reintegration of children with brain tumours or leukaemia and their families after completion of cancer treatment: a study protocol

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e014505 ◽  
Author(s):  
Mona Leandra Peikert ◽  
Laura Inhestern ◽  
Corinna Bergelt
Keyword(s):  
Observational Study ◽  
Cancer Treatment ◽  
Childhood Cancer ◽  
Quantitative Study ◽  
Prospective Observational Study ◽  
Daily Life ◽  
Oncological Rehabilitation ◽  
Rehabilitation Measures

IntroductionFor ill children as well as for their parents and siblings, childhood cancer poses a major challenge. Little is known about the reintegration into daily life of childhood cancer survivors and their families. The aim of this prospective observational study is to further the understanding of the role of rehabilitation measures in the reintegration process of childhood leukaemia or brain tumour survivors and their family members after the end of cancer treatment.Methods and analysisThis prospective observational study consists of three study arms: a quantitative study in cooperation with three German paediatric oncological study registries (study arm 1), a quantitative study in cooperation with a rehabilitation clinic that offers a family-oriented paediatric oncological rehabilitation programme (study arm 2) and a qualitative study at 12-month follow-up including families from the study arms 1 and 2 (study arm 3). In study arm 1, children, parents and siblings are surveyed after treatment (baseline), 4–6 months after baseline measurement and at 12-month follow-up. In study arm 2, data are collected at the beginning and at the end of the rehabilitation measure and at 12-month follow-up. Families are assessed with standardised questionnaires on quality of life, emotional and behavioural symptoms, depression, anxiety, fear of progression, coping and family functioning. Furthermore, self-developed items on rehabilitation aims and reintegration into daily life are used. Where applicable, users and non-users of rehabilitation measures will be compared regarding the outcome parameters. Longitudinal data will be analysed by means of multivariate analysis strategies. Reference values will be used for comparisons if applicable. Qualitative data will be analysed using thematic analysis.Ethics and disseminationThis study has been approved by the medical ethics committee of the Medical Chamber of Hamburg. Data will be published in peer-reviewed journals and presented at conferences.

scholarly journals Evaluation of Aetiology and Outcome of Acute Kidney Injury in a Tertiary Care Hospital of India- A Prospective Observational Study

2020 ◽  
Author(s):  
VS Gaurav Narayan ◽  
SG Ramya ◽  
Sonal Rajesh Kumar ◽  
SK Nellaiappa Ganesan
Keyword(s):  
Acute Kidney Injury ◽  
Intensive Care ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Rapid Decline ◽  
Care Hospital ◽  
Medical Intensive Care

Introduction: The Acute Kidney Injury (AKI) is a rapid decline in renal filtration function. The aetiological spectrum, prevalence of AKI and outcome is highly variable. This variation exists due to the difference in the criteria used, study population and demographic features. Huge differences are noted when AKI is compared in developing and developed countries. Hence, it is important to analyse the spectrum of AKI to facilitate earlier diagnosis and treatment which shall help in improving the outcome. Aim: To study the prevalence, aetiology and outcome of AKI in the medical intensive care. Materials and Methods: This was a prospective observational study conducted in a medical intensive care for 18 months where 1490 patients were screened and 403 patients were included as AKI by KDIGO criteria. History, examination, appropriate investigations and treatment details including dialysis were noted. The serum creatinine levels were obtained every day, to know the time of onset of AKI, at the time of death or discharge, and after one month for patients who turned up for follow-up. Patients were categorised based on outcome as survivors and nonsurvivors. Survivors were divided into as fully recovered and partially recovered and those who left the Intensive Care Unit (ICU) against medical advice were termed as lost to follow-up. Results: A total of 403 patients (27.04% of 1490) of medical intensive care admissions were found to have AKI. Sepsis was the most common cause of AKI. At the end of the month, 78.4% of AKI patients fully recovered, 1.2% partially recovered and the mortality was 14.9%. Mortality was higher in AKI associated with chronic medical conditions like cardiac failure, chronic liver disease and stroke. Conclusion: If treated early, AKI is mostly reversible. Regional differences in AKI should be studied extensively and local guidelines should be formulated by experts for prevention and early treatment, to improve the disease outcome.

scholarly journals Role of JIGSAW method of teaching in improving clinical diagnosis among final year medical students – A prospective observational study

2021 ◽  
Vol 12 (12) ◽  
pp. 44-49
Author(s):  
Appandraj S ◽  
Sivagamasundari V ◽  
Varatharajan Sakthivadivel
Keyword(s):  
Observational Study ◽  
Test Score ◽  
Prospective Observational Study ◽  
Coronary Syndrome ◽  
Post Test ◽  
Jigsaw Method ◽  
The Mean ◽  
The Difference ◽  
Didactic Lecture ◽  
Teaching Learning

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.

scholarly journals COMPARATIVE STUDY OF CLINICAL VERSUS USG IN DIAGNOSIS OF EARLY TRIMESTER BLEEDING PV

2020 ◽  
pp. 60-62
Author(s):  
Narendra Nath Hait ◽  
Brahmarshi Das ◽  
Ratan Chandra Mandal ◽  
Haricharan Roy ◽  
Debarshi Jana
Keyword(s):  
Statistical Analysis ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Common Cause ◽  
Clinical Method ◽  
Medical College ◽  
Threatened Miscarriage ◽  
Obstetrics And Gynaecology ◽  
Threatened Abortion ◽  
The Difference

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.

scholarly journals Combination of caudal epidural steroids with oral gabapentin for radicular low back pain: a prospective observational study

2019 ◽  
Vol 5 (1) ◽  
pp. 5-10
Author(s):  
Grisuna Singh ◽  
Binod Thapa ◽  
Kiran Gurung ◽  
Nirmal Gyawali
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Low Back ◽  
Socioeconomic Condition ◽  
Psychological Burden ◽  
Epidural Steroids ◽  
Caudal Epidural

Introduction: The physical, socioeconomic and psychological burden of low back pain is enormous. The poor socioeconomic condition and geographical constrains confines people to limited health facilities. The objective of the study was to evaluate whether combination of caudal epidural steroids with local anaesthetics and gabapentin is effective for radicular low back pain in the rural Nepal setting. Methods: It was a prospective observational study including 300 patients with radicular low back pain done over a period of 6 months (13/4/2016 to 30/10/2016). All participants received caudal epidural steroid injection (6ml 2% Xylocaine with adrenaline plus Depomedroxy steroid 80mg plus 12 ml distilled water) and 200 mg gabapentin daily for three months. All patients were followed up for three months and were evaluated. Results: Mean age of presentation was 41.21 years (SD ± 11.02) with majority of farmers (42.31%). Mean Numerical Rating Scale at the baseline was 8.01(SD±1.00) and at the first follow up was 3.98 (SD±0.83) (p <0.001). Mean Oswestry Disability Index at baseline was7.85 (SD±0.98) and at the first follow up was 4.04 (SD±0.80) (p <0.001). Straight Leg Raising Test at baseline was less than 70° in 84.7% which improved to more than 70° in 87.9% of the patients (p-value <0.001). Conclusion: Caudal epidural steroids combined with gabapentin is safe, economical and technically less demanding. This treatment modality can be used with good outcomes in the rural areas with limited diagnostic and therapeutic facilities.

scholarly journals Mortality dynamics of Pseudomonas aeruginosa bloodstream infections and the influence of defective OprD on mortality: prospective observational study

2019 ◽  
Vol 74 (9) ◽  
pp. 2774-2783 ◽  
Author(s):  
Eun-Jeong Yoon ◽  
Dokyun Kim ◽  
Hyukmin Lee ◽  
Hye Sun Lee ◽  
Jeong Hwan Shin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pseudomonas Aeruginosa ◽  
Observational Study ◽  
Prospective Observational Study ◽  
Cox Regression ◽  
Bloodstream Infections ◽  
Clinical Settings ◽  
Kaplan Meier ◽  
Steep Decrease

Abstract Background To assess the mortality dynamics of patients with Pseudomonas aeruginosa bloodstream infections (BSIs) and the influence of OprD deficiencies of the microorganism on early mortality. Methods A prospective multicentre observational study was conducted with 120 patients with P. aeruginosa BSIs occurring between May 2016 and April 2017 in six general hospitals in South Korea. PCR and sequencing were carried out to identify the alterations in oprD and the presence of virulence factors. Cox regression was used to estimate the risk factors for mortality at each timepoint and Kaplan–Meier survival analyses were performed to determine the mortality dynamics. Results During the 6 week follow-up, 10.8% (13/120) of the patients with P. aeruginosa BSIs died in 2 weeks, 14.2% (17/120) in 4 weeks and 20.0% (24/120) in 6 weeks, revealing a steep decrease in cumulative survival between the fourth and sixth weeks. ICU admission and SOFA score were risk factors for mortality in any weeks after BSI onset and causative OprD-defective P. aeruginosa had a risk tendency for mortality within 6 weeks. Among the 120 P. aeruginosa blood isolates, 14 were XDR, nine produced either IMP-6 or VIM-2 MBL, and 21 had OprD deficiency. Conclusions BSIs caused by OprD-defective P. aeruginosa resulted in a 2-fold higher 6 week mortality rate (33.3%) than that of BSIs caused by OprD-intact P. aeruginosa (17.2%), likely due to the decreased susceptibility to carbapenems and bacterial persistence in clinical settings.

Sign in / Sign up

Export Citation Format

Share Document