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2022 ◽  
Vol 7 (4) ◽  
pp. 728-730
Author(s):  
I D Chaurasia ◽  
Yogita Chaurasia

To evaluate the visual and neurological outcomes of Optic Neuritis Treatment Trial (ONTT). 40 Patients presenting with optic neuritis were enrolled in this study to analyze the Visual and Neurological outcomes after treatment according to ONTT Protocol, with emphasis on signs of anaemia, protein calorie malnutrition, vitamin deficiency, generalized lymphadenopathy, sinusitis, septic foci. Patients were followed up for three subsequent visits to assess the rate of visual recovery.Maximum patient 35(87.5) treated according to ONTT protocol while 5 (12.5%) treated with oral steroids alone. Maximum 33 eyes (70.2%) attain BCVA > 6/36 after 1st follow-up (with in 1 month) while 10(21.3%) eyes attain BCVA of 6/6 after 1st follow-up. 11 eyes (25.6%) attain BCVA 6/6 after II follow-up. General prognosis for recovery of vision was good and was slightly worse in more severely affected cases in the present series. Pallor of the optic disc and defect of vision did not always correspond–3 eyes which showed temporal of the disc at the end of follow up had a final vision of 6/9 or better in each eye.


2021 ◽  
Vol 25 (9) ◽  
pp. 1743-1746
Author(s):  
T.A. Adebisi -Fagbohungbe ◽  
A.S. Kehinde ◽  
O.O. Babatunde ◽  
I.E. Odiaka ◽  
F.A. Abuldulazeez ◽  
...  

The impact of captive rearing of snails (Archachatina marginata) on the bio-accumulation of some heavy metals (HMs) (Fe, Mn, Cu, Pb, Co, Ni, Cd and Cr) in the meat and haemolymph was evaluated in a two treatment trial (snails from the wild, (SW) and captive reared snails, (SC), each comprised of sixty snails of three replicates. Alldata collected (using standard analytical procedures) were subjected to ANOVA and significant means separated by Duncan Multiple Range Test. The trial revealed that the meat of SC had outstanding (P>0.05) Fe (22.30mg/kg) and Mn(4.79mg/kg), with no significant variation for DM, while the haemolymph recorded non-significant (P< 0.05) concentration for (Mn, Pb, Co, Ni, Cd and Cr). Its levels of Fe (3.50mg/kg) and Cu (2.06mg/kg) were however significantly (P>0.05) impacted by captive rearing. Generally the level of Cr in the meat and haemolymph were higher than 0.05mg/kg recommendation by WHO, hence snail meat and haemolymph must be consumed with caution and guidance.


Author(s):  
Roberto Cattivelli ◽  
Anna Guerrini Usubini ◽  
Gian Mauro Manzoni ◽  
Francesco Vailati Riboni ◽  
Giada Pietrabissa ◽  
...  

The purpose of this Individually Randomized Group Treatment Trial was to compare an Acceptance and Commitment Therapy-based (ACT) group intervention and a Cognitive Behavioral Therapy-based (CBT) group intervention for weight loss maintenance in a sample of adult patients with obesity seeking treatment for weight loss. One hundred and fifty-five adults (BMI: Kg/m2 = 43.8 [6.8]) attending a multidisciplinary rehabilitation program for weight loss were randomized into two conditions: ACT and CBT. Demographical, physical, and clinical data were assessed at the beginning of the program (t0), at discharge (t1), and at 6-month follow-up (t2). The following measures were administered: The Acceptance and Action Questionnaire-II (AAQ-II) and the Clinical Outcome in Routine Evaluation-Outcome Measure (CORE-OM). Generalized linear mixed models were performed to assess differences between groups. Moderation effects for gender and Eating Disorders (ED) have been considered. From baseline to discharge, no significant differences between interventions were found, with the only exception of an improvement in the CORE-OM total score and in the CORE-OM subjective wellbeing subscale for those in the CBT condition. From discharge to follow-up, ACT group participants showed significant results in terms of weight loss maintenance, CORE-OM total score, and CORE-OM and AAQ-II wellbeing, symptoms, and psychological problems subscales. Gender moderated the effects of time and intervention on the CORE-OM subscale reporting the risk for self-harm or harm of others. The presence of an eating disorder moderated the effect of time and intervention on the CORE-OM total score, on the CORE-OM symptoms and psychological problems subscales, and on the AAQ-II. Patients who received the ACT intervention were more likely to achieve a ≥5% weight loss from baseline to follow-up and to maintain the weight loss after discharge. The ACT intervention was thus effective in maintaining weight loss over time.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Padmini Dahanayake ◽  
Tharaka L. Dassanayake ◽  
Manoji Pathirage ◽  
Saman Senanayake ◽  
Mike Sedgwick ◽  
...  

Abstract Background The combined corticosteroid regimen of the original Optic Neuritis Treatment Trial (ONTT) is used in many centers to treat optic neuritis. Though pattern reversal visual evoked potentials (PRVEPs) are a sensitive, standard measure of visual conduction in optic neuritis, no studies hitherto have investigated the effect of combined ONTT regimen on PRVEPs. We aimed to determine the effect of combined corticosteroid regimen of the ONTT on changes of PRVEPs in patients with first-episode optic neuritis over 3 months post-treatment. Methods This is a prospective, observational study in which 44 patients with optic neuritis were seen pre-treatment (baseline) and follow-up, at 1 month (FU1) and 3 months (FU2). Twenty-nine patients were treated with ONTT combined regimen (ONTT+ Group) while 15 were conservatively managed without corticosteroids (ONTT- Group). The median latency and amplitude values of the P100 PRVEP component and the visual acuity (i.e. LogMAR values) at pre-treatment, FU1 and FU2 were compared in the two groups using Friedman’s rank test and Wilcoxon Signed Ranks test. Results Median P100 latency improved significantly (to the normal range) as early as by 1 month after the commencement of treatment in the ONTT+ Group, and then remained significantly lower than the baseline over next 2 months. In the ONTT- Group, the median P100 latency improved more slowly over the two follow up assessments and reached the normal range by 3 months. Median visual acuity values also improved significantly at 1 and 3 months after the commencement of treatment in the ONTT+ Group but not in the ONTT- Group. Conclusion ONTT combined corticosteroid regimen improves conduction in the visual pathways of patients with first-episode optic neuritis earlier than does conservative management. We provide electrodiagnostic evidence that combined ONTT regimen–compared with conservative management–results in early remission of visual conduction abnormalities in first-episode optic neuritis.


2021 ◽  
Vol 1 ◽  
pp. 96
Author(s):  
Patty P.A. Dhooge ◽  
Philipp T. Möller ◽  
Camiel J.F. Boon ◽  
Andrew J. Lotery ◽  
Philipp Herrmann ◽  
...  

Background: This report describes the study design and baseline characteristics of patients with Stargardt disease (STGD1) enrolled in the STArgardt Remofuscin Treatment Trial (STARTT). Methods: In total, 87 patients with genetically confirmed STGD1 were randomized in a double-masked, placebo-controlled proof of concept trial to evaluate the safety and efficacy of 20 milligram oral remofuscin for 24 months. The primary outcome measure is change in mean quantitative autofluorescence value of an 8-segment ring centred on the fovea (qAF8). Secondary efficacy variables are best corrected visual acuity (BCVA), low-luminance visual acuity (LLVA), mesopic microperimetry (mMP),  spectral domain optical coherence tomography (SD-OCT), reading speed on Radner reading charts, and patient-reported visual function as assessed by the National Eye Institute Visual Functioning Questionnaire 25 (NEI VFQ-25) and Functional Reading Independence (FRI) Index. Results: Mean age of participants was 35±11 years with 49 (56%) female. Median qAF8 value was 438 Units (range 210-729). Median BCVA and LLVA in decimal units were 0.50 (range 0.13-0.80) and 0.20 (range 0.06-0.63), respectively. The median of the mean retinal sensitivity with mMP was 20.4 dB (range 0.0-28.8). SD-OCT showed median central subfield retinal thickness of 142 µm (range 72-265) and median macular volume of 1.65 mm3 (range 1.13-2.19). Compared to persons without vision impairment, both reading performance and patient-reported visual function were significantly lower (p<0.001, one sample t-test). Mean reading speed was 108±39 words/minute with logRAD-score of 0.45±0.28. Mean VFQ-25 composite score was 72±13. Mean FRI Index score 2.8±0.6. Conclusions: This trial design may serve as reference for future clinical trials as it explores the utility of qAF8 as primary outcome measure. The baseline data represent the largest, multi-national, STGD1 cohort to date that underwent standardized qAF imaging, reading speed assessment and vision-related quality of life measures which all contribute to the characterization of STGD1. EudraCT registration: 2018-001496-20 (09/05/2019)


2021 ◽  
pp. jnnp-2021-326443
Author(s):  
Johannes Jungilligens ◽  
Rosa Michaelis ◽  
Stoyan Popkirov

ObjectiveTo determine the epidemiology of prolonged psychogenic non-epileptic seizures (pPNES) misdiagnosed as status epilepticus, as well as the risks associated with non-indicated treatment.MethodsWe performed an individual patient data analysis from the Rapid Anticonvulsant Medication Prior to Arrival Trial (RAMPART) and the Established Status Epilepticus Treatment Trial (ESETT) to assess incidence, patient characteristics and clinical course of misdiagnosed pPNES.ResultsAmong 980 patients aged 8 years or older diagnosed and treated for status epilepticus in RAMPART and ESETT, 79 (8.1%) were discharged with a final diagnosis of pPNES. The relative incidence was highest in adolescents and young adults (20.1%). The typical female preponderance seen in that age bracket was not evident in children and older adults. Adverse effects, including respiratory depression and intubation, were documented in 26% of patients with pPNES receiving benzodiazepines in RAMPART and 33% of patients receiving additional second-line medication in ESETT. In ESETT, patients who were treated with benzodiazepines before hospital admission had higher rates of unresponsiveness and severe adverse effects than those treated after admission, suggesting cumulative effects of accelerated treatment momentum. Across trials, one in five patients with pPNES were admitted to an intensive care unit.ConclusionsMisdiagnosis and treatment of pPNES as status epilepticus are a common and widespread problem with deleterious consequences. Mitigating it will require training of emergency staff in semiological diagnosis. Status epilepticus response protocols should incorporate appropriate diagnostic re-evaluations at each step of treatment escalation, especially in clinical trials.


Author(s):  
David R. Weakley ◽  
Scott Lambert ◽  
Deborah K. VanderVeen ◽  
Edward Wilson ◽  
Stacey Kruger ◽  
...  

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