Medicine Intake Research Articles

Study of pattern of blood donor deferral at a Tertiary Health care centre over 10 years in Navi Mumbai, India

Introduction: Donor and recipient safety are of paramount importance in Blood bank. Recent advances in science and regulatory authorities guide to formulate donor selection criteria. The aim of our study was to evaluate the blood donor referral patterns at our institute and formulate methods to decrease temporary deferral rates. Material and Methods: This was a retrospective observational study. It was carried out on all donors who came willingly for allogeneic blood donation. The duration of study was 10 years from December, 2009, until December 2018, in Blood Bank of Dr. D Y Patil medical College and Hospital, Navi Mumbai. The license is approved by the FDA, Thane. The donation and deferral data were analyzed to determine the causes of temporary and permanent deferral and demographic variations in the same. Results: The blood donor deferral rate was 13%, we had segregated the deferrals in category A- Permanent Deferrals Category B- Temporary Deferrals. The majority of deferrals were temporary deferrals (63.4%) of young donors. The maximum number of donors deferred (30.7%) due to Low hemoglobin (Anaemia) (temporary), closely followed by 29.6% due past history of diseases like heart disease and Jaundice. History of malaria, intake of medicines, infections, underweight, last blood donation within 3 months (temporary deferral), and history of heart and lung diseases, diabetes, and with suspicious identity (permanent deferral) were other major causes identified. Conclusion: The pattern of donor deferral is important to formulate blood donation policies and provide guidelines for donor safety at regional and national levels. We conclude that patient education about blood donation criteria can help to decrease the rate of temporary blood donation deferrals.

Spectroscopic studies of interactions of 2-(2-Oxo-2-Phenylethyl)-1, 2-benzisothiazol-3(2H)-one-1, 1-dioxide with human DNA

The interaction of small molecules with DNA has become the most prominent area of research for the discovery of new drugs that may be helpful in curing of the diseases. The present research work was designed to explore the interactions of 2-(2-Oxo-2-Phenylethyl)-1,2-benzisothiazol-3(2H)-one 1,1-dioxide (BTZDO) with DNA by spectroscopic methods in physiological buffers of pH 4.7 and 7.4. Spectral results showed the hypochromic and bathochromic shifts after addition of DNA. The binding constant (Kf) of 5.18 × 102 and 8.62 × 102 Lmol−1 were determined at pH 4.7 (stomach pH) and 7.4 (blood pH) respectively. Strong values of binding constants reflected strong complex between BTZDO and DNA. The observed values of binding constant suggested that the intake of BTZDO inside human body via blood is more effective as compared to the oral intake. The interpretation of physical mode to intake the newly synthesized BTZDO drug into human body is the novelty of this research work. An intercalation binding of the BTZDO with DNA was supported by the results obtained from DNA melting studies. The Gibbs free energy calculated at pH 4.7 was −15.22 kJmol-1 and at pH 7.4 was −16.46 kJmol-1. The negative values of free energies are the prerequisite that the binding process to be spontaneous. Thermodynamic parameters (enthalpy and entropy) were also calculated. The enthalpy calculated for this system was −29.23 kJmol−1K−1 at pH 4.7 and −52.56 kJmol−1K−1 at pH 7.4. The entropy calculated for present system at pH 4.7 was −48.22 Jmol−1K−1 and at 7.4 the value was −122.89 Jmol−1K−1. Negative values of entropy predicted that a compact complex was formed between BTZDO and DNA. The focal point of this investigation was the observation of the effect of temperature on binding between the BTZDO and DNA, nature of complex formed and especially, the preferred mode adopted for the intake of medicine.

A A Review – Rasasindur Various Types of Anupanas w.r.t. Rastangini

Ras Sindoor is an Ayurvedic medicine, with herbal and mineral ingredients, in powder form. Anupana is explained by all Bruhatrayis in detail.Those substances which are drunk along with or after medicine or food intake is known as anupana. Ayurveda also teaches us that certain substances have a particular affinity for specific tissue and channels in the body. A carrier substance (anupan or anupana, in Sanskrit) can be used to help catalyze the delivery of a particular herb or formula to a specific tissue or channel, to encourage its penetration deep into the cells, or to moderate its effect in some way. In this paper introduce Rassindur and various types of anupan use in various diseases.

Adenoids – a review of kantha shalook

Nasal obstruction & mouth breathing frequently caused by multiple factors, one of them being hypertrophied adenoid and tonsils. It is perhaps one of the usually discussed reasons for partial airway obstruction & related respiratory abnormalities. The aim of this article is to provide a lucid illustration of issues pertaining to obstructive breathing and its implication on craniofacial growth. Inefficient medical management and reluctance to surgery necessitates an alternative and novel non-surgical approach to deal this condition. With the very aim of fulfilling the same this case study was taken which involved intake of Ayurvedic medicines and an adoption of Ayurvedic procedure.

Trabalho docente e saúde das professoras da educação infantil

O artigo apresenta resultados de um estudo de caráter quantitativo e qualitativo que investigou a relação entre o processo de trabalho docente e a saúde de todas as professoras de educação infantil de uma cidade de porte médio no Rio Grande do Sul. Fizeram parte do estudo 196 docentes. Nesse artigo apresentamos os resultados da etapa qualitativa que, através de entrevista semiestruturada, investigou as práticas educacionais utilizadas pelas professoras em seu cotidiano de trabalho. A partir dos eixos que conduziram as entrevistas, identificou-se sete categorias elencadas a partir da escuta das entrevistas, foram elas: Ação de Gestão Vocacional, Discurso moralizante, Intensificação, Identidade, Generificação e Medicamentação. Para analisar as entrevistas utilizou-se o modelo de Análise de Conteúdo de Bardin. Os resultados demonstraram que as docentes estão desenvolvendo seu trabalho em condições precárias, baixos salários, exigências burocráticas, condições físicas desfavoráveis, e esses fatores podem estar levando ao uso de medicamentos e ao adoecimento. Como modalidade de trabalho relativamente nova, estudos que deem visibilidade a esse grupo são necessários com o intuito de melhorar as condições laborais das docentes e evitar problemas em sua saúde.

Acorus calamus gold nanoparticles as enhanced anti‐microbial agents for transdermal patches

During the past 20 years, there has been a drastic advancement in the formulation and administration of drugs. In comparison to the conventional oral, traditional and invasive methods of drug delivery, the transdermal (TD) delivery system offers enhanced drug delivery through skin permeation. TD delivery market is contributing greatly to the medical field as it is as an alternate to all other medicinal intake approaches. Nanoparticles enhance the performance of biomaterials in cancer therapy, drug delivery and microbial management. This study involves the synthesis of gold nanoparticles using the aqueous extracts of Acorus calamus and the incorporation of Acorus gold nanoparticles with the biomaterial collagen extracted and isolated from soy seeds. Collagen exhibits biodegradability, low antigenicity and superior biocompatibility in addition to its physiological properties as a natural extracellular matrix component. Acorus calamus mediated gold nanoparticles were fabricated onto TD patches using sonication technique. The treatment of synthesised gold nanoparticles as anti-microbial agents for TD application against E. coli has been evaluated.

Prevalence of herbal medicines in patients with chronic allergic disorders in Western Saudi Arabia.

Objectives:To assess the prevalence and pattern of the use of herbal medicines by allergic patients in Western Kingdom of Saudi Arabia.Methods:Cross-sectional study design was used to collect data from consecutively recruited patients with chronic allergic disorders from July 2018 to October 2018. Participants from 2 allergy clinics in Jeddah, Kingdom of Saudi Arabia were interviewed face-to-face using a structured questionnaire.Results:One hundred and two patients with allergy were interviewed. Their average age was 34±18 and 72.5% were female. The most common primary diagnoses were allergic rhinitis (24.5%), atopic dermatitis (19.6%), and bronchial asthma (16.7%). Herbal medicines were used by 60% of participants, including: Nigella sativa (19.6%), Pimpinella anisum (12.7%), Boswellia sacra (11.8%), Zingiber officinale (10.8%), Foeniculum vulgare (9.8%), Psidium guajava (9.8%), Olea europaea (8.8%), Thymus vulgaris (5.9%), Matricaria chamomilla (4.9%), Mentha piperita (4.9%), Syzygium aromaticum (4.9%), and others. Of those, 63% reported subjective improvement in symptoms. A significant association was found between asthma and herbal medicines intake (p=0.001).Conclusion:Despite the insufficient evidence, there was a high prevalence of herbal medicines used by allergic patients (more than half), especially in bronchial asthma. Black seed, anise and olibanum were the most commonly used.

Evaluating digital medicine ingestion data from seriously mentally ill patients with a Bayesian Hybrid Model

The objective of this work was to adapt and evaluate the performance of a Bayesian hybrid model to characterize objective temporal medication ingestion parameters from two clinical studies in patients with serious mental illness (SMI) receiving treatment with a digital medicine system. This system provides a signal from an ingested sensor contained in the dosage form to a patient-worn patch and transmits this signal via the patient’s mobile device. A previously developed hybrid Markov-von Mises model was used to obtain maximum-likelihood estimates for medication ingestion behavior parameters for individual patients. The individual parameter estimates were modeled to obtain distribution parameters of priors implemented in a Markov chain-Monte Carlo framework. Clinical and demographic covariates associated with model ingestion parameters were also assessed. We obtained individual estimates of overall observed ingestion percent (median:75.9%, range:18.2–98.3%, IQR:32.9%), rate of excess dosing events (median:0%, range:0–14.3%, IQR:3.0%) and observed ingestion duration. The modeling also provided estimates of the Markov-dependence probabilities of dosing success following a dosing success or failure. The ingestion-timing deviations were modeled with the von Mises distribution. A subset of 17 patients (22.1%) were identified as prompt correctors based on Markov-dependence probability of a dosing failure followed by a dosing success of unity. The prompt corrector sub-group had a better overall digital medicine ingestion parameter profile compared to those who were not prompt correctors. Our results demonstrate the potential utility of a Bayesian Hybrid Markov-von Mises model for characterizing digital medicine ingestion patterns in patients with SMI.

Comorbidity and healthcare utilization in osteoarthritis; a primary care survey from Odisha, India

BackgroundThe study aimed to explore the pattern of comorbidities among Osteoarthritis (OA) patients attending urban primary care settings and its association with healthcare utilization. MethodsAge (±3 years) and sex matched (1:1) case-control study was done among randomly selected 514 people (OA + non-OA) attending primary care settings. Information was collected on 18 comorbidities and healthcare utilization was measured by number of hospital visits in last one year and numbers of medicines taken daily. Multivariate logistic regression was used to examine the association with multimorbidity and linear regression analysis was performed for identifying association between healthcare utilization and comorbidities. ResultThere were 260 radiologically confirmed OA cases and 254 matched controls. The mean age of people with OA was 52.7 years compared to 54.5 years in controls. Mean number of comorbidities among OA was 2.5. Leading comorbidities were acid peptic diseases, chronic back pain, hypertension and diabetes. The adjusted odds of having two or more comorbidities among OA patients was 1.8 [95% CI 1.4–2.2]. The adjusted β coefficient for number of medicines taken was 0.5[95% CI 0.2–0.8] in OA patients with two or more comorbidities compared to non-OA with less than two comorbidities. The hospital visits were 0.7 times less among OA patients with two or more comorbidities compared to non-OA with less than two comorbidities after adjusting for other variables. ConclusionOsteoarthritis has significant association with multimorbidity, which increases medicines intake and health care utilization. Comorbidities in OA should be considered for designing integrated care approach.

Factors Associated with Adherence to Antiretroviral Therapy Among People Living With HIV & AIDS

Introduction: AIDS and STD is prioritised disease control program of Nepal. Successful treatment of HIV positive patient is fundamental to control the progression to AIDS and ART adherence is crucial for successful treatment. The objective of the study was to find out the factors associated with adherence to antiretroviral therapy among people living with HIV/AIDS.
 Methods: Descriptive cross sectional research design was adopted. A total of 195 people living with HIV who were above the age 18 years and taking ARV therapy for at least six months from the ART centre of Sukraraj Tropical and Infectious Disease Hospital were selected by using purposive sampling technique. Data was collected using interview technique with semi structured questionnaire. Collected data was analysed using descriptive and inferential statistics.
 Results: The findings showed that 91.28% of the respondents reported perfect adherence (≥95%) and 8.71% of the respondents reported non- adherence. Age (OR: 4.28; CI 1.00-18.26) and marital status (OR: 4.96; CI 1.67-14.75) were the socio-demographic factors associated with adherence to ARV therapy. Number of tablets per day (OR: 10.72; CI 1.21-94.4) and use of reminders tool (OR:11.14; CI 2.35-52.75) were the patient related factors significantly associated with the adherence to ARV therapy. Likewise, experience of no discrimination (OR 3.90; CI 1.11-13.69) and help for the intake of medicine from family members (OR 2.95; CI 1.95-9.19) were the psychosocial factors significantly associated with adherence to ARV therapy. Adherence counselling (OR 13.38; CI 2.99-59.75) and lower travelling cost (OR 3.99; CI 1.40-11.34) were the service factors significantly associated with adherence to ARV therapy.
 Conclusions: The prevalence of adherence found in this study was good. Help from the family members, adherence counselling and use of reminders tool for intake of medicine enhanced adherence. Whereas, side effects, alcohol use, burden of pills, experience of discrimination were the barriers for adherence to ART. For improving adherence government and as well as the hospital requires interventions which recognise these barriers.

Exploring Drug-Related Problems in Diabetic Patients during Ramadan Fasting in Saudi Arabia: A Mixed-Methods Study.

This study aimed to identify any drug-related problems (DRPs) in diabetic patients during Ramadan fasting in Saudi Arabia. The study used a mixed-methods approach consisting of two phases and was conducted in Makkah, Saudi Arabia from December 2017 to March 2018. The first phase of the study involved qualitative semi-structured individual interviews with diabetic patients. A 13-item questionnaire was used in the second phase to further identify DRPs in the wider population. The data was mainly presented as frequencies and percentages. Inferential statistics was performed using Statistical Package for Social Sciences (SPSS) version 21 to compare relevant variables/questions using the chi-square test. Twenty patients (10 male, 10 female) attended face-to-face interviews during the first phase of the study while 95 (40 male, 55 female) completed the questionnaire in the second phase of the study. Two possible risk factors for DRPs were identified from the qualitative data: patient-related factors, including changes in their medicine intake during fasting, and healthcare professionals-related factors, including lack of advice from healthcare professionals regarding fasting. The quantitative results indicated that 52 (54%) of the 95 participants who observed fasting reported to have changed the way they were taking their medicines. Furthermore, 41% of the participants experienced general healthcare problems such as hypoglycemia, hyperglycemia, fatigue, excessive sweating, and gastrointestinal disturbances. Healthcare professionals need to educate patients who are at risk of DRPs by providing structured education and counseling.

Repair of Adult Mammalian Heart after Myocardial Damages by Oral Intake of Traditional Chinese Medicines

Background: Adult mammalian heart repair after myocardial damage is highly inefficient due to the post-mitotic nature of cardiomyocytes. Interestingly, in Traditional Chinese Medicine (TCM), there are reported effective treatments of myocardial infarction and heart failure in adult humans by oral intake of a TCM concoction named Gu Ben Pei Yuan San (GBPYS) . Methods: We fed the mice with GBPYS after myocardial damages through everyday self-feeding. We then examined the effect of everyday oral intake of GBPYS on improving cardiac function and myocardial repair in adult mice after apical resection or myocardial infarction. Findings: We found that long-term oral intake of GBPYS significantly improved cardiac function after myocardial damages in adult mice. Brdu, Phospho-histone 3, and AuroraB staining indicated increased cell proliferation at the border zone of MI after TCM feeding. GBPYS feeding reduced organ inflammation and is nontoxic to mice after long-term oral intake. Further, serum derived from TCM fed MI rats promoted division of both neonatal rat cardiomyocytes and human iPSC-derived cardiomyocytes in vitro. Interpretation: Oral intake of GBPYS improved heart repair after myocardial damages in adult mice. Our results suggest that there are substances present in GBPYS that help improve adult mammalian heart repair after MI. Funding Statement: This work was supported by the National Natural Science Foundation of China (NSFC No.31571527, N.S.; No.31501098, Q.L.; No.81500241, C.X.), the National Key R&D Program of China (2016YFC1000500, 2016YFC1305100), the Science and Technology Commission of Shanghai Municipality (No. 17XD1400300, No.17JC1400200), and the Haiju program of National Children's Medical Center EK1125180102. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: All the protocols in this study were approved by the Guide for the Care and Use of Laboratory Animals (National Institutes of Health, Publication No. 85-23, Revised) and was carried out under the supervision of the Fudan University Institutional Animal Care and Use Committee.

Use of alternative medicine, ginger and licorice among Danish pregnant women \u2013 a prospective cohort study

BackgroundThe use of alternative medicines and dietary supplements is constantly changing, as are dietary habits. One example of this phenomenon is the current popularity of ginger products as an everyday health boost. Ginger and licorice has also been shown to ameliorate nausea a common complaint in early pregnancy. Alternative medicines are often regarded as safe. However, they might affect fetal development, such as through alterations of hormone metabolism and cytochrome P450 function. Health care professionals may be unaware of the supplementation habits of pregnant women, which may allow adverse exposures to go unnoticed, especially if the rates of use in pregnancy are not known. We therefore investigated the use of alternative medicines and licorice among pregnant Danish women.MethodsA total of 225 pregnant women were included in a prospective cohort when attending the national prenatal screening program at gestational weeks 10–16. Participants were asked to complete a questionnaire regarding their socio-economic status and lifestyle habits, including their intake of alternative medicine and licorice.ResultsWe found that 22.7% of women reported taking alternative medicines, with 14.7% reporting daily consumption. Ginger supplements were consumed by 11.1%, mainly as health boost and 87.1% reported consumption of licorice. Regular or daily licorice consumption was reported by 38.2 and 7.1%, respectively. Notably, the use of licorice was reflected by an increase in blood pressure of the pregnant women.ConclusionsThe use of licorice and alternative medicines appears to be common in pregnant Danish women, supporting the need for further investigations into the safety of alternative medicine use during pregnancy and the importance of up-to-date personalized counseling regarding popular health trends and lifestyle habits.

Anisocoria: Realities, Recognition, and Remedial Aspects.

ABSTRACTThe realities, recognition, and remedial aspects of anisocoria at the bedside were highlighted by Adhikari et al.,1 which is almost similar to an earlier report from India.2 Since this condition involves patient safety and clinical assessment, we would like to touch upon 3 Ps (physiological, pathological, and pharmacological) of anisocoria. First and foremost is to elicit a thorough clinical history and then to assess the case in detail which not only rules out injuries, infections, instillation, or ingestion of medicines and instigating mechanisms but also helps rule out various other life-threatening conditions.How to cite this articleSenthilkumaran S, Jena NN, Balamurugan N, Florence B, Thirumalaikolundusubramanian P. Anisocoria: Realities, Recognition, and Remedial Aspects. IJCCM 2019;23(11):543.

Leprosy Scenario in Ahmedabad District (Gujarat).

Background:In India, leprosy still continues to be one of the major public health problems and demands a continuous awareness for its eradication. The reduction of the load of infection is the cornerstone of leprosy control.Aims:The aim of the present study was to enumerate the epidemiology of leprosy in the Ahmedabad district of Gujarat.Methods:Three hundred new cases of leprosy (multidrug therapy cases) and patients who had completed antileprosy treatment and developed new signs and symptoms after that during the period from June 2010 to December 2012 were included in the study. A detailed history, clinical examination, and relevant tests were done.Results:Out of a total of 300 patients, male-to-female ratio was 2.1:1. Family history was positive in 4.3% of patients. Lepromatous leprosy was seen in 27.3%, pure neuritic leprosy occurred in 12 (3.9%), and smear positivity was seen in (44.6%). Thirty (10%) patients developed type 1 reaction and 32 (10.6%) patients had type 2 reaction. Nearly 1.3% of the cases were relapsing cases.Limitations:The study had geographical limitation and the study did not cater the whole population but only the cases who reported to the hospital. Hence, the social stigma factor associated with leprosy could not be annulled.Conclusions:Leprosy still prevails and adequate knowledge and clinical skills, sensitive diagnostic tools and proper supply of medicines from the medical end and early reporting of symptoms, compliance regarding medicine intake, and social awareness to null social stigma associated with it from the patient's end may bring the country as a whole to the target of leprosy elimination.

A Qualitative Assessment of the Determinants of Adherence to Antiretroviral Therapy among Adolescents living with HIV in the Centre Region of Cameroon

Background: Adherence to antiretroviral therapy (ART) is known to be challenging among adolescents living with HIV/AIDS, meanwhile it is the key to success for ART programmes. In Cameroon, although a few researchers have investigated on the quantitative aspects of adherence among adolescents, less is known about qualitative information. This study aimed at investigating the key factors that contribute to ART adherence for adolescents living with HIV in the Centre Region of Cameroon. Methods: The study was conducted in the Centre Region of Cameroon. Adolescents on ART with disclosed status was recruited from health facilities. Six focus group discussion (FGD) sessions were conducted with 56 adolescents both girls and boys aged more than 15. In addition, 3 FGD with 34 parents/guardians and 10 individual in-depth interviews with health care providers were all conducted between the months of June and September 2018. Results: A total of 56 adolescents, 34 parents and 10 health care providers were approached for participation. Results showed that a range of factors related to the individual, family, environment, medication and health system levels determine the reasons for poor adherence to ART among adolescents living with HIV. In fact, most adolescents mentioned in this study that compliance with medicine intake is seen as a punishment or drudgery. Conclusion: In supporting adherence to ART, it would be important to develop approaches that facilitate and help adolescents to adequately comply to medication intake like the creation of discussion groups through phone messages and WhatsApp for the sharing of experiences and for mutual support. A multi-sectorial approach would also be needed to address this issue.

Incidence of Egyptian Live Births of Cleft Lip and/or Palate in Cairo, Luxor, Aswan and New Valley Governorates: A Survey Study in 237,783 Children

Objective: To evaluate the prevalence, cleft types distribution and etiological risk factors among newly born babies with cleft lip and/or palate (CL±P) in four governorate of the Arab Republic of Egypt, beginning the 1st of January 2013 till the 31st of December 2013. Material and Methods: Total 237,783 newly born babies from Cairo (162174), Aswan (42880), Luxor (32729), and New Valley (877) governorate in the Arab Republic of Egypt were included in this study. Incidence of CL±P babies per 1000 births was calculated in each district for the four studied governorates. Percentage distribution of cleft types within each governorate. Chi-square test was used for determining significance of difference of incidence and percentages within and between the governorates. Results: The mean prevalence value of CL±P in the four Egyptian studied governorates was 0.40/1000. The highest percentage of cleft type was cleft lip and palate followed by cleft lip and isolated cleft palate. The highest etiological risk factor was maternal passive smoking in the four studied governorates followed by consanguineous marriage and medicine intake during pregnancy. Conclusion: These data provided a picture of the prevalence of CL±P in four different governorate of Egypt and also provided a useful reference for cleft types distribution and etiological risk factors of CL±P data in Egypt and internationally.

Efficacy of Nano-Hydroxyapatite on Enamel Surface of Primary Teeth Following Exposure to Liquid Medications in Comparison with Sodium Fluoride: An in Vitro Study

Background: Demineralization initiated by acids is occasionally resulting from the intake of liquid medicines used to treat children on regular basis. Fluoride and nano-Hydroxyapatite has been broadly utilized in remineralization of erosive lesions. Aim: To compare the efficacy of nano-Hydroxyapatite with sodium fluoride on enamel surface of primary teeth after exposure to pediatric liquid medications by investigating the topographical and weight changes. Materials and Method: Thirty posterior primary teeth were extracted from (3-6) years old children. They were assigned to three groups: (A) nano-Hydroxyapatite, (B) sodium fluoride, and (C) artificial saliva (control). Groups A and B were exposed to pediatric liquid medications including: (Cephalexin and ParAzar). Afterwards, they were treated with 1% nano-Hydroxyapatite suspension and 2% sodium fluoride solution. The samples were examined for changes in surface roughness and weight using Atomic Force Microscope and an electronic balance respectively; at three periods: baseline, after 7 days of exposure to liquid medications, and 1 day of exposure to treatment agents. Results: Group A showed a highly-significant difference in roughness for subgroups treated with nanoHydroxyapatite. A highly-significant increase in roughness was noticed for Cephalexin between baseline and treatment periods and a highly- significant reduction between baseline and ParAzar exposure periods. Regarding weight, a highly-significant difference was found for Cephalexin, and a significant difference for ParAzar after nano-Hydroxyapatite treatment. Conclusion: 1% nano-hydroxyapatite suspension had the greatest remineralization efficacy when compared with 2% sodium fluoride solution.

An Unusual Case of Psychogenic Non-Epileptic Seizures in the Elderly Female: A Case Report and Review of Literature

Psychogenic Non-Epileptic seizures (PNES) are classified under Functional Neurological Symptoms Disorders in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. PNES is usually misdiagnosed as a seizure disorder in the elderly population. As a result, they keep on taking Anti-Epileptic Drugs (AED) for years before they come to know that are suffering from PNES. Apart from clinical history, Video electroencephalography (EEG) monitoring, which is the standardised approach for ruling out epilepsy, is rarely performed in every elderly patient. Even during monitoring of video-EEG, anxiety, loss of immobility can occur during the 24 hours procedure which can interfere with the results. Hence, it is important for all neurologist and psychiatrist to be sensitive enough to diagnose the PNES and to identify the psychological stressors. Early identification can prevent the undue intake of medicines and also increase the quality of life of the patient.

Prenatal and Perinatal Risk Factors for Autism at National Children’s Hospital

Background: Autism, or autism spectrum disorder, refers to a broad conditions characterized by challenges with social skills, repetitive behaviors, speech and nonverbal communication.
 Objectives: To determine the demographic profile of patients diagnosed with ASD, determine the significant prenatal and perinatal risk factors associated with ASD.
 Results: A total of 116 subjects were included in the study with 58 cases and 58 controls. They belong to the age ranging from 4 to 16 years old. Every case had a confirmed diagnosis of autism at NCH. There was a significant association noted between neonatal jaundice, nulliparity (OR=2.38; 95% CI, 0.85-6.8) and family history of autism (OR=5.30; 95% CI, 1.29-25.1) with ASD. Exposure to x-ray, medical problems, medicine intake and maternal complications during pregnancy were not significantly associated with ASD with OR 0.74; 95% CI, (0.12-4.15), OR 1.00; 95% CI (0.38-2.61), OR1.49; 95% CI, (0.63-3.53), and OR 1.27; 95%
 CI, (0.28-6.05), respectively.
 Conclusion: The current study indicates that the only significant predictor of ASD is a family history of autism. However, neonatal jaundice, maternal age of >40 years old, smoking during pregnancy and nulliparity showed a trend towards being risk factors for ASD. None of the other prenatal and perinatal characteristics significantly predicts ASD.