Therapeutic Aspects Research Articles

High-frequency episodic migraine: Time for its recognition as a migraine subtype?

High-frequency episodic migraine (HFEM) has gained attention in the field of headache research and clinical practice. In this narrative review, we analyzed the available literature to assess the evidence that could help decide whether HFEM may represent a distinct clinical and/or biological entity within the migraine spectrum. The output of the literature search included 61 papers that were allocated to one of the following topics: (i) socio-demographic features and burden; (ii) clinical and therapeutic aspects; (iii) pathophysiology; and (iv) classification. Multiple features differentiate subjects with HFEM from low-frequency episodic migraine and from chronic migraine: education, employment rates, quality of life, disability and psychiatric comorbidities load. Some evidence also suggests that HFEM bears a specific profile of activation of cortical and spinal pain-related pathways, possibly related to maladaptive plasticity. Subjects with HFEM bear a distinctive clinical and socio-demographic profile within the episodic migraine group, with a higher disease burden and an increased risk of transitioning to chronic migraine. Recognizing HFEM as a distinct entity is an opportunity for the better understanding of migraine and the spectrum of frequency with which it can manifest, as well as for stimulating further research and more adequate public health approaches.

Unveiling Ayurveda Aahara and regulatory provisions

Food is vital for human health, providing energy, nutrients, and other essential benefits. Ensuring food safety is of the utmost importance and crucial, as highlighted by the World Health Organization, for maintaining proper nutrition. Ayurveda, the oldest living holistic healthcare system, emphasizes equally on wellness as well as therapeutic aspects by proposing its unique dietetic principles (Aahara) as a probable solution. This could also be observed since the demand for plant-based Ayurvedafood products is surging substantially. To uphold quality, safety, standards, and efficacy in Ayurvedafood products, the Ministry of Ayush and the Food Safety and Standards Authority of India (FSSAI) have taken the joint initiative to include a new category, that is, Ayurveda Aahara, under the ambit FSSAI regulations in May 2022. An attempt has been made to integrate Ayurveda food-related principles with contemporary scientific understanding within the regulatory framework, which is expected to strengthen India’s global position as a custodian of Ayurveda wellness practices through dietetics, thereby contributing toward United Nations Development Programme that is Sustainable development goals related to human health and wellbeing. In this manuscript, the data were collected from various online and offline sources.

Knowledge And Attitude Of Nurses About Radiation Safety And Radiation Protection: A Scoping Review

Background: Radiation is an electromagnetic wave which is coming across the daily activity of humans. There are naturally occurring and man-made radiations. X-rays, being the commonest radiation mostly known to the people are used in the medica field for diagnostic and therapeutic aspects. Despite of being at good in the preliminary evaluation of pathologies, it also possess a risk of biological effects of radiation on living tissues. This is crucial for the people who are associated with radiation as part of their occupation. The occupational staff must be well aware of the biological effects of radiation and the different means of radiation protection and safety. Nurses, being the largest community in the healthcare, and associated with most of the procedures carried out in a hospital, are expected to have a good knowledge and understanding about the radiation and radiation safety. The aim of this review was to assess the nurses’ awareness and knowledge of radiation safety and protection, which is essential for their health and performance as a healthcare team. Materials and Methods: A systematic search was conducted using PubMed and ProQuest databases with relevant keywords from 2013 to 2023. A total of 104 articles were found based on the search techniques, were screened for eligibility based on predefined criteria and only 7 articles were included in the final analysis. Results: The review found that nurses’ knowledge and attitudes towards radiation safety and protection were insufficient and varied across different settings and specialties. The main barriers to adequate knowledge and practice were lack of education, training, and resources. Conclusion: The review highlighted the need for improving nurses’ knowledge and competence in radiation safety and protection through regular and comprehensive training programs, guidelines, and policies. This would enhance the quality and safety of the services provided by the nurses and protect them from the harmful effects of radiation exposure.

Stab Wounds of the Abdomen: Epidemiological, Clinical, Therapeutic and Evolutionary Aspects in the General Surgery Department of the N'zérékoré Regional Hospital (Guinea)

Aim: To determine the place of abdominal wounds among abdominal traumas and to describe their clinical, therapeutic and evolutionary aspects. Patients and Methods: This was a retrospective descriptive study based on analysis of the records of patients seen for abdominal stab wounds in the general surgery department of the N'Zérékoré regional hospital during the period from January 2011 to December 31, 2020. Epidemiological, clinical, therapeutic and evolutionary parameters were studied. Results: Out of a total of 745 cases of abdominal trauma, we found 89 cases of abdominal stab wounds, a frequency of 12.49%. The average age was 36, with a clear male predominance (78%). Pupils/students were the most represented (32.58%), and criminal assault was the most common circumstance (70.79%). Operative treatment was the most common (74%), and the small intestine was the organ most affected (34.84%); the after-effects were simple in 89.39% of patients, and we recorded 4 deaths (6.06%). Conclusion: Stab wounds of the abdomen are a real public health problem in Africa, especially in low-resource countries such as ours. Surgery is still indicated for severe injuries or complications.

INVASTIGATION OF PATIENT AND HOSPITAL PERCEPTIONS OF CHILDREN PARTICIPATING IN EDUCATION AT THE HOUSE OF COMPASSION

This study was conducted to determine the perceptions of children, one of whose relatives was undergoing chemotherapy treatment and who participated in education at the House of Compassion, about the patient and hospital perceptions and their views on the House of Compassion. Case study design, one of the qualitative research designs, was used. Criterion sampling, one of the purposeful sampling types, was used to determine the study group. The study group consisted of 20 children who participated in the training at the House of Compassion in a hospital in Ankara and one of whose relatives was undergoing chemotherapy treatment. In the study, "Demographic Information Form" was used to collect information about children and parents, "Child Interview Form" and "Children's Pictures" were used to determine children's perceptions of patients, hospital and House of Compassion. The data obtained were analyzed using the descriptive analysis technique. As a result of the research, it was observed that children knew the definition of the hospital, the personnel working in the hospital, and the practices carried out, and emphasized the healing and therapeutic aspects of the hospital. Children reported coming to the House of Compassion to play games, have fun, and have a good time. It was determined that children felt happy and sound in the House of Compassion and that they liked the House of Compassion. As a result, it can be said that the House of Compassion has positive effects on children's perceptions of the patient and the hospital.

Animal Models of Autistic-like Behavior in Rodents: A Scoping Review and Call for a Comprehensive Scoring System

Appropriate animal models of human diseases are a cornerstone in the advancement of science and medicine. To create animal models of neuropsychiatric and neurobehavioral diseases such as autism spectrum disorder (ASD) necessitates the development of sufficient neurobehavioral measuring tools to translate human behavior to expected measurable behavioral features in animals. If possible, the severity of the symptoms should also be assessed. Indeed, at least in rodents, adequate neurobehavioral and neurological tests have been developed. Since ASD is characterized by a number of specific behavioral trends with significant severity, animal models of autistic-like behavior have to demonstrate the specific characteristic features, namely impaired social interactions, communication deficits, and restricted, repetitive behavioral patterns, with association to several additional impairments such as somatosensory, motor, and memory impairments. Thus, an appropriate model must show behavioral impairment of a minimal number of neurobehavioral characteristics using an adequate number of behavioral tests. The proper animal models enable the study of ASD-like-behavior from the etiologic, pathogenetic, and therapeutic aspects. From the etiologic aspects, models have been developed by the use of immunogenic substances like polyinosinic-polycytidylic acid (PolyIC), lipopolysaccharide (LPS), and propionic acid, or other well-documented immunogens or pathogens, like Mycobacterium tuberculosis. Another approach is the use of chemicals like valproic acid, polychlorinated biphenyls (PCBs), organophosphate pesticides like chlorpyrifos (CPF), and others. These substances were administered either prenatally, generally after the period of major organogenesis, or, especially in rodents, during early postnatal life. In addition, using modern genetic manipulation methods, genetic models have been created of almost all human genetic diseases that are manifested by autistic-like behavior (i.e., fragile X, Rett syndrome, SHANK gene mutation, neuroligin genes, and others). Ideally, we should not only evaluate the different behavioral modes affected by the ASD-like behavior, but also assess the severity of the behavioral deviations by an appropriate scoring system, as applied to humans. We therefore propose a scoring system for improved assessment of ASD-like behavior in animal models.

Virtual reality for assessing emergency medical competencies in junior doctors – a pilot study

BackgroundThe teaching and assessment of clinical-practical skills in medical education face challenges in adequately preparing students for professional practice, especially in handling emergency situations. This study aimed to evaluate the emergency medical competencies of junior doctors using Virtual Reality (VR)-based scenarios to determine their preparedness for real-world clinical situations.MethodsJunior doctors with 0–6 months of professional experience participated in one of three VR-based emergency scenarios. These scenarios were designed to test competencies in emergency medical care. Performance was automatically assessed through a scenario-specific checklist, and participants also completed self-assessments and a clinical reasoning ability test using the Post-Encounter Form.ResultsTwenty-one junior doctors participated in the study. Results showed that while general stabilization tasks were performed well, there were notable deficiencies in disease-specific diagnostic and therapeutic actions. On average, 65.6% of the required actions were performed correctly, with no significant variance between different scenarios. Participants achieved an average score of 80.5% in the Post-Encounter-Form, indicating a robust ability to handle diagnostic decisions. Self-assessments did not correlate significantly with objective measures of competency, highlighting the subjective nature of self-evaluation.ConclusionVR-based simulations can provide a detailed picture of EMC, covering both diagnostic and therapeutic aspects. The findings of this pilot study suggest that while participants are generally well-prepared for routine tasks, more focus is needed on complex case management. VR assessments could be a promising tool for evaluating the readiness of new medical professionals for clinical practice.

Acute Appendicitis at the Bougouni Reference Health Center

Introduction: Acute appendicitis is an acute inflammation of the vermicular appendix. The objective was to describe the epidemiological, clinical, anatomo-pathological, and therapeutic aspects of appendicitis. Methodology: We carried out a prospective study from January 2020 to December 2020. Results: We listed 60 cases of acute appendicitis which represented 34.4% of surgical emergencies. The average age was 30.9 years. There is a predominance of men with a sex ratio of 1.61. The average consultation time was 2 days. The clinical manifestation was pain in the right iliac fossa. Abdominal ultrasound revealed thickening of the appendicular wall in 55 (91.67%) of cases. The blood count showed hyperleukocytosis in 59 (98.3%). The Alvarado score was between 08 -10 in 57 (95%) of cases. The appendix was laterocecal in 36 (60%) of cases. Appendectomy with burial of the stump was performed in 40 (66.7%), appendectomy without burial in 20 (33.3%). The postoperative complication was parietal abscess 1 (1.66%). Mortality was 0%. Conclusion: Acute appendicitis is the most common abdominal surgical emergency in our department. Early treatment would help reduce complications.

Development of mRNA Lipid Nanoparticles: Targeting and Therapeutic Aspects.

Lipid nanoparticles (LNPs) have emerged as leading non-viral carriers for messenger RNA (mRNA) delivery in clinical applications. Overcoming challenges in safe and effective mRNA delivery to target tissues and cells, along with controlling release from the delivery vehicle, remains pivotal in mRNA-based therapies. This review elucidates the structure of LNPs, the mechanism for mRNA delivery, and the targeted delivery of LNPs to various cells and tissues, including leukocytes, T-cells, dendritic cells, Kupffer cells, hepatic endothelial cells, and hepatic and extrahepatic tissues. Here, we discuss the applications of mRNA-LNP vaccines for the prevention of infectious diseases and for the treatment of cancer and various genetic diseases. Although challenges remain in terms of delivery efficiency, specific tissue targeting, toxicity, and storage stability, mRNA-LNP technology holds extensive potential for the treatment of diseases.

Therapeutic and pharmacological applications of extracellular vesicles and lipoproteins.

In recent years, various approaches have been undertaken to eliminate lipoproteins co-isolated with extracellular vesicles, as they were initially regarded as contaminating entities. However, novel discoveries are reshaping our perspective. In body fluids, these distinct particles not only co-exist, but also interactions between them are likely to occur. Extracellular vesicles and lipoproteins can associate with each other, share cargo, influence each other's functions, and jointly have a role in the pathomechanisms of diseases. Additionally, their association carries important implications for therapeutic and pharmacological aspects of lipid-lowering strategies. Extracellular vesicles and lipoprotein particles may have roles in the elimination of each other from the circulation. The objective of this minireview is to delve into these aspects. Here, we show that under certain physiological and pathological conditions, extracellular vesicles and lipoproteins are 'partners' rather than 'strangers' or 'rivals'.

Analysis of cognitive behavioural therapy apps for generalised anxiety disorder: Evidence-based content and user experience

Mental illness substantially contributes to the global burden of disease, with anxiety high in prevalence. The increase of mobile technology, mental health apps have potential to lessen this burden. However, within apps, the use of evidence-based interventions, such as cognitive behavioural therapy (CBT) are limited. Regardless, many commercially available mental health apps are highly rated by users, highlighting the need to understand what makes mental health apps valuable to the user. The contribution of this study was to uncover apps that support generalised anxiety disorder (GAD) and worry with a CBT basis, explore app functionality, and user experience. Firstly, by identifying apps that support GAD and worry and included CBT. Secondly, by identifying and analysing therapeutic and engagement functions within the apps, and finally, by thematically analysing user reviews. Six apps were identified to support GAD and worry that purported to be CBT-based. However, CBT therapeutic features and engagement features were minimally present in the apps. User reviews yielded 112 comments about the apps and key themes were identified about the app users’ global experiences with the app, and about the combination of technological (e.g., useability, reliability) and therapeutic experiences (e.g., learning and using skills). Future development of quality apps to support GAD and worry must consider the empirical standing of both therapeutic and technology aspects, to provide efficacious and engaging interventions.

The development, feasibility and acceptability of Empower-Autism: A new psychoeducational and psychotherapeutic programme for caregivers of children recently diagnosed with autism.

What is already known about the topic?Parents and carers face many challenges following their child's autism diagnosis. They often look for information, and social and emotional support. There has been relatively little research into how best to provide this support and this means that there is no evidence to guide the delivery of services. Studies have suggested that an approach called Acceptance and Commitment Therapy can help parents and carers with their adjustment and emotional wellbeing.What does this article add?This article describes the development of a new group-based programme to address the diverse needs of caregivers after their child's autism diagnosis. The new programme was developed with caregivers, autistic people and professionals. It was called Empower-Autism and contained lots of information about autism and strategies to support autistic children, alongside therapeutic aspects based on Acceptance and Commitment Therapy. The programme was delivered to 29 parents/carers in three groups. Attendance at the groups was satisfactory. Both parents/carers and facilitators liked and valued the programme and found it accessible. They made suggestions for improvements. After the programme, parents and carers described improved wellbeing. They felt more positive and more connected to other people. They also described parenting their child in a more informed and sensitive way.Implications for practice, research or policyThe new programme is being tested within a large clinical trial. If there are positive results, the programme could be recommended for delivery and this would address an important gap in evidence-based practice.

Jesus and Therapy in the Gospel of Matthew 8:2-9:35

The article provides a brief panoramic review of the narrative plot of the Gospel of Matthew 8:2-9:35 in the context of the therapeutic ministry of Jesus. The article analyzes both Jesus' motivation for healing and therapy, also the therapeutic methods used by Jesus. As a result, the therapeutic aspects of Mt. 8:2-9:35 are placed in a soteriological key, which is reflected by the analysis of the organic connection between Jesus' therapy and the gift of salvation. The relevance of the article is due to the growing interest in the historical search for the Jesus Christ and the current state of research – the so-called Nest Quest.

Influence of Different Diagnostic Criteria on Alzheimer Disease Clinical Research.

Updates in Alzheimer disease (AD) diagnostic guidelines by the National Institute on Aging-Alzheimer's Association (NIA-AA) and the International Working Group (IWG) over the past 11 years may affect clinical diagnoses. We assessed how these guidelines affect clinical AD diagnosis in a cohort of cognitively unimpaired (CU) and cognitively impaired (CI) individuals. We applied clinical and biomarker data in algorithms to classify individuals from the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort according to the following diagnostic guidelines for AD: 2011 NIA-AA, 2016 IWG-2, 2018 NIA-AA, and 2021 IWG-3, assigning the following generic diagnostic labels: (1) not AD (nAD), (2) increased risk of developing AD (irAD), and (3) AD. Diagnostic labels were compared according to their frequency, convergence across guidelines, biomarker profiles, and prognostic value. We also evaluated the diagnostic discordance among the criteria. A total of 1,195 individuals (mean age 73.2 ± 7.2 years, mean education 16.1 ± 2.7, 44.0% female) presented different repartitions of diagnostic labels according to the 2011 NIA-AA (nAD = 37.8%, irAD = 23.0%, AD = 39.2%), 2016 IWG-2 (nAD = 37.7%, irAD = 28.7%, AD = 33.6%), 2018 NIA-AA (nAD = 40.7%, irAD = 9.3%, AD = 50.0%), and 2021 IWG-3 (nAD = 51.2%, irAD = 8.4%, AD = 48.3%) frameworks. Discordant diagnoses across all guidelines were found in 512 participants (42.8%) (138 [91.4%] occurring in only β-amyloid [CU 65.4%, CI 34.6%] and 191 [78.6%] in only tau-positive [CU 71.7%, CI 28.3%] individuals). Differences in predicting cognitive impairment between nAD and irAD groups were observed with the 2011 NIA-AA (hazard ratio [HR] 2.21, 95% CI 1.34-3.65, p = 0.002), 2016 IWG-2 (HR 2.81, 95% CI 1.59-4.96, p < 0.000), and 2021 IWG-3 (HR 3.61, 95% CI 2.09-6.23, p < 0.000), but not with 2018 NIA-AA (HR 1.69, 95% CI 0.87-3.28, p = 0.115). Over 42% of the studied population presented discordant diagnoses when using the different examined AD criteria, mostly in individuals with a single positive biomarker. Except for 2018 NIA-AA, all guidelines identified asymptomatic individuals at risk of cognitive impairment. Our findings highlight important differences between the guidelines, emphasizing the necessity for updated criteria with enhanced staging metrics, considering clinical, research, therapeutic, and trial design aspects.

Mandibular Rhabdomyosarcoma in an Eniente Woman: About a Case

Introduction: Rhabdomyosarcoma is the most common soft tissue sarcoma in patients under 25 years of age. The occurrence of mandibular rhabdomyosarcoma in a pregnant woman is rare with an incidence of 0.07 to 0.1 and the literature describes one case per 1000 deliveries. Only biopsy and histological examination make a definitive diagnosis. Treatment is based on a combination of chemoradiation and surgery. Objectives: To describe the diagnostic and therapeutic aspects of mandibular rhabdomyosarcoma in pregnant women. Observation: It was a 19-year-old patient who had consulted for left mandibular swelling evolving over 28 weeks. A morphological assessment had been requested but being almost full-term, the patient chose to let her pregnancy progress. She was seen again after delivery with a swelling that had tripled in volume with abundant bleeding on the alteration of the general condition. The imaging concluded that there was a large osteolytic mass of the mandible. The biopsy performed came back in favor of an infiltrating pleomorphic rhabdomyosarcoma. Treatment consisted of radiation therapy followed by surgery. The evolution was marked by the death of the patient after 01 month of radiotherapy. Conclusion: Rhabdomyosarcoma is an aggressive malignant tumor that most often affects subjects under 25 years of age and its appearance in pregnant women is rare.

Digestive Surgical Emergencies at Tominian: Therapeutic Aspects

Purpose: To describe the therapeutic aspects of digestive surgical emergencies at the Tominian referral health center. Methodology: This was a prospective cross-sectional study from December 1, 2022 to November 30, 2023, i.e. 12 months, in the general surgery department of Tominian CS Réf. We enumerated 116 patients during our study period, and included in this study all patients received and operated on for digestive surgical emergencies. The parameters studied were etiologies, duration of disease evolution, treatment and postoperative follow-up. Results: Digestive surgical emergencies (n=116) accounted for 22.97% of all procedures (n=505). Men accounted for 73.3% (n=85) and women 26.7% (n=31), with a sex ratio of 2.74. Mean age was 29.25 years, with extremes of 4 and 71 years. 61.2% (n=71) consulted between 49 and 72 hours of disease evolution. The main etiologies were acute appendicitis 47.4% (n=55), acute peritonitis 29.3% (n=34). The surgical procedures performed were appendectomy 47.4% (n=55), appendectomy + lavage 13.8% (n=16), perforation suture 12.9% (n=15). Postoperative follow-up was uncomplicated 87.9% (n=102), complicated by surgical site infection 7.8% (n=9). There were 3.4% (n=4) deaths. Hospital stay was 8 to 14 days in 49.1% of cases (n=57). Conclusion: Digestive surgical emergencies are numerous in Tominian. Their management requires multiple and varied therapeutic means, the rapid initiation of which guarantees a good oronostic outcome.

Plummer-Vinson syndrome: Clinical, therapeutic and evolutionary aspects: a Moroccan case series

Plummer Vinson syndrome (PVS) is a rare entity characterized mainly by upper dysphagia, irondeficiency anemia, and the presence of an esophageal ring on endoscopic examination. We conducted a retrospective study over a period of 18 years describing the epidemiological and clinical profile, endoscopic management and the medium and long-term evolution. A total of 96 patients were enrolled, with a median age of 41,5 years and a clear female predominance (19/77). dysphagia was present in almost all our patients (97,9%), and an anemic syndrome in half the cases (52%). Female gender was significantly associated with PVS occurrence (p=0.002). The frequency of the disease was significantly higher after the age of 30 years with a peak in frequency in the 4th decade (p&lt;0.034). Upper endoscopy found a membranous ring located in the cervical area in all cases. 1 patient had, in addition to the plummer vinson ring, a lower esophageal membranous called Schatzki ring with a small sliding hiatal hernia. PVS was associated with other autoimmune diseases mostly represented by celiac disease and autoimmune thyroiditis. Treatment was based on iron supplementation followed by endoscopic dilatation with Savary dilators in 91,6% (n=88) and balloons for 8,3% of cases (n=8). long-term outcome was favorable in 79.1% of patients with no clinical recurrence. 20,8% patients relapsed after a median of 29,2 months [2-72 months] requiring a second dilation. PVS was complicated by squamous cell carcinoma in 5,2% (n=5).

Cocaine- and Levamisole-Induced Vasculitis: Defining the Spectrum of Autoimmune Manifestations.

Drug-induced or associated vasculitis is a prevalent form of vasculitis that resembles primary idiopathic antineutrophil cytoplasmic autoantibody (ANCA) vasculitis (AAV). Cocaine is a diffuse psychostimulant drug and levamisole is a synthetic compound used to cut cocaine. Their abuse may result in a spectrum of autoimmune manifestations which could be categorized into three overlapping clinical pictures: cocaine-induced midline destructive lesion (CIMDL), levamisole-adulterated cocaine (LAC) vasculopathy/vasculitis, and cocaine-induced vasculitis (CIV). The mechanisms by which cocaine use leads to disorders resembling AAV are not well understood. Cocaine can cause autoimmune manifestations ranging from localized nasal lesions to systemic diseases, with neutrophils playing a key role through NETosis and ANCA development, which exacerbates immune responses and tissue damage. Diagnosing and treating these conditions becomes challenging when cocaine and levamisole abuse is not suspected, due to the differences and overlaps in clinical, diagnostic, therapeutic, and prognostic aspects compared to primary idiopathic vasculitides.

Ameloblastoma Cases in the Mandible: Experience from the Professor Hamady Traoré National Center of Odonto-Stomatology of Bamako

Introduction: Mandibular ameloblastoma is the most common benign odontogenic tumour in stomatological and maxillofacial surgery practice. The aim of this work was to study the epidemiological, anatomopathological and therapeutic aspects of mandibular ameloblastoma in our context. Methodology: It was a descriptive cross-sectional study over a 4-year period (January 2017 to December 2020) of cases of mandibular ameloblastoma confirmed by histology of the operative specimen in the stomatology and and maxillofacial surgery department of the CHU-CNOS in Bamako. Data were collected on a survey form, entered and analyzed using SPSS version 19.0 software. Results: There were 44-recorded cases. Males accounted for 61.36% of cases, with an M/F sex ratio of 1.6. The mean age was 33 years, with a standard deviation of 12 years. The 20-40 age bracket was in the majority (52.27%). In 79.55% of cases, patients consulted for swelling with facial deformity. Dental signs such as mobility, displacement or absence were found in 97.72% of cases. Hemi-mandibular location was the most frequent (45.45%). The main histological type was follicular ameloblastoma in 88.64% of cases. Radical surgery with disarticulation was performed in 47.73% of cases. Conclusion: Mandibular ameloblastoma is common in young adults. Radical surgery is the current trend. Reconstructive techniques are still limited in a context of underdevelopment.

Epidemiological, Clinical, Etiological, and Therapeutic Aspects of Cerebral Palsy in Dakar

AbstractCerebral palsy is one of the most frequent causes of motor disability in children. The aim of our study was to characterize the epidemiological, clinical, paraclinical, etiological, and therapeutic aspects in Dakar. This was a retrospective and descriptive study from March 2010 to March 2020 at the Albert Royer National Children's Hospital and the Neurology Department of the Fann National University Hospital. We collected 913 patients, 13.7% of all pediatric neurology consultations, out of which 556 (60.9%) were males. The average age of the patients was 32.99 months (ranging between 25 days and 17 years). The most common subtype was isolated axial hypotonia (50%) followed by pyramidal (40.5%) and 45% had epilepsy. Brain imaging revealed cortico-subcortical atrophy in 15% of cases. Five hundred and fifty-two children (60.5%) had an electroencephalogram out of which 19.4% had diffuse irritative anomalies. In terms of treatment, 73% had received motor kinesitherapy. Sodium valproate was the most commonly used antiseizure medication at 76.67%. The average follow-up was 12 months. Seven hundred and ninety-two children (86.8%) were lost to follow-up and 5 children (0.5%) died. Psychomotor development improved in 219 children (13.4%) who acquired standing. Note that 267 children (30%) in a stable sitting position and 29 children had acquired language. Cerebral palsy is a disabling condition that needs to be diagnosed early and early interventions can improve the quality of life of the child.