Hewittbyskov2565
Ultra-high-performance liquid chromatography (UHPLC) hyphenated to tandem mass spectrometric methods using the dimethylpentafluorophenylpropyl stationary phase with polar and nonpolar characteristics of a 2-μm fused-core silica particle packing were evaluated to perform efficient separation for the analysis of donepezil in human plasma. The fused-core silica particle design providing the shorter diffusional mass transfer path for the analytes is less affected in resolving power by increasing mobile-phase velocity for faster chromatographic resolution between the administered compound and multiple interfering peaks from the extracted quality control, calibration standard and study samples following simple protein precipitation extraction procedures. In this work, two UHPLC-MS/MS approaches requiring 1.2 min per sample run time and neither expensive ultra-high-pressure instrumentation nor new laboratory protocols were applied and compared for determination of donepezil in human plasma at sub-nanograms per milliliter region to support a randomized, crossover bioequivalence (BE) study in which healthy volunteers each received a single oral dose of the test and reference formulations of 10 mg donepezil hydrochloride. The column performance in terms of chromatographic separation efficiency, peak asymmetry and resolution and retention time reproducibility was found to be sustainable over a thousand extracted plasma injections. The linear dynamic range was detected over a concentration range of 0.2-50 ng/mL. The intra- and inter-day assay accuracy and precision were within 15% for the analyte in individual biological fluids. Positive correlation coefficients (r) greater than 0.98 and 0.99 for donepezil concentrations in study plasma samplers measured by the proposed UHPLC-MS/MS approaches and another validated HPLC-MS/MS method were observed.
We investigated the ABO blood group and Rh factor distributions in patients with epilepsy (PWE) in comparison with a comparator population.
We recruited patients who were admitted to the epilepsy ward at Namazi hospital in Shiraz, Iran, in 2021. GSK343 We classified epilepsies into two categories focal vs. generalized. We also used the anonymous data from Fars Blood Transfusion Organization from 15th June to 30th June, 2021, as the comparator population (to estimate the frequencies of various blood types in the cohort from which PWE were recruited).
Overall, 390 PWE were included [131 (33.6%) with generalized and 259 (66.4%) with focal epilepsy]. We also included 7672 blood donors [from Fars Blood Transfusion Organization data]. The O phenotype had the highest frequencies in both PWE and the comparator population, followed by A, B, and AB blood groups. Similar patterns were observed in patients with focal and generalized epilepsy. With regard to Rh blood group, the Rh-positive phenotype was more prevalent in all groups. The differences between the groups were not significant in any of the comparisons.
While we did not observe any significant associations between blood group and epilepsy in the current study, previous studies have demonstrated compelling evidence that risks of some neuropsychiatric disorders are related to the chemistry of blood, including blood group classification. The issue of the association between epilepsy and blood group should be investigated in large and well-designed studies in the future.
While we did not observe any significant associations between blood group and epilepsy in the current study, previous studies have demonstrated compelling evidence that risks of some neuropsychiatric disorders are related to the chemistry of blood, including blood group classification. The issue of the association between epilepsy and blood group should be investigated in large and well-designed studies in the future.
Seizure severity has been increasingly gaining attention as a complementary assessment to seizure frequency for the measurement of treatment responses. This study aimed to assess the reliability and external validity and of the Persian version of the Seizure Severity Questionnaire (SSQ).
The study sample was recruited from 126 patients with epilepsy who attended the neurology outpatient clinic at Imam Khomeini and Roozbeh hospitals, Tehran, Iran. The Forward-Backward technique was applied to translate the questionnaire. The reliability of SSQ was assessed by Cronbach's alpha coefficient. The external validity of SSQ was assessed by correlating SSQ scores with Quality of Life in Epilepsy Inventory-31 (QOLIE-31) subscales.
The sample comprised 63 women (50%) and 63 men (50%) aged 13-76 years. The mean scores of SSQ items ranged from 3.46 to 5.48. Distribution was skewed for all component scores, with a tendency for the item scores to concentrate toward the highest scores. Reliability for almost all domains were moderate to good, with Cronbach's alpha ranging from 0.615 to 0.770. Component B to D and total score of SSQ had weak-to-moderate inverse correlation with QOLIE-31 subscale scores. However, the result showed no significant correlation with age, sex, or education.
With some limitations, the Persian version of the SSQ shows relatively good reliability and content validity, supporting its use as a specific measure of seizure severity in epilepsy in Iran.
With some limitations, the Persian version of the SSQ shows relatively good reliability and content validity, supporting its use as a specific measure of seizure severity in epilepsy in Iran.
Epilepsy is one of the most common but manageable neurological disorder. The relation between epilepsy, sleep, and health-related quality of life (HRQoL) in culturally distinct environment of Pakistan remains unclear. The purpose of this study was to determine prevalence and predictors of excessive daytime sleepiness (EDS), poor sleep quality (SQ), and to analyze their association with HRQoL in people with epilepsy (PWE).
A study was conducted among PWE attending two tertiary care hospitals of Islamabad and Rawalpindi, Pakistan. The EDS, SQ, and HRQoL were evaluated by Urdu versions of Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and Quality of Life in Epilepsy-31 (QOLIE-31).
The study included 200 PWE and 51 healthy controls with mean (SD) ages of 33.1 ± 13.9, 32.9 ± 10.9, and a disease duration of 5.01 ± 6.17, respectively. The majority of the respondents (n = 130, 65%) had poor seizure control, and most of these (n = 88, 68%) were on combination antiepileptic drug (AED) ther poor SQ in PWE in Pakistan. A significant negative association exists between sleep complaints and HRQoL. During routine clinical consultations, awareness about sleep hygiene practices must be provided to enhance HRQoL.
Effectiveness of different tele-medicine strategies varies in different medical conditions. Use of basic tele-medicine strategy like mobile health (m-health) can be an effective option in different medical conditions in a resource-poor setting.
To study effectiveness and satisfaction of tele-medicine among persons with epilepsy (PWE) in a developing nation during COVID-19 pandemic.
Persons with epilepsy aged 18 years or more who have attended epilepsy clinic at least once physically and were asked for regular follow-up were included. A cross-sectional telephonic survey was conducted to assess effectiveness of tele-medicine over past 1 year. Satisfaction was assessed by tele-medicine satisfaction questionnaire.
31.9% of PWE have used tele-medicine facility in last 1 year and 58.2% were unaware of the availability of such a facility. Among those who utilized tele-medicine, 95.3% were able to explain their concerns satisfactorily during tele-consultation and change in prescription was done in 42.8%. None experienced any new adverse event. Overall, more than 95% were satisfied with tele-consultation and more than 80% wanted to use it again.
Even basic tele-medicine strategies can be a very effective and satisfactory mode of follow-up for PWE in resource-poor settings. Steps should be undertaken to make people aware of the availability of such a facility.
Even basic tele-medicine strategies can be a very effective and satisfactory mode of follow-up for PWE in resource-poor settings. Steps should be undertaken to make people aware of the availability of such a facility.Neuroinflammation not only contributes to epileptogenesis and neurodegeneration, but is also associated with cognitive impairment. Nod-like receptor family pyrin domain containing 3 (NLRP3) inflammasome-mediated neuroinflammation is positively correlated with progression of temporal lobe epilepsy (TLE) and cognitive impairment. Recent studies have shown that the anti-aging protein, klotho, exerts anti-neuroinflammation effects and enhances cognition in neurodegenerative disorders. In the present study, we investigated the role and underlying mechanism of klotho action in NLRP3 inflammasome-mediated neuroinflammation in a TLE model. Specifically, we first injected an adeno-associated viral (AAV)-mediated overexpression of klotho (AAV-KL) into the bilateral hippocampus of rats. After 3 weeks, rats were intraperitoneally injected with lithium-chloride pilocarpine (LiCl-Pilo) to generate a TLE model. Results showed that klotho was significantly downregulated six weeks after TLE, while AAV-mediated klotho overexpression substantially attenuated TLE-induced hippocampal neuronal injury and cognitive impairment. Interestingly, klotho overexpression significantly alleviated expression of NLRP3, IL-1β, and caspase-1 proteins, but up-regulated activation of nuclear factor erythroid 2-related factor 2 (Nrf2). However, treatment with Nrf2 inhibitor ML385 significantly reversed klotho's beneficial effects, including alleviated neuroinflammation, attenuated neuronal injury, and improved cognitive function. Taken together, these results indicated that klotho alleviated NLRP3 inflammasome-mediated neuroinflammation by activating the Nrf2 signaling pathway in the TLE rat model, suggesting that this the anti-aging protein could be a novel and promising therapeutic agent for managing TLE-associated cognitive impairment.
To evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on the disease course, lives, and psychosocial wellbeing of persons with epilepsy (PWE) in Uganda.
From April 2021 till May 2021, we carried out a descriptive cross-sectional study at four hospitals located in four regions of Uganda. PWE presenting at the study sites were offered a structured questionnaire in the local language. We used the PHQ-9 questionnaire to screen for depression and the GAD-7 to screen for anxiety. Univariate and multivariable logistic regression was used to investigate factors associated with anxiety and depression.
A total of 370 responses were collected. The median age of the respondents was 20.5 years (IQR 15-29), and 51.9% were males. During the lockdown period, the seizure frequency increased in 87 (23.5%) PWE. Various forms of physical and psychological violence were inflicted upon 106 (28.6%) PWE. Fifty-eight (15.7%) screened positive for anxiety and 65 (17.6%) positive for depression. Both increased seizure frequency and experienced violence were associated with experiencing depression and anxiety.
The COVID-19 pandemic and lockdown impacted seizure frequency and the psychosocial wellbeing of PWE in Uganda. Increased seizure frequency was associated with higher rates of anxiety and depression. This underlines the importance of continued follow-up of PWE and a low threshold to screen for depression, anxiety, and domestic violence.
The COVID-19 pandemic and lockdown impacted seizure frequency and the psychosocial wellbeing of PWE in Uganda. Increased seizure frequency was associated with higher rates of anxiety and depression. This underlines the importance of continued follow-up of PWE and a low threshold to screen for depression, anxiety, and domestic violence.
