International Research Journal of Medicine and Medical Sciences

Number 3, 2017

37-43
Antiepileptic drugs use among patients attending epilepsy clinic at Jimma university teaching and referral hospital, southwest Ethiopia: Retrospective facility based cross-sectional descriptive study

Authors: Walelign Atalay, Chernet Abebe and Waju Beyene Salgedo

Abstract

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Antiepileptic drugs (AEDs) are primary therapeutic mode for epilepsy. Nevertheless, the risks of significant adverse effects and drug interaction increase when more than one drug is used. A retrospective cross-sectional facility based study was carried out in Jimma university specialized teaching hospital, southwest Ethiopia, from June 25 to July 5, 2015. The sample size was determined by Joint Commission on the Accreditation of Health Care Organization (JCAHO) criteria by taking 5% of the total patient medical cards through systematic random sampling technique. Data were collected by trained data collectors using the pre-developed data collection format. It was entered onto computer and analyzed by SPSS 20.0 for window and the result was presented in tables and descriptive narrations. A total of 154 patients’ treatment cards which contains AEDs were studied. 95 (61.7%) of the subjects were males and majority, 74 (48%), were in the age group of 5 to 18 years old. Generalized tonic-clonic seizure (76.3%) was the most common type of epileptic seizure seen. Monotherapy (89.7%) was most frequently used. Headache (64.4%) was the commonest adverse effect complained by the patients. Almost eighty percent (79.20%) of AED use was in accordance with indications while 20.8% were difficult to conclude whether it is correct or incorrect indications since the type of epilepsy is not specified. There was 17.7% under dose, 8.4% over dose and 21.1% AED use. There were potential drug-drug interactions in 9.4%. The present study has revealed prudent use of AEDs pertaining to indications and contraindications. The classification of seizure, use of drugs with potential drug interaction, dose and duration experiences need urgent intervention of giving health education to patients to report to physicians on follow-up days.

44-49
Serum cholinesterase as liver function test in cirrhotic patients at Soba Teaching hospital, Khartoum, Sudan

Authors: Nagah A. A. Mohamed, Mohamed Amanullah, Ramazan Amanvermez, Mariam A. Ibrahim and Moneer Abbas

Abstract

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Number of views: 490

It is suggested that plasma cholinesterase level is affected by liver cirrhosis due to hepatocyte injury. The objective of this study was to determine cholinesterase values in association with albumin and prothrombin during both the compensated and decompensated stages in cirrhotic patients. A total of 150 consecutive episodes of liver cirrhotic patients, aged (68.9 ± 10 years) admitted to the hospital between June 2015 and December 2015 were studied. They were classified into subgroups according to severity and the stages of disease into group A (compensated stage) and group B (decompensated stage), each containing 75 patients. Fifty apparently healthy participants aged 64.5 ± 13 years were recruited as controls. Blood samples were drawn and targeted parameters were assessed using commercial kits according to the manufacturer’s guide. SPSS package was used for data analysis. There was a significant difference in the mean serum cholinesterase activity, albumin level and prothrombin time of cases and controls. The mean serum cholinesterase value of compensated cirrhotic patients was 3143.83 ± 1583.44 IU/L and it was significantly higher (p = 0.000) than that of decompensated cirrhotic patients (1895.32 ± 531.79 IU/L). There was a strong negative correlation between serum cholinesterase activity and prothrombin time (r = -0.580, p = 0.000) and a strong positive correlation between serum cholinesterase activity and albumin concentration (r = 0.617, p = 0.00). The results conclude that, cholinesterase level reflects liver cell conditions wherein low levels indicate hepatocellular damage. In addition, its levels are stable and not easily affected by medications that are given for cirrhotic patients thus, can be used as a marker for the diagnosis and prognosis of liver damage along with prothrombin time and albumin.