Day 3 :
- Neurology and Neuropharmacology
Location: Armstrong
Chair
Hardeep Sahota
Chelsea and Westminster NHS Foundation Trust, UK
Co-Chair
Melanie Dani
Chelsea and Westminster NHS Foundation Trust, UK
Session Introduction
Muaz Abd Alrahman Ibrahim
University of Bahri, Sudan
Title: Correlation between serum level of antiepileptic drugs and their side effects
Biography:
Muaz Abd Alrahman Ibrahim is a medical student at University of Bahri and interested in research conducting now 3 researches and a member of Daoud research group under supervision of senior neurologist and will see 200 patients of neurology per week in our charity clinic.
Abstract:
The aim of the study is to investigate the relation between serum levels of anticonvulsants and their side effects. This is a prospective cross sectional hospital based study conducted at Al Shaab Teaching Hospital. 120 patients were included in the study. The AEDs used were phenytoin, phenobarbitone, carbamazibine, and sodium valproate. The results showed that the side effects among the studied group were not uncommon. There was no relationship between serum levels of AEDs and their side effects.
Tasneem Mahdi Elfaki
University of Bahri, Sudan
Title: A study of prevalence of epilepsy among Sudanese AIDS patients and the underlying causes and types of epilepsy
Biography:
Abstract:
The aim of this study was to describe the prevalence of epilepsy among Sudanese AIDS patients and to study the underlying causes and types of epilepsy. About 700 AIDS patients were included in the cross sectional hospital based study. Almost 5.71% of the patients had epilepsy and 50% of them had generalized convulsion. Encephalitis was found to be the commonest cause of epilepsy followed by meningitis, brain abscess, CNS lymphoma and toxoplasmosis. The EEGs showed abnormal discharge in 28 patients (70%). AIDS is a great mimicker. It can be present in almost any neurological manifestation. Epilepsy is not an uncommon neurological manifestation associated with AIDS.
Mawadda Karrar Ibrahim
University of Bahri, Sudan
Title: Possible predisposing factors for thrombotic cerebrovasculer accidents in Sudanese patients
Biography:
Mawadda Karrar Ibrahim is a Medical Student at University of Bahri, Sudan. She is interested in research field particularly in Neurology and Infectious Diseases, member of Daoud Research Group , it is intended to give more chances for health care professionals in research field, attending neurologic clinic every week, She will see approximately 100 patients per week with professor of neurology Abbashar Hussein, also every month she travel to other states in my country for mobile charity clinic to see neurologic cases with professor of neurology Abbashar Hussein, and participating now in one research, and one other research under the process of publication.
Abstract:
Background: Stroke is a condition that involves loss of brain functions caused by loss of blood supply to part of the brain. It is the third most common cause of death in the developed countries and in 40% of young patients no cause can be identified.
Methodology: A case control study involving 100 patients with thrombotic CVA and 300 age and gender matched healthy control (2002-2004).
Results: In this study, the hematological profiles for patients were within normal range. With normal ranges of APTT (activated partial thromboplastin time) and thrombin clotting time, LA and dysfibrinogenemias can be excluded. Natural anticoagulants (PC, PS, and AT-III) were at the lower range of normal in all patients (p=0.04), and were significantly lower from those of the age (p=0.04), and gender matched controls (p=0.02). In addition, most of the female patients were on oral contraceptive pills at the time of the stroke. Female patients had even lower AT-III levels compared to female controls.
Conclusion: Relative PC, PS, AT-111 deficiencies could be a possible cause of increase thromboembolic CVAs in Sudan.
Monzer Hassan Balla Mustafa
University of Bahri, Sudan
Title: Cosmetic effects of anti-epileptic drugs
Biography:
Monzer Hassan Balla Mustafa is a Medical Student interested in Neurology and Neuroscience, member in Daoud Research Group in which they tend to see 200 patients/week with neurological disorders under supervision of Professor Abbashar Hussein (Senior Neurologist). Now he is participating in three researches and one more research is under the process of publication.
Abstract:
Background: Cosmetic effects of AEDs are of particular concern to the female population as they impair body image and self-esteem.
Methodology: This is across sectional analytical non-intervention clinical based study (2011 -2012.
Results: 45 patients received phenytoin, 42 received Phenobarbitone, 35 received carbamazepine and 38 patients received sodium valproate. Eighty patients (66.6%) took one drug, while 40 (33.4%) received more than one drug. Regarding Idiosyncratic side effects, out of 45 patients on phenytoin, five had acne, four had skin rash, four had coarse facial appearance, one had blood dyscrasias, one had Steven-Johnsons syndrome and one patient had duptuytrens contracture. Dose related side effects of phenytoin (four had gum hypertrophy), four received carbamazepine had skin rash. Out of 42 patients who received Phenobarbitone; four had skin rash. Out of 35 patients who received sodium valproate; four had weight gain, three had tremor, while two patients experienced hair loss. It appeared that most of the patients (60%) who showed some evidence of side effects due to the AEDs had normal serum levels of the AEDs.
Conclusion: Hair loss and weight gain are the most common side effects
Ismat B A Babiker
University of Medical Sciences and Technology, Sudan
Title: The clinical presentations of Epilepsy among adult Sudanese patients and its correlation with stigma and psychogenic non epileptic seizures during October 2016-April 2017
Biography:
Abstract:
Objective: This study aimed to determine the clinical presentations of epilepsy and its correlation with stigma of epilepsy and occurrence of psychogenic non epileptic seizures.
Materials & Methods: This is a prospective cross-sectional health facility based study that was conducted on 66 patients with epilepsy aged from 18-71 years attending Banat Charity Clinic in Omdurman city. Verbal consent was obtained from participants and a predesigned structured questionnaire was used to interview them. Statistical analysis was performed using SPSS version 23.
Results: Out of 66 patients 39 (60%) were males and 26 (40%) were females. Generalized seizure types constituted 50 (75.7%), while focal seizure types constituted 14 (21.2%). Generalized tonic clonic was the commonest seizure type 45 (68.2), followed by focal motor seizure with impaired awareness 10 (15.1%), focal to bilateral 4 (6%), myoclonic and atypical absence 2 (3%) each and clonic seizure 1 (1.5%), two data were missing. Regarding stigma, 22.7% had felt stigma, 7.6% had courtesy stigma, 27.3% had coaching stigma, and 16.7% had coping stigma. Psychogenic non epileptic seizures (PNES) co-existed with epilepsy in 21.2%. PNES, type of epilepsy and educational level were statistically associated with stigma of epilepsy.
Conclusion: The clinical presentation of epilepsy, co-existence of psychogenic non epileptic seizures and epilepsy, and stigma were different from what was mentioned in the literature
Chandrika Dasgupta
Shaheed Ziaur Rahman Medical College, Bangladesh
Title: Antibiotic resistance and physician’s choice of antibiotic in urinary tract infections in Western Bangladesh
Biography:
Chandrika Dasgupta is studying MBBS (5th year) at Shaheed Ziaur Rahman Medical College, Bangladesh. She is very much interested in research and wants to devote herself to invent new era in Medical Science
Abstract:
Objectives: Antibiotic resistance is an important obstacle for treatment of UTI specially in low cost health setup of developing countries. The aim of this study is to investigate the resistance pattern of the common pathogens responsible for UTI in Bogra, Bangladesh. Specific factors associated with antibiotic resistance and prescription pattern were also explored to render data for appropriate empiric evidence-based antibiotic guidelines for this area.
Methods: This retrospective analysis was done among the patients presented with clinical suspicions of UTI for a period of 1 year from October 2016 to September 2017. A total 1256 patients were included in the study. A single clean catch midstream urine sample was collected per patient and samples with more than 105 CFU/mL bacteria were considered positive. 552 samples met the inclusion criteria and in these samples, the bacteria were identified by standard microbiological techniques and the profile of antibiotic susceptibility was obtained using Kibry- Bauer method following Clinical and Laboratory Standards Institute (CLSI) guidelines. Patients’ characteristics, self-reported previous antibiotic consumption history within last 1 year, presenting symptoms, empirical antibiotic prescription given at presentation are also recorded and statistical analysis was done using Stata 15 to investigate the possible factors associated with resistance.
Results: UTI was more common in women (61.5%) and its incidence varied with age, affecting more the elderly patients (29.6%). E. coli was the predominant isolate (61.05%, n=337), followed by Klebsiella (22.28%, n=123). E. coli showed very high frequency of resistance ranging from 54.30% to 77.15% to cefixime, ciprofloxacin, cotrimoxazole and nalidixic acid, moderately high resistance (47.18% to 48.96%) to cefipime, ceftazidime, ceftriaxone and azithromycin and low resistance (1.19% to 16.62%) to imipenem, amikacin, nitrofurantoin and netilimycin. Previous antibiotic consumption history revealed macrolides, cephalosporins and quinolones are mostly consumed antibiotic and 36.34% was based on self-medication and 25.78% was recommended by quacks and drug sellers. 78.29% registered physicians used empirical antibiotic at presentation. Mismatching differences of antibiotic prescription and resistance were slightly evident.
Conclusion: High percentage of resistance to most of first line low cost antibiotics made the choice of empirical therapy critical. Continued surveillance, educational interventions and antibiotic stewardship programs for clinicians are necessary to fight the rising problem of antimicrobial resistance. Further exploration of physician prescribing behavior with development of evidence based empirical therapy for infectious diseases is recommendeda