Effects of fasting during Ramadan on seizure control and quality of life in patients with epilepsy.

BACKGROUND: During Ramadan, the ninth month of the lunar Islamic calendar, adult Muslims are obliged to fast, which involves refraining from taking any food, beverages, or oral medications from dawn to sunset. Fasting's effect on seizure control is not fully understood, and a few observational studies have provided inconclusive results. This study aimed to investigate the effect of fasting during Ramadan on seizure control and quality of life in adult patients with epilepsy. METHODS: This was a prospective observational study over a 3-month period (one month before fasting, the fasting month, and one month after fasting). We recruited adult patients with active epilepsy who were able to fast during the month of Ramadan. The primary outcome measures were as follows: 1) seizure control and 2) quality of life score using the Arabic version of the Ferrans and Powers Quality of Life Index (QLI). Changes in anticonvulsant medications were not allowed during the study period. We used a seizure log provided to participants to record the number of seizures during the 3-month period. Quality of life was scored at the end of each month of the study period. RESULTS: Thirty-seven patients were studied (59% males). The mean age was 30 years (range, 14-51 years), and mean age at epilepsy onset was 13 years (range, 0.5-35 years). On average, patients were on three antiepileptic medications at baseline (range: 2-5). A total of 1576 seizures were reported during the 3-month follow-up, where seizures prior to fasting represented 35.5% of all seizures. Multilinear regression analysis revealed a significant decline of seizures by 21% during the fasting month compared with baseline (adjusted coefficient = 0.79, p < 0.01, 95% confidence interval (CI); 0.61-0.98, R2 = 0.81) and by 29% during post fasting compared with baseline (adjusted coefficient = 0.71, p < 0.01, 95% CI; 0.53-0.90, R2 = 0.79). No significant change was found in the QLI scores calculated during the three months of the study period. CONCLUSION: Fasting during Ramadan might have a positive impact on seizure control in patients with epilepsy, which continued during the month following fasting, whereas the quality of life scores were not affected by fasting.

Transforming growth factor-ß1 in children with diabetic nephropathy.

BACKGROUND: Transforming growth factor-ß1 (TGF-ß1) is a multifunctional cytokine that has numerous biological processes. Earlier research indicates that protein and mRNA production of TGF-ß1 are enhanced in the renal tissues of patients with diabetic nephropathy (DN). Our aim was to evaluate the role of TGF-ß1 in early prediction of DN in children with type 1 diabetes mellitus (T1DM). METHODS: Fifty patients with T1DM were enrolled in an observational study. Patients were eligible to participate if at least 3 years had passed since T1DM diagnosis. Patients were classified into two groups (A and B) according to the presence or absence of microalbuminuria, respectively. Serum TGF-ß1 was measured by ELISA in the patients. RESULTS: Out of the 50 studied patients with T1DM, there were 23 (46%) patients with microalbuminuria. There was a significant difference between patients in group A and B as regards TGF-ß1 (p < 0.001). HbA1c had very little influence in controlling for the relationship between TGF-ß1 and disease duration. Diagnostic cutoff value of TGF-ß1 was 358.5 pg/ml with sensitivity and specificity of 100%. CONCLUSION: TGF-ß1 was significantly higher in children with DN in comparison with children without. It could be used as an early indicator of DN in children with T1DM with high sensitivity and specificity.

The Optimal Dose of Amobarbital in the Wada Test for the Presurgical Evaluation of Patients With Temporal Lobe Epilepsy.

OBJECTIVE: The use of amobarbital in the Wada test varied between epilepsy centers, with no unified dosing or protocols available in the literature to standardize its use. We aimed to determine the dose of amobarbital in the presurgical evaluations of patients with temporal lobe epilepsy. METHODS: A retrospective study of patients with temporal lobe epilepsy seen between January 2004 and December 2018 in King Faisal Specialist Hospital and Research Centre in Jeddah, Saudi Arabia, was conducted, and those who successfully underwent a Wada test were studied. A neuropsychologist or a neurologist will assess the memory and language, using standardized testing. RESULTS: A total of 90 patients were studied. The mean age was 30 years (range, 16-52 years), where 49 (57%) of them were men. All patients had a routine neurological examination, including language and memory. The average dose of amobarbital given was 10.1.1 mg (range, 65.7-150 mg). There was no statistical difference between the dosing given to patients who passed or failed the memory testing (101.4 mg vs 94.7 mg, P = 0.1). Multivariate regression analysis showed that amobarbital dose needed an adjustment to patient's weight only for those older than 30 years, (P < 0.05; 95% confidence interval, 0.1-0.5), where an increase in the dose by 0.3 mg·kg·y was required to execute Wada test successfully. CONCLUSION: It was only the patient's age that could influence the modification of Amobarbital dose in the Wada test, yet establishing a universal protocol is challenging because of the lack of well-defined dose determinants.

Chemical Composition and Antioxidant Activity of Lawsonia inermis Seed Extracts from Morocco.

The aim of the present study was to investigate the composition of Lawsonia inermis (henna) seed oil from Morocco and to evaluate some of its activities in order to use it in cosmetics. Phytosterols are valuable henna-oil constituents, but henna oil does not present any interesting antioxidant activity.