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BACKGROUND AND OBJECTIVES: Currently, we have a shortage of comprehensive information about newer antiepileptic drugs (AEDs) in the pediatric population. This might explain the discrepancies among pediatricians' preferences in this regard. Therefore, it is crucial to study the multifaceted impacts of these drugs on children. The endpoints of our study were non-AED predictors of the requirement of combination therapy for seizure management, seizure-free period >6 months and >12 months, change in Quality of Life in Childhood Epilepsy Questionnaire - 55 (QOLCE-55), and incidence of adverse events. METHODS: This prospective, observational study was conducted in KIMS, Bhubaneswar, India, from January 2021 to November 2022. Children of 2-12 years of age were treated with monotherapy of either newer antiepileptics, e.g., levetiracetam, topiramate, and oxcarbazepine or older antiepileptics, e.g., valproic acid, phenytoin, phenobarbital, and carbamazepine. Univariate and multivariate analyses were performed for the assessment of predictors. We used R software (version 4.1.1) for data analysis. RESULTS: One hundred and ninety-eight (91.7%) of 216 enrolled participants completed this study. The mean age of the study population was 5.2 years and 117 (59%) of them were males. The univariate analysis showed that male gender, low birth weight, preterm birth, assisted vaginal delivery and site-specific epilepsy, and maternal history of epilepsy were significant predictors of combination therapy and reduced seizure-free period. There was a non-significant difference regarding the improvement of QOLCE-55 scores. None of the adverse events were serious. CONCLUSIONS: Perinatal complications and maternal history of epilepsy contribute significantly toward the efficacy of antiepileptics. However, multivariate analysis did not yield statistically significant results.
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INTRODUCTION: Coronary heart disease and hyperlipidemia is a global problem in today's world. A large number of people suffer from hypertension, atherosclerosis and all these has strong association with the hyperlipidemia. There are many drugs for the treatment of hyperlipidemia, but statins are most commonly used. But, with high dose of statins, the side effect is also there which restricts its use in high dose. Ezetimibe is a comparatively new drug for the treatment of hyperlipidemia having lesser adverse effect as compared to statin. This study has been planned to find out the comparative efficacy of Ezetimibe and Atorvastatin alone and in combination on the lipid profile in rats. METHODOLOGY: This study was conducted in SCB Medical College, Cuttack. 60 rats were fed on atherogenic diet. These were divided in six groups having ten rats in each group and followed for 12 weeks. Group I received only atherogenic diet. All other groups received drugs after four weeks. Group II received Ezetimibe 1mg/kg, Group III received Ezetimibe 2mg/kg, Group IV received Atorvastatin 4mg/kg, Group V received Atorvastatin 8mg/kg and Group VI received Atorvastatin 4mg/kg and Ezetimibe 1mg/kg. Blood lipid profile measured at zero week, four weeks and 12 weeks. RESULTS: All the lipid profile parameters improved significantly with treatment groups as compared with control group. There was no significant difference in the level of different lipid parameters between Group V (Atorvastatin 8mg/kg) and Group VI (Atorvastatin 4mg/kg and Ezetimibe 1mg/kg). CONCLUSION: High dose of Atorvastatin is associated with more adverse effect. The efficacy of high dose of Atorvastatin is comparable to combination of low dose Atorvastatin with Ezetimibe. This combination has lesser side effects. So, this can be a good alternative.