Did Prophet Mohammad (PBUH) have epilepsy? A neurological analysis.

INTRODUCTION: The Prophet of Islam is one of the several famous religious figures who allegedly suffered from epilepsy. Early Greek chronicler Theophanes was one of the first to mention that the revelations of The Prophet were episodes of epilepsy, sparking a debate that has continued to date. This argument, for the most part, was confined to historic literary writings only until it was quoted by some eminent neurologists of recent times. They suggested probable diagnosis of temporal lobe epilepsy, adding credibility to the historical claims. MATERIAL AND METHOD: Review of works of some prominent historians, orientalists, literati from previous twelve centuries, and recent neurologists who believed The Prophet to be epileptic was done. The resource material that influenced them to believe this was likewise examined. Other archived literature including Hadith, the primary resource material that provides detailed information about the day-to-day happenings in The Prophet's life with books on the life of The Prophet by orientalists and Muslim historians describing such features during revelations and other events, was scrutinized. Documentations of these events from all resources were compared and analyzed from a neurological perspective. RESULTS: The author on analysis found literature indicating faulty translations of the original Arabic text into Latin as one of the reason for misleading conclusions. Verbatim translations of Arabic phrases used symbolically have taken away the exact construal giving it a wrong perspective. Similarly, The Prophet's peri-revelation episodes as they appear in Hadith when evaluated from a neurological perspective suggest that The Prophet did not have epilepsy. CONCLUSION: A judicious analysis of the features on which the historians and literati based their suspicion to label The Prophet epileptic, provides little supportive evidence when analyzed from a neurological perspective. Without judicious analysis of clinical data chances of misdiagnosis tend to be fairly high.

Epilepsy treatment gap and stigma reduction in Pakistan: A tested public awareness model.

High epilepsy treatment gap (ETG) and stigma remain a major issue globally. Addressing the basic problems is necessary, for advances in management to be effective. According to the 1987 population-based study, prevalence of active epilepsy in Pakistan is 0.98% with 98.1% ETG in rural and 72.5% in urban population and the presence of stigma. These dismal figures were a stimulus for our reported activities. Recognizing the problems faced by 2.2 million people with epilepsy (PWE) in the country, a group of volunteers mostly from the medical community has attempted to address these issues with an ongoing sustained awareness program over the last 18 years, working within the constraints of prevailing healthcare system, with gratifying results. In 2001, under a nongovernmental organization (NGO), the Comprehensive Epilepsy Control Programme of Pakistan (CECP) was launched to address the various paucities in knowledge, attitude, and practice about epilepsy; especially ETG and stigma. The CECP has two primary components: Epilepsy Support Pakistan (CECP-ESP) for awareness and mass education and National Epilepsy Centre (CECP-NEC) for holistic management of PWE, professional education, and research. Both work in tandem, and there is an overlap of their activities. This article only evaluates the outcome of sustained awareness activities of the CECP-ESP, through direct and indirect measures after 5 years of its initiation. A significant reduction in ETG and stigma exclusively through public awareness has been possible. This model can be easily replicated by any country, with involvement of the local population.

Toxicity assessment of ash and dust from handmade gold jewelry manufacturing workshops in Bangladesh.

Traditionally, handmade gold jewelry played a very important role in the cultural heritage of Bangladesh. Goldsmiths still are partially using ancient manufacturing process with coal fire, candle flame blowing, and nitric and sulfuric acid treatments. Such process leads to the contamination of workplace with the dust of toxic metals, acidic vapors, and particles of different natures. To evaluate contamination by particulate matter (PM), the passive particle collectors were installed in different manufacturing units for a period of 85 days at Tanti Bazar, Dhaka, Bangladesh. The laser diffraction analysis of the samples collected at the soldering units showed significant amounts of particulates, both PM10 and PM 2.5, and also nanoparticles in both nucleation and accumulation mode. SEM/EDS analysis revealed partially melted micro blebs that contain a very high concentration of Fe along with Cu. The toxic elements were detected with ICP analysis and include higher concentrations of cadmium (Cd), chromium (Cr), lead (Pb), and arsenic (As). It is notable that detection of arsenic contamination was unexpected since raw materials used for jewelry making should not have any arsenic.

The analysis and accuracy of mortality prediction scores in burn patients admitted to the intensive care burn unit (ICBU).

BACKGROUND: To date, multiple scoring systems have been utilised in predicting outcomes in burn patients. The aim of this study is to determine the accuracy of three established scoring systems used for burn patients admitted to the intensive care unit and to determine the risk factors associated with poor outcomes. METHODS: A total of 211 patients who were admitted to the ICBU in a tertiary care centre in Kuwait from January 2017 to December 2019 were analysed retrospectively. Data were collected using patient medical records. The FLAMES, BOBI and revised Baux scores were calculated, and the survivor and non-survivor scores of patients were analysed to determine the sensitivity, specificity and Area Under the Receiver Operating Characteristics (AUROC) of the different scoring modalities. RESULTS: The majority of the analysed population were male patients (165/211) and the most common mechanism of burns was flame burns (166/211). Most of the patients admitted to the ICBU survived (188/211). Female gender was associated with a higher mortality rate, whilst inhalational injury and co-morbidities were not associated with a higher mortality rate. The revised Baux score had a sensitivity value of 96% and 90% specificity. The BOBI score had a sensitivity of 91% and 76% specificity. The FLAMES score had a sensitivity of 96% and the highest specificity of 99%. All 3 scores had AUC values exceeding 90%. CONCLUSION: Statistically, FLAMES score had the highest accuracy of predicting outcomes in burn patients, however all three scores demonstrated acceptable predictive rates when it comes to practical application, permitting the use of either one of the studied scores with satisfactory prognostic outcomes.

Clinical and neurological study of women with precatamenial epilepsy.

OBJECTIVE: To describe clinical features and seizure dispersion in precatamenial/pericatamenial epilepsy patients. DESIGN: Case series. PLACE AND DURATION OF STUDY: Department of Neurology (formerly Neuropsychiatry), Jinnah Postgraduate Medical Centre (JPMC), Karachi, from July 1991 to November 2001. PATIENTS AND METHODS: Present study included 33 untreated pericatamenial (n: 23, age: 12-40 years, menstrual cycles: 147) and precatamenial (n: 10, age: 13-32 years, menstrual cycles: 70) epileptics with tonic-clonic seizures. Clinical features and seizure dispersion were evaluated during premenstruation, menstruation, and postmenstruation phases. RESULTS: Women with precatamenial epilepsy had highly significant mean phase day seizures during premenstruation versus other phases, whereas women with pericatamenial epilepsy did not show any significant variations. Premenstrual seizures were found significantly more and others as significantly less in % number in precatamenials compared to those in pericatamenials. Furthermore, precatamenial epileptics with primary generalized seizures were significantly higher in % number and secondary generalized seizures as significantly lower against those in pericatamenial epileptics. All precatamenial epileptics under study had incontinence compared to 65% pericatamenial epileptics that had incontinence. Majority of the patients in both groups showed post-ictal headache. CONCLUSION: The present report describes the extent of exacerbation of premenstrual tonic-clonic seizures with clinical features. These investigations may help in understanding partly the complexity of catamenial/precatamenial/ pericatamenial/noncatamenial seizures, and similarities and dissimilarities between pericatamenial and precise precatamenial seizures.

Influence of steroid hormones in women with mild catamenial epilepsy.

BACKGROUND: In view of considerable differences of opinion regarding the reproductive steroid hormonal pathogenesis in catamenial epilepsy, hormonal analysis of estrogen and progesterone in catamenial epileptics for a precise correlation is of significant importance. METHODS: Clinical, neurological and physiological assessments, and radioimmunoassay of plasma estradiol-17beta and progesterone a day prior to the onset of menstruation were carried out in noncatamenial and mild catamenial epileptics having multiple frequency tonic-clonic (primary and secondary generalized) seizures. RESULTS: Highly significant rise (p > 0.0001) of estradiol-17beta was obtained for catamenial epileptics compared to normal subjects as well as noncatamenial epileptics (p > 0.02). However, nonsignificant fluctuations of progesterone were found for both catamenial and noncatamenial epileptics against normal subjects as well as catamenial versus noncatamenial epileptics. CONCLUSIONS: The present report suggests that estradiol have a precise role in the mild premenstrual exacerbation of seizures. However, no significant change in progesterone levels might have been due to mild exacerbation of seizures in these patients. Furthermore, we suggest the importance of how we collect and categorize the data and which pathophysiologic process/ clinicobiological mechanism is involved in patients with catamenial epilepsy. Contradictory results in literature may be related to differential levels of excitation/inhibition equilibrium during various cycle phases. More precise studies including the determination of the blood levels of antiepileptic drugs, however, are required.

Effects of maximum aggregate size on UPV of brick aggregate concrete.

Investigation was carried out to study the effects of maximum aggregate size (MAS) (12.5mm, 19.0mm, 25.0mm, 37.5mm, and 50.0mm) on ultrasonic pulse velocity (UPV) of concrete. For investigation, first class bricks were collected and broken to make coarse aggregate. The aggregates were tested for specific gravity, absorption capacity, unit weight, and abrasion resistance. Cylindrical concrete specimens were made with different sand to aggregate volume ratio (s/a) (0.40 and 0.45), W/C ratio (0.45, 0.50, and 0.55), and cement content (375kg/m(3) and 400kg/m(3)). The specimens were tested for compressive strength and Young's modulus. UPV through wet specimen was measured using Portable Ultrasonic Non-destructive Digital Indicating Tester (PUNDIT). Results indicate that the pulse velocity through concrete increases with an increase in MAS. Relationships between UPV and compressive strength; and UPV and Young's modulus of concrete are proposed for different maximum sizes of brick aggregate.