International Journal of Advances in Medicine, 2016
Background: Incidence of different myoclonic epileptic syndromes is variable in different regions... more Background: Incidence of different myoclonic epileptic syndromes is variable in different regions. Here in as there is very few literature available internationally being inclusive of all myoclonic epilepsies together. Very few studies are available which describe all characteristics in a given study population. The aim of the study was to find incidence of different types of myoclonic epilepsies among patients presenting with myoclonic seizures their characteristics and to study all myoclonic epilepsies and juvenile myoclonic epilepsy in the study population. Methods: In this study conducted in neurological unit at Ruby hall clinic, a total of 188 case of epileptic disorder were enrolled irrespective of age and sex, among 136 were new case of epileptic disorder were classified based on seizure pattern, 23 were new cases of myoclonic epilepsy, these 23 new case of myoclonic epilepsy along with 52 old cases of myoclonic epilepsy attending to neurological unit were clubbed, a total of 75 cases myoclonic epilepsy were studied. All cases of myoclonic epilepsy and juvenile myoclonic epilepsy were studied with respect to age of onset different seizures, relation with family history, response to treatment, EEG findings. Results: Out of 136 cases 23 were new cases of myoclonic epilepsy, these 23 newly diagnosed cases of myoclonic epilepsies along with 52 already diagnosed myoclonic epilepsy are clubbed together, total of 75 cases were further studied. Incidence of myoclonic epilepsy among epileptic patients found to be 16.9%. Incidence of JME among myoclonic epilepsies is 75-80%, in all myoclonic epilepsies and JME association with GTCS, family history, EEG abnormalities were common finding, valproate and leviteracetam are good therapeutic options, carbamazepine aggravated myoclonus. Conclusions: For diagnosis of myoclonic epilepsy proper clinical history stress laid to ask history of myoclonic jerk in case of all seizure disorder, diagnosis basically depends on proper knowledge of myoclonic epileptic syndrome, eliciting history, EEG as an ancillary testing when in doubt always expert opinion is required as misdiagnosis of the myoclonus as partial seizure leads to wrong prescription of carbamazepine which exacerbates the myoclonus.
International Journal of Advances in Medicine, 2016
Background: As the severity of pancytopenia and the underlying pathology determines the managemen... more Background: As the severity of pancytopenia and the underlying pathology determines the management and prognosis of these patients, identifying the correct etiopathology in a given case is crucial and helps in implementing timely and appropriate treatment.The objective of the study was to determine the etiological profile of pancytopenia. Methods: The present study included 44 patients with pancytopenia comprising of all ages and both sex. All cases were analyzed with respect to age, sex, clinical features at presentation, hemogram, peripheral smear, serum B12, plasma Folate, serum ferritin and bone marrow aspiration and etiological profile of pancytopenia was ascertained. Whether critical analysis of peripheral smear provides clue to the underlying pathology and how frequently bone marrow aspiration yields the diagnosis were also studied. Results: Megaloblastic anemia was the most common cause of pancytopenia in this study (54.5%). Malignant and premalignant conditions (20.5%) were the second commonest cause of pancytopenia. Among 24 patients of megaloblastic anemia, 13 patients (54.16%) had macrocytic picture on peripheral smear suggestive of uncomplicated megaloblastic anemia. Of the 24 patients of megaloblastic anemia, 22 patients (91.66%) had low serum B12 levels. The distribution of cellularity, megakaryopoiesis, erythropoiesis, granulopoiesis on bone marrow aspiration differed significantly across various causes of pancytopenia (p-value <0.001). Conclusions: Megaloblastic anemia should be considered first when managing a patient of pancytopenia and peripheral smear should be carefully examined for features of megaloblastic anemia.
International Journal of Advances in Medicine, 2016
Background: Incidence of different myoclonic epileptic syndromes is variable in different regions... more Background: Incidence of different myoclonic epileptic syndromes is variable in different regions. Here in as there is very few literature available internationally being inclusive of all myoclonic epilepsies together. Very few studies are available which describe all characteristics in a given study population. The aim of the study was to find incidence of different types of myoclonic epilepsies among patients presenting with myoclonic seizures their characteristics and to study all myoclonic epilepsies and juvenile myoclonic epilepsy in the study population. Methods: In this study conducted in neurological unit at Ruby hall clinic, a total of 188 case of epileptic disorder were enrolled irrespective of age and sex, among 136 were new case of epileptic disorder were classified based on seizure pattern, 23 were new cases of myoclonic epilepsy, these 23 new case of myoclonic epilepsy along with 52 old cases of myoclonic epilepsy attending to neurological unit were clubbed, a total of 75 cases myoclonic epilepsy were studied. All cases of myoclonic epilepsy and juvenile myoclonic epilepsy were studied with respect to age of onset different seizures, relation with family history, response to treatment, EEG findings. Results: Out of 136 cases 23 were new cases of myoclonic epilepsy, these 23 newly diagnosed cases of myoclonic epilepsies along with 52 already diagnosed myoclonic epilepsy are clubbed together, total of 75 cases were further studied. Incidence of myoclonic epilepsy among epileptic patients found to be 16.9%. Incidence of JME among myoclonic epilepsies is 75-80%, in all myoclonic epilepsies and JME association with GTCS, family history, EEG abnormalities were common finding, valproate and leviteracetam are good therapeutic options, carbamazepine aggravated myoclonus. Conclusions: For diagnosis of myoclonic epilepsy proper clinical history stress laid to ask history of myoclonic jerk in case of all seizure disorder, diagnosis basically depends on proper knowledge of myoclonic epileptic syndrome, eliciting history, EEG as an ancillary testing when in doubt always expert opinion is required as misdiagnosis of the myoclonus as partial seizure leads to wrong prescription of carbamazepine which exacerbates the myoclonus.
International Journal of Advances in Medicine, 2016
Background: As the severity of pancytopenia and the underlying pathology determines the managemen... more Background: As the severity of pancytopenia and the underlying pathology determines the management and prognosis of these patients, identifying the correct etiopathology in a given case is crucial and helps in implementing timely and appropriate treatment.The objective of the study was to determine the etiological profile of pancytopenia. Methods: The present study included 44 patients with pancytopenia comprising of all ages and both sex. All cases were analyzed with respect to age, sex, clinical features at presentation, hemogram, peripheral smear, serum B12, plasma Folate, serum ferritin and bone marrow aspiration and etiological profile of pancytopenia was ascertained. Whether critical analysis of peripheral smear provides clue to the underlying pathology and how frequently bone marrow aspiration yields the diagnosis were also studied. Results: Megaloblastic anemia was the most common cause of pancytopenia in this study (54.5%). Malignant and premalignant conditions (20.5%) were the second commonest cause of pancytopenia. Among 24 patients of megaloblastic anemia, 13 patients (54.16%) had macrocytic picture on peripheral smear suggestive of uncomplicated megaloblastic anemia. Of the 24 patients of megaloblastic anemia, 22 patients (91.66%) had low serum B12 levels. The distribution of cellularity, megakaryopoiesis, erythropoiesis, granulopoiesis on bone marrow aspiration differed significantly across various causes of pancytopenia (p-value <0.001). Conclusions: Megaloblastic anemia should be considered first when managing a patient of pancytopenia and peripheral smear should be carefully examined for features of megaloblastic anemia.
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