Background This study aims to identify the determinants of cognitive dysfunction and compare the effect of CPZ and LTC on cognition in WWE. Methods An observational study involving 87 consenting adult WWE aged between 16 and 40 years on LTC or CZP monotherapy. At enrollment, an interviewer‐based questionnaire was used to obtain demographic and clinical information from participants. The diagnosis of epilepsy was mainly clinical and supported by electroencephalographic (EEG) features and classified based on recommendation by the 2017 International League Against Epilepsy (ILAE). Zung Self‐Reporting Depression Scale (ZSRDS) was used to assess the mood of participants. The Community Screening Interview for Dementia (CSID) was used to assess various cognition domains. The National Hospital Seizure Severity Scale (NHS‐3) was used to assess disease severity. Results There were statistical differences between the CZP and LTC groups in all domains of cognition assessed except for orientation. The total CSID scores of the LTC group were 59.2 (4.9) as opposed to CZP group, 57.2 (5.0); p: .005. Those with focal onset seizures had lower median total CSID score (58; IQR: 54–62) when compared to those with generalized onset seizures (62; IQR: 58–62), p: .012. There was a significant correlation between ZSRD score and NHS‐3 score; rho: 0.30, p: .007. Bivariate analysis shows statistically significant correlation between total CSID score and ZSRDS (rho: −0.65), BMI (rho: 0.22), and NHSS‐3 score (rho: −0.36), respectively. However, the effect of AED on CSID scores was lost after multivariate quantile regression with only ZSRDS retaining significance. Conclusion Depression, seizure severity, type and structural etiology were associated with cognitive impairment among WWE. However, on regression model, only depression was statistically significant. The presence of more risks for cognitive impairment in the CZP group limits possible conclusion of LTC superiority.
Effective use of antimicrobial agents for treatment/management of infectious diseases is decreasing due to emergency of multi-drug and cross resistant strains of pathogenic microbes. Medicinal plants are now increasingly used alone or as an adjunct in the management of infectious diseases as a result of their claimed efficacy and safety. This research focused on evaluating the antimicrobial potential of ethanol fruit peel extract of Mangifera indica against isolated Urinary tract infection (UTI) pathogens. Urinary tract infection (UTI) bacterial strains (staphylococcus aureus, escherichia coli and pseudomonas aeruginosa) were isolated from midstream urine of infected students using standard procedures after which the isolated Urinary tract infection pathogens were subjected to antimicrobial susceptibility test by agar-well diffusion method (Cup plate method) and the mean diameter of growth inhibition zones (n=3) of the extract at different concentrations were compared against the controls (sterile water and ciprofloxacin). Ethanol fruit peel extract of Mangifera indica significantly and dose dependently inhibit the growth of all the isolated Urinary tract infection pathogens with E.coli exhibiting the highest inhibition zone ranging from 16.83 to 28.23 mm, this was followed by pseudomonas aeruginosa with inhibition zone of 24.33 mm and staphylococcus aureus least susceptible with 22.63 diameter of zone inhibition. Ethanol fruit peel extract of Mangifera indica demonstrated a dose dependent antimicrobial activity with more pronounced effect exhibited by E. coli suggesting that the extract is more effective against gram negative bacteria despite their permeability barrier, thus suggesting Mangifera indica fruit peel as a potential candidate for the management of bacterial infections especially those caused by gram negative organisms.
Background: The prospect of EEG as a potential biomarker for detecting a cognitive decline in those living with epilepsy has not been extensively studied. Objective: To determine the relationship between electroencephalographic (EEG) changes and cognitive functions in Women with Epilepsy (WWE). Methods: The study involved 100 adult WWE aged between 16 and 40 years on Levetiracetam (LEV) or Carbamazepine (CAB) monotherapy. Zung Self-Reporting Depression Scale (ZSRDS) was used to assess the mood of participants while the Community Screening Interview for Dementia (CSID) was used to assess various cognition domains. Results: The frequency of Periodic Epileptiform Discharges (PED) (p = 0.008), delta waves and theta waves (p = 0.004) were higher in WWE with Cognitive Impairment (CI) compared to those without CI. Lower cognitive scores were seen among those with delta wave across the domains of cognition with statistical significance for language fluency (p = 0.039), language comprehension (p = 0.000), and total CSID (p = 0.000). WWE with PED had a lower mean total CSID score compared to those without PED (p = 0.019). The absence of alpha wave (p = 0.027), presence of delta wave (p = 0.013), slow frequency (p = 0.015) and PED (p = 0.031) were EEG predictors of cognitive impairment. Medication type (p = 0.016) and depression (p = 0.001) were the clinical predictors of cognitive impairment in WWE. Conclusion: The frequencies of PED and slow waves were higher in WWE with CI while the absence of alpha wave, presence of delta wave and PED were EEG predictors of CI.
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