Background: Levetiracetam is broad spectrum, second generation antiepileptic drug which is highly tolerated in children with minor adverse events. Studies evaluating the effect of levetiracetam on hematological parameters have reported an unexplained increased incidence of infections such as pharyngitis and rhinitis. There have been case reports of pancytopenia, thrombocytopenia, eosinophilia and lymphopenia. However, cases of isolated low red blood cell counts, hemoglobin and hematocrit as compared to placebo are reported. Aim of Study: This study aimed to evaluate the changes in complete blood picture, prothrombin time, partial thromboplastin time and platelet functions in children with idiopathic epilepsy who were treated with levetiracetam as monotherapy. Patients and Methods: This study was conducted on fifty children of both sexes presented with idiopathic epilepsy during the period from June 2016 to May 2017. Patients were assessed by monitoring complete blood picture, prothrombin time, partial thromboplastin time and platelet functions before and 6 months after receiving levetiracetam monotherapy. Results: There were no significant alterations in the evaluated parameters during the study after levetiracetam administration when compared to results before treatment. Conclusion: Levetiracetam monotherapy has proven to be well tolerated in treatment of children with idiopathic epilepsy and does not appear to cause significant changes in complete blood picture, prothrombin time, partial thromboplastin time and platelet functions.
Introduction: Liver cirrhosis is an important cause of morbidity and mortality. Methods: Our study aimed to describe the clinical pattern of cirrhosis and its associated factors among adult patients attending Hepatology Clinic, Serdang Hospital, Malaysia from 1st January 2010 to 30th June 2017. Aetiology was further determined by history, biochemistry and/or histology. The severity of the cirrhosis, together with the presence of complications and incidence of hepatocellular carcinoma were documented. Results: A total of 357 adult patients were diagnosed with cirrhosis including 199 male patients (55.7%) and 158 female patients (44.3%), with a mean age of 54-year-old (range: 28–84 –year-old). The causes of cirrhosis were chronic hepatitis B (N=145, 40.6%), chronic hepatitis C (N= 67, 18.8%), cryptogenic liver disorder (N= 63, 17.6%), alcohol (N=42, 11.8%), non-alcoholic fatty liver disease (N=25, 7.0%), and others (N=15, 4.2%). Chronic hepatitis B was the predominant aetiology among Chinese whereas alcohol was the main aetiology among Indians, and Hepatitis C cirrhosis was highest among Malays. Majority of the patients had compensated cirrhosis with Child-Pugh A (N=221, 61.9%) at the time of diagnosis. 80.4% (N=287) of the cirrhotic patients had performed at least one endoscopy surveillance, with 28.6% (82/287) of them had endoscopic evidence of portal hypertension. 32.2% of patients had at least one hospitalization due to complication of cirrhosis. 41 patients (11.5%) had concurrent hepatocellular carcinoma during the follow up. Conclusions: Despite universal hepatitis B vaccination, Hepatitis B viral infection remains the most common cause of cirrhosis among patients attending Hepatology Clinic, Serdang Hospital. Keywords: Aetiology - Liver cirrhosis - Malaysia
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