Background:Migraine hampers child's life through school absence, limitation of home and social activities. The goal of prophylactic (preventive) therapy is to reduce headache frequency, headache days, and headache severity with minimum side effects.Objective: To evaluate the efficacy and tolerability of levetiracetam compared to flunarizine as prophylactic treatment of Migraine in children.Methods: This prospective study was carried out in the outpatient department of a tertiary care hospital in Bangladesh. A total of 105 children aged 6-15 years, diagnosed as migraine without aura, were enrolled. Patients were treated with flunarizine or levetiracetam for three months. Headache disabilities were evaluated at baseline and at the end of three months. Results:In flunarizine group, 54 children and in levetiracetam group, 51 children were enrolled. Among them thirty nine children in flunarizine group and 36 children in levetiracetam group completed the study. Headache frequency, headache days, VAS (Visual Analogue Scale) score and PedMIDAS (Paediatric Migraine Disability Assessment Score) score were evaluated at baseline and during the follow up. After three months, headache frequency, headache days, pain severity (Visual Analogue Scale score) reduced significantly compared to baseline (p<0.05). PedMIDAS score was also reduced from 60.35(±16.36) to 30.13(±14.28) in flunarizine group and from 64.25(±19.63) to 25.91(±18.6) in levetiracetam group (p<0.05). Some minor side effects were also reported by both groups, but were well tolerated by the patients and need not withdrawal of medication. Conclusion: Levetiracetam is as effective as flunarizine in paediatric MigraineProphylaxis.
In the recent past we encountered a pair of newborn who were symmetrically conjoined. We found a 30 years old woman who delivered those conjoined babies by caesarean section at full term. Antenatal ultrasonography at 26 weeks revealed twin pregnancy but no comment regarding conjunction. After delivery, babies were found fuse from upper thorax to umbilical region. Postnatal ultrasonography revealed single liver. Till date many such cases have been reported worldwide but so far no case report has been published in our country. Bang Med J (Khulna) 2016; 49 : 40-42
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