Open Access Letter to the Editor
The “Type of Article” of this paper is “Letter to the Editor”. This paper discuses about: “The Use of a Topographic Model to Describe Cognitive Disorders for Patients with Multiple Sclerosis”. No formal abstract is available. Readers are requested to read the full article.
Open Access Original Research Article
Aims: This is to investigate the results of the multimodality regimen including surgery, postoperative craniospinal irradiation and clarify the role of chemotherapy as well as the influence of multiple variables on desmoplastic medulloblastoma patient’s survival.
Study Design: Original research papers.
Place and Duration of Study: It took place in the period between January 2001 and Sept 2015 at Neurosurgery and Clinical Oncology & Nuclear Remedies Departments of Mansoura university Hospital.
Methodology: We reviewed data of (28) patients histological confirmed as desmoplastic medulloblastoma (17 male beside 11 female) including clinical history, examination, investigation and management.
Results: The median age was 17.8 years, (range 3-41) with male to female ratio was (1.5:1). The most dominating symptoms were vomiting (82%) and throbbing headache (71.4%). The positioning of tumor was lateral in 64.3% and midline in 35.7%. The total resection of the tumor was achieved in 17 (60.7%) patients. All patients received craniospinal irradiation. The median dosage to the posterior fossa was 54 Gy (range 49- 56 Gy). 71.4% of the patients received adjuvant chemotherapy. The median follow-up was 52.3 months (range 25 -120). Five years’ overall survival rates were 71.4% and 67.8% respectively.8 patients developed relapse. Posterior fossa was the commonest site for relapse (21.4%). Brain stem infiltration was bad prognostic factor (p= 0.006). The extent of surgical resection can be considered a good prognostic factor (p=0.004). Age, sex and tumor location did not significantly affect the results of survival. One of the most reported side effect was substantially, sensory neuropathy, nausea, vomiting, fever and neutropenia.
Conclusion: Patients with desmoplastic medulloblastoma being given chemotherapy adjuvant to surgical resection and radiotherapy (Multimodality approach) remain alive longer than patients who had management of surgery and radiotherapy only although brain stem infiltration, large post-operative residual are often associated with poor prognosis.
Open Access Original Research Article
Objectives: To evaluate serum levels of C-reactive protein (CRP), Interleukin-6 (IL-6) and copeptin in children with febrile seizure (FS) and their ability to discriminate between simple (SFS) and complex FS (XFS).
Patients and Methods: The study included 80 febrile children; 40 did not develop febrile seizure (FC), 29 developed SFS and 11 developed XFS. The study also included 10 healthy children as negative control (NC). Clinical evaluation included full history taking, general examination and neurological examination to evaluate patients' general conditions and to confirm inclusion criteria. On admission; body temperature was measured and a venous blood sample was obtained for determination of complete blood count (CBC.) and ELISA estimation of serum CRP, IL-6 and copeptin.
Results: Male-to-female ratio was 2.64:1 and frequency of family history of FS was 17.5%. At admission; body temperature was significantly higher in febrile patients with significantly higher temperature in FS patients than in FC patients. Haemoglobin (Hb.) concentration of febrile patients was significantly lower than NC children with significantly lower Hb. Conc. in FS patients compared to FC patients. Serum CRP, IL-6 and copeptin levels and TLC were significantly higher in febrile patients compared to NC children and in FS patients compared to FC patients. Receiver operating characteristic (ROC) curve analysis defined high serum copeptin, IL-6, CRP, at admission body temperature, low Hb. Conc. and high total leucocytic count (TLC) as predictors for FS, in decreasing order of significance. Regression analysis defined high serum copeptin and IL-6 as the persistently significant predictors for FS among febrile patients and XFS among FS patients, respectively.
Conclusion: FS are associated with significantly altered immune and neuroendocrinal responses to infection. Extent of induced alterations correlates with severity of infection. Elevated serum levels of copeptin and IL-6 could discriminate febrile children susceptible to develop seizure. Elevated serum IL-6 could discriminate patients liable to develop XFS.
Open Access Original Research Article
The study assessed the perspectives of nurses in Neuropsychiatric Hospital, Aro, Abeokuta, Nigeria on the effectiveness of substance abuse management. It made use of a descriptive research design. The study was conducted at the Department of Nursing, Neuropsychiatric Hospital, Aro, Abeokuta, Ogun state, Nigeria. A sample size of hundred nurses was used. This was calculated using thirty percent of the target population (ninety nurses) at ten percent error (ten nurses) to accommodate for attrition rate according to the rule of thumb. A stratified random sampling technique was utilized. Eight of the ten hospital wards were selected at random. Twelve of all the twenty nurses in each of the selected wards were randomly selected. Hundred questionnaires were printed and distributed. The instrument for data collection used for this study was a self-designed questionnaire consisting of closed-ended questions. A hundred percent of distributed questionnaires were retrieved. Data collected were analyzed through the use of tables, followed by interpretation in percentages. Out of hundred nurses, eighty-eight percent (88%) are of the view that people exposed to some types of treatment and remain in them subsequently reduce their use of psychoactive substances and ninety-seven percent (97%) believed treatment attends to multiple needs of the individual, not just drug abuse. Ninety percent (90%) rejected single treatment as effective in managing substance abuse and ninety-three (93%) believed skills learnt through cognitive-behavioural approaches remain with the individual after completion of treatment. It was concluded from the nurses’ viewpoint that individuals should be exposed to some types of substance abuse treatment and remain in it before there can be subsequent reduction of psychoactive substance. Treatment should attend to multiple needs of the individual, not just drug abuse and different approaches should also be employed. It was thereby recommended that addiction treatment should be provided by healthcare professionals equipped with the knowledge and skills and government should pay attention to funding and policy making as regards substance abuse management.
Open Access Review Article
Objectives: The present review provides an overview of the appropriate literature on the use of nutraceuticals in depression. The goal was to examine whether nutraceuticals, in combination with the current pharmacotherapies or even as mono-therapies, could be effective in depressive patients.
Methods: A literature search was conducted on PubMed database for articles using the terms: ‘major depressive disorder’, ‘tricyclic antidepressants’, and ‘SSRIs’ combined with ‘nutraceuticals’, ‘pharmacotherapies’, ‘adjuvant therapies’, ‘amino acids’, ‘biochemical disturbances’, ‘(precursors of) neurotransmitters’, ‘tryptophan’, ‘tyrosine’, ‘phenylalanine’, ‘omega-3 fatty acids’, ‘omega-6 fatty acids’, ‘S-adenosylmethionine’, ‘B-vitamins’, ‘folate’, ‘methyl folate’, or ‘vitamin B12’. Search results were manually reviewed, and relevant reviews and studies were selected for inclusion as suitable.
Results: Nutraceuticals may relieve depressive symptoms. In particular tryptophan, omega-3 fatty acids, S-adenosylmethionine, and folate as mono- or adjuvant therapy to current pharmacotherapies in depressive disorder may enhance response and increase efficacy.
Discussion: Some nutraceuticals administered as mono- or adjuvant therapy may be useful in the treatment of depressive disorder. Nevertheless, accurate medical diagnoses and consideration of all possible treatments should always be the first step in addressing depressive disorder. Therapy with nutraceuticals should be supervised and doses be adjusted for each patient individually to achieve optimal outcomes.