Preliminarily Analysis of Carbamazepine (CBZ) C0 in Patients Visited Isfahan Epileptic Clinics.

Preliminarily Analysis of Carbamazepine (CBZ) C0 in Patients Visited Isfahan Epileptic Clinics.

Int J Prev Med. 2013 May; 4(Suppl 2): S343-6
Tolou-Ghamari Z, Najafi MR, Habibabadi JM, Zare M

Carbamazepine (CBZ) is mostly considered as the first line of effective treatment against simple or complex partial seizure and primary-secondary generalization. To prevent side-effects related to higher amount of CBZ minimum concentration (C0) in body fluid or seizure attacks associated to lower amount of CBZ-C0, the suggested minimum therapeutic concentrations range from 4 to 12 ng/ml (according to previous publications). The aim of this preliminarily study was to investigate the scope of discrepancy associated to the C0of CBZ in patients visited Isfahan Epileptic Clinic.A cross-sectional study of 22 patients located in neurology ward of Isfahan Neurosciences Research Centre (INRC) was carried out between April 1, 2012 and December 31, 2012. Female (n = 9) and male subjects (n = 13) with a mean age of 27.4 years (range; 16-38 years) were studied. Pharmacological (CBZ-C0) and demographical variables were recorded and processed in excel.The results of CBZ-C0 showed wide inter-individual variability. The mean value of CBZ-C0 was 7.2 ng/ml. In 10 out of 22 patients, CBZ-C0 were lower than the suggested therapeutic window (4-12 ng/ml). CBZ-C0 in nine patients was non-detectable and in one patient was 0.5 ng/ml (45% < 4 ng/ml). In 55% of the patients, CBZ-C0 ranged from 4.8 to 12 ng/ml.A schedule therapeutic drug monitoring based on measurement of CBZ-C0for individual patient could be a practical marker to achieve therapeutic objectives. Further study related to correlating of CBZC0to clinical events in Iranian Epileptic population seems to be valuable. HubMed – drug


Antiepileptic drugs: a consideration of clinical and biochemical outcome in patients with epilepsy.

Int J Prev Med. 2013 May; 4(Suppl 2): S330-7
Tolou-Ghamari Z, Zare M, Habibabadi JM, Najafi MR

The challenge of antiepileptic drugs (AEDs) management is to attain the best compromise between the desire to maximize seizure control and the need to keep side-effects within tolerable limits for the individual patient. To reduce devastation in Iranian epileptic patients, the aim of this study was to explore the overall outcome following AEDs prescription.A cross-sectional study of 36 patients located at the epilepsy ward, conducted to Isfahan Neurosciences Research Centre was carried out during the year 2011. Female (n = 17) and male subjects (n = 19) with a mean age of 27 years (range; 7-74 years) were studied. Variables including, sex, age, age of seizure onset, type, and number of AEDs, biochemical and hematological data were recorded in d-Base and statistical analyses were performed using SPSS (version 18) for windows.The main drug to control seizure attack was carbamazepine and valproic-acid. The following tests were the most frequently influenced; alkaline phosphatase (AP), lymphocyte (Lymph), white blood cell (WBC) counts and hemoglobin (Hgb). There was a significant increase in (AP) (mean; 534.6 u/l(?); [P = 0.02] in three patients and (Lymph) (55%(?); [43-84] %(?); [P = 0.04] in seven patients. WBC was lower than 4400 mm(3?) (P = 0.02) in six patients. Hgb was significantly lower in 70.6% of women (11.8(?); [10-14.2] g/dl(?); [P = 0.04] and 68.4% of men population (12.3(?); [9.7-13.8] g/dl(?); [P = 0.01]. Mean age of epilepsy onset was 15.6 years (range: Birth-74 years). Analysis of drug prescriptions showed that the incidence of monotherapy and polypharmacy (2 up to six AEDs simultaneously) was 19.4% plus 80.6% respectively.In Iranian epileptic population, effectiveness of treatment should be attributed by the close supervising of AEDs in relation to clinical circumstance, laboratory data, and therapeutic drug monitoring. Any significant change in patients’ biochemical and hematological data may require close verifying for the rapid detection of severe anemia, leukopenia, lymphocytosis, osteomalacia, or liver failure. HubMed – drug


Application and preventive maintenance of neurology medical equipment in isfahan alzahra hospital.

Int J Prev Med. 2013 May; 4(Suppl 2): S323-9
Alikhani P, Vesal S, Kashefi P, Pour RE, Khorvash F, Askari G, Meamar R

Nowadays Medical equipment plays an important role in the treatment and in the medical education. Using outdated preventive maintenance (PM) system may cause problems in the cutting edge medical equipment, Nervous system disease’s equipment (In diagnosis and treatment) which are crucial for every medical center. Based on above facts we focused on nervous system treat units’ equipment and informed the supervisors and their colleagues about the latest equipment maintenance status and promoted methodical and correct method to be used for medical equipment maintenance.This research is an analytical descriptive and has been done on the base information from a particular time to past. We gathered our required information of 2009 from Alzahra Medical Center. We divided this research info 2 main phases. In the first phase, we picked out Neurosurgery and Neourology diseases medical equipment (diagnosis and therapy equipment) and in the second phase, we need to implement a methodical PM for every equipment.Research has shown that there are 19nervous system equipment in Alzahra Medical center, categorized in diagnostic (13 pcs), therapeutic (4 pcs) and diagnostic-therapeutic (2 pcs). As we declare in methods part of this research, we categorized medical equipment in Food and Drug Administration (FDA) segmentation. Capital-scarce equipment: Magnetic resonance imaging, Eco Doppler, Kamalaarak ultrasonic surgical aspirator, Stereotactic, computed tomography-scan, euroendoscope/vital-scarce equipment: Coblation, Sonoco, vaterjet/scarce equipment: Transcranial color Doppler, electroencephalogram, electromyography, surgical microscope.Survey of application and preventive maintenance of neurology medical equipment in Isfahan Alzahra hospital show there is no P.M system. Implementing a complete P.M system for this medical center is crucial to preventing cause problems for these medical equipment and decreasing maintenance costs and gaining uptime. Researchers of this article have tried to provide PM, use of texts, web and experts. HubMed – drug