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Purpose: Since late 2019, coronavirus disease 2019 (COVID-19) has rapidly spread worldwide. Some children with COVID-19 present with seizures; in particular, studies have reported an increase in seizure episodes during the Omicron wave of the pandemic. This study was performed to describe the clinical characteristics of seizures among children hospitalized with COVID-19 before and during the Omicron wave. Methods: A retrospective cross-sectional study was conducted on all pediatric admissions for COVID-19 at Hospital Tunku Azizah from June 2021 to May 2022. Results: During this period, 1,586 children were admitted with COVID-19, of whom 111 (7.0%) experienced seizures. Patients with seizures were more likely to have a history of seizure (odds ratio [OR], 71.4; 95% confidence interval [CI], 23.7 to 215.2; P<0.001) and prior antiseizure medication use (OR, 55.1; 95% CI, 6.1 to 497.4; P<0.001). Most seizures (55.0%) occurred on the first day of illness, with 86.5% lasting less than 5 minutes. None of the children required intubation or admission to the pediatric intensive care unit, and all were discharged without complications. Between June 2021 and January 2022, the seizure rate varied from 1.3% to 3.4%; however, it increased to 18% in April 2022, coinciding with the period of Omicron variant predominance in Malaysia. Children admitted during the Omicron wave had significantly higher odds of experiencing seizures (OR, 7.89; 95% CI, 2.07 to 13.07; P<0.001) than children hospitalized prior to this wave. Conclusion: In conclusion, the study revealed a marked increase in seizures associated with pediatric COVID-19 cases during the Omicron wave. [ABSTRACT FROM AUTHOR]

The predictability of neurocognitive outcomes in patients with traumatic brain injury is not straightforward. The extent and nature of recovery in patients with mild traumatic brain injury (mTBI) are usually heterogeneous and not substantially explained by the commonly known demographic and injury-related prognostic factors despite having sustained similar injuries or injury severity. Hence, this study evaluated the effects and association of the Brain Derived Neurotrophic Factor (BDNF) missense mutations in relation to neurocognitive performance among patients with mTBI. 48 patients with mTBI were prospectively recruited and MRI scans of the brain were performed within an average 10.1 (SD 4.2) hours post trauma with assessment of their neuropsychological performance post full Glasgow Coma Scale (GCS) recovery. Neurocognitive assessments were repeated again at 6 months follow-up. The paired t-test, Cohen's d effect size and repeated measure ANOVA were performed to delineate statistically significant differences between the groups [wildtype G allele (Val homozygotes) vs. minor A allele (Met carriers)] and their neuropsychological performance across the time point (T1 = baseline/ admission vs. T2 = 6th month follow-up). Minor A allele carriers in this study generally performed more poorly on neuropsychological testing in comparison wildtype G allele group at both time points. Significant mean differences were observed among the wildtype group in the domains of memory (M = -11.44, SD = 10.0, p = .01, d = 1.22), executive function (M = -11.56, SD = 11.7, p = .02, d = 1.05) and overall performance (M = -6.89 SD = 5.3, p = .00, d = 1.39), while the minor A allele carriers showed significant mean differences in the domains of attention (M = -11.0, SD = 13.1, p = .00, d = .86) and overall cognitive performance (M = -5.25, SD = 8.1, p = .01, d = .66).The minor A allele carriers in comparison to the wildtype G allele group, showed considerably lower scores at admission and remained impaired in most domains across the timepoints, although delayed signs of recovery were noted to be significant in the domains attention and overall cognition. In conclusion, the current study has demonstrated the role of the BDNF rs6265 Val66Met polymorphism in influencing specific neurocognitive outcomes in patients with mTBI. Findings were more detrimentally profound among Met allele carriers.

We explored the prognostic value of diffusion tensor imaging (DTI) parameters of selected white matter (WM) tracts in predicting neuropsychological outcome, both at baseline and 6 months later, among well-characterized patients diagnosed with mild traumatic brain injury (mTBI). Sixty-one patients with mTBI (mean age=27.08; standard deviation [SD], 8.55) underwent scanning at an average of 10 h (SD, 4.26) post-trauma along with assessment of their neuropsychological performance at an average of 4.35 h (SD, 7.08) upon full Glasgow Coma Scale recovery. Results were then compared to 19 healthy control participants (mean age=29.05; SD, 5.84), both in the acute stage and 6 months post-trauma. DTI and neuropsychological measures between acute and chronic phases were compared, and significant differences emerged. Specifically, chronic-phase fractional anisotropy and radial diffusivity values showed significant group differences in the corona radiata, anterior limb of internal capsule, cingulum, superior longitudinal fasciculus, optic radiation, and genu of corpus callosum. Findings also demonstrated associations between DTI indices and neuropsychological outcome across two time points. Our results provide new evidence for the use of DTI as an imaging biomarker and indicator of WM damage occurring in the context of mTBI, and they underscore the dynamic nature of brain injury and possible biological basis of chronic neurocognitive alterations.

The CORFIS ("Community-Based Cardiovascular Risk Factors Intervention Strategies") program was piloted in community clinics in Malaysia to address the lack of health education in chronic disease management. The stages of change model was applied in a multicenter quasi-experimental design to evaluate adherence to advocated behaviors in CORFIS patients with hypertension. Based on submitted diet and exercise records (n = 209), adherence to sodium reduction, regular exercise, and increasing fruit and vegetable intake behaviors were quantified against weight, waist circumference (WC), systolic blood pressure (SBP), and diastolic blood pressure (DBP) changes. Patients were categorized at 6 months into nonadherent/N-A (Precontemplation, Contemplation, and Preparation), newly adherent/NA (Action) and totally adherent/TA (Maintenance) groups. Self-reported adherence records did not meet recommended targets for healthful behaviors, but clinical benefits were achieved by adherent groups as indicated by effect size (Cohen's d) comparisons. SBP reduction was associated with adherence to sodium reduction in NA (d = 0.60, p < 0.001) and TA (d = 0.45, p < 0.001) compared to N-A (d = 0.13, p > 0.05). Marginally increasing fruit and vegetable consumption (? = 0.41 servings) resulted in sizeable reductions in weight for NA (d = 0.81, p < 0.001) > TA (d = 0.54, p < 0.001) > N-A (d = 0.21, p > 0.05) and in WC for NA (d = 0.68, p < 0.00) > TA (d = 0.53, p < 0.001) > N-A (d = 0.52, p > 0.05). Exercise behavior was least successful as pedometer counting was below 10,000 steps but sizeable weight and WC reductions were largest for NA (d = 0.71 and 0.79, respectively) > TA (d = 0.60 and 0.53, respectively) > N-A (d = 0.33 and 0.35, respectively). Patients reporting a shift to positive stages of change behaviors enjoyed clinically beneficial reductions in SBP, DBP, weight, and WC.