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Background: The assessment of knowledge and skills plays an important part in student nurse’s progression because they need to demonstrate competency and confidence in the performance of clinical skills. OSCE has been recognized as the most reliable method for evaluation of clinical skills among Nursing students. The study aims to assess the effectiveness of OSCE on antenatal assessment among nursing students. Methods: An experimental approach with post-test only design was used to select 60 IV Year BSc Nursing students. They were selected by using a simple random sampling method. 30 were in the experimental group received planned teaching program on antenatal assessment and evaluated by OSCE, 30 were in the control group received traditional method of teaching on antenatal assessment and evaluated by traditional clinical evaluation (TCE). An observational checklist and the opinionnaire on the usefulness of OSCE were used to collect the data. Results: Average marks scored by the students who are evaluated by OSCE (21.96±1.44) were higher as compared to traditional clinical evaluation scoring (14.93±2.75) which was statistically significant (p< 0.001) Most of the students gave positive feedback on OSCE. Conclusion: Learning in the nursing clinical area gives present reality to nursing students to build up the information, abilities, dispositions, and skills. OSCE is an important, reasonable, helpful and acceptable method for assessing student’s clinical performance due to different positive particulars. The study concluded that OSCE was an effective method to evaluate the clinical skills of nursing students on antenatal examination.

IMPORTANCE: Overall, immunotherapy has been shown to improve outcomes and reduce relapses in individuals with N-methyl-d-aspartate receptor (NMDAR) antibody encephalitis (NMDARE); however, the superiority of specific treatments and combinations remains unclear. OBJECTIVE: To map the use and safety of immunotherapies in individuals with NMDARE, identify early predictors of poor functional outcome and relapse, evaluate changes in immunotherapy use and disease outcome over the 14 years since first reports of NMDARE, and assess the Anti-NMDAR Encephalitis One-Year Functional Status (NEOS) score. DATA SOURCES: Systematic search in PubMed from inception to January 1, 2019. STUDY SELECTION: Published articles including patients with NMDARE with positive NMDAR antibodies and available individual immunotherapy data. DATA EXTRACTION AND SYNTHESIS: Individual patient data on immunotherapies, clinical characteristics at presentation, disease course, and final functional outcome (modified Rankin Scale [mRS] score) were entered into multivariable logistic regression models. MAIN OUTCOMES AND MEASURES: The planned study outcomes were functional outcome at 12 months from disease onset (good, mRS score of 0 to 2; poor, mRS score greater than 2) and monophasic course (absence of relapse at 24 months or later from onset). RESULTS: Data from 1550 patients from 652 articles were evaluated. Of these, 1105 of 1508 (73.3%) were female and 707 of 1526 (46.3%) were 18 years or younger at disease onset. Factors at first event that were significantly associated with good functional outcome included adolescent age and first-line treatment with therapeutic apheresis, corticosteroids plus intravenous immunoglobulin (IVIG), or corticosteroids plus IVIG plus therapeutic apheresis. Factors significantly associated with poor functional outcome were age younger than 2 years or age of 65 years or older at onset, intensive care unit admission, extreme delta brush pattern on electroencephalography, lack of immunotherapy within the first 30 days of onset, and maintenance IVIG use for 6 months or more. Factors significantly associated with nonrelapsing disease were rituximab use or maintenance IVIG use for 6 months or more. Adolescent age at onset was significantly associated with relapsing disease. Rituximab use increased from 13.5% (52 of 384; 2007 to 2013) to 28.3% (311 of 1100; 2013 to 2019) (P < .001), concurrent with a falling relapse rate over the same period (22% [12 of 55] in 2008 and earlier; 10.9% [35 of 322] in 2017 and later; P = .006). Modified NEOS score (including 4 of 5 original NEOS items) was associated with probability of poor functional status at 1 year (20.1% [40 of 199] for a score of 0 to 1 points; 43.8% [77 of 176] for a score of 3 to 4 points; P = .05). CONCLUSIONS AND RELEVANCE: Factors influencing functional outcomes and relapse are different and need to be considered independently in development of evidence-based optimal management guidelines of patients with NMDARE.

Myelin-oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a recently identified autoimmune disorder that presents in both adults and children as CNS demyelination. Although there are clinical phenotypic overlaps between MOGAD, multiple sclerosis, and aquaporin-4 antibody-associated neuromyelitis optica spectrum disorder (NMOSD) cumulative biological, clinical, and pathological evidence discriminates between these conditions. Patients should not be diagnosed with multiple sclerosis or NMOSD if they have anti-MOG antibodies in their serum. However, many questions related to the clinical characterisation of MOGAD and pathogenetic role of MOG antibodies are still unanswered. Furthermore, therapy is mainly based on standard protocols for aquaporin-4 antibody-associated NMOSD and multiple sclerosis, and more evidence is needed regarding how and when to treat patients with MOGAD. © 2021 Elsevier Ltd

A first episode of acquired demyelinating disorder (ADS) in children is a diagnostic challenge as different diseases can express similar clinical features. Recently, antibodies against myelin oligodendrocyte glycoprotein (MOG) have emerged as a new ADS biomarker, which clearly allow the identification of monophasic and relapsing ADS forms different from MS predominantly in children. Due to the novelty of this antibody there are still challenges and controversies about its pathogenicity and best technique to detect it. In this manuscript we will discuss the recommendations and caveats on MOG antibody assays, role in the pathogenesis, and additionally discuss the usefulness of other potential new biomarkers in MOG-antibody associated disorders (MOGAD).

International audience; Background: Onset of multiple sclerosis (MS) before 18 years old, called Paediatric-onset MS (PoMS), is considered as a rare disease, with prevalence estimates ranging from 0 to 3 cases per 10,000 inhabitants in the world. In France, about 100,000 people live with MS, but it is not currently known how many children and youth are affected. Regarding disease management, most of the disease-modifying therapies (DMTs) licensed in the adult-MS population is not approved in the PoMS population and they are frequently used off-label.Objective: The present study aims to estimate the prevalence of PoMS in France and describe characteristics of the disease management, especially DMTs prescriptions, of this specific population, using administrative health data over the period 2010 to 2015.Methods: Access to the national health insurance database which covers 97% of the French population offers the opportunity to perform a population-based nationwide study on that topic. PoMS cases were identified over 2010-2015 in patients < = 18 years thanks to a 3-criteria algorithm using diagnoses of hospital admissions, MS-specific DMTs and MS long disease duration status. Access to health services and use of DMTs over the 6-year study period was described.Results: Overall, 1104 cases (742 girls and 382 boys) were identified, leading to an estimated prevalence of approximately 1 case per 10,000 inhabitants. Age at MS identification was < 6 years in 1.4%, 6-11 years in 6.8%, 11-16 years in 32.6% and >=16 years in 59.2%. Regarding DMTs, 39.5% never received any DMT over 6 years. In treated patients, mean age at first DMT initiation was 16 years old and the three most frequently prescribed drugs were interferons, glatiramer acetate and natalizumab. Moreover, about 89% of cases had at least one hospital admission, whatever the cause. Finally, five deaths occurred over the study period (4 other causes than MS, 1 unknown).Conclusion: Data issued from the national health insurance system offers the opportunity to estimate the prevalence of PoMS in France and to study care practices in this specific population at national level, without selection bias. Therapeutic sequences will be deeply studied, as well as the profiles of health care providers involved in the follow-up of such children.

International audience; BACKGROUND: Treatment of patients younger than 18 years of age with multiple sclerosis has not been adequately examined in randomized trials. We compared fingolimod with interferon beta-1a in this population. METHODS: In this phase 3 trial, we randomly assigned patients 10 to 17 years of age with relapsing multiple sclerosis in a 1:1 ratio to receive oral fingolimod at a dose of 0.5 mg per day (0.25 mg per day for patients with a body weight of

Herpes simplex virus encephalitis (HSVE) is a devastating condition that relapses, often with a chorea in children, despite adequate antiviral treatment. At relapse, evidence of viral replication is frequently absent, suggesting that the relapse may be immune-mediated. Seven children who had a neurological relapse following their initial encephalitis, identified from 20 cases of pediatric HSVE, were studied. Serum and/or cerebrospinal fluid (CSF) were tested for N-methyl-D-aspartate receptor (NMDAR) and other antibodies previously reported in central nervous system autoimmunity. Five of the 7 relapsing children had choreoathetosis; 2 of these were NMDAR antibody-positive, 2 were negative (1 with HSV-positive CSF), and 1 was not available for testing. An additional patient, who relapsed with cognitive regression but with no movement disorder, was also NMDAR antibody-positive. In 2 of the NMDAR antibody-positive patients who were treated at relapse and in 1 who was treated only after 10 years of having a relapsing encephalopathy, a beneficial response was observed. Neurological relapses after HSVE may frequently be immune-mediated, particularly in children with chorea. NMDAR antibodies are common, and immunotherapy may be beneficial. © 2013 Movement Disorder Society.