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Background: There is growing evidence that inflammation plays a specific role in the pathogenesis of epilepsy and seizures also induce inflammation. The Neutrophil/Lymphocyte ratio (NLR) is an emerging inflammatory biomarker of epilepsy. Objectives: To determine the association between epilepsy and Neutrophil /Lymphocyte Ratio among adults. Methods: Adults with epilepsies the attending outpatient neurology clinics at two Nigerian tertiary health facilities, were recruited. One hundred cases and one hundred age-matched, healthy controls were recruited. The total white blood cell (WBC) and its differential counts were extracted from Full Blood Count (FBC) results and NLR was calculated. The predictors of the association between WBC parameters and epilepsy were established using a linear regression model derived from WBC parameters associated with epilepsy. Results: Out of 100 cases and controls, there was no gender-related statistical difference between the cases and controls (p = 0.777). There was no difference between the mean ages of cases and control (p = 0.058). The total mean white blood cell count among the cases was 8.80±9.84×109 cells/L compared to was 6.30±1.90 ×109 cells/L in the controls, (p = 0.013). The mean neutrophil count in the cases was 59.00±17.89 ×109 cells/L compared to 49.50±15.44 ×109 cells/L among the controls (p < 0.001). The mean NLR for the cases was 4.24±10.44 compared to 1.84±2.26 in the controls (p = 0.026). The Neutrophil/Lymphocyte Ratio (p = 0.013) and Basophil (p < 0.001) predicted epilepsy on linear regression analysis. Conclusion: This study shows a clear difference in the TWBC and NLR with between adults with epilepsies and health controls.

Abstract Background The study is aimed to identify the predictors of Quality of Life (QOL) in women with epilepsy (WWE) on carbamazepine (CBM) and levetiracetam (LTM) monotherapy. 100 WWE were recruited (50 each on CBM and LTM), after clinical diagnosis of epilepsy supported by Electroencephalography (EEG) features and seizures classification by 2017 International League Against Epilepsy (ILAE) criteria, the Quality of Life Inventory Scale 31(QOLIE-31) and Zung Self-Rating Depression Scale (ZSRDS) were used to assess QOL and depression, respectively. Result Higher QOLIE-31 scores was seen in the LTM group across all domains except seizure worry (p = 0.051) compared to CBM group. Logistic regression showed that the use of CBM (p = 0.000), fast frequency on EEG (p = 0.005), longer duration of epilepsy (p = 0.017), presence of depression (p = 0.008) and lower level of education (p = 0.003) were predictors of QOL. Progesterone (p = 0.040), oestradiol (p = 0.011) and prolactin (p = 0.002) in follicular phase showed significant association with QOLIE-total score. In the luteal phase, luteinizing hormone–follicle stimulating hormone (LH–FSH) ratio (p = 0.009) and testosterone (p = 0.015), FSH (p = 0.015), prolactin (p = 0.000), showed significant association with QOL. None of the hormones independently predicts QOL. Conclusion LTM group appears to have better QOL than CBM group. Healthcare providers should focus on addressing these identified predictors which include medication effect, depression, Level of education, EEG background and duration of epilepsy with aim of improving QOL.

Introduction and Aim: Diabetes mellitus (DM) is one of the most common non-communicable diseases worldwide. Diabetics with autonomic neuropathy tend to have larger gallbladder (GB) with poor contraction after fatty meals predisposing them to gallstones and cholecystitis. This may be prevented and treated if detected early using ultrasound. This study sonographically evaluated the GB in adults with type 2 diabetes and compared the findings with a non-diabetic age and sex-matched control group., Methods: In this case-control study, 120 patients with type 2 diabetes and 120 non-diabetic controls between the ages of 18 and 80 years at National Hospital Abuja had their GB evaluated after eight hours of overnight fast using B-mode ultrasound. The data were analyzed using IBM SPSS version 20.0 (Armonk, NY: IBM Corp.) and presented in tables., Result:  There were 60 males and 60 females with mean ages of 53.3 and 52 years for the cases and controls, respectively. The average fasting gallbladder volume (FGBV) in diabetics (34.51 + 3.16cm 3 ) was higher than that of controls (27.17 + 1.25cm 3 ). Eleven (9.2%) diabetics had gallstone (GS), while none was detected in controls. The GB wall thickness was significantly higher in diabetics than in the controls (0.28 ± 0.06 cm vs 0.25 ± 0.04 cm)., Conclusion: A significant proportion of type 2 diabetics had higher FGBV, GB wall thickness, and presence of gallstone compared to the non-diabetic controls. B-mode ultrasound is a very important non-invasive and accurate tool for detecting these changes early., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Ikhuoriah et al.)

Background: This study aims to identify the determinants of cognitive dysfunction and compare the effect of CPZ and LTC on cognition in WWE., Methods: An observational study involving 87 consenting adult WWE aged between 16 and 40 years on LTC or CZP monotherapy. At enrollment, an interviewer-based questionnaire was used to obtain demographic and clinical information from participants. The diagnosis of epilepsy was mainly clinical and supported by electroencephalographic (EEG) features and classified based on recommendation by the 2017 International League Against Epilepsy (ILAE). Zung Self-Reporting Depression Scale (ZSRDS) was used to assess the mood of participants. The Community Screening Interview for Dementia (CSID) was used to assess various cognition domains. The National Hospital Seizure Severity Scale (NHS-3) was used to assess disease severity., Results: There were statistical differences between the CZP and LTC groups in all domains of cognition assessed except for orientation. The total CSID scores of the LTC group were 59.2 (4.9) as opposed to CZP group, 57.2 (5.0); p: .005. Those with focal onset seizures had lower median total CSID score (58; IQR: 54-62) when compared to those with generalized onset seizures (62; IQR: 58-62), p: .012. There was a significant correlation between ZSRD score and NHS-3 score; rho: 0.30, p: .007. Bivariate analysis shows statistically significant correlation between total CSID score and ZSRDS (rho: -0.65), BMI (rho: 0.22), and NHSS-3 score (rho: -0.36), respectively. However, the effect of AED on CSID scores was lost after multivariate quantile regression with only ZSRDS retaining significance., Conclusion: Depression, seizure severity, type and structural etiology were associated with cognitive impairment among WWE. However, on regression model, only depression was statistically significant. The presence of more risks for cognitive impairment in the CZP group limits possible conclusion of LTC superiority., (© 2021 The Authors. Brain and Behavior published by Wiley Periodicals LLC.)

Objective: The study is aimed at comparing effects of older drugs like carbamazepine (CBZ) and newer agent like levetiracetam (LEV) on polycystic ovarian syndrome (PCOS) in women with epilepsy (WWE)., Methods: An interviewer-based questionnaire was used to obtain relevant clinical information from 50 WWE on CBZ and LEV monotherapy, respectively, and 50 age-matched controls. The diagnosis of epilepsy was clinical with electroencephalographic features taken into consideration and the seizures classified using the 2017 International League Against Epilepsy classification. The diagnosis of PCOS was based on the European Society for Human Reproduction and Embryology/American Society for Reproductive Medicine., Results: The frequency of PCOS and its subcomponent were higher among WWE compare to controls. PCOS was present in 22 (44%) of LEV group compare to 8 (16%) CBZ group. The frequency of its subcomponent was higher among those on LEV except for comparable effect with regard to oligomenorrhea. The levels of the sex steroid hormone were comparable in both groups of WWE except luteal phase luteinizing hormone, which was lower among the LEV group (P .001). The follicular phase estradiol level was lower (P .021), and follicle-stimulating hormone level was about 2-fold higher (P .03) among WWE compare to controls. The mean value testosterone was significantly lower among controls compared to WWE., Conclusions: The increased frequency of PCOS and its subcomponent and the unsatisfactory effect of LEV compared to CBZ on reproductive endocrine function underscore the need for routine reproductive endocrine evaluation to improve overall quality of life., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Stevens-Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are potentially life-threatening, immune-mediated adverse reactions characterized by widespread erythema, epidermal necrosis, and detachment of skin and mucosa. Efforts to grow and develop functional international collaborations and a multidisciplinary interactive network focusing on SJS/TEN as an uncommon but high burden disease will be necessary to improve efforts in prevention, early diagnosis and improved acute and long-term management. SJS/TEN 2019: From Science to Translation was a 1.5-day scientific program held April 26-27, 2019, in Vancouver, Canada. The meeting successfully engaged clinicians, researchers, and patients and conducted many productive discussions on research and patient care needs., (Crown Copyright © 2020. Published by Elsevier B.V. All rights reserved.)