Kepatuhan terhadap terapi farmakologi merupakan kunci utama pengobatan penyakit diabetes, tetapi belum mendapat perhatian penuh oleh para klinisi. Beberapa systematic review faktor kepatuhan telah dilakukan di beberapa kawasan negara. Namun, tidak menampilkan studi dari Indonesia. Penelitian ini bertujuan untuk meninjau secara sistematis faktor-faktor yang dapat memengaruhi kepatuhan minum obat diabetes melitus (DM) di Indonesia. Systematic literature review dilakukan melalui pencarian pada database jurnal Nasional (Garuda dan Sinta) dan Internasional (PubMed dan Science Direct). Penelitian yang sesuai dengan kriteria inklusi dan dipublikasikan pada Januari 2011 – Desember 2020. Kualitas penelitian dinilai menggunakan panduan SQAT. Metode pelaporan penelitian menggunakan pedoman PRISMA. Faktor kepatuhan diklasifikasikan berdasarkan domain faktor kepatuhan menurut World Health Organization (WHO). Sebanyak 370 artikel ilmiah penelitian dari database Garuda (n=36); Science Direct (n= 108); PubMed (n= 18); Sinta (n= 208). 341 artikel penelitian dieksklusi, 29 artikel skrining full text, dan 16 artikel penelitian memenuhi kriteria inklusi untuk dianalisis. Faktor yang memengaruhi kepatuhan minum obat diabetes adalah faktor sosial dan ekonomi (penghasilan, tingkat pendidikan, dan pekerjaan), faktor tenaga dan sistem kesehatan (tenaga kesehatan), faktor terapi pasien (jumlah obat diabetes, frekuensi minum obat, dan produk obat), faktor penyakit pasien (kadar gula darah, durasi penyakit), faktor pasien (jenis kelamin, faktor emosional, dukungan sosial, tingkat pengetahuan, dan kepuasan pengobatan), dan faktor pengelolaan penyakit (konseling dan edukasi farmasi). Faktor yang memengaruhi kepatuhan minum obat DM di Indonesia sangat beragam, dan multi faktor. Faktor tersebut dapat berfungsi sebagai target intervensi yang relevan. Para klinisi perlu mempertimbangkan penyesuaian frekuensi minum obat dan pemberian dukungan sosial kepada pasien DM.

Much ilham novalisa aji wibowo

Field studies were carried out in wet seasons of 2014 and 2015 in rice fields of College Farm, Rajendranagar, Hyderabad to understand the abundance and biodiversity of spiders in varied rice cultivation systems. Design of the experiment was split plot with three main modules, viz., transplanted, broadcasted and drum sown rice and subtreatments under each main module included three plant protection methods viz., organic protection, farmers’ practices and ‘no protection’ practices. Results showed that predator numbers in ‘no protection’ and organic protection plots of all main treatments were more than in farmers’ practices indicating the impact of the chemical pesticides. A total of 22 genera of spiders belonging to 12 families were recorded which comprised of seven guilds based on their hunting strategies and microhabitats. Shannon diversity index ranged between 1.83 and 2.26 and Pielou’s evenness index was 0.59-0.72 in two years of study indicating a stable ecosystem and even species distribution in rice crop at Rajendranagar. Study of the guild assemblage indicated that orb-weavers constituted 28.1% of the population, ground runners 23.51%, space web builders 18.38%, sheet-web builders 13.12%, stalkers 8.04% and ambushers made upto 0.38% of the spider population. Understanding the vertical stratification of various spider genera on the plant gave further insight into the prey preferences of these predators.

Gorthi anitha

In view of the on-going global debate about the economics curriculum and its teaching, this paper explores how the faculty responsible for teaching introductory economics at a South African university understand learning and teaching of their subject. We have adopted a qualitative research approach, phenomenography, to complement what we already know from mainstream literature on undergraduate economics education, predominantly published by academic econ- omists using a quantitative methodology. After a phenomenographic analysis of interview data with lecturers and tutors, six conceptions of teaching introductory economics (Economics 1) emerged: (I) team collaboration to implement the economics curriculum; (II) a thorough knowledge of the content; (III) implementing the curriculum in order for students to pass as- sessment; (IV) helping students learn key economics concepts and representations to facilitate learning; (V) engaging students through their real-life economics context to acquire economic knowledge; and (VI) helping students think like economists. These are discussed first in relation to the implications for student learning and second, in a broader context of higher education discourses and educational development

Dr emmanuel ojo

Background: Hospital acquired infections (HAIs) are infections that patients acquire while receiving treatments for other conditions. Studies have shown that stethoscopes and sphygmomanometers can act as potential sources of these infections in patients accessing treatment in healthcare facilities. This study aimed to increase awareness among health workers in Nigeria of the potentials of stethoscopes and sphygmomanometers to transmit HAIs. Methods: Moist swab sticks were used to collect samples from 38 randomly selected stethoscopes and sphygmomanometers from some departments of four district hospitals. Collected samples were cultured using standard microbiological techniques. In addition, self-designed questionnaire was used to assess the knowledge and practice of doctors and nurses on the roles of stethoscopes and sphygmomanometers in HAIs. Results: About 83.8% of the health workers demonstrated some awareness of the roles of stethoscopes and sphygmomanometers in HAIs. 42.5% cleaned their stethoscopes, while 5% their sphygmomanometers. Staphylococcus aureus, (65.9% of stethoscopes), proteus mirabilis, Pseudomonas aeruginosa (67.6% of sphygmomanometers), Streptococcus and Coliform species were isolated. There was no significant difference between the contamination of stethoscopes and sphygmomanometers by the isolates, except for Pseudomonas aeruginosa (t=3.49, p=0.04). Conclusions: Awareness did not match practice in cleaning the stethoscopes and sphygmomanometers in the four facilities. Staphylococcus aureus and Pseudomonas aeruginosa were the two most common organisms isolated with a significant difference (t=3.49, p=0.04) between stethoscopes and sphygmomanometers in isolation of Pseudomonas aeruginosa. To curb HAIs, health workers need to improve on their practice of cleaning stethoscopes and sphygmomanometers.

Emmanuel umegbolu

This study examined the spatial distribution pattern of public lower basic schools for the implementation of lower basic education in Rivers State. One research question guided the study. The descriptive survey design was used. The population for the study was the 942 public lower basic schools in Rivers State. Stratified random sampling technique was used to draw the sample size of 289 schools. A handheld Global Positioning System receiver was the instrument used for the study. Nearest neighbour analysis was used to answer the research question. Findings revealed that the overall pattern of distribution of existing public lower basic schools in Rivers State is clustered. Specifically the distribution of schools in Degema and Akuku-Toru Local Government Areas is dispersed with Rn of 1.72 and 1.36 respectively. The pattern of distribution of Bonny, Opobo/Nkoro, Abua/Odual, Port Harcourt, Obio/Akpor and Ikwerre indicates a clustered pattern with Rn of 0.91, 0.83 0.84, 0.74, 0.72 and 0.24 respectively. The study therefore recommended among other things that the state governments should make policies that guide school mapping and ensure their strict compliance. Since school mapping is an integral aspect of micro-planning, every local government should be statutorily required to have a comprehensive school map of its area that should be updated at least every decade. The services of professional planners should be utilized by the Ministry of Education and should also ensure that modern mapping equipment are deployed for this very important exercise.

Fxintegrity publishing

The present study reveals that the enriched aerobic cultures of indigenous microbes can be used successfully for decolorizing dye effluents. Physico-chemical analysis of dye effluent revealed high load of pollution indicators. Textile dye effluent and contaminated soils were collected and analyzed for selection of suitable bacteria for dye degradation. The residual bacterial load was found to be in the range of 108 cfu/mL. Six bacterial strains viz., two species of Bacillus, two species of Klebsiella,, one species each of Planococcus and Micrococcus luteus were isolated. The best two dye degraders namely species of Planococcus and Bacillus were further optimized for the effect of carbon and nitrogen source, pH, temperature and percentage of inoculum. The optimized conditions for both the isolates of Planococcus sp. and Bacillus sp. were used in bio-decolorization studies of textile effluent. More than 50% of decolorization was achieved within 4 d of incubation. After 6 d of incubation, decolorization was achieved above 80%. The isolates Planococcus sp. and Bacillus sp. exhibited maximum decolorization ability at pH between 5-8 and temperature 37C. Moreover, 10% (v/v) inoculums, glucose and peptone as carbon and nitrogen sources were found to be the optimum for decolorization. Both the isolates showed highest decolorization percentage of Coractive Blue 3R dye effectively during optimization and more interestingly showed consistent decolorization of textile dye throughout the study.

Dr. saranya devi k

This research was conducted to form students to be more disciplined in maintaining time, especially in prayer, as well as to strengthen aqidah and increase the worship of students of Madrasah Ibtidaiyah Salafiyah Syafi'iyah. The focus of this research is: 1) How to plan the prayer chapter of fiqh learning through audio-visual media for students of Class IV Madrasah Ibtidaiyah Salafiyah Syafi'iyah Ajung, 2) How to implement the prayer chapter of fiqh learning through audio-visual methods for students of Class IV Madrasa Ibtidaiyah Salafiyah Syafi 'iyah Ajung, 3) How is the evaluation of fiqh learning in the prayer chapter for fourth grade students of Madrasah Ibtidaiyah Salafiyah Syafi'iyah Ajung. This research uses qualitative research with descriptive qualitative research. Determination of research subjects in this study was carried out purposively. Data collection techniques used observation, interviews, and documentation. Analysis of the data, the researcher used the data analysis model of the Miles, Huberman, and Saldana models including: Data Condensation (Condensation), Data Presentation (Display), Conclusions Drawing. The validity of the data in this study used source triangulation and technical triangulation. The results showed that: 1) The use of audiovisual media was very relevant in learning fiqh in the prayer chapter 2) Active, innovative, creative, effective and fun learning made students enthusiastic and enthusiastic in learning and not boring. 3) the completeness of learning facilities and infrastructure is very influential in the evaluation stage including summative evaluation and formative evaluation, input evaluation, process evaluation and output evaluation. Penelitian ini dilakukan untuk membentuk peserta didik lebih disiplin dalam menjaga waktu khususnya dalam shalat, serta memantapkan aqidah dan meningkatkan ibadah peserta didik Madrasah Ibtidaiyah Salafiyah Syafi’iyah. Fokus penelitianini adalah: 1) Bagaimana Perencanaan Pembelajaran fiqih bab sholat melalui media audio visual bagi peserta didik Kelas IV Madrasah Ibtidaiyah Salafiyah Syafi’iyah Ajung, 2) Bagaimana Pelaksanaan pembelajaran fiqih bab sholat melalui metode audio visual bagi peserta didik Kelas IV Madrasah Ibtidaiyah Salafiyah Syafi’iyah Ajung, 3) Bagaimana evaluasi pembelajaran fiqih bab sholat bagi peserta didik kelas IV Madrasah Ibtidaiyah Salafiyah Syafi’iyah Ajung. Penelitian ini menggunakan penelitian kualitatif dengan jenis penelitian kualitatif deskriptif. Penentuan subyek penelitian dalam penelitian ini dilakukan secara purposive.Teknik pengumpulan data menggunakan observasi, wawancara, dan dokumentasi. Analisis data, peneliti menggunakan model analisis data model Miles, Huberman, dan Saldana meliputi: Kondensasi Data (Condensation), Penyajian Data (Display), Penarikan Kesimpulan (Conclusions Drawing). Keabsahan data dalam penelitian ini menggunakan triangulasi sumber dan triangulasi teknik.Hasil penelitian menunjukkan, bahwa: 1) Penggunaan media audiovisual sangat relevan dalam pembelajaran fiqih bab sholat 2) Pembelajaran aktif, inovatif, kreatif, efektif, dan menyenangkan membuat peserta didik semangat dan antusias dalam belajar serta tidak membosankan. 3) kelengkapan sarana dan prasarana pembelajaran sangat berpengaruh pada tahap evaluasi meliputi evaluasi Sumatif dan evaluasi Formatif evaluasi input, evaluasi proses dan evaluasi output.

Educare: journal of primary education

The study was conducted on glass slides to observe the growth patterns of urinary calcium oxalate monohydrate crystals and their inhibition using 5, 10 and 15% Phaseolus vulgaris seed infusion. For this purpose, a drop of gel medium (sodium metasilicate of 1.06 specific gravity and 3M acetic acid solution) at pH 5.02-5.17 was placed in the middle of the glass slide and converted into gel. A single drop of 1 M oxalic acid was dropped to the left, and 1 M calcium chloride and magnesium acetate (1:1) solution fell to the right side of the adequately formed gel. The glass slide was observed under microscope till it was completely dried. In the case of the crystal inhibition study, a drop of Phaseolus vulgaris infusion was also added on the right side just after adding calcium chloride and magnesium acetate solution. The results without infusion showed detailed morphology and aggregation patterns of observed crystals as donut, dumbbells, needles, platy, prismatic, rosette, round edges, and loose and compact aggregates. All infusions of Phaseolus vulgaris showed defective crystals. 5 % infusion inhibited crystals of all morphologies with their loose and compact aggregates except rosettes. Whereas 10 and 15 % infusion converted the rosette crystals into ineffective calcium oxalate dihydrate crystals of tetragonal bipyramidal and elongated rod shape. The microscopic study of calcium oxalate crystal growth and its inhibition is simple and provides rapid qualitative analysis of antiurolithiatic activity.

Dr. salman ahmed

Use of chemical fungicide to control plant diseases causes several adverse effects such as, development of resistance in the pathogen, residual toxicity, pollution to the environment etc. So an alternative way to overcome the usage of dreadful chemicals is very important. The use of plant extracts as biofungicide is one of the popular and effective method. Araucaria columnaris is a commonly seen ornamental plant known as Christmas tree. It’s a South African species, under the family Araucariaceae. Hence, in the present study, the plant resin extract was tested in-vitro against major plant pathogensby preliminary bioassay. It was found that up to 95% reduction of mycelium growth was observed against major phytopathogens such as Fusarium oxysporyum, Rhizoctoniasp, Cylindrocladiumsp, Alternariasp, and Colletrotricum sp., causing tomato wilt, damping off, foliage blight, and leaf blight diseases in economically important plants. Up to our knowledge it is the first report showing the antifungal activity of Araucaria columnaris resin as antifungal agent. By using this valuable tree, further work will be done to formulate commercial biofungicide.

Dr. saranya devi k

Freeze desalination (FD) is a method in which saline water is cooled below its freezing point and freshwater is separated from the brine in the form of ice crystals. FD is relatively insensitive to the salinity of the feed solution, making it suitable for desalination of high concentration brines such as the brine rejected from the seawater desalination plants. The design of the FD system and the thermochemical behavior of the brine upon freezing are critical factors in the energy performance of this method. To date, thermochemical properties of the concentrated seawater during cooling, such as the threshold of formation of ice and salt-hydrates and their corresponding cooling load of formation, are not well known. Likewise, the optimal configuration of the FD system to achieve the maximum energy efficiency has not been investigated. This work provides comprehensive data about the cooling load of freezing of concentrated brine rejected from seawater desalination plants along with the threshold of formation of ice and salt-hydrates backed-up by validation. Furthermore, the optimal configuration of the FD system is identified and the effects of the compressor isentropic efficiency and effectiveness of the system’s heat exchangers on the work consumption of the FD system were investigated.

Aly elhefny

Air pollution is a major health problem in developing countries and has adverse effects on human health and the environment. Non-thermal plasma is an effective air pollution treatment technology. In this research, the performance of a dielectric barrier discharge (DBD) plasma reactor packed with glass and ceramic pellets was evaluated in the removal of SO2 as a major air pollutant from air in ambient temperature. The response surface methodology was used to evaluate the effect of three key parameters (concentration of gas, gas flow rate, and voltage) as well as their simultaneous effects and interactions on the SO2 removal process. Reduced cubic models were derived to predict the SO2 removal efficiency (RE) and energy yield (EY). Analysis of variance results showed that the packed-bed reactors (PBRs) studied were more energy efficient and had a high SO2 RE which was at least four times more than that of the non-packed reactor. Moreover, the results showed that the performance of ceramic pellets was better than that of glass pellets in PBRs. This may be due to the porous surface of ceramic pellets which allows the formation of microdischarges in the fine cavities of a porous surface when placed in a plasma discharge zone. The maximum SO2 RE and EY were obtained at 94% and 0.81 g kWh−1, respectively under the optimal conditions of a concentration of gas of 750 ppm, a gas flow rate of 2 l min−1, and a voltage of 18 kV, which were achieved by the DBD plasma packed with ceramic pellets. Finally, the results of the model's predictions and the experiments showed good agreement.

Niloofar

Background Type 2 diabetes and obesity are serious public health concerns globally and a growing burden in Africa. Both conditions have serious repercussions on health when they co-occur, yet the extent of their co-occurrence in Africa remains unknown. Therefore, this review aimed to identify the prevalence and associated factors of overweight and obesity among persons with type 2 diabetes in Africa. Method A systematic search was conducted on PubMed, MEDLINE, Embase, African Index Medicus (AIM), and African Journals Online (AJOL) for observational studies that reported the prevalence of overweight and/or obesity among type 2 diabetes patients in Africa. The prevalence data from individual studies were aggregated through a random-effects meta-analysis. The I2 statistic was used to evaluate between-studies heterogeneity, while subgroup analysis and mixed-effects meta-regression were performed to identify sources of heterogeneity. We assessed publication bias using funnel plots and Egger’s test. This review adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Results Of 1753 records retrieved, 80 articles were eligible for this review, with 74 cross-sectional studies included in the meta-analysis. The pooled prevalence of overweight and obesity was 35.6% and 25.6% respectively, while the overall prevalence of both overweight and obesity was 61.4%. Also, the pooled prevalence of both overweight and obesity across the five geographical areas in Africa ranged from 56.9% in East Africa to 88.5% in Southern Africa. Nineteen factors were significantly associated with overweight and obesity among patients with type 2 diabetes. Conclusion The high prevalence of overweight and obesity among patients with type 2 diabetes is a significant public health concern that transcends geographical boundaries within Africa. The findings from this review highlight the need for innovative weight management interventions that are tailored to the cultural context of the African setting

Emmanuel ekpor

Pedagogical leadership has become an emerging and essential debate in the field of educational administration and leadership. This was a result of the shift from the hierarchical type in the past to a more inclusive, collaborative, and participative leadership. Previous studies indicate the furtherance of the inquiry into pedagogical leadership since it is a work in progress. For this reason, a systematic literature review mapped the literature relevant to pedagogical leadership. The review drew the lines between the empirical and theoretical-conceptual contributions, including the methodologies considered in both contributions. The results have implications for a more robust theoretical-empirical model or framework of pedagogical leadership applicable to specific levels of education, especially higher education contexts. The study also implies applying pedagogical leadership in the team, at departmental and organizational levels. Results imply promoting the culture of pedagogical leadership.

Manuel caingcoy

In an era where technology prevails, entrepreneurs as well as marketers see the need to keep up with the fast pace of change or risk being outdated. Gone are the days when a pure-bricks business model will thrive well in current market scenario. It is practically impossible to design a marketing strategy without considering social networks. Social media had become really important gradient in today’s marketing mix in general and in promotion mix in particular. Adapting some form of marketing online through social media is a key node for all businesses, especially in an industry where trends constantly change such as fashion and handicrafts. The paper carries out empirical research to understand the effectiveness of social media as a marketing tool and an effort has been made to analyze the extent social media helps consumers in buying decision making. In addition strategies have been suggested for maximizing the effectiveness. Various statistical tests have been applied to support the research hypothesis.

Abu bashar

Digital governance has become a cornerstone of modern administrative systems, enabling governments to provide efficient and transparent services to citizens. Telangana, a state in southern India, has emerged as a pioneer in implementing various digital governance initiatives to enhance service delivery and promote inclusive development. This paper provides a comprehensive overview of the digital governance initiatives undertaken by the Government of Telangana, highlighting their objectives, key features, and impact on governance. The paper begins by outlining the context of digital governance in Telangana, emphasizing the state government's commitment to leveraging technology for governance reforms. It then delves into specific initiatives across various sectors, including e-governance, digital infrastructure, citizen services, and smart city projects. Each initiative is analyzed in terms of its objectives, implementation strategies, technological components, and outcomes. Key initiatives such as the Telangana State Portal, T App Folio mobile app, MeeSeva portal for e-services, and the T-Fiber project for broadband connectivity are discussed in detail. Additionally, the paper examines the integration of emerging technologies like artificial intelligence, blockchain, and Internet of Things (IoT) in governance processes to improve efficiency and transparency. Furthermore, the paper evaluates the impact of these initiatives on governance outcomes, including enhanced service delivery, increased transparency, and improved citizen engagement. It also identifies challenges faced in the implementation process and offers recommendations for overcoming them. Overall, this paper provides valuable insights into the digital governance landscape in Telangana, showcasing the state's efforts in harnessing technology to build a more efficient, responsive, and citizen-centric administration. By documenting the successes, challenges, and lessons learned, it aims to inform policymakers, researchers, and practitioners interested in digital governance and public administration reform.

Dr gedam kamalakar

Hydatid disease or hydatidosis is a worldwide zoonosis disease caused by the tapeworm of Echinococcus granulosus and still widely endemic in Tunisia especially in rural areas where the sheep-dog cycle is dominant. It is an important public health problem in the pediatric age group causing significant morbidity and mortality. We report a case of primary hydatid cyst of the small intestine in a child and we want to highlight the difficulty that we meet in the diagnosis despite the contribution of imaging.

Sameh

Salinity is a major environmental stress which has been studied extensively and has its impact on agriculture in the past, present and future. The global importance of salt affected soils can be explained by their wide distribution on all continents covering about 10% of the total land surface. At present, there are nearly 954 million ha of saline soils on earth’s surface. It is extremely difficult to quantify the social and economic costs of salt prone land and water resources. Plant Growth Promoting Rhizobacteria (PGPR) is a group of bacteria that actively colonize plant roots and increase plant growth and yield. They play an important role within the interaction between soil and plant. As plants grow on marginal soils such as saline soils, the importance of the rhizobacteria increases as they mobilize nutrients and provide tolerance ability to the plants. In the present study, an attempt was made and isolated 51 PGPR isolates (Phosphate Solubilizing Bacteria–18; Azotobacter spp.-16 and Azospirillum spp.-17) from different salt affected areas in Tamil Nadu and Puducherry. All the isolates were screened for their efficacy against different sodium salts namely sodium chloride, sodium citrate and sodium sulphate. It was observed that the absorbance of the culture broth grown in salt stress to sodium chloride decreased with increasing concentration of the salt. Similarly decrease in growth pattern in terms of the absorbance was also observed in salt stress to sodium citrate and sodium sulphate.

Dr. saranya devi k

Noncommunicable diseases, also known as chronic diseases, tend to last long and result from genetic, physiological, environmental, and behavioural factors. Uric acid nephrolithiasis, arthritis and gout come under noncommunicable diseases related with Monosodium urate monohydrate (MSUM ) crystals. MSUM crystals are deposited in peripheral joints, causing gout and eliciting an intense localized inflammatory attack. In contrast, in collecting ducts and medullary interstitium, it is a urinary calculi which causes dysuria, nausea and hematuria. The study aims to explore the possible morphological features of monosodium urate monohydrate crystals. The study was carried out on a glass slide under a microscope to observe the growth patterns of MSUM crystals. For this purpose, a drop of gel medium (sodium meta silicate solution + 0.2M sodium hydroxide + 2N acetic acid) at pH 5.02 - 5.17 was placed in the middle of a glass slide and converted into a gel. A 0.07 M uric acid drop was added to the adequately formed gel. The glass slide was observed under a microscope till it was completely dried. Monosodium urate monohydrate was formed as spherical ring banded spherulites, dumbbell and composite spherulites. The current study provides different phases of MSUM crystallization on a glass slide for the first time. It may also be used as a model to evaluate prophylactic management against gouty and renal stones through in vitro assessment of crystal growth and aggregation inhibition and modulation of developing or developed crystals by using different natural products.

Dr. salman ahmed

Brilliant Grid is intended to incorporate progressed correspondence/organizing innovations into electrical power frameworks to make them ''more intelligent''. The current circumstance is that a large portion of the power outages and voltage lists could be forestalled in the event that we have better and quicker specialized gadgets and advancements for the electrical matrix. To make the flow electrical force lattice a Smart Grid, the plan and execution of another correspondence framework for the lattice are two significant fields of examination. Be that as it may, Brilliant Grid projects have just been proposed as of late and a couple of recommendations for forward-looking necessities and starting exploration work have been offered in this field. No efficient audits of correspondence/organizing in Smart Grids have been led at this point. In this manner, we direct an orderly survey of correspondence/organizing innovations in Smart Grid in this paper, including correspondence/organizing engineering, distinctive correspondence innovations that would be utilized into this design, nature of administration (QoS), upgrading the use of resources, control and the board, and so forth.

Dr.a.shaji george

Epilepsy is a chronic neurologic disease that comes third after cerebrovascular and Alzheimer’s disease. Anti-epileptic drugs may affect certain hematological parameters of epileptic patients. Few researches investigated hematological adverse effects of antiepileptic drugs in Libya. Thus, the aim was to evaluate hematological parameters in epileptic children who are on antiepileptic drugs. This retrospective study included 83 pediatric patients with epilepsy recruited from Benghazi Children Hospital, Department of Neurology, from December 2017 to April 2018. Data collected included demographic characteristics, types of epilepsy, anti-epileptic drugs and serum hematological parameters. Hematological parameters recorded included: hemoglobin, hematocrit, platelet, mean cell volume, mean cell hemoglobin, mean cell hemoglobin concentration and white blood cell count. In all treated patients, regardless of the number of antiepileptic drugs therapy used, the average levels of hematological parameters were significantly lower in treated group compared to control group (11.64 gm per dl, 34.53%, 27.74 pg and 33.13 gm per dl, respectively). A significant increase (12.12109 per l) in white blood cell counts in treated group was found. Average hemoglobin, hematocrit and mean cell hemoglobin concentration levels were significantly lower in patients on poly-therapy compared to mono-therapy and control groups. Average white blood cell counts were significantly increased in patients on anti-epileptic drugs. In sodium valproate users, levels of hematological parameters were significantly decreased but significantly increased in white blood cell counts. In diazepam users, significant increases in white blood cells and platelet but no difference in other parameters observed. There were no differences in all hematological parameters among patients using carbamazepine except for platelet counts (significantly decreased). In conclusion, there is substantial effect of the anti-epileptic drugs, especially sodium valproate, on hematological parameters of children despite the effects were not critical as the changes were still in the normal range.

Mediterranean journal of pharmacy and pharmaceutical sciences