WoS İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14627/6
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Article Ramadan Fasting and Seizure Activity in Adults with Epilepsy: A Systematic Review and Meta-Analysis(Academic Press Inc Elsevier Science, 2026) Ibrahim, Ismail A.; Shaaban, Sally; Elewa, Mandy; Rahman, Muhammad Samir Haziq Bin Abd; Mohamed, Lobna Ahmed; Talaia, Ahmed M.; Khoo, Ching Soong; Haziq bin Abd Rahman, Muhammad SamirPurpose: Ramadan fasting in Muslims entails abstaining from food and fluids from dawn to sunset, which can influence sleep patterns, medication timing, and food intake. Building on evidence that ketogenic diets and intermittent fasting may improve seizure control, we aim to analyze the link between intermittent Ramadan fasting in adults with epilepsy and seizure activity. Method: We systematically searched PubMed, Scopus, Web of Science, Cochrane Library, and Embase between 2000 and January 2025 for articles that appeared between these dates. The terms used for searching included fasting in Ramadan with epilepsy or seizures. The seizure frequency and seizure status of the participants are the outcomes that we analyzed. Two reviewers independently screened and extracted data, with a third resolving any differences that arose between them. Meta-analysis was done using the random-effects model with statistical heterogeneity using the I2 statistic. Results: Of the 1485 articles, only eight were found to be relevant, and 4 of these included 564 patients who met the inclusion criteria. The analysis of the pooled data demonstrated that 61.1% of patients remained seizure-free throughout Ramadan (95% CI: 38.8%-83.4%), with considerable heterogeneity (I2 = 87.7%). Seizure risk was higher in patients on polytherapy with poor baseline seizure control, increased fasting times, or high potassium levels. In contrast, extended seizure-free intervals and increased sleep duration pre-Ramadan were good predictors of safe fasting, and each seizure-free week increased the chance of remaining seizure-free by 10%, as did each extra hour of sleep by 30%. Seizure frequency increases were caused by interruption of daily rhythms, psychological tension, tiredness, and extended fasting. Conclusion: While many patients remained seizure-free during Ramadan, high study variability highlights the need for standardized research. With proper medical supervision, fasting may be safely practiced for selected epilepsy patients.Article A Rare Presentation of Bilateral Periventricular Nodular Heterotopia With Intra-Axial Pontine Lesion: A Case Report and Treatment Approach(Elsevier, 2024) Shenno, Milad; Al-Qiami, Almonzer; Ibrahim, Ismail A.; Elhaw, Lojin; Nashwan, Abdulqadir J.This report presents a rare case of a 19-year-old male with bilateral periventricular nodular heterotopia (PVNH), a congenital brain abnormality resulting from failed neural cell migration, along with an intra-axial pontine lesion of unknown pathology. The differential diagnosis of childhood brainstem tumors in such cases commonly includes diffuse midline glioma (DMG), which is associated with a dismal prognosis due to H3 K27 gene mutation. However, this case exhibits a unique focal dorsal exophytic brainstem glioma variant, accounting for only a small percentage (approximately 10 %) of pontine tumors and carrying a more favorable prognosis. The lesion is suspected to be a pilocytic astrocytoma, presenting distinct neurological symptoms. In this case, the patient presented with symptoms include mainly occasional tonic-clonic seizures, right side mild spasticity with ataxic gait and right eye blurring of vision along with right side facial palsy. The patient's clinical evaluation, in conjunction with various medical diagnostic tests and MRI with and without contrast, led to the final diagnosis. Management began with anti-epileptic medication, with a plan for further treatment and follow-up.