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  1. Article ; Online: Risk factors for seizure recurrence after initial withdrawal of anti-seizure medications in children with epilepsy at Aga Khan University Hospital, Nairobi, Kenya.

    Odero, Nicholas / Oyieke, Katherine / Gwer, Samson / Samia, Pauline

    Epilepsy & behavior reports

    2023  Volume 22, Page(s) 100596

    Abstract: Objectives: We sought to determine risk factors associated with seizure recurrence following initial withdrawal of anti-seizure medications (ASM) among children with epilepsy.: Methods: This was a retrospective observational study of children aged ... ...

    Abstract Objectives: We sought to determine risk factors associated with seizure recurrence following initial withdrawal of anti-seizure medications (ASM) among children with epilepsy.
    Methods: This was a retrospective observational study of children aged between 2 and 18 years with a diagnosis of epilepsy who underwent withdrawal of anti-seizure medication following remission of seizures. All eligible medical records between January 2011 and December 2019 were included. Demographic, clinical, imaging and electroencephalography data of all eligible patients were analyzed against seizure remission within 24 months after withdrawal of ASM, using appropriate parametric and non-parametric tests.
    Results: A total of 49 records of children who underwent withdrawal of ASM out of a total of 613 patients on follow up during the same period were included. The median age at ASM withdrawal was 70 months (IQR 52-112 months) and 14 (28.6%) were female. Thirteen patients (26.5%) had seizure recurrence within 24 months following withdrawal of ASM. Focal onset seizure type was associated with significant risk of seizure recurrence (OR 13.7; 95% CI 0.97, 193.54; P value = 0.011). Age at epilepsy diagnosis, abnormal EEG at initiation of treatment and at the time of de-escalation, abnormal MRI findings, first or second degree relative with epilepsy, history of developmental delay, seizure burden, use of 2 or more ASMs and duration of seizure-freedom before de-escalation of ASM were not associated with increased risk of relapse.
    Conclusion: Focal onset seizure type is associated with increased with risk of seizure recurrence in this cohort.
    Language English
    Publishing date 2023-03-21
    Publishing country United States
    Document type Journal Article
    ISSN 2589-9864
    ISSN (online) 2589-9864
    DOI 10.1016/j.ebr.2023.100596
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: The ethical and validity conundrum in epilepsy research in LMIC settings.

    Samia, Pauline / Shah, Adeel / Patel, Archana / Olielo, Philip / Mudave, Lionel / Gwer, Samson

    Frontiers in neurology

    2023  Volume 14, Page(s) 1196261

    Language English
    Publishing date 2023-05-17
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2564214-5
    ISSN 1664-2295
    ISSN 1664-2295
    DOI 10.3389/fneur.2023.1196261
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Magnetic Resonance Imaging Findings in Childhood Epilepsy at a Tertiary Hospital in Kenya.

    Samia, Pauline / Odero, Nicholas / Njoroge, Maureen / Ochieng, Shem / Mavuti, Jacqueline / Waa, Sheila / Gwer, Samson

    Frontiers in neurology

    2021  Volume 12, Page(s) 623960

    Abstract: Background: ...

    Abstract Background:
    Language English
    Publishing date 2021-02-12
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2564214-5
    ISSN 1664-2295
    ISSN 1664-2295
    DOI 10.3389/fneur.2021.623960
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Burden of brain tumors in low- and middle-income countries: a systematic review protocol.

    Mwita, Clifford C / Rowland, Thabo / Gwer, Samson

    JBI database of systematic reviews and implementation reports

    2018  Volume 16, Issue 3, Page(s) 609–614

    Abstract: Review question/objective: The objective of this review is to determine the best available evidence on the burden of brain tumors in low- and middle-income countries (LAMICs). More specifically, the objective is to determine the incidence and prevalence ...

    Abstract Review question/objective: The objective of this review is to determine the best available evidence on the burden of brain tumors in low- and middle-income countries (LAMICs). More specifically, the objective is to determine the incidence and prevalence rates for brain tumors in LAMICs.
    MeSH term(s) Brain Neoplasms/epidemiology ; Developing Countries ; Humans ; Incidence ; Prevalence ; Systematic Reviews as Topic
    Language English
    Publishing date 2018-04-06
    Publishing country Australia
    Document type Journal Article
    ISSN 2202-4433
    ISSN (online) 2202-4433
    DOI 10.11124/JBISRIR-2017-003424
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Diagnostic accuracy of clinical stroke scores for distinguishing stroke subtypes: a systematic review.

    Mwita, Clifford / Kajia, Duncan / Gwer, Samson / Etyang, Anthony / Newton, Charles

    JBI library of systematic reviews

    2018  Volume 10, Issue 42 Suppl, Page(s) 1–10

    Language English
    Publishing date 2018-02-22
    Publishing country Australia
    Document type Journal Article
    ISSN 1838-2142
    ISSN 1838-2142
    DOI 10.11124/jbisrir-2012-241
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Neurotoxicity of antimalarial drugs: a systematic review.

    Mwai, Leah / Gwer, Samson / Gatakaa, Hellen / Kokwaro, Gilbert / Newton, Charles

    JBI library of systematic reviews

    2018  Volume 6, Issue 12 Suppl, Page(s) 1–14

    Language English
    Publishing date 2018-02-22
    Publishing country Australia
    Document type Journal Article
    ISSN 1838-2142
    ISSN 1838-2142
    DOI 10.11124/01938924-200806121-00005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Treatment of Madura foot: a systematic review.

    Salim, Amos Omondi / Mwita, Clifford Chacha / Gwer, Samson

    JBI database of systematic reviews and implementation reports

    2018  Volume 16, Issue 7, Page(s) 1519–1536

    Abstract: Review question/objective: The objective of this review was to determine the best available evidence on the most effective treatment of Madura foot.: Introduction: Madura foot or mycetoma is a chronic granulomatous soft-tissue infection that is ... ...

    Abstract Review question/objective: The objective of this review was to determine the best available evidence on the most effective treatment of Madura foot.
    Introduction: Madura foot or mycetoma is a chronic granulomatous soft-tissue infection that is endemic to several regions of Africa and Asia. It may be of fungal (eumycetoma) or bacterial (actinomycetoma) origin, warranting therapy with either antifungal or antibacterial medication as well as surgery. Without timely intervention, it often results in lifelong disability. However, it is unclear what regimes are most effective for treatment.
    Inclusion criteria: This review considered studies that included individuals of all ages with Madura foot (actinomycetoma or eumycetoma) as confirmed by microbiological or histological studies. Studies that evaluated antibiotic and antifungal regimens (any drug, dosage, frequency, duration) as well as surgical interventions (wound debridement, advanced excision or limb amputation) for Madura foot were included. Outcomes of interest were disease resolution (as determined by complete healing of mycetoma lesion after treatment), recurrence (return of mycetoma lesion after successful treatment) and mortality. Although this review considered both experimental and epidemiological study designs for inclusion, only case series and individual case reports were identified and were therefore included in the review.
    Methods: A three-step search strategy, involving an initial search, a second more comprehensive search using identified keywords and a third search involving the reference lists of included articles, was utilized. Ten databases were searched. An additional 13 sources were searched for gray and/or unpublished literature. Included studies were assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardized critical appraisal instruments from the Joanna Briggs Institute. Disagreements were resolved through discussion or with a third reviewer. A data extraction tool was used to extract data on interventions, populations, study designs and outcomes of significance to the review question. Statistical pooling was not possible, therefore a narrative synthesis was performed.
    Results: Thirty-one studies were included in the review (27 case reports and four case series). A total of 47 patients with Madura foot were analyzed. Twenty-five had eumycetoma, 21 actinomycetoma and one had both. Therapy involved varying dosages of sulfa drugs (co-trimoxazole and dapsone), amikacin and tetracyclines administered for the therapy of actinomycetoma with resolution of disease in all affected patients. The azole derivatives (itraconazole, ketoconazole, voriconazole, fluconazole and miconazole) as well as co-trimoxazole were the most commonly employed drugs for eumycetoma, with resolution of disease in 88% of included patients. Surgery was performed in a total of 21 patients with resolution of disease in all cases. The overall resolution rate following therapy was 95.7%.
    Conclusion: Therapy for Madura foot is informed by case series and case reports which provide low level evidence for practice. Antimicrobials in conjunction with surgery lead to resolution of disease.
    MeSH term(s) Adult ; Africa ; Amputation ; Anti-Bacterial Agents/administration & dosage ; Antifungal Agents/administration & dosage ; Humans ; Mycetoma/drug therapy ; Mycetoma/surgery ; Treatment Outcome
    Chemical Substances Anti-Bacterial Agents ; Antifungal Agents
    Language English
    Publishing date 2018-07-10
    Publishing country Australia
    Document type Journal Article ; Systematic Review
    ISSN 2202-4433
    ISSN (online) 2202-4433
    DOI 10.11124/JBISRIR-2017-003433
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Effective treatment of Madura foot: a systematic review protocol.

    Salim, Amos Omondi / Mwita, Clifford Chacha / Gwer, Samson

    JBI database of systematic reviews and implementation reports

    2016  Volume 14, Issue 11, Page(s) 91–98

    Abstract: Review question/objective: The objective of this review is to determine the best available evidence on the effective treatment of Madura foot. More specifically, the objectives are to identify. ...

    Abstract Review question/objective: The objective of this review is to determine the best available evidence on the effective treatment of Madura foot. More specifically, the objectives are to identify.
    MeSH term(s) Anti-Bacterial Agents/therapeutic use ; Antifungal Agents/therapeutic use ; Humans ; Mycetoma/drug therapy ; Mycetoma/surgery
    Chemical Substances Anti-Bacterial Agents ; Antifungal Agents
    Language English
    Publishing date 2016-12-08
    Publishing country Australia
    Document type Journal Article ; Review
    ISSN 2202-4433
    ISSN (online) 2202-4433
    DOI 10.11124/JBISRIR-2016-003179
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Telemedicine for Individuals with epilepsy: Recommendations from the International League Against Epilepsy Telemedicine Task Force.

    Samia, Pauline / Sahu, Jitendra Kumar / Ali, Amza / Caraballo, Roberto Horacio / Chan, Josephine / Coan, Ana Carolina / Fortini, Pablo Sebastián / Gwer, Samson / Jocic-Jakubi, Bosanka / Kissani, Najib / Rivera, Yanin / Sarfo, Fred Stephen / Singh, Mamta Bhushan / Trinka, Eugen / Yoo, Ji Yeoun / Yu, Hsiang-Yu / Zelano, Johan / Cross, J Helen

    Seizure

    2023  Volume 106, Page(s) 85–91

    Abstract: Worldwide, People with Epilepsy (PWE) are confronted with several barriers to face-to-face consultations. These obstacles hamper appropriate clinical follow-up and also increase the treatment gap for Epilepsy. Telemedicine holds the potential to enhance ... ...

    Abstract Worldwide, People with Epilepsy (PWE) are confronted with several barriers to face-to-face consultations. These obstacles hamper appropriate clinical follow-up and also increase the treatment gap for Epilepsy. Telemedicine holds the potential to enhance management as follow-up visits for PWE are focused on more on clinical history and counselling rather than physical examination. Besides consultation, telemedicine can also be used for remote EEG diagnostics and tele-neuropsychology assessments. In this article, the Telemedicine Task Force of the International League Against Epilepsy (ILAE) outlines recommendations regarding optimal practice in utilizing in the management of individuals with epilepsy. We formulated recommendations for minimum technical requirements, preparing for the first tele-consultation and the specificities for follow-up consultations. Special considerations are necessary for specific populations, including paediatric patients, patients who are not conversant with tele-medicine and those with intellectual disability. Telemedicine for individuals with epilepsy should be vigorously promoted with the aim of improving the quality of care and ultimately reduce the wide clinician access related treatment gap across several regions of the globe.
    MeSH term(s) Humans ; Child ; Telemedicine ; Epilepsy/diagnosis ; Epilepsy/therapy ; Referral and Consultation ; Neuropsychological Tests ; Intellectual Disability
    Language English
    Publishing date 2023-02-10
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 1137610-7
    ISSN 1532-2688 ; 1059-1311
    ISSN (online) 1532-2688
    ISSN 1059-1311
    DOI 10.1016/j.seizure.2023.02.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Correlates of isoniazid preventive therapy failure in child household contacts with infectious tuberculosis in high burden settings in Nairobi, Kenya - a cohort study.

    Okwara, Florence Nafula / Oyore, John Paul / Were, Fred Nabwire / Gwer, Samson

    BMC infectious diseases

    2017  Volume 17, Issue 1, Page(s) 623

    Abstract: Background: Sub-Saharan Africa continues to document high pediatric tuberculosis (TB) burden, especially among the urban poor. One recommended preventive strategy involves tracking and isoniazid preventive therapy (IPT) for children under 5 years in ... ...

    Abstract Background: Sub-Saharan Africa continues to document high pediatric tuberculosis (TB) burden, especially among the urban poor. One recommended preventive strategy involves tracking and isoniazid preventive therapy (IPT) for children under 5 years in close contact with infectious TB. However, sub-optimal effectiveness has been documented in diverse settings. We conducted a study to elucidate correlates to IPT strategy failure in children below 5 years in high burden settings.
    Methods: A prospective longitudinal cohort study was done in informal settlings in Nairobi, where children under 5 years in household contact with recently diagnosed smear positive TB adults were enrolled. Consent was sought. Structured questionnaires administered sought information on index case treatment, socio-demographics and TB knowledge. Contacts underwent baseline clinical screening exclude TB and/or pre-existing chronic conditions. Contacts were then put on daily isoniazid for 6 months and monitored for new TB disease, compliance and side effects. Follow-up continued for another 6 months.
    Results: At baseline, 428 contacts were screened, and 14(3.2%) had evidence of TB disease, hence excluded. Of 414 contacts put on IPT, 368 (88.8%) completed the 1 year follow-up. Operational challenges were reported by 258(70%) households, while 82(22%) reported side effects. Good compliance was documented in 89% (CI:80.2-96.2). By endpoint, 6(1.6%) contacts developed evidence of new TB disease and required definitive anti-tuberculosis therapy. The main factor associated with IPT failure was under-nutrition of contacts (p = 0.023).
    Conclusion: Under-nutrition was associated with IPT failure for child contacts below 5 years in high burden, resource limited settings. IPT effectiveness could be optimized through nutrition support of contacts.
    Language English
    Publishing date 2017-09-16
    Publishing country England
    Document type Journal Article
    ISSN 1471-2334
    ISSN (online) 1471-2334
    DOI 10.1186/s12879-017-2719-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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