dc.contributor.author | Kwasa, J K | |
dc.date.accessioned | 2014-02-03T07:12:20Z | |
dc.date.available | 2014-02-03T07:12:20Z | |
dc.date.issued | 2007 | |
dc.identifier.citation | Judith K. Kwasa (2007). Bone Metabolism In Ambulatory, Premenopausal Women Using Antiepileptic Drugs, Attending The Neurology Clinic At The Kenyatta National Hospital. Master of Medicine | en_US |
dc.identifier.uri | http://hdl.handle.net/11295/64455 | |
dc.description.abstract | BACKGROUND
Long term antiepileptic drug use causes multiple abnormalities in calcium
and bone metabolism that have been described in both institutionalized and
ambulatory patients, in the Western set-up.
On average at Kenyatta National Hospital, 30 to 35% of the total numbers of
patients seen weekly at the Neurology clinic are women with epilepsy.
RATIONALE
Exposure to anti-epileptic drugs puts women at a higher risk for osteoporosis,
before they reach menopause.
No studies have been published locally to describe the effect of long term
AED use on women's bone health.
OBJECTIVE
The broad objective of this study was to assess bone metabolism in
ambulatory females of reproductive age on antiepileptic drugs, at KNH.
METHODS
This was a cross-sectional comparative study that explored the relationship
between Bone health and long-term treatment with anti epileptic drugs in
women of reproductive age. Fifty seven women on drugs for more than 1
year were compared with 53 age-matched controls. Biochemical markers of
bone metabolism were measured, namely serum Calcium, Phosphate,
Alkaline Phosphate and Urinary Calcium Excretion. Bone Mineral Density
measurement at the Lumbar Spine was undertaken on a limited number of
subjects due to financial constraints. (24 patients and 24 controls) Patients
were, as closely as possible, matched for age, weight and height with an
otherwise healthy control.
RESULTS
The mean duration of treatment for epilepsy was 8.8years (±6.3). Majority
of the patients were on enzyme inducing drugs, either alone or in
combination with non-enzyme inducers (98.2%). There was a significantly
lower mean serum calcium and a higher alkaline phosphatase level among
the patients (P=0.002 and 0.0001 respectively) than among the controls. The
urinary marker of bone loss (mean Urine calcium excretion) was also
significantly raised among the patients (P=0.003). The mean Lumbar BMD
T-score results were not significantly different in the two groups.
CONCLUSION
Long-term antiepileptic drug use significantly affects biochemical
parameters of bone metabolism. These effects on bone biochemistry markers
were not reflected in Lumbar spine BMD
RECOMMENDATIONS
Further studies with larger sample sizes are required to fully elucidate the
impact of AEDs on bone metabolism.
Health care workers should be aware of the possible side effects of AEDs on
bone health; especially as regards women, who are prone to age-related
osteoporosis. | en_US |
dc.language.iso | en | en_US |
dc.publisher | University of Nairobi | en_US |
dc.title | Bone Metabolism In Ambulatory, Premenopausal Women Using Antiepileptic Drugs, Attending The Neurology Clinic At The Kenyatta National Hospital | en_US |
dc.type | Thesis | en_US |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |