<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03806946</url>
  </required_header>
  <id_info>
    <org_study_id>Impact of ADHD and epilepsy</org_study_id>
    <nct_id>NCT03806946</nct_id>
  </id_info>
  <brief_title>Impact of Relationship of Epilepsy and Attention Deficit Hyperactive Disorder</brief_title>
  <official_title>Impact of Relationship of Epilepsy and Attention Deficit Hyperactive Disorder</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Assiut University</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Assiut University</source>
  <oversight_info>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      The most common neuropsychiatric disorder in early childhood is attention&#xD;
      deficit/hyperactivity disorder (ADHD) with evidence of abnormality in structure and function&#xD;
      of brain. Epilepsy is one of the commonest comorbidity associated with ADHD with negative&#xD;
      outcome on childrens' quality of life, and is considered to be a risk for academic&#xD;
      underachievement. These two disorders are highly associated, with more possibility to be a&#xD;
      bidirectional relationship. The mechanisms of this comorbidity are unknown. In this&#xD;
      association, a difficult challenge is presented since antiepileptic therapy and drugs used to&#xD;
      treat ADHD may aggravate the clinical picture of each other. The main objectives are to&#xD;
      evaluate this overlap of those disorders, find their complications on child and his family,&#xD;
      and to suggest possible solutions to improve the outcome of those children.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      The commonest childhood disorder is attention deficit hyperactivity disorder(ADHD) which&#xD;
      continues into adulthood.The main two symptoms are inattention and hyperactivity.&#xD;
&#xD;
      As epilepsy is one of the commonest comorbidity with ADHD to about (40%), there are many&#xD;
      overlap symptoms between both disorders for example:&#xD;
&#xD;
        -  Behavioral features which are shared in both frontal lobe epilepsy with ADHD such as&#xD;
           impulsivity, disinhibition, and irritability&#xD;
&#xD;
        -  The electroencephalogram: there is an increase in the rate of spikes in children with&#xD;
           ADHD with no epileptic symptoms, which supports the theory of presence similar mechanism&#xD;
           about central nervous system dysfunction.&#xD;
&#xD;
      These reasons lead to increase obstacles for diagnosis, assessment, and treatment for both&#xD;
      disorders.&#xD;
&#xD;
      As this comorbidity duplicates the complications (i.e. drop the school, financial cost,&#xD;
      stress on families, negative effect on academic, vocational, social relations and self-esteem&#xD;
      ) so there is a great need to study this comorbidity to give a proper care for these&#xD;
      patients.&#xD;
&#xD;
      In this study, all participants will be enrolled over a period of 12 months from Assiut&#xD;
      outpatients clinic .All participants will be assessed in the psychiatric interview by using&#xD;
      prepared child and adolescent psychiatric sheet include (psychiatric and neurology history,&#xD;
      physical examination and mental state examination). After that electroencephalogram(EEG) will&#xD;
      be done to diagnoses epilepsy and identify different types of seizures.&#xD;
&#xD;
      All participants will be categorizing into 4 groups ( ADHD, epilepsy, ADHD,and epilepsy,&#xD;
      healthy) according to EEG and the psychiatric sheet. Each group will be assessed by different&#xD;
      psychometrics scales to evaluate cognitive, social, economic and behavioral outcome. The&#xD;
      results of all groups will be analysed by using Stata version 15 to evaluate the effect of&#xD;
      ADHD and epilepsy in children and adolescent and identify the possible risk factors to&#xD;
      improve outcome&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date type="Actual">February 15, 2019</start_date>
  <completion_date type="Actual">March 1, 2020</completion_date>
  <primary_completion_date type="Actual">December 30, 2019</primary_completion_date>
  <study_type>Observational</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <observational_model>Case-Control</observational_model>
    <time_perspective>Retrospective</time_perspective>
  </study_design_info>
  <primary_outcome>
    <measure>measure intellectual equations for children with epilepsy and ADHD</measure>
    <time_frame>baseline</time_frame>
    <description>WISC-III provided scores for Verbal IQ (VIQ), Performance IQ (PIQ), and Full-Scale IQ (FSIQ).&#xD;
The child's verbal IQ score was derived from scores on six of the subtests: information, digit span, vocabulary, arithmetic, comprehension, and similarities.&#xD;
The child's performance IQ was derived from scores on the remaining seven subtests: picture completion, picture arrangement, block design, object assembly, coding, mazes, and symbol search.&#xD;
The overall intelligence quotient, called the full scale IQ, as well as a verbal IQ and a performance IQ. The three IQ scores are standardized in such a way that a score of 100 is considered average and serves as a benchmark for higher and lower scores.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>measure socioeconomic class for families and children with comorbid epilepsy and ADHD</measure>
    <time_frame>baseline</time_frame>
    <description>It will be measure by Socioeconomic class scale which consist of It contain four main variables 1-the educational level of the father and mother 2-the occupation of the father and mother 3-total family income 4-life style of the family. The total score of the scale equal the sum of scores in each level, the scores 36-42 mean the high socioeconomic class, the scores 21-26 mean the low socioeconomic class, and scores between them mean the middle class.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>measure mood and feeling changes in children with comorbid epilepsy and ADHD.</measure>
    <time_frame>baseline</time_frame>
    <description>It will be measure by Mood and Feelings Questionnaire (MFQ) arent Report is a 13-item measure assessing recent depressive and describe feelings and mood,more than 26 is consider for evaluation of depression</description>
  </primary_outcome>
  <primary_outcome>
    <measure>measure quality of life for children with comorbid epilepsy and ADHD</measure>
    <time_frame>baseline</time_frame>
    <description>It is composed of 23 items that assessment function in the following four areas: physical (eight items), emotional (five items), social (five items), and school (five items). Patients report their function using a 5-point Likert scale ranging from 0 to 4. These responses are reverse scored and linearly transformed to a 0 to 100 scale, with a higher score indicating a higher QOL.&#xD;
The Psychosocial Health Summary score is a computed mean of the emotional, social, and school functioning subscales of the PedsQL. The physical functioning scale is the same as the Physical Summary score. In addition, the computed mean of the Emotional, Social, School functioning, and Physical scales are used to generate a Total Summary score. PedsQL scales are composed of parallel child self-report and parent-proxy report formats.</description>
  </primary_outcome>
  <number_of_groups>5</number_of_groups>
  <enrollment type="Actual">100</enrollment>
  <condition>Attention-Deficit Hyperactivity Disorder</condition>
  <condition>Epilepsy</condition>
  <arm_group>
    <arm_group_label>group1</arm_group_label>
    <description>ADHD with normal EEG</description>
  </arm_group>
  <arm_group>
    <arm_group_label>group 2</arm_group_label>
    <description>ADHD with abnormal EEG</description>
  </arm_group>
  <arm_group>
    <arm_group_label>group 3</arm_group_label>
    <description>Epilepsy</description>
  </arm_group>
  <arm_group>
    <arm_group_label>group 4</arm_group_label>
    <description>Healthy control group</description>
  </arm_group>
  <arm_group>
    <arm_group_label>group 5</arm_group_label>
    <description>ADHD and epilepsy</description>
  </arm_group>
  <intervention>
    <intervention_type>Diagnostic Test</intervention_type>
    <intervention_name>electroencephalography</intervention_name>
    <description>diagnosis epileptic discharge</description>
    <arm_group_label>group 2</arm_group_label>
    <arm_group_label>group 3</arm_group_label>
    <arm_group_label>group 4</arm_group_label>
    <arm_group_label>group 5</arm_group_label>
    <arm_group_label>group1</arm_group_label>
    <other_name>EEG</other_name>
  </intervention>
  <intervention>
    <intervention_type>Diagnostic Test</intervention_type>
    <intervention_name>psychometric scales to diagnosis psychiatric disorders</intervention_name>
    <description>to diagnosis intellectual disability, attention deficit hyperactivity disorder ,epilepsy,autism and other mental illness.</description>
    <arm_group_label>group 2</arm_group_label>
    <arm_group_label>group 3</arm_group_label>
    <arm_group_label>group 4</arm_group_label>
    <arm_group_label>group 5</arm_group_label>
    <arm_group_label>group1</arm_group_label>
    <other_name>WISC III (Wechsler Intelligence Scale for Children),conners 3rd Edition,(cbcl)The Child Behavior Checklis,Epilepsy interview,The Childhood Autism Spectrum Test (CAST)</other_name>
  </intervention>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>psychometric scales for assesment socioeconomic and behaviour problems</intervention_name>
    <description>to assessment other behavioural comorbidity as aggression ,mood changes,etc and help in identify function impairment, social and economic burden</description>
    <arm_group_label>group 2</arm_group_label>
    <arm_group_label>group 3</arm_group_label>
    <arm_group_label>group 4</arm_group_label>
    <arm_group_label>group 5</arm_group_label>
    <arm_group_label>group1</arm_group_label>
    <other_name>socioeconomic class, pediatric quality of life inventory, The Strengths and Difficulties Questionnaire (SDQ),The Mood and Feelings Questionnaire (MFQ),</other_name>
  </intervention>
  <eligibility>
    <study_pop>
      <textblock>
        childern and adolescent attending psychiatric outpatients clinic of Assiut university who&#xD;
        had diagnosis of attention deficit hyperactivity disorder or epilepsy or both and with age&#xD;
        (6y-11y)&#xD;
      </textblock>
    </study_pop>
    <sampling_method>Probability Sample</sampling_method>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Both males and females were included.&#xD;
&#xD;
          -  Age range from 6- 11 years.&#xD;
&#xD;
          -  Diagnosis of ADHD and/or epilepsy was verified and confirmed either on a clinical&#xD;
             basis or by using reliable psychometric tests.&#xD;
&#xD;
          -  In epilepsy groups: only Idiopathic type was included.&#xD;
&#xD;
          -  Willing of the parents or the caregivers to participate in the study.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Children whom caretakers refused to give informed consent.&#xD;
&#xD;
          -  Children with intelligence quotient below 70.&#xD;
&#xD;
          -  Children with history or current substance use.&#xD;
&#xD;
          -  Children with medical or other neurological conditions.&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>6 Years</minimum_age>
    <maximum_age>11 Years</maximum_age>
    <healthy_volunteers>Accepts Healthy Volunteers</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Alaa El-Din Darweesh, PhD</last_name>
    <role>Study Director</role>
    <affiliation>Assiut University</affiliation>
  </overall_official>
  <overall_official>
    <last_name>HossamEddin Ahmad, PhD</last_name>
    <role>Study Chair</role>
    <affiliation>Assiut University</affiliation>
  </overall_official>
  <overall_official>
    <last_name>Patrick Bolton, PhD</last_name>
    <role>Study Chair</role>
    <affiliation>King's College London</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>Assiut University Hospital</name>
      <address>
        <city>Assiut</city>
        <zip>71111</zip>
        <country>Egypt</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>Egypt</country>
  </location_countries>
  <results_reference>
    <citation>Dunn DW, Austin JK, Huster GA. Behaviour problems in children with new-onset epilepsy. Seizure. 1997 Aug;6(4):283-7.</citation>
    <PMID>9304719</PMID>
  </results_reference>
  <results_reference>
    <citation>Kanner AM. The use of psychotropic drugs in epilepsy: what every neurologist should know. Semin Neurol. 2008 Jul;28(3):379-88. doi: 10.1055/s-2008-1079342. Epub 2008 Jul 24.</citation>
    <PMID>18777484</PMID>
  </results_reference>
  <results_reference>
    <citation>Chou IC, Chang YT, Chin ZN, Muo CH, Sung FC, Kuo HT, Tsai CH, Kao CH. Correlation between epilepsy and attention deficit hyperactivity disorder: a population-based cohort study. PLoS One. 2013;8(3):e57926. doi: 10.1371/journal.pone.0057926. Epub 2013 Mar 6.</citation>
    <PMID>23483944</PMID>
  </results_reference>
  <results_reference>
    <citation>Sherman EM, Slick DJ, Connolly MB, Eyrl KL. ADHD, neurological correlates and health-related quality of life in severe pediatric epilepsy. Epilepsia. 2007 Jun;48(6):1083-91. doi: 10.1111/j.1528-1167.2007.01028.x. Epub 2007 Mar 22.</citation>
    <PMID>17381442</PMID>
  </results_reference>
  <results_reference>
    <citation>Kaufmann R, Goldberg-Stern H, Shuper A. Attention-deficit disorders and epilepsy in childhood: incidence, causative relations and treatment possibilities. J Child Neurol. 2009 Jun;24(6):727-33. doi: 10.1177/0883073808330165.</citation>
    <PMID>19491115</PMID>
  </results_reference>
  <results_reference>
    <citation>Kirov R, Kinkelbur J, Banaschewski T, Rothenberger A. Sleep patterns in children with attention-deficit/hyperactivity disorder, tic disorder, and comorbidity. J Child Psychol Psychiatry. 2007 Jun;48(6):561-70. doi: 10.1111/j.1469-7610.2007.01729.x.</citation>
    <PMID>17537072</PMID>
  </results_reference>
  <results_reference>
    <citation>Dickstein, L.J., Roba, M.B. and Oldham, J.M.(1997): Review of psychiatry. AmericanPsychiatric Press. Washington, DC. London,England.</citation>
  </results_reference>
  <verification_date>April 2020</verification_date>
  <study_first_submitted>May 9, 2018</study_first_submitted>
  <study_first_submitted_qc>January 12, 2019</study_first_submitted_qc>
  <study_first_posted type="Actual">January 16, 2019</study_first_posted>
  <last_update_submitted>April 13, 2020</last_update_submitted>
  <last_update_submitted_qc>April 13, 2020</last_update_submitted_qc>
  <last_update_posted type="Actual">April 14, 2020</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Assiut University</investigator_affiliation>
    <investigator_full_name>Gellan Karamalllah Ramadan Ahmed</investigator_full_name>
    <investigator_title>Assistent lecture</investigator_title>
  </responsible_party>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Epilepsy</mesh_term>
    <mesh_term>Attention Deficit Disorder with Hyperactivity</mesh_term>
  </condition_browse>
  <pending_results>
    <submitted>August 31, 2020</submitted>
    <returned>September 18, 2020</returned>
  </pending_results>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03806946
org study id: Impact of ADHD and epilepsy
nct id: NCT03806946
lead sponsor: 
is fda regulated drug: No
is fda regulated device: No
The most common neuropsychiatric disorder in early childhood is attention
      deficit/hyperactivity disorder (ADHD) with evidence of abnormality in structure and function
      of brain. Epilepsy is one of the commonest comorbidity associated with ADHD with negative
      outcome on childrens' quality of life, and is considered to be a risk for academic
      underachievement. These two disorders are highly associated, with more possibility to be a
      bidirectional relationship. The mechanisms of this comorbidity are unknown. In this
      association, a difficult challenge is presented since antiepileptic therapy and drugs used to
      treat ADHD may aggravate the clinical picture of each other. The main objectives are to
      evaluate this overlap of those disorders, find their complications on child and his family,
      and to suggest possible solutions to improve the outcome of those children.
The commonest childhood disorder is attention deficit hyperactivity disorder(ADHD) which
      continues into adulthood.The main two symptoms are inattention and hyperactivity.

      As epilepsy is one of the commonest comorbidity with ADHD to about (40%), there are many
      overlap symptoms between both disorders for example:

        -  Behavioral features which are shared in both frontal lobe epilepsy with ADHD such as
           impulsivity, disinhibition, and irritability

        -  The electroencephalogram: there is an increase in the rate of spikes in children with
           ADHD with no epileptic symptoms, which supports the theory of presence similar mechanism
           about central nervous system dysfunction.

      These reasons lead to increase obstacles for diagnosis, assessment, and treatment for both
      disorders.

      As this comorbidity duplicates the complications (i.e. drop the school, financial cost,
      stress on families, negative effect on academic, vocational, social relations and self-esteem
      ) so there is a great need to study this comorbidity to give a proper care for these
      patients.

      In this study, all participants will be enrolled over a period of 12 months from Assiut
      outpatients clinic .All participants will be assessed in the psychiatric interview by using
      prepared child and adolescent psychiatric sheet include (psychiatric and neurology history,
      physical examination and mental state examination). After that electroencephalogram(EEG) will
      be done to diagnoses epilepsy and identify different types of seizures.

      All participants will be categorizing into 4 groups ( ADHD, epilepsy, ADHD,and epilepsy,
      healthy) according to EEG and the psychiatric sheet. Each group will be assessed by different
      psychometrics scales to evaluate cognitive, social, economic and behavioral outcome. The
      results of all groups will be analysed by using Stata version 15 to evaluate the effect of
      ADHD and epilepsy in children and adolescent and identify the possible risk factors to
      improve outcome
observational model: Case-Control
time perspective: Retrospective
measure: measure intellectual equations for children with epilepsy and ADHD
time frame: baseline
description: WISC-III provided scores for Verbal IQ (VIQ), Performance IQ (PIQ), and Full-Scale IQ (FSIQ).
The child's verbal IQ score was derived from scores on six of the subtests: information, digit span, vocabulary, arithmetic, comprehension, and similarities.
The child's performance IQ was derived from scores on the remaining seven subtests: picture completion, picture arrangement, block design, object assembly, coding, mazes, and symbol search.
The overall intelligence quotient, called the full scale IQ, as well as a verbal IQ and a performance IQ. The three IQ scores are standardized in such a way that a score of 100 is considered average and serves as a benchmark for higher and lower scores.
measure: measure socioeconomic class for families and children with comorbid epilepsy and ADHD
time frame: baseline
description: It will be measure by Socioeconomic class scale which consist of It contain four main variables 1-the educational level of the father and mother 2-the occupation of the father and mother 3-total family income 4-life style of the family. The total score of the scale equal the sum of scores in each level, the scores 36-42 mean the high socioeconomic class, the scores 21-26 mean the low socioeconomic class, and scores between them mean the middle class.
measure: measure mood and feeling changes in children with comorbid epilepsy and ADHD.
time frame: baseline
description: It will be measure by Mood and Feelings Questionnaire (MFQ) arent Report is a 13-item measure assessing recent depressive and describe feelings and mood,more than 26 is consider for evaluation of depression
measure: measure quality of life for children with comorbid epilepsy and ADHD
time frame: baseline
description: It is composed of 23 items that assessment function in the following four areas: physical (eight items), emotional (five items), social (five items), and school (five items). Patients report their function using a 5-point Likert scale ranging from 0 to 4. These responses are reverse scored and linearly transformed to a 0 to 100 scale, with a higher score indicating a higher QOL.
The Psychosocial Health Summary score is a computed mean of the emotional, social, and school functioning subscales of the PedsQL. The physical functioning scale is the same as the Physical Summary score. In addition, the computed mean of the Emotional, Social, School functioning, and Physical scales are used to generate a Total Summary score. PedsQL scales are composed of parallel child self-report and parent-proxy report formats.
arm group label: group1
description: ADHD with normal EEG
arm group label: group 2
description: ADHD with abnormal EEG
arm group label: group 3
description: Epilepsy
arm group label: group 4
description: Healthy control group
arm group label: group 5
description: ADHD and epilepsy
intervention type: Diagnostic Test
intervention name: electroencephalography
description: diagnosis epileptic discharge
arm group label: group 2
arm group label: group 3
arm group label: group 4
arm group label: group 5
arm group label: group1
other name: EEG
intervention type: Diagnostic Test
intervention name: psychometric scales to diagnosis psychiatric disorders
description: to diagnosis intellectual disability, attention deficit hyperactivity disorder ,epilepsy,autism and other mental illness.
arm group label: group 2
arm group label: group 3
arm group label: group 4
arm group label: group 5
arm group label: group1
other name: WISC III (Wechsler Intelligence Scale for Children),conners 3rd Edition,(cbcl)The Child Behavior Checklis,Epilepsy interview,The Childhood Autism Spectrum Test (CAST)
intervention type: Other
intervention name: psychometric scales for assesment socioeconomic and behaviour problems
description: to assessment other behavioural comorbidity as aggression ,mood changes,etc and help in identify function impairment, social and economic burden
arm group label: group 2
arm group label: group 3
arm group label: group 4
arm group label: group 5
arm group label: group1
other name: socioeconomic class, pediatric quality of life inventory, The Strengths and Difficulties Questionnaire (SDQ),The Mood and Feelings Questionnaire (MFQ),
study pop: 
sampling method: Probability Sample
criteria: 
gender: All
minimum age: 6 Years
maximum age: 11 Years
healthy volunteers: Accepts Healthy Volunteers
last name: Alaa El-Din Darweesh, PhD
role: Study Director
affiliation: Assiut University
last name: HossamEddin Ahmad, PhD
role: Study Chair
affiliation: Assiut University
last name: Patrick Bolton, PhD
role: Study Chair
affiliation: King's College London
facility: 
country: Egypt
citation: Dunn DW, Austin JK, Huster GA. Behaviour problems in children with new-onset epilepsy. Seizure. 1997 Aug;6(4):283-7.
PMID: 9304719
citation: Kanner AM. The use of psychotropic drugs in epilepsy: what every neurologist should know. Semin Neurol. 2008 Jul;28(3):379-88. doi: 10.1055/s-2008-1079342. Epub 2008 Jul 24.
PMID: 18777484
citation: Chou IC, Chang YT, Chin ZN, Muo CH, Sung FC, Kuo HT, Tsai CH, Kao CH. Correlation between epilepsy and attention deficit hyperactivity disorder: a population-based cohort study. PLoS One. 2013;8(3):e57926. doi: 10.1371/journal.pone.0057926. Epub 2013 Mar 6.
PMID: 23483944
citation: Sherman EM, Slick DJ, Connolly MB, Eyrl KL. ADHD, neurological correlates and health-related quality of life in severe pediatric epilepsy. Epilepsia. 2007 Jun;48(6):1083-91. doi: 10.1111/j.1528-1167.2007.01028.x. Epub 2007 Mar 22.
PMID: 17381442
citation: Kaufmann R, Goldberg-Stern H, Shuper A. Attention-deficit disorders and epilepsy in childhood: incidence, causative relations and treatment possibilities. J Child Neurol. 2009 Jun;24(6):727-33. doi: 10.1177/0883073808330165.
PMID: 19491115
citation: Kirov R, Kinkelbur J, Banaschewski T, Rothenberger A. Sleep patterns in children with attention-deficit/hyperactivity disorder, tic disorder, and comorbidity. J Child Psychol Psychiatry. 2007 Jun;48(6):561-70. doi: 10.1111/j.1469-7610.2007.01729.x.
PMID: 17537072
citation: Dickstein, L.J., Roba, M.B. and Oldham, J.M.(1997): Review of psychiatry. AmericanPsychiatric Press. Washington, DC. London,England.
responsible party type: Principal Investigator
investigator affiliation: Assiut University
investigator full name: Gellan Karamalllah Ramadan Ahmed
investigator title: Assistent lecture
mesh term: Epilepsy
mesh term: Attention Deficit Disorder with Hyperactivity
submitted: August 31, 2020
returned: September 18, 2020