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Background: Epileptic children can pose an additional risk of poor bone health; this study aimed to evaluate the influence of anti-seizure medications (ASMs) on vitamin D level and sclerostin as a bone turnover biomarker in children with epilepsy. Subject and methods: This case–control comparative study was conducted on 180 children aged from 5–18 years diagnosed with epilepsy according to the definition of the International League Against Epilepsy on ASMs for more than 3 months and were classified into 90 epileptic children on ASM monotherapy and 90 epileptic children on ASM polytherapy, in addition to 90 healthy children age- and sex-matched who served as controls. After obtaining basic data, laboratory investigations were performed, including serum calcium, phosphorus, alkaline phosphatase, parathyroid hormone, vitamin D, and serum sclerostin. Results: When we compared epileptic patients to the control group, there was a statistically significant low level of vitamin D, calcium, and phosphorus and a high level of sclerostin among both epileptic groups with mono or polytherapy. Sclerostin has a statistically significant negative correlation with vitamin D, alkaline phosphatase and parathyroid hormone. Additionally, it has a negative correlation with serum phosphorus, but without a significant correlation. On the other hand, sclerostin has a statistically positive correlation with age and serum calcium, but without a significant correlation. Multiple linear regression analyses were conducted to predict the contributing factors of sclerostin. Only duration of treatment and BMI were significant predictors of high levels of sclerostin. In contrast, the other factors failed to show any significant contribution. Conclusion: The present study showed that ASMs modulate the serum levels of sclerostin and vitamin D hence, might be involved in their adverse effects on bone. [ABSTRACT FROM AUTHOR]

Background: Dysphagia is an important complication of acute stroke. Aspiration pneumonia is the most important acute complication of stroke related dysphagia. Objective: To estimate the frequency and risk factors of pneumonia in acute stroke patients fed by nasogastric tube. Methods: This prospective study was done on 50 consecutive patients with acute stroke who were given tube feeding because of dysphagia. The study was done in Zagazig university hospitals, over one year period (Sept 2012 to Sept 2013). All patients were assessed daily for the presence pneumonia. Results: Pneumonia was diagnosed in 44% of the tube fed patients. As measured by the NIHSS score, patients who acquired pneumonia, were more severely affected than patients without pneumonia. Patients with decreased consciousness and severe facial palsy are at high risk of pneumonia. Conclusions: Decreased consciousness and severe facial palsy are risk factors for development of post-stroke pneumonia. [ABSTRACT FROM AUTHOR]

SSDSDD [ABSTRACT FROM AUTHOR]

Introduction: Intracerebral hemorrhage (ICH) is characterized to be the most lethal form of stroke, with high rates of mortality, not only during the acute phase (39%), but also 3 months later (33.5%) with a significant long-term disability. The National Institutes of Health Stroke Scale (NIHSS) score is a purely clinical scale, is easily administrable, and does not require the use of any additional diagnostic procedure.Objectives: To evaluate if the admission NIHSS score in acute primary ICH patients can be a predictive tool for their short-term outcome.Patient and methods: We included 120 patients diagnosed with spontaneous ICH. All patients were subjected to full history taking, general, and neurological examination with assessment of neurological function on admission using the NIHSS. Laboratory assessment on admission including complete blood count, routine liver and kidney functions, and coagulation profile. Radiological investigations included computerized tomography (CT). The patients were followed, both clinically using the NIHSS score, radiologically with CT brain after 1 week and 4 weeks from the onset to assess the hematoma growth, its complications, and or resolution. Modified Rankin score (mRS) was done after 30 days of onset to assess patient's disability.Results: The 30-day mortality was about one third of the patients. The intracerebral hematoma volume on admission has a significant positive correlation with the NIHSS, and ICH score significantly correlates with the 30-day outcome.Conclusion: Admission NIHSS has an independent predictive value of the 30-day outcome in cases of primary ICH as regards mortality and disability. [ABSTRACT FROM AUTHOR]