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Background: The consumption of fast-food is increasing among children, adolescents and adults. Carbonated drinks are widely consumed with fast food that also exists in the form of diet drinks as Diet Coke. One of the thousands of chemicals used in our new high-tech foods is the monosodium glutamate (MSG). Aim of the Study: This study was conducted to investigate the effect of Diet Coke and monosodium glutamate salt either separately or in combination on the cerebellar cortex and kidney of adult male albino rats. Materials and Methods: Twenty five adult male albino rats were divided into four groups. Group I: control group (10 rats) divided equally into two subgroups, subgroup IA in which rats had free access to food and water and subgroup 1B in which each rat administrated 0.5 ml of distilled water once daily by oral gavage. Rats had free access to food and water. Group II (5 rats): in which rats received Diet Coke instead of water throughout the day. Group DI (5 rats): in which each rat received 0.5m1 of MSG salt solution by dose of 3ern MSG/kgm by oral gavage once daily. Group IV (5 rats): in which each rat received Diet Coke instead of water throughout the day and 0.5m1 of MSG salt solution by dose of 3gm MSG/kgm by oral gavage once daily. Cerebella and kidneys were dissected out and processed for histological, immunohistochemical and morphometric studies. Results: Histological examination of the cerebellum and the kidney revealed that both Diet Coke and MSG either separately or in combination resulted in degenerative changes that were more significant in the combination group. The cerebellum showed degeneration of Purkinje cells and vaculations in the molecular layer. The kidney showed shrunken glomeruli, vacuolations of cells lining renal tubules with pyknotic nuclei. Hyaline debris detected in renal sections of combination group. Conclusion: Diet Coke and MSG induced degenerative changes in both the cerebellum and the kidney that was more significant in their combination. [ABSTRACT FROM AUTHOR]

Background: Subclavian steal syndrome (SSS) is not rarely found during ultrasound examinations. Previous reports demonstrated a relation between ethnic factors and SSS. Data regarding SSS in non-Western population are still lacking. We aimed to investigate the frequency of SSS in a sample of Egyptian population., Methods: In a single-center observational study, we conducted a retrospective analysis of successive patients with competent ultrasound examinations of the brain supplying vessels. The patients presented to our neurovascular laboratory in the context of routine clinical practice., Results: We enrolled 514 patients in our study. SSS was detected in 9 patients (1.8 %) with a median (IQR) age of 58 (56-63) years. One patient with second-degree SSS received a subclavian stent. Among patients with SSS, 4 patients (44.4 %) had carotid atherosclerosis, 4 patients (44.4 %) had ischemic vascular events in the posterior circulation, and two (22.2 %) had hemodynamically significant carotid stenosis ≥50 %. Using a ROC curve, an interarm SBP (systolic blood pressure) difference of ≥10 mmHg had a sensitivity of 77.8 % and specificity of 66 %, whereas a difference of ≥20 mmHg was associated with a sensitivity of 55.6 % and specificity of 92.4 % for SSS (AUC 0.79, 95 % CI 0.6-0.97, p = 0.004)., Conclusions: SSS is not rare among Egyptian population and should be in mind during ultrasound examination, especially for patient with ischemic events in the posterior circulation and those with significant interarm SBP difference., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Objectives: To explore the effectiveness of an adapted 14-week cognitive stimulation therapy (CST) protocol on psychoaffective symptoms and quality of life (QOL) for people living with mild dementia., Method: The sample for this pragmatic study were people with dementia who underwent CST between May 2016 and September 2022 during routine healthcare. Measures of participants' psychoaffective symptoms and QOL were administered before CST ('baseline') and following CST ('post-intervention'). The Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety symptoms, depression symptoms, and their sum score (referred to as HADS-total). The Quality of Life-Alzheimer's Disease (QOL-AD) scale was used to measure participants' quality of life (both patient and carer ratings were available). Change in these outcomes was assessed using linear mixed models., Results: Two hundred and twenty-five participants attended ≥1 session of adapted CST (84% attended at least 9/14 sessions, considered 'high' adherence). The mean change [95% confidence interval] in HADS-total scores indicated improvement (-0.9; [-1.9, -0.0]). Mean scores on the other outcomes showed neither improvement nor worsening., Conclusion: Overall, this pragmatic study shows that an adapted 14-week face-to-face CST protocol is effective in improving mental health in people with mild dementia and has the potential to be widely implemented within routine healthcare.

Background: Flow diversion with or without coiling has been established as the treatment of choice for large unruptured aneurysms. This study aims to assess possible predictors for radiological and clinical outcome such as location of the aneurysm (anterior or posterior circulation), complexity by a branching artery, bifurcation, and adjuvant coiling., Methods: This study was conducted on 65 consecutive patients with 65 large, unruptured intracranial aneurysms (size ≥ 10 mm) treated with flow diverters. Follow-up angiography was done for 60 patients (92.3%) at 12 ± 8.6 months range from 3 to 36 months., Results: Complete occlusion was achieved in 50 from 60 aneurysms (83.4%), while 8 aneurysms (13.3%) had neck remnant, and another two aneurysms (3.3%) remained with aneurysmal remnant. Periprocedural complications were encountered in 14 patients (21.5%) with morbidity in six patients (9.2%) and mortality in one patient (1.5%). In a multivariate logistic regression, anterior versus posterior location was less likely associated with worse outcome; adjusted OR (95% CI) of 0.16 (0.07-0.01), p = 0.006. Complete occlusion in complex aneurysms with branching artery was 60% versus 88% in simple aneurysms without branching artery (p-value = 0.04)., Conclusions: Flow diverter deployment of a large, unruptured aneurysm in the anterior circulation might have a better outcome than one in the posterior circulation. Flow diverter of aneurysms with branching artery or at bifurcation might be associated with aneurysm persistence and complications respectively., (© 2022. The Author(s).)

Background: Increased nighttime BP variability (BPV) was associated with stroke. Left atrial (LA) enlargement is the default clinical hallmark of structural remodeling that often occurs in response to LA pressure and volume overload. Blood pressure has proven to be an essential determinant of LA enlargement. We aimed to evaluate the influence of BPV as a risk factor for cryptogenic stroke and highlight the importance of including the (APBM) in the workup for those patients and test the relation between BPV and LA remodeling in these patients, which could be used as a clue to add APM monitoring to their workup. Also, LA remodeling may be a substrate for occult atrial fibrillation (AF). We included Group I (108 consecutive patients with cryptogenic ischemic stroke) and Group II (100 consecutive adult participants without a history of stroke or any structural heart disease). We measured the maximal LA volume index (Max LAVI) and minimal LA volume index (Min LAVI). We calculated the left atrial ejection fraction (LAEF). All the participants were subjected to ABPM., Results: In our prospective, cross-sectional cohort study, the patients in Group I had statistically significantly higher Min LAVI and Max LAVI and Less LA EF than Group II, with a P value of (0.001, 0.001, and 0.008), respectively. The Group I patients had higher BPV as measured by SD parameters than patients in Group II, with a P value of 0.001 for all SD parameters. The BPV parameters, as measured by SD parameters, were positively related to the LA remodeling parameters in both groups. After adjusting all variables, we found that age, night systolic SD, and night diastolic SD parameters were independent predictors of LA remodeling., Conclusions: The patients with cryptogenic stroke had higher short-term BPV, Min LAVI, and Max LAVI but lower LA EF. Careful monitoring of BPV may be of value for both primary and secondary preventions of ischemic stroke., (© 2022. The Author(s).)

Background: Surgery of the brain tumors near eloquent areas carries the risk of either disabling neurological deficit or inadequate resection with bad prognosis in both situations. Awake surgery is the gold standard procedure for such lesions. However, it requires certain anesthetic drugs, advanced techniques, and trained teams that are not available in every neurosurgical institute. This work aims to evaluate safety, feasibility, and outcome of operating on patients with space occupying lesions near eloquent areas under scalp block being continuously examined by a neurologist through retrospective study of 20 cases with supratentorial lesions related to language or sensorimotor cortex., Results: There were 12 males and 8 females with mean age 36.8 years. Forty percent of patients were presented by motor weakness. Tumors were related to motor cortex in 11 patients and to language areas in 9 patients. Mean operative time was 210 min. Gross or near total resection was achieved in 15cases, four cases had subtotal resection and biopsy only was done in 1 case. Two patients suffered from intraoperative seizures and conversion to general anesthesia was required in one patient., Conclusion: Operating on tumors near eloquent brain areas under scalp block and continuous neurological examination during tumor resection proved to be effective in early detection and prevention of permanent major deficits especially in the developing countries with limited resources., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s) 2021.)

Introduction: The treatment of wide-neck bifurcation aneurysms is still challenging despite the use of new techniques, such as Y-stenting, the waffle-cone technique and intrasaccular flow disrupters, in recent years. Moreover, the use of flow diverter stents in bifurcation aneurysms has been proposed by several teams, although the results remain controversial. This study aims to evaluate the feasibility and efficacy of Y-stent assisted coiling of bifurcation aneurysms with braided stents., Methods: We retrospectively reviewed all patients in whom Y-stenting with braided stents had been performed in our center. Six patients were identified and analyzed. Technical success, complications, angiographic outcomes, procedural data, and follow-up controls are reported here. This study was approved by our local ethical committee., Results: Technical success was achieved in all procedures. Overall procedure-related morbidity and mortality was 0%. In the immediate post-treatment angiography, adequate occlusion (neck remnant or total occlusion) was observed in all patients. Short- and long-term follow-up angiography showed adequate occlusion of the aneurysms., Conclusions: In this small, retrospective single-center analysis we showed that Y-stent assisted coiling with braided stents is a safe and feasible technique. Moreover, it has a high immediate occlusion rate and very good long-term stability., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)