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Background: Acute ischemic stroke and thyroid conditions have complicated interactions. With mixed findings, earlier research has suggested a link between thyroid function and the severity and outcome of strokes. Aim: Toevaluate the impact of thyroid function on acute ischemic stroke patient's functional outcome and stroke severity. Patients and methods: This prospective cohort study, which comprised 70 patients admitted within 48 hours of the beginning of their first acute ischemic stroke, was carried out at the Stroke and Critical Care Units of the Neurology Department at Zagazig University Hospitals. On admission, routine laboratory tests and thyroid hormone levels were examined. Modified Rankin scales [mRS] and the National Institute of Health and Stroke scale [NIHSS] were used to measure the severity of the stroke and the functional outcome, respectively. Results: In 41% of patients, abnormal thyroid function was found. Nonthyroid sickness syndrome was the thyroid anomaly that was most frequently noted [low FT3]. Stroke severity and a poor outcome were substantially correlated with high TSH and low FT3. Conclusion: The severity and functional prognosis of an ischemic stroke may be predicted by abnormal thyroid hormone levels at presentation. [ABSTRACT FROM AUTHOR]

Background: Post-stroke fatigue (PSF) is a common symptom that can have debilitating effects. Furthermore, it is cited as one of the worse symptoms by up to 40% of stroke survivors. Numerous risk factors for PSF, including clinical, laboratory, and hormonal variables, particularly thyroid hormones, were investigated. We aimed To assess the prevalence and contributing factors of post-stroke fatigue in AIS patients. Patients and Methods: This prospective cohort study, which included 70 patients with their first-ever AIS, conducted from August 2022 to January 2023 in the stroke units of the Zagazig neurology department. Patients were evaluated using the fatigue severity scale (scale 7-item version) one month after the stroke's onset. At admission to stroke units, routine laboratory and specialized hormonal assays for thyroid function were performed. Results: 16% of our patients reported post-stroke fatigue. Low T3, high TSH, and dyslipidemia were the three most frequently seen predictors. Conclusions: Dyslipidemia and altered thyroid function are linked to post-stroke fatigue, pointing to a potential role for neuroendocrine responses in PSF. [ABSTRACT FROM AUTHOR]

Background and purpose: Patients with ischemic stroke frequently develop hemorrhagic transformation (HT), which could potentially worsen the prognosis. The objectives of the current study were to determine the incidence and predictors of HT, to evaluate predictor interaction, and to identify the optimal predicting models. Methods: A prospective study included 360 patients with ischemic stroke, of whom 354 successfully continued the study. Patients were subjected to thorough general and neurological examination and T2 diffusion-weighted MRI, at admission and 1 week later to determine the incidence of HT. HT predictors were selected by a filter-based minimum redundancy maximum relevance (mRMR) algorithm independent of model performance. Several machine learning algorithms including multivariable logistic regression classifier (LRC), support vector classifier (SVC), random forest classifier (RFC), gradient boosting classifier (GBC), and multilayer perceptron classifier (MLPC) were optimized for HT prediction in a randomly selected half of the sample (training set) and tested in the other half of the sample (testing set). The model predictive performance was evaluated using receiver operator characteristic (ROC) and visualized by observing case distribution relative to the models' predicted three-dimensional (3D) hypothesis spaces within the testing dataset true feature space. The interaction between predictors was investigated using generalized additive modeling (GAM). Results: The incidence of HT in patients with ischemic stroke was 19.8%. Infarction size, cerebral microbleeds (CMB), and the National Institute of Health stroke scale (NIHSS) were identified as the best HT predictors. RFC (AUC: 0.91, 95% CI: 0.85-0.95) and GBC (AUC: 0.91, 95% CI: 0.86-0.95) demonstrated significantly superior performance compared to LRC (AUC: 0.85, 95% CI: 0.79--0.91) and MLPC (AUC: 0.85, 95% CI: 0.78-0.92). SVC (AUC: 0.90, 95% CI: 0.85-0.94) outperformed LRC and MLPC but did not reach statistical significance. LRC and MLPC did not show significant differences. The best models' 3D hypothesis spaces demonstrated non-linear decision boundaries suggesting an interaction between predictor variables. GAM analysis demonstrated a linear and non-linear significant interaction between NIHSS and CMB and between NIHSS and infarction size, respectively. Conclusion: Cerebral microbleeds, NIHSS, and infarction size were identified as HT predictors. The best predicting models were RFC and GBC capable of capturing nonlinear interaction between predictors. Predictor interaction suggests a dynamic, rather than, fixed cutoff risk value for any of these predictors. [ABSTRACT FROM AUTHOR]

Background: One of the heterogeneous chronic diseases affecting the kidneys is chronic kidney disease (CKD). Patients with chronic kidney disease, which is associated with high morbidity and mortality, are more likely to experience nervous system problems. Objective: This work was performed to estimate the prevalence and predictors of peripheral neuropathy in children with End Stage Renal Disease (ESRD) on hemodialysis. Patient and methods: A total of 80 children from Egypt were recruited and divided into 2 separate groups. As a first step, a case group of 40 children (5-18 years old) with ESRD who were receiving regular hemodialysis was established. Besides the control group of 40 healthy children matched by age and gender to the case group. We subjected all the participants to detailed history taking stressing on duration of dialysis, family history of renal diseases, consanguinity and history of neuromuscular symptoms such as distal paresthesia, or muscle weakness. General examination for weight, height, blood pressure, vital signs, systemic examination including: Heart examination, chest, abdominal and neurological examination. Routine laboratory investigations and nerve conduction studies were done. Results: We found a statistically significant difference in weight and height between the two studied groups. 40% of patients had polyneuropathy. Multivariate analysis showed that longer disease duration (7 years), high parathyroid hormone level and high ferritin were independent predictors of polyneuropathy. Conclusion: Peripheral neuropathy is a common complication among children with end stage renal disease. Longer dialysis duration, high ferritin and parathormone levels were considered strong predictors of polyneuropathy among CKD patients. [ABSTRACT FROM AUTHOR]

Background: Cerebrovascular stroke is considered as the most common cause of symptomatic seizures. Post-stroke seizures herald a poor functional outcome, a high mortality rate, and a long in-hospital duration of stay.Aim: To assess the incidence and risk factors responsible for early seizures after the first-ever cerebral stroke, and its relation to the functional outcome and the in-hospital mortality following stroke as well as the duration of stay.Patients and Methods: 150 patients with first-ever stroke, who were admitted in an intensive care and stroke unit of the Neurology Department of Zagazig University Hospitals, Egypt, within the first 24 hours of stroke onset were included in the study. Early seizures (within 7 days of stroke onset), stroke severity (National Institutes of Health stroke scale; NIHSS), radiological data, functional outcome (Barthel index), in-hospital mortality and duration of stay were collected and analyzed.Results: The incidence of early seizures associated with first-ever stroke was 9.3%. Risk factors for early seizures were intracerebral hemorrhage (ICH) [odds ratio (OR) = 3.2, P = <0.001), cortical lesions (OR = 2.8, P = <0.05), and a large lesion size (OR = 2, P= <0.05). Patients with early seizures had lower scores on the Barthel index than those without seizures (7.5 ± 4.1 versus 10.5 ± 3.5), had higher discharge National Institutes of Health Stroke scale (NIHSS) scores, had a higher in-hospital mortality rate (35.7% versus 6.6% in patients without seizures) and duration of stay (19.4 ± 6.5 versus 10.7 ± 4.2 days respectively).Conclusion: The incidence of early post-stroke seizures was high in our study and was positively associated with a poor functional outcome, a higher in-hospital mortality rate and a longer duration of in-hospital stay. The most important risk factors were ICH, the cortical site of involvement and a large size of the lesion. [ABSTRACT FROM AUTHOR]