Search

Background: Epidemiology of MS in Sharkia is not properly recognized. Clinical evaluation including demographic, laboratory and radiological features of MS patients will help to achieve better understanding of the distribution of disease for a good management that offers better quality of life. This clinical study aims at detection and evaluation of multiple sclerosis patients in Sharkia Governorate in Egypt. Methods: This was a retrospective, observational study undertaken in the period between January 2021 and July 2021 in the multiple sclerosis unit (MSU), outpatient clinics of the neurology department, Zagazig University Hospitals. Medical records of all patients were reviewed and data were identified and extracted. Any patient not from or living outside Sharkia Governorate had excluded. Results: The total number of patients recorded in MSU was 258 patients. Female to male ratio was 2.03:1. The mean age (± SD) of onset of the disease was 27 (± 4.3). Family history of MS was reported in 1.94% of patients. RRMS was the most common MS type in our study (77.1%). The overall are suffering from motor symptoms (22.48%), followed by the visual (20.5%) then sensory symptoms (17%). The mean (± SD) EDSS score of our patients was 2.17 (±1.87). Conclusion: This is the first MS register from Sharkia Governorate. The frequency of MS in Sharkia Governorate is 3.376 / 100,000 population. The most common type is RRMS, and the motor symptoms are the most frequent presenting symptoms. Our results are comparable to the results of other literature. [ABSTRACT FROM AUTHOR]

Background: There is limited and inconsistent data on metabolic syndrome (MetS) in multiple sclerosis (MS) patients. The aim of this study was to estimate the frequency of MetS and its components in MS patients and to evaluate their association with disease disability in Egyptian MS patients., Methods: A cross-section study was carried out on 60 patients (19 males and 41 females) with relapsing remitting MS. All patients were subjected to full general and neurological examination, laboratory and radiological investigations. Assessment of disease disability was performed using Expanded Disability Status Scale (EDSS) and MetS was diagnosed according to National Cholesterol Education Program Adult Treatment Panel Ш (NCEP-ATP III)., Results: The frequency of MetS in MS patients was 36.7%. Our findings show that 53.3% of MS patients had abdominal obesity, 21.7% had hypertension, 38.3% had diabetes mellitus, 43.3% had elevated triglycerides level and 56.7% had dyslipidemia. Linear regression analysis revealed that body mass index (BMI), dyslipidemia, current medication and disease duration were significantly associated with disease disability., Conclusion: High frequency of MetS and its component was observed in MS patients. Disease duration and current medication as well as some MetS component such as BMI, dyslipidemia, were significantly associated with disability in MS patients., (Copyright © 2020. Published by Elsevier B.V.)

Background: Few studies addressed the prevalence of cerebral microbleeds (CMB) and associated risk factor profile in Egyptian ischemic cerebral stroke patients with atrial fibrillation (AF)., Methods: The prevalence of CMB was estimated in 150 cases of AF ischemic stroke patients and compared to the prevalence in 150 age- and sex-matched controls of ischemic stroke patients without AF. CMB-associated risk factors were identified by comparing AF ischemic stroke patients with and without CMB. All participants were subjected to complete general, neurological examination, and magnetic resonance imaging., Results: The prevalence of CMBs in ischemic stroke with and without AF was 40.7% and 49.3%, respectively. Age, hypertension, diabetes mellitus, past history of stroke, antiplatelet, anticoagulant, National Institutes of Health Stroke Scale, CHA 2 DS 2 VASc, and white matter lesions (WML) were significant risk factors associated with CMB on univariate analysis. On multivariable logistic regression analysis, age (odds ratio [OR] 1.1, confidence interval [CI] 1.02-1.13), hypertension (OR 3.2, CI 1.19-8.81), anticoagulant (OR 3.3, CI 1.17-9.40), and WML (OR 9.6, CI 3.49-26.3) were the only independent risk factors associated with the presence of CMBs., Conclusions: AF in ischemic stroke patients was not associated with higher prevalence of CMBs. Old age, hypertension, anticoagulant treatment, and WML were the independent risk factors associated with CMB in AF ischemic stroke patients. Our results suggest that elderly hypertensive AF ischemic stroke patients maintained on anticoagulant therapy should be screened for the incidence of CMBs and monitored regularly for the development of intracerebral hemorrhage., Competing Interests: Conflict of Interest All authors declare no conflict of interest., (Copyright © 2020 Elsevier Inc. All rights reserved.)

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., Competing Interests: There are no conflicts of interest