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Background Parkinson’s disease (PD) is one of the most common neurodegenerative diseases. There is accumulating evidence that link gut microbiota to symptomatology and pathophysiology of PD. The aim of this study was to describe the pattern of gut microbiota and its association with PD and identify the effect of environmental factors on gut microbiota. This case–control study included 46 patients diagnosed as Parkinson’s disease (PD) and 31 healthy volunteers age and sex matched. Detailed history including age of onset, duration of disease, environmental risk factors, diet data, treatment, Unified Parkinson’s Disease Rating Scale (UPDRS), and gastrointestinal tract (GIT) domain of Non‐Motor Symptoms Scale (NMSS) were assessed. After extraction of bacterial DNA from the fecal samples, bacterial abundance was quantified by qPCR using 16S rRNA group-specific primers. Results Significant high abundance of Clostridium cluster IV, Akkermansia, Bifidobacterium, and lactic acid bacteria were found in the PD group compared with the control group (P P P = 0.002), while no significant correlations between different gut microbiota and demographic, environment data, different rating scores or dominant type of PD. There was a significant negative correlation between the Bifidobacterium with the duration of illness (P = 0.012). Conclusion The present study highlighted a significant connection between PD and levels of certain types of gut microbiota, in support of a possible link between gut microbiota and a neurodegenerative cascade of PD.

BackgroundCOVID-19 can be accompanied by acute neurological complications of both central and peripheral nervous systems (CNS and PNS). In this study we estimate the frequency of such complications among hospital in-patients with COVID-19 in Assiut and Aswan University Hospitals.Material and MethodsWe screened all patients with suspected COVID-19 admitted from 1 June to 10 August 2020 to the university hospitals of Assiut and Aswan in Upper Egypt. Clinical and laboratory data, CT/MRI of chest and brain, and neurophysiology were performed for each patient if indicated.Results439 patients had confirmed/probable COVID-19; neurological manifestations occurred in 222. Of these 117 had acute neurological disease; the remainder had non-specific neuropsychiatric symptoms such as headache, vertigo, and depression. The CNS was affected in 75 patients: 55 had stroke; the others had convulsions (5), encephalitis (6), hypoxic encephalopathy (4), cord myelopathy (2), relapse of RR-MS (2), and meningoencephalitis (1). The PNS was affected in 42 patients: the majority had anosmia and ageusia (31); the others had GBS (4), peripheral neuropathy (3), myasthenia gravis (2), or myositis (2). Fever, respiratory symptoms and headache, were the most common general symptoms. Hypertensions, Diabetes Mellitus, ischemic heart disease were the most common comorbidities in patients with CNS affection.ConclusionIn COVID⍰19, both the CNS and PNS are affected. Stroke was the most common complication for CNS and anosmia and/or ageusia were common for PNS diseases. However there were 6 cases encephalitis, 2 cases of spinal cord myelopathy, 2 cases of MG and 2 cases of myositis.

Background: Ventilator associated pneumonia (VAP) remains an area of active clinical research with little data about effect of (VAP) on outcome among patients with acute exacerbation of chronic obstructive pulmonary disease. Materials and methods: A prospective study included patients with COPD exacerbation requiring endotracheal intubation for more than 48 h. Clinical assessment and Quantitative culture done for all patients for the occurrence of VAP. Results: Out of one hundred fifty two patients 92 patients (60.5%) were with VAP diagnosis. Their mean age was 56.1 ± 15.02 (38 cases developed early while 54 cases developed late VAP). Forty eight cases were discharged (54%) while 44 cases (46%) died. In comparing mean age of both groups 45.08 ± 15.52 and 57.41 ± 16.34 with P value 0.003. Prolonged use of antibiotics, re-intubation and steroid use are possible risk factors for VAP with significant P values 0.03, 0.001, 0.05 respectively. Age above vs. below 60 showed adjusted odds ratio 5.33; 95% confidence interval 1.59–7.83 with P value 0.007. Early vs. late VAP, and prolonged use of antibiotics vs. none showed significant odds ratio 0.32; 95% CI 0.13–0.76, odds ratio 2.85; 95% CI 1.07–7.59 with P values 0.01, 0.04 respectively. Conclusions: Old age, late onset VAP, re-intubation and prolonged use of antibiotics were predictors of mortality in VAP patients with AECOPD.