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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]

Byline: Nahed. Shehta, Rasha. Fahmi, Bothina. Ramadan, Engy. Emad, Ahmed. Elsaid Background: Cerebrovascular stroke is considered as the most common cause of symptomatic seizures. Post-stroke seizures herald a poor functional [...]

Background: Previous studies had linked obesity to the pathogenesis and risk of multiple sclerosis (MS) but little is known about its association with disease course. This study aimed to assess the frequency of obesity in MS patients and its relation to disease disability. Methods: A cross-section study included 60 patients with clinically definite relapsing remitting multiple sclerosis was selected from the inpatients wards and outpatients clinic of Neurology Department, Zagazig during the period from March 2020 to September 2020. All patients underwent a thorough physical and neurological examination, as well as laboratory and radiographic tests. Obesity was diagnosed if body mass index (BMI) =30. The Expanded Disability Status Scale (EDSS) was used to assess disease disability. Patients were divided into 2 groups (obese and non-obese) according to BMI. Results: Obesity frequency was 43.3% (26 MS patients). Obese MS patients had higher disease duration (6.23 ± 4.65) and more disease disability (EDSS= 4.0 ± 2.21). There was positive correlation between BMI with EDSS, disease duration, number of relapses and total cholesterol. Multiple regression analysis showed that EDSS was independently associated with obesity in MS patients. Conclusion: There was a high frequency of obesity in MS patients. Disease disability (EDSS) was significantly associated with obesity in MS patients. Obesity screening should be a regular component of MS management. [ABSTRACT FROM AUTHOR]

Objective: When patients feel spiritually supported by staff, we find increased use of hospice and reduced use of aggressive treatments at end of life, yet substantial barriers to staff spiritual care provision still exist. We aimed to study these barriers in a new cultural context and analyzed a new subgroup with "unrealized potential" for improved spiritual care provision: those who are positively inclined toward spiritual care yet do not themselves provide it.Method: We distributed the Religion and Spirituality in Cancer Care Study via the Middle East Cancer Consortium to physicians and nurses caring for advanced cancer patients. Survey items included how often spiritual care should be provided, how often respondents themselves provide it, and perceived barriers to spiritual care provision.ResultWe had 770 respondents (40% physicians, 60% nurses) from 14 Middle Eastern countries. The results showed that 82% of respondents think staff should provide spiritual care at least occasionally, but 44% provide spiritual care less often than they think they should. In multivariable analysis of respondents who valued spiritual care yet did not themselves provide it to their most recent patients, predictors included low personal sense of being spiritual (p < 0.001) and not having received training (p = 0.02; only 22% received training). How "developed" a country is negatively predicted spiritual care provision (p < 0.001). Self-perceived barriers were quite similar across cultures.Significance of resultsDespite relatively high levels of spiritual care provision, we see a gap between desirability and actual provision. Seeing oneself as not spiritual or only slightly spiritual is a key factor demonstrably associated with not providing spiritual care. Efforts to increase spiritual care provision should target those in favor of spiritual care provision, promoting training that helps participants consider their own spirituality and the role that it plays in their personal and professional lives. [ABSTRACT FROM AUTHOR]

Background Diabetic neuropathy is the most common complication of diabetes.We hypothesized that uncontrolled diabetes is associated with subclinical diabetic neuropathy that is influenced by duration of disease. Assessment of the prevalence and associated determining factors will be important for the prevention and treatment of neuropathy. Objective This aim of this study was to assess the frequency and determining factors of subclinical peripheral neuropathy in type 1 diabetic (T1DM) patients. Patients and methods The current hospital-based, case-control study was conducted at Zagazig University Hospitals. It included three age-matched and sex-matched groups. Each group comprised 30 participants: group A included diabetic patients with a duration of T1DM of 5 years or less; group B included patients with a duration of T1DM of more than 5 years; and the control group included normal healthy individuals. Clinical assessment was carried out to exclude symptoms and signs of neuropathy. Laboratory investigations including fasting and 2-h postprandial blood glucose level, glycosylated hemoglobin (HbA1c), lipid profile, liver function, kidney function, and nerve conduction studies were carried out for every participant. Results The frequency of subclinical neuropathy in group A and group B was 46.6 and 76.6%, respectively, and this difference was statistically significant (P=0.03). Univariate analysis revealed significantly higher levels of HbA1c, dyslipidemia, and nerve conduction parameters in group B compared with group A and the control group. Multivariate logistic regression analysis showed that duration of diabetes (P=0.02) and HbA1c (P=0.02) were the only independent factors associated with subclinical neuropathy. Conclusion The high frequency of subclinical neuropathy in diabetic patients highlights the importance of nerve conduction studies for the early detection of neuropathy in T1DM. [ABSTRACT FROM AUTHOR]

Background: Low vitamin D levels had been shown to play a role in the pathogenesis of multiple sclerosis (MS). Currently, there is a paucity of information regarding the correlation between low levels of vitamin D and severity of MS in Egypt. Objective: This study aimed at detection of association between serum vitamin D concentrations and MS and its relation to the disease severity in Egypt. Methods: The present study was a case- control type, it included 25 patients with definitive multiple sclerosis on the basis of 'McDonald' criteria and 25 matched controls. All subjects were clinically evaluated including disease severity using EDSS. Serum levels of 25(OH) vitamin D were measured in the patients and controls. The patients were divided into three groups according to disease severity. Results: The mean level of vitamin D were significantly lower in patients group (19.92±8.94) as compared to control group (33.30±13.52). Inverse correlations were found between vitamin D levels and duration of illness (r=-0.746, P<0.001), Expanded Disability Status Scale (EDSS) (r=-0.755, P<0.001) and MRI lesion load (r=-0.611, P<0.01). Further analysis showed that there were statistical significant difference between the three groups regarding, duration of illness, mean score of EDSS, vitamin D level and MRI lesion load. Conclusion: Serum vitamin D levels were significantly decreased in MS patients compared to controls and were significantly correlated with MS severity and MRI lesion load. [ABSTRACT FROM AUTHOR]

Background: Renal dysfunction is a risk factor for vascular disease and has been associated with small vessel disease, which has been implicated in white matter hyperintensity (WMH). Objective: The aim of this study was to evaluate the association of kidney function white matter hyperintensity in patients with ischemic stroke. Methods: The study included 80 patients with first-ever ischemic stroke. All patients underwent complete medical history and neurological examination. Brain CT or MRI, electrocardiography and carotid ultrasonography determined stroke etiology. NIHSS was used to assess stroke severity on admission. Kidney function was expressed as estimated glomerular filtration rate (eGFR) by the Modification of Diet in Renal Disease method. WMH on MRI was classified by the Fazekas score. Outcome was assessed by modified Rankin Scale after 3-months. Results: Patients with low eGFR had more history of hypertension, overweight (body mass index >25 kg/m2), small vessel disease, severe stroke, severe WMH and poor outcome. Hypertension, overweight and severe WMH were still associated with low eGFR in multivariate analysis. Univariate differences among groups of WMH revealed that severe WMH was associated with age, hypertension, overweight (body mass index >25 kg/m2), small vessel disease, low eGFR and poor outcome. In multivariate analysis age, hypertension, low eGFR, small vessel disease, and poor outcome remained associated with severe WMH. Conclusion: Our results suggested that ischemic stroke patients with low eGFR were associated with severe WMH and poor short-term outcome. [ABSTRACT FROM AUTHOR]