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Backgrounds: Recovery for poststroke aphasia has a decelerating trajectory, with the greatest improvement is within weeks and the slope of change decreasing over time. Therefore, it is essential to predict the prognosis of aphasia at an early stage as it could provide useful data in specific plans for management strategies. The aim of this work was to assess the arcuate fasciculus in stroke patients with aphasia and its impact on predicting the outcome. A prospective study was performed including 25 patients with acute ischemic stroke and aphasia and 10 healthy control subjects with no history of neurologic or psychiatric disease. All patients underwent language assessment using an Arabic version of the Comprehensive Aphasia Test (Arabic CAT), with the resultant mean T-score aphasia quotient (AQ). Early assessment of stroke and delayed assessment at three months. All patients had diffusion-weighted magnetic resonance imaging (DWI-MRI) of the brain to localize the lesion and 3D diffusion tensor imaging (DTI) of the arcuate fasciculus (AF) within 30 days of stroke. Results: Patients in whom the AF could not be reconstructed had a poor score in early and late AQ and a poor prognosis compared to those in whom the AF could be reconstructed. Preservation of the left AF on DTI could mean the potential recovery of aphasia after stroke. Conclusion: The prognosis of aphasia in patients whose left AF could be reconstructed was better than those whose left AF could not be reconstructed, irrespective of the AF's integrity. That is why, we can assume that evaluation of the DTI of the left AF at early stages of stroke can help in predicting outcome of aphasia. [ABSTRACT FROM AUTHOR]

Telemedicine has proven to help fill the gap of deficiency of healthcare services whether due to deficient numbers of specialists or unavailability of specialized care in under privileged areas. To study the feasibility of implementing the "Treat and Teach' initiative package at the East Africa University (EAU), somalia. An observational study that implemented its "Treat and Teach" package at the East Africa University, bosaso, somalia recruiting the Somali healthcare team. Acceptance of stakeholders, knowledge and confidence of physicians, percentage of undiagnosed cases and causes were assessed pre-and post-intervention. Needs assessment revealed several deficits as specialized cardiological, neurological and critical care. The 'Treat and Teach' package was well accepted by stakeholders. 1500 patients presented to the new cardiology and neurology outpatient clinics. About two thirds of neurology and cardiology cases were diagnosed and treated by the trained healthcare team. The 'Treat and Teach' package is feasible in underprivileged areas (as somalia) as it tailors a program according to needs assessment and targets sustainability through capacity building and continuous support in all sectors not merely the medical domain. [ABSTRACT FROM AUTHOR]