Search

Background: Electrodiagnosis is a localizing, diagnostic, and prognostic tool for individuals with suspected neuromuscular diseases. In addition to detailed history taking and thorough clinical examination, correct execution and interpretation of these tests can provide vital insights into the underlying neuromuscular disorders and frequently guide the need for proper management decision. The request for an electrodiagnosis examination should include brief clinical information and a provisional clinical diagnosis; this enhances the efficient easy performance of the test. The current study aims to detect the pattern of neuromuscular diseases in the Alexandria Main University Hospital, Egypt, and to evaluate the quality of the referral system to the electrodiagnosis unit. Results: The study included 371 patients, out of which, 65% were referred from the Governmental Specialized Medical Councils and the Neurosurgery department. Although sensory complaints were the main reason for referral, yet 28.8% of patients did not show any electrodiagnosis abnormality. A compatible referral note led to shorter test times and fewer electromyography needle insertions. Conclusion: Disorders of the peripheral nerves are the most frequent neuromuscular diseases referred to the electrodiagnosis unit with carpal tunnel syndrome being the most common disorder. A compatible referral letter is necessary when requesting an electrodiagnosis test, to save the physician time and focus on targeted procedures. [ABSTRACT FROM AUTHOR]

Iphiona mucronata (Family Asteraceae) is widely distributed in the Eastern desert of Egypt. It is a promising plant material for phytochemical analysis and pharmacologic studies, and so far, its specific metabolites and biological activity have not yet been thoroughly investigated. Herein, we report on the detailed phytochemical study using UPLC-Q-TOF-MS approach. This analysis allowed the putative annotation of 48 metabolites belonging to various phytochemical classes, including mostly sesquiterpenes, flavonoids, and phenolic acids. Further, zebrafish embryotoxicity has been carried out, where 100 µg/mL extract incubated for 72 h resulted in a slow touch response of the 10 examined larvae, which might be taken as a sign of a disturbed peripheral nervous system. Results of in vitro testing indicate moderate cytotoxicity towards VERO, FaDu, and HeLa cells with CC50 values between 91.6 and 101.7 µg/mL. However, selective antineoplastic activity in RKO cells with CC50 of 54.5 µg/mL was observed. To the best of our knowledge, this is the first comprehensive profile of I. mucronata secondary metabolites that provides chemical-based evidence for its biological effects. A further investigation should be carried out to precisely define the underlying mechanisms of toxicity. [ABSTRACT FROM AUTHOR]

Background: Leprosy is a chronic, infectious disease caused by Mycobacterium leprae. It mainly affects the skin, the peripheral nerves, mucosa of the upper respiratory tract, and the eyes. Nerve damage may result in lack of ability to feel pain, which can lead to loss of parts of a person's extremities from repeated injuries or infection due to unnoticed wounds. Egypt is one of the first countries in the region to achieve the elimination target at the national level as early as 1994, However Leprosy is still endemic in certain foci in Egypt. Thus, our study aims to evaluate the epidemiology of leprosy in Elqalaah leprosy clinic in Cairo over the last decade to support the current national control program of leprosy with updated data. Objective: This study presents an analysis of pattern of new cases of leprosy detected annually from 2009 to 2020 in Elqalaah Dermatology and leprosy clinic in Cairo as the new-case detection rate is better than prevalence as an indicator of disease trends. Methods and Material: Data about patients with newly diagnosed leprosy were collected from Elqalaah dermatology and leprosy clinic registry, the main referral center in Cairo governorate. Case detection rates (CDR) were calculated for each year by dividing the newly diagnosed cases by mid-year populations for the same year. Results: 504 patients were newly diagnosed between 2009 and 2020. The mean age of patients at diagnosis was 38.16 years, 64.5% were males, and 5.4% were children below 14 years of age. The new case detection rate ranged from 0.66/100,000 population in 2009 to 0.12 /100,000 population in 2020. 82.5% were classified as multibacillary. 75.6% were detected by notification method, and 82.5% of patients completed their treatment course. Macules was the most common clinical finding and was found in 67.7% of patients. 18.5% of cases had previous history of contact with other leprosy patient. 13.1% and 2.4% suffered type one and type two leprae reactions respectively. 11.9% of cases had grade two hand disabilities, 6.7% had grade two feet disabilities and 1.8% had grade two eye disabilities. Conclusions: The new case detection rate is acceptable compared to the global level and there was a decline in the number of cases throughout the years of the study, however community- based research should be encouraged and leprosy trends over years from different regions need to be reported to know the actual status of leprosy in different regions of country and continued surveillance of patients and their contacts is required to detect relapses and undiagnosed cases. [ABSTRACT FROM AUTHOR]

COVID-19 is typically associated with fever and severe respiratory symptoms including dry cough and dyspnea. However, COVID-19 may also affect both central and peripheral nervous systems. To date, the incidence rate of spinal cord involvement in COVID-19 is not known and the pathogenesis is still not fully understood. We report here two female patients admitted to Assiut University Hospitals/Egypt during the period from first of July to August 10, 2020. Both presented with a positive SARS-CoV-2 polymerase chain reaction (PCR) nasopharyngeal swab, elevated serum d-dimer and ferritin levels, and bilateral ground glass appearance in a CT chest scan. The first was a 60-year-old female with acute onset of flaccid paraplegia 10 days after flu-like symptoms, in whom MRI revealed transverse myelitis. The second was a 21-year-old female with symptoms of acute quadriplegia, fever, headache, and anosmia in whom an MRI scan revealed long cervico-thoracic myelopathy. Anterior spinal artery occlusion and possibly transverse myelitis were considered as differential diagnosis of long segment myelopathy. [ABSTRACT FROM AUTHOR]

Abstract: Background and study aims: Neurological complications in HCV-infected patients occur predominantly in the peripheral nervous system. Vasculitic neuropathy is the most firmly linked neurologic illness associated with HCV infection. This type of neuropathy occurs frequently in the presence of cryoglobulinemia. HCV-related cranial neuropathies have been also reported. This study was conducted to investigate the various peripheral neurological complications of chronic hepatitis C infection and their possible pathogenetic mechanisms. Patients and methods: This study was conducted on 160 patients with chronic hepatitis C infection comprised two subgroups: group I, composed of 80 chronic hepatitis C patients with clinically apparent neurological complication(s), and group II, composed of 80 chronic hepatitis C patients neurologically asymptomatic. Patients were subjected to clinical evaluation, estimation of hepatitis markers, cryoglobulins, anticardiolipin antibodies, antinuclear antibodies and nerve conduction studies. Results: Peripheral neuropathies represented the most commonly encountered neurological disorders, occurring in 25 patients (31.25%). The sensory peripheral neuropathy was the most common type, representing 32% of neuropathic patients (8/25). A statistically significant difference was found between groups I and II regarding the presence of cryoglobulin and anticardiolipin antibody, being more common in group I. Antinuclear antibody was more common in group I than in group II. Results of nerve conduction studies showed nerves were more affected in group I and in cryoglobulin and ANA positive patients. Conclusion: Peripheral neuropathies represent the most common HCV-related peripheral neurological disorders especially when associated with cryoglobulins and ANA antibodies. [Copyright &y& Elsevier]

Background: COVID-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 inpatients with COVID-19 in Assiut and Aswan university hospitals., Materials and Methods: We 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 tests, CT/MRI of the chest and brain, and neurophysiology study were performed for each patient if indicated., Results: 439 patients had confirmed/probable COVID-19; neurological manifestations occurred in 222. Of these, 117 had acute neurological disease and the remainder had nonspecific neuropsychiatric symptoms such as headache, vertigo, and depression. The CNS was affected in 75 patients: 55 had stroke and the others had convulsions (5), encephalitis (6), hypoxic encephalopathy (4), cord myelopathy (2), relapse of multiple sclerosis (2), and meningoencephalitis (1). The PNS was affected in 42 patients: the majority had anosmia and ageusia (31) and the others had Guillain-Barré syndrome (4), peripheral neuropathy (3), myasthenia gravis (MG, 2), or myositis (2). Fever, respiratory symptoms, and headache were the most common general symptoms. Hypertension, diabetes mellitus, and ischemic heart disease were the most common comorbidities in patients with CNS affection., Conclusion: In 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 of encephalitis, 2 cases of spinal cord myelopathy, 2 cases of MG, and 2 cases of myositis., (© 2021 S. Karger AG, Basel.)