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Abstract Background There is a growing body of evidence that severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) or COVID-19 infection is associated with the development of autoimmune diseases. A recent systematic review reported that the new-onset autoimmune disorders during or after COVID-19 infection included inflammatory myopathies such as immune-mediated necrotizing myopathies. Case presentation We described a 60-year-old man diagnosed with COVID-19 infection and later presented with a two-week history of myalgia, progressive limb weakness, and dysphagia. He had a Creatinine Kinase (CK) level of more than 10,000 U/L, was strongly positive for anti-signal recognition particle (SRP) and anti-Ro52 antibody, and a muscle biopsy revealed a paucity-inflammation necrotizing myopathy with randomly distributed necrotic fibers, which was consistent with necrotizing autoimmune myositis (NAM). He responded well clinically and biochemically to intravenous immunoglobulin, steroids and immunosuppressant and he was able to resume to his baseline. Conclusion SARS-CoV-2 may be associated with late-onset necrotizing myositis, mimicking autoimmune inflammatory myositis.

Intravenous (IV) thrombolysis is a safe and effective treatment for acute ischemic stroke. The therapeutic benefit is not extended to more than 4.5 hours in many patients due to the protocol’s time window restriction. Here, we reported two acute stroke cases with a moderate National Institutes of Health Stroke Scale (NIHSS) and onset greater than 4.5 hours that were successfully thrombolysed with intravenous recombinant tissue plasminogen activator (tPA) - low-dose Tenecteplase (TNK). The decision to thrombolysed both patients were based on Magnetic Resonance Imaging (MRI) Diffusion-weighted imaging (DWI)-Fluid Attenuation Inversion Recovery (FLAIR) mismatch – tissue basis rather than a time window, and this resulted in a good neurological recovery with a significant improvement in functional Modified Rankin Score (MRS) to zero at 90 days post stroke regardless of the stroke aetiology. In summary, Intravenous thrombolysis in acute ischemic stroke outside the therapeutic window but with significant penumbra based on MRI DWI-FLAIR tissue mismatch resulted in a remarkable neurological recovery after 90 days.

Peripheral neuropathy is a common cause for neurological consultation, especially among those with diabetes mellitus. However, research on peripheral neuropathy among the general population is lacking in Malaysia. This study aimed to determine the prevalence and factors associated with peripheral neuropathy in a setting of retail pharmacies. This cross-sectional study of 1283 participants was conducted at retail pharmacies in Selangor. Peripheral neuropathy was defined as the final score in the mild to severe category in the severity rating scale using a biothesiometer. SPSS version 26 was used to perform the analysis. Multiple logistic regressions were used to determine the factors associated with peripheral neuropathy. The prevalence of peripheral neuropathy based on the biothesiometer was 26.5%. According to multiple logistic regression, the predictors of peripheral neuropathy were those who have diabetes (AOR = 3.901), aged more than 50 years (AOR = 3.376), have secondary education or below (AOR = 2.330), are male (AOR = 1.816), and have underlying hypertension (AOR = 1.662). Peripheral neuropathy is a reasonably prevalent condition, affecting a quarter of the general population, and often goes undiagnosed. It is crucial for healthcare providers to proactively screen for peripheral neuropathy, particularly in high-risk populations, to prevent potential complications. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this systematic review and meta-analysis was to evaluate the prevalence of thirteen neurological manifestations in people affected by COVID-19 during the acute phase and at 3, 6, 9 and 12-month follow-up time points. Methods: The study protocol was registered with PROSPERO (CRD42022325505). MEDLINE (PubMed), Embase, and the Cochrane Library were used as information sources. Eligible studies included original articles of cohort studies, case-control studies, cross-sectional studies, and case series with ≥5 subjects that reported the prevalence and type of neurological manifestations, with a minimum follow-up of 3 months after the acute phase of COVID-19 disease. Two independent reviewers screened studies from January 1, 2020, to June 16, 2022. The following manifestations were assessed: neuromuscular disorders, encephalopathy/altered mental status/delirium, movement disorders, dysautonomia, cerebrovascular disorders, cognitive impairment/dementia, sleep disorders, seizures, syncope/transient loss of consciousness, fatigue, gait disturbances, anosmia/hyposmia, and headache. The pooled prevalence and their 95% confidence intervals were calculated at the six pre-specified times. Results: 126 of 6,565 screened studies fulfilled the eligibility criteria, accounting for 1,542,300 subjects with COVID-19 disease. Of these, four studies only reported data on neurological conditions other than the 13 selected. The neurological disorders with the highest pooled prevalence estimates (per 100 subjects) during the acute phase of COVID-19 were anosmia/hyposmia, fatigue, headache, encephalopathy, cognitive impairment, and cerebrovascular disease. At 3-month follow-up, the pooled prevalence of fatigue, cognitive impairment, and sleep disorders was still 20% and higher. At six- and 9-month follow-up, there was a tendency for fatigue, cognitive impairment, sleep disorders, anosmia/hyposmia, and headache to further increase in prevalence. At 12-month follow-up, prevalence estimates decreased but remained high for some disorders, such as fatigue and anosmia/hyposmia. Other neurological disorders had a more fluctuating occurrence. Discussion: Neurological manifestations were prevalent during the acute phase of COVID-19 and over the 1-year follow-up period, with the highest overall prevalence estimates for fatigue, cognitive impairment, sleep disorders, anosmia/hyposmia, and headache. There was a downward trend over time, suggesting that neurological manifestations in the early post-COVID-19 phase may be long-lasting but not permanent. However, especially for the 12-month follow-up time point, more robust data are needed to confirm this trend. [ABSTRACT FROM AUTHOR]

Many are still unaware of the fact that Alzheimer’s disease (AD) also affects the caregivers quite significantly. Caregivers refer to people who are accountable of taking care of AD patients which provide helps with his or her daily living activities and may become a full-time commitment for the caregiver. This gives rise to a concept called caregiver burden. As these caregivers spend most of their time taking care of AD patients, most of them suffer psychologically as well as physically. Unfortunately, the risk of mental and physical impairment among the caregivers of Alzheimer’s patient may cause poor quality of life to both the patients and their caregivers. In addition, due to their role and responsibilities as a caretaker, they often do not have the opportunity to seek help and advices. This review article was conducted by sieving through numerous literature and studies regarding the challenges and how to help the burden of the caregivers of Alzheimer’s patients . This paper aims to give and overview, suggestions as well as to increase the awareness of the caregiver’s burden.

Delirium is commonly encountered in the elderly. It is important to recognize and subsequently treat delirium early to prevent morbidity and mortality. The primary objective of this article review is to gather specific information about each clinical manifestation of delirium in elderly. Sieving through numerous literature and studies regarding the topic of Delirium in the elderly. Majority of the article source were from Medline and PubMed as subscribed by the institution where there are more than 27 million citations in the field of biomedical articles. The articles include articles that was published in Malaysia and also international article due to the limitation in Malaysia itself. The articles were retrieved from publications in the year 1992 up to the current year 2017. Clinical manifestation of delirium that had been reviewed include disordered thinking, euphoric, language impairment, illusion, reversal of sleep wake cycle, inattention, disoriented and memory deficit. Most of the information is about prevalence, clinical diagnosis, and pathophysiology of each of the clinical manifestation. Delirium in elderly is very complex and complicated which involve physical, emotion feelings not only for the patient but also for people in their surroundings. Many articles reviewed explain about each of the symptoms in further details in term on how they act and how they interact with people surrounding.

Age-related macular degeneration (AMD) is the most widely recognised cause of irreversible vision loss and previous studies have suggested that the advancement of wet AMD is influenced by both modifiable and non-modifiable elements. Single nucleotide polymorphism (SNPs) and copy number of variations (CNVs) have been associated with AMD in various populations, however the results are conflicting. Our aim is to determine the CNVs of Complement Factor H-Related genes among Malaysian subjects with wet AMD. 130 patients with wet AMD and 120 healthy controls were included in this research. DNA was extracted from all subjects and CNVs of CFH, CFHR1 and CFHR3 genes; determined using quantitative real-time PCR and were compared between the two groups. A consistent association was observed between CFH gene and wet AMD susceptibility (P