Screening of SHOX gene sequence variants in Saudi Arabian children with idiopathic short stature / 소아과

PURPOSE: Short stature affects approximately 2%–3% of children, representing one of the most frequent disorders for which clinical attention is sought during childhood. Despite assumed genetic heterogeneity, mutations or deletions in the short stature homeobox-containing gene (SHOX) are frequently detected in subjects with short stature. Idiopathic short stature (ISS) refers to patients with short stature for various unknown reasons. The goal of this study was to screen all the exons of SHOX to identify related mutations. METHODS: We screened all the exons of SHOX for mutations analysis in 105 ISS children patients (57 girls and 48 boys) living in Taif governorate, KSA using a direct DNA sequencing method. Height, arm span, and sitting height were recorded, and subischial leg length was calculated. RESULTS: A total of 30 of 105 ISS patients (28%) contained six polymorphic variants in exons 1, 2, 4, and 6. One mutation was found in the DNA domain binding region of exon 4. Three of these polymorphic variants were novel, while the others were reported previously. There were no significant differences in anthropometric measures in ISS patients with and without identifiable polymorphic variants in SHOX. CONCLUSION: In Saudi Arabia ISS patients, rather than SHOX, it is possible that new genes are involved in longitudinal growth. Additional molecular analysis is required to diagnose and understand the etiology of this disease.

T-lymphocytes subsets variation in breast cancer Egyptian patients

In this work, we investigate T-lymphocytes subsets in breast cancer patients among Egyptian populations to evaluate the immune response towards cancer and understanding their behavior towards tumor and normal cell growth before the influence of chemotheraputic agents under simple immune system response At first stage of disease. T cells are capable of in vivo expansion and provide protection for the immune effector cells re-populating the host. Survival of these cells and long-term memory development in patients with malignancy are necessary for improving clinical benefits of immunotherapy. By measuring CD4 and CD8 we recognized that no change in the helper T cells and Cytotoxic cells in these patients who were prepared to receive chemotherapeutic agents at the first stage and in the control group. T cells have been found with either deficient or normal functional activity in both groups these heterogeneous results greatly confuse the role played by CD4 T cells and CD8 responses. Immunological measures of white blood cell, lymphocyte, CD3+, CD4+, and CD8+ counts, 40 patients were divided into a control group [15] and patients group [25]. Total T-cell, helper T-cell and suppressor T-cell counts which [P<0.05], as well as control T-cell function [P < 0.05] when compared with normative data, were found some significant increase CD4 cells and CD4/CD8 ratio in cell count most of cases no changes to the total leukocyte lymphocyte CD3+and CD8+ count. Our study points out that immune response began to defend against tumor cells after a brief period of tumor stimulation but is still not sufficient to induce strong immune response. These data invite us to focus on period which immune system needs to respond which may help in deciding the possibility of immune therapy and determine when immune therapy can start

Determinants of hand hygiene compliance in Egypt: building blocks for a communication strategy

Hand hygiene of health-care staff is one of the most important interventions in reducing transmission of nosocomial infections. This qualitative study aimed to understand the behavioural determinants of hand hygiene in order to develop sustainable interventions to promote hand hygiene in hospitals. Fourteen focus group discussions were conducted with nurses in 2 university hospitals in Egypt. The interviews were tape recorded and transcribed. Thematic analysis was conducted by 2 independent investigators. The findings highlighted that nurses did not perceive the benefits of hand hygiene, and that they linked the need to wash hands to a sense of dirtiness. Knowledge of hand hygiene and related products was limited and preference for water and soap was obvious. Environmental constraints, lack of role models and social control were identified as barriers for compliance with hand hygiene. A multi-faceted hand hygiene strategy was developed based on existing cultural concepts valued by the hospital staff

Therapeutic effect of dimethyl dimethoxy biphenyl dicarboxylate on collagen-induced arthritis in rats / 中国结合医学杂志

<p><b>OBJECTIVE</b>To study the effect of oral administration of dimethyl dimethoxy biphenyl dicarboxylate (DDB) on adjusting angiogeneic/inflammatory mediators and ameliorating the pathology of bones in rats with collagen-induced arthritis (CIA).</p><p><b>METHODS</b>Wistar rat model of CIA was set up using bovine collagen type II. Fifty rats were divided into five groups randomly: normal, CIA model, DDB treatment, methotrexate (MTX) treatment, and combined DDB+MTX treatment. Ankle joints of rats were imaged with digital X-ray machine to show the destruction of joints. Fore and hind paw and knee joints were removed above the ankle joint then processed for haematoxylin and eosin staining. Plasma levels of vascular endothelial growth factor (VEGF), platelet derived growth factor, interleukin-8 (IL-8), IL-4, tumor necrosis factor α (TNF-α), and cyclooxygenase-2 (COX-2) were quantified by enzyme-linked immunosorbent assay. Nitric oxide levels were detected by Griess reagent.</p><p><b>RESULTS</b>Compared with the CIA model group, a remarkable reduction in various angiogenic (VEGF and IL-8) and inflammatory mediators (TNF-α, IL-4 and COX-2) after treatment with DDB either alone or combined with MTX P<0.05 or P<0.01). Histopathological and X-ray findings were confirmatory to the observed DDB anti-arthritic effect. The DDB-treated group showed amelioration in signs of arthritis which appeared essentially similar to normal.</p><p><b>CONCLUSION</b>Our data shed light on the therapeutic efficacy of DDB in experimental rheumatoid arthritis (RA) compared with a choice drug (MTX) and it may be offered as a second-line drug in the treatment of RA.</p>

Interleukin 10 gene promoter polymorphism and risk of diffuse large B cell lymphoma [DLBCL]

Given the importance of understanding the genetic variations involved in the pathogenesis of non-Hodgkin's lymphoma [NHL], this work was designed to study the impact of IL-10 [-1082 G/A; rs!800896 and -819 C/T; rs!800871] gene promoter polymorphism on susceptibility of Egyptians to diffuse large B cell lymphoma [DLBCL]; the major type of NHL. To the best of our knowledge, this study is the first one that examines IL-10 promoter polymorphism in DLBCL in Egyptians. Genotyping polymorphism is performed using sequence-specific primers polymerase chain reaction [SSP-PCR] in 100 Egyptian DLBCL patients and 119 normal controls. Circulating plasma levels of IL-10 were measured using Enzyme-linked immunosorbent assay [ELISA]. Insignificant change in IL-10 [-1082 and -819] genotypes was recorded. Although A allele is slightly decreased in DLBCL patients, it did not reach statistical significance. GT haplotype was significantly elevated [P < 0.05] in NHL patients. A significant linkage disequilibrium between the -1082 and 819 SNPs with D' = 0.596 and r[2] = 0.1032 [P < 0.001] was demonstrated. Significantly increased plasma IL-10 [P < 0.01] was found which is positively correlated [r = 0.307; P < 0.01] with the disease Taken together, our findings demonstrated that IL-10 promoter gene polymorphism [-1082 and -819] may not have an influence on the clinical outcome of DLBCL, especially in terms of overall secretion level. Further investigations of other cytokine gene polymorphisms will lead to a better understanding of the disease's biological background

Cyclooxygenase-2 expression is associated with elevated AST level in hepatocellular carcinoma

Cyclooxygenase-2, the inducible rate-limiting enzyme of prostaglandins biosynthesis, has been reported to be involved in the pathogenesis of a variety of chronic inflammation-related human malignancies including Hepatocellular Carcinoma [HCC]. However, its clinical significance in HCC remains obscure. Our objectives were to evaluate COX-2 expression in HCC and correlate its expression to the different clinicopathological parameters and to assess its impact on patient survival. The present study was conducted on 17 HCC and 21 adjacent non-tumor liver tissues obtained from 22 HCC patients underwent curative hepatectomy at the National Cancer Institute, Cairo University, Egypt. Eight normal liver tissues taken from normal donors and HepG2 cell line were used as controls. Total RNA from tissues and cells was extracted and COX-2 mRNA was detected by RT- PCR and correlated to the clinicopathological criteria as well as to patient's survival. COX-2 mRNA was detected in 58.8% of the HCC tissues and in 28.6% of the adjacent non-tumor liver tissues. COX-2 expression was significantly associated with elevated levels of serum aspartate aminotransferase [AST] with high specificity for the detection of the disease. However, there was no significant correlation between COX-2 expression and any of the histopathological criteria. COX-2 expression may be involved in HCC carcinogenesis with high specificity for the detection of the disease It was significantly associated with elevated AST levels indicating disease severity. However cox2 expression seems to be an independent factor with no correlation to any of the clinicopathological data or patient's survival

Diagnosis of exudative pleural effusion using ultrasound guided versus medical thoracoscopic pleural biopsy

Introduction: Medical thoracoscopy increases the diagnostic yield in patients with non-diagnosed pleural effusion when thoracocentesis and closed pleural biopsy [CPB] are non-diagnostic. Chest ultrasound [US] is a very useful imaging method for pleural diseases and the technique of ultra sound-guided cutting biopsy with a tru-cut needle has been well described

Aim of the work: The aim of this work was to diagnose exudative pleural effusion using ultrasound guided versus medical thoracoscopic pleural biopsy

Subjects and methods: Forty patients with, non-diagnosed exudative pleural effusion admitted to the chest department, Alexandria university hospital, were enrolled after obtaining informed consents. All patients were subjected to; full history taking, thorough clinical examination, laboratory investigations including prothrombin activity and INR, biochemical, pathological and microbiological evaluation of the pleural aspirate and radiological evaluation. Then the patients were divided [randomly] into 2 groups each containing 20 patients. Pleural biopsies were performed using medical rigid thoracoscopy on group 1 and ultrasound guided tru-cut pleural biopsy on group 2

Results: The mean age in-group I was 55.0 +/- 13.05 years and in-group II was 52.60 +/- 17.77 years. There was no statistically significant difference between the two groups regarding age, sex, smoking, marital status and past medical conditions. There was no statistically significant difference between the two groups regarding radiological findings. There was no statistically significant difference between the two groups regarding the pleural fluid analysis. There was no statistically significant difference between the two groups regarding the gross pleural findings. In group II non- specific pleurisy was found in 5 [25.0%] patients [by thoracoscopy 1 of them was finally diagnosed as metastatic deposits from adenocarcinoma of unknown primary, one was confirmed to be tuberculous pleurisy and the remaining 3 cases were confirmed to be non- specific pleurisy]. As regards complications in-group I, local wound infection occurred in 1 [5.0%] patient, and empyema occurred in 1 [5.0%] patient. In-group II, local wound infection occurred in 1 [5.0%] patient, and empyema occurred in 1 [5.0%] patient

Conclusion: It is better to use thoracoscopy in cases of undiagnosed exudative pleural effusion presented with a sufficient amount of pleural fluid to avoid lung injury while inserting the trocar. Whereas, ultrasound guided tru-cut pleural biopsy may be used in cases of undiagnosed exudative pleural effusion presented with thickened pleura but with an insufficient amount of pleural fluid

diagnostic utility of fibroindex in patients with chronic hepatitis C

Fibroindex was first described by Koda et as a simple, non invasive indirect marker of liver fibrosis, it was derived from the platelet count, AST, and gammaglobulin measurements. The aim'of the present study is to evaluate the fibrogenic marker: Fibroindex as a non invasive marker of liver fibrosis in chronic hepatitis C and to correlate its serum levels with the stage of fibrosis assessed by histopathological staging of liver biopsy and virological characteristics including HCV RNA tilers. This study was carried out on 40 patients with evidence of chronic hepatitis C [positive HCV-Ab and positive HCV-RNA by PCR], they were [35] male and [5] female. All cases were selected from out patient clinic of the hepatology unit of research institute for tropical medicine [2011].the patients were had liver fibrosis from Fl to F4, Patients with no advanced liver fibrosis [Fl-F2] were considered as control. Fibroindex was calculated according to the equation described by related authors. [Fibroindex

Tumor necrosis factor-alpha -308G/A polymorphism and risk of hepatocellular carcinoma in hepatitis C virus-infected patients / 癌症

Tumor necrosis factor-alpha (TNF-α) is an important cytokine in generating an immune response against infection with hepatitis C virus (HCV). The functions of TNF-α may be altered by single-nucleotide polymorphisms (SNPs) in its gene structure. We hypothesized that SNPs in TNF-α may be important in determining the outcome of an HCV infection. To test this hypothesis, we investigated the role of the polymorphism -308G/A, which is located in the promoter region of the TNF-α gene, in the progression of HCV infection in Egyptian patients using a quantitative real-time polymerase chain reaction (qRT-PCR). The distribution of this polymorphism and its impact on the serum level of TNF-α was compared between 90 HCV-infected patients [45 with HCV-induced cirrhosis and 45 with HCV-related hepatocellular carcinoma (HCC)] and 45 healthy Egyptian volunteers without any history of liver disease. Our results showed that at the TNF-α -308 position, the G/G allele was most common (78.5%) in the study population, with the G/A and A/A alleles occurring less frequently (13.3% and 8.1%, respectively). Frequencies of G/G, G/A, and A/A genotypes were 87%, 7%, and 6% in patients with liver cirrhosis and were 94%, 4%, and 2% in patients with HCC, respectively. Serum levels of TNF-α were significantly higher in HCV-infected patients than in healthy controls, indicating that the TNF-α -308 polymorphism does not influence the production of TNF-α. The serum level of TNF-α was positively correlated with HCV infection. Taken together, these findings suggest that the TNF-α -308 polymorphism may not be a host genetic factor associated with the severity of HCV infection, but may be an independent risk factor for HCC.

Case-control study to evaluate risk factors for acute hepatitis B virus infection in Egypt

Hepatitis B virus [HBV] infection is a significant health problem in Egypt. To better define risk factors associated with HBV transmission, we conducted a case-control study among patients admitted with acute hepatitis to an infectious disease hospital in Cairo. A total of 60 cases and 120 controls were interviewed about various exposures within 6 months prior to admission. Univariate analysis revealed HBV case-patients were more likely to report providing injections to relatives or friends, injecting drug use, exposure to a household contact with hepatitis, exposure to invasive medical procedures and being in the military. Efforts should be made to implement strict infection control standards in Egypt

Sentinel surveillance for patients with acute hepatitis in Egypt, 2001-04

Viral hepatitis is a major problem in Egypt. To define the epidemiology of the disease, sentinel surveillance was established in 5 hospitals in diverse areas of the country in 2001. Data were completed for patients meeting the case definition for viral hepatitis. Of a total of 5909 patients evaluated, 4189 [70.9%] showed positive antibody markers for hepatitis. Out of those, 40.2% had evidence of hepatitis A virus [HAV] infection, 30.0% hepatitis B virus [HBV] and 29.8% hepatitis C virus [HCV] infection. This surveillance system was useful in identifying the variable endemicity of acute HAV infection in different regions and for better understanding the epidemiology of HBV and HCV infection

Injection prescribing patterns in public health care facilities in Egypt

This study assessed the frequency of and rationale for use of injections at health care facilities in Egypt based on WHO core drug use indicators. We reviewed 1406 prescriptions in 43 randomly selected hospitals and primary health care clinics in 2 governorates in Upper and Lower Egypt in 2001. Patients received an injection at 18.1% of encounters. The most frequently prescribed parenteral drugs were anti-infectives [56.9% of injections] and analgesics [13.7%]. Injections were more often prescribed in hospitals than in primary health care clinics and in rural than in urban settings. Most injections [94.7%] could have been replaced by a suitable oral preparation. Further efforts are needed to enforce the essential medicines programme in Egypt to improve rational drug prescribing

Genetic analysis of Blastocystis hominis isolated from symptomatic and asymptomatic human hosts in Egypt

Extensive genomic polymorphism was demonstrated among morphologically identical B. hominis isolates. A genetic diversity would be a powerful tool for identification or classification of B. hominis subtypes. In this study, 14 Egyptian B. hominis isolates were collected, 5 of them were isolated from asymptomatic people whose infections were detected during routine medical check-up and 9 were isolated from patients with gastrointestinal symptoms. Restriction fragment length polymorphism [RFLP] analysis of PCR amplified small-subunit rDNA [SSU rDNA] was used to study genetic diversity of B. hominis isolates by 3 different restriction enzymes [Hin-fl, Rsal and Sau3AI]. Cluster analysis of the riboprint patterns showed 7 distinct genotypes out of 14 B. hominis isolates, 4 were previously reported riboprints and 3 were new ones. The frequency of intestinal symptoms was 64% in Blastocystis cases, Abdominal pain was the most frequent symptom 78% [7/9]. There was no definite correlation between RFLP-banding pattern or genetically distinct genotypes and pathogenecity

MURCS association: a case report

MURCS association is a rare developmental disorder that affects females. The acronym MURCS stands for Mullerian, Renal, Cervicothoracic Somite abnormalities. It appears to occur randomly [sporadic] with a frequency of 1 in 50.000 females. In this paper, we present a two-year-old girl with typical features of this syndrome in association with right deviation of anorectal canal, subglottic stenosis and unilateral oblique inguinal hernia

Impact of experimental duel infections with schistosoma mansoni and echinoccocus granulosus on hepatic histopathology

Experimental duel infection with S.mansoni and E. granulosus was induced in mice to determine their effect on serum nitric oxide [NO] level and accordingly on the sequences of histopathological lesions affecting the liver. The results showed that serum NO level was significantly increased [p

Immunohistochemical Detection of HCV in nerves and muscles of patients with HCV associated Peripheral Neuropathy and Myositis

Background: Chronic hepatitis C Virus [HCV] infection may be associated with numerous extrahepatic manifestations, such as mixed cryoglobulinaemia, membranoproliferative glomerulonephritis, sicca syndrome. Cryoglobulinaemia [CG] is a condition characterized by the presence of serum proteins that reversibly precipitate in the cold. The objective of the present work was to study the histopathological changes in neuromuscular biopsies in patients with HCV associated peripheral neuropathy, or myopathy; with and without cryoglobulinemia, and to assess the presence of HCV in nerve and muscle tissues of those patients which might clarify some pathogenetic mechanisms for neuropathy, and myopathy associated with HCV

Methods: The study was conducted on 17 cases of HCV infected patients with peripheral neuropathy and myositis. All patients were subjected to thorough laboratory investigations, neurological examination, electrophysiologic studies including nerve conduction, and needle EMG studies

Results: Histopathological examination of nerve biopsies showed features of vascultis in 2/10 cases, interstitial inflammatory infiltrates in 5/10. Muscle biopsies showed intense inflammatory reaction, degenerative changes in the muscles of 3/10 cases diagnosed as myositis. Immunohistochemical results, showed in nerve biopsies, 7/10 cases with positive reaction for HCV with nuclear and perinuclear staining.. Two patients showed positive reaction in the epineural, and endoneural blood vessels and a negative reaction in nerve bundles, while in five patients, reaction was only positive in the nerve bundles. In muscle biopsies, 7/10 cases showed positive reaction for HCV in the nuclei of the muscle fibers, including the cases presented with myositis

Conclusion: The presence of HCV particles in nerve and muscle biopsies of patients with peripheral neuropathy suggests a virus triggered immune mediated mechanism

Serum interleukin levels in asthmatic patients with eosinophilia

The incidence, morbidity and mortality of bronchial asthma have increased over the last two decades. Immune and inflammatory responses mediated by cytokines are essential in the pathophysiology of bronchial asthma. Substantial evidence has implicated Th2 cytokines, IL-4 and IL-5, in the pathology of allergic asthma and demonstrated protective effects of Th1 cells. This work was conducted to study the serum levels of IL-4, IL-5, IL-12 and IL-18, in patients with allergic asthma associated with eosinophilia. Interleukins levels were correlated with IgE level and the degree of eosinophilia in these patients. The study included 25 asthmatic patients with acute attack of bronchial asthma, associated with history of allergy and eosinophilia; and 25 normal healthy controls. All patients and controls were subjected to full medical history, clinical examination, and laboratory investigations for assessment of the eosinophil count and measurement of serum levels of IgE and interleukins [IL-4, IL-5, IL-12 and IL-18]. The correlation between interleukin [IL] levels, and degree of eosinophilia and IgE levels were also examined in these patients. Measurement of serum levels of interleukins showed significant elevation of IL-4, IL-5 and IL-18 levels in asthmatic patients as compared with the control group [p<0.0001], whereas IL-12 levels did not show any significant change [p>0.05]. Marked elevation in the IgE level and eosinophil count were also detected in asthmatic patients as compared with the control group [p<0.0001]. Significant positive correlations were observed between serum levels of IL-4, IL-5 and IL-18 and the degree of eosinophilia in asthmatic patients. A significant positive correlation was also detected between level of IL-18 and the IgE level in asthmatic patients. Patients with allergic bronchial asthma have elevated levels of IL-4, IL-5 as well as IL-18; and these levels correlated significantly with degree of eosinophilia in these patients. Further studies are needed to clarify the signaling cascade involved in allergic responses mediated by these ILs. This may help in developing new therapeutic modalities, as blockade of IL receptors, for these conditions

Immunohistochemical detection of HCV in nerves and muscles of patients with HCV associated peripheral neuropathy and myositis

Chronic hepatitis C Virus [HCV] infection may be associated with numerous extrahepatic manifestations, such as mixed cryoglobulinaemia, membranoproliferative glomerulonephritis, sicca syndrome, Cryoglobulinaemia [CG] is a condition characterized by the presence of serum proteins that reversibiy precipitate in the cold. The objective of the present work was to study the histopathological changes in neuromuscular biopsies in patients with HCV associated peripheral neuropathy, or myopathy; with and without cryoglobulinemia, and to assess the presence of HCV in nerve and muscle tissues of those patients which might clarify some pathogenetic mechanisms for neuropathy, and myopathy associated with HCV. The study was conducted on 17 cases of HCV infected patients with peripheral neuropathy and myositis. All patients were subjected to thorough laboratory investigations, neurological examination, electrophysiologic studies including nerve conduction, and needle EMG studies. Histopathological examination of nerve biopsies showed features of vascultis in 2/10 cases, interstitial inflammatory infiltrates in 5/10. Muscle biopsies showed intense inflammatory reaction, degenerative changes in the muscles of 3/10 cases diagnosed as myositis. Immunohistochemical results, showed in nerve biopsies, 7/10 cases with positive reaction for HCV with nuclear and perinuclear staining. Two patients showed positive reaction in the epineural, and endoneural blood vessels and a negative reaction in nerve bundles, while in five patients, reaction was only positive in the nerve bundles. In muscle biopsies, 7/10 cases showed positive reaction for HCV in the nuclei of the muscle fibers, including the cases presented with myositis. The presence of HCV particles in nerve and muscle biopsies of patients with peripheral neuropathy suggests a virus triggered immune mediated mechanism

Assessment of heme oxygenase-1 (HO-1) activity in the cavernous tissues of sildenafil citrate-treated rats / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To assess heme oxygenase-1 (HO-1) activity in the cavernous tissue of sildenafil citrate-treated rats.</p><p><b>METHODS</b>One hundred and ninety-two Sprague-Dawley male rats, divided into four equal groups, were investigated. Group 1, the control group, received regular animal chow; group 2 received sildenafil citrate by intragastric tube; group 3 received sildenafil and HO inhibitor (zinc protoporphyrin, ZnPP); and group 4 received sildenafil and nitric oxide synthase (NOS) inhibitor L-nitroarginine methyl ester (L-NAME). Twelve rats from each group were killed after 0.5 h, 1 h, 2 h and 3 h of drug administration. Then HO-1 activity, cGMP levels and NOS enzymatic activity in the cavernous tissues were estimated.</p><p><b>RESULTS</b>In cavernous tissue, HO-1 activity, NOS enzymatic activity and cGMP concentration increased significantly in sildenafil-treated rats compared to other groups throughout the experiment. Rats receiving either HO or NOS inhibitors showed a significant decrease in these parameters. HO-1 cavernous tissue activity and NOS enzymatic activity demonstrated a positive significant correlation with cGMP levels (r = 0.646, r = 0.612 respectively; P < 0.001).</p><p><b>CONCLUSION</b>The actions of PDE5 inhibitor sildenafil citrate in the cavernous tissue are partly mediated through the interdependent relationship between both HO-1 and NOS activities.</p>

Study of the correlation between risk factors and clinical manifestations in different ischemic stroke subtypes

The aim of the present work was to identify risk factors in different ischemic stroke subtypes, namely; cortical, large subcortical and lacunar infarctions and to correlate between clinical presentation and radiological findings in each of the previous stroke subtypes. Eighty one patients were included in this study. According to computed tomography and/or magnetic resonance imaging results, the patients were subdivided into cortical, large subcortical and lacunar infarct groups. Risk factors were studied according to Stroke Risk Assessment Form. The clinical picture was studied according to Mini-Mental Scale and Canadian Neurological Scale. In cortical infarctions, atrial fibrillation and high mean platelet count were more common. In large subcortical infarctions, oral contraceptives were more commonly used. Pure lacunar infarctions were more related to positive history of hypertension, and high mean systolic blood pressure. As regards Mini-Mental Scale; orientation, registration and total score were lower among cortical infarctions. There were no statistically significant difference between the three groups as regards the Canadian Neurological Scale; mentation score, total motor score with or without comprehension deficit. There are differences between different stroke subtypes as regards clinical picture and risk factors