Screening for cognitive dysfunction in patients with hypothyroidism

Thyroid disorders had been incriminated a lot in reversible dementia at the end of the last century. Yet, the relation between myxedema per se and cognitive dysfunction has been of great concern nowadays. is to screen the incidence and delineate the characteristics of cognitive dysfunction that may occur in association to hypothyroidism; also to decide the best test to achieve rapid diagnosis in such a problem our study included 50 subjects; 30 patients [20 patients with overt hypothyroidism and 10 with subclinical hypothyroidism] and 20 healthy subjects serving as control group. All were submitted to general medical and neurological examination, laboratory investigations to complete the diagnosis of hypothyroidism, MRI brain, P300 latency assessment and neuropsychological assessment [WAIS-R,WMS-R and tests for frontal executive functions]. A definite cognitive impairment in both hypothyroid patient's group was noted in comparison to controls, as proved by statistically significant prolonged absolute P300 latency and positive neuropsychological tests among them. WAIS subtests especially: [Picture arrangement test, Block design test and Digit backward test] can be used as a premonitory test to detect cognitive dysfunction with hypothyroidism

Risk Factors in Cerebral Stroke [A case Control Study in Kasr-El Aini Hospital]

Stroke is the third leading cause of death in the world, it is the first leading cause of adult disability. Many clinical and laboratory risk factors are accused to be predisposing for the occurrence of stroke such as hypertension, diabetes cardiac diseases and hypercholestrolemia. The current study is a case control study, conducted on 450 subjects attending Kasr El Aini hospitals [150 stroke patients and 300 control subjects]. The objective of this study is to detect these risk factors, and assess their relation to the disabling effects of stroke to be used in the future as alarming signals for early diagnosis. Tools of the study included physical examination, dietary pattern, lab investigations, duplex, ECG and Echo cardiography. Patients group was subjected to additional investigations such as Neurological assessment scales including: Mini Mental State Examination [MMSE], Motoricity Index, Barthel Index and Modified Rankin out come scale. CT scan was also performed. Results showed a statistical significant difference between patient and control groups regarding most clinical and laboratory risk markers. Hypertension, smoking and transient ischemic attacks [TIAs]were considered among the most predominant risk markers among the patient group with a poor outcome on cognitive, motor deficits, and disability. Hypercholestrolemia recorded the worst outcome as regards Modified Rankin disability scale. Moreover, prompt control of these risk factors are associated with lowering these disabilities. Dietary habits played a major role in stoke. The most frequent food categories consumed by the patient group were fats, proteins, and caffeine; yet vegetables, and carbohydrates were the most frequently consumed by control subjects. It is recommended that knowledge about risk factors together with their effects on the outcome of the stroke attack be used in planning of a national preventive program directed to the risk groups and also be included in the primary care facilities for early detection and proper management of such risk markers