RESUMO
This study was conducted on 374 students who constituted about one fourth of third grade primary school failed students in whole Minoufiya governorate and 100 never failed students from the same classes as a control group. Semi structured psychiatric interview and thorough, neurological examination, beside sociodemographic data sheet and psychometric assessment using children depressive inventory children's phobia scale and Anxiety scale for children, child behavior checklist and IQ assessment. 45.9% of failed students were founded to have psychiatric disorders in comparison to 27% of the control group. 9.1% of the repeaters were founded to be mentally retarded. and 34.3% of them were of border line IQ compared to 2% and 20% of the control group respectively. Epilepsy was present among 2.1% of failed students compared to 1% of the control group. The failed group were founded to be significantly different from control group as regard parental education, family size, make truancy from school. Abnormal behavior problems were more prevalent among failed students than control group. Learning problems as reading, writing and mathematics problems were founded to be more prevalent among failed students. No difference of significant value was detected between failed males and females students regarding the studied items, except for conduct disorder and [Aggressive, Delinquent, Hyperactive disorders "ADHD"]
RESUMO
This study was undertaken to determine the incidence and time course of cerebral micro emboli [high-intensity transient signals HITS] detected by transcranial doppler [TCD] in patients with acute hemispheric ischaemic stroke and to assess the value of TCD in throwing light on the pathophysiological mechanisms of acute ischaemic stroke. We recruited 85 patients with clinical and radiological evidence of acute hemispheric ischaemic stroke within 72 hours of stroke onset. The patients were evaluated neurologically according to the National Institute of health stroke scale score [NIHSS]. Risk factors for stroke were searched for. All patients underwent 2-dimensional echocardiograms. carotid duplex and transcranial doppler. Eleven patients were excluded because of failure of ultrasound insonation. Monitoring of symptomatic hemispheres was 30 minutes for each patient per session. Patients were then classified according to their perfusion patterns, CT appearance and risk factors of stroke. The embolic signals were detected in 12.1% and were mainly presented in carotid stenosis patients [95%]. Few emboli in patients with myocardial ischaemia [5%]. There were no identifiable emboli signals in all atrial fibrillation patients. Embolic signals were more frequent shortly after symptom onset and their rate decreased with time. They were mainly in the symptomatic hemisphere and randomly distributed over the cardiac cycle. Although embolic signals appeared more common in territorial infarctions than lacunar infarcts and normal CT, there was no significant difference. The significant differences in the mean velocity [MV], pulsatility index [PI] and resistance index [RI] between the different groups of patients emphasised the importance of these indices. Cerebral embolism was the likely mechanism of stroke in myocardial infarction patients while haemodynamic insufficiency may be relevant in atrial fibrillation. TCD studies was helpful for understanding the pathophysiological mechanism of stroke subtypes, but it cannot explain the clinical state of the patients particularly in acute stage with a single study. CT as well as clinical scoring of the patients should be associated with TCD at this stage