Frequency, characteristics, and predictors of headache attributed to acute ischemic stroke.

OBJECTIVES: Although headache is a common symptom in acute ischemic stroke, the clinical and radiological factors associated with its occurrence are controversial. This work aimed to determine the frequency, characteristics, and predictors of headache occurrence among patients with acute ischemic stroke. METHODS: This cross-sectional study was conducted on 303 patients with acute ischemic stroke. The patients were submitted to detailed history taking, clinical and radiological assessment. A detailed analysis of headache was performed for the patients who experienced headache temporally related to stroke onset. RESULTS: Diagnosis of headache attributed to the ischemic stroke was established in 129 (42.6%) patients; sentinel headache in 17.2% of patients, and headache at stroke onset in 25.4% of patients. The headache group had a significantly younger age (P=0.017), lower NIHSS score (P=0.042), higher frequency of pre-existing headache disorders (P=0.001), substance use disorder (P=0.021), and fever (P=0.036), and lower frequency of chronic hypertension (P=0.013) and small vessel disease (P=0.004) than non-headache group. Infarction involving posterior circulation was more frequent in headache than in non-headache groups (P=0.003). The presence of migraine, tension-type headache, other types of headache, fever and posterior circulation stroke increased the odds of headache by 27.4 (95%CI=8.0-94.4), 7.6 (95%CI=3.93-14.6), 26.2 (95%CI=8.0-85.8), 3.75 (95%CI=1.22-11.6) and 3.15 (95%CI=1.65-6.0) times, respectively, whereas, the presence of small vessel disease decreased the odds of headache by 0.51 (95%CI=0.279-0.95) times. CONCLUSION: Pre-existing headache disorder, fever, and posterior circulation stroke were associated with headache occurrence in acute ischemic stroke patients.

Synergism of deltamethrin with a mixture of short chain fatty acids for toxicity against pyrethroid-resistant and susceptible strains of Tribolium castaneum (Coleoptera: Tenebrionidae).

Deltamethrin is one of the most effective pyrethroid compounds used in stored product protection to control a wide range of pests. However, the development of resistance to deltamethrin in many pest species has been reported and useful research to overcome this problem is required. The present study investigated the possible synergistic effect of a commercial formulation of a mixture of the short chain fatty acids, octanoic, nonanoic and decanoic acid, in a formulation called "C8910" on the lethal activity of deltamethrin against susceptible (Lab-S) and relatively pyrethroid-resistant (Pyr-R) strains of T. castaneum. The possible mechanisms of synergism were studied by investigating the inhibitory effect of C8910 on the activity of detoxification enzymes including cytochrome P450s, esterases, and glutathione S-transferases (GST). In addition, the possible role of C8910 in enhancement of cuticular penetration of deltamethrin through insect cuticle was studied using GC analysis. The results showed that C8910 enhanced the toxicity of deltamethrin at mixing ratios of 1:5 and 1:10 against the Lab-S strain after 24 and 48 h of exposure, and synergistic factors (SF) ranged between 5.69 and 13.59. C8910 also showed greater synergism on the deltamethrin toxicity against the resistant strain than the susceptible one after 24 and 48 h of treatment at 1:5 and 1:10 ratios with SF values ranging from 22.82 and 47.16. C8910 showed strong inhibition of cytochrome P450 of rat microsomal fraction with IC50 value of 6.24 mM. Meanwhile, C8910 inhibited the activity of general esterases in Lab-S and Pyr-R strains with IC50 values of 26.22 and 51.73 mM, respectively. However, weak inhibition of GST activity was observed with inhibition of 52.0 and 22.6% at concentration of 100 mM of C8910 for Lab-S and Pyr-R, respectively. In addition, the results showed no significant difference between the unpenetrated amounts of deltamethrin when insects were treated with deltamethrin alone or with deltamethrin+C8910 (1:20) through the insect cuticle. Results suggested that the synergism between C8910 and deltamethrin could be related to the ability of C8910 to inhibit the detoxification enzymes such as cytochrome P450 and esterases. Therefore, C8910 could be a promising synergist to enhance deltamethrin toxicity and to be a possible natural alternative for conventional synergists such as piperonyl butoxide.

Ethanedinitrile as a Fumigant for Lasioderma serricorne (Coleoptera: Anobiidae), and Rhyzopertha dominica (Coleoptera: Bostrichidae): Toxicity and Mode of Action.

This study evaluated the fumigant ethanedinitrile (EDN) against the cigarette beetle, Lasioderma serricorne, and phosphine-resistant and susceptible lesser grain borer, Rhyzopertha dominica, life stages under laboratory conditions. Eggs of both species were the most susceptible stage to EDN. EDN is, therefore, a promising alternative because eggs are generally tolerant to most common fumigants. Lasioderma serricorne eggs were the most susceptible with an LC50 estimated of 50.4 ppm, followed by adults, pupae and larvae with LC50 values of 160.2, 192.5, and 446.6 ppm, respectively, after 24-h exposure at 25°C. Eggs of phosphine-susceptible (LC50 = 11.2 ppm) and resistant (LC50 = 12.0 ppm) R. dominica strains were more susceptible to EDN than were adults of both strains, with LC50 values of 27.7 and 36.0 ppm, respectively. Lasioderma serricorne mixed life stage cultures were completely controlled at concentrations ≥2,000 ppm at 24 h. Fumigation with 600 ppm was enough to suppress adult emergence in the case of the phosphine-susceptible R. dominica strain (USDA), while an average of only 4.0 adults emerged from the phosphine-resistant R. dominica strain (Belle Glade) compared with 514.3 adults in the control. Lasioderma serricorne was more tolerant to EDN than both R. dominica strains. EDN caused 61.8 and 68.2 % inhibition of R. dominica (USDA) cytochrome c oxidase activity at concentrations of 0.0038 and 0.0076 mM in vitro, respectively, and it did not inhibit its activity in the case of an in vivo assay. These results suggest that cytochrome c oxidase may not be the main target for EDN toxicity.

Schistosomal appendicitis in the Eastern Province of Saudi Arabia: A clinicopathological study.

BACKGROUND: In cases of schistosomiasis, the appendix is commonly infested. It is not known if this is a predisposing factor for appendicitis, or a mere coincidental histological finding. PATIENTS AND METHODS: A total of 56 patients (51 males and 5 females) underwent appendectomy for schistosomal appendicitis over a 10-year period at Dammam Central Hospital. The histological slides of 41 of the patients (73.2%) were retrospectively studied. RESULTS: The highest incidence of schistosomal appendicitis was recorded in the 21-40-year age group. Ova were seen in the submucosal layers of all the excised appendices. The most common tissue responses were submucosal fibrosis (92.7%) and eosinophilia (87.8%), followed by the presence of suppurative inflammation (80.5%). Granulomatous reaction was evident in only 13 cases (31.7%). A striking feature was atrophy of submucosal lymphoid follicles in 70.7% of the cases. Hyperplasia of lymphoid follicles and serosal granulomas were rare (2.4%). Similar tissue responses were histologically seen in four normal appendices examined. CONCLUSION: Appendiceal infestation may predispose to appendicitis in the majority of affected cases, but in others, it may well be a mere coincidental histological finding. However, preoperative knowledge bears no clinical significance and does not alter management.