Prediction of motor recovery after ischemic stroke: Clinical and diffusion tensor imaging study.

BACKGROUND: The severity of stroke-induced disruption to the corticospinal tract (CST) would be predictable to affect motor outcome. Diffusion tensor imaging (DTI) is a noninvasive technique that can be applied to assess the structural integrity of the CST. AIM OF THE WORK: To assess the value of DTI in patients early presenting with acute ischemic stroke as a prognostic modality to predict the clinical outcome PATIENTS AND METHODS: Thirty-four patients with acute ischemic stroke underwent clinical assessment using the National Institutes of Health Stroke Scale (NIHSS), Modified Rankin Scale (mRS), Medical Research Council (MRC) score, Morticity Index (MI), and DTI to detect the degree of reduction of fractional anisotropy (FA), and pattern of CST at baseline and after 6 months follow up. Seventeen age, sex matched controls underwent DTI assessment. RESULTS: The stroke patients showed a significant reduction in the baseline FA values of the CSTs on the affected sides compared to the contralateral sides and controls. Moreover, they showed lower mean baseline FA lesion side and FA ratio(rFA) compared to follow up. The patients with high baseline FA, rFA showed good recovery response with cut off values of 0.483, 0.948 respectively. There was a significant negative correlation between baseline FA on the lesion side, rFA and follow up NIHSS, and MRS scores and they had a significant positive correlation with follow up MI scores. CONCLUSION: Patients with higher baseline FA, rFA values were correlated with better motor recovery, and could predict the motor recovery in ischemic stroke patients.

Correction to: Rapid guide to the management of cardiac patients during the COVID-19 pandemic in Egypt: "a position statement of the Egyptian Society of Cardiology".

An amendment to this paper has been published and can be accessed via the original article.

Rapid guide to the management of cardiac patients during the COVID-19 pandemic in Egypt: "a position statement of the Egyptian Society of Cardiology".

COVID-19 pandemic poses an enormous challenge to healthcare system in Egypt. This document is a position statement from the Egyptian Society of Cardiology. It aims to provide information to cardiovascular healthcare providers in Egypt to guarantee delivery of quality patient care and ensure adequate levels of protection against infection during the COVID-19 pandemic. Older patients and those with cardiovascular disease are at higher risk of mortality. The current situation requires unusual allocation of resources which may negatively impact the care of patients with cardiovascular disease. Cardiologists should be prepared in the COVID-19 pandemic. The challenge is in providing the best quality of care despite limited resources while keeping all medical staff as safe as possible. Consider deferring elective procedures whenever possible. All medical staff should undergo rigorous training on infection control and the use of high-quality personal protection equipment. Cardiologists should promote telemedicine in the outpatient setting, prioritize outpatient contacts, and avoid nosocomial dissemination of the virus to patients and healthcare providers. A much conservative approach for emergent cardiac patients is recommended, and invasive interventions are reserved for high risk hemodynamically unstable patients. During the pandemic, the most important principles of treatment should be controlling the spread of infection as the first priority, prompt assessment of patient risk, recommending conservative medical therapy rather than invasive interventions, and strict infection control measures to limit infection spread within the hospital and to healthcare workers.

Nutritional knowledge following interventional educational sessions in children on regular hemodialysis.

To evaluate the impact of nutritional knowledge following interventional educational sessions in chronic dialysis patients, we studied 40 children on chronic regular hemodialysis (HD) at the beginning and after six months of nutrition educational sessions using a predesigned questionnaire. We also measured the anthropometric parameters of nutrition to evaluate the impact of this education on the health of patients. We found a highly statistically significant increase in patients' scores and in adequate knowledge using the questionnaire after the educational sessions. Our results showed a statistically significant decrease in body mass index and weight after educational sessions for six months. Moreover, there were no significant decreases in serum phosphorus, ferritin, iron and creatinine, in contrast with no significant increase in hemoglobin, serum calcium, blood urea nitrogen and serum albumin. We conclude that nutritional education is significantly effective with regard to the level of knowledge, but not with regard to the attitude and practice in children on chronic HD.