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In multiple sclerosis (MS), the immune system attacks and destroys the fatty myelin coating that surrounds and insulates nerve cells in a process known as demyelination. MS is a lifelong condition, and common symptoms include fatigue, muscle spasms, walking difficulties, or numbness and tingling of the face, body, arms and legs. These symptoms can worsen with time, affecting daily activities and reducing a person’s quality of life. The disease is highly variable, and some people are affected more than others upon and after diagnosis. Treatments are available to help manage a number of symptoms. Life expectancy for people with MS has increased considerably in the last 20 to 25 years. On average, however, a person with MS can expect to live seven fewer years than someone without this disease. According to the National MS Society, on average, an MS patient lives about seven fewer years than someone in the general public, largely because of disease complications or other medical conditions, like cardiovascular disease. Only rarely does the disease progress so quickly that it is deadly. Due to advances in treatments, care, and lifestyle adjustments, MS often progresses slowly. Many studies show that, nowadays, about two-thirds of all patients retain a fair degree of mobility—the ability to walk, although likely with an assisted device—some 20 years after being diagnosed. Assisted devices can range from supports to aid in walking, to scooters used on occasion to save energy and avoid fatigue. The course of the disease depends on each patient’s risk factors, like having a family member with MS, cigarette smoking, and vitamin D sunlight exposure. And, among African-Americans, the disease tends to be a more progressive form and progression can be quicker. MS prognosis is thought to be better for people with relapsing-remitting MS than for those with progressive forms of MS, likely because of a better response to disease-modifying therapies.

Background Acute stroke management is well-established in developed countries with no gender difference. Yet, in developing countries there are reports on gender disparity in medical services including stroke services. Egypt, a developing low–middle-income country, heavily populated, in the Middle East is a good example to answer whether acute ischemic stroke service is provided equally to males and females or there is disparity in risk factors, onset to door (OTD), door to needle (DTN), and outcome. The current study was prospective observational analytical hospital-based study, on acute ischemic stroke cases admitted to Nasr city insurance hospital stroke unit between September 2020 and September 2022. Results 350 cases were included, 257 males and 93 females. Hypertension was the commonest risk factor 66% males and 81% females P = 0.011, atrial fibrillation was predominant in females P < 0.001, smoking was predominant in males P < 0.001. Median OTD in hours was 8.0 among both genders with minimum zero and maximum 96 h in males compared to minimum 1 and maximum 120 h in females, DTN was around 30 min with no significant difference. Median NIHSS on which rtPA was administered was 12.5 (6–13) in females compared to 10 (6–12) in males. Males who did not receive rtPA had a better mRS on discharge and on 90 days P = 0.01, 0.009, respectively, while there was no significant difference on discharge and 90 days between both genders on receiving rtPA. Conclusions No gender disparity was found in DTN, discharge outcome, and 90 days among rtPA recipients. Females tended to have higher NIHSS and relatively delayed presentation to ER with less favorable outcome at discharge and 90 days in case of not receiving rtPA. Encouraging earlier arrival and conducting awareness campaigns for risk factors management is warranted.