Introduction Migraine is a common disabling primary headache disorder with significant personal and socio-economic impacts. Medical students usually have multiple triggers for migraine, particularly stress and irregular sleep. Objective To assess the prevalence, characteristics, and degree of disability of migraine in a sample of Egyptian medical students and to study their health care-seeking practice when having migraine Patients and methods A descriptive cross-sectional, questionnaire-based study included 631 undergraduate medical students enrolled in the Faculty of Medicine. Participants’ sociodemographic data, migraine prevalence, characteristic, migraine disability, and health care-seeking practice were evaluated. By using the MIDAS test in the questionnaire, we assessed the impact of migraine headache on the daily activities of the students. The severity of headache was assessed using the visual analog scale (VAS) scores. Results Prevalence of migraine in medical students was found to be 17.9% causing moderate disability. Migraine was significantly more prevalent and caused more disability among female students compared to males (p value 0.001 and 0.001). Only 35.4% of the migraineurs had already seen doctors for their migraine, and self-prescription of medications for migraine was practiced by 58.4%. Statistically significant positive correlation was found between migraine frequency, migraine severity, and low academic performance (p value 0.001 and 0.003 respectively). Conclusion Migraine is highly prevalent among medical students with predominant female prevalence and has a negative impact on their academic performance and other activities.

Background Cognitive decline is a common presentation of Parkinson’s disease (PD) and a continued search exists for a reliable biomarker for early identification and management of this clinical problem. The objective of this study is to select the most useful biomarker in assessment of PD-related cognitive decline. This cross-sectional study included 47 patients with PD and 47 matched healthy controls. All participants were assessed by quantitative electroencephalography (QEEG) spectral (relative power and background peak frequency) and connectivity measures (coherence and phase lag degree), in addition to clinical evaluation using Unified Parkinson’s Disease Rating Scale (UPDRS)and Modified Hoehn and Yahr staging scale and neuropsychological assessment of the patients using Montreal Cognitive Assessment (MoCA). Results PD patients showed significantly higher relative power in all frequency bands over the right temporal region with no significant changes in peak frequency, coherence and phase lag degree compared to healthy controls. PD patients with impaired cognition (MoCA < 26) had significantly lower global relative power, more marked in alpha and beta frequency bands compared to PD patients with normal cognition. Alpha and beta relative power in frontal and temporal regions showed significant correlation with different cognitive domains of MoCA score. Conclusions QEEG measures especially spectral relative power could be used as adjunct to neuropsychological assessment in evaluation of PD-related cognitive decline.

Background: Cognitive decline in patients with Parkinson disease (PD) is a major and progressing health problem that needs reliable and objective assessment tools. Aim: To explore the value of EEG spectral ratio as cognitive biomarker in patients with PD. Methods: This crosssectional case control study enrolled 35 patients with PD and 20 matched healthy controls. All participants were evaluated by quantitative electroencephalography (EEG) spectral power ratio (slow/fast) over different head regions, in addition to clinical and neuropsychological assessment of the patients using Unified Parkinson's Disease Rating Scale (UPDRS) and Montreal Cognitive Assessment (MoCA). Results: The UPDRS score of the patients was (mean 46.8 ± SD 26.6) andtotal MoCA score was (mean 20.3 ± SD 5.7). Twenty four of PD patients had cognitive impairment (MoCA <26) and showed significant higher spectral power ratio over the occipital region compared to PD patients with normal cognition (P=0.028). No significant differences of spectral power ratio between PD patients and controls. No significant correlation was found between power spectral ratio, UPDRS and MoCA scores. Conclusions: The occipital EEG spectral power ratio could be used as a complementary tool to neuropsychological assessment in evaluation and follow up of cognitive decline in patients with PD.

Objective The present study aimed to detect the behavioral problems pre- and post-cochlear implantation in comparison to normal hearing group to be able to manage these problems to get more benefit from using cochlear implants.Methods A case-control study included 53 children was done. They were divided into 2 groups, the control group included 28 healthy volunteers with normal hearing and the case group included 25 children with severe to profound hearing loss, fitted for cochlear implantation. The Arabic Child Behavior Checklist (CBCL) was used to detect different behavioral problems in both groups. Case group children were followed up and reassessed again by CBCL 3 months later after cochlear implantation.Results There were highly significant differences regarding total scores of internalizing and externalizing domains of empirically based CBCL between the control group and the case group after cochlear implants (p=0.001). There were non-significant differences in children within case group (pre- and post-cochlear implantation) regarding emotional and behavioral problems on both empirically based and Diagnostic and Statistical Manual of Mental Disorders-based CBCL.Conclusion For better results, it is necessary to include a specialist of psychosomatic medicine in the cochlear rehabilitation teamwork.

Background The primary treatment for acute ischemic stroke (AIS) patients is intravenous recombinant tissue plasminogen activator (IV rt-PA). A link between vitamin D insufficiency and worse post-stroke outcomes and more severe strokes was suggested. The present study aimed to assess the prognostic significance of baseline vitamin D levels in AIS patients treated with rt-PA. The present prospective study was conducted 66 patients with acute ischemic stroke within the therapeutic window and treated with rt-PA. Vitamin D levels were assessed using commercial double antibody sandwich enzyme linked immunosorbent assay. The primary study outcome is patient disability of any degree as assessed by the modified Rankin scale (mRS). Results The present study included 66 ischemic stroke patients treated with rt-PA. At baseline, there were 37 patients (56.1%) with low vitamin D levels. Comparison between patients with normal and low vitamin D levels regarding baseline data revealed that the former group were significantly younger and had significantly smaller infarct size patients with normal vitamin D had significantly lower NIHSS at day 2 and day 7. Interestingly, patients with low vitamin D levels had significantly higher frequency of rt-PA related hemorrhage, higher frequency of chest infection, longer hospital stay and higher mRS at 90 days. Multivariate logistic regression analysis identified vitamin D level as significant predictor of functional outcome at 90 days. Conclusions Baseline vitamin D levels is considered a significant predictor of functional outcome in AIS patients treated with rt-PA. It’s also related to infarct size and treatment complications.