No abstract

Objective: Telemedicine has been increasingly used, especially during the COVID-19 pandemic; however, limited data are available from developing countries. The present study aimed to evaluate the feasibility, satisfaction of patients and physicians, and quality of service provided during virtual visits for Parkinson's disease (PD) patients during the COVID-19 pandemic and the associated limitations. Methods: Thirty-nine PD patients were contacted to schedule virtual visits using the Zoom application. Thereafter, we rated the feasibility, satisfaction, and quality of service provided by virtual visits using patients' and physicians' questionnaires. Results: Twenty-one out of 39 PD patients were scheduled for virtual visits. Nineteen virtual visits out of 21 (90.5%) were conducted successfully; 16 of these were accomplished in the first attempt (76.2%). The scores of satisfaction, quality of service, and set-up/preparation were 9.5 (8.5-10), 9.5 (9-10), and 8 (5-10) for the patients and 9 (7-10), 8 (6-10), and 10 (10-10) for the physicians, respectively. The average time that was saved was 270.79 ± 142.17 min, while an average of 76.38 ± 95.15 km of travel was avoided for the patients per visit. The most common limitations for conducting virtual visits were a lack of Internet connection and the inability to use technology (75%). Conclusions: The present study showed the feasibility and the high satisfaction level of patients and physicians as well as the favorable service quality of virtual visits for PD in a developing country during the COVID-19 pandemic. However, the lack of Internet connectivity and the inability to use technology were the main limitations.

Background High-quality data on time of stroke onset and time of hospital arrival is required for proper evaluation of points of delay that might hinder access to medical care after the onset of stroke symptoms. Purpose Based on (SITS Dataset) in Egyptian stroke patients, we aimed to explore factors related to time of onset versus time of hospital arrival for acute ischemic stroke (AIS).

No abstract

Background Patent foramen ovale closure in the setting of stroke was debatable until the recent data from the long-term follow-up of multiple randomized control trials. These recent data have led to increase the number of the procedure worldwide. To our knowledge, there was no previous formal structured program in Egypt between cardiologists and neurologists for investigation and management of patients with cryptogenic stroke. The first Egyptian-dedicated stroke team was created in two large tertiary centers with collaboration between cardiologists, dedicated cardiac imagers, and neurologists for investigation and management of patients with cryptogenic stroke. Results Sixty-three patients with cryptogenic stroke were identified from a total of 520 patients admitted to the stroke units between 2016 and 2019. Twenty-five patients had a proven PFO-related stroke. Three patients were referred for surgical closure, 19 patients underwent transcatheter PFO closure, and procedural success was met in 18 patients (94.7%). We did not experience any major procedure-related complication. Complete closure was achieved in 83.3% of patients at 6 months. One patient had a single attack TIA within the first 3 months after device closure; one patient had a device-related thrombosis; both were managed successfully. Conclusion Our initial experience in collaboration between cardiologist and neurologist with the establishment of a dedicated cryptogenic stroke team added significantly to the management of patients with stroke. The results of the first Egyptian cohort who underwent transcatheter PFO closure demonstrated procedural feasibility, safety, and efficacy with very low incidence of major complications. A nationwide program is needed to reduce the ischemic stroke disease burden and the risk of recurrence.