Background: Parkinson's disease (PD) is one of the most common degenerative diseases of the central nervous system (CNS). Alpha-synuclein (A-syn) plays a critical role in the pathogenesis of PD. The close relation between the salivary glands and the CNS could render the A-syn secretions in the saliva useful biomarkers for PD. Aim of the work: To study the salivary A-syn levels in a cohort of PD Egyptian patients and to correlate these Asyn levels with the patients' clinical data and disease severity. Patients and methods: Twenty-five PD patients and 15 age-and sex-matched healthy subjects, as a control group, were enrolled. Evaluation of PD patients was performed using the Unified Parkinson's Disease Rating Scale (UPDRS) and modified Hoehn and Yahr scale (HYS). Samples of the saliva were analyzed using the enzyme-linked immunosorbent assay (ELISA) technique for the specific anti A-syn total and anti A-syn oligomer (A-synolig). Results: There was a statistically significant increase in A-synolig level and A-synolig/A-syn total ratio and a decrease in A-syn total level among PD patients. A statistically significant increase in A-synolig level was detected among patients having bradykinesia and rigidity as predominant symptoms. Also, there was a statistically significant positive correlation between A-synolig level and the disease duration. No statistically significant correlation was found between A-syn concentrations and disease severity. Conclusion: Salivary A-syn total and A-synolig can be used as potential biomarkers for PD diagnosis.
BackgroundCerebrovascular ischemic stroke is highly prevalent in the general population and is considered one of the frequent causes of mortality and disability. Insulin-like growth factor-1 (IGF-1) is recognized as an important neuro-protective factor against cerebral vascular ischemic insult.Aim of the workTo study the relationship between serum IGF-1 levels and acute ischemic stroke (AIS) in the Egyptian population.Patients and methodsTwo hundred patients with AIS (within the first 24 h) were subjected to full neurological examination, assessment of stroke severity using National Institute of Health Stroke Scale (NIHSS) and measurement of serum IGF-1 levels. The control group included 100 subjects matched for age, gender, and conventional vascular risk factors.ResultsSerum IGF-1 levels were significantly reduced in cases of first AIS compared to control group. A reduced serum IGF-1 level was an independent risk factor for ischemic stroke with cut off value less than 148.3 ng/ml associated with increased AIS risk.ConclusionLower IGF-1 levels are significantly related to risk of ischemic stroke occurrence, independent from other conventional risk factors in the Egyptian population.
Background: Migraine is a significant health problem due its frequency and accompanying morbidity.Objectives: This study aims to estimate the prevalence of migraine headache among the population of Al-Quseir city (Upper Egypt) and its impact on the patients' life.Methods: This study is part of a door-to-door survey of major neurological disorders in Al-Quseir city, Red Sea Governorate. All inhabitants (n = 33,285 persons) were screened through door to door by three specialists of neurology. Then, positive cases were subjected to clinical and neurological examination by three staff members of neurology each separately. Respondents were identified as suffering from migraine with aura, migraine without aura, and probable migraine as defined by the diagnostic criteria of the International Headache Society (IHS). Migraine Disability Assessment Scale (MIDAS) questionnaire was used to assess the impact of the disease on the patients' daily life. Results:We identified 911 patients suffering from migraine. The lifetime prevalence was 3.38/100 with male prevalence of 1.95/100 and female prevalence of 4.8/100. The highest prevalence figures were found during early adult life (18-40 years) among both genders reaching a total prevalence of 4.77/100 (2.89/100 for male and 6.53/100 for female). Among migraine patients, most of the attacks recorded were of moderate to severe intensity (97%) although virtually 66% of migraine patients reported that headache significantly interfered with their daily activities.Conclusion: Lifetime prevalence of migraine is 3.38/100. Migraine headache has a deleterious impact on the patient's functional and wellbeing.
Background: Idiopathic intracranial hypertension (IIH) is a syndrome characterized by elevated intracranial pressure (ICP) of unknown etiology Aim of the work: The aim of this research is to study the quantitative D-dimer level and the role of anticoagulant therapy in absence of occlusive sinus thrombosis in patients with IIH. Methodology: Twenty-four patients with IIH according to the modified Dandy criteria were enrolled. Headache impact test (HIT6), ophthalmological assessment including Frisen classification for papilledema, visual acuity, visual field, and visual evoked potentials were performed to the patients. Serum quantitative D-dimer level was measured using the enzyme-linked immunosorbent assay (ELISA) technique for the patients and for 24 healthy matched controls. Patients were divided into two groups: group (1) received acetazolamide and low molecular weight heparin (LMWH) in a prophylactic dose for 2 weeks while group (2) received acetazolamide only. Both groups continued on acetazolamide for 6 months. We followed the patients after 1 and 6 months later through the HIT6 test and the ophthalmological assessment. Results: D-dimer level was statistically higher among the cases compared to the controls. Also, a statistically significant improvement was recorded in the ophthalmological assessment after 6 months among both groups; more evident in group (1). Conclusion: The elevated D-dimer level and the visual improvement in IIH patients receiving LMWH added to acetazolamide suggest the presence of an underlying unrecognized non-occlusive venous cerebral microthrombi impeding the cerebrospinal fluid (CSF) drainage.
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