Stroke is the third most common cause of death in industrialized countries. Stroke is the most important cause of morbidity and longterm disability in Europe as well as in other industrialized nations. Prevalence rate was higher among men compared with women 3.44 and 2.41 per 1000 respectively. Data from the Northern Manhattan study showed the age adjusted incidence of first ischemic stroke per 100,000 was 88 in Whites 191 in Blacks and 149 in Hispanics. Black has almost thrice the risk of first ever stroke compared with Whites. The age adjustment stroke incidence rates for first ever stroke are 167 for White males, 138 for White females, 323 for Black males and 260 for Black females. Among American-Indian age 65-74, the annual rates per 1,000 population of new and recurrent stoke are 6.1 for men and 6.6 for women. 22The prevalence of stroke in American Indian mean age 45-74 ranges from 0.2 to 1.4 percent and in women from 0.2 to 0.7 percent 5 . In a study in Bangladesh the prevalence rate of stroke were 2.0, 3.0, 2.0, 10.0 , and 10.0 per 1000 within age groups of 40 -49 years, 50-59 years, 60-69 years, 70-79 years and 80 years to above age group respectively 6 . Prevalence rate rose with age. People with age range 70-79 years compared to 40-49 years age range is 4.98 times and people with age range > 80 years compared to 40-49 years age range is 4.78 times more likely to have suffered from stroke. Prevalence rate was higher among men compared with women 3.44 and 2.41 per 1000 respectively 7 . On average every 45 seconds someone in the United States has a stroke. Each year about 700,000 people experience a new or current stroke 5 . About 500,000 of these are first attack and 200,000 are recurrent attacks 4 . Each year about 46,000 more men than women have a stroke 6 . Men's stroke incidence rate is 1.25 times greater than women's 6 .

Background: Significant proportion of psychiatric illnesses has been reported in neurology inpatients and outpatients. Objective: The purpose of the present study was to find out the referral pattern of patients to psychiatry department from different departments of National Institute of Neurosciences and Hospital (NINS&H) and to make diagnosis of referred patients. Methodology: This descriptive cross sectional study was done in psychiatry department at NINS&H, Dhaka from

Background: To investigate the relative contributions of cerebral cortex and basal ganglia to movement stopping, we tested the optimum combination Stop Signal Reaction Time (ocSSRT) and median visual reaction time (RT) in patients with Alzheimer’s disease (AD) and Parkinson’s disease (PD) and compared values with data from healthy controls. Methods: Thirty-five PD patients, 22 AD patients, and 29 healthy controls were recruited to this study. RT and ocSSRT were measured using a hand-held battery-operated electronic box through a stop signal paradigm. Result: The mean ocSSRT was found to be 309 ms, 368 ms, and 265 ms in AD, PD, and healthy controls, respectively, and significantly prolonged in PD compared to healthy controls (p = 0.001). The ocSSRT but not RT could separate AD from PD patients (p = 0.022). Conclusion: Our data suggest that subcortical networks encompassing dopaminergic pathways in the basal ganglia play a more important role than cortical networks in movement-stopping. Combining ocSSRT with other putative indices or biomarkers of AD (and other dementias) could increase the accuracy of early diagnosis.

Background: The management of Guillain-Barré Syndrome is very crucial for the outcome of the patient. Objective: The aim of the study was to compare efficacy of IvIg(Intravenous Immunoglobulin) versus PE(Plasmaexchange) in treatment of mechanically ventilation adults with GBS in neuro-intensive care unit of Bangladesh. Methodology: Thiswas a prospective, observationalcohort study, in a Neuro-ICU from 2017 to 2018. We included all patients with GBS who required mechanical ventilation (MV). We defined two groups: group 1 (group treated by IvIg: 0.4 g/kg/day for 5 days) and group 2 (group treated by PE: 5 PE during 10days, every alternate day). We collectedclinical and therapeutic aspects and outcome. Results: A total number of 49 patients (34 in group 1 and 15 in group 2) were enrolled. The mean age was 37.4±9.2 years, with a male predominance (65.3%). on electrophysiological findings, in 4(32.7%) patients had acute inflammatory demyelinating polyradiculoneuropathy (AIDP) and acute motor axonal neuropathy (AMAN) in 26 (53.1%) patients and acute motor-sensory axonal neuropathy (AMSAN) was 3(6.1%)and NCS was not done in 4(8.2%) cases. The mean length of ICU stay was 20±19.10 days and 46.60±30.02 days in IVIG and PE group respectively. The ICU stay was significantly shorter (p = 0.001) in the IvIg group than PE group. Patients receiving IvIg were early weaned of MV (p = 0.002) compared to those receiving PE with a statistical significance. Also, duration of M/V (P=.002), Need of tracheostomy (p=.005) and over all surval rate (p=.007) was significantly in favoue of IvIg group than PE group. Out of 49 patients, total 3 patients were died and they all were AMAN variety. Conclusion: Our work reveals a meaningful difference for the MV duration, ICU stay, weaning and excellent recovery in IvIg group compared to PE group in terms of less complcations. Journal of National Institute of Neurosciences Bangladesh, 2019;5(2): 118-122

Hyponatremia is a very common electrolyte imbalance in admitted diabetic patients which leads to substantial morbidity and mortality. There is no existing record for profiling of hyponatremia in Bangladeshi diabetic subjects. The objective of this study was to find out the factors influencing hyponatremia and associated co-morbidities in admitted diabetic patients of a tertiary care hospital. Samples were selected from all adult nonpregnant diabetic patients with serum sodium level < 135 mmol/L irrespective of their cause of admission. A total number of 115 admitted diabetic patients with hyponatremia were studied. Informations were collected in a semi structured data collection form for analysis. Hyponatremia was found to be more common in the aged (47%) and female populations (63.5%). Vomiting was found to be the most common factor (51.3%) causing hyponatremia in the admitted diabetic patients. Other common factors influencing hyponatremia were diarrhea, sweating, severe hyperglycemia, diabetic ketoacidosis and drugs especially diuretics. The commonest co-morbid condition associated with diabetes was hypertension. Thiazide diuretics should be used with caution in the elderly who are prone to develop hyponatremia. DOI: http://dx.doi.org/10.3329/medtoday.v26i1.21301 Medicine Today 2014 Vol.26(1): 04-08