Background Stroke has a higher negative effect on women than men. In developed countries, stroke has regressed to be the fifth cause of death in men but still the third cause in women. It is suggested that there will be an increase of stroke burden in women in the future. Aim The aim was to study clinical presentation, risk factors, and short-term outcome of acute ischemic stroke in women admitted to Tanta University hospitals. Patients and methods A cross-sectional study was conducted that included 386 patients admitted to the Department of Neuropsychiatry and Centre of Psychiatry, Neurology, and Neurosurgery at Tanta University Hospitals with first-ever ischemic stroke. We assessed stroke severity by National Institutes of Health Stroke Scale. Stroke type and etiology were assessed by Oxford Shire Community Stroke Project classification and Trial of org 10172 in acute stroke treatment classification. The authors assessed outcome on discharge by modified Rankin scale. Results Regarding type of stroke, cerebral venous thrombosis was more in females, with significant difference; arterial ischemic stroke in females was less than in males, with significant difference; and total anterior in females was more than in males, with significant difference. Predictors of unfavorable outcome in females were age above 60 years old, being unmarried, hypertension, diabetes, and cardiac disease. Conclusion Hypertension, mean duration of diabetes, and BMI increase the risk of ischemic stroke in women. Age above 60 years old, currently unmarried, hypertension, cardiac diseases, and diabetes mellitus increase unfavorable outcome in women.

Background Conventional TURBT includes tumour fragmentation; this impairs pathological examination and is associated with a high risk of residual disease, tumour understaging and early recurrence. En-bloc TURBT (eTURBT) is supposed to overcome these major drawbacks. It includes uprooting of the whole tumour in one piece, providing an intact specimen for accurate pathological evaluation with a low risk of scattering malignant cells. Aim This study aimed to evaluate the efficacy, safety and oncological outcomes of bipolar eTURBT in resection of a small primary bladder mass. Patients and methods This prospective study included 63 patients with a primary bladder mass suspected to be non-muscle invasive bladder cancer (NMIBC). All patients underwent bipolar eTURBT using a mushroom loop electrode. All operations were performed by one experienced uro-oncologist and all the procedures were successfully completed. The patients included were scheduled for follow-up cystoscopy at 3, 6 and 12 months. Results The mean (SD) operative time was 37.01 (±5.50) min, enucleation time was 23.11 (± 6.26) min and obturator nerve jerk occurred only in three cases (4.76%); the mean (SD) postoperative irrigation time was 1.21 (±3.32) h, haemoglobin drop was 0.3 (± 0.57) g/dl, with no need for blood transfusion at all, and the mean (SD) hospital stay was 2.30 (±0.53) days. There were no other perioperative complications. Conclusion Bipolar eTURBT is effective and safe for managing NMIBC as it preserves well-intact specimens, with negligible perioperative complications.

Background Neck pain is a common complaint. One of the most common causes of neck pain is myofascial pain syndrome (MFPS). Ultrasound (US) is used as a diagnostic and therapeutic method. Aim The paper aims to compare the effects of US-guided trigger point (TrP) injection with dextrose prolotherapy vs. lidocaine in treating cervical MFPS. Patients and methods The study included 40 MFPS patients with chronic primary cervicitis divided randomly into two equal groups according to the line of treatment. Group 1 included 20 patients treated by one injection with 1 ml of dextrose 5% per TrP. Group 2 included 20 patients treated by one injection with 1 ml of 2% lidocaine per TrP. Both groups were US-guided. After treatment, both groups did stretching and strengthening exercises for 1 month. Follow-up was done 1 week and 1 month post injection. Results There was a significant improvement of visual analog scale and the degree of tenderness in both groups, more significant improvement in group 1 than group 2 as regards the degree of tenderness, significant improvement of the neck range of motion (ROM) in lateral flexion in both groups, significant improvement of the neck disability index (NDI) in both groups, and significant improvement in both groups as regards the absence of TrPs 1 month post injection. Conclusion TrP injection with prolotherapy or lidocaine showed faster improvement in pain, neck ROM, and functional NDI, but the improvement was short term. Dextrose prolotherapy showed slower but prolonged improvement.

Background Serum bilirubin (SB) increases acutely after ST segment elevation myocardial infarction (STEMI)/percutaneous coronary intervention (PCI), peaking at 21 h after the intervention. Aim The aim of this study is to investigate the association of SB levels with the prognosis of STEMI patients after 1ry PCI. Patients and methods This study was carried out on 90 patients admitted with STEMI and treated with 1ry PCI and were divided into three equal groups: group I included patients with high SB levels (≥0.7 mg/dl), group II included patients with intermediate SB levels (0.49–0.7 mg/dl) and group III included patients with low SB levels (≤0.49 mg/dl). Comparison of clinical results was performed in terms of major adverse cardiac events (MACE) during hospital admission. Results Patients with high SB had higher Killip class II–IV, higher hemoglobin and white blood cell count, lower HDL levels, lower ejection fraction (EF) and higher rate of death and congestive heart failure. No significant difference was found in age, sex, family history of coronary artery disease (CAD), history of HTN, diabetes mellitus or smoking, dyslipidemia, symptoms duration, time to reperfusion, random blood sugar on admission, STEMI location, infarction-related artery, number of diseased vessels, type of intervention, Thrombolysis in Myocardial Infarction (TIMI) flow, serum triglycerides and LDL level, serum creatinine and Creatinine Kinase - MB (CK-MB) level on admission, number of patients undergoing reinfection and target vessel revascularization. High SB levels predicted the overall MACE following STEMI. Conclusion High SB was accompanied by in-hospital cardiac mortality, advanced heart failure and MACE after 1ry PCI in STEMI patients.

Background Acute suppurative otitis media is a disease widespread at childhood. Aim The study is to compare between topical ciprofloxacin in treatment of acute suppurative otitis media versus oral amoxicillin/clavulanic acid combination +topical ciprofloxacin. Patients and methods This is a prospective, randomized (computer-generated randomization), open-label, controlled study on 50 patients who presented to the outpatient clinic with acute suppurative otitis media (ASOM). Results In this study, topical ciprofloxacin treatment was found to be effective for an acute suppurative otitis media as was the combination treatment. Conclusion Topical ciprofloxacin was found to be as effective as the combination of topical ciprofloxacin ear drops and oral amoxicillin/clavulanic acid in management of discharging acute suppurative otitis media.

Background Cerebral palsy (CP) is a physical disability that affects movement and posture; it is a term that refers to a group of disorders affecting a person’s ability to move, due to damage to the developing brain either during pregnancy or shortly after birth. CP can affect body movement, muscle control, muscle coordination, muscle tone, reflex, posture, and balance. Aim The aim of the study was to identify the most important risk factors that are implicated in the etiology of global developmental delay in children with CP. Patients and methods This cross-sectional study was carried out on 100 patients with the diagnosis of CP aged less than 17 years who were attending the Pediatric Neurology Outpatient Clinic of Tanta University Hospital during the period from August 2019 to June 2020. Results The most common risk factors associated with severe mental retardation were low socioeconomic level, epilepsy, especially if uncontrolled, antiepileptic drugs, especially Na valproate alone or in combination with levetiracetam or topiramate, perinatal hypoxia, postencephalitic etiology, congenital brain anomalies, spastic quadriplegia, and mixed type. The most common risk factors associated with severe developmental delay were perinatal hypoxia, congenital infection, and congenital brain anomalies. Conclusion The most common risk factors of CP in this study were perinatal hypoxia, prematurity, and prenatal hypoxia.

Background Transthoracic ultrasound (TUS) is a useful diagnostic tool in peripheral pulmonary lesions. US-guided transthoracic needle biopsy has become an easy and safe procedure that provides adequate tissue samples of lesions for cytological or histopathological examination. Aim The purpose of the study was to evaluate the role of transthoracic fine-needle aspiration and core-needle biopsy under US guidance in the diagnosis of peripheral pulmonary lesions. Patients and methods The study included 30 patients with undiagnosed peripheral parenchymal lesions. Fine-needle aspiration with or without core-needle biopsy under US guidance was performed using needles of different pores and lengths, and spring-loaded biopsy needles having needle size (16–18–20 gauge) and core length (1–2 cm) for core biopsy. Results The total diagnostic yield of transthoracic lung sampling was 80%. The diagnostic yields of fine-needle aspiration, core-needle biopsy, and their combined techniques were 70%, 72.73%, and 81.82%, respectively. The sensitivity of the combined technique (94.12%) was higher than fine-needle aspiration alone (76%) and that of core-needle biopsy alone (88.24%). Conclusion TUS-guided biopsy is an easy and reliable cheap sampling method with less complication. US-guided fine-needle aspiration and core-needle biopsy can be used as complementary procedures for sampling tissue in the diagnosis of peripheral pulmonary lesions abutting the pleura.