Objectives: In this research we wanted to highlight the importance of defining Borderzone infarctions (BZI) as a separate subtype in stroke classifications. We thus studied cases of isolated BZI, small vessel disease (SVD), and large vessel disease (LVD), to identify their points of similarities and difference in a sample of Egyptian patients. Methods: This is a cross-sectional (observational) study. Consecutive 637 acute ischemic stroke patients were recruited over a 2 year period, from 2 stroke units of Ain Shams University hospitals in Egypt. Medical history and laboratory investigations were done to identify risk factors. National Institute of Health Stroke Scale (NIHSS) was performed on admission, and modified Rankin scale (mRS) on admission, and after 3 months. MRI brain was done to identify stroke subtype; MRA and carotid duplex were used to define vascular status. Results: Among the studied group of patients, 72 (11.3%) had BZI, 145 (22.8%) had SVD, 165 (26%) had LVD, and 255 were excluded as they had either undetermined, or mixed etiology. BZI showed significantly older age, early confluent lesions, more disease severity by NIHSS, and worst outcome by mRS (P < 0.05). SVD had more microbleeds than BZI and LVD. LVD showed lower prevalence of hypertension and lower high-density lipoprotein levels. Conclusions: Isolated BZI, SVD, and LVD infarctions have characteristic risk factors and clinical patterns. Further studies are needed to identify if they are different from cases with mixed pathology. This could have an impact on the selection of primary and secondary preventive measures appropriate to each type.
Background: Vitamin D deficiency and obesity may be related to the pathogenesis and disease activity of multiple sclerosis (MS). This study aimed to assess the correlation between the serum level of 25(OH) vitamin D, body mass index (BMI) and the Expanded Disability Status Scale (EDSS) in a sample of Egyptian MS patients. Subjects and Methods: This was an observational study that included 130 MS patients who were recruited consecutively among the patients attending the MS unit of Ain Shams University Hospital, Cairo, in the period between December 2017 and March 2018. The serum level of 25(OH) D, BMI and EDSS were recorded. Results: : Females represented 77.7% of the study sample, the mean age was 32.4 ± 8.2 years. MS types were: RRMS 83.1%, SPMS 14.6% and PPMS in 2.3%. Serum level of 25(OH) vitamin D was deficient (less than 10 ng/ml) in 69.2% and insufficient (10–30 ng/ml) in 19.2% of the study population. The mean BMI was 25.5 ± 4.7 kg/m² (classified as overweight). The mean EDSS was 3.5 ± 1.9. The relationship between the EDSS score and 25(OH) D level was inversely correlated, all patients with EDSS ≤ 2 had sufficient levels while all patients with EDSS ≥ 4.5 had deficient levels. High EDSS scores were statistically correlated (p < 0.001) to high BMI and low Log 25(OH) D levels. An inverse correlation was found between the BMI and log 25(OH) D. Conclusion: Vitamin D deficiency and overweight are predominant among Egyptian MS patients. The EDSS was positively correlated to the BMI and negatively correlated to 25(OH) D. These factors may possibly play a role in the pathogeneses and progression of MS in Egypt.